Lift Hands Extra: 'Medical Implications of Combat T’ai Chi Ch’uan Techniques'

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TR EX

Editor Nasser Butt

perception realization activation action

Lift Hands The Internal Arts Magazine

EXTRA Editor

Nasser Butt

L’orso Solitario

Published by L’orso Solitario Books, Leicester, United Kingdom Lift Hands The Internal Arts Magazine Editor Nasser Butt Copyright © by Nasser Butt, 2020 & Fa-jing Ch’uan Internal Chinese Boxing Schools Dr. Gregory T. Lawton asserts the moral right to be identified as the copyright © holder & author of these articles.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the editor.

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The points of view represented here are solely those of the authors’ concerned. You do not have to subscribe to them if you do not wish. Nor is their inclusion here necessarily an endorsement by Fa-jing Ch’uan Internal Chinese Boxing School or its affiliates.

Cover Photo (main): Dr Gregory T. Lawton with Mohamed Jabateh Cover Design © Nasser Butt, 2020 Photography: Abass Ali Back Design: Nasser Butt 2020; Photography: Abass Ali

contents Editor’s Note Part 1

Page 7

Part 2

Page 19

Part 3

Page 30

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Nasser Butt

The following series of excellent articles on ‘Medical Implications of Combat T’ai Chi Ch’uan Techniques: Investigating Blunt Force Trauma’ by Dr. Gregory T. Lawton appeared in Volumes 13, 14 and 15 of Lift Hands Magazine in 2020. His expertise on the subject and knowledge are second to none!

editor’s Note

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t is very rare when you get an author, a philosopher, a poet, an artist, a medical practitioner, a martial artist with an impeccable pedigree, a veteran of the armed forces and above all a human being who in my opinion exemplifies the best of the human spirit - all roll into a singular person. Dr. Gregory T. Lawton represents all that and much more.

In this ‘Extra Supplement’ of Lift Hands, I have compiled all three of the original articles into a singular body for folk to enjoy as well as a work of reference.

The covers of the original Volumes in which these articles were published appear below.

My gratitude to Greg, whom I am honoured to call a dear friend, for sharing his knowledge with us all.

Enjoy.

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Gird up your loins and place upon your fingers your burial rings! The limbs of the strong and the meek shall quake and fear and trembling shall seize them all. Now is the time of calamity. Enter then the fortress and set the torch alight.

Scent of a Forgotten Flower

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n 1968 Mr. Bruce Tegner published a book entitled,

“SELF-DEFENSE NERVE CENTERS & PRESSURE POINTS”. Mr. Tegner described his book as a “practical guide to the most efficient use of weaponless self-defense using the least possible force.” He went on to state that.

“Modern knowledge of physiology and anatomy is applied to this subject which has long been much obscured by myth, superstition and legend. The so called “deadly" blows are evaluated. Fantasy and fact are separated.”

Although Mr. Tegner died in 1985 I want to thank him not only for promoting the martial arts worldwide, for his considerable contribution to martial arts literature, and also for writing what I will use as the introduction to this series of articles that will investigate the medical implications of Tai Chi Chuan techniques and the blunt force trauma that results from the strikes employed in Tai Chi Chuan and other martial arts. I find in Mr. Tegner’s 1968 book an excellent explanation of my intention in writing this article.

It is my intention to investigate the physiological effects of various strikes to the human body systems and their anatomical components. In writing this article I am drawing upon six decades of martial arts training, five decades as a health care provider, and five decades as a health science educator and author. As I cover the effects of, and damage caused by various strikes to the human body, I will organize this information by the anatomical region that contains the organs of the body system we are reviewing. Although I will Photograph 1 primarily examine the effects of the strikes of Tai Chi Chuan in terms of blunt force trauma, this review will include strikes that are commonly incorporated within the armamentarium of many martial arts. As was stated by Kenpo Grandmaster Will Tracey, “Before one begins..., a kick is a kick, and a punch is a punch, a block is a block. As one progresses, a kick is no longer a kick, a punch is no longer a punch, a block is no longer a block. But when he masters the system, he realizes a kick is a kick, a punch is a punch and a block is a block.”

It is my belief that every martial artist should have a solid background in human anatomy and physiology. There are eleven human body systems each comprised of anatomical parts or organs. For example, the human nervous system is organized into the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS is comprised of the brain and spinal cord and the PNS includes the nerves that leave the brain (twelve cranial nerves) and the spinal cord (thirty-one pairs). Each of the eleven human body systems is comprised of organs that in one way or another are critical to the maintenance of human life. Each of these eleven human body systems is vulnerable to blunt force trauma or physical stressors.

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Dr. Gregory T. Lawton

The eleven organ systems of the human body include the integumentary, skeletal, muscular, nervous, endocrine, circulatory, lymphatic, respiratory, digestive, urinary, and reproductive systems. Each of these systems and their organs perform life critical functions which includes: 1. The integumentary system (skin) supports and protects the body and its organs, regulates body temperature, manufactures biochemicals and hormones, and acts as a sense organ.

2. The skeletal system supports and protects the body and its organs, facilitates body movement via joints and muscles, stores minerals and makes blood cells in the bone marrow.

3. The muscular system facilitates body movement, maintains posture, and produces heat through work.

4. The nervous system connects a person to the environment and integrates and controls how the body responds to the environment.

5. The endocrine system secretes hormones into the blood that serve to communicate with, integrate, and control body function and homeostasis.

6. The circulatory system transports blood and other substances through the body and to the cells, tissues and organs such as the brain and lungs.

7. The major functions of the lymphatic system are the movement of fluid (lymph) from tissues and back to the circulatory system and its critical role in the defense mechanism of the body against disease.

8. The respiratory system exchanges oxygen from the air for the waste product carbon dioxide in the blood.

9. The digestive system breaks down food, absorbs nutrients, and excretes solid waste.

10. The urinary system removes waste products from blood in the form of urine and maintains electrolyte balance, water balance, and acid-base balance.

11. The reproductive system produces sperm and ovum (egg cell), allows the movement of sex cells and sexual fertilization to occur, supports the development and birth of human offspring, nourishes the embryo through its developmental stages, and produces the sex hormones.

Over the years I have seen, read, and collected many articles, books, magazines, or videos on the “physics” of the martial arts. I must admit that if the material focused strictly on the mathematical formulae that calculates pressure (force), mass, speed, or other mechanical or Newtonian physics factors, I was often left unsatisfied because I knew from personal experience and as a doctor practicing physical medicine that these equations did not adequately explain the physiological trauma and damage inflicted to cells, soft tissues, organs, and the joint complex, or the disruption that occurs to the function of the autonomic nervous system and organ systems.

In addition, I have read, attended seminars, and reviewed countless videos of “expert” martial artists who lack medical training and credentials who offer various opinions regarding the effectiveness and effects of various martial arts strikes and techniques on the human body. Frankly, I think that if you have not actually witnessed, evaluated, and treated blunt force trauma that you really do not know much about it.

Any martial arts technique, regardless of the style or system, delivered to a vulnerable area of the body or body organ with enough force can cause blunt force trauma. In blunt force trauma the cause of death is often internal bleeding into the brain, abdominal cavity, or lungs. Most blunt force trauma injuries are directed to the abdominal organs. There may be fractures, such as a broken neck, and all these forms of trauma can cause death.

Blunt force trauma is direct physical damage to a body part or organ, whether by impact, falls, injury or physical attack. Blunt force trauma is the first step in a trauma cascade, from which develops more specific types of trauma such as contusions, abrasions, lacerations, hemorrhage, joint capsule destruction, organ rupture, and/or bone fractures. A simple form of blunt force trauma would be a “black eye” and a more extreme form would be a ruptured liver from a kick, punch, knee, or elbow strike to the liver.

Blunt force trauma is graded by degrees of clinically assessed organ, soft tissue, or bone damage, and the damage is the result of the pressure (force) that a body area or organ receives. Some body areas are more prone to damage than others and this is due to the role that protective aspects of body posture, the skin, connective tissues such as fascia, muscle, ligaments, bones, and body fat play in defending the body, its tissues and organs.

Some areas of the body have a lot of protection and some areas do not have much.

In the upcoming parts of this series I will write in detail regarding specific strikes and the blunt force trauma that they can create from contusions to organ rupture, hemorrhage, or failure. The information that I provide will be based upon medical evidence and patient case histories of actual damage or death.

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In this introduction to this series I want to look at three common misconceptions regarding Tai Chi Chuan strikes by examining attacks to a bone (bone breaks), the eyes, and the throat. Also, for the purposes of this article I am writing about blunt force trauma that is caused by “empty hand” techniques and not weapons. In our training classes we teach the use of many weapons including weapons of opportunity that are part of the physical environment where an attack might occur.

