Volume 5, Number 4 | Winter 2010

Japanese Acupuncture - Current Research
Reality of Japanese Acupuncture and Moxibustion- A Review of History of Acupuncture and Moxibustion
System Masahiro Minowa
Visting Researcher of National University Corporation
Tsukuba University of Technology,
Faculty of Urban Environmental Sciences
Tokyo Metropolitan University Tokyo Graduate School,
Vice President of Shakai Shinkyu Kenkyukai

The conduct of “acupuncture and moxibustion” ismedical care services or medical

treatment to heal

diseases or relieve symptoms in humans. With its
roots going back to China, it is believed to have beenbrought to Japan during the period between 4th and
The “Taiho Code (Taiho Ritsuyo)”enacted in 701 expressly defined acupuncture andmoxibustion as a medical system in the clauserelating to diseases1). As civilization was progressingin the Edo period which was under the closed door
policy, acupuncture and moxibustion made their own
development independent from the original styleand became a representative medicine of Japanreferred to as Kampo medicine.
However, the new Meiji government establishedin the period of Meiji Restoration decided to adopt
Western medicine (German medicine) as the official
medicine of Japanand radically advanced theestablishment of Western medical system and its
education

together

with

the

enactmentof“Healthcare System and Laws” in 1874 (Year 7 of
Meiji). In the situation, it was generally thought that
Kampo medicine died out and similarly acupuncture
and moxibustion was extinct from the Japanesesociety.

However, in 1886 (Year 18 of Meiji) the

Meiji government officially permitted the operationof acupuncture and moxibustion as business under
the supervision of the authorities. In 1911 (Year 44
of Meiji), the “act regulating acupuncture and2national ordinance, was established. Similarly its
education system was permitted by the government2).
Thereafter, with rising health consciousness ofthe people, needs for acupuncture and moxibustion
also increased. Then the outbreak of the Second
World

War

devastatedthesurroundingsofacupuncture and moxibustion. After the War, theGHQ’s reform drove it close to the brink of extinction.
However, the “banning” was avoided by the

1. Introduction

5th century.

moxibustion business” (Regulatory Rules), the firstprotesting campaigns of the people who had
supported acupuncture and moxibustion medicine.
In 1947 (Year 22 of Showa), the original Business
Law concerning Japanese Traditional Massage,
Finger Pressure, Acupuncture, Moxacautery, andJudo-Orthopaedy

wasestablished

in

the

Constitution of Japan (Act No. 217 so-called AHAKI

Law).
After the War, there were no major institutionalchanges and stable conditions continued. In 1988
(Year 63 of Showa), substantial amendments to the
AHAKI Law were made for the purpose of improving
the qualifications and quality of practitioners. And
then and up until today, those who want to practiceacupuncture and moxibustion are required to receive
unified national examinations.
In China and South Korea where traditional
medicine of each country is valued given the social
background of individual countries, acupuncture
and moxibustion is categorized under traditional
Chinese medicine (physician of traditional Chinese
medicine) in China and traditional Korean medicine(physician of traditional Korean Medicine) in Korea
and is accepted equally to modern Western medicine.
In the United States, it has rapidly become
popular since the 1970s’ media report about
acupuncture anesthesia and is now being positioned
as a method of primary care. In European countries,
people have begun to acknowledge the value. The
world surrounding acupuncture and moxibustion

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 5, Number 4 | Winter 2010

has also begun to make dynamic changes along withmodern medical care.] He suggests [the necessity ofthe progress of integrative medicine.

conducting

In Japan of modern age, on the other hand,acupuncture and moxibustion is not regarded as

medicalsociologicalanalysisofacupuncture and moxibustion practice from theinstitutional and structural points of view 3).]

medical practice in terms of institution but isregarded as “quasi medical practice or acts similar to

2-2 Contradicting interpretations - inside or outside

medical practice,” so that under the medical

the medical systeminsurance of Japan it is not provided by way ofConcerning acupuncture and moxibustion, the“performance in kind” and the cost of the practice is

Ministry of Health & Welfare’s understanding shown

non-refundable. Some medical sociologists call thisin the 50-Year History of the Ministry of Health &medical system as a “half-institutionalized system”3).

