Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

Japanese Acupuncture Schools andtheir Characteristics

Wen, Ling Shu, Nan Jing, and Zhen Jiu Jia Yi Jing.

Hiromichi Yasui
Japan Institute of TCM Research

diagnosis of channel excess of deficiencies, which were

The Chinese medical system and techniques werereduction. The techniques of this school rely mainly on

introduced to Japan approximately 1,300 years ago.

the use of command points on arms and legs for the

Since then, the Japanese have cherished it as theirtreatment.

own medical system, using the relevant knowledge andcharacteristics, this school has been called theskills in their clinical practice. Acupuncture and"Channel therapy school".

These relied predominately on pulse diagnosis and thethen treated with appropriate reinforcement orWithreferencetothetherapeutic

moxibustion have been handed down alongside withAnother school is called the "Taikyoku Therapy

pharmacotherapy as important pillars supporting thephenomenon" which relies on the diagnosis of

medical system in an unbroken tradition to theimbalances in the five phases determined by the four

present day. During this process, Chinese theory anddiagnostic methods and subsequently the therapeutictechniques

only

adjustment of that balance. The name of this school,foundations. A number of unique Japanese concepts

the Sawada style, is derived from the name of its

were developed and put into practice. Those practicing

founder, Ken Sawada. This style uses considerable

acupuncture

moxibustion.

remained,

and

but

were

moxibustion

notformedtheindividual

schools and transmitted the advantages of their

Still another style (at that time being the latest

schools. Some of these traits are still preserved today.

kind of scholarly attainment) is based on the

These have been handed down as the Japaneseknowledge of physiology and tries to adjust imbalances

acupuncturein the autonomic nervous system using acupunctureandmoxibustion

traditionfromand moxibustion. At one of the leading centers ofgeneration to generation.
Based on a decision by the new Meiji government

academism at the time, the faculty of physiology atin 1868, acupuncture and moxibustion were set apart

Kyoto University provided the foundation for this style

from medicine in schools. Their preservation andwhich relied on a scientific basis. Although there is no

development have been maintained by acupuncturists.

specific name for this style, it could be called the

Even then, the treatment modality was not directly

scientific style.

endorsed by western medicine. However, the tradition

Besides the mentioned styles, there have been

was kept alive. Yet, the characteristics developed bynumerous acupuncturists guided by their individual

previous generations of the various schools graduallytheories and techniques but which did not develop into

faded.

formal styles.

By the 1930’