The Characteristics and Essence of Japanese Acupuncture
by Oura Jikan
1. Characteristics of Japanese Acupuncture
Although Japanese acupuncture is becoming better known worldwide, the Japanese practitioners who work with it on a daily basis are challenged to explain what it really is. With this in mind, I would like to discuss in this article the essence and defining characteristics of Japanese acupuncture in order to establish a starting point for debate about it.
My focus here is traditional Japanese acupuncture -– its diagnostic methods, treatment techniques and theoretical background – as it has been practiced intermittently in Japan since the Edo era (1603-1868). In modern times, Japanese acupuncture incorporates what we regard as “scientific methods,” including Ryodoraku, low-frequency electro-acupuncture, and the use of ion-pumping cords methods and needles with polarity. While these newer methods are widely used in clinical situations, for the purposes of this discussion, I will focus on the more traditional Japanese acupuncture – which requires only a needle, a pinch of moxa wool, and no other instruments.
Japanese acupuncture generally uses much finer needles than Chinese acupuncture. The needle is inserted into the guide tube and tonification and sedation are performed with relatively shallow insertion. In terms of diagnostic methods, Japanese acupuncture places primary importance on any approach involving the practitioner’s sense of touch, such as palpation of the six radial pulses, palpation of the meridians, and abdominal diagnosis. In Chinese acupuncture, questioning and tongue diagnosis are considered more important. As I will discuss later in this article, such differences are significant in terms of the insertion techniques that have evolved in the Chinese and Japanese systems respectively.
2. Does More Stimulation Get a Better Effect?
Factors determining how much stimulation will be used in acupuncture include needle size (thick or fine, long or short), insertion depth, the intensity of the technique (tonification-sedation), and needle-retaining time. It is probably correct to assume that, in general, Chinese acupuncture tends to apply more stimulation to the patient’s body. If this is the case, questions arise. Does this greater stimulation yield a better effect -– does it bring improvement sooner and last longer?
In Japanese acupuncture, delicate stimulation is given with a fine needle. The needle is usually inserted shallowly and removed relatively quickly. Does this type of acupuncture have a lesser effect, bring less improvement that lasts for a shorter period? I can state emphatically this is not the case.
By using techniques that produce greater stimulation, a practitioner can easily over stimulate, surpassing the body’s physiological ability to accept it, and this can possibly cause damage. Acceptable limits of stimulation vary greatly from individual to individual. Big differences in sensitivity or acceptable limits of stimulation can be seen between physical laborers and professional workers, urban and rural dwellers, stocky and slender people, young individuals and older ones, and between men and women.
By living in a climate that offers four distinct seasons, the Japanese have developed a special sensitivity: they must be able to adapt to delicate changes. They have also developed skills to perform delicate work. Thus, the Japanese have developed finer gauge needles and guide tubes to facilitate relatively painless insertion into the skin. They also tend to practice shallow insertion to minimize damage to the tissues. Japanese practitioners seek to maximize results by minimizing stimulation and through the development of special tools and insertion techniques. This is not meant as a critique of Chinese acupuncture, but rather, an attempt to identify a distinctive character and philosophy underlying Japanese acupuncture.
3. The Refinement of Skill in Japanese Acupuncture
Now, I would like to examine how the Japanese have endeavored to develop refined techniques. Since I have already mentioned the development of finer gauge needles and guide tubes, let me focus on the technical aspects of Japanese acupuncture with respect to the following:
A. In diagnosis, Japanese acupuncture focuses on palpation of the six radial pulses, palpation of the meridians, and abdominal diagnosis. Of course, Chinese acupuncture also classifies pulse qualities (mai zhuang) in great detail and uses them as an important source of information in creating a complete picture of illness. Japanese acupuncture, however, incorporates just the “basic pulse qualities” – discriminating just floating/sunken, slow/fast, and deficient/excess qualities is sufficient. Instead, the method of palpating the six positions was developed, in which the findings of the superficial (floating) and deep (sunken) levels at the distal (cun), middle (guan), and proximal (chi) positions of both the wrists are used to determine deficiency or excess of each meridian. The distal, middle, and proximal positions also correspond to the Upper, Middle and Lower Burners (jiao) respectively so that one can determine the location of the problem by palpating the pulse in these positions.
Due to the influence of Kanpo (Japanese herbology), which developed a unique style of abdominal diagnosis, traditional Japanese acupuncture places its diagnostic emphasis on the abdomen. In the Mubun school, which uses the Dashin technique, the practitioner examines the pulsation in the area between Kidneys (Jin-kan no Doki) and also seeks abdominal findings of soft, hard, deficient, and excess in specific diagnostic areas.
The Dashin technique involves superficial insertion only on the abdomen with a thick gold needle: the needle handle is tapped with a wooden mallet and made to vibrate. Although applied only on the abdomen, this technique was used to treat problems of the entire body.
The main voice for the Koho school of Kanpo, Yoshimasu Todo, has stated that abdominal diagnosis is the primary diagnostic method: “The abdomen is the source of the life force, therefore all the illnesses are also rooted there.” Further to this, I would add: things that become harmful to one’s health can accumulate (stagnate) in the abdomen. These include stagnant food (Shokutai), gas, stagnant stools (Bendoku), stagnant blood (Ketsudoku), and stagnant body fluids (Suidoku). These accumulations cause problems not only in the abdomen, but throughout the body.
