Guest guest Posted November 21, 2006 Report Share Posted November 21, 2006 I posted a few weeks back about my experience of Advanced Clinical training in Xiamen University Medical School ,Fujian, China. As i said , the tropical location and the price of the program is its advantage, however I am feeling less satisfied with the content here. This is partly due to the language barrier, (in spite of my interpreter), and the general pace of the clinical environment. However, I'm remaining positive since I believe the student is truly paramount in the learning process. So far, instead of learning anything new, I find myself only confirming what I already have learned.Theres a certain satisfaction there, but I guess I expected " advanced " to be advanced, whereas I am seeing that institutionalized acupuncture here is indeed " cookbook " style. There is little thought given to bian zheng or palpatory dx, and point combinations are more or less standardized; this does however depend on that particular docs style. The afternoon classes are not advanced either. Its 50% western med and the TCM presented is all in our books already. I am more impresssed with Peter Deadman's book than ever! I really am hoping to gain clinical " gems " from here, and I think that I will, but generally its just standard TCM acupuncture practiced in a busy institutional Chinese environment. I'm going to be positive and think of this a 'self-directed' program, so ,I hope to become more assertive and spend more time in dialog with the doctors. As for hands on , Ive decided to learn freehand style as done here. However, I am struggling with that; its a little embarrassing as I have developed my own guidetube technique over the years. Guidetubes are seen as " training wheels " over here.. Does anyone feel " more in touch with the qi of the patient " using freehand? Thats what I'm looking for,and the greater speed offered. I can learn to treat a great number of patients quickly, albeit with a simplified approach. I'm not sure that is all that valuable... Attilio, and anyone who's done Clinic in China, a question.. How did you find a way to take advantage of an educational situation which has a lot to be desired and still learn a lot? Skip Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2006 Report Share Posted November 21, 2006 Hi Skip, & All, Re the Advanced Clinical acupuncture training in Xiamen University Medical School ,Fujian, China, Skip wrote: > So far, instead of learning anything new, I find myself only confirming > what I already have learned.Theres a certain satisfaction there, but I > guess I expected " advanced " to be advanced, whereas I am seeing that > institutionalized acupuncture here is indeed " cookbook " style. There > is little thought given to bian zheng or palpatory dx, and point > combinations are more or less standardized; this does however depend on > that particular docs style. I had more or less identical experiences when I visited clinics in Taiwan in 1982. See: THE TAIWAN REPORT http://users.med.auth.gr/~karanik/english/vet/taiwan1.htm http://users.med.auth.gr/~karanik/english/vet/taiwan2.htm http://users.med.auth.gr/~karanik/english/vet/taiwan3.htm In particular, my experience in Taiwan agrees with Skip's comment: " There is little thought given to bian zheng or palpatory dx, and point combinations are more or less standardized; this does however depend on that particular docs style. " The main type of AP that I saw in the clinics was " Cookbook " style, with great emphasis put on detecting and treating trigger points and eliciting strong Deqi. See Cookbook Points (Top Ten Points for Clinical Conditions) at: http://homepage.eircom.net/~progers/adtop.htm http://homepage.eircom.net/~progers/ad1.htm http://homepage.eircom.net/~progers/ad2.htm and (especially) http://homepage.eircom.net/~progers/ff.htm See also Cookbook Points for male/female urogenital conditions (Acupuncture in Genitourinary & related Conditions) at: Overview: http://homepage.eircom.net/~progers/gu3a.htm Female Disorders: http://homepage.eircom.net/~progers/gu3b.htm Male Disorders: http://homepage.eircom.net/~progers/gu3c.htm Urinary & General Disorders: http://homepage.eircom.net/~progers/gu3d.htm Best regards, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 21, 2006 Report Share Posted November 21, 2006 I think your responses are not uncommon no matter what part of China you are in. It's pretty much how I felt a dozen years ago in Shanghai. My suggestion is to try to get away from the acpuncture department somehow and get to the internal medicine departments or tuina etc.... There isn't much in the way of -secrets-, people tend, for better or worse, innovative here in the West. But coming back with free hand skills will serve you well. Keep with it, eventually you are going to see some things that in no way you would see in the West and then you will have some cool techniques under your belt. Be patient if possible and I feel for you. doug Chinese Medicine , " skip8080 " <skip8080 wrote: > > I posted a few weeks back about my experience of Advanced Clinical > training in Xiamen University Medical School ,Fujian, China. > As i said , the tropical location and the price of the program is its > advantage, however I am feeling less satisfied with the content here. > This is partly due to the language barrier, (in spite of my > interpreter), and the general pace of the clinical environment. > However, I'm remaining positive since I believe the student is truly > paramount in the learning process. > So far, instead of learning anything new, I find myself only > confirming what I already have learned.Theres a certain satisfaction > there, but I guess I expected " advanced " to be advanced, whereas I am > seeing that institutionalized acupuncture here is indeed " cookbook " > style. There is little thought given to bian zheng or palpatory dx, > and point combinations are more or less standardized; this does > however depend on that particular docs style. > The afternoon classes are not advanced either. Its 50% western med and > the TCM presented is all in our books already. I am more impresssed > with Peter Deadman's book than ever! I really am hoping to gain > clinical " gems " from here, and I think that I will, but generally its > just standard TCM acupuncture practiced in a busy institutional > Chinese environment. > I'm going to be positive and think of this a 'self-directed' program, > so ,I hope to become more assertive and spend more time in dialog with > the doctors. > > As for hands on , Ive decided to learn freehand style as done here. > However, I am struggling with that; its a little embarrassing as I > have developed my own guidetube technique over the years. Guidetubes > are seen as " training wheels " over here.. > Does anyone feel " more in touch with the qi of the patient " using > freehand? Thats what I'm looking for,and the greater speed offered. I > can learn to treat a great number of patients quickly, albeit with a > simplified approach. I'm not sure that is all that valuable... > > Attilio, and anyone who's done Clinic in China, a question.. > > How did you find a way to take advantage of an educational situation > which has a lot to be desired and still learn a lot? > > Skip > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 22, 2006 Report Share Posted November 22, 2006 Chinese Medicine , " skip8080 " <skip8080 wrote: > > > As for hands on , Ive decided to learn freehand style as done here. > However, I am struggling with that; its a little embarrassing as I > have developed my own guidetube technique over the years. Guidetubes > are seen as " training wheels " over here.. > Attilio, and anyone who's done Clinic in China, a question.. > > How did you find a way to take advantage of an educational situation > which has a lot to be desired and still learn a lot? > > Skip > Hi Skip, What some of my classmates who had questionable acupuncture teachers did, was decamp to another hospital in the same city to study with a woman who was an expert in abdominal acupuncture and who did very traditional diagnosis and point selection. Others absconded to other acupuncture rooms in the same hospital to observe with doctors that they felt they could learn more from. Where they went wrong, however, was when someone actually complained to the two universities (the one in china and the one in Australia) which set in motion a nightmare of chinese admin face saving and retribution from the higher ups in the university and teaching hospital. So, the lesson here is 1.) Be versatile and go elsewhere if you need to, you may not need to pay, some doctors enjoy the kudos of having foreign students observing them,and others are just nice people. and 2) Dont cause a big stir or start laying blame if you are dissatisfied, this is China and no-one likes to lose face (or the possibility of losing money) just find a better option and " ...if it aint broke, dont fix it. " in terms of getting official permission to do anything. Just do it. In regards to guide tube free needling, we had no choice but to learn how to needle without a guide tube as nothing else was available, what we were advised to do by our teacher was to get a cotton ball and wrap it around the needle and hold it that way to put the needle in, a senior female acupuncture doctor actually did it this way, and did not view it as a " training wheels " thing. The male students did though! This is considered a " girlie " option, the male students refused and felt they had to do it the way the male doctors were doing it, and as a result caused alot of discomfort to patients with their ineptness at first. In regards to translators, often it is postgrad students who are asked to translate for the foreign students, and some who may come rich families feel this is beneath them, but have to do it anyway. So some would refuse to translate everything that was being said out of sheer laziness and spite, and as some of us were originally from Taiwan and the rest of us spoke enough Mandarin to realize what was going on, this caused some big problems. The students who went the year before us actually " fired " their translator. This backfired as firstly see point 1 above, and secondly, the translators were the ones who in effect marked our end of year exams and case studies. The best option here is to try and befriend another student who speaks mandarin and tag along with them, this option turned out to be the only saving grace for some students. I felt that there were some really useful and interesting things we learnt in China, but in terms of practicing in the west, I cant say it was all that necessary, in fact, I was the last year that had a compulsory 1 year internship as part of the degree, since then the Uni only has a three month internship in China and the rest of clinical study is done in Australia. I really enjoyed the internship, but others actually came back from China feeling so disillusioned that they didnt want to practice anymore. If you are purely paying for the experience and do not have to do this as part of your degree program or course, then I guess you may have the luxury to throw your weight around a little more and express dissatisfaction, but I would still, personally let discretion be the better part of valour. PS I strongly advise you talk yourself into everywhere you can, we talked our way into the herb dispensory, the gynae exam room (Im female so messing around with swabs and speculum didnt freak me out too much, however one of my classmates had a bit of a turn when faced with his first cervix. ) I absconded from my allocated Tuina room and hung out with the lady doctor who did paediatric tuina instead. Another friend managed to somehow to talk his way into the bone marrow biopsy and endoscopy room. If anyone questions this, tell them " The students last year did it. " Oh, and if you arent doing inpatients as well as outpaitents, I highly recommend you request to go and speak to some patients and take case histories there, too. Good Luck, Lea. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 22, 2006 Report Share Posted November 22, 2006 Chinese Medicine , " skip8080 " <skip8080 wrote: > > > As for hands on , Ive decided to learn freehand style as done here. > However, I am struggling with that; its a little embarrassing as I > have developed my own guidetube technique over the years. Guidetubes > are seen as " training wheels " over here.. > Attilio, and anyone who's done Clinic in China, a question.. > > How did you find a way to take advantage of an educational situation > which has a lot to be desired and still learn a lot? > > Skip > . Hi Skip and all, Lea made some good points- Lea, did you study in Nanjing? If you complain, make sure you know who you're complaining to. The Belgian group complained to Nanjing TCM uni on several occasions, and that was the only way things would change. The students were not allowed to needle after a few days of clinic, so the supervisor went to complain to the principal. First there was some anger, but when the Belgian supervisor threatened to go to another city, the problems evaporated quickly. From the next day onwards, all students were allowed to needle. There are translation problems, and the best way to get around this is to learn Mandarin yourself. Which I understand may not be an option. However, many old doctors will appreciate you learning the language and the cullture, including following their habits, and only then let you in on their small group of students. In other words, in China you have to earn their respect. Bringing some oranges or apples for the doctor, inviting him and his wife for dinner,...are all ways you can earn his respect. In China, students will accept anything their teacher " gives " to them, and almost never question what he says directly. Students