Elisa Rossi Foreword by Julian Scott Publishers: Donica Publishing, 2012. Hardback, 352 pp.+ DVD. ISBN 9781901149074 Price: £49.00
(Reviewed by Marian Fixler, EJOM Vol. 7 No. 2)
Elisa Rossi’s book ‘Pediatrics in Chinese Medicine’ expands the repertoire of approaches to the treatment of children, at a time when there is increasing debate within the profession regarding the need for further ‘specialist’ training in certain areas of practice. It is one of two recent additions to the area of paediatrics, alongside Stephen Birch’s book Shonishin, on Japanese paediatric acupuncture.
Rossi draws on her extensive and diverse clinical experience of treating children over many decades. Her impressive background not only in acupuncture and tui na massage, but also in Western medicine and psychotherapy informs her practice and the content of this book. Her involvement in the development of dedicated paediatric Oriental medicine clinics and her collaborative work with practitioners of other disciplines (in particular, psychologists), offers insights into the treatment of children, not only from an Oriental medicine perspective but also from a psychological angle. She emphasises the importance of a multi-dimensional approach, not only to treatment, but also to understanding what underlies any disease condition.
Rossi’s approach is firmly within a TCM framework and she has extensive links with medical institutions in China. Another major proponent in this field, Julian Scott, wrote the foreword and the book makes references to Scott’s approach – for example, in the treatment of phlegm conditions. I was interested to see what this book would offer that would be different to Scott and Barlow’s comprehensive tome on paediatric acupuncture.
While Scott’s book focuses predominantly on a wide range of conditions, which are clearly listed and indexed, this book devotes more space to the underlying theory of qi and zang fu development in children. There are detailed chapters devoted to pathophysiology, causes of disease, signs and symptoms, patterns of disease and the treatment of disease patterns. The reader will certainly have a clear understanding from reading this book on how children’s qi and its development is different to that of adults.
There is a detailed chapter on the energetics of food and diet, which is relevant not only to the treatment of children. There is also a chapter on clinical practice with regard to how this needs to be adapted to children including a psychological approach.
The chapter on clinical conditions focuses on five common areas including atopic eczema, ADHD, sleep, gastrointestinal and respiratory disorders. The chapter on ADHD in particular has very detailed information regarding the diagnosis of this spectrum of disorders. Although a wide range of commonly occurring problems encountered in the clinic are covered, the reader does have to go back and forth from one chapter to the next for information on the best approach to treatment. The emphasis is more on disease pattern differentiation rather than disease labels. Treatment strategies are covered more under TCM patterns than specific conditions, though there are some summaries for particular conditions. This makes it a little more challenging at times to use as a quick reference guide in clinic. Also, conditions such as colic are not even mentioned in the index and instead are covered under abdominal pain.
Similar to Birch’s book on shonishin, Rossi also has a non-invasive approach to treatment, namely tui na massage. As one would expect, the techniques used on children are simplified versions of those used on adults and can be learnt quite quickly. The accompanying DVD is an essential component of this book, particularly for those who do not have a background in tui na. Though this cannot replace hands on training, the range of techniques and treatment areas are covered clearly and comprehensively. Interestingly, reference is made to a series of additional zang fu channels on the hand that apparently only exist in children. This may be unfamiliar to many practitioners; yet regrettably, no reference is given for the source of this information. The book describes and illustrates all the techniques and tui na treatment options. However, for those unfamiliar with the terminology, it would be helpful to have small diagrams of treatment strategies, in the treatment sections, as otherwise it involves referencing back and forth between chapters. This would be more useful than the illustrated chapter on commonly used acupuncture points, which is material that is already covered in many points text books and should be familiar to all qualified practitioners.
Home therapy is an integral part of the tui na treatment and the DVD illustrates how this is taught to parents in Rossi’s dedicated paediatric clinic. The younger the child, the more relevant tui na is and as the child gets older, the more acupuncture is emphasised. The numerous case histories at the end of the book are listed chronologically according to the age of the child, which helps to illustrate when tui na or acupuncture are more appropriate.
The DVD certainly gives a flavour of Rossi’s approach in clinic with both children and parents. In contrast to the more gentle approach of tui na, I was surprised to see quite deep needling with strong stimulation and retention of needles in children even as young as two years old, in which Rossi was eliciting quite distinct de-qi sensations. Although she is calm and reassuring on the DVD, at times it is clear that the child finds the needling very uncomfortable. It would need an experienced and confident practitioner to be able to work in this way and still ensure that a child is willing to return for more treatment.
Rossi brings to life the clinical experience of treating children in all its aspects. Her philosophy is to fully involve children in whatever way possible, dependent on their age and stage of development, asking the child to tell her for example when the needle and the body are talking to each other and getting the child to help her remove the needles! She prefers this approach to one of distracting the child and believes that a more direct approach is important for the development of the child.
Rossi’s detailed explanation of the theoretical background to childhood diseases and her practical approach to treatment from many angles is a welcome addition to the increasing compendium of paediatric acupuncture texts. I particularly enjoyed learning more about the use of tui na, aided by the clear descriptions and illustrations as well as the practical demonstrations in the DVD. Aside from the minor criticisms regarding ease of reference, I would certainly recommend this book to anyone interested in expanding their knowledge and skill base in the treatment of children.
Marian Fixler Marian Fixler has been in practice since 1991. She was a Senior Lecturer for many years at the University of Westminster and currently teaches and organises courses on Japanese acupuncture in the UK and the Netherlands including Japanese paediatric acupuncture. She has also attended courses in tui na massage. Marian runs clinics in North London and worked for many years on the NHS in a GP practice. She has published a number of articles including a recently published paper evaluating her NHS work, collaboratively with colleagues at the University of Westminster.