Treatment in the Koho school consisted of expelling these accumulations (poisons) with the “poison” in herbs. Since the days of Yoshimasu, the notion of pathologic accumulations has greatly influenced Japanese acupuncture. So, in addition to balancing the meridians via the five phasic points on the extremities, the emphasis is also to balance the five zang organs by treating abdominal tightness and masses via the Front-mu and Back-shu points.
To assess the deficiency and excess of meridians, Japanese practitioners stroke the course of the meridians and the five phasic points, feeling with their fingertips whether the skin is cold or warm, moist or dry, hard or soft. Locating acupuncture points for Japanese practitioners is not about measuring a distance in a certain part of the body such as “this point is located so and so cun superior to the wrist.” Instead it is about looking for the “live point,” the one producing a palpable reaction. This “live point” is an effective treatment point even when using minimum stimulation. Japanese acupuncture schools demonstrate a great deal of rivalry over whose “live points” are most effective. Occasionally, they bestow names to their special-effect points.
B. Most often, shallow insertion is preferred in Japanese acupuncture. Both Chinese and Japanese practitioners adjust insertion depth according to the level of the pathogen (Ja). Nevertheless, Japanese practitioners generally obtain good results while keeping the insertions as shallow as possible. In one school of acupuncture, the needle is barely inserted and, sometimes, the needle tip merely contacts the skin, as practitioners aim to affect Qi flow distally in the meridians. Another school focuses on affecting the pathology in a deep part of the body by applying subtle stimulation, inserting the needle just under the skin.
C. In Japanese acupuncture, even when performing deeper insertion, the practitioner endeavors to produce the mildest possible needling sensation. When the pathogen is so deep it cannot be treated with shallow insertion, Japanese practitioners will use deeper insertion as in Chinese acupuncture. However, they use refined techniques to avoid causing an unnecessary Deqi sensation or uncomfortable stimulation.
This Deqi sensation occurs in deep needling when the needle tip reaches the fascial layers. For patients who fear or dislike Deqi or strong stimulation, Japanese acupuncurists insert the needle to the depth just before the fascia and then manipulate the needle by twisting it or moving it up and down slightly (sparrow-pecking technique) to provide mild stimulation. Muscle tension or spasms in a relatively acute stage can be treated with this mild stimulation.
For muscle tension or spasms in a relatively chronic stage, we must insert the needle into the muscle tissues, but there are many techniques for manipulating the needle at this depth. The Irie school of acupuncture established in Kyoto in the early Edo period (1700s) placed great emphasis on the “force of twisting the needle.” These twisting techniques also included some up and down movement of the needle. One of these techniques was called “Ryusei,” where the practitioner supplely flexed the body of the needle -– as if leaves of a willow tree were rustling in the wind – in order to relax the layers of muscle. A second technique was called “Kensei,” where the practitioner repeatedly pricked the hard muscle in a fine motion with the needle tip, searching for the hardest areas – as if a dog were sniffing around for an unfamiliar object. A third technique was called “Fuubasei,” where the practitioner made a powerful twisting motion with the needle to relax stiff muscles – as if a horse were pushing a wagon against the wind. The last method was called “Kaitousei,” where the practitioner moved the needle in a large motion like a giant wave crashing against a rock and covering the whole reef. All of these Irie school techniques were handed down to the Sugiyama school and organized into the Hundred Needling Techniques (Hyappou Shinjutu).
D. The Development of Delicate Moxibustion Techniques: the technology for producing smaller, softer moxa cones improved, so did Japanese techniques using gentle heat stimulation. In modern Japan, moxibustion using a half rice-grain size cones is popular. An experienced practitioner can even perform painless treatment with a string-like cone.
4. Philosophy of Treatment
In 1988, before I became interested in Japanese acupuncture, I studied Chinese acupuncture at a hospital in Beijing. Therefore, I consider myself knowledgeable about the advantages and effectiveness of Chinese acupuncture. The main characteristic of Chinese medicine is its treatment procedure, based on a logically organized system of differentiated syndromes (bian zheng lun zhi). This is why the Chinese approach places such emphasis on the Questioning examination. Japanese acupuncture, on the other hand, generally depends on tactile information. The Japanese practitioner decides on a treatment strategy through palpation of the pulses, abdomen, and meridians, and looks for a focal point through the holistic observation of the patient. This is known as Me-no-Tsuke Dokoro (place to pay attention to). This concept may sound mysterious to Western practitioners, but for Japanese practitioners, it denotes a very precise and simple focal point for treatment. We do determine the Sho (zheng) or diagnosis, at least to identify which of the five Zang organs or meridians is imbalanced. However, the next crucial step in a Japanese treatment after diagnosis is to look at the patient from an intuitive and holistic point of view. This is a skill that the practitioner can master only through clinical experience. This skill is also known as kan-no-me (the eye of intuition).
Chinese practitioners who go through the complete process of diagnosis (bian zheng), deciding the treatment strategy (zhi fa) and point prescription (pei xue), as well as the selection of techniques (tonification or sedation) may consider Japanese acupuncture “illogical.” What are Japanese practitioners looking at when they practice the observation skills of “place to pay attention” or “eye of intuition?” They are looking at the condition of pathogenic Qi (Jaki), harmful accumulations (Doku), and fluctuations of Qi (Ki-no-hendo), which will determine the treatment strategy, point prescription, and selection of techniques. Experienced practitioners can carry out this procedure naturally and smoothly.