stand by the side, hand the doctor his needles, and write down what he says. Doctors seem to appreciate this, and after you have done this for a while, they may start to trust you even more, and tell you more about their hard-earned clinical experience. They might give you a line from the classics and ask you to look it up and tell him what you think about that line. Like Lea, I would encourage you to look around and go to different departments, if possible. In the beginning though, in one department I would think that: " I know what they're doing here, I've seen that " . I found that I was wrong. Doctors that were practicing cookbook acupuncture sometimes would say things that revealed a much more profound knowledge than I though they had. It doesn't always show in what they do, or how we perceive it. Best regards, Tom._,_._,___ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 22, 2006 Report Share Posted November 22, 2006 To needle freehand you need to touch the shaft of the needle, which may go against the USA clean needle technique training but is perfectly safe. If you don't touch the shaft to guide it, you will hurt the patient. Hold the needle between thumb and forefinger then use the ringfinger and pinky to stabilize the shaft, insert it through the tough layer of skin swiftly and deftly, then insert it deeper slow if you are tonifying, fast to disperse...You also need to use at least a .30 width needle or else forget it it will bend, maybe a .25 but thats pushing it... Chinese Medicine , " Tom Verhaeghe " <tom.verhaeghe wrote: > > > > > > Chinese Medicine , " skip8080 " > <skip8080@> wrote: > > > > > > As for hands on , Ive decided to learn freehand style as done here. > > However, I am struggling with that; its a little embarrassing as I > > have developed my own guidetube technique over the years. Guidetubes > > are seen as " training wheels " over here.. > > Attilio, and anyone who's done Clinic in China, a question.. > > > > How did you find a way to take advantage of an educational situation > > which has a lot to be desired and still learn a lot? > > > > Skip > > > . > Hi Skip and all, > > Lea made some good points- Lea, did you study in Nanjing? > If you complain, make sure you know who you're complaining to. The Belgian > group complained to Nanjing TCM uni on several occasions, and that was the > only way things would change. The students were not allowed to needle after > a few days of clinic, so the supervisor went to complain to the principal. > First there was some anger, but when the Belgian supervisor threatened to go > to another city, the problems evaporated quickly. From the next day onwards, > all students were allowed to needle. > > There are translation problems, and the best way to get around this is to > learn Mandarin yourself. Which I understand may not be an option. However, > many old doctors will appreciate you learning the language and the cullture, > including following their habits, and only then let you in on their small > group of students. In other words, in China you have to earn their respect. > Bringing some oranges or apples for the doctor, inviting him and his wife > for dinner,...are all ways you can earn his respect. In China, students will > accept anything their teacher " gives " to them, and almost never question > what he says directly. Students stand by the side, hand the doctor his > needles, and write down what he says. Doctors seem to appreciate this, and > after you have done this for a while, they may start to trust you even more, > and tell you more about their hard-earned clinical experience. They might > give you a line from the classics and ask you to look it up and tell him > what you think about that line. > > Like Lea, I would encourage you to look around and go to different > departments, if possible. In the beginning though, in one department I would > think that: " I know what they're doing here, I've seen that " . I found that I > was wrong. Doctors that were practicing cookbook acupuncture sometimes would > say things that revealed a much more profound knowledge than I though they > had. It doesn't always show in what they do, or how we perceive it. > > Best regards, > > Tom._,_._,___ > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 27, 2006 Report Share Posted November 27, 2006 -Jason, sorry but you are dead wrong. You do not need to touch the shaft of the needle when needling freehand...You just need real needling skill. I often do it with .32 and sometimes .34 gauge needles. I prefer 30's but 32's work just fine. Michael - In Chinese Medicine , " jasonwcom " <jasonwcom wrote: > > To needle freehand you need to touch the shaft of the needle, which > may go against the USA clean needle technique training but is > perfectly safe. If you don't touch the shaft to guide it, you will > hurt the patient. Hold the needle between thumb and forefinger then > use the ringfinger and pinky to stabilize the shaft, insert it > through the tough layer of skin swiftly and deftly, then insert it > deeper slow if you are tonifying, fast to disperse...You also need to > use at least a .30 width needle or else forget it it will bend, maybe > a .25 but thats pushing it... > > > Chinese Medicine , " Tom Verhaeghe " > <tom.verhaeghe@> wrote: > > > > > > > > > > > > Chinese Medicine , " skip8080 " > > <skip8080@> wrote: > > > > > > > > > As for hands on , Ive decided to learn freehand style as done > here. > > > However, I am struggling with that; its a little embarrassing as I > > > have developed my own guidetube technique over the years. > Guidetubes > > > are seen as " training wheels " over here.. > > > Attilio, and anyone who's done Clinic in China, a question.. > > > > > > How did you find a way to take advantage of an educational > situation > > > which has a lot to be desired and still learn a lot? > > > > > > Skip > > > > > . > > Hi Skip and all, > > > > Lea made some good points- Lea, did you study in Nanjing? > > If you complain, make sure you know who you're complaining to. The > Belgian > > group complained to Nanjing TCM uni on several occasions, and that > was the > > only way things would change. The students were not allowed to > needle after > > a few days of clinic, so the supervisor went to complain to the > principal. > > First there was some anger, but when the Belgian supervisor > threatened to go > > to another city, the problems evaporated quickly. From the next day > onwards, > > all students were allowed to needle. > > > > There are translation problems, and the best way to get around this > is to > > learn Mandarin yourself. Which I understand may not be an option. > However, > > many old doctors will appreciate you learning the language and the > cullture, > > including following their habits, and only then let you in on their > small > > group of students. In other words, in China you have to earn their > respect. > > Bringing some oranges or apples