To offer a further definition, in our school we teach what we call “combat” Tai Chi Chuan. Our Tai Chi Chuan is primarily based upon the lineage of the Yang family, specifically, Yang Shao Hou, and Professor Huo ChiKwang the founder of the Chinese Cultural Academy. Our curriculum in Yang Tai Chi Chuan includes the following disciplines: Yang Tai Chi Chuan forms (some Chen and Wu) Chi kung and dao yin San-sau, push hands, kumite Chin Na Shuai jiao Kempo Weapons training, sword, staff, spear Established in 1980 our martial arts curriculum includes mixed martial arts techniques, Kali, escrima, and knife.

We are a state licensed post-secondary school and all our training programs are approved by the state. We also offer an extensive array of classes in both traditional and contemporary healing arts including Asian medicine.

Photograph 2. Class held at the Academy.

Bone Breaks In our form of Tai Chi Chuan (I am not attempting to speak for all systems of Tai Chi Chuan) our objective is not to employ joint locks. Instead we attempt to execute joint “breaks’ (Cuo gu or Tsuoh guu) which means that through extreme hyperextension of a joint we seek to destroy the joint complex which is composed of tendons, ligaments, cartilage, and the joint capsule. The “intention” in executing such a technique is different in that we are not attempting to employ a joint lock or control, but we are attempting to destroy the joint complex with as much speed and force as possible. In our Tai Chi Chuan we employ strikes, throws, and Chin Na. Our Chin Na is practiced so that it can be executed to its conclusion which is the effective destruction of the joint.

Examples of this technique would be driving your forearm through an opponent’s elbow joint creating extreme

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hyperextension of the joint and a grade III sprain/strain which is a severe ligament/muscle tendon injury, this is the most serious among the three grades of ligament/muscle tendon sprains/strains. Most of the ligament/muscle tendon fibers will be torn. The ligaments and muscle tendons are completely torn or ruptured. The pain that results from such an injury is severe and incapacitating and may result in permanent disability.

Photograph 3. Normal elbow joint in flexion.

Photograph 4. Normal elbow joint in extension.

Photograph 5. Severely dislocated elbow joint.

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However, let’s look at a simple bone break. I will not write about bone fractures that I have not had direct experience with or treated in my practice as the result of a martial arts injury. It is not easy to break a bone in the human body; they are tough and designed to withstand the tremendous repetitive and concussive forces applied to them. I have treated fractures of the clavicle, ribs, radial and ulnar bones, boxers’ fractures of the bones of the hand, fractures of the bones of the foot, mandible, maxilla, zygomaticus and nasal bones, spinal vertebra, and the tibia and fibula.

Let’s clarify an important point again, soft or connective tissue trauma is much more common in all forms of martial arts than are bone fractures. I have treated hundreds of cases of soft or connective tissue trauma and I am aware of only several dozen or so bone fractures over my martial arts training history spanning six decades.

The clavicle is one of the most accidentally fractured bones in the human body, mostly as a result of falls on an outstretched arm or on the shoulder. The medical evidence supports the fact that the clavicle is one of the easiest bones in the body to break. (1) The clavicle is one of the only bones that given the opportunity I would attempt to break. If I struck the clavicle and it did not break, I would simply move on to another technique. I have direct experience with one fracture of the clavicle related to a martial an elbow strike. I have witnessed and treated many clavicle fractures due to throws and falls and these occurred mainly among practitioners of Judo, Jujitsu, and Aikido. Frankly, you are more likely to cause a clavicle fracture with a throw than with a strike.

Photograph 6. Fracture of the clavicle.

The clavicle is easily accessed due to its position and location on the anterior superior shoulder area. When the clavicle breaks it usually breaks in one location, although multiple fractures of the clavicle are not uncommon.

The clavicle is S shaped and the most common site of fracture is on the body of the clavicle in the direction of and closer to the shoulder. If you feel your own clavicle it will be the location away from the sternum at which point the clavicle is generally thicker and has a very strong arch shape and if you feel along the clavicle towards the shoulder you will find an area along the body of the clavicle that is thinner. This is the easiest breaking point of the clavicle and where most blunt force trauma clavicle fractures will occur. Like everything there are exceptions to the rule due to personal differences in anatomical structure, bone thickness and density.

One of the common criticisms of Tai Chi Chuan is due to a misconception regarding the use of palm strikes. Tai Chi Chuan critics often do not know the correct application of a Tai Chi Chuan palm strike. A palm strike might lead with a finger poke or gouge and end with the palm strike or a palm strike may involve the use of the pisiform carpal bone in the wrist. The pisiform carpal bone is commonly used to break boards, bricks, and/or concrete patio slabs. It is a sturdy bone for its size and accounts for less than one percent of all carpal bone fractures. Breaking bones or boards with a Tai Chi Chuan palm strike follows the same basic rules as any martial arts break. Breaking requires striking through the object that is to be broken with penetration (pung), force and speed.

One of the first lessons taught to beginning martial arts students is the concept of focusing pressure (force), mass, and speed into the object being struct. The analogy that one of my teachers used with me in the early 1960s was using an ice pick to break up a block of ice rather than a baseball bat. The more that the energy is

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focused down to a one-inch square point of contact the more pressure there is that is being driven into a focused point on the object or body part.

My favorite Tai Chi Chuan “bone breaking� technique is High Pat on Horse. With High Pat on Horse the arm and palm (with the pisiform carpal bone as the point of contact) is brought directly down on the point of contact on a bony surface. This technique is most effective when directed at the nasal bone and cartilage, the zygomatic bone, the maxilla, lower eye socket, and upper teeth, or the mandible. In the United States, zygomatic fractures are the second most common fracture of the facial bones following nasal bone fractures. (2) For a fracture to occur in the zygomatic bone the severity of the injury is directly proportional to kinetic force of the impact. The zygomatic bone is strong as it serves as a buttress between the skull and the maxilla. However, its projection on the anterior surface of the face makes it particularly vulnerable to injury, especially when impact occurs on either side of the face. A common cause of zygomatic fractures is a physical altercation that results in a punch to the face.

Photograph 7. Normal clavicle showing point of contact for bone break.

There are several mechanical factors at play in bone breaking, pressure (force), mass (the entire arm), speed, torque, shearing, gravity, and angle of attack. This makes the mathematical equation in terms of Newtonian physics very complicated but all that I care about is does it work.

Photograph 8. Bone break to the clavicle showing contact with the pisiform bone.

High Pat on Horse, because it comes on a vertical line from above and strikes downward, surprises attackers and fighters who have never seen the technique, especially fighters trained in boxing and MMA who expect a jab, hook, or cross on a horizontal line.

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Let’s take a pause here. At our school we teach personal self-defense and because we specialize in teaching and empowering women and teenagers who have been victims of rape, incest, and domestic abuse what we teach is violent and for the purpose of maiming or effectively stopping an opponent. We use combat Tai Chi Chuan as a vehicle for teaching effective self-defense techniques. We select our students carefully and we do not teach students who are violent or who want to hurt people, students who are emotionally unstable, students with a perverse character, students who will not work towards personal growth and self-improvement, or students who cannot learn or apply what we teach.

Here is the long list of techniques that mixed martial art fighters may not use in sport competition. This list is a list of the techniques that we teach in self-defense classes: 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

Butting with the head.

Eye gouging of any kind.

Biting.

Hair pulling.

Fish hooking.

Groin attacks of any kind.

Putting a finger into any orifice or into any cut or laceration on an opponent. (Gouging) Small joint manipulation.

Striking to the spine or the back of the head. (Rabbit punch) Striking downward using the point of the elbow. (Elbow (strike)) Throat strikes of any kind, including, without limitation, grabbing the trachea.

Clawing, pinching or twisting the flesh.

Grabbing the clavicle.

Kicking the head of a grounded opponent.

Kneeing the head of a grounded opponent.

Stomping a grounded opponent.

Kicking to the kidney with the heel.

Spiking an opponent to the canvas on his head or neck. (Piledriver) Throwing an opponent out of the ring or fenced area.

Holding the shorts or gloves of an opponent.

Spitting at an opponent.

The vast majority of my students do not want to compete in sports martial arts, ring or cage fighting and because of the high injury rate in mixed martial arts, especially Traumatic Brain Injury (TBI) and Chronic Traumatic Encephalopathy (CTE) a degenerative brain disease found in fighters who have experienced repetitive brain injury.

Eye Gouging The next technique in this article is eye gouging, I prefer the descriptive term “eye gouging” to an eye poke because a poke may just irritate an opponent but a properly executed eye gouge may result in severe contusion of the eye, traumatic enucleation of eye from the eye socket, and/or temporary or permanent blindness.

There are three types of eye gouging. One involves pushing the fingers or the thumbs into the socket which while it creates a crushing trauma to the eye(s) it does not remove the eye from the eye socket and is too easily defended against since both of the opponents hands are available to defend against the technique. The second technique is called an eye hook and an eye hook is when a finger or fingers pushes into the medial aspect of the eye and drags across the eye laterally (from the tear ducts outward). The third eye gouge is the main technique that we teach, the traumatic enucleation of the eye. To execute a traumatic enucleation of eye the forefinger is used to enter the eye socket medially (at the tear ducts) and adjacent to the nasal bone. The right forefinger is used to remove the opponent’s right eye and the left forefinger is used to remove the left eye. The finger technique that we use in eye gouging is called One Finger Zen and it is a hand form that we practice in a chi kung exercise called Golden Bridge. It is also used immediately after the Commencement of our Tai Chi Chuan form and prior to Crossing the Heavens.

