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Acupuncture with Amazing Results: An Interview
with Robert Chu, L.Ac.
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Can you give us a little background on your Chinese Medicine
training and experience?
I came to Chinese medicine from my study of martial arts. I studied
the
martial arts for over 30 years. My teachers always stressed that
defending
yourself requires knowledge of the body and healing is a must
because you
might get injured yourself. As a student of Chinese martial arts,
you are
exposed to Dit Da Ke (Traumatology), Tui Na, Acupuncture and Herbology.
The old way of study is hard. You learn an herbal formula and
you have to look up the herbs for it to understand why it works.
Also, the long hours apprenticing with a master might just involve
sitting at the clinic, looking at all the herbs, and then gathering
them when the formula is needed. You are basically a gopher.
Because my interest was in computers, I pursued Business school
instead and did that professionally after college, rather than
going directly into TCM. About 9 years ago, my interest in Chinese
medicine piqued, and I decided to pursue Acupuncture as a second
career. So, I worked full time and went to acupuncture school
full time. I graduated a few years ago and have since pursued
acupuncture and herbology as my livelihood. This was after dabbling
in Chinese Medicine for nearly 30 years!
I am licensed in California as an Acupuncturist, and I specialize
in musculoskeletal disorders, Pain disorders, Orthopedics and
Internal Medicine. I am also a Qualified Medical Evaluator (QME).
I am affiliated with the St. Vincent Hospital Center for Health
and Healing in Los Angeles, CA, where I teach Tai Chi and Qigong
and practice Chinese Medicine. I was also on the faculty at Samra
University of Oriental Medicine teaching acupuncture, and taught
Tai Chi and Qigong at Loyola Law School. Regarding my martial
arts career, I co-authored "Complete Wing Chun", (Charles
E. Tuttle Co., Inc, 1998) and published numerous articles for
Acupuncture.com, California Journal of Oriental Medicine, Inside
Kung Fu, Martial Arts Combat Sports and other publications. I
also have branch schools of my Wing Chun system throughout the
USA, the UK, and Thailand.
Your own style of treatment incorporates theories and techniques
from a number of traditions- can you talk about how you developed
it- what worked and didn't work for you- how you choose when to
use which system...?
I'd say I have my own way of doing Chinese Medicine now, rather
than strictly the TCM I learned in school. I have drawn from what
I consider the best in Acupuncture. My system is based primarily
on Master Tong's (Dong Jing Chang) system. Although I draw heavily
on classical acupuncture from the Nei Jing (Inner Classic), Nan
Jing (Classic of Difficulties), Jia Yi Jing (A-Z of Acupuncture),
and Zhen Jiu Da Cheng (Great Compendium of Acupuncture) because
I think practical application without scholarship is useless.
From my good friend, Jacques MoraMarco, I learned the Korean Sasang
Constitutional Acupuncture. I also use Korean style Sa Am Acupuncture
in the clinic. I am a great fan of the work of Chen Chao - the
creator of Yi Lei Zhen Jiu (Acupuncture based on the principles
of the I Ching), and the Balance Method of Richard Tan. I also
use some unusual methods of chronoacupuncture, based on time and
day called Ling Gui Ba Fa and Zi Wu Liu Zhu. I have also studied
Japanese methods of acupuncture and very impressed with Kiiko
Matsumoto and the works of Yoshio Manaka. I use Japanese abdominal
palpation, magnets, some needle techniques, and ionic cords in
my clinic.
I found in my clinical experience, the TCM method of acupuncture
used too many needles, was too slow, goes directly to the site
of the pain, and has mediocre results. I reasoned, if you want
to see 4 or more patients an hour, you have to have a fast, efficient
clinical style, and one that gets immediate results. In my clinic,
I generally keep a patient with needles for 30 - 45 minutes on
the table. This is the basis of my style of acupuncture. I recall
seeing a patient with sciatica and inserting 6 inch needles into
her GB30 point, putting in bilateral needles at UB40, UB 60, UB
57, and innumerable Ashi points, then having her get up off the
table with just a minimum relief 45 minutes later. That really
frustrated me and caused me to sit up late nights trying to figure
out why such mediocre results. It caused a great hunger in me
to read as many books on acupuncture as I could. When the books
in English didn't cut it, I started to look more into the works
in Chinese. This is when I found that TCM is basically herbalized
acupuncture, that is, taking herbal theory and putting acupuncture
around it. This made me more hungry to figure out how it differed
to what the Chinese were practicing for centuries. Acupuncture
was based on channels and collaterals, and if the channels are
diseased (i.e. qi and blood were not flowing well), then we must
select the correct channel and treat it from there. But reading
and researching is not enough - one has to apply the knowledge
in the clinic to see what works and what doesn't.