In the Kanze school of Noh theatre, each play consists of three stages. There is the introduction, Jo, where quiet music is played. Then, in the second stage, Ha, there is a lot of movement and change. The final stage, Kyu, is a short section with exciting atmosphere and movement. At the very end, the play returns to stillness with a trailing note. All forms of traditional Japanese theatre in addition to Noh, including Kabuki, Joruri, Gakkyoku, and Kodan, have these three stages. It can be said that Japanese traditional acupuncture also possesses Jo, Ha, and Kyu stages. The three stages can even be identified in one insertion technique, such as “twisting.” And they can be seen in a single treatment.
Japanese acupuncturists tend to dislike arguments or excessive theorizing. They would rather “exchange Qi” with their patients during the treatment and manifest “healing” and “beauty” in their lives. Japanese acupuncture is the “healing of the body and mind” as well as a treatment. It is more an art than a science.
5. Nature and the Harmonious Flow of Qi
For the Japanese, nature has never been something to conquer. Neither has the world been perceived as an arena of conflict between good and evil. In Japan, we have mountains covered with trees and verdant growth. In early spring, the snow begins to melt and new growth sprouts. In summer, the rivers gain volume from thunderstorms and flow through forest-clad mountains. In autumn, the leaves change to red and yellow. In winter, the mountains are covered with deep snow, and people wait patiently for the arrival of spring. Human beings can learn from nature how to live well. A simple lifestyle that embraces a harmonious co-existence with nature is reflected in Japanese acupuncture. Many traditional acupuncture techniques are named after the planet’s elements – earth (Chi), water (Mizu), fire (Hi), wind (Kaze)” – and creatures. There is an acupuncture technique described as “hooking Qi at the tip of the needle.” This technique is further delineated as “Hooking of Water,” “Hooking of Fire,” and “Hooking of Wind.” Needling techniques have names like Sparrow Pecking (Jakutaku-jutsu) and Leaking of Raindrops (Okurou-jutsu).
Names for Chinese acupuncture techniques are also are derived from nature and its creatures. But these usually relate to the supernatural: Penetrating Heaven Coolness (tou tian lian), Setting the Mountain on Fire (shao shan huo), Blue Dragon’s Tail Wagging (qing long bai wei), and White Tiger’s Shaking Head (bai hu yao tou). Such names suggest their inherent power and strongly connote the fight against illness.
Japanese acupuncture techniques, on the other hand, are named after natural phenomena and creatures seen everyday, such as insects, sparrows, raindrops, and the wind blowing between pine trees. I can see the difference in meanings and purposes for the naming of each set of techniques.
One important characteristic of Japanese acupuncture is the use of a “wave motion” (Hado). The classic Shindo Hiketsu Shu (Compilation of Secrets of Acupuncture), which explains the Mubun-style Dashin technique, describes the Kachibiki-no-hari and Aibiki-no-hari techniques. In the Dashin technique, a thick gold needle is inserted superficially into the body and the head of the needle is tapped rhythmically with a wooden mallet. In Kachibiki-no-hari, the practitioner taps the needle to disperse pathogenic Qi, and this is a technique of sedation. In Aibiki-no-hari, on the other hand, the practitioner gently taps the needle in order to draw pathogenic Qi to the needle tip, and then removes the needle together with the pathogenic Qi. This is a technique of tonification. The amplitude of the wave motion is what distinguishes these two techniques.
The classic Sugiyama Shiden Ryu (The Authentic Tradition of Sugiyama School) describes techniques that use a wave motion. In one, the practitioner places the guide tube over a needle already inserted into the body, then taps the top of the guide tube with his finger. In another technique, the practitioner inserts the needle, pinches his thumb and index finger around it to hold it in place (Oshide), then taps both fingertips with a heavy silver guide tube. The vibration of the needle and the wave motion of the guide tube produce the effect. Wave motions of different amplitudes can disperse, induce, or move pathogenic Qi (Jaki). At the same time, they harmonize Qi flow and relax the body. I believe that the amplitude of the wave created by the needle motion in Japanese acupuncture can be continually adjusted to suit the sensitivity of the patient and obtain the best results.
6.The Foundation of Japanese Acupuncture
Japan experiences many natural disasters, such as typhoons, earthquakes, volcanic eruptions, tsunamis, and strong thunderstorms. The Japanese long ago realized they were vulnerable to nature. So they had to discipline themselves to live in harmony with it rather than trying to conquer it. This is how ascetic training (Shugendo) and mountain climbing faiths (Sangaku Shinko) developed in various regions of the country. Traditional Japanese acupuncture emerged along with these practices. In the beginning, acupuncture in Japan consisted of techniques imported from China and the Korean Peninsula. The Japanese used these techniques to treat the royal family and nobility, and, in wartime medicine, Samurai. Later on, from the Azuchi-Momoyama period to the early Edo era, acupuncture came to be used as folk medicine among commoners. Religious authorities such as Zen Buddhist monks, Shinto priests, and Shugen ascetics established many different schools of acupuncture and contributed to its popularity.
For example, Koya Hijiri, who popularized "Moxibustion of Koubou (Koubou-no-kyu)," was a Buddhist monk. Mubun who invented the Dashin technique was a Zen Buddhist monk. Taga Houin and his colleagues were Buddhist monks who belonged to the Tendai sect. Yoshida Ikyu who established the Yoshida school of acupuncture was a Shinto priest for the Izumo-Taisha shrine. Sugiyama Waichi, a founder of the Sugiyama School, had a strong faith in Benzaiten.
