Introduction

Teil 1 des Gesamtvortrages - der 2. Teil trägt die Nunmmer: V_TCMAT13_28

Teil 2 des Gesamtvortrages - der 1. Teil trägt die Nunmmer: V_TCMAT13_23

Content:
The workshop aims to provide a theoretical and practical knowledge of Paediatric Tuina to TCM practitioners and students. It refers to the work of the Free Children Clinic Xiaoxiao, in Milano.
It is focused on clinical practice, learning through problem-solving in small groups.
Its contents are:
- Introduction to children physiology, pathology, semeiotics and diagnosis.
- Areas, lines and points used in children.
- Main patterns and related treatment strategies.
- Specific paediatric tuina techniques and sequences.
- Treatment for the most common problems, as poor appetite, lassitude; fever, respiratory diseases; digestive and intestinal disorders; sleeping troubles, hyperactivity.
- Use of guasha and moxibustion in children patterns.
- Case history discussion or direct work with some little patients.

Comments:
The clinic Xiaoxiao treats only children, with paediatric tuina and acupuncture, and it is run for the 4° year, once every week, in Milano, Italy.
In the first 3 years (2005-08) it led a pilot-study for the cure and prevention of recurrent respiratory diseases in 0-12 years old children, with 8 sessions free of charge: the first 7 sessions take place every 10 days and the last one around two months after the completion of treatment.
The current pilot-study is designed for children who do not sleep well or are hyperactive.
The therapeutic choices are not rigidly set by protocols: they follow the Chinese diagnosis and take into account the complexity and the variability of the patients.
Paediatric Tuina is the main treatment, but we also use acupuncture, moxibustion, cupping, ear-seeds, guasha, plum-blossom needle.
This project is supported by the Federation of Italian Schools of Tuina and Qigong (FISTQ).
From November 2005 to June 2008, during school time, we treated 58 children, from 2 months to 12 years old, for a total of 392 sessions (45 children for prevention and cure of respiratory disorders, of which 39 have completed the 8 sessions).
From October 2008 to January 2009 we treated 27 children, for a total of 104 sessions (40 sessions for respiratory disorders, 41 for hyperactivity or sleep disorders, 26 for other problems, as infant abdominal pain, nocturnal enuresis, dermatitis, intestinal disorders, growing problems).

We usually teach the parents the main individual tuina sequence, which will then be applied daily at home. Parents also learn some “emergency” sequences (in case of common cold or cough, fever, constipation, etc.).
The care-givers can also attend a two-days course that takes place twice a year. Here they get a basic knowledge of Chinese Medicine and of specific children physiology, pathology, diagnosis, tuina points and techniques, acquiring the ability to recognise the main clinical patterns and to design and apply a treatment.

The Xiaoxiao clinic also acts as a clinical training centre for tuina practitioners and acupuncturists (in Italy acupuncturists must be MD) who already have a good knowledge of Chinese Medicine and wish to focus on paediatrics: by June 2009 35 practitioners will be trained through a basic or advanced paediatric course.

Observations on the preliminary results can be read on the Journal of Chinese Medicine (n.85, October 2007)

- Emotions and the movement of qi (emotions and classical thought, emotions and movement of qi, emotions and illness), with a focus on clinical practice.
- Constraint (yu), internal heat (neire), agitation & restlessness (fanzao) and their relationship to TCM patterns and most common clinical manifestations (depression, anxiety, insomnia etc.).
- A brief overview of classical disease categories (zangzao, bentunqi, baihebing, meiheqi, diankuang) and their application in clinical practice.
- Main patterns seen in psycho-emotional disorders and treatment by acupuncture.
- Case examples will be given throughout and the patient/practitioner relationship will be discussed

Comments:
The opening of the first Chinese text dedicated to acupuncture reads: “All acupuncture methods must find their root in the shen” (Huangfu Mi, Zhenjiu jiayijing, “The systematic classic of acupuncture and moxibustion”, AD 259, chapter 1). These words echo the first sentence of chapter 8 of the Lingshu.
Those who treat the ill and in particular those who use non-conventional medicines are well aware of the importance of certain psychic aspects in the disorders told by patients.
Some patients speak directly of anxiety, depression, insomnia and agitation, expressing an emotional and mental discomfort, others describe this “feeling unwell” through sensations such as pain, weight, swelling, knots.
There are times when the “emotional illness” shows itself clearly, others in which it seeps in with the most alarming modalities. In both cases it is clear that a psychic part permeates our everyday practice.
Acupuncture has attracted many of us precisely because it is a medicine which considers the person as a whole. Moreover it seems to produce substantial effects even on the most subtle aspects, in spite of its apparent focus on the body.
It is always fascinating to see how important is the connection between psychic and physical disorders in the “Chinese” way of interpreting signs in patients. It is also of great comfort to see how our work is facilitated by not having to separate emotional, mental and somatic areas.
The perspective we shall take in this lecture is mainly on emotions as movements of qi. And we shall discuss clinical presentation of disturbing states (as anxiety, depression, panic attacks, food disorders, psychotic outbursts) in relation to Chinese medical point of view. This will lead us to consider treatment hypothesis and doubts, successes, questions of real cases.
Starting from the classics, we’ll see how emotions, that is, internal movements of qi, interact with the denser and thinner forms of qi (body, zangfu, shen).
And we’ll talk about the single emotions, how to recognize th

By treating the weakest link in the Elemental chain, the practitioner achieves a deeper and more lasting change. Treating this constitutional imbalance also forms an important part of any treatment designed to improve symptoms and/or a patient’s overall well being.
The constitutional imbalance is diagnosed by colour on the face, sound in the voice, the patient’s body odour and the most-out-of-balance-emotion. The emotional imbalance is the most revealing of all of these. Each Element produces a wide range of related emotions. For example, anger is the emotion associated with Wood, but an imbalanced Wood can produce depression, mild frustration, anger and ballistic rage – with many variations.
Simple observation, whilst sometimes successful, is rarely sufficient to determine the emotional imbalance. J.R. Worsley developed the process he called ‘emotion testing’ which produces what simple observation alone cannot achieve.
John will show you:
• Through demonstration and lecture, how to develop an ‘emotion-testing’ strategy,
• By using videos of patients, how to see the difference between a normal and an abnormal response, and
• Through exercises and practise, how to develop the required skills.