Welfare (50-Year History) published in 1988 is […inThe modern history of Japanese acupuncture

view of the fact that Japanese traditional massage,and moxibustion has many unclear points, like a

etc. having a long history play a certain role inkind of “black box.” The main contributing factors, in

health care, four types of business including

the first place, may be that research environment

Japanese traditional massage (note by the author:

has not adequately been cultivated and there are a

acupuncture, moxibustion, Judo-Orthopaedy, etc.

limited number of researchers in Japan. There has

are referred to herein) are institutionally granted

been 100 years since the enforcement of the

only outside the medical system4).] Accordingly, in

Regulatory Rules and it is a matter of urgency toreference to the understanding of the Ministry that

dredge up facts being buried for these 100 years or

governs the nation’s healthcare, the author has

rather about 150 years after the Meiji Restoration

presented ‘acupuncture and moxibustion’ until now

for verification.

as a healthcare that is outside the healthcare
system,” which is like aniethesis, SUZUMURA, who

2. Research background

was an official and a technical officer of the Ministry2 – 1 Suggestions from medical sociology

of Health & Welfare, and Mr. Teizo ASHIDA gave

Medical sociologist Prof. Junichi Sato, says

their interpretation of acupuncture and moxibustion

about acupuncture and moxibustion: [Although

in their co-authored book [Anma, Hari-Kyu, Jyudo“medical care with acupuncture and moxibustion” isSeifuku, nado Eigyou Hou no Kaisetsu] that […that

legally bounded and regulated by “AHAKI Law,” etc.,

is to say, licensing referred to herein is the act of theits definition is made partially and very ambiguously

nation which lifts a partial banning of medical

in a polysemous and arbitrary way compared tobusiness and those who have been licensed will be

modern medicine, and it is “institutionalized

allowed to conduct a part of medical business within

partially and to a limited extent” on the premise thatthe range of individual business5).]

modern medicine has been institutionalized in

In short, from this interpretation, acupunctureadvance, so that it can be said that it is a half

and moxibustion was a “part of medical care” andinstitutionalized non-modern medicine.] He further

placed “inside.” Their interpretation was madepointed out that [it exists as “one system for giving

almost in real time, no time lag from thetreatment” in the modern Japanese society and it

establishment of the law.

functions as the second largest medical sector after

carries the recommendation from Yutaro AZUMA,The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Moreover, this book3

Volume 5, Number 4 | Winter 2010

then Director General of the Ministry of Health &3.

Welfare, at the beginning of the book. Forty years

acupuncture and moxibustion legal system

after

3-1 Summary of changes in the acupuncture andSuzumuraandAshidapublished

theirinterpretation, the Health & Welfare Ministry’s

Consideration

concerningthehistoryofmoxibustion system

understanding was expressed in printed form in the

The major changes in the acupuncture and

50 Year History. It is no wonder that there mightmoxibustion system that were made during thehave been some arbitrary manipulation as theperiod from the “enactment of Healthcare System

medical sociologist Jyunichi SATO said. In a sense,and Laws” in 1874 (Year 7 of Meiji) (which was thethe institutional double standards were applied to

Meiji government policy) to the current days are

the official standing of acupuncture and moxibustion

summarized in Table 1.

in the Japanese society. And the author thinks it aSince the decision by the Fukuoka District Court

problem that the level of awareness regarding theof 1998 for the “case of request for reversal of non-inside interpretation is low in the acupuncture andresignation

moxibustion world.

