One of the things I find so interesting about your Child Massage is how you influence the whole body through the hand and forearm. I am familiar with reflexology but your system and application is quite different. Your system as I understand is based in TCM diagnosis and treatment. Your treatment in 2002 of a polyp on the vocal cord is quite amazing.

http://www.urban4est.com/childtuina/houjing4.jpg

If you are traveling in Northeast China with children be sure to take Dr. Zhang's address and email with you. Just in case of emergency or to see this amazing branch of TCM. Dr. Zhang and her Mother are gracious hosts.

Dan,thank you joined my group.Your skill is great too.I remember that old lady who you massage for her in my clinic.When you ended the massage for her,her shoulders were better than before and she praised you with "miraculous".Then she turned up her thumb for you.

Hello Dr Zhang, thankyou for taking the time to join MBP. I am looking forward to learning much about methods, although I do not treat many children myself.

Yes I remember that fondly. I hope sometime I have a chance to visit again and study more from you.

Welcome to China to visit or learn my Tuina.
Luck,Zhang Yu.

Hello Stephen Jeffrey,thank you to join my group.Hope you would like to learn my child massage.You can treat children in the future.
Regards,Zhang Yu

Hi Zhang Yu Please may I ask this question ?
Previously the importance of fascia had been totally overlooked. Now here in the West we have had a huge renewed interest in fascia, its bodywide connections and nerve activity. It's now thought possible, fascia may offer a pathway for explanation for accupuncture meridian's, reflexology etc. (the missing link for science and research)
Is there any excitment in China, re fascia as missing link or have your anatomists already established a working knowlege of its function?

I found this in the Chinese medical dictionary.

筋膜　　
筋膜位于肌肉的表面，分为浅筋膜和深筋膜两种。 　　
1）浅筋膜 位于皮下，又称皮下筋膜，由疏松结缔组织构成，其内含有脂肪、浅静脉、皮神经以及浅淋巴结和淋巴管等。脂肪的多少因身体部位、性别和营养状况不同。临床常作的皮下注射，即将药液注入浅筋膜内。 　　2）深筋膜 位于浅筋膜深面，又称固有筋膜，由致密结缔组织构成，遍于全身且互相连续。深筋膜包被肌或肌群、腺体、大血管和神经等形成筋膜鞘。四肢的深筋膜。伸入肌群之间与骨相连，分隔肌群，称肌间隔。 　　
筋膜 　　
解剖结构名。指肌肉的坚韧部分。附于骨节者为筋，包于肌腱外者为膜。是联络关节、肌肉，主司运动的组织。为肝所主，并赖肝血的滋养。《素问·痿论》：“肝主身之筋膜。” 1 is superficial fascia and 2 is deep fascia as my bing translator gives it from the medical dictionary.

Compartment Syndrome uses fascia in the Chinese word for it.
Which I find interesting 筋膜间隔区综合征. The word directly translated would be syndrome of the fascial interval, I believe.
科技名词定义
中文名称：筋膜间隔区综合征 英文名称：syndrome of aponeurotic space 定义：肌间隔内压力增高而造成间隔内血循环、肌肉、神经等重要组织结构的功能障碍，组织坏死的综合征。 所属学科： 中医药学（一级学科） ；骨伤科疾病（二级学科） ；扭挫伤（三级学科） 本内容由全国科学技术名词审定委员会审定公布
百科名片
筋膜间隔区综合征，英文名：compartmentsyndrome，别 名：间隔综合征；筋膜间隙综合征。筋膜间隙综合征(compartmentsyndrome，CS)系肢体创伤后发生在四肢特定的筋膜间隙内的进行性病变，即由于间隙内容物的增加，压力增高，致间隙内容物主要是肌肉与神经干发生进行性缺血坏死。
The word directly translated would be syndrome of the fascial interval, I believe.
The dictionary provides three and a half pages of fascia terms. These are mostly specific fascia related to organs and muscles.

Stephen, I found this thread online fascinating http://www.ttem.org/forum/index.php?topic=1807.10

Some such as Professor Dr. Yuan Lin, from Guangzhou have been investigating the anatomical existance of meridians and acupoints. He concludes that the fascial network of the human body was the anatomical basis. He now proposes to study the fascia network - what he calls the supporting and storing system - in new discipline named fasciaology.