for the doctor, inviting him and > his wife > > for dinner,...are all ways you can earn his respect. In China, > students will > > accept anything their teacher " gives " to them, and almost never > question > > what he says directly. Students stand by the side, hand the doctor > his > > needles, and write down what he says. Doctors seem to appreciate > this, and > > after you have done this for a while, they may start to trust you > even more, > > and tell you more about their hard-earned clinical experience. They > might > > give you a line from the classics and ask you to look it up and > tell him > > what you think about that line. > > > > Like Lea, I would encourage you to look around and go to different > > departments, if possible. In the beginning though, in one > department I would > > think that: " I know what they're doing here, I've seen that " . I > found that I > > was wrong. Doctors that were practicing cookbook acupuncture > sometimes would > > say things that revealed a much more profound knowledge than I > though they > > had. It doesn't always show in what they do, or how we perceive it. > > > > Best regards, > > > > Tom._,_._,___ > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 27, 2006 Report Share Posted November 27, 2006 Well, I've watched and been needled by lots of doctors from Asia with 30+ years of experience and that's how they do it. I also have a book from China about needling techniques and that's how they show how to needle. I've had Americans do it your way and it hurts more... Chinese Medicine , " michael " <miclac1 wrote: > > -Jason, sorry but you are dead wrong. You do not need to touch the > shaft of the needle when needling freehand...You just need real > needling skill. I often do it with .32 and sometimes .34 gauge > needles. I prefer 30's but 32's work just fine. > > Michael > > - In Chinese Medicine , " jasonwcom " > <jasonwcom@> wrote: > > > > To needle freehand you need to touch the shaft of the needle, which > > may go against the USA clean needle technique training but is > > perfectly safe. If you don't touch the shaft to guide it, you will > > hurt the patient. Hold the needle between thumb and forefinger > then > > use the ringfinger and pinky to stabilize the shaft, insert it > > through the tough layer of skin swiftly and deftly, then insert it > > deeper slow if you are tonifying, fast to disperse...You also need > to > > use at least a .30 width needle or else forget it it will bend, > maybe > > a .25 but thats pushing it... > > > > > > Chinese Medicine , " Tom > Verhaeghe " > > <tom.verhaeghe@> wrote: > > > > > > > > > > > > > > > > > > Chinese Medicine , " skip8080 " > > > <skip8080@> wrote: > > > > > > > > > > > > As for hands on , Ive decided to learn freehand style as done > > here. > > > > However, I am struggling with that; its a little embarrassing > as I > > > > have developed my own guidetube technique over the years. > > Guidetubes > > > > are seen as " training wheels " over here.. > > > > Attilio, and anyone who's done Clinic in China, a question.. > > > > > > > > How did you find a way to take advantage of an educational > > situation > > > > which has a lot to be desired and still learn a lot? > > > > > > > > Skip > > > > > > > . > > > Hi Skip and all, > > > > > > Lea made some good points- Lea, did you study in Nanjing? > > > If you complain, make sure you know who you're complaining to. > The > > Belgian > > > group complained to Nanjing TCM uni on several occasions, and > that > > was the > > > only way things would change. The students were not allowed to > > needle after > > > a few days of clinic, so the supervisor went to complain to the > > principal. > > > First there was some anger, but when the Belgian supervisor > > threatened to go > > > to another city, the problems evaporated quickly. From the next > day > > onwards, > > > all students were allowed to needle. > > > > > > There are translation problems, and the best way to get around > this > > is to > > > learn Mandarin yourself. Which I understand may not be an option. > > However, > > > many old doctors will appreciate you learning the language and > the > > cullture, > > > including following their habits, and only then let you in on > their > > small > > > group of students. In other words, in China you have to earn > their > > respect. > > > Bringing some oranges or apples for the doctor, inviting him and > > his wife > > > for dinner,...are all ways you can earn his respect. In China, > > students will > > > accept anything their teacher " gives " to them, and almost never > > question > > > what he says directly. Students stand by the side, hand the > doctor > > his > > > needles, and write down what he says. Doctors seem to appreciate > > this, and > > > after you have done this for a while, they may start to trust you > > even more, > > > and tell you more about their hard-earned clinical experience. > They > > might > > > give you a line from the classics and ask you to look it up and > > tell him > > > what you think about that line. > > > > > > Like Lea, I would encourage you to look around and go to different > > > departments, if possible. In the beginning though, in one > > department I would > > > think that: " I know what they're doing here, I've seen that " . I > > found that I > > > was wrong. Doctors that were practicing cookbook acupuncture > > sometimes would > > > say things that revealed a much more profound knowledge than I > > though they > > > had. It doesn't always show in what they do, or how we perceive > it. > > > > > > Best regards, > > > > > > Tom._,_._,___ > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 27, 2006 Report Share Posted November 27, 2006 ..32 and .34? Those are some thick needles! I think you mean #32 and #34? You can insert any width needle freehand, but if you manipulate it you risk bending or breaking it, especially with a 2 cun or longer needle... Chinese Medicine , " jasonwcom " <jasonwcom wrote: > > Well, I've watched and been needled by lots of doctors from Asia with > 30+ years of experience and that's how they do it. I also have a > book from China about needling techniques and that's how they show > how to needle. I've had Americans do it your way and it hurts more... > > Chinese Medicine , " michael " > <miclac1@> wrote: > > > > -Jason, sorry but you are dead wrong. You do not need to touch the > > shaft of the needle when needling freehand...You just need real > > needling skill. I often do it with .32 and sometimes .34 gauge > > needles. I prefer 30's but 32's work just fine. > > > > Michael > > > > - In Chinese Medicine , " jasonwcom " > > <jasonwcom@> wrote: > > > > > > To needle freehand you need to touch the shaft of the needle, > which > > > may go against the USA clean needle technique training but is > > > perfectly safe. If you don't touch the shaft to guide it, you > will > > > hurt the patient. Hold the needle between