orthopaedic practitioners” (hereafter Fukuoka Court

of

the

training

schoolof

Judo-decision), vocational colleges have newly been
established one after another and new departments
have been increasingly set up, which, if notinstitutional innovations or restructuring, is aphenomenon reflecting the social conditions and asignificant fact in the institutional history6).
Table 1 Summary of changes in the acupuncture and moxibustion system
1874 (Meiji era 7) Enactment of Healthcare System and Laws
→ Principles of westernization of medical care of modern Japan, and prohibition of acupuncture andmoxibustion practice outside medical care management
1885 (Meiji ear 18) Regulatory measures for acupuncture and moxibustion business (Interior Ministry’s
notification Ko 10-go)→ supervision was transferred to local governors
1911 (Meiji era 44) Regulatory rules for acupuncture and moxibustion business (Interior Ministry’s
notification Ko 11-go)→Enactment of the first national law. Education system was explicitly described in statutory form forthe first time.
1947 (Showa 22) “The business law of anma-massage, acupuncture, moxibustion and Judo-Orthopaedics,
etc.” (Law number 217-go referred to as AHAKI Law in shortened form)→Passage of the bill after GHQ’s reform challenges.
Later, the law was revised into the law of status “concerning anma-massage-shiatsu therapists,
acupuncturists, moxibustionists, etc.”
1988 (Showa 63) Major revisions were made to the AHAKI Law designed to enhance qualifications.
→ The examination system in which examinations were held by prefectural governors was changed tothe system of uniform national examinations.

4

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 5, Number 4 | Winter 2010

3-2

An aspect of the acupuncture and moxibustion

system in modern Japanand moxibustion was controlled under the Article
537).

The Meiji Restoration was the transition period

In 1877 (Meiji 10) and onward, individual

to the modern country from the period of shogunate

prefectures began to maintain statistical records ofand han (domain) system and to the era of opening

the number of practitioners who was doing theup Japan. The Meiji government had the overriding

business of acupuncture and moxibustion in Japan.

imperative of joining the ranks of powerful advanced

In 1885 (Meiji 18), the Internal Ministry issued thecountries and was engaged in the country’s“Regulatory

measuresfor

acupuncture

modernization process with the slogans of cultural

moxibustion

business”

toprefectural

enlightenment, prosperous country and strong army.

entrusting them to permit and regulate or control

However, the domestic scene was devastating; thethe business of acupuncture and moxibustion. In fact,

Boshin War broke out, then the Seinan War followed

the original intent and purpose of the law to place

and a cholera epidemic was raging (Meiji 11).

the practice of acupuncture and moxibustion under

When Sensai NAGAYO who took the office ofandoffices,a doctor’s supervision were not achieved. In the

Deputy General of Medical Affairs of the Education

meantime,

Ministry in 1873 (Meiji 6), he issued an order forgovernment policy, ordering local governments tonationwide investigations concerning health andadopt the permission system in which they checked

medicine and submitted a draft medical law

applications and evaluate qualifications of those who

consisting 76 articles prepared based on the researchwanted to do the business of acupuncture andresults to the central government (equivalent to themoxibustion and if qualified, issued permission.

present cabinet) in 1874 (Meiji

7)7).

the

Meiji

government

issueda

The Law of

Medical System and Laws was the guidelines for

Table 2 Number of acupuncturists and physicians inJapan to undergo drastic westernization andmodern Japan

introduce Western ideas of healthcare as the

Acupuncturists

Physicians

modernized country. Article 53 of the law stipulated

1887 (Meiji 20)

12,14540,343that the practice of acupuncture and moxibustion

1897 (Meiji 30)

24,39339,392was only allowed in effect under a doctor’s
supervision. If this clause is viewed from a different

Prepared by the author based on the statisticalangle, it may be said that the Law was the official

data of NDL (National Diet Library) Modern Digital

document that recognized the existence of the people

Library and data from 50-Year History of the

who were engaged in acupuncture and moxibustion

Ministry of Welfare & Health. (The total number ofas their business – the business of acupuncture andphysicians in 1887 includes 32,839 physicians who

moxibustion was documented for the first time in thewere traditionally on their own business. The total

modern system of Japan. At the same time, thisnumber of physicians in 1897 includes 23,596

indicates the fact that acupuncture and moxibustion

physicians who were traditionally on their own

treatment was continuously being practiced duringbusiness.)