The forefinger is thrust forcefully and deeply into the eye socket in the location described above then the finger is “hooked” as the hand and finger are quickly pulled laterally (towards the outside of the head) and away from the eye socket. When the forefinger is thrust into the eye socket the remaining three fingers remain curved and flexed so that they are not injured when they strike against the zygomatic and maxilla bones of the face.

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Photograph 9. This shows the location where the finger enters the eye socket.

Photograph 10. This showing the finger has penetrated the eye socket and the technique for “hooking’ the eyeball and ripping it out of the socket.

Crushing the Throat Once again when it comes to blunt force trauma to the anterior (front) throat area there is a lot of misinformation from various “expert” sources. It is true that if an opponent is careful and keeps their chin down that the lower jaw (mandible), the sternum, and the sternocleidomastoid (SCM) muscles will protect the throat from blunt force trauma but saying that attacks against the anterior throat, larynx, and cartilage and bony structures of the neck cannot be effectively performed is not true. If this was true then neck cranks, chokes or the rear naked choke would be useless, and they are not. I am going to cover this topic in greater detail in a future article when I review blunt force trauma and direct strikes to the head and neck region and the organ systems and vessels that pass through the neck region. However, let’s look at the rear naked “choke”.

The rear naked choke is a “blood” choke (Dian Mai or Dian Xue) and it is commonly employed in several martial arts styles including MMA. In our style of combat Tai Chi Chuan we do not choke out opponents, we practice to directly crush the bones and cartilage of the throat. This technique is called a forearm throat crush or sealing the breath (Bi Qi or Bih Chi). To accomplish this action we move behind an opponent, perhaps after deflecting a punch, and immediately apply the radial bone of the forearm across the anterior throat area and then quickly and forcefully draw the forearm posteriorly (towards ourselves as we stand behind the opponent and drag them backwards to keep them off balance) and in a movement that is partly strangulation and partly a strike through the neck. Think of a fa jing movement of the forearm (radial bone) towards your own chest but moving through the opponent’s neck and you will get some idea of the force of this technique. The resulting

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damage to the throat is catastrophic and may cause death by asphyxiation. (3) The medical implications of this technique are so obvious as to defy arguments that it will not work. If you can get into a position to choke an opponent, crushing the throat with the radial bone is much faster and less likely to fail.

Photograph 11. This shows the radial bone over the anterior throat in position for a fa jing strike into the throat.

Photograph 12. This image shows the bone and cartilage damaged by strikes to the throat.
 Not seen are the soft tissue, respiratory and digestive, nerve and blood vessels that are also damaged.

Conclusion As I have mentioned, at our school, we teach martial arts and self-defense primarily to ordinary people, victims of traumatic abuse, abused junior youth and youth, and immigrants and refugees to the United States. We do not charge for self-defense instruction. We do not train people to fight professional fighters but rather to defend themselves when necessary in the street or in the home. Mostly, violence is not necessary but not everyone has been or will be that fortunate. The two primary concepts of self-defense are situational awareness and avoidance of conflict.

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In this introduction to The Medical Implications of Combat Tai Chi Chuan Techniques, Investigating Blunt Force Trauma I have briefly covered three combat Tai Chi Chuan blunt force trauma techniques; the bone break, the eye “gouge," and the throat crush. I consider bone breaks the least effective of these three techniques because they are unpredictable, and I will cover the application of extreme hyperextension to the joint complex involving traction, torque, and shearing forces directed at joints in a future article. I will also cover blunt force trauma leading to organ damage, haemorrhage, rupture, and failure in a future article as well.

The martial arts were originally created to be violent, to maim, and to kill. The techniques, movements, postures and principles of Tai Chi Chuan were designed to accomplish the same objectives and the early practice of Tai Chi Chuan was commonly associated with martial chi kung, Chin Na, and various hand, foot, and body conditioning exercises. It was later in the historical development of Tai Chi Chuan (by the third and fourth generations of the Yang system) that Tai Chi Chuan began to be practiced as a “health” exercise and became less and less an effective martial art. Our schools’ approach to combat Tai Chi Chuan is an attempt to restore the martial roots and practices of Tai Chi Chuan as was intended by its original founders.

References: 1. Incidence and mechanism of injury of clavicle fractures in the NEISS database: Athletic and non-athletic injuries, Steven F. DeFroda, Nicholas Lemme, Justin Kleiner, Joseph Gil, Brett D. Owens Journal of Clinical Orthpaedics and Trauma, Elsevier, September–October 2019 2. Etiology and incidence of zygomatic fracture: a retrospective study related to a series of 642 patients, Ungari C, Filiaci F, Riccardi E, Rinna C, Iannetti G. European Review for Medical and Pharmacological Sciences.

2012 Oct;16(11):1559- 1562.

3. Fractured Larynx: Classification, Symptoms, Diagnosis, Treatment, Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA, https://www.epainassist.com/face-mouth-throat/fractured-larynx

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...and foolishly I asked, “How will I know when I am a master?”, and the answer came, “When you have mastered all aspects of your life as a man, a husband, and a father, as a citizen, and in all things as a true servant of humanity. Then will you be a master.”

Scent of a Forgotten Flower

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art 1 of this series on The Medical Implications of Combat

Tai Chi Chuan Techniques, Investigating Blunt Force Trauma was an introduction to several techniques which included sealing the blood, sealing the breath, displacing the bone, bone fractures, and gouging or hooks and the significant medical consequences of these techniques.

Liu Jin Sheng is the co-author of the book Chin Na Fa which was written in collaboration with Zhao Jiang. The first edition of the book was issued in July of 1936 as a manual for the Police Academy of Zhejiang province. Liu Jin Sheng stated, "...if you are in command of this technique, you can sway the destiny of the enemy. You can kill your enemy, cause unbearable pain, tear his muscles and sinews, break his bones or make him unconscious for some time and completely disable him to resist. Even a woman or a physically weak man who mastered this technique can curb a strong enemy. This technique demands deftness and skill, not brute force.

It is necessary to train oneself daily to make the body flexible and nimble, but "hardness" must be hidden inside this “softness."" (1) Once again, I have found my central theme in a book written by a former martial arts master because I fully attest to Liu Jin Sheng’s statement.

It is not often that I find myself in total agreement with a martial arts author, but Liu Jin Sheng’s statement on Chin Na is both accurate and brilliant. I remember first reviewing and purchasing this book in the Peking Book Store in Evanston, Illinois in 1976.

Photograph 1

Every martial art that I have studied over the last six decades has contained Chin Na (“Devil’s Hand or Poison Hand”) training to a greater or lesser degree and the knowledge of the instructor was largely dependent upon the depth of their training. I found that American black belts who had trained in Korea, Japan, or Okinawa during their one or two years of military service in those countries had limited exposure to, and training in, Chin Na but that native born black belts from these countries had extensive training and expertise in Chin Na (even though they used different terminology). My first Kenpo instructor (1963) was highly proficient in Chin Na but he was a US Army Ranger tactical combat instructor who received part of his training at the Kodokan in Japan.

Chin Na means to seize, catch, stop, or immobilize and can be within itself a separate and complete martial art system or simply a group of techniques within another martial arts system. Virtually every Chinese martial art that I have studied Tai Chi Chuan, Pa Kua, Hsing Yi, Shaolin Long Fist, and Kempo/Chuan Fa, have all included Chin Na. Chin means to seize or trap and na means to lock or to break. Chin Na is the father and mother of Jujitsu, Judo, and Aikido. I was introduced to Judo in 1962 by a police officer who taught me the three “forbidden” strikes of Judo that would be applied to a downed opponent, a blow to the throat, the solar plexus, and the groin.

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The following is a general description of traditional Chin Na technique categories: 1. "Fen Jin” or "Zhua Jin” (dividing the muscle/tendon, grabbing the muscle/tendon) - Fen means "to divide,” zhua is "to grab" and Jin means "tendon, muscle, sinew". They refer to techniques which tear apart an opponent's muscles or tendons.

2. "Cuo gu" (misplacing the bone) - Cuo means "wrong, disorder" and gu means "bone". Cuo gu therefore refers to techniques which put bones in wrong positions and is usually applied specifically to joints.

3. "Bi qi" (sealing the breath) - Bi means "to close, seal or shut" and qi, or more specifically kong qi, meaning "air". "Bi qi" is the technique of preventing the opponent from inhaling. This differs from mere strangulation in that it may be applied not only to the windpipe directly but also to muscles surrounding the lungs, supposedly to shock the system into a contraction which impairs breathing.

4. Dian mai" or "dian xue" (sealing the vein/artery or acupressure cavity) - Like the Cantonese Dim Mak, these are the technique of sealing or striking blood vessels and chi points.

5. "Rou dao" or "rou shu dao" (soft techniques) which generally refers to the techniques deemed safe for sparring and/or training purposes.