I wonder if there are more researching in this direction. Perhaps Dr. Zhang knows of such research in China, as well as the status of fascia in TCM.

Hello Stephen Jeffrey, I found this for you .Maybe it benifits to you.This site is all about acupuncture.(http://www.med126.com/yingyu/tcmyy/zhenjiu/)
You click the Chinese and will show the English.
This site is a part of the acupuncture to heal fascia hurt .(http://www.med126.com/yingyu/2008/23420.shtml)
I hope it can help you.
Zhang Yu

In the link http://www.med126.com/yingyu/tcmyy/zhenjiu/ you will find the English articles by clicking the navigation link on the second line of links first from the left. It reads 中医英语.

Dr. Zhang, these articles explain TCM meridians and Qi but do not make any clear reference to fascia 筋膜　that I find. Are there any internet studies by Dr. Yuan Lin or others that might be translated to English that demonstrate a relationship between meridians and fascia? It would be interesting if the meridians follow or have a relationship to lines or configuration of the fascia. In the USA the study of fascia is very new and quickly has added to the understanding of the body.

Stephen, from what I witnessed at Dr. Zhang's clinic she and her Mother are manipulating the Qi in the youngsters' bodies through very light touch on fingers, palm and forearm of the left hand. These are strokes toward the body or outward to increase or decrease the Qi. They are done repeatedly for a time and repeated over days. If the fascia is involved it would be interesting how such manipulation can change organ condition.

Xiao Er Tuina is different from other TCM because it works on the undeveloped meridians of infants and children and is used for every type of ailment. Is the fascia system fully developed at birth?

Child Tuina while different in application from General Tuina, it uses diagnosis and some prescription of TCM. Dr.Zhang did I understand this correctly, if not please correct me.

Hi Zhang yu and Daniel
thank you so much for this invaluable information, I will make it available for discussion in other groups, it seems a monumental shift in anatomical, physilogical thinking and teaching is required across many professions :)

The Child Tuina is called Xiao Er Tuina too in China.Xiao Er Tuina is an amazing branch of Traditional Chinese Medicine.The method can treat all the childhood diseases.And you cann't find it in the book of Traditional Chinese Medicine . The wonderful massage skill is from the folk.Welcome to discuss.

Zhang Yu

My Child Tuina(massage) points only on the hand and the forearm.It's easy to do .Only need the child's left hand to massage.
The different points toghter can send the massage energy to different organ and Meridian of the body. My child massage isn't the TCM Meridian massage.It's a special massage. It handed down from my ancestors.You need to do the diagnosis and treatment based on an overall analysis of the illness and the patient's condition.
The children can accept it easily. The massage has an immediate effect.It needn't take medicine and inject.Have no hurt and dread.So my child Tuina(massage) is the first choice to heal diseases.
Zhang Yu

My Tuina not only treat children but also treat adults diseases too.The effect is the same.At first,I need to know your body situations,then I teach you how to massage .You can massage for your family or yourself.

I know the patient's condition first,then I do the overall analysis of the illness and teach you the Tuina method. I can teach you by the cam.Only Tuina hand and forearm.Anyone can learn.
Zhang Yu

My friend and Teacher would like to introduce her Xiao Er Tuina to America and train Massage Therapists.

" I can teach my Tuina massage privately.You can come to my town or by learn cam to cam.

The parents can learn it too and I do the overall analysis of the illness for you or your child first.

Pay for $500 to learn one disease massage method.

You can apply the disease and I teach you how to work on any type of disease.