and after the period of Meiji Reformation. The Law

The 12,145 acupuncturists of 1887 (Meiji 20)

of Healthcare System and Laws did not have a

include those who started practice before thestrong binding and it is not a fact that acupuncture

notification

of

the

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)“Regulatory

measuresfor5Volume 5, Number 4 | Winter 2010acupuncture and moxibustion business”. After the

3-3 Westernization - Modern Japan’s imperative

notification, the number of acupuncturists steadily

In line with the objectives of the “Medical Systemincreased to 24,393 in 1897 (Meiji 30). The number

and Laws” of 1874 (Meiji 7), the Meiji governmentof acupuncturists almost doubled during these 10

steadily carried out the modernization process by

years, whereas physicians remained at the sameenacting decrees, in rapid succession, of the “Rules

level. It is more interesting to note that the number

for the National Medical Practitioners Qualifyingof the traditionally independent physicians focusing

Examination” in 1879 (Meiji 12), “General Rules andmainly on Kampo medicine decreased by about 9,000

Regulations for Medical Schools” in 1882 (Meiji 15),in these 10 years. In other words, although theand “Regulations concerning Doctor Licenses in

reduced number of physicians went into Western

18838).

medicine, the number of acupuncturists increased.
In those days, Western medicine was not an easy

In formulating the acupuncture related law of“Regulatory

measuresfor

acupunctureandaccess for the people of Japan from economic andmoxibustion business,” no descriptions were madelimited institutional standpoints. With roughly

concerning matters relating to Western medicine in

40,000 physicians of Western medicine, needs andthe regulatory. However, it is not correct to say thatdemands for healthcare services from the people
could not be met. In the situation, it may be said that
acupuncture and moxibustion absorbed the unmet
requirements. The Meiji government certainly kept
a tally of the number of people who were engaged in
acupuncture and moxibustion and regulated andcontrolled them. It can be gathered that because thegovernment took a national policy of adopting
Western medicine with the intention of Kampo
medicine fading away, the Meiji government had to
grant acupuncture and moxibustion as “business”
instead of medical practice.
The momentum led to the establishment of the firstnationa1911 (Meiji 44) ordinance of the “Regulatory
rules for acupuncture and moxibustion business.”
Then the education system for acupuncture andmoxibustion was put in statutory form for the first time
and the acupuncture and moxibustion education stoodat the dawn of a new era.

acupuncture and moxibustion was not involved in
the westernization at all.

Movements in concert

with the westernization were seen.
In 1889 (Meiji 22), “Tokyo Shinkyu Chi Kai (Toyo
Acupuncture Moxibustion Treatment Associatioin)
was inaugurated for the purposes of organizing an
association for practitioners engaged in the businessof acupuncture and moxibustion in Tokyo-fu and forthe enhancement of their qualifications. The key
persons in setting up the organization were Shouzou
HIROSE and Genshi OKAMOTO who were doctorsof the Imperial Household Ministry.

ceremony was attended by 1,500 people including
Shokichi TAKE (medical officer of Tokyo-fu) who
delivered a speech and Noritami KAWASAKI(anatomical physiologist of Medical School) who gave
a lecture9). After that, the association provided
voluntary education in the form of lecture or speechthrough workshops of Western medicine in order toimprove qualifications of practitioners.

6

The opening

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Volume 5, Number 4 | Winter 2010

When referring to the purpose of the enactmentof the 1911 (Meiji 44) Regulatory Rules, Noda, who

4. Unrealized enactment of “Medical Law for
acupuncture and moxibustion physicians”

was then a technician of the Internal Ministry,

With the establishment of the institutional systemexpressed his opinion that it was necessary toat the end of the Meiji period, acupuncture andurgently prepare school educational environment

moxibustion began to be recognized by the society.