I find this list limiting in that some books on the topic of Chin Na for Tai Chi Chuan practitioners and other martial artists omit blunt force trauma to certain vulnerable organs such as the liver and information and techniques specific to major nerve tracks and nerve plexuses of the autonomic nervous system.

I stated in Part One of this series that knowledge of human anatomy, not metaphysical anatomy, but detailed human anatomy was important to a well-trained marital artist. Many early martial artists were farmers who acquired their knowledge of human anatomy not from books, but from the raising and slaughtering of animals for meat. The well-trained martial artist should be very familiar with the human skeletal system and bony architecture, muscle formation and structure, the placement and composition of major body organs, as well as, the anatomy of the nervous and circulatory systems. The competent application of Chin Na is based upon how to attack and destroy these anatomical structures and how to inflict damage to body organs located within body cavities such as the thorax, abdomen, and pelvis.

Chin Na is a far older than many martial arts, including Tai Chi Chuan. The first known written record of this Chin Na dates from the Spring and Autumn period of the Warring States era (475 – 221 BCE). Historically, martial artists have trained in Chin Na, evolving and perfecting their skills and contributing to the compendium of martial arts knowledge. Chin Na is based upon more than technique and requires expert abilities in anatomy, physiology, and kinesiology or body movement. Knowing how the joints move and in what directions and to what degree is known as the science of kinesiology and range of motion (ROM). In Chin Na when applying fen jin or cuo gu the martial artist will move a joint into a position that is beyond the kinesiological ROM and this will result in destruction of the tendon, ligaments, and joint capsule. This causes great pain and destroys the function of a joint. We will cover these Chin Na attacks in greater detail in the next part of this series.

Chin Na has been and continues to be the most effective method and tactical martial art for Chinese military personnel and police officers. In the military Chin Na is taught and used to maim or to kill, in the law enforcement branches it is taught and used to control civilians and criminals with the least amount of damage to the individual possible.

In our school’s curriculum we teach Chin Na on the military model. We also teach these principles: 1.

2.

3.

4.

5.

6.

Situational awareness and intuition Razor sharp focus and concentration Pre-emptive attacks when necessary Strike without hesitation Escalate the attack until the attacker is no longer a threat Remain alert and protect yourself and others

The state that our school is established has a “First Strike” law which means that if a person reasonably believes that their personal safety or life is in danger, they can strike preemptively to protect themselves or others. An example of a legal preemptive first strike against an attacker would be if an attacker stated, “I am going to kill you," you would be within your legal rights to use any means possible, including defensive weapons, to stop the attacker. You do not have to wait to be assaulted.

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We teach many Chin Na applications that come directly from the Tai Chi Chuan, Pa Kua, and/or Hsing Yi forms but we caution students to keep their use and application of these techniques simple. A few well honed and practiced techniques a student feels competent in executing are far better than an encyclopedic knowledge of techniques. In addition, we train our students to literally act in the “blink of an eye”. A blink of an eye is about 300 to 400 milliseconds. There are 1000 milliseconds in each second, a blink of an eye takes a bit more than .33 of a second. We train students using a stopwatch and some of our Chin Na techniques take only .25 of a second to execute.

We train students according to their physical and psychological capacity. A physically frail student will not be able to execute techniques that require strength against a large opponent, or a student may not be psychologically capable of performing a technique such as an eye gouge which may lead to blindness. There is no point in teaching or learning techniques that will not carried out with expertise and decisiveness should the need arise.

In Part One I introduced a few simple concepts related to joint “breaks’ (Cuo gu or tsuoh guu), “seal the blood” choke (Dian mai or dian xue), sealing the breath (Bi qi or bih chi), and “eye gouging”. If you have not yet read that article, I encourage you to do so because the material in this article will make more sense to you. In Part One I included several images that illustrated the techniques that I described in the article. The images included the application of High Pat on Horse for the purpose of breaking (fracturing) several bones in the face including the zygomatic, nasal, and maxilla. I want to expand upon that information with a breaking technique for the mandible.

Photograph 2. The Mandible

The mandible is susceptible to fracture in several locations and in the area between the thumb placement in Photograph 2. It is also susceptible to dislocation and fracture at the temporomandibular joint (TMJ).

Photograph 3 shows the common mandible fracture sites. Note, that I am suggesting blunt force trauma at two common fracture sites that together account for 50 to 60 percent of all mandible fractures.

The temporomandibular joint is a synovial joint which means that it has a joint capsule, an inner disc, synovial fluid in the capsule, and it is richly innervated with sensory and motor nerves. Blows to the mandible and directly to the TMJ frequently result in dropping an opponent to the ground and/or unconsciousness. The mandibular nerve (third branch of the trigeminal nerve) provides the main nerve supply of the temporomandibular joint. Additional innervation comes from the masseteric nerve and deep temporal nerves. The anterior division of the auricular nerve sends branches around the TMJ. This rich neurological innervation is what makes attacks to the mandible an effective location for knocking an attacker out. (2) Photograph 4 shows the pathways of the major nerves that innervate the TMJ. Photograph 3. Mandible fracture sites (Source: Wikipedia)

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Photograph 4. By Henry Vandyke Carter - Henry Gray (1918) Anatomy of the Human Body

I previously recommended High Pat on Horse for breaking bones in the face and I am now suggesting both High Pat on Horse and a Descending Fist (Hammer Fist or Fist Descends from Heaven). When using Descending Fist, the fist, like High Pat on Horse, is moving downward from above the contact point into the point on the mandible. The striking surface on your hand is located at the lateral edge of the knuckle of the fifth metacarpal (little finger). The fist is held loosely (Tai Chi Chuan fist), and the side of the knuckle contacts the mandible or the other suggested contact points on the face as are illustrated below in Photographs 5, 6, and 7.

Photograph 5. Striking point for zygomatic bone fracture.

Photograph 6. Striking point for zygomatic bone fracture.

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Photograph 7. Striking point for zygomatic bone fracture.

Photograph 8 below demonstrates the application of an upward palm heel strike directly to the angle of the mandible. This is one of the “knock out� points on the jaw. Photograph 9 shows the exact location and contact point at the angle of the mandible.

Photograph 8. Upward palm heel strike to the angle of the mandible.

Photograph 9. The angle of the mandible!

Let’s review Chin Na from the context of attacking acupuncture points and/or meridian pathways. In Part One of this series I stated that the ability to reliably break bones, and I gave an example of the clavicle, are not supported by statistical evidence gleaned from the combative sports and were therefore in my opinion unreliable. Since I teach self-defense to victims of rape, incest, and domestic abuse I will not teach techniques that I do not feel are reliable or that my students will not be able to execute consistently. My opinion regarding attacks to acupuncture points and meridians is similar - they are not reliable or consistent.

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Many acupuncture points, and I am writing as both a martial artist and an acupuncturist, while they may inflict temporary pain on an attacker are not reliable as a means of immediately incapacitating an attacker. Pain is not a reliable method for stopping attackers. People have different pain thresholds and pain tolerance levels; endogenous endorphins and the hormone adrenalin are natural pain mediators in the human body. An attacker may be intoxicated by alcohol or street drugs and their ability to withstand pain even severe pain may be very high. I do not recommend attempting to rely upon pain to stop an attacker. What we teach in our school are techniques that result in total incapacitation.

For example, a wrist lock with thumb pressure applied at Large Intestine 4, while potentially painful, has different effects on different people. A new student may cry out in pain and a seasoned fighter or drugged attacker may care less. In our kumite training we teach low “cut” kicks to and through the leg with an attempt to make bone on bone contact with Spleen 6. Spleen 6 is one of the more sensitive acupuncture points on the human body, but once again a fighter conditioned to pain may be only mildly annoyed by a kick to this point.

Acupuncture points are not “pain generating” they are points through which chi is thought to pass. Nerves, nerve endings (nociceptors), nerve trunks, and nerve plexuses are pain generators. Chances are the acupuncture point that you may believe is the cause of incapacitation sits on top of a major nerve, a bundle of sensory nerves, a nerve trunk or plexus. Or perhaps the point is located over an airway or a major blood vessel. The carotid artery, like most major blood vessels is richly innervated with nerves and contains baroreceptors in the carotid sinuses and aortic arch which are a part of the vascular system’s auto-regulation in the setting of hemodynamic (blood pressure) changes. Carotid artery injuries caused by blunt force trauma often cause thrombosis (blood clots/stroke) and delayed neurologic deficits and are associated with death in forty percent of the victims who experience this trauma. (3) Striking a specific acupuncture point on a cooperating student in a martial arts class, training seminar, or video is easy, but hitting an acupuncture point on a mugger or during a street attack with any accuracy or effectiveness is very difficult. As Mike Tyson said, “Everybody has a plan until they get punched in the mouth.”