Japanese arts and culture overall were heavily influenced by Buddhism, especially Zen Buddhism. Buddhist concepts found in Japanese acupuncture include Shindo Fuji (the body and the earth are inseparably connected as one), Shinshin Ichinyo (the body and mind are united as one), and Joue Fuji (pure and impure does not matter in the eternal truth). These concepts were reformulated in Taga Houin’s maxim about acupuncture, Seija Ichinyo (Evil Qi and Normal Qi are united as one) as well as in Mubun’s idea that, “The technique of tonification (Ho) can be sedation (Sha) and likewise the technique of sedation (Sha) can be tonification. Sedation exists within tonification technique and tonification exists within sedation technique.”
Japanese practitioners also felt that they should disregard excessive theorizing about acupuncture and distill the theory down to “one true principle.” This is reflected in some of the classical Japanese texts on acupuncture. In Shinchi Sho (The Book of Acupuncture Treatment), it is stated that, “There is sedation but no tonification technique in acupuncture.” Another classic, Shindo Happi, (Uncovering the Secrets of Acupuncture) written by Kengyou Ashiwara near the end of Edo period, introduced the idea that “all the illnesses originate from one pathogen (Ja).”
7. The Practitioner’s State of Mind
The practitioner’s state of mind has always been regarded as important in the practice of Japanese acupuncture. There is an old saying that “Medicine is (the doctor’s) intention (to heal) (I-wa I-nari).” The practice of medicine should be the manifestation of the practitioner’s wish to help patients who are suffering. True healing cannot occur if the practitioner is thinking “how much should I charge this patient?”
In Buddhism, saving people from suffering and bringing joy is an act of compassion (Bakku Yoraku). An acupuncturist’s state of mind should also be one of compassion. Many skilled acupuncturists in the Edo era talked about the importance of the practitioner’s mental training. The classic Shindo Hiketsu Shu states that, “The principle of our school is to pay attention to the state of one’s mind during the needle insertion. If one has a quiet mind and is not bothered by thoughts of mundane matters, (the treatment) can be natural, free, spiritual, unrestricted, and mysteriously effective.”
The classic Shindo Happi also states that, “Above all, you must practice controlling your mind. When you are successful in stilling your mind, you can do anything you wish.”
In the Kaiden volume of the Japanese acupuncture classic Sugiyama Shinden Ryu, this is elucidated as follows: “After he has successfully performed the tonification and sedation technique, the practitioner will achieve a state of mind called Shinsei (mind achieved).” It further states that, “After the practitioner brings the patient’s body to the state that it should have been in, the body will enter the state of fusion where we can no longer classify the body into the concepts of Cold, Heat, Deficient, or Excess.” This state is called Konka (state of fusion) and when it happens, it is the time that you can simply remove the needle.”
To convey the essence of their teachings, the authors of traditional Japanese acupuncture texts would conclude their work with a classic Japanese poem (Waka). These particular poems were called Douka (poems of The Way). I have cited a few of the more famous ones below.
When shooting without drawing the bow and releasing an arrow, you may not hit the target, but neither will you miss the target.
Shindo Hiketsu Shu (Compilation of Secrets of Acupuncture)
A person’s mind can be the mind of Buddha or Kami (the Shinto spirit), then, why do people waste their mind (with worries and trivial thoughts)?
Shindo Happi (Uncovering the Secrets of Acupuncture)
No matter how much you study wonderful theories, if you have not mastered your technique, you cannot disperse Jaki.
Kasuya Chui Sensei Densho (Report Paper from Kasuya Chui Sensei’s Teachings)
The secret acupuncture point of my school is located in you yourself (your ego) and resides in your mind.
Kasuya Chui Sensei Densho (Report Paper from Kasuya Chui Sensei’s Teachings)
8. Final Words
In this article I have attempted to explain the characteristics of traditional Japanese acupuncture. I have characterized it as more an art than a science. I have discussed its history and explored the influences of nature upon it, as well as the importance of the practitioner’s state of mind. Japanese acupuncture has been forced to change to keep up with the times and meet people’s needs. As a result, it has developed in various directions, including the incorporation of “scientific” and “modern” methods. Although on the surface Japanese acupuncture has changed somewhat, it still retains its basic characteristics and concepts.
When I became a disciple of Master Yokota Kanpu, the leader of our Mui-jyuku study group had a series of rules. One was, “A member who does not possess a seeker’s mind must leave our group.” Later on, Master Yokota relaxed this rule to say, “Students shall strive to improve and grow together.” He realized that times have changed and simply being strict does not encourage students, but puts them off. It has become more and more difficult to be a sincere seeker of The Way. Nonetheless, in our study group, we strive to delve deeper into the essence of what Japanese acupuncture is and pass that knowledge along to the next generation. We must first look back to our own traditions. I believe this will help us communicate better with Chinese practitioners as well as with the rest of the world.
Translated by Takahashi Hideo
Oura Jikan was born in 1955 and studied law at Keio University. He graduated from the Goto College of Medical Arts and Sciences in 1992. In 1993, he opened his own acupuncture clinic, Robou-an. He is currently Chief of Staff at the rehabilitation section of the Utsunomiya-Higashi Hospital and director of the Robou-an clinic. He is also a guest researcher at the Kitasato Institute’s Oriental Medicine Research Center and Master teacher of the Association of Seekers for Healing (Iyashi no Michi Kyokai).