Zhang Yu, born in a well-known family of TCM in Dandong City. She lives and practices in Liaoning province,China . She currently holds the following positions;Superintendent of Xiao Er(Pediatric) Tuina Massage Health Care Clinic of Liaoyang City, Liaoning Province. TCM Tuina Senior Technician. TCM Tuina Senior Lecturer. Chinese TCM Healing Therapy and Health Care Committee Specialist. She was awarded "Special Skill Celebrity" and "Chinese Medicine divine physician". Having undertaken patrimonial TCM Xiao Er Tuina from 1995. Managing more than 140 kinds of children’s illness. Having released several disquisition.Bookmaking:《Chinese Xiao Er Tuina》. The name of my clinic had been catalogued in the book"Cuansu of Chinese TCM Medical Institution"by Chinese State Administration of Traditional Chinese Medicine .
In past years, on the base of knowledge from upper generations, I got many valuable experence from practice. I summarized a new principle : “Same prescription for different diseases, same disease using different prescription”. I have healed many cases that former doctors haven’t met, or dare not take , or thought impossible. And even created quite a few miracle that western doctors couldn’t believe. In practice, I used Xiao Er Tuina for adults also and had healed many cases. That created a new field of Xiao Er Tuina. This skill had already attracted foreign massagists to come and learn Xiao Er Tuina. This promoted the international exchange of Tuina.


Tuina fit for 0-18 years old children Or adults(with different price).



Application

1. Head and the five sense organs :

Headache / Vertigo / Cerebral Concussion / Waterhead / Newborn Cerebral Hemorrhage / Sunk Fontanel / Bulging of Fontanel in Infant / Eye Dryness and Xenophthalmia / Eye Congestion and Pain / Eye Itching / Stye / Pteryguim in Eye / Blurring of Vision / Eyelid Inability / Strabismus / Eye Hemorrhage / Rhinitis / Epistaxis / Hypertrophy of Adenoids / Indisposition / Globus Hystericus / Chapped Lips and Cheilitis / Wagging Tongue / Thrush / Oral Ulcer / Halitosis / Excessive Salivation in Children / Toothache / Inflammation around Tooth / Teeth Hemorrhage / Swelling Gum / Tympanitis Combined with Mastoiditis / Tinnitus and Deafness / Flaccidity of Nape / Neck Ridigity and Pain of Nape / Facial Edema

2. Respiratory system:

Common Cold / Laryngitis / Tonsillitis / Acute and Chronic or Frequent Bronchitis and Pneumonia / Asthma / Cough

3. Digestive system :

Vomit / Tympanites / Diarrhea / Bellyache / Anorexia / Much Eatting and Easily Hungry / Hiccup / Astriction / Rectocele / Hemorrhoids / Appendicitis / Abdominal Distension / Indigitation / Hernia / Crissum Inflammation

4. Urinary system :

Frequency of Micturition / Urgency of Urination / Urethral Painful Swelling / Hematuria / Turbid / Retention of Urine / Urinary Incontinence / Enuresis / Nephrotic Syndrome / Nephritis.

5.Circulatory system

Myocarditis / Palpitation / Angina / Arrhythmia / High Blood Pressue / Hypotensive / Anaemia

6. Nervous system :

Affright / Falling Sickness / Convulsion / Walkabout Disease / Crying at Night / Paralysis / Trigeninal Pain / Neurasthenic / Insomnia / Alogia / Hyperactivity / Impediment / Somnolence / Heteroptics and Delirium

7.Dermal system :

Heat-Syndrome in Newbon / Chicken Pox / Drug Rash / Eczema / Papular Eruption
/ Urticaria / Irritability Purpura / Carbuncle and Furuncle / Newborn Flesh Stiffness / Navel Inflammation

8. Others:

Durative Neonatal Jaundice / Long Low Fever / Spontaneous Sweating / Night Sweat / Heliosis / Arthralgia-Syndrome / Tumour / cyst / Granulation / Hydrocele / Edema / Parotitis / Dysentery / Uterine Prolapse / Leukorrhea Diseases / Pelvic Cavity Inflammation / Hypochondriac Pain / Delayed Development / Lassitude / Metrostaxis / Mastitis / Cold Hands and Feet / Hot Hands and Feet / Lumbago / Urine and Stool Emphraxis

Tuina(massage) knowledge

　
Diagnosis of pediatric diseases
As the infant can not express the disease,the doctor infer the disease only from asking the relatives of the patient and inspection,auscultation and pluse-feeding.So it is also called mute department.
Inspection
observation of physical condition and behavior


complexion


sprout and orifice
eyes,nose,ear,lip,throat,teeth,tongue,two lower orifices
hands and feet
superficial collaterals of the index finger

