Radha Thambirajah First English edition translated from the German. Published by Churchill Livingstone Elsevier, 2010 Hardback, 459 pages Price: £44.99
(Reviewed by Peter Mole, EJOM Vol. 6 No. 5)
Anybody tempted by the title of this book to think that it will provide an easy way to practise Five Element acupuncture as developed by J.R. Worsley is in for a disappointment. What they will get, however, is a fascinating description of a style of acupuncture never previously described in print (at least to my knowledge). Despite having been based in Walsall for many years her style is almost unknown in the UK. She is much better known as a teacher in Europe, especially in Germany, where this book was first published. It is obvious that the author has a huge amount of clinical experience.
The book also provides a tantalising glimpse into the development of TCM (if we define TCM as that form of Chinese medicine promoted in recent years by the government of the Peoples’ Republic of China). The author grew up in Sri Lanka and, owing to her membership of the youth wing of a Maoist political party, was invited to study in Shanghai for four years, 1966-70. In the 1960s China was almost completely closed to outsiders and few, if any, in the West had any idea what was being taught in the colleges of traditional medicine.
In 1966 Shanghai was one of the centres of the Cultural Revolution. This was the era when respected teachers in any discipline were often sent to the country for ‘re-education’. Radha studied at the Shanghai Military College, which (along with the military in general), was relatively sheltered from this upheaval. She therefore predominantly learnt from experienced teachers of Chinese medicine. The treatment protocols that Radha learnt in Shanghai form the basis of this text. They are never described in any of the TCM textbooks that emerged from China in the 1970s and 80s or subsequently.
This is part of a general movement that has relegated the Five Elements to a minor role in the theory and to virtually no place in the clinical practice of TCM. One only has to look at the influential textbook, Acupuncture – A Comprehensive Text which emanated from the Shanghai College of Traditional Medicine in 1974 to see how much variation there was between different colleges in the same city and over a few years. As it says ‘A mechanical application of the theory (Five Elements), however, such as basing the selection of points solely on the Five Phases is never recommended in this text and is actively discouraged’. And yet this is exactly what the author was learning across the city only a few years previously.
The methods of diagnosis set out in the book are similar, but not identical, to what any student or practitioner of acupuncture would recognise from the works of Maciocia and other writers. Familiar patterns or syndromes are used to differentiate a range of diseases. What is distinctive, however, are the treatment protocols used to treat these patterns. Points are not used as they are currently described in contemporary TCM texts as though they are herbs with specific ‘actions’. This is predominantly a twentieth century way of using acupuncture points and has been described by Mark Seem as ‘herbalised acupuncture’.
As the author puts it ‘ My approach – since the inception of my practice in acupuncture – has been that of ‘energy balancing’ – choosing points that would cause energy flow between organs in order to balance their quality and quantity.’
Five Element treatments She describes the use of points based on Nei Jing descriptions of point functions. Qi is transferred from where there is a relative excess to where there is a relative deficiency. Luo junction points, sedation points, tonification points and yuan source points form the basis of many of the treatment protocols. For example, for the treatment of short menstrual cycles and excessive bleeding caused by Kidney and Liver Fire-heat, she recommends treating Kid 4 (luo point tonify yin and sedate yang) Ren 3 (mu point of Bladder – cools and calms) Bl 40 (Earth point Grandmother point – tonifies yin of uterus) Liv 5 (luo point – tonifies yin and sedates yang) Sp 6 (Distal point for lower warmer)
Point selection also takes in other aspects of traditional acupuncture that find no place in contemporary TCM. The diurnal flow of qi based on the Organ Clock is often taken into consideration so horary points are found in many of the treatment protocols. The use of Entry and Exit points is also discussed and recommended in some situations. Some use is also made of so-called empirical points, e.g. Ki 6 a ‘wake up’ point or Sp 10 for allergy.
For any TCM practitioner this book therefore outlines a completely different methodology for choosing points to treat patterns or syndromes that are familiar to them. It is unlikely that many practitioners are going to completely change their usual criteria for point selection because of reading this book. This book, therefore, may seem too different to many practitioners’ familiar practice to be of much use.
But there is much clinical wisdom to be found within its pages. Her variations to conventional diagnoses are interesting in their own right but her method of treatment is worthy of serious consideration by practitioners who are eager to expand the variety of treatment principles they can offer their patients.
If this book serves to remind us that TCM, until very recently, was nothing like as homogenous as it now currently appears, it will have served a very useful purpose. If it also helps to re-instate the Five Elements and the concept of ‘energy balancing’ at the heart of some acupuncturists’ clinical practice then perhaps it may have served an even greater good.
Peter Mole Peter Mole has been practising acupuncture since 1978. He is Dean of the College of Integrated Chinese Medicine in Reading where he also teaches. He has written a book for the general public entitled Acupuncture for Body, Mind and Spirit. He has also co-authored a major textbook entitled Five Element Consitutional Acupuncture.