(NAJOM Volume 14 Number 41 p3-p6)
by Oura Jikan
1. Characteristics of Japanese Acupuncture
Although Japanese acupuncture is becoming better known worldwide, the Japanese practitioners who work with it on a daily basis are challenged to explain what it really is. With this in mind, I would like to discuss in this article the essence and defining characteristics of Japanese acupuncture in order to establish a starting point for debate about it.
My focus here is traditional Japanese acupuncture -– its diagnostic methods, treatment techniques and theoretical background – as it has been practiced intermittently in Japan since the Edo era (1603-1868). In modern times, Japanese acupuncture incorporates what we regard as “scientific methods,” including Ryodoraku, low-frequency electro-acupuncture, and the use of ion-pumping cords methods and needles with polarity. While these newer methods are widely used in clinical situations, for the purposes of this discussion, I will focus on the more traditional Japanese acupuncture – which requires only a needle, a pinch of moxa wool, and no other instruments.
Japanese acupuncture generally uses much finer needles than Chinese acupuncture. The needle is inserted into the guide tube and tonification and sedation are performed with relatively shallow insertion. In terms of diagnostic methods, Japanese acupuncture places primary importance on any approach involving the practitioner’s sense of touch, such as palpation of the six radial pulses, palpation of the meridians, and abdominal diagnosis. In Chinese acupuncture, questioning and tongue diagnosis are considered more important. As I will discuss later in this article, such differences are significant in terms of the insertion techniques that have evolved in the Chinese and Japanese systems respectively.
2. Does More Stimulation Get a Better Effect?
Factors determining how much stimulation will be used in acupuncture include needle size (thick or fine, long or short), insertion depth, the intensity of the technique (tonification-sedation), and needle-retaining time. It is probably correct to assume that, in general, Chinese acupuncture tends to apply more stimulation to the patient’s body. If this is the case, questions arise. Does this greater stimulation yield a better effect -– does it bring improvement sooner and last longer?
In Japanese acupuncture, delicate stimulation is given with a fine needle. The needle is usually inserted shallowly and removed relatively quickly. Does this type of acupuncture have a lesser effect, bring less improvement that lasts for a shorter period? I can state emphatically this is not the case.
By using techniques that produce greater stimulation, a practitioner can easily over stimulate, surpassing the body’s physiological ability to accept it, and this can possibly cause damage. Acceptable limits of stimulation vary greatly from individual to individual. Big differences in sensitivity or acceptable limits of stimulation can be seen between physical laborers and professional workers, urban and rural dwellers, stocky and slender people, young individuals and older ones, and between men and women.
By living in a climate that offers four distinct seasons, the Japanese have developed a special sensitivity: they must be able to adapt to delicate changes. They have also developed skills to perform delicate work. Thus, the Japanese have developed finer gauge needles and guide tubes to facilitate relatively painless insertion into the skin. They also tend to practice shallow insertion to minimize damage to the tissues. Japanese practitioners seek to maximize results by minimizing stimulation and through the development of special tools and insertion techniques. This is not meant as a critique of Chinese acupuncture, but rather, an attempt to identify a distinctive character and philosophy underlying Japanese acupuncture.
3. The Refinement of Skill in Japanese Acupuncture
Now, I would like to examine how the Japanese have endeavored to develop refined techniques. Since I have already mentioned the development of finer gauge needles and guide tubes, let me focus on the technical aspects of Japanese acupuncture with respect to the following:
A. In diagnosis, Japanese acupuncture focuses on palpation of the six radial pulses, palpation of the meridians, and abdominal diagnosis. Of course, Chinese acupuncture also classifies pulse qualities (mai zhuang) in great detail and uses them as an important source of information in creating a complete picture of illness. Japanese acupuncture, however, incorporates just the “basic pulse qualities” – discriminating just floating/sunken, slow/fast, and deficient/excess qualities is sufficient. Instead, the method of palpating the six positions was developed, in which the findings of the superficial (floating) and deep (sunken) levels at the distal (cun), middle (guan), and proximal (chi) positions of both the wrists are used to determine deficiency or excess of each meridian. The distal, middle, and proximal positions also correspond to the Upper, Middle and Lower Burners (jiao) respectively so that one can determine the location of the problem by palpating the pulse in these positions.
Due to the influence of Kanpo (Japanese herbology), which developed a unique style of abdominal diagnosis, traditional Japanese acupuncture places its diagnostic emphasis on the abdomen. In the Mubun school, which uses the Dashin technique, the practitioner examines the pulsation in the area between Kidneys (Jin-kan no Doki) and also seeks abdominal findings of soft, hard, deficient, and excess in specific diagnostic areas.
The Dashin technique involves superficial insertion only on the abdomen with a thick gold needle: the needle handle is tapped with a wooden mallet and made to vibrate. Although applied only on the abdomen, this technique was used to treat problems of the entire body.
The main voice for the Koho school of Kanpo, Yoshimasu Todo, has stated that abdominal diagnosis is the primary diagnostic method: “The abdomen is the source of the life force, therefore all the illnesses are also rooted there.” Further to this, I would add: things that become harmful to one’s health can accumulate (stagnate) in the abdomen. These include stagnant food (Shokutai), gas, stagnant stools (Bendoku), stagnant blood (Ketsudoku), and stagnant body fluids (Suidoku). These accumulations cause problems not only in the abdomen, but throughout the body.