I learned some of the Tong style as a student in school, but
only a few points like Ling Gu, Da Bai, Fu Ke, etc. Dr. Tan's
work influenced me, but I was hungry for more. I procured Miriam
Lee's book, "Master Tong's Acupuncture" and went through
the book and applied it to my clinic. But then I looked at Young
Wei-Chieh's book on Master Tong's Extraordinary Points in Chinese
and soon discovered that basic principles were missing from Miriam
Lee's book, point locations were off, and treatment formularies
reflected more of Miriam Lee's style, rather than Master Tong's
original style. This led me to seek out Miriam Lee's disciple
and apprentice, Esther Su, and we met to discuss what was in Master
Tong's system and how Miriam Lee differed. Esther suggested I
seek out Dr. Young and I attended his classes on Tong's points,
as well as reading his works in Chinese. I later bought a library
of books by Tong's students in Taiwan, and all of the puzzle was
clearer to me. I started getting great results in the clinic,
almost instantaneous, with Tong's method.
One of the Tong's principle is to use points contralateral to
the pain. It reminded me of what was in the Nei Jing Chapter 63
- called Miu Ci (Contralateral Needling) - "If there is disease
on the right, treat the left". This helped me in cutting
down on the number of points I needed.
Dr. Tan's Balance Method based on the Ba Gua really interested
me, especially since I studied Daoism and Chinese martial arts.
I later found out that Dr. Tan was taking fundamental methods
from Chen Chao's work.
"Chen Chao" who is that?
Dr. Chen is a pioneer in his system of acupuncture based on the
Yi Jing (I Ching) - the Book of Changes. The Book of changes is
a divination tool, an oracle, and a means of determining health
in Chinese culture. Usually, most people are familiar with the
casting of coins or yarrow sticks, or even use a computerized
version of it to aid in decision making. The Yi Jing has roots
in shamanism of Ancient China. With regards to medicine, there
are many passages in the Nei Jing which correlate to the Yi Jing.
Chen Chao created a modern system based on his study of the Yi
Jing and Acupuncture. He is also a prolific writer from Taiwan
on the theory of Yi Jing. Dr. Chen published his methods in his
7 books in the mid 1970's, and he explains the relationship between
the Ba Gua and Chinese Medicine and how to balance the channels.
His methods include using the Xian Tian Ba Gua to balance the
channels, using the methods of Hou Tian Ba Gua, and the Tai Yang
Ba Fa, a method of using the 8 extra channels.
Xian Tian Ba Gua is the arrangement of the Ba Gua according to
Fu Xi. Basically, each channel is equated with one of the gua
(trigrams). The gua are represented by the 14 channels and balance
each other. Using the principle, if we know there is pain in the
right knee along the Spleen channel, we can choose left Lu 5 to
treat the pain, because the Hand Tai Yin channel can balance the
Foot Tai Yin channel. This system is practical for limbic pain
or symptomatic pain and clears it immediately. The results are
remarkable clinically!
Hou Tian Ba Gua is the method of the Ba Gua based on Wen Wang
configuration. In this arrangement, the 5 elements are superimposed
on the 8 trigrams. On the simplest level, we take the paired couplets
of the six channels (i.e. Tai Yin/Yang Ming, Shao Yin/Tai Yang,
and Jue Yin/Shao Yang) and treat the body with the Shu Stream/Yuan
Source Point and the He Sea Point of those channels according
to symptoms. This method is better for internal medicine problems,
as it takes the circuit pathways of the body and harmonizes them.
The Tai Yang Ba Fa is a unique way of using the 8 extra channel
points. Chen Chao's configuration is to balance the Ren (Lu7)
and Du (SI3), the Yin Wei (Pc6) with Yang Wei (SJ5), Yin Qiao
(K6) with Yang Qiao (UB62), and Chong (Sp4) with the Dai Mai (GB41).
This method is far reaching in clinical efficacy. It uses the
involved channels and has them balanced. Advanced use is choosing
points based on the time of day, or when symptoms occur at what
time.
You practice a number of systems and techniques that aren't
well-covered in most TCM schools these days... for example, what
is the metacarpal bone system... when do you apply it, what are
the results, how do patients respond?
I have two mottoes in life, "let application be your guide"
and "let function rule over form" because most of the
time when people are doing a certain thing, they do because they
were taught that way, and may have no idea of the actual function.
