The article is my professor, Mark Petruzzi wrote for the North American Journal of Oriental Medicine in their Nov 2023 issue on using the teishin at Stony Brook Children's Hospital. Great examples for Teishin's application. His shonishin padiatric acupuncture class will come soon......Please stay tuned for our news.
Bringing Teishin to Stony Brook Children’s Hospital
By Mark Petruzzi
For the past 10 years, I have held privileges at Stony Brook University Hospital and
Stony Brook Cancer Center on Long Island, NY. I was a presenter at their 2016 and 2017 Pediatric Palliative Care Conferences for Pediatric Oncology, giving talks and
demonstrations on Shonishin (Japanese Pediatric Acupuncture), moxibustion and Lymph Drainage Therapy. Thru parts of 2020/21, I attended weekly morning rounds for inpatients on the pediatric oncology floor, identifying the appropriate patients for
treatment and how they could benefit. In 2022, I began an acupuncture and integrative therapy program at Stony Brook Children’s Hospital, emphasizing the Traditional Japanese styles, teishin and shonishin.
A typical day at the Children’s hospital begins with morning rounds with the pediatric oncology (PONC) group. I discuss cases with the attending physician, do some education with the families of any child I have not seen before, and provide treatment. After I finish on the PONC floor, I will check with the acute care team (which sees all newly admitted patients) and the pediatric intensive care unit. Periodically, I will be called into the outpatient children’s cancer center which is attached to the children’s hospital.
I explain to the children and their families that, rather than targeting their disease process, my focus is to support their system in functioning as optimally as possible before, during and after their allopathic treatments.
Dispersed throughout the remainder of this article are some examples of my clinical
experiences in using the teishin at Stony Brook Children’s Hospital.
A 5 day old baby was on her way to the Neonatal Intensive Care Unit (NICU) with elevating bilirubin levels that were not responding to the prescribed blue light therapy. She received one teishin treatment (less than 5 minutes later in the NICU, went back under the lights her numbers started to improve!
The teishin (blunt/millet head needle) has become the treatment tool of choice for many of our young patients. The rounded point quickly puts the child at ease when they see/feel it, providing a sharp contrast (pun intended) to the hypodermic needles they are frequently being poked with. It’s versatility allows treatment to be given in almost any circumstance. The child can receive treatment in any position, no matter how intertwined they are with wires, tubes or parent’s arms. Applied with a soft touch that is non-insertion, it eases concerns of infection with extremely low WBC counts and removes any worry of bleeding in exceedingly low platelet counts, post stroke, or other situations where the patient needs to be on high levels of blood thinners.
The comfort provided to the patient when utilizing these gentle teishin techniques
quickens the practitioner’s ability to settle into their hands and broaden their gaze;
moderating dosage at the acupoint or along the channel. This enables the continual assessment of the “palpable physiological reality of the channels” 1 that is fundamental in the traditional Japanese styles.
An 11 day old baby with continuous vomiting was suspected to have pyloric stenosis. I gave a full body teishin tx with some additional stimulation (TST-hamon/ripple technique) over the major junctions of the GI track (ileocecal valve, Duodenojejunal (DJ) junction, sphincter of Oddi, pylorus, and Gastro-Esophageal (GE) junction). The treatment was once again no more than 5 minutes. I treated the baby (who fell asleep directly after) in grandma’s arms, and then I treated mom. The attending physician pulled me aside the next day I was at the hospital and said, “grammy told me you changed the whole energy in the room; she relaxed, mom relaxed, and the baby stopped vomiting.”
Children respond very quickly to treatment. This quick responsiveness will be amplified if the child is dealing with a severe illness (such as cancer), as their allopathic treatments typically involve toxic levels of medications, which can leave their system extremely volatile. As a general rule, the younger and/or weaker the child, the shorter and more gentle the treatments become.
The shonishin treatment appears very simple; rhythmic stroking and/or tapping with the teishin to the arms, legs, abdomen, back and head; along with some focused stimulation on a few key acupuncture points. Underlying this simplicity, however, lays complexity. The complexity of the changes that happen under your hands while stroking or stimulating with the tei shin. Appreciating temperature, texture, tone and fluid fluctuations; thixotropic phase change and piezoelectric discharges thru the fascia. Assessing these changes will enhance, and in many cases, decide treatment effectiveness.
10 year old boy admitted with weakness, pain and paresthesia in his legs (and a lesser extent his arms) causing an inability to stand on his own. He was given a full work up by pediatrics, orthopedics and neurology, with nothing notable found. On palpatory assessment, he was a LIV Kyo pattern with Shao Yang Channel jitsu. There was increased tension in the skin around the left UB-52 area (with a fascial
pull inferior/lateral likely indicating perifascial tension around the lateral femoral cutaneous nerve); decreased pulse strength at left KI-3 (post tibial artery) and Lt UB40 (popliteal artery). He received one treatment with the teishin along with some Lymph Drainage Therapy. Reassessment revealed signs of improvement in the pulse and abdomen; his fascia tension thru the Gall Bladder channel and at Left UB52 softened and the KI-3/UB-40 pulses strengthened. I checked in a few hours after the session, the boy reported feeling “a lot better” with his pain and paresthesia significantly reduced. He was able to be discharged later that day for further follow up, in an outpatient setting.
The traditional Japanese styles view the surface (skin and subcutaneous layer) as having the most yang ki, making it the most reactive and the most malleable. Teishin (and other contact needling techniques) can have a larger global response in the system. Modern understandings of the ontogeny of the skin begins to provide some explanation. The skin is derived from the same embryological tissue as the CNS. The most superficial layer of the skin, the epidermis (0.06-0.2mm), is mainly made up of keratinocytes. According to skin scientists Dr Denda and Dr Nakanishi(2), “Mechanical stimulation of the skin surface activates neuronal nitric oxide synthase (nNOS) in the keratinocytes, leading to release of nitric oxide (NO) from the epidermis. Keratinocytes stimulate anti-inflammatory mediators, activate/recruit neutrophils, macrophages and T-cells, release oxytocin (bringing about feelings of bonding and comfort), and activate TRPV1 expression (enhancing thermal regulators and vasodilation).”
This global response can also illicit effects that are less tangible, but no less profound. Incorporating teishin into the treatment enhances your ability to quiet the heart and calm the spirit.
A 20 year old male in end of life care, told the doctor’s on his last few visits, he didn’t want to see them...he only wanted his acupuncture treatment. He would be taken in on a wheelchair and needed two family members to help him onto the treatment table. He was clearly in a lot of pain, and needed to be propped with many pillows to find a comfortable position. While working work with the teishin, he would quickly drift into a more peaceful state; the visible tension on his face would soften and his breathing would deepen. Even thou his body was riddled with tumors, he would concurrently have a considerable decrease in pain level along with an increased sense of calm.
The subtle and refined techniques of teishin have an aesthetic beauty. The treatment becomes a fluid dance, adapting as the child’s system responds. The clinical effectiveness, however, is driving its recent resurgence. The consistent positive results are permeating thru the Children’s hospital and have sparked discussions for increasing the acupuncture presence both for patient care, and in resident education. I am humbled to be in a position to help to these children, and
hope that this work lays a foundation to expand the use of teishin, shonishin, and the traditional Japanese styles in this and other integrated facilities.