and its substantiation, and that it was important to
conduct

research

to

study

mechanismsofacupuncture and moxibustion in the (Western)
medical method10). The Regulatory Rules had theprovisions concerning examinations for obtaining
license/license tag for conducting the business ofacupuncture and moxibustion. The examination
subjects provided in the Rules were related

to

Then

in

the

Taishoperiod,acupunctureandmoxibustion also began to satisfy needs of the people
with their increasing health consciousness. At the endof the Taisho era, “Shinkyu Ihou Kisei Doumei(Association)” was organized. Ryosai YAMAZAKI, anacupuncturist of Osaka, who was the main player fororganizing the association, invited Ichiro KIYOSE(who was a lawmaker of the House of Representatives)
as Adviser of the association. About lobbying activities

Western medicine such as “human body structure,andfunctions of main organs, and relations between

moxibustionists in order to advance reforms throughmuscles and neurovasculars” and “synopsis ofcorrecting institutional disparities and enhancing

sterilization.” It was the end of the Meiji era that

their status, the then “Nippon Shinkyu Zasshi

Western(Journal of Acupuncture and Moxibustion of Japan)

medicine

was

also

standardized

institutionally in acupuncture and moxibustion.

schemesofmodernacupuncturists

andmade detailed reports.

Table 3 From “Nippon Shinkyu Zasshi (Journal of Japanese Acupuncture and Moxibustion)” of the modern age
Nippon Shinkyu Zasshi Vo. 213 issued on September 10, 1921 (Taisho 10)(Dainippon Shinkyushi Kai [Great Japan Acupuncturists and Moxibustionists Association])[Legislatively, necessity of enacting the law of acupuncture and moxibustion physicians] Law maker of theHouse of Representatives, Lawyer, Bachelor of Laws-Ichiro Kiyose (Advisor of the association)[Problems of the law of acupuncture and moxibustion physicians in terms of social policy] Law maker of theHouse of Representatives Kotaro Nakagawa (his background not known)[Shinkyu Ishi-hou Ron (Discussing the Law of Acupuncure and Moxibustion Physicians)] Ryousai
Yamazaki[Shigyousha toshite Shinkyu-I-Hou Hissu no Kaname (Necessity and Important points of the law ofacupuncture and moxibustion physician as a person engaged in the business)][Problems of the law of acupuncture and moxibustion physicians viewed from the position of a physicist]
Physician Kazumi Ishimitsu
Nippon Shinkyu Zasshi Vo. 247 issued on October 10, 1924 (Dainippon Shinkyushi Kai)
[Statement of the reasons for the petition concerning the enactment of the law of acupuncture andmoxibustion physicians]
Nippon Shinkyu Zasshi Vo. 275 issued in March, 1927 (Dainippon Shinkyushi Kai)
[The petition concerning the law of acupuncture and moxibustion physicians passed both Houses ] Ryousai
Yamazaki

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Volume 5, Number 4 | Winter 2010

After the passage of the bill at the Lower HouseThe United States brought acupuncture andin 1923 (Taisho 11), no progress was made toward its

moxibustion into the country 40 years ago andenactment at the House of Lords and it was scrapped.

has rapidly arranged the education and system

Then, the “petition for the enactment of the law ofduring these 30 years. This means that theacupuncture and moxibustion physicians” was re-United States has the environment in which an

46th Imperial

institutional position can be given and actuallysubmitted to theDiet. Eventually it

was not enacted.

has been given to the method of treatment by

As legal revisions and legislation were not

manualadjustment/correction

such

as

realized, a series of processes are weathering. The

chiropractic and osteopathy and such method has

author thinks it necessary for future development ofbeen accepted culturally. It is obvious that theJapanese acupuncture and moxibustion to verify thefact that is going to be forgotten by people.

and the United States are quite different nationsin terms of the social background, of course, and

5. Conclusion
In 1978, the two-year college of acupuncture andmoxibustion was founded in Japan. And then thecollege became a university of four year system. Now
there are nine universities of acupuncture andmoxibustion in Japan, of which three universities
have the master’s program and one university has
the doctoral program. Even so, no major changes
have

taken

1997 NIH statement created a momentum. Japan

place

in

the

socialstatusofacupuncturists and moxibustionists during theperiod from the enactment of the post-war law No.
217 to the present. There may have been minor

the healthcare system. However, what the author
will be or is concerned about is dynamic
movements

betweenacupunctureandmoxibustion and the people of the U.S.
Japan,

which

begun

acupunctureandmoxibustion practice much earlier than European
countries and the United States, finds itself left
behind in the world and is becoming shadowed under
the influence of China. The underlying causes arelack of the base on which visions and strategies are

institutional changes in response to their request.