If you only study TCM, you might learn an acupuncture formula
for back pain consisting of UB 23, UB 40, UB 57, Yao Tong Xue,
K3 and other points. Most acupuncturists apply this mechanically,
as this is the way they are taught. But when it doesn't work -
what options do you have? I think if you have more tools at your
disposal, you can do a lot more.
While doing research on Microsystems class I taught at Samra
University, I thought the curriculum was short compared to what
was taught in China. So I expanded the curriculum, emphasizing
the practical methods of microsystems in the clinic. For example,
I taught the 12 point system of the 2nd metacarpal bone, a system
that can treat the entire body with just a few points that stretch
between LI3 and Ling Gu. The clinical results are excellent! When
I taught class, I always gave demonstrations. My idea was to inspire
the students and show them what was practical and that acupuncture
did work instantaneously! I also taught periocular acupuncture,
ear microsystems - Nogier and Chinese, face acupuncture, nose
acupuncture, hand acupuncture, foot acupuncture, Wrist and Ankle
acupuncture, Sa Am acupuncture, Tong's acupuncture, and various
styles of scalp acupuncture. The idea was to teach the students
how to use them practically. I personally think to emphasize a
few points is better than bogging down a student with too much
theory.
In the clinic, I choose the system or technique according to
the patient, the illness, how much time we have, and what I've
tried before. For example, if a patient has back pain, and using
TCM acupuncture doesn't help, I may try the Tong system, or Metacarpal
Bone, or the Hand acupuncture system. I let him get up and walk
about with the needles in his arm or hand. And it makes sense
to see what works, and how well. Patients are very happy with
this way. They want a physician that is always learning, always
willing to try things and does not have the answers to everything.
Miriam Lee's book about Master Tong is long on points and short
on theory/principles/concepts. Can you give us a sense of what
we're missing out on?
I don't think Miriam Lee left out anything on purpose, but rather,
her book is a reference of her use of the Tong points based on
her clinical style. Much of the book has a lot of practical clinical
value. It is a great book that introduces Master Tong's style
in English. It would be my advice to study the treatment formulary
to get a better idea of how to apply that system, rather than
try to memorize all the points. Master Tong's system to non-Chinese
speaking students might be a bit challenging, as the points are
referenced in Chinese and the numbering system is a poor one.
One thing I disagree with the Blue Poppy book is the history
of the Tong system. I think Master Tong was a genius, rather than
just having a family style of acupuncture passed down to him.
Personally, I think he created the system, and I heard from others
he was always experimenting and modifying points. From the different
books on the Tong system I gathered from Taiwan, one can see different
students stayed with him at different periods of his life and
learned different points. This would suggest that he was creating
something new all the time based on his clinical results.
The Blue Poppy book is also incorrect in certain point locations.
For example, the point Ren Huang is not the same as Sp6, as was
discussed in Miriam Lee's book. Ren Huang is located higher than
Sp6. Most people use the tip of the medial malleolus as the starting
point for finding Sp6. 3 cun above the top of the malleolus is
Ren Huang - it make a 0.5 - 1 cun difference. Fine if you use
"good enough", but it is technically wrong. The people
following the English text would have the point incorrectly located.
There are numerous other points off in the book, too numerous
to mention here. My advice would be to find an experienced Tong
practitioner like Esther Su, Frank Chong, or Young Wei-Chieh to
learn the proper locations of the points.
Master Tong's style emphasizes a lot of bleeding methods,
especially on the torso. Bleeding methods, or "Fang Xue"
(literally "blood letting") is an efficient way of clearing
the channels, and might be a little stronger than just regular
needles in certain circumstances. Basically, you bleed the patient's
points and might go so far as to cup the bled points. Instead
of a triangle type needle, I use a modern lancet device. Master
Tong's system includes five elements bleeding - a technique of
bleeding across the areas of the 5 elements on the limbs and body.
I also use bleeding on stubborn cases of arthritis or heel spurs
- I usually do this after a patient and I have tried other needle
methods and they know me a bit more.
Patients respond well, usually a drop of two is all you need.
Classically in the Tong school, they use cupping right after you
bleed the patient, and want to make sure the cup bottom is filled
with blood. With today's Clean Needle Technique protocols, I'm
not sure many acupuncturists would want to use this technique.
Also, some patients or even doctors might faint at the sight of
blood.
Another unique feature of the Tong school, they use palm diagnosis
to diagnose a patient for internal disorders. It's similar in
idea to ancient hand diagnosis methods.
A great feature of the Tong system is the 8 basic imaging methods.
The 8 imaging methods explain why they choose non-channel points,
and why Tong acupuncturists have a unique method of using regular
channel points. Master Tong's methods also emphasize different
depths of needle insertion, no manipulation of the needle, needling
contralaterally while a patient exercises the painful area, and
needling according to proper time and season.