Auscultation and Olfaction
crying
voice
breath
cough
odour
Inter-rogation
cold and heat
sweat
head and body
urine and stool
diet
sleep

Pulse take and Palpation
Pulse
floating
deep
slow
rapid
taut
slippery
Palpation
head and fonticulus
skin
abdomen
limbs
Bianzheng
Assaying and synthesizing the history,symptoms and signs etc.to draw a
correct conclusion is called Bianzheng.It conclues Eight Principles Bianzheng,
zang-fu Bianzheng,causes Bianzheng,Tri-energizer Bianzheng,Qi-blood Bianzheng
etc.
Eight Principles Bianzheng
Exterior and Interior
Exterior
exterior cold
exterior heat
exterior excess
exterior deficiency
Interior
inrerior heat
interior cold
interior excess
interior deficiency
Both Exterior and Inrerior
Cold and Heat
Cold
deficiency cold
excessive cold
Heat
deficiency heat
excessive heat

Deficiency and Excess
deficiency syngrome
excess syndrome
Yin and Yang
Yin syndrome
Yang syndrome

Zang and Fu Bianzheng

Heart
Heart -yang deficiency
heart-yin deficiency
heart-fire flaring
mental disturbance due to phlegm-fire
breakdown of coordination between heart and kidney
qi and blood deficiency in heart and spleen
Small Intestine
small intestine deficiency
small intestine excessive heat
Liver
stagnation of liver-qi
hyperactivity of liver-yang
liver-yin deficiency
up-stirring of liver-wind
liver-qi attacking stomach
liver and kidney's yin deficiency
Gallbladder
gallbladder deficiency
gallbladder excessive heat
Spleen
spleen-yang deficiency
middle-qi deficiency
accumulation of damp-heat in spleen
accumulation of cold-damp in spleen
yang deficiendy ofspllen and kindey
Stomach
stomach cold
stomach heat
stomach deficiency
stomach excess
Lung
wind-cold attack of lung
obstruction of lung due to phlegm-damp
lung-qi deficiency
lung-yin deficiency
heat exopathogen attack lung
spleen-lung deficiency
Large Intestine
large Intestine cold
large Intestine heat
large Intestine deficiency
large Intestine excess
Kidney
kidney-yin deficiency
kidney-yang deficiency
eczema due to kidney-yang deficiency
failure in receiving qi due to kidney deficiency
fire flaring due to kidney-yin deficiency
lung and kidney deficiency
spleen and kidney deficiency



Tri-energizer Bianzheng

Tri-energizer including upper-energizer, middle-energizer, lower-energizer.Its
function is to control the qi activities and to make the passage of water unblocked.
Tri-energizer Bianzheng refers to a guideline to differentiate syndromesfor treating
epidemic febrile diseases.
Causes Bianzheng
Six Exopathic Factors
wind
cold
summer-heat
dampness
dry
fire
Seven enclogenous factors
joy
anger
melancholy
anxiety
grief
fear
terror

Non-endo-exo-pathogcnic factors
diet
fatigue
trauma
beasts and insects
drowning
phlegm

Contact Zhang Yu :

tnzy001@hotmail.com

Tel: (0086)419-2153966

(0086)13188609129

Weiguo Road 49-19#，Baita District, Liaoyang City, Liaoning Province,China (111000)"

Her is an online explanation of Pediatric Tuina
http://findarticles.com/p/articles/mi_g2603/is_0002/ai_2603000274/

Chinese pediatric message, or xiao er tui na, is a form of Tui na massage adapted to the special needs of children from birth to 12 years of age. The Chinese believe that a child's energy system is different from an adult's because children have fewer physical and emotional barriers in place. Their qi is therefore more accessible to treatment. The acupoints and techniques used in pediatric massage are different from those used with adults. A massage oil, typically sesame oil , is often used with children. The sessions are much shorter than those for adults, usually only 15-20 minutes, but they may be repeated several times a day for children who are seriously ill. Pediatric massage is used to treat such chronic conditions as asthma, bed wetting, and nightmares as well as teething, colic, nausea, fever, constipation, and the common cold . Parents often learn the basic techniques of pediatric massage as preventive health care for their children or to treat minor illnesses.