Treatment in the Koho school consisted of expelling these accumulations (poisons) with the “poison” in herbs. Since the days of Yoshimasu, the notion of pathologic accumulations has greatly influenced Japanese acupuncture. So, in addition to balancing the meridians via the five phasic points on the extremities, the emphasis is also to balance the five zang organs by treating abdominal tightness and masses via the Front-mu and Back-shu points.
To assess the deficiency and excess of meridians, Japanese practitioners stroke the course of the meridians and the five phasic points, feeling with their fingertips whether the skin is cold or warm, moist or dry, hard or soft. Locating acupuncture points for Japanese practitioners is not about measuring a distance in a certain part of the body such as “this point is located so and so cun superior to the wrist.” Instead it is about looking for the “live point,” the one producing a palpable reaction. This “live point” is an effective treatment point even when using minimum stimulation. Japanese acupuncture schools demonstrate a great deal of rivalry over whose “live points” are most effective. Occasionally, they bestow names to their special-effect points.
B. Most often, shallow insertion is preferred in Japanese acupuncture. Both Chinese and Japanese practitioners adjust insertion depth according to the level of the pathogen (Ja). Nevertheless, Japanese practitioners generally obtain good results while keeping the insertions as shallow as possible. In one school of acupuncture, the needle is barely inserted and, sometimes, the needle tip merely contacts the skin, as practitioners aim to affect Qi flow distally in the meridians. Another school focuses on affecting the pathology in a deep part of the body by applying subtle stimulation, inserting the needle just under the skin.
C. In Japanese acupuncture, even when performing deeper insertion, the practitioner endeavors to produce the mildest possible needling sensation. When the pathogen is so deep it cannot be treated with shallow insertion, Japanese practitioners will use deeper insertion as in Chinese acupuncture. However, they use refined techniques to avoid causing an unnecessary Deqi sensation or uncomfortable stimulation.
This Deqi sensation occurs in deep needling when the needle tip reaches the fascial layers. For patients who fear or dislike Deqi or strong stimulation, Japanese acupuncurists insert the needle to the depth just before the fascia and then manipulate the needle by twisting it or moving it up and down slightly (sparrow-pecking technique) to provide mild stimulation. Muscle tension or spasms in a relatively acute stage can be treated with this mild stimulation.
For muscle tension or spasms in a relatively chronic stage, we must insert the needle into the muscle tissues, but there are many techniques for manipulating the needle at this depth. The Irie school of acupuncture established in Kyoto in the early Edo period (1700s) placed great emphasis on the “force of twisting the needle.” These twisting techniques also included some up and down movement of the needle. One of these techniques was called “Ryusei,” where the practitioner supplely flexed the body of the needle -– as if leaves of a willow tree were rustling in the wind – in order to relax the layers of muscle. A second technique was called “Kensei,” where the practitioner repeatedly pricked the hard muscle in a fine motion with the needle tip, searching for the hardest areas – as if a dog were sniffing around for an unfamiliar object. A third technique was called “Fuubasei,” where the practitioner made a powerful twisting motion with the needle to relax stiff muscles – as if a horse were pushing a wagon against the wind. The last method was called “Kaitousei,” where the practitioner moved the needle in a large motion like a giant wave crashing against a rock and covering the whole reef. All of these Irie school techniques were handed down to the Sugiyama school and organized into the Hundred Needling Techniques (Hyappou Shinjutu).
D. The Development of Delicate Moxibustion Techniques: the technology for producing smaller, softer moxa cones improved, so did Japanese techniques using gentle heat stimulation. In modern Japan, moxibustion using a half rice-grain size cones is popular. An experienced practitioner can even perform painless treatment with a string-like cone.
4. Philosophy of Treatment
In 1988, before I became interested in Japanese acupuncture, I studied Chinese acupuncture at a hospital in Beijing. Therefore, I consider myself knowledgeable about the advantages and effectiveness of Chinese acupuncture. The main characteristic of Chinese medicine is its treatment procedure, based on a logically organized system of differentiated syndromes (bian zheng lun zhi). This is why the Chinese approach places such emphasis on the Questioning examination. Japanese acupuncture, on the other hand, generally depends on tactile information. The Japanese practitioner decides on a treatment strategy through palpation of the pulses, abdomen, and meridians, and looks for a focal point through the holistic observation of the patient. This is known as Me-no-Tsuke Dokoro (place to pay attention to). This concept may sound mysterious to Western practitioners, but for Japanese practitioners, it denotes a very precise and simple focal point for treatment. We do determine the Sho (zheng) or diagnosis, at least to identify which of the five Zang organs or meridians is imbalanced. However, the next crucial step in a Japanese treatment after diagnosis is to look at the patient from an intuitive and holistic point of view. This is a skill that the practitioner can master only through clinical experience. This skill is also known as kan-no-me (the eye of intuition).
Chinese practitioners who go through the complete process of diagnosis (bian zheng), deciding the treatment strategy (zhi fa) and point prescription (pei xue), as well as the selection of techniques (tonification or sedation) may consider Japanese acupuncture “illogical.” What are Japanese practitioners looking at when they practice the observation skills of “place to pay attention” or “eye of intuition?” They are looking at the condition of pathogenic Qi (Jaki), harmful accumulations (Doku), and fluctuations of Qi (Ki-no-hendo), which will determine the treatment strategy, point prescription, and selection of techniques. Experienced practitioners can carry out this procedure naturally and smoothly.