thumb and forefinger > > then > > > use the ringfinger and pinky to stabilize the shaft, insert it > > > through the tough layer of skin swiftly and deftly, then insert > it > > > deeper slow if you are tonifying, fast to disperse...You also > need > > to > > > use at least a .30 width needle or else forget it it will bend, > > maybe > > > a .25 but thats pushing it... > > > > > > > > > Chinese Medicine , " Tom > > Verhaeghe " > > > <tom.verhaeghe@> wrote: > > > > > > > > > > > > > > > > > > > > > > > > --- In Chinese Medicine , " skip8080 " > > > > <skip8080@> wrote: > > > > > > > > > > > > > > > As for hands on , Ive decided to learn freehand style as done > > > here. > > > > > However, I am struggling with that; its a little embarrassing > > as I > > > > > have developed my own guidetube technique over the years. > > > Guidetubes > > > > > are seen as " training wheels " over here.. > > > > > Attilio, and anyone who's done Clinic in China, a question.. > > > > > > > > > > How did you find a way to take advantage of an educational > > > situation > > > > > which has a lot to be desired and still learn a lot? > > > > > > > > > > Skip > > > > > > > > > . > > > > Hi Skip and all, > > > > > > > > Lea made some good points- Lea, did you study in Nanjing? > > > > If you complain, make sure you know who you're complaining to. > > The > > > Belgian > > > > group complained to Nanjing TCM uni on several occasions, and > > that > > > was the > > > > only way things would change. The students were not allowed to > > > needle after > > > > a few days of clinic, so the supervisor went to complain to the > > > principal. > > > > First there was some anger, but when the Belgian supervisor > > > threatened to go > > > > to another city, the problems evaporated quickly. From the next > > day > > > onwards, > > > > all students were allowed to needle. > > > > > > > > There are translation problems, and the best way to get around > > this > > > is to > > > > learn Mandarin yourself. Which I understand may not be an > option. > > > However, > > > > many old doctors will appreciate you learning the language and > > the > > > cullture, > > > > including following their habits, and only then let you in on > > their > > > small > > > > group of students. In other words, in China you have to earn > > their > > > respect. > > > > Bringing some oranges or apples for the doctor, inviting him > and > > > his wife > > > > for dinner,...are all ways you can earn his respect. In China, > > > students will > > > > accept anything their teacher " gives " to them, and almost never > > > question > > > > what he says directly. Students stand by the side, hand the > > doctor > > > his > > > > needles, and write down what he says. Doctors seem to > appreciate > > > this, and > > > > after you have done this for a while, they may start to trust > you > > > even more, > > > > and tell you more about their hard-earned clinical experience. > > They > > > might > > > > give you a line from the classics and ask you to look it up and > > > tell him > > > > what you think about that line. > > > > > > > > Like Lea, I would encourage you to look around and go to > different > > > > departments, if possible. In the beginning though, in one > > > department I would > > > > think that: " I know what they're doing here, I've seen that " . I > > > found that I > > > > was wrong. Doctors that were practicing cookbook acupuncture > > > sometimes would > > > > say things that revealed a much more profound knowledge than I > > > though they > > > > had. It doesn't always show in what they do, or how we perceive > > it. > > > > > > > > Best regards, > > > > > > > > Tom._,_._,___ > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 27, 2006 Report Share Posted November 27, 2006 I haven't had the good fortune to study in China, but my Chinese and Japanese teachers, here in the states, went nuts if they saw any of us touch the shaft of the needle. I tend to use 40 gauge, occasionally 38 gauge, needles. I do use those " training wheels, " the guide tubes, except for facial and auricular acupuncture. My patients almost never have any discomfort and I'm getting good results, so I guess I'll stick (pardon the pun) without what I'm doing. I do appreciate hearing about everyone else's experiences. Peace, Liz Casey - jasonwcom Chinese Medicine Monday, November 27, 2006 3:30 PM Re: China Clinical report #2 .32 and .34? Those are some thick needles! I think you mean #32 and #34? You can insert any width needle freehand, but if you manipulate it you risk bending or breaking it, especially with a 2 cun or longer needle... Chinese Medicine , " jasonwcom " <jasonwcom wrote: > > Well, I've watched and been needled by lots of doctors from Asia with > 30+ years of experience and that's how they do it. I also have a > book from China about needling techniques and that's how they show > how to needle. I've had Americans do it your way and it hurts more... > > Chinese Medicine , " michael " > <miclac1@> wrote: > > > > -Jason, sorry but you are dead wrong. You do not need to touch the > > shaft of the needle when needling freehand...You just need real > > needling skill. I often do it with .32 and sometimes .34 gauge > > needles. I prefer 30's but 32's work just fine. > > > > Michael > > > > - In Chinese Medicine , " jasonwcom " > > <jasonwcom@> wrote: > > > > > > To needle freehand you need to touch the shaft of the needle, > which > > > may go against the USA clean needle technique training but is > > > perfectly safe. If you don't touch the shaft to guide it, you > will > > > hurt the patient. Hold the needle between thumb and forefinger > > then > > > use the ringfinger and pinky to stabilize the shaft, insert it > > > through the tough layer of skin swiftly and deftly, then insert > it > > > deeper slow if you are tonifying, fast to disperse...You also > need > > to > > > use at least a .30 width needle or else forget it it will bend, > > maybe > > > a .25 but thats pushing it... > > > > > > > > > Chinese Medicine , " Tom > > Verhaeghe " > > > <tom.verhaeghe@> wrote: > > > > > > > > > > > > > > > > > > > > > > > > --- In Chinese Medicine , " skip8080 " > > > > <skip8080@> wrote: > > > > > > > > > > > > > > > As for hands on , Ive decided to learn freehand style as done > > > here. > > > > > However, I am struggling with that; its a little embarrassing > > as I > > > > > have developed my own guidetube technique over the years. > > > Guidetubes > > > > > are seen as " training wheels " over here.. > > > > > Attilio, and anyone who's done Clinic in China, a question.. > > > > > > > > > > How did you find a way to take advantage of an educational > > > situation > > > > > which has a lot to be desired and still learn a lot? > > > > > > > > > > Skip > > > > > > > > > . > > > > Hi Skip and all, > > > > > > > > Lea made some good points- Lea, did you study in Nanjing? > > > > If you complain, make sure you know