JCM ReviewSarah Pritchard’s latest book is a welcome addition to the growing number of tuina publications and DVDs that have recently become available. It looks and feels like a more cohesive and complete study aid than her previous publication (which was perhaps aimed at a more general audience) and has been structured with the tuina student in mind. The book does not include sections on basic TCM theory or Western medicine, which would be studied thoroughly as part of a comprehensive tuina course. It is split into three main sections: the foundations and history of tuina, techniques and methods used in treatment (the largest section – including a chapter on external herbs and ancillary treatments), and principles for creating and planning tuina treatments.
The book begins with a brief account of the history of tuina and identifies the different styles that have evolved in the West. There is also a discussion of the importance of qigong, and advice on becoming an effective qigong practitioner - although this is not a book that details this vital aspect in any depth. Sarah does, however, recommend regular practice of qigong and discusses several basic exercises, stating that, ‘you need to develop your strength, flexibility, stamina and coordination and to cultivate your Qi so that you can become both manually proficient at applying the techniques and therapeutically effective by learning to direct Qi through your hands.’ I completely agree with this approach to developing skill in tuina. Later in the book there is a short section on how to affect the different levels of a patient’s qi. Sarah states in this section that it is possible to reach the deeper layers of a patient’s body, ‘if you have developed your ability to direct your qi and intention’, although she does not elaborate on how one might pursue such a process of development. There is also no mention of the value of a tuina therapist practising tai chi (despite references to a technique called ‘tai chi hands’ in the text). Instead Sarah recommends activities such as the Alexander technique, yoga, swimming or running as ways to develop oneself as a practitioner. Although these activities have value in their own right, they are not as beneficial or effective as tai chi and qigong for helping a tuina student learn about directing qi and intention, or learning to move their bodies ‘with the maximum efficiency and minimum amount of tension’. Although it may not be the remit of this book to cover this process in detail, it should be pointed out that the ability to concentrate one’s qi and intention and apply it through refined and strong techniques is a basic requirement of students, and should not be seen as advanced training.
The main body of the book (the techniques and methods section) is well put together, with clear descriptions of techniques (including their Chinese and English names), how to practice them, their therapeutic effects and their common uses. It is always difficult to describe complex anatomical movements (that often at first feel unnatural) in a textbook, as little appreciation of feeling or touch can be transmitted. To accomplish this, helpful black and white photos of the techniques are included, as well, of course, as the well-produced accompanying DVD where Sarah demonstrates the techniques and discusses them further. The instruction provided in this section combined with the DVD is of high quality and forms a valuable complement to any tuina course. This section also contains chapters on moxibustion, cupping and guasha, as well as a section on external massage media (written by Andrew Croysdale). There is not a great deal of information generally available on this subject and so this chapter makes interesting reading; the recipes will be very useful to those inclined to making and using their own herbal compresses, ointments and tinctures.
The section on treatment is arranged to encourage students to develop their own treatment styles and methods and differs from other (mostly English translations of Chinese) tuina books in that it does not provide specific treatment protocols for particular conditions or diseases. Instead, the section begins with a discussion of topics including case taking, planning a treatment, choosing points and techniques, when to apply ancillary techniques and how to work with the patient's breath. This is followed by a detailed section on the treatment of several categories of disease: musculoskeletal, digestive, gynaecological, headaches and hypertension, coughs/colds and asthma, and finally a section on combining acupuncture and tuina. There is plenty of good information in each of these categories, beginning with a discussion of the ailment in TCM terms, and suggestions for how treatment might be approached and which techniques might be used. Finally, there are many detailed case studies illustrating different approaches for treating the various conditions. Sarah writes that students benefit from the clarity provided by having a simple framework to follow at the beginning, but rightly says that ‘good tuina practitioners need to strike a balance between structure and flexibility’ during treatment. This last chapter in the book clearly illustrates the flexibility and creativity that a practitioner can use when treating patients with tuina.
This text states its primary aim as offering a comprehensive foundation in tuina for students and practitioners, and its contents are informed by the great expertise that Sarah has acquired over her many years of teaching and practise. It has succeeded in this aim and will no doubt be valuable for students and practitioners of tuina, both as a reference book and an inclusive study aid.
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