Robert Chu is the consummate Chinese-style healer. He strives to embody the traditional Taoist ideal of skillful mastery in all of the important disciplines of humanity. He studied the martial arts; became a wing chun sifu (master); and dabbled in tuina, dit da ke (traumatology) and herbology for 30 years before making the career shift to acupuncture. Now his research and clinical experimentation have provided him with valuable insights about the amazingly effective acupuncture style of Master Tong.

Brian Benjamin Carter (BBC): Tell us about your progression from TCM acupuncture to the style you practice now.

Robert Chu (RC): In my experience, the TCM method used too many needles, was too slow, and yielded mediocre results. I recall seeing a patient with sciatica. I inserted six-inch needles into GB30, and needled bilaterally at UB40; UB60; UB57 and innumerable ashi points. She got up off the table with minimal relief 45 minutes later. That really frustrated me. I sat up night trying to understand my mediocre results. I read a bunch of acupuncture books. When English ones didn't cut it, I read Chinese books. I found out that TCM is herbalized medicine · they took herbal theory and developed an acupuncture around it. TCM acupuncture is based on herbal paradigms: the Eight Principles; Shang Han Lun; Wen Bing; San Jiao; and Zang Fu. Often, those paradigms don't fit acupuncture theory. TCM was designed for quick an easy dissemination · as an answer to desperate medical needs in the rural areas of China. It's not that TCM acupuncture is not good · but there are better methods. I studied what they'd done for centuries before TCM. Acupuncture was based on the channels and collaterals, not herbal-style functions.

BBC: Your own style of treatment incorporates theories and techniques from a number of traditions. How did it develop?

RC: I have drawn from the best in acupuncture. My system is based on Master Tong's (dong jing chang). 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).

I learned Korean sasang constitutional acupuncture from my good friend, Jacques Mora Marco. I do Korean-style sa am acupuncture. I also use some unusual methods of chronoacupuncture (based on time and day) called ling gui ba fa and zi wu liu zhu. I've studied Japanese methods of acupuncture, and am 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 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. Dr. Tan's ba-gua-based balance method really interested me, especially since I studied Daoism and Chinese martial arts. I later found out that Dr. Tan found his fundamental methods in Chen Chao's work.

BBC: Chen Chao · who's that?

RC: Dr. Chen created an acupuncture system based on the Yi Jing (I Ching). Dr. Chen published seven books in the mid-1970s. He explained the ba gua/Chinese medicine relationship and how to balance the channels. He uses the xian tian ba gua, the hou tian ba gua and the tai yang ba fa. Xian tian ba gua is Fu Xi's ba gua. Each of the 14 channels equates with a gua (trigram), and they balance one another. For example, if there's right knee pain along the spleen channel, left Lu 5 will treat it, because hand tai yin balances foot tai yin. Limbic and symptomatic pain disappears immediately. It's remarkable!

Hou tian ba gua is Wen Wang's ba gua. The five elements are superimposed on the eight 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 the symptoms. This works great for internal medicine problems.
The tai yang ba fa is a unique way of using the eight extra channel points. Chen Chao's configuration is to balance the ren (Lu 7) and du (SI 3); the yin wei (PC 6) with yang wei (SJ 5); yin qiao (K 6) with yang qiao (UB 62); and chong (Sp 4) with the dai mai (GB 41). This one has broad applications.

BBC: You emphasize imaging methods (a.k.a. microsystems). For example, what is the metacarpal bone system?

RC: I expanded the curriculum of the microsystems class at Samra University to emphasize practical methods. I taught the 12-point system of the second metacarpal bone, a system that can treat the entire body with just a few points that stretch between LI 3 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 that acupuncture should work instantaneously! I also taught periocular, Nogier and Chinese ear, face, nose, hand, foot, wrist and ankle microsystems; sa am acupuncture; Tong's acupuncture; and various styles of scalp acupuncture. In the Tong system, the eight imaging methods explain how to choose non-channel points and regular channel points.

BBC: How do you decide when to apply these systems?

RC: I decide 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 TCM doesn't help, I'll try the Tong system, or metacarpal bone, or the hand acupuncture system. I then let the patient get up and walk around with the needles in their arm or hand. Then we can see what works. Patients like this. They want a physician who's always learning, who's willing to experiment, and who doesn't have all the answers.

BBC: Miriam Lee's book (from Blue Poppy Press) about Master Tong is long on points and short on theory/principles/concepts. What are we missing out on?

RC: I don't think Miriam Lee left out anything on purpose. Her book is a reference for Tong points based on her clinical style. It has a lot of practical value, and it's a great introduction for English speakers, but I'd advise studying the treatment formulary to see how to apply the system, rather than memorizing all the points.

I learned some of the Tong style in school, and Dr. Tan's work influenced me, but I wanted more. I applied Miriam Lee's Master Tong acupuncture in my clinic. Some point locations were off, and the 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. We met to discuss what was in Master Tong's system and how Miriam Lee differed. Ester suggested I seek out Dr. Young. I attended his classes on Tong's points and read his works in Chinese. I later bought a library of books by Tong's students in Taiwan, and the whole puzzle became clearer. I started getting great results in the clinic, almost instantaneously, with Tong's method.
I disagree with Blue Poppy's version of the Tong system's history. From the different books on the Tong system, it's clear that students that stayed with him at different times learned different points. He was constantly creating something new - experimenting and modifying points - based on the clinical results. I suspect he created the whole system. I think he was a genius.

The Blue Poppy book is also incorrect in certain point locations. For example, ren huang is not the same as Sp 6. Ren huang is higher. Most people locate Sp 6 from the lower tip of the medial malleolus. Ren huang is three cun above the top of the medial malleolus.