Do you think what acupuncturists practice is a matter just of
choice? How much of it is a lack of resources and exposure? What
do you think this means for U.S. acupuncturists and their patients?
I believe that acupuncturists practice what they know. Esther
Su said to me that, "People may know different things, but
may not put as much mental energy into a subject to really delve
into it." I thought that was pretty profound, it applies
to many acupuncturists. In this country, we have different systems
from different countries, and most practitioners have an eclectic
blend of various systems. I think to know how good a system is,
is you have to see the clinical results. There is no shortage
of good information here, but we also have a lot of "foo-foo"
information flying about. If one's basics are not good, it is
hard to distinguish good from bad.
It means that patients may not experience acupuncture from a
real expert, but rather, from a technician or a mediocre practitioner.
The end result is our profession develops a bad rap for being
ineffective. I think the answer is that clinicians should have
a deep hunger to be the best in their field. To research, study,
learn and practice should be a way of life.
There are many new books published and more resources in English.
Of course there are many more books published in China. I think
there are probably about a thousand books in English on Chinese
Medicine, whereas in Chinese, there are probably more like one
hundred thousand books. In terms of overall knowledge, of course,
there is more information in Chinese, but much of the new information
is a rehash of older methods or a combination of Western Medicine
and Chinese Medicine. In terms of basics and what is needed in
the clinic, most acupuncturists have that. But the bottom line
is clinical results. If they aren't getting results, then they
should look into alternative methods.
Personally, I think if you are an acupuncturist, you owe it to
yourself and your patients to be the best you can, that is - attend
seminars, read books, read case studies, attend lectures, listen
to audio tapes, try to apprentice yourself with great practitioners,
have a mentor or role model, and research as much as you can.
Then apply it in the clinic! This way, the level of acupuncture
here in the USA will become better and our profession will grow.
When patients benefit from your methods, they often refer more
patients and your practice grows.
Would you go so far as to make a comparison of the effectiveness
of TCM acupuncture with other styles?
As I've said, what counts with acupuncture is what clinical results
you get. People have different styles, and if they can make it
work, then great. What is called TCM acupuncture is just a beginning
- the basics. If I didn't have that training, I wouldn't be able
to build upon that foundation. When I read up on acupuncturists
in China, each doctor has their own strategy and methods, and
some are quite effective. I think there are some outstanding acupuncturists
there, but they just aren't as well known here. If you develop
your own style or method, you have to try it in the clinic and
see your results. In this way, theory gives way to principle.
Daily you cultivate and try to make that method work under all
circumstances. If you follow a paint by number method, that usually
does not get good results, simply because everyone is different.
You have to have a conceptual approach, rather than be a technician.
For me, my method is about having flexibility and efficiency.
My method is based upon seeing an average of 4 patients an hour,
where I keep the patients for 45 minutes on the table, and one
that I can have instant clinical results with. If a patient has
pain, they should feel relief immediately. If they have an internal
medical problem, they should feel profoundly relaxed and their
symptoms subside. To say that TCM Acupuncture is no good, would
be wrong; however, there are better methods. TCM methods were
designed to be simple and easy to use and remember, and disseminate
across a large population. TCM is based on herbal paradigms of
8 Principle diagnosis, Shang Han Lun, Wen Bing, San Jiao, and
Zang Fu theory. Often, those paradigms don't fit with Acupuncture
theory.
My method is easy, but one should have the basics in TCM to understand
why I do things a different way. I focussed on many different
strategies: Instead of choosing points bilaterally, it is better
to choose the more sensitive contralateral side. Instead of using
many needles, it is better to use fewer needles. Instead of choosing
only local or ashi points, it might be better to select distal
points to see the results immediately. Instead of using 28 gauge
needles because they use that in China, perhaps it might be better
to use thinner gauges here. Instead of obtaining a strong "De
Qi" sensation, we can choose a milder one. Instead of turning
the needles, it might be better to leave them, as the qi will
arrive. Instead of inserting the needles without directing needle
sensation, it is better to control it. Instead of just having
patients lie down passively, it would be better to have them exercise
their affected area. Instead of just needling the same way all
the time, it might be better to be ambidexterous and needle from
any position. And instead of choosing points "by the book",
it might be better to reason why select points according to imaging,
point category or channel relationship. I use these methods because
I find them to be better for my patients. I developed my method
in an attempt to answer the questions in my mind. And I believe
practicing these methods can make a mediocre practitioner into
a great clinician.
Thank you, Doctor Chu for interviewing with us. You've certainly
given us some great insights!
My pleasure!
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