In your Chin Na or Dim Mak training you may have been trained to attack acupuncture point Stomach 9 to stop an opponent. Stomach 9 is located on the neck, lateral to the Adam's apple, on the anterior border of the sternocleidomastoid muscle (SCM), where the common carotid artery pulsates. This is one of the acupuncture points, Stomach 9, that is responsible for the mythology of Dim Mak delayed death strikes. It was even implicated in the death of Bruce Lee who died as a result of cerebral edema thought to related to pain medication that he was taking. There are numerous documented deaths related to blunt force trauma to the carotid artery (remember the death rate for this injury is forty percent). The normal progression in blunt force trauma to the carotid artery is damage to the artery that causes swelling of the inner muscular walls of the artery resulting in a stoppage or serious reduction of blood flow to the brain and the formation of a blood clot(s) (thrombosis).

Photograph 10. Gray’s Anatomy Common Carotid Artery

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Also, in Photograph 10 you will see the Vertebral Artery running parallel to the Common Carotid Artery. The Vertebral Artery because of its circuitous route through the cervical vertebrae is subject to “traumatic dissection” (ruptured and torn) if the head is bent backwards (hyper-extension) and the neck is rapidly and violently rotated (hyper-rotation) past the point of normal range of motion. Photographs 11 and 12 show the anatomical skeletal model posed in cervical flexion and flexion with hyper-rotation.

Photograph 11. Hyperextension of the head and neck.

Photograph 12. Cervical hyperextension and hyper-rotation of the head.

Let’s discuss the brachial stun. The brachial stun is so named because some people are of the opinion, and one theory exists, that a strong blow to the brachial plexus temporarily overwhelms and confuses the nervous system resulting in neurovascular shock (a stun) which can cause an attacker to drop to the ground, render the attacker unconscious or disoriented and confused. There are numerous well documented examples of the effectiveness of the brachial stun and it is taught by many military units and police training academies. I have taught and applied the brachial stun to probation officers and police officers in law enforcement and tactical training classes.

There are at least four different theories regarding how the brachial stun effects the human body physiologically but no good medical studies that examine how it works in a physiological sense. Opinions on how the brachial stun works include: 1. Sudden overload due to compression and stretching of the sensory nerves of the brachial plexus nerve trunks located in the neck.

2. Sudden overload of the Great Auricular Nerve and its branches located by and around the sternocleidomastoid (SCM) muscle. (See photograph 13.)

3. Sudden stimulation of the baroreceptors of the Common Carotid Artery causing a neurogenic vasomotor response with a drop in blood pressure.

4. All the above.

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For what my professional opinion is worth, I lean towards theory three listed above and possibly theory four, all the above. Regardless of how it works, the brachial stun is effective. In reviewing research on the brachial stun, it became evident that many martial artists are confusing the anatomical location of the brachial plexus with the anatomical location of the carotid baroreceptor and many practitioners are attacking both areas at the same time.

A well-executed penetrating blow to the carotid baroreceptor location on the neck would, at the same time, contact the auricular nerve and possibly the superior trunk of the brachial plexus. I have seen and experienced “pure” blows, properly executed, to the inferior trunk of the brachial plexus repeatedly fail to “stun” an opponent, especially an opponent with a well-developed upper trapezius muscle.

The brachial plexus is a network (plexus) of nerves (formed by the anterior ramus of the lower four cervical nerves and first thoracic nerve (C5, C6, C7, C8, and T1) and is therefore located from the middle region of the neck downward towards the base of the neck. Some martial arts instructors demonstrate a brachial stun applied above the fifth cervical vertebral, on the upper aspect of the sternocleidomastoid muscle, below the ear and the angle of the mandible. The brachial plexus, as is explained above lies below this striking point.

Photograph 13. Illustration of the path of the Greater Auricular Nerve overlying and around the SCM muscle.

There are several ways in which to strike the side of the neck where the SCM muscle, the carotid baroreceptors, and great auricular nerve are located. Various types of palm and forearm strikes are commonly used in striking this area. At our school we teach the forearm strikes using either the ulnar or radial bones of the forearm to strike this area of the neck. Photograph 14 below demonstrates the use of the ulnar bone of the forearm. Several Tai Chi Chuan postures allow for the application of a brachial stun including Commencement (as is found in San Sau training), Partition of the Wild Horses Mane, Brush Knee and Twist Step, and Ward Off.

Photograph 14. Position of the ulnar bone used in a brachial stun.

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Blunt force trauma is the leading cause of death of individuals from age one to fifty-five in the United States and results in 100,000 deaths per year. In reviewing research on knockouts that occurred in street fights and how they were accomplished the palm heel strike to the mental aspect of the mandible (chin) was a potent source of consistent knockouts, but so were any form of hand attack to the mandible that was executed with sufficient force. In our training program we discourage punches to the head in favor of open hand or palm strikes to the head, face, neck, and throat. We recommend not punching to the face and head because of the risk of fracture to the bones of the hand.

A strike to the mandible can cause temporary paralysis or seizures, mild concussion, and unconsciousness. The mandible acts as a lever that can relay the force of a blunt force trauma to the back of the brain (medulla) where the cardiac and respiratory mechanisms are regulated and controlled.

The five major physiological causes of knockouts that we teach in our program include: 1. Direct brain trauma and concussion.

2. Blunt force trauma that causes a disruption of the function of the central nervous system via an overload of the autonomic function of the peripheral nervous system.

3. Termination of regular blood flow in the neck and to the brain.

4. Blunt force trauma to a body organ such as the abdomen or liver.

5. Trauma to any other part of the body that causes a disruption of the function of the central nervous system via an overload of the autonomic component of the peripheral nervous system.

The anatomical location of the chin, jawbone, or mandible is a potent location for rendering an attacker unconscious.

Of course, for an individual to be capable of defending themselves from attack they need to have some degree of physical and aerobic conditioning. Of all the many martial arts Tai Chi Chuan is supreme at maintaining the health of the human body provided that the practitioner does not destroy their health through bad health habits.

Tai Chi Chuan is an excellent choice for individuals looking to maintain their health over their lifetime and it is even more beneficial when it is combined with Dao Yin and Chi Kung exercises.

Some forms of marital art, specifically those that involve extreme methods of training and full contact fighting result in early trauma to the musculoskeletal system and the autonomic functions of the central nervous system.

The autonomic nervous system regulates body process that occur without conscious effort. The autonomic system is the part of the peripheral nervous system (sympathetic/parasympathetic) that is responsible for regulating involuntary body functions such as heartbeat, blood flow, and breathing. Fighters that compete in “reality” based sports contests are considered “washed up” by the age of thirty to thirty-five. Arthritis is common among practitioners that use practice methods that cause sustained repetitive stress and strain to the musculoskeletal system and Parkinson’s and Alzheimer’s diseases risk increases by twenty-five to thirty-three percent in sports with head trauma such as mixed martial arts. In a study entitled, “Dangers of Mixed Martial Arts in the Development of Chronic Traumatic Encephalopathy” the following was reported: “A systemic review and meta-analysis of the epidemiology of injuries in MMA revealed that head injuries accounted for the highest distribution of injuries by anatomic region, with data ranging from 67.5% to 79.4% [19]. The authors also found that the injury pattern in MMA was quite similar to that of professional boxing, unlike other combat sports such as judo [20] or taekwondo [21], where blows to the head are outlawed. It is concerning that head injuries account for the highest proportion of injuries sustained by the competitor during the bout, and this became even more worrying after video analysis of 844 telecasted UFC MMA bouts revealed that about 90% of TKOs were a result of repetitive strikes. When the TKOs secondary to repetitive strikes were examined further, the 30 seconds before match stoppage was characterized by the losing competitor being hit by a series of multiple strikes to the head that increased in frequency [22]. Few would argue that when a contestant experiences a KO, he would meet the criteria for concussion, which is a type of traumatic brain injury.” (4) Some mixed martial artists have been publicly critical of Tai Chi Chuan and other internal or “Kung Fu” martial arts systems. I do not concern myself with their negativity or the controversy because it has been my experience that only a rare few MMA fighters last beyond a few years in the sport. Their injury rates from training and fighting are so high that few have either the genetics or the luck to sustain long-term training.

When I attend martial arts seminars, training camps, and gatherings it is evident that too many aging traditional martial artists and instructors (by their fourth or fifth decade of life) are physically deconditioned and they are

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exhibiting the clinical signs of obesity, type 2 diabetes, heart disease, and musculoskeletal disease. These conditions are not the result of normal aging but rather the result of poor lifestyle behaviors and addiction to food, alcohol and drugs. A mature martial artist does not have to be ready to compete in the ring or Octagon, but they should personify a healthy mind, emotions, body, and spirit and be physically capable of executing the techniques that they teach regardless of their age.

In Part Three of this series on, The Medical Implications of Combat Tai Chi Chuan Techniques, Investigating Blunt Force Trauma, we will investigate the techniques and methods of destroying the architectural integrity of the body’s joints.

References: 1. Shaolin Chin Na Fa: Art of Seizing and Grappling, by Liu Jin Sheng, Shan Wu, Shanghai, China, 1936 (Copyright Andrew Timofeevich 2005).

2. Essential Clinical Anatomy of the Nervous System 1st Edition, Kindle Edition, Paul Rea, 2015, Copyright Academic Press, London, United Kingdom.