Xiao Er Tuina is mostly found in the provinces of Shandong and Liaoning. Some TCM Colleges in those areas teach Xiao Er Tuina in their curriculum. Dr. Zhang practices the traditional form of her family handed down from her Grandfather Dr. Li. It is an excellent treatment for parents to learn as they can work on their child's illness at home making it easy to give daily treatments.

Dr. Zhang my friend's baby has autism. Do you have a case of autism published that you could post here that I could forward to them?

Hello Dan,the TCM thinks the baby autism belongs "dementia",cause of the deficiency of heart, kidney,liver and spleen, so the marrow is not sufficient. I treat the autism's methods as same as the brain paralysis. The baby must can be changed if her/his parents to use my Xiao Er Tuina.You can tell them to pay for 500 dollars and I teach them how to Tuina for their baby cam to cam.At first,I need to know their baby's situations.For example,the appetite,the faeces,the urine,the sleeping,the sweat,the fur color of the tongue and the tongue color,if with the bed-wetting,the baby's hands and feet are hot or cold,if with the halitosis,etc.
To see the cases 24,25,26,37 what I cured.The line
http://www.massageprofessionals.com/profiles/blogs/china-zhang-yus-...

Hope the baby luck.
Zhang Yu

When doing Xiao Er Tuina oil is not used. Dr. Zhang showed me how to use Ginger water instead. It is regarded in TCM aas a meridian opener. Cut thin slices of fresh ginger and soak in a dish of water. When you do the strokes on the hand you dip your fingers in the ginger water.

Today I have a couple of reflexology treatments to do and I will try ginger essential oil on them. I often find that methods from one modality can be used in another of similar application.

Tomorrow I will make the ginger water and see if I notice a difference between the EO and the water.

There is so much to explore in bodywork.

You should choose the ginger water to Tuina when you think the patient belongs cold symptom.You dip your finger if you feel your hand and the patient's skin are dry.You don't choose the ginger water if the patient belongs the heat symptom.You should choose the talcum powder and put it on the skin.

Unfortunately Dr. Zhang has been unable get to the site for sometime. China's infamous internet control off and on has blocked this site from her access. I am posting some information for her that is on the internet.

http://www.urban4est.net/childtuina/Album1.htm Photos of some of the children she has treated and the illness they were brought to her for.

Diarrhea

 

 

 

 

 

 

 

 

 

 

 

child case of myocarditis

Dear Dan,I want to thank you so much.It's  effective what you post the information for me here.The blockade of the my website has been raised.I am so happy.Thank you again.

Xiao Er Tuina tools of diagnosis.

 

Traditional Chinese Medicine interpretation of condition used in Xiao Er Tuina (Chinese Pediatric Massage)

                             Tri-energizer Bianzheng

Here is a bit about Dr. Zhang from her Chinese website http://hi.baidu.com/childtuina/blog/item/c33625a37f8fd29bd1435885.html

 

  Zhang Yu, born in a well-known family of TCM in Dandong City, Liaoning provine,China . Superintendent of Xiao Er(Pediatric) Tuina Massage Health Care Clinic of Liaoyang City,Liaoning Province. TCM TuinaSenior Technician. TCM Tuina Senior Lecturer. Chinese TCM Healing Therapy and Health Care Committee Specialist. She was awarded "Special Skill Celebrity" and "Chinese Medicine divine physician". Having undertaken patrimonial TCM Xiao Er Tuina from 1995. Managing more than 140 kinds of children’s illness. Having released several disquisition.Bookmaking:《Chinese Xiao Er Tuina》. The name of my clinic had been catalogued in the book"Cuansu of Chinese TCM Medical Institution"by Chinese State Administration of Traditional Chinese Medicine .
            In past years, on the base of knowledge from upper generations, I got many valuable experince from practice. I summarized a new principle : “Same prescription for different diseases, same disease using different prescription”. I had healed many cases that former doctors haven’t met, or dare not take , or thought impossible. And even created quite a few miracle that western doctors couldn’t believe. In practice, I used Xiao Er Tuina for adults also and had healed many cases. That created a new field of Xiao Er Tuina. This skill had already attracted foreign massagists to come and learn Xiao Er Tuina. This promoted the international exchange of Tuina.