who you're complaining to. > > The > > > Belgian > > > > group complained to Nanjing TCM uni on several occasions, and > > that > > > was the > > > > only way things would change. The students were not allowed to > > > needle after > > > > a few days of clinic, so the supervisor went to complain to the > > > principal. > > > > First there was some anger, but when the Belgian supervisor > > > threatened to go > > > > to another city, the problems evaporated quickly. From the next > > day > > > onwards, > > > > all students were allowed to needle. > > > > > > > > There are translation problems, and the best way to get around > > this > > > is to > > > > learn Mandarin yourself. Which I understand may not be an > option. > > > However, > > > > many old doctors will appreciate you learning the language and > > the > > > cullture, > > > > including following their habits, and only then let you in on > > their > > > small > > > > group of students. In other words, in China you have to earn > > their > > > respect. > > > > Bringing some oranges or apples for the doctor, inviting him > and > > > his wife > > > > for dinner,...are all ways you can earn his respect. In China, > > > students will > > > > accept anything their teacher " gives " to them, and almost never > > > question > > > > what he says directly. Students stand by the side, hand the > > doctor > > > his > > > > needles, and write down what he says. Doctors seem to > appreciate > > > this, and > > > > after you have done this for a while, they may start to trust > you > > > even more, > > > > and tell you more about their hard-earned clinical experience. > > They > > > might > > > > give you a line from the classics and ask you to look it up and > > > tell him > > > > what you think about that line. > > > > > > > > Like Lea, I would encourage you to look around and go to > different > > > > departments, if possible. In the beginning though, in one > > > department I would > > > > think that: " I know what they're doing here, I've seen that " . I > > > found that I > > > > was wrong. Doctors that were practicing cookbook acupuncture > > > sometimes would > > > > say things that revealed a much more profound knowledge than I > > > though they > > > > had. It doesn't always show in what they do, or how we perceive > > it. > > > > > > > > Best regards, > > > > > > > > Tom._,_._,___ > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2006 Report Share Posted November 28, 2006 Tubes should not be considered " training wheels " they were invented by a blind Japanese man in a moment of divine inspiration, and they have a shrine there to mark the spot, it made acupuncture easier for blind people to preform with thinner needles. Tubes are perfect for thinner needles. Chinese Medicine , Liz <lizzzrd wrote: > > I haven't had the good fortune to study in China, but my Chinese and Japanese teachers, here in the states, went nuts if they saw any of us touch the shaft of the needle. I tend to use 40 gauge, occasionally 38 gauge, needles. I do use those " training wheels, " the guide tubes, except for facial and auricular acupuncture. My patients almost never have any discomfort and I'm getting good results, so I guess I'll stick (pardon the pun) without what I'm doing. I do appreciate hearing about everyone else's experiences. > Peace, Liz Casey > > - > jasonwcom > Chinese Medicine > Monday, November 27, 2006 3:30 PM > Re: China Clinical report #2 > > > .32 and .34? Those are some thick needles! I think you mean #32 and > #34? You can insert any width needle freehand, but if you manipulate > it you risk bending or breaking it, especially with a 2 cun or longer > needle... > Chinese Medicine , " jasonwcom " > <jasonwcom@> wrote: > > > > Well, I've watched and been needled by lots of doctors from Asia > with > > 30+ years of experience and that's how they do it. I also have a > > book from China about needling techniques and that's how they show > > how to needle. I've had Americans do it your way and it hurts > more... > > > > Chinese Medicine , " michael " > > <miclac1@> wrote: > > > > > > -Jason, sorry but you are dead wrong. You do not need to touch > the > > > shaft of the needle when needling freehand...You just need real > > > needling skill. I often do it with .32 and sometimes .34 gauge > > > needles. I prefer 30's but 32's work just fine. > > > > > > Michael > > > > > > - In Chinese Medicine , " jasonwcom " > > > <jasonwcom@> wrote: > > > > > > > > To needle freehand you need to touch the shaft of the needle, > > which > > > > may go against the USA clean needle technique training but is > > > > perfectly safe. If you don't touch the shaft to guide it, you > > will > > > > hurt the patient. Hold the needle between thumb and forefinger > > > then > > > > use the ringfinger and pinky to stabilize the shaft, insert it > > > > through the tough layer of skin swiftly and deftly, then insert > > it > > > > deeper slow if you are tonifying, fast to disperse...You also > > need > > > to > > > > use at least a .30 width needle or else forget it it will bend, > > > maybe > > > > a .25 but thats pushing it... > > > > > > > > > > > > Chinese Medicine , " Tom > > > Verhaeghe " > > > > <tom.verhaeghe@> wrote: > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > --- In > Chinese Medicine , " skip8080 " > > > > > <skip8080@> wrote: > > > > > > > > > > > > > > > > > > As for hands on , Ive decided to learn freehand style as > done > > > > here. > > > > > > However, I am struggling with that; its a little > embarrassing > > > as I > > > > > > have developed my own guidetube technique over the years. > > > > Guidetubes > > > > > > are seen as " training wheels " over here.. > > > > > > Attilio, and anyone who's done Clinic in China, a question.. > > > > > > > > > > > > How did you find a way to take advantage of an educational > > > > situation > > > > > > which has a lot to be desired and still learn a lot? > > > > > > > > > > > > Skip > > > > > > > > > > > . > > > > > Hi Skip and all, > > > > > > > > > > Lea made some good points- Lea, did you study in Nanjing? > > > > > If you complain, make sure you know who you're complaining > to. > > > The > > > > Belgian > > > > > group complained to Nanjing TCM uni on several occasions, and > > > that > > > > was the > > > > > only way things would change. The students were not allowed > to > > > > needle after > > > > > a few days of clinic, so the supervisor went to complain to > the > > > > principal. > > > > > First there was some anger, but when the Belgian supervisor > > > > threatened to go > > > > > to another city, the problems evaporated quickly. From the > next > > > day > > > > onwards, > > > > > all students were allowed to needle. > > > > > > > > > > There are translation problems, and the best way to get > around > > > this > > > > is to > > > > > learn Mandarin yourself. Which I understand may not be an > > option. > > > > However, > > > > > many