In the Kanze school of Noh theatre, each play consists of three stages. There is the introduction, Jo, where quiet music is played. Then, in the second stage, Ha, there is a lot of movement and change. The final stage, Kyu, is a short section with exciting atmosphere and movement. At the very end, the play returns to stillness with a trailing note. All forms of traditional Japanese theatre in addition to Noh, including Kabuki, Joruri, Gakkyoku, and Kodan, have these three stages. It can be said that Japanese traditional acupuncture also possesses Jo, Ha, and Kyu stages. The three stages can even be identified in one insertion technique, such as “twisting.” And they can be seen in a single treatment.
Japanese acupuncturists tend to dislike arguments or excessive theorizing. They would rather “exchange Qi” with their patients during the treatment and manifest “healing” and “beauty” in their lives. Japanese acupuncture is the “healing of the body and mind” as well as a treatment. It is more an art than a science.
5. Nature and the Harmonious Flow of Qi
For the Japanese, nature has never been something to conquer. Neither has the world been perceived as an arena of conflict between good and evil. In Japan, we have mountains covered with trees and verdant growth. In early spring, the snow begins to melt and new growth sprouts. In summer, the rivers gain volume from thunderstorms and flow through forest-clad mountains. In autumn, the leaves change to red and yellow. In winter, the mountains are covered with deep snow, and people wait patiently for the arrival of spring. Human beings can learn from nature how to live well. A simple lifestyle that embraces a harmonious co-existence with nature is reflected in Japanese acupuncture. Many traditional acupuncture techniques are named after the planet’s elements – earth (Chi), water (Mizu), fire (Hi), wind (Kaze)” – and creatures. There is an acupuncture technique described as “hooking Qi at the tip of the needle.” This technique is further delineated as “Hooking of Water,” “Hooking of Fire,” and “Hooking of Wind.” Needling techniques have names like Sparrow Pecking (Jakutaku-jutsu) and Leaking of Raindrops (Okurou-jutsu).
Names for Chinese acupuncture techniques are also are derived from nature and its creatures. But these usually relate to the supernatural: Penetrating Heaven Coolness (tou tian lian), Setting the Mountain on Fire (shao shan huo), Blue Dragon’s Tail Wagging (qing long bai wei), and White Tiger’s Shaking Head (bai hu yao tou). Such names suggest their inherent power and strongly connote the fight against illness.
Japanese acupuncture techniques, on the other hand, are named after natural phenomena and creatures seen everyday, such as insects, sparrows, raindrops, and the wind blowing between pine trees. I can see the difference in meanings and purposes for the naming of each set of techniques.
One important characteristic of Japanese acupuncture is the use of a “wave motion” (Hado). The classic Shindo Hiketsu Shu (Compilation of Secrets of Acupuncture), which explains the Mubun-style Dashin technique, describes the Kachibiki-no-hari and Aibiki-no-hari techniques. In the Dashin technique, a thick gold needle is inserted superficially into the body and the head of the needle is tapped rhythmically with a wooden mallet. In Kachibiki-no-hari, the practitioner taps the needle to disperse pathogenic Qi, and this is a technique of sedation. In Aibiki-no-hari, on the other hand, the practitioner gently taps the needle in order to draw pathogenic Qi to the needle tip, and then removes the needle together with the pathogenic Qi. This is a technique of tonification. The amplitude of the wave motion is what distinguishes these two techniques.
The classic Sugiyama Shiden Ryu (The Authentic Tradition of Sugiyama School) describes techniques that use a wave motion. In one, the practitioner places the guide tube over a needle already inserted into the body, then taps the top of the guide tube with his finger. In another technique, the practitioner inserts the needle, pinches his thumb and index finger around it to hold it in place (Oshide), then taps both fingertips with a heavy silver guide tube. The vibration of the needle and the wave motion of the guide tube produce the effect. Wave motions of different amplitudes can disperse, induce, or move pathogenic Qi (Jaki). At the same time, they harmonize Qi flow and relax the body. I believe that the amplitude of the wave created by the needle motion in Japanese acupuncture can be continually adjusted to suit the sensitivity of the patient and obtain the best results.
6.The Foundation of Japanese Acupuncture
Japan experiences many natural disasters, such as typhoons, earthquakes, volcanic eruptions, tsunamis, and strong thunderstorms. The Japanese long ago realized they were vulnerable to nature. So they had to discipline themselves to live in harmony with it rather than trying to conquer it. This is how ascetic training (Shugendo) and mountain climbing faiths (Sangaku Shinko) developed in various regions of the country. Traditional Japanese acupuncture emerged along with these practices. In the beginning, acupuncture in Japan consisted of techniques imported from China and the Korean Peninsula. The Japanese used these techniques to treat the royal family and nobility, and, in wartime medicine, Samurai. Later on, from the Azuchi-Momoyama period to the early Edo era, acupuncture came to be used as folk medicine among commoners. Religious authorities such as Zen Buddhist monks, Shinto priests, and Shugen ascetics established many different schools of acupuncture and contributed to its popularity.
For example, Koya Hijiri, who popularized "Moxibustion of Koubou (Koubou-no-kyu)," was a Buddhist monk. Mubun who invented the Dashin technique was a Zen Buddhist monk. Taga Houin and his colleagues were Buddhist monks who belonged to the Tendai sect. Yoshida Ikyu who established the Yoshida school of acupuncture was a Shinto priest for the Izumo-Taisha shrine. Sugiyama Waichi, a founder of the Sugiyama School, had a strong faith in Benzaiten.