3. Perry MO, Snyder WH, Thal ER. Carotid artery injuries caused by blunt trauma. Ann Surg. 1980 Jul; 192(1):74-7. doi: 10.1097/00000658-198007000-00013. PMID: 7406566; PMCID: PMC1344809.

4. Lim LJH, Ho RCM, Ho CSH. Dangers of Mixed Martial Arts in the Development of Chronic Traumatic Encephalopathy. Int J Environ Res Public Health. 2019;16(2):254. Published 2019 Jan 17. doi:10.3390/ ijerph16020254

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The lowliest ant busied in the dirt knows this truth, how is it then that you do not?

Translated From A Foreign Tongue

his article on The Medical Implications of Combat Tai Chi Chuan, Investigating Blunt Force Trauma, Part 3, has been preceded by Parts 1 and 2. If the reader of this article has not read Part 1 or Part 2 of this series, it is recommended that they first review those two articles. Part 1 of this series on The Medical Implications of Combat Tai Chi Chuan Techniques, Investigating Blunt Force Trauma was an introduction to several techniques which included sealing the blood, sealing the breath, displacing the bone, bone fractures, and gouging, or hooks and the significant medical consequences of these techniques. In Part 2 of this series we investigated the physiological effects of various strikes to the human body systems, such as the circulatory and nervous systems and their anatomical components. Additionally, the parts in this series are being written in sequence from greater to lesser physiological damage inflected on an attacker’s body. Therefore, the techniques described in Parts 1 and 2 have the potential to do more physical harm than the techniques covered in Part 3. Properly executed Combat Tai Chi Chuan techniques, which are firmly based upon the essential principles of classical Tai Chi Chuan, represent the authentic practice of Tai Chi Chuan in reality-based offensive and defensive applications for the purpose of selfdefense.

T

The writing of this series was begun prior to the COVID-19 pandemic and the violence that has been escalating in cities around the world but it was written with an awareness of increasing violence resulting from unarmed and armed attacks on innocent citizens world-wide and an awareness of the growing potential for increased violence that could occur in the coming months on unprecedented levels. Increasing numbers of individuals are being attacked, injured, and killed on the streets, on their way to work, at family and public gatherings, in parks, in their automobiles, and in their homes. Many of the attacks against individuals are from muggers, criminals attempting home invasions, violent protesters, rioters, and looters whose attacks against others are often unprovoked. The attackers are employing weapons of opportunity such as rocks, bricks, sticks, and street signs, but guns and knifes are ubiquitous in many cities and so injuries and deaths from these weapons are skyrocketing. People who formerly espoused gun control reforms are now arming themselves (In countries where they are allowed to own guns) at unprecedented levels and guns and ammunition are in short supply.

These worldwide events with escalating violence in our cities place the question of the moral appropriateness of reality-based self-defense in a clarifying context. Where criticism of self-defense techniques whose prime purpose is to incapacitate, maim or to kill an attacker frequently faced moral condemnation, those arguments have dimmed in the shadow of rampant social unrest and violence. Considering the obvious decline in society and the decay of existing institutions of governance, justice, public safety and education, there is every reason to believe that the need for personal self-defense training will greatly increase in the immediate future.

The most effective self-defense techniques are those that are the simplest to execute and those that are based upon the fewest but most efficient movements. I call this approach “effective simplicity”. The more esoteric or complex a self-defense technique is the less likely it is to be effective. Therefore, in many cases, a welldesigned self-defense program is better at preparing students to defend themselves and their families from an attack than years of martial arts training. The original foundation of most traditional martial arts systems is based on lethal combat techniques and Tai Chi Chuan is no exception. Unfortunately, many Tai Chi Chuan students and practitioners have not trained in the combat aspects of their art and therefore they lack these skill sets. Several times in this article I will quote this military adage, ““Remember, you will fight as you train!”

Where a marital artist trained in light or limited contact kumite, san-sau, or sports fighting may kick an opponent in the thigh, a martial artist whose art includes Chin Na will attempt a thrust or kick intended to shear through the ligaments, menisci, and connective tissues that attach the femur to the tibial bone. If a student is “realistically” trained, they will execute an attack without moral hesitation or concern for “rules”.

Let us review several of the essential elements of the application of effective self-defense techniques. elements These elements include:

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1. Embrace the concept of effective simplicity.

2. Practice a few well-honed and effective attack sequences and combinations.

3. Practice your techniques once for form and flow, once for strength and power, and once for speed. When you practice at full speed do so with form, flow, strength, and power.

4. Offensive and preemptive attacks – if you perceive that you are going to be attacked do not wait for the attack, but rather initiate an offensive attack.

5. Deliver an attack that is the most decisive and destructive that you can deliver.

6. In self-defense there is only one speed, blindly fast.

7. Self-defense has no rules or limitations. When you are faced with an attacker who is threatening your wellbeing or life you are morally and legally justified in answering the threat with extreme violence to the point of incapacitating the attacker.

8. Use all the self-defense tools that you have been trained to use, your fingers, hands, wrist, arms, shoulders, head, hips, knees, legs, ankles, feet, and even your teeth.

9. Do not waste effort or time on attacks that will not maim or completely incapacitate an attacker.

10. Never fight on equal terms and counter whatever skills, abilities, or weapons an attacker brings to the fight with a greater counterattack.

11. If an attacker or opponent has superior skills, is larger, taller, heavier, and younger, use an appropriate weapon to defend yourself.

12. Be aware of and use the environment that the attack is occurring in including the walls, windows, poles, sidewalk, and every solid object that an attacker can be pushed or thrown into.

“When the opponent makes the slightest move, you move first”.

Yang Family Secret Transmissions Compiled and translated by Douglas Wile A word about the practice of Tai Chi Chuan. Many students of Tai Chi Chuan never learn to perform their Tai Chi Chuan form at full speed but continue to practice in the slow meditative style that is so common. Once you have learned a Tai Chi Chuan form to become proficient at fighting you must be able to perform the form at full speed and in addition you must practice the various Tai Chi Chuan postures over and over again as training drills and you must practice the postures applications with the three characteristics of form and flow, strength and power, and speed. Another word of advice, do not sacrifice speed for strength. If I had to chose between speed and strength. I would always chose speed. Remember, as little as, “Four ounces can move one thousand pounds”, especially if that “four ounces” gets to its target first!

Look into the technique of using four ounces of energy to control the force of a thousand pounds. Such techniques as these do not depend upon brute force to overcome.

Tai Chi Classics, Waysun Liao

X-ray of dislocated knee Source: Duprey K, Lin M. Posterior knee dislocation. West J Emerg Med. 2010;11(1):103-104.

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In the x-ray image above, we see a posterior dislocation at the knee. This injury can be induced by a strong thrust or kick to the anterior surface of the knee joint at or below the patella which is at the junction of the femur and the tibial bone. A dislocation of this severity and degree will completely shear and detach the ligaments of the knee. Such an injury will result in extreme pain and an inability to bear weight on the joint or the leg.

The most effective means of destroying a joint is to create a fulcrum point against a “bony landmark” on your own body and to destroy the joint capsule by forcing the joint to bend in a direction and degree of motion that the joint would not normally bend to. A bony landmark is a location on a joint that provides a firm “table” over which you can effectively apply force to an attacker’s joint. In the demonstration photographs to follow I am demonstrating trapping a kick and creating a fulcrum point against my forearm and hip, but you can use any firm bony surface by which to destroy a joint. In addition to using a fulcrum you should also twist or “split” the attacker’s joint. When you do this you are using both torque and shearing to dislocate the joint and to tear the ligaments and tendons of the joint capsule.

Trap the extremity, create a fulcrum, twist, torque, or “split” the joint.

Driving a shearing force (elbow) through the joint to dislocate and destroy the joint capsule.

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Like many martial arts instructors I have taught students self-defense who have been the victims of vicious attacks, incidents of physical assault, or domestic abuse. While the reader may think that my methods are extreme and that this approach is too violent, I am reminded of the young female student that I trained who was raped in her home by two men, at knife point, and in front of her eleven year old daughter and husband. I believe that she would disagree with you.

Many traditional martial artists enjoy the esoteric, metaphysical, and philosophical dimensions of their art and the many benefits that are derived for their mind, body, and spirit, but it must not be forgotten that the authors and originators of these arts were themselves fierce fighters and warriors who lived, not unlike today, in a time of lawlessness and violence. The growth of the martial arts was nourished and watered by the need for personal and family protection. That need still exists today.

The context of this article, and the previous two parts of this series, is that situational awareness, avoidance, and de-escalation has failed, and you are now in a life and death self-defense situation. Therefore, the techniques that are described in this article are designed to preserve your life, or the life of someone else. As a martial arts instructor to have a student reach this point and realization means that everything that I have attempted to inculcate within them in terms of preserving the peace, avoiding violence, and that “It is better to heal than to harm” has failed. In this kind of situation force is justified, warranted, and perhaps the only way that you will survive. To prevail you must persevere mentally and physically and be willing to escalate the violence to the point of incapacitating your attacker. If violence must occur do not hesitate to inflict it. From the words of one of my teachers, “Never enter a fight without the intention to kill, and the willing acceptance of your death. But do neither, do not kill and do not die.” The meaning of these words is to never face an opponent in any contest without the expectation of death, even in the most benign of encounters. This attitude speaks to the heart of the martial spirit.

