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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