planned and a manpower shortage. This may be

Today 100 years have elapsed since the enactment ofcontributed,

inthe nationwide ordinance of 1911 (Meiji 44), theambiguous

existenceauthor thinks that no dynamic changes have been

moxibustion in the Japanese society.

the author’s opinion,ofbyacupuncture

the
and

seen in the relationship between the people andThe

acupuncture and moxibustion.

authorthinksitnecessary

that

the

In the United States, there are 60-70 schools oftransitions Japanese acupuncture and moxibustion

acupuncture and moxibustion (university or university

went through in about 150 years from the Meiji

graduate school), of which 60 schools are accredited as

Restoration to the present be verified from theeducational institutes for master’s level programs byviewpoint of research. We urgently need to dig up

ACAOMfacts that are still berried, observe unearthed facts,(The

Accreditation

Commission

Acupuncture and Oriental Medicine)12).

8

forapprehend with philosophy and create the meaning.

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Volume 5, Number 4 | Winter 2010

6. References
1) Written by FUJIKAWA, Yu. Nihon Igakushi6) OKUMIYA N: Jyudo Seifukushi touno Yousei

Youkou. Toyo Bunko 258. Heibonsha Limited,

Shisetsu no Kaisetsu Seigen to Dokusen Kinshi

Publishers. 10th reprint from the initial print.

Hou no Kisei – Judo Seifukushi Yousei Shisetsu

1990: 20-23.

Fushitei Shobun Torikeshi wo Megutte. Shakai

2) MINOWA M: Nihon no Igaku, Iryou to Shinkyu no
Ichi – Nihon Kindai-ki no Shiritsu Shinkyu Gakko
no Seiritsu Katei ni Chakumokushite. Shakai
Shinkyu-gaku Kenkyu 2010 Extra Edition. Shakai
Shinkyu-gaku Kenkyu-kai. 2010.
3) SATO J: Gendai Iryou no naka-deno Shinkyu Iryou– Iryou Shakai-gaku no Shiten kara Kangaeru.
Shakai Shinkyu-gaku Kenkyu 2009 Vol. 4. Shakai
Shinkyu-gaku Kenkyu-kai. 2010: 8-20.

Shinkyu-gaku Kenkyu-kai 2006 Inaugural issue.
Shakai Shinkyu-gaku Kenkyu-kai 2007.
7) SOEDAY:

Naimu-shouno

Shakai-shi.

University of Tokyo Press. 2007:104-10.
8) SUGAYA A: Nihon no Iryou Seido-Shi (revisedand expanded edition) Tokyo. Hara Shobo. 1978 :25.
9) Tokyo Shinkyu Hakkaishiki Shukuji Enzetsu(NDL library) edited by: Genshi OKAMOTO, a4) The Editorial Committee of 50 Year History of theworrier class member of Tochigi Prefeture.

Ministry of Health & Welfare. Kousei Mondai

Published by a printer in Tochigi Prefecture.

Kenkyu-kai. 1988.

18795) SUZUMURA S, ASHIDA T: Anma, Hari-Kyu,

10) NODA T: Kisoku Happu ni Tsuite. Tokyo

Judo-Seifuku tou Eigyou-Hou no Kaisetsu.

Shinkyu Zasshi Sankou10-go, 1912. (Edited by

Initial print. Daiichi Shorin. 2nd Chapter 2nd

Hidetaro MORI, Reprint 9 of Toyo Igaku Zasshi,

Clause No. 2 Sejyutsusha no Mibun no Shutoku

Oriet Shuppan Sha 2005.)– Menkyo no Seishitsu. 1948:23-4.

11) http://www.acaom/

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