It is recommended that anyone who believes that they may be placed in a situation where they have to employ maiming or lethal force should educate themselves regarding their local or national self-defense laws and the legal consequences of injuring or killing an attacker. For example, in some legal jurisdictions you have the right to preemptive offensive actions if you believe that your life is endangered. While you may have the legal right to defend yourself there is a definite legal distinction between acts of self-defense to the point of incapacitating your attacker and being able to withdraw from an attack and crossing the line from self-defense into engaging in “combat”. In many legal jurisdictions, although you may have first been the victim of an attack, if you cross the line into combat you have become an aggressor and both you and your attacker will be subject to legal sanctions. As many legal advisor’s state, “The first fight is to defend yourself or those you love, the second fight is the legal battle that will often follow the incident”. The second fight may be against criminal charges or defense against a civil lawsuit from your attacker or their family.

Chin Na and the Traditional Martial Arts: Traditional Chinese martial arts, including both internal and external systems, contain Chin Na techniques intended to seize, hold, or lock joints. For those readers unfamiliar with Chin Na technique, applications, and terminology these are the board categories: 1. "Fen jin" or "zhua jin" (dividing the muscle/tendon, grabbing the muscle/tendon). Fen means "to divide", zhua is "to grab" and jin means "tendon, muscle, sinew". They refer to techniques which tear apart an opponent's muscles or tendons.

2. "Cuo gu" (misplacing the bone). Cuo means "wrong, disorder" and gu means "bone". Cuo gu therefore refer to techniques which put bones in wrong positions and is usually applied specifically to joints.

3. "Bi qi" (sealing the breath). Bi means "to close, seal or shut" and qi, or more specifically kong qi, meaning "air". "Bi qi" is the technique of preventing the opponent from inhaling. This differs from mere strangulation in that it may be applied not only to the windpipe directly but also to muscles surrounding the lungs, supposedly to shock the system into a contraction which impairs breathing.

4. "Dian mai" or "dian xue" (sealing the vein/artery or acupressure cavity). Like the Cantonese Dim Mak, these are the technique of sealing or striking blood vessels and chi points.

Historically, and for military applications, original traditional martial arts systems contained strikes and grappling techniques intended to maim or to kill. For the purposes of sports competition these techniques were removed or watered down to the point where succeeding generations of marital artists either did not receive realistic training in these techniques or they had little or no practical experience in their application.

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In Chen Pan Ling’s Original Tai Chi Chuan Textbook, translated by his student Y.W. Chang Chen, Pan Ling wrote, “In ancient times, Chinese martial arts experts knew physiology very well. They used hit-vital point (tien Hsueh) to destroy the nervous system, to stop chi and blood circulation,,., and to damage the internal organs of the body. They used catch-and-snap technique (chin na) specifically to damage muscles, irritate sinew points and tendons, and to control the functions of the joints.” Chen Pan Ling then continues by stating, “If you do not know physiology well it is impossible to use such extraordinary techniques. He then continues his discussion by explaining how to train in these techniques.

Photo of the author with Y.W. Chang student of Chen Pan Ling and the authorized translator of his book, Chen Pan-Ling’s Original Tai Chi Chuan Textbook In this era of “mixed martial arts”, the traditional martial arts have been the recipient of criticism by amateur sports martial artists who fight for titles and trophy’s and professional sports fighters who compete for titles and money. Of course, unless a fighter is visiting from another planet all fighting systems practiced today originated from one or more traditional martial arts. There are those who like to point out that traditional martial arts and martial artists frequently do not do well in sporting contests against contemporary mixed martial artists.

However, there are numerous examples of traditionally trained marital artists who have successfully “crossed over” from the traditional martial arts to contemporary sport fighting.

There are many reasons for the poor performance of some traditional marital artists who attempt to compete against fighters in mixed martial arts competition. Some of the reasons are related to poor training and conditioning, lack of complete training in a traditional martial art system where vital training such as Chin Na training has been omitted, and unrealistic or delusion thinking regarding the esoteric applications of complex traditional fighting techniques. Perhaps the main reason is that in order to compete in modern sporting contests a traditional martial artist must adhere to a set of competition rules that strip away the maiming and killing techniques that have been the foundation of most traditional martial arts for centuries. Remember the adage, “Never play another man’s game” and the military mantra, “Remember, you will fight as you train!” If you train to grapple and to strike avoiding lethal and maiming anatomical areas of the body that is how you will fight in a high stress encounter. There is a significant difference in the mental intent of attacking an elbow joint to dislocate it and to rip its ligaments apart as opposed to attacking the joint to lock or control it in the hope of obtaining a submission to win a sporting contest.

An important aspect of becoming a successful, effective, enduring, and capable martial artist is found in the moral balance and the physical health of the fighter. Too many martial artists and sports fighters have succumbed to their baser instincts, passions, and behaviors. Martial arts competitors in the amateur and professional fighting sports are seduced by short term glory and rewards and sacrifice their health and physical abilities to steroids and other performance enhancing drugs. The demands of preparing and training for professional competition and then engaging in the extreme violence that is glorified in sports fighting contests rapidly expends the talent capital of young martial artists. Hence, we witness the revolving door of sports fighters who have their 15 minutes of glory only to end their careers with a catastrophic injury. Most concerning among the long list of musculoskeletal and central nervous system injuries that sports fighters experience are

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traumatic brain injuries, dementia, and Parkinson’s disease.

It is not so much the system or style of martial art that a man or woman practices that determines their capabilities as a fighter. It is rather their moral balance and physical conditioning. If a fighter cannot control their baser instincts, vices, and addictions they will not last long as a fighter, they will sacrifice their personal health and wellbeing. I frequently share this statement with my young students, “The vices and addictions that you do not overcome in your life will be the cause of your death, but before you die, you will slowly lose your abilities and capabilities, you will lose the things that you enjoy doing in life, and you will watch them fade away.”

If you are observant and consider the decline of many aging marital artists few personify good health habits and consequently by their 4th or 5th decade of life, they have experienced serious health problems such as obesity and have lost their physical capacities as martial artists. Aging is inevitable but most “aging” is neglect, the result of poor diet and lifestyle habits, and a lack of proper physical conditioning.

Misplacing the Bone, or Destruction of the Anatomical Joint Complex In this article, Part 3, we are going to investigate the application of extreme hypermobility to the joint complex involving traction, torque, and shearing forces directed at joints. The normal movements of a joint occur around an axis which involves joint physics. Joint physics may be defined as traction, torque, shearing, and accommodation, and involves flexion, extension, adduction, abduction, circumduction pronation, supination inversion and eversion. These movements are known as joint range of motion and they are normally measured in degrees of movement within the distance and direction that the joint can move. Range of motion is restricted by the anatomical architecture of a joint, mainly its capsule, ligaments, and tendons.

The joint complex is comprised of the bones of the joint, usually two, the joint capsule, ligaments, muscles, and tendons. In addition, each joint and its anatomical components will have nerves and blood vessels. All this anatomical architecture from the bones to the soft tissue structures is vulnerable to attack. Depending upon the technique used and against what kind of anatomic structure it is being used against there is the potential for an attack to result in destruction of the integrity of a joint, extreme pain, and permanent disability.

The human body contains 206 bones that are held together by connective tissues such as ligaments and tendons.

Over half of the bones in the body are contained in the hands and feet. Bones meet or are joined at a joint and there are hundreds of joints in the human body, some moveable and some immovable. From a fighting perspective we are primarily interested in the major joints that can be dislocated through the destruction of the joint complex with a tearing of the connective tissues that hold the bones of the joint in place. Using the shoulder as an example, the shoulder is the most mobile joint in the body, and it is held in place by the rotator cuff tendons. Techniques that serve to dislocate the shoulder joint will frequently cause a full or partial tear in the rotator cuff tendons and a dislocation of the shoulder joint.

Learning to dislocate a joint and to destroy the joint complex requires basic knowledge of the anatomy and physiology of joints and the limits of their normal range of motion. Anatomy and physiology of joints should be a routine part of the education of a martial artist. In addition to learning about joint anatomy and physiology martial artists need to know the kinesiology (science of body movement) or range of motion of a joint because the destruction of a joint will be accomplished by moving the joint beyond its normal range of motion. One example, again using the shoulder, is to move the shoulder joint into extreme hyperextension which will separate the head of the humerus from the glenoid fossa tearing the rotator cuff tendons and the ligaments of the joint capsule.

The following images demonstrate techniques to dislocate the shoulder joint tearing the rotator cuff tendons and the ligaments of the joint capsule. The first photograph shows a standing arm lock to shoulder dislocation, while the second technique employs a “Guillotine choke” with the radial bone applied to the attacker’s airway and positioned to crush the airway. The next step is the dislocation of the shoulder joint. Many of the major bony landmarks of your body can be used as natural surfaces over which to bend and destroy an attacker’s joints.