old doctors will appreciate you learning the language > and > > > the > > > > cullture, > > > > > including following their habits, and only then let you in on > > > their > > > > small > > > > > group of students. In other words, in China you have to earn > > > their > > > > respect. > > > > > Bringing some oranges or apples for the doctor, inviting him > > and > > > > his wife > > > > > for dinner,...are all ways you can earn his respect. In > China, > > > > students will > > > > > accept anything their teacher " gives " to them, and almost > never > > > > question > > > > > what he says directly. Students stand by the side, hand the > > > doctor > > > > his > > > > > needles, and write down what he says. Doctors seem to > > appreciate > > > > this, and > > > > > after you have done this for a while, they may start to trust > > you > > > > even more, > > > > > and tell you more about their hard-earned clinical > experience. > > > They > > > > might > > > > > give you a line from the classics and ask you to look it up > and > > > > tell him > > > > > what you think about that line. > > > > > > > > > > Like Lea, I would encourage you to look around and go to > > different > > > > > departments, if possible. In the beginning though, in one > > > > department I would > > > > > think that: " I know what they're doing here, I've seen that " . > I > > > > found that I > > > > > was wrong. Doctors that were practicing cookbook acupuncture > > > > sometimes would > > > > > say things that revealed a much more profound knowledge than > I > > > > though they > > > > > had. It doesn't always show in what they do, or how we > perceive > > > it. > > > > > > > > > > Best regards, > > > > > > > > > > Tom._,_._,___ > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2006 Report Share Posted November 28, 2006 I asked a Japanese-trained intern about guidetubes yesterday,and She told me that the reason he invented it was because in fact, he had poor needling skills! Shrines are a dime a dozen in the east. I do prefer the divine inspiration version of the story.. (*: Chinese Medicine , " jasonwcom " <jasonwcom wrote: > > Tubes should not be considered " training wheels " they were invented > by a blind Japanese man in a moment of divine inspiration, and they > have a shrine there to mark the spot, it made acupuncture easier for > blind people to preform with thinner needles. Tubes are perfect for > thinner needles. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2006 Report Share Posted November 28, 2006 1) needles and evolving notions of cleanliness Back when I took the USA national " Clean Needle Technique " training, early 1990's, " sterile " equipment was the emphasis using table covering, cotton, needles, etc. that were sterile, at least before opening and exposing to air. Soon thereafter the terminology changed to " clean " for everything, except the needle shaft, but even this after exposure to air. As jason <jasonwcom (Wed, 22 Nov 2006 19:55:15 0000) noted, not touching the shaft is dogma in the USA. As he also added, doing so " is perfectly safe " , presuming, he would probably also admit, " cleanliness " of the fingers. After a century or so of overreaction since the discovery of germ theory, scientific WM is gradually refining these notions, in the face of further evidence. (A recent article noted that the death of a 19th Century American president who had been shot, was actually due to allopathic treatment using their unwashed hands to probe his innards trying to find the bullet. A consulting homeopath had made a correct diagnosis, but did not prevail.) For instance, at last estimate, the normal human body consists of come 30 trillion cells, but is permeated with some 100 trillion guest microbes bacteria, fungi, viruses (which are not cells), etc. without which we could not function. We probably all carry staph, strep, e coli, etc., but under control of our immune systems and other of the " friendly " bugs which often control each other all orchestrated by healthy weiqi. Another bit of recent science finds that the human genome contains about 8%, or about 100,000 gene strands which were patched in by retroviruses (HERVs, not all of which are as vicious as HIV), probably over millions of years. This furthers the awareness that we function within, and indeed are made up of a symbiosis of living entities. To my mind, this is modern validation of the worldview that permeates the SuWen. Again, when I was a child, superficial wounds were treated with iodine or methiolate; decades later that was out, and hydrogen peroxide was in. Now all those invasive substances are out, and the orthodox cleaning of wounds (surface lesions) is washing with warm/hot water and soap. (Except for operating room procedures, which are still focused on radical disinfection.) The tales told back in TCM school about " unhygienic " practices observed in Chinese hospitals were probably colored more by cultural bias than clinical evidence. Despite " cleaning " point locations with alcohol, needles no doubt carry in with them minute amounts of the flora which populate the skin, and the interstitial weiqi handles that. And perhaps minute amounts of flora from the practitioner's skin can be taken in by needles also. (Perhaps this is even a part of the therapy?) Just don't advertise that you use your fingers, or tell your malpractice insurance underwriter! Then again, there's " antibacterial " soap, which has become ubiquitous in the USA (also in Europe or Australia?). All the medical and otherwise scientific literature indicates that this practice is virtually useless, even harmful damages the skin, potentially breeds antibiotic resistance. And now some cities in the USA are seeking to stop this, banning it, or at least banning city purchase of such products (e.g. Palo Alto, California). It turns out, measurable amounts of triclosan (the active antibacterial ingredient) are turning up in San Francisco Bay and messing with the marine biosystems. 