Massage knowledge

Massage is a branch of medicine, there are two thousand years of history. Early massage and tuina is no clear distinction, The word "Tuina" is not mentioned. Ming Dynasty, "Tuina" is really there, Tuina therapy as an independent system of formation and development. Therefore, the broad variety of massage, including massage today (such as Tuina certification full three year course), treatment of muscle and soft tissue injury of massage (such as frozen shoulder, cervical spondylosis, muscle strain of the massage), massage and treatment of disease. Ming and Qing Dynasties, reached the height of massage therapy, mainly for Treating childhood diseases, people there have been many famous works of massage practitioners and massage, and gradually into many genres.

Handling Precautions

1. Room should maintain a certain temperature, not hot or too cold, the air fresh.

2. The attitude to be kind, to trim nails, wash your hands before each performer.

3. Children's posture to sit comfortably, and strive to nature.

4. In the massage, the children left and right hands can be used, but both men and women on the habits, the use of children left hand. If local skin damage, ulcers, fractures, tuberculosis, cancer, bleeding, banned here for massage.

5. Acupoints operating practices should be accurate, correct technique, proper weight, forced even. Generally 100-200 times per minute for about appropriate, Xu Zheng mild disease or customers, forced to light, the speed should be slow, daily massage 1; seriously ill children or real disease, operation time should be long and hard to weight, speed of fast times daily or continuous massage massage combined with specific circumstances.

6. Massage hole side options, can choose a side to massage points, or repeat the massage, the symptoms improved that side according to the original point massage until cured; can also select two points or the points side by disease in order to select the massage; massage process or massage after the customer has the feeling of discomfort, differentiation and selection of points should be re-side. Determine the disease there will be some false and individual differences, so that is difficult to correctly judge the performer, the performer need to continue to accumulate experience in practice to improve the massage techniques.

7. In the operation, For a long time operation of a point, to avoid skin damage can be talc, oil, water applied to the massage area.

8. Massage shelter from the wind and cold after the note, so complex sense of evils, worse, make it sweat, more should pay attention.

9. If you experience weakness in children, or have serious chronic disease, another new disease, gradually re-adjusted to the upright, and then modulating the new disease, or rousing; such as children with chronic disease, but not serious, there are new diseases, to Treating the new disease-based, after modulating chronic disease.

          Basic techniques

1. Push method: massage children who left, left hand left hand (left hand as an example to children, the same here), with the right hand thumb side of the food we eat, the two fingers to move closer to a straight line to push Mount points selected, it is called push. Extrapolation carved meeting (refer to the root from the fingertips to push), diarrhea (from the root to the finger that pushed) and reinforcing-reducing (push back and forth, also known as the clear method) of three. Extrapolation of the operation, shoulder, arm, hand, etc. should be relaxed, force appropriate.

2. Take the law: The institute is called to get pinched. Food in the thumb and two fingers, or four fingers with the thumb and the rest of relative strength, to a certain point on the site and provide rhythmic kneading.

3. Kneading method: the thumb, index finger or middle finger at a certain point at the left and right rotation, known as the rubbing method. Rubbing direction: "clockwise" direction to make, "counterclockwise" direction for the diarrhea.

4. Transport method: The performer right thumb side of the site in the treatments for curved or ring from the push to another and the points, repeated handling, as the transport method. Shun-Yun (clockwise) to make the reverse operation (counterclockwise) for diarrhea.

5. Pinch method: press the point with a nail, known as the pinch.

6. According to law: the thumb side (or middle finger) in selected parts of the relief force to the first use, the less stop, then continue following the use of force by the slow, after slowly raised his hand, called by.


7. Point method: the thumb or middle finger, down to the appropriate force in selected parts of tapping, repeated operation, known as points.
                   
8. Points system: the two parts of the thumb by the selected points to both sides of the push, repeated operation, known as points.
                           
9. Squeeze method: a two-handed thumb and two fingers food in selected parts of the fixed pinch, and then the two-handed thumb, food forced two fingers to squeeze together, then relax, repeat operation, the local skin red or purple color red or dark purple for the degree, called the squeeze.