Learn how to use them effectively.

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Applying the standing arm lock to dislocation of the shoulder joint.

Application of a “brachial stun� to setup the entry for the Guillotine choke and radial bone airway crush.

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Demonstration of the Guillotine choke with the edge of the radial bone applying pressure to the airway, while dislocating the shoulder to destroy the joint capsule.

X-ray of dislocated shoulder
 Source: Hellerhoff / CC BY-SA (https://creativecommons.org/licenses/by-sa/3.0)

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When a sports grappler is attempting a joint lock, the technique is normally applied with increasing strength and pressure against the joint until the “end range” or limit of the range of motion of a joint is reached. Upon reaching the joints end range the martial artist will feel resistance in the joint and the attacker will begin to feel pain. This is the point in sports fighting where the opponent will submit.

Within a self-defense scenario the joint technique is not applied with gradual strength or pressure into the joint, but rather with a sudden explosive manoeuvre of the joint that quickly moves beyond the joints end range or the limit of the joints range of motion. This sudden explosive movement destroys the connective tissue attachments of the joint detaching and tearing the ligaments and tendons that are attached to the joint.

The set up and application of a joint lock in a sports contest is significantly different than that which may occur in a self-defense scenario where the purpose is not to “lock” the joint or to force a submission but rather the intention is to destroy the integrity of a joint as quickly and forcefully as possible. For example, in practicing the Japanese art of Aikido, first control involves a wrist and an elbow lock with a takedown to submission. In the Korean martial art of Hap Do Sool a wrist lock is combined with rapidly and powerfully driving an elbow through the elbow joint, dislocating the joint and tearing ligaments and tendons from the bone. The Aikido technique is elegant and “nonviolent” and the Hap Do Sool technique is brutal, violent, and effective.

Store energy like drawing a bow; release it like shooting an arrow. Yang Family Secret Transmissions Compiled and translated by Douglas Wile

Demonstration of an elbow break by drawing the wrist lock to my waist hip bone to create a fulcrum and then driving my forearm through the attacker’s elbow joint.

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Once again, I am demonstrating the concept of creating a fulcrum over which to destroy the attacker’s joint capsule. In this photograph I am rotating my waist to break the attacker’s elbow joint against the natural curvature of my rib cage.

Dislocation of the Fingers and Thumb: Opportunities to dislocate and separate the joints of the fingers, the metacarpal bones, and the thumb may occur when an attacker has grabbed on to a victim such as in a bear hug, choke hold, or any attempt to restrain a victim by holding on to their arms, wrist, or hands. In recommending an attempt to dislocate or separate the metacarpal bones of the fingers and thumb we are assuming that because of the position that the victim is in, other more lethal or maiming attacks are not practical, for example, crushing the attackers airway, gouging into an eye socket, dislocating the mandible, or grabbing and crushing the genitals.

Some traditional martial arts teach complex finger, hand, or wrist techniques and the more complex the technique is the less likely it is to be effective. If you study the anatomy and the range of joint motion in a finger joint, the metacarpals, you will learn that they have excellent range of motion in flexion but limited range of motion in extension. A finger placed into hyperextension is very vulnerable to dislocation, separation, and complete detachment of the ligaments that hold the metacarpal joints together. Depending upon the attacker’s grip and hand position the thumb is often the easiest of the digits to dislocate. Finger dislocation and separation is also very painful. However painful finger or thumb dislocation cannot be relied upon to stop an attacker in every circumstance which is why if a finger dislocation is executed against an attacker an immediate more effective follow-up technique should also be employed. There are many scenarios were pain alone is not an effective deterrent to stopping an attacker. High levels of adrenalin and street drug use are two examples where an attacker may be impervious to pain. This principle of following one disabling attack with another is called “continuous” attack and it involves attacking until the attacker is on the ground and incapacitated.

Normally, within our rules of engagement we begin with the most effective technique that the situational circumstances allow but in some cases, as with a grab or choke hold, a finger dislocation may need to be employed before a more effective technique can be executed.

As mentioned above some martial arts instructors teach intricate and complex finger dislocation techniques but the most effective way to dislocate and separate the metacarpal bones is to combine three movements; pull, twist, and bend.

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1. Pull - traction the finger.

2. Twist - torque, turn or rotate the finger.

3. Bend - hyperextend the finger to its separation point.

We find in our classes that our students learn these three finger attack manipulations faster than complex finger locks. They just must remember; pull, twist, and bend. The analogy that we use is removing a turkey leg from a roasted turkey on Thanksgiving Day. To separate the leg from the carcass you will naturally pull, twist, and bend the leg and the soft tissue structures, ligaments, tendons, and joint cartilage will separate and tear apart.

Demonstration of finger dislocation with the 3 techniques of pull, twist, and bend. Also demonstrated is stepping directly on the attacker’s foot to limit movement and their balance.

I have placed my elbow into the attacker’s throat.

I do not ascribe or recommend a cookbook approach to fighting techniques. Every attack is unique and may be completely unexpected. As they say, “Everyone has a plan until they are punched in the face”. Rather, the martial artist should be so well trained and comfortable in their art that they are capable of moving with creative, spontaneous, and instantaneous attacks and attack counters without thought.

Photograph Dislocated finger, 5th Metacarpal Source: Mdumont01 / CC BY-SA (https://creativecommons.org/licenses/by-sa/3.0)

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Conclusion: The object of this 3-part series of articles has been to investigate the medical implications of authentic Tai Chi Chuan utilized for combat purposes and as a realistic form of self-defense. It is a sad situation that contemporary Tai Chi Chuan has been stripped of much of its historical roots as a combat martial art and has been relegated as a metaphysical new age exercise and meditation practice. As a result of this inaccurate connotation Tai Chi Chuan has been discarded by many martial artists, fighters, and self- defense instructors as too esoteric and convoluted to have any practicality in serious combat, fighting, or self-defense situations.

I have an extensive personal library, collected over a period of more than 50 years, of books on Tai Chi Chuan.

None of these books, many of them considered to be Tai Chi Chuan classics, contain the basic combat applications of Tai Chi Chuan that have been included in these articles. This observation is not intended to be a criticism. In the past it was simply not considered appropriate to transmit combat applications, often thought of by teachers of Tai Chi Chuan as ‘secret” information to only be shared with “inner door” students, in publications intended for the general population.

It is my hope that this brief series of articles on The Medical Implications of Combat Tai Chi Chuan Techniques, Investigating Blunt Force Trauma, has placed some light on authentic Tai Chi Chuan and its historical roots as a formidable martial art.

Photography Credit and Assistance: Many thanks to the gifted and talented photographer Abass Ali for his excellent images and to Mohamed Jabateh who assisted this effort as my “attacker” and who endured no small amount of pain for his effort. Both Abass Ali and Mohamed Jabateh are talented and dedicated martial artists who, although in their teenage years, have trained with me for the past 8 years.

The author, in his 8th decade of life, (far right) with students Mohamed Jabateh (far left ) and Abass Ali (center)

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References: 1. Chen Pan-Ling’s Original Tai Chi Chuan Textbook, Chen Pan Ling, Transliterated by Y.W. Chang, Translated by Y.W. Chang, and Ann Carruthers, Ed.D, Blitz Design, New Orleans, Louisiana, 1998, Copyright Y. W. Chang and Ann Carruthers 2. Shaolin Chin Na Fa: Art of Seizing and Grappling, by Liu Jin Sheng, Shan Wu, Shanghai, China, 1936 (Copyright Andrew Timofeevich 2005).

3. Tai-Chi Touchstones: Yang Family Secret Transmissions, Compiled and translated by Douglas Wile, Sweet Ch’i Press, Brooklyn, New York, Copyright 1983, Douglas Wile 4. T’ai Chi Classics, Waysun Liao, Shambhala Publications, Boston & London, 1977/1990, Copyright Waysun Liao 5. Trail Guide to the Body, Second Edition, Andrew Biel, Books of Discovery, Boulder, Colorado, 1997/2001, Copyright Andrew Biel

About the author: Dr. Gregory T. Lawton, D.C., D.N., D.Ac. is a chiropractor, naprapath, and acupuncturist. He is the founder of the Blue Heron Academy of Healing Arts and Sciences where he teaches biomedicine, medical manual therapy, and Asian medicine. Dr. Lawton is nationally board certified in radiology, physiotherapy, manual medicine, and acupuncture. He was the vice president of the Physical and Athletic Rehabilitation Center which provided physical therapy for professional athletes, Olympians, and victims of closed head and spinal cord injuries.

Since the early 1960s Dr. Gregory T. Lawton has studied and trained in Asian religion, philosophy and martial arts such as Aikido, Jujitsu, Hap Do Sool, Kenpo/kempo, and Tai Chi Chuan.

Dr. Lawton’s most noted Asian martial art instructor was Professor Huo Chi-Kwang who was a student of Yang Shao Hou.

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