2) needles and sensation Chinese, at least the older generations, are conditioned to heavy needle sensation. A local (Chinese) vendor of needles used to advertise that Huang Di said acupuncture doesn't work without strong deqi, and silicon coated Japanese needles don't do the trick. The Japanese, apparently, believe acupuncture works with minimal perception of deqi. Americans tend to be more like the Japanese in this regard. Too strong stimulation can tighten up the whole body and block the subtle interaction among points. Occasionally patients discontinue treatment because of this, especially from immigrant Chinese practitioners who can't yet read the cultural differences. A person working at that vendor was a student in a TCM ethics class I taught once, and submitted a paper citing an incident reported in Japan of silicon traces from needles causing some sort of damage, proposing that use of silicon-coated needles was unethical. But the market rules here in the USA, and that same vendor now offers Chinese-made super smooth, silicon coated needles, largely in the narrow gauges, and even using the Seirin color-coding scheme. My sense of needling is that the tube is useful as its pressure masks the insertion through the nerve-rich dermal layer. Patient's marvel that the needle's already in, but they didn't " feel " it. Then working the needle ¼, ½, etc. inches in, and manipulating, eventually the tissues react to its presence (the fish-hook metaphor from the classics), and the nerves (eventually the patient's subjective awareness) activate because of the reactive motion of tissue not because the needle is causing damage. In this sense, acupuncture is not invasive, but rather evocative. Often without insertion tube, as in jing-well points, and scalp or facial threading, the insertion can be masked by prior fingertip massage (part of point location), and/or pinching the skin. Back when I taught and worked in a local Chinese school/clinic, once an elderly, but robust, Chinese lady called me back as I was leaving the room, demanding stronger needle sensation. On the other hand, American patients sometimes cringe when I come back into the room to reactivate points (as in Master Tong style). ---------- Version: 7.5.430 / Virus Database: 268.14.19/555 - Release 11/27/2006 6:09 PM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2006 Report Share Posted November 28, 2006 It was both, he did have poor skills and it was divine, try a treatment from a Japanese master who uses thin gold and silver needles inserted with a tube. The proof's in the pudding. That shrine is a " good luck " type of shrine. Check out the " correct tendons " video clip(you can only see it in the dsl ones)on this site: http://www.tungspoints.com/acupuncture_video_dvd.html Chinese Medicine , " skip8080 " <skip8080 wrote: > > I asked a Japanese-trained intern about guidetubes yesterday,and She > told me that the reason he invented it was because in fact, he had > poor needling skills! > Shrines are a dime a dozen in the east. > > I do prefer the divine inspiration version of the story.. (*: > > Chinese Medicine , " jasonwcom " > <jasonwcom@> wrote: > > > > Tubes should not be considered " training wheels " they were invented > > by a blind Japanese man in a moment of divine inspiration, and they > > have a shrine there to mark the spot, it made acupuncture easier for > > blind people to preform with thinner needles. Tubes are perfect for > > thinner needles. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2006 Report Share Posted November 28, 2006 The big question is, does needling with v. without tubes have anything to do with patient outcome? Avery On Tue, 28 Nov 2006 15:30:17 -0500, jasonwcom <jasonwcom wrote: > It was both, he did have poor skills and it was divine, try a > treatment from a Japanese master who uses thin gold and silver > needles inserted with a tube. The proof's in the pudding. That > shrine is a " good luck " type of shrine. Check out the " correct > tendons " video clip(you can only see it in the dsl ones)on this site: > http://www.tungspoints.com/acupuncture_video_dvd.html > > > Chinese Medicine , " skip8080 " > <skip8080 wrote: >> >> I asked a Japanese-trained intern about guidetubes yesterday,and > She >> told me that the reason he invented it was because in fact, he had >> poor needling skills! >> Shrines are a dime a dozen in the east. >> >> I do prefer the divine inspiration version of the story.. (*: >> >> Chinese Medicine , " jasonwcom " >> <jasonwcom@> wrote: >> > >> > Tubes should not be considered " training wheels " they were > invented >> > by a blind Japanese man in a moment of divine inspiration, and > they >> > have a shrine there to mark the spot, it made acupuncture easier > for >> > blind people to preform with thinner needles. Tubes are perfect > for >> > thinner needles. >> > >> > >> > > -- Avery L. Jenkins, DC, FIAMA, DACBN Chiropractic Physician Fellow, International Academy of Medical Acupuncturists Diplomate, American Clinical Board of Nutrition www.docaltmed.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 28, 2006 Report Share Posted November 28, 2006 Jason Thanks for the link. My big question was " Do any practitioners " feel more in touch with the qi of the patient using freehand?' " I dont think we can quantify outcomes, but I'm rather interested in your subjective views on this. And a question about safety; Im observing and practicing a technique used on severe stroke sequela patients, its very aggressive needling on UB 40 HT 2 SP 6 in what looks like stimulating the nerve to cause the limb to jump. Results are immediate, but.. Isn't there a possibility of damaging the nerve this way? Its seems rather invasive! Skip Chinese Medicine , " Dr. Avery Jenkins " <docaltmed wrote: > > The big question is, does needling with v. without tubes have anything to > do with patient outcome? > > Avery > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 29, 2006 Report Share Posted November 29, 2006 This is a great conversation. I too, believe that this hinges on cultural ideas of distinctions and really boils down to the quality of the individual practitioner in sharpening our tools. For instance, what's better? zen or pure land buddhism? Asking for a qualitative answer is purely speculative. It really depends on the discipline of the individual in refining the art. So, then again, what works better, a koan or a mantra? I'm intrigued by the question posed by Avery... How does using a guide tube or not affect practice outcomes? And how does superficial needling interact with the psycho-physiology differently than deeper forms of needling? Is the subjective acknowledgement of de qi by the patient required for a productive treatment? K. On 11/28/06, skip8080 <skip8080 wrote: > > Jason Thanks for the link. > > My big question was > > " Do any practitioners " feel more in touch with the qi of the patient > using freehand?' " > I dont think we can quantify outcomes, but I'm rather interested in > your subjective views on this. > > And a question about safety; Im observing and practicing a technique > used on severe stroke sequela patients, its very aggressive needling > on UB 40 HT 2 SP 6 in what looks like stimulating the nerve to cause > the limb to jump. Results are immediate, but.. > Isn't there a possibility of damaging the nerve this way? Its seems > rather invasive! > > Skip > > --- In Chinese Medicine <Chinese Medicine%40yaho\ ogroups.com>, > " Dr. Avery > Jenkins " <docaltmed wrote: > > > > The big question is, does needling with v. without tubes have > anything to > > do with patient outcome? > > > > Avery > > > > > -- 'Freedom from the desire for an answer is essential to the understanding of a problem.' Jiddu Krishnamurti Quote Link to comment Share on other sites More sharing options...
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