There are too many other errata to mention here. My advice would be to find an experienced Tong practitioner like Esther Su or Frank Chong to learn the proper locations of the points. (Note: Susan Johnson, another of Miriam Lee's students, is preparing a book of corrections.)

BBC: What's unique about Master Tong's acupuncture style?

RC: Master Tong's style emphasizes bleeding, especially on the torso. Fang xue ("bloodletting"), in certain circumstances, clears the channels more effectively than regular needling. I use a modern lancet device, usually after we've tried other methods and the patient knows me better. Master Tong's system includes Five Elements bleeding - a technique of bleeding across the areas of the Five Elements on the limbs and body. I also bleed stubborn arthritis or heel spurs.
Patients respond well - usually a drop or two is all you need. Classically in the Tong school, they cup right after bleeding, and fill the bottom of the cup with blood. Many acupuncturists will be hesitant to do this. Some patients - and doctors - will faint at the sight of blood! Master Tong's methods also emphasized varying depths of needle insertion; no manipulation of the needle; needling contralaterally while a patient exercises the painful area; and needling according to the proper time and season.
Also, in the Tong school, they use palm diagnosis to diagnose a patient for internal disorders.

BBC: Why do you think acupuncturists practice the way they do?

RC: I believe acupuncturists practice what they know. Esther Su said to me, "People may know many different things, but not put enough mental energy in to really delve into any of them."
In the U.S., we have many systems from different countries. Most acupuncturists practice a blend of systems. There's a lot of information out there: some of it good, and some that's rather "foo-foo." If you don't know the basics of Chinese medicine, how can you distinguish good from bad? You can judge a system by its clinical results.

I have two mottoes in life: "Let application be your guide" and "Let function rule over form." It seems a lot of acupuncturists use the points they were taught, but don't always know the theory behind them. For example, TCM teaches the back pain formula UB 23, UB 40, UB 57, yao tong xue, K3, etc. You can follow this cookbook recipe, but when it doesn't work, what do you do? The more tools you have at your disposal, the more options you have.

BBC: What does this mean for U.S. acupuncturists and their patients?

RC: Patients may not be treated by an expert, but by a technician or mediocre practitioner. Ultimately, our profession develops a bad rap for being ineffective. Clinicians should have a deep hunger to be the best. Research, study, learning and practice should be a way of life. You owe it to yourself and your patients to be the best you can!

Attend lectures and seminars; read books and case studies; listen to audio tapes; apprentice yourself with great practitioners; have mentors and role models; and research as much as you can. Then apply it in the clinic. This way, the level of acupuncture in the U.S. will improve, and we'll grow. The better your results with patients, the more they refer, and the more your practice grows.

BBC: What are your clinical goals with acupuncture, and how do you achieve them?

RC: What counts with acupuncture is results. I see about four patients an hour, and each patient is on the table for 45 minutes. Pain patients should feel relief immediately. In internal medicine cases, they should feel profoundly relaxed and their symptoms should subside.

My goals are flexibility and efficiency. There are many styles - if they get results, then great. TCM acupuncture is just a beginning · the basics. I built my style upon that foundation. As you develop and test your methods clinically, theory gives way to principle. Daily, you improve in ability and understanding, and try to get good results every time. If you follow a "paint-by-numbers" method, your results will be inconsistent, because every patient is different. That's the difference between the principle-based approach and being a technician.

My method is easy, but one should have the basics in TCM to understand why I do things differently.
I focus on many different strategies: Needling on the more sensitive contralateral side is better than bilateral needling. Fewer needles are better. Distal points get results immediately - faster than local or ah-shi points. I use thinner gauges than the 28 gauge needles they use in China. I sometimes go for a milder de qi sensation. I leave the needles rather than stimulating, because the qi will arrive anyway. Instead of inserting the needles without directing needle sensation, it is better to control it. For greater effect, patients can exercise their affected area while the needles are in. I am ambidextrous and needle from any position, and instead of choosing points "by the book," I always have a reason for the points selected according to imaging, point category and/or channel relationship.
I use these methods because I've found that they work better for my patients. I believe practicing these methods can make a mediocre practitioner into a great clinician.

BBC: What do you think about practitioner ethics? What kinds of attitudes should we have toward our patients, other practitioners, and the medicine as a whole?

RC: I believe a medical professional needs to develop a compassionate heart. I see some doctors who are just driven by money or profit, but we must remember we are healers first. Sometimes it is necessary to extend charity to a patient. Many times our patients are suffering long term, and we are their last resort. We have to take a proper history, understand their suffering, and use our medicine as a vessel to deliver them from their suffering. Often it's not easy; patients are depressed, frustrated, cynical, angry, and have no hope.

We have to empty ourselves, focus on the patient's needs, and tell them if we cannot help them. Since Chinese medicine is based on harmonizing and balancing. We should fit in the moment and be appropriate and apply medicine at hand. Sometimes it's not just herbs or acupuncture, but counseling them properly - how to behave, how to eat, what to think. A skillful practitioner helps his family, friends and community to be healthy. This is the proper mindset for a practitioner.

BBC: Thank you for sharing your experiences and insights, Doctor Chu.

RC: My pleasure!

Brian Benjamin Carter, BPh, HHP, CTM
San Diego, California

Robert Chu can be reached at the Upland Pain Relief and Rehabilitation Center, 876 North Mountain Avenue, Suite 107, Upland, CA 91786. He may also be reached by phone at (909) 920-3465, or online at chusauli@aol.com

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