Japanese arts and culture overall were heavily influenced by Buddhism, especially Zen Buddhism. Buddhist concepts found in Japanese acupuncture include Shindo Fuji (the body and the earth are inseparably connected as one), Shinshin Ichinyo (the body and mind are united as one), and Joue Fuji (pure and impure does not matter in the eternal truth). These concepts were reformulated in Taga Houin’s maxim about acupuncture, Seija Ichinyo (Evil Qi and Normal Qi are united as one) as well as in Mubun’s idea that, “The technique of tonification (Ho) can be sedation (Sha) and likewise the technique of sedation (Sha) can be tonification. Sedation exists within tonification technique and tonification exists within sedation technique.”
Japanese practitioners also felt that they should disregard excessive theorizing about acupuncture and distill the theory down to “one true principle.” This is reflected in some of the classical Japanese texts on acupuncture. In Shinchi Sho (The Book of Acupuncture Treatment), it is stated that, “There is sedation but no tonification technique in acupuncture.” Another classic, Shindo Happi, (Uncovering the Secrets of Acupuncture) written by Kengyou Ashiwara near the end of Edo period, introduced the idea that “all the illnesses originate from one pathogen (Ja).”
7. The Practitioner’s State of Mind
The practitioner’s state of mind has always been regarded as important in the practice of Japanese acupuncture. There is an old saying that “Medicine is (the doctor’s) intention (to heal) (I-wa I-nari).” The practice of medicine should be the manifestation of the practitioner’s wish to help patients who are suffering. True healing cannot occur if the practitioner is thinking “how much should I charge this patient?”
In Buddhism, saving people from suffering and bringing joy is an act of compassion (Bakku Yoraku). An acupuncturist’s state of mind should also be one of compassion. Many skilled acupuncturists in the Edo era talked about the importance of the practitioner’s mental training. The classic Shindo Hiketsu Shu states that, “The principle of our school is to pay attention to the state of one’s mind during the needle insertion. If one has a quiet mind and is not bothered by thoughts of mundane matters, (the treatment) can be natural, free, spiritual, unrestricted, and mysteriously effective.”
The classic Shindo Happi also states that, “Above all, you must practice controlling your mind. When you are successful in stilling your mind, you can do anything you wish.”
In the Kaiden volume of the Japanese acupuncture classic Sugiyama Shinden Ryu, this is elucidated as follows: “After he has successfully performed the tonification and sedation technique, the practitioner will achieve a state of mind called Shinsei (mind achieved).” It further states that, “After the practitioner brings the patient’s body to the state that it should have been in, the body will enter the state of fusion where we can no longer classify the body into the concepts of Cold, Heat, Deficient, or Excess.” This state is called Konka (state of fusion) and when it happens, it is the time that you can simply remove the needle.”
To convey the essence of their teachings, the authors of traditional Japanese acupuncture texts would conclude their work with a classic Japanese poem (Waka). These particular poems were called Douka (poems of The Way). I have cited a few of the more famous ones below.
When shooting without drawing the bow and releasing an arrow, you may not hit the target, but neither will you miss the target.
Shindo Hiketsu Shu (Compilation of Secrets of Acupuncture)
A person’s mind can be the mind of Buddha or Kami (the Shinto spirit), then, why do people waste their mind (with worries and trivial thoughts)?
Shindo Happi (Uncovering the Secrets of Acupuncture)
No matter how much you study wonderful theories, if you have not mastered your technique, you cannot disperse Jaki.
Kasuya Chui Sensei Densho (Report Paper from Kasuya Chui Sensei’s Teachings)
The secret acupuncture point of my school is located in you yourself (your ego) and resides in your mind.
Kasuya Chui Sensei Densho (Report Paper from Kasuya Chui Sensei’s Teachings)
8. Final Words
In this article I have attempted to explain the characteristics of traditional Japanese acupuncture. I have characterized it as more an art than a science. I have discussed its history and explored the influences of nature upon it, as well as the importance of the practitioner’s state of mind. Japanese acupuncture has been forced to change to keep up with the times and meet people’s needs. As a result, it has developed in various directions, including the incorporation of “scientific” and “modern” methods. Although on the surface Japanese acupuncture has changed somewhat, it still retains its basic characteristics and concepts.
When I became a disciple of Master Yokota Kanpu, the leader of our Mui-jyuku study group had a series of rules. One was, “A member who does not possess a seeker’s mind must leave our group.” Later on, Master Yokota relaxed this rule to say, “Students shall strive to improve and grow together.” He realized that times have changed and simply being strict does not encourage students, but puts them off. It has become more and more difficult to be a sincere seeker of The Way. Nonetheless, in our study group, we strive to delve deeper into the essence of what Japanese acupuncture is and pass that knowledge along to the next generation. We must first look back to our own traditions. I believe this will help us communicate better with Chinese practitioners as well as with the rest of the world.
Translated by Takahashi Hideo
Oura Jikan was born in 1955 and studied law at Keio University. He graduated from the Goto College of Medical Arts and Sciences in 1992. In 1993, he opened his own acupuncture clinic, Robou-an. He is currently Chief of Staff at the rehabilitation section of the Utsunomiya-Higashi Hospital and director of the Robou-an clinic. He is also a guest researcher at the Kitasato Institute’s Oriental Medicine Research Center and Master teacher of the Association of Seekers for Healing (Iyashi no Michi Kyokai).
(NAJOM Volume 14 Number 41 p3-p6)