 

推拿知识

推拿是中医学的一个分支，有二千多年的历史。早期推拿和按摩是没有明确区分的，也没有“推拿”一词，都叫做按摩。明代， “推拿”一词真正出现，推拿作为一个独立的治疗体系形成并发展。所以，广义的推拿包括现在的各种保健按摩（如按摩足三里），治疗肌肉、软组织损伤的按摩（如肩周炎、颈椎病、肌肉拉伤的按摩），和治疗疾病的推拿。明清时期，推拿疗法达到鼎盛，主要用于调治儿童疾病，民间出现了不少有名的推拿医生和推拿著作，而且逐渐分成许多流派。

操作注意事项 

1.室内应保持一定温度，不可过凉过热，空气新鲜。

2.态度要和蔼,指甲要修剪，每次施术前要洗手。

3.小儿的姿势要坐卧舒适,力求自然。

4.在推拿时,小儿左右手皆可使用，但习惯上无论男女，多采用小儿左手。若局部皮肤破损、溃疡、骨折、结核、肿瘤、出血等，禁止在此处作推拿。

5.操作手法宜取穴准确，手法正确，轻重适宜, 用力均匀。一般每分钟以进行100-200次左右为宜,轻病或虚症顾客，用力要轻，速度宜缓，每日推拿1次；重病或实症小儿，操作时间宜长，用力要重，速度要快，每日可多次推拿或连续推拿，结合具体情况决定。

6.推拿穴方的选择，可以选择一个穴方进行推拿，或重复推拿，症状好转即依原穴方推拿直至痊愈；也可以选择两个穴方或按症选取穴方依次进行推拿；推拿过程中或推拿之后顾客有不适的感觉，应重新辨证和选取穴方。判断疾病时会有一些假象和个体差异，使施术者难以正确判断，因此需要施术者在实践中不断积累经验，提高推拿技术。

7.在操作时，若需长时间操作某个穴位，为避免损伤皮肤，可将滑石粉、油剂、水等涂于推拿部位。

8.推拿后注意避风和寒，以免复感外邪，加重病情, 使之发汗的，更应注意。

9．如果遇到衰弱的小儿，或有严重的宿疾，又有新病，调整到正气渐复后，再调治新病，或扶正祛邪；如小儿有宿疾，但不严重，又有新病，以调治新病为主，之后再调治宿疾。                         

          基本手法     

1.推法：推拿者左手托小儿左手( 以小儿左手为例，下同此)，用右手拇指侧或食、中两指靠拢沿直线推摩选定之穴位，则称为推。推法中分补(由指尖向指根推)、泻(由指根向指尖推)及平补平泻(来回推，又称清法)三种。推法的操作，肩、臂、手等都要放松，用力适当。

2.拿法：捏而提起则称为拿。以拇指和食中两指，或用拇指和其余四指相对用力，在一定部位和穴位上进行节律性的提捏。

3.揉法：以拇指、食指或中指按在某一穴位处，左右旋转，称为揉法。揉的方向：“顺时针”方向为补，“逆时针”方向为泻。

4.运法：施术者右手拇指侧，于施术部位起作弧形或环形推运至另一穴，反复操作，为运法。顺运(顺时针)为补，逆运(逆时针)为泻。

5.掐法：用指甲按压穴位，称为掐。

6.按法：以拇指端(或中指端)在选定部位上先用缓力按之后，少停，再继继用缓力按之，以后慢慢将手抬起，称为按。


7.点法：以拇指或中指，在选定部位向下适当用力叩击，反复操作，称为点。
                  
8.分法：两拇指由选定的部位向两侧分推，反复操作，称为分。
                          
9.捏挤法：以两手拇、食两指，在选定部位固定捏住，然后再使两手拇、食两指一齐用力向里挤，然后放松，反复操作，使局部皮肤色红或紫红色或黑紫色为度，称为捏挤。

Dear Dan, really thank you very much.Hope I can teach Xiao Er Tuina in China and  U.S.A. in the future.I am moved.Thank you again.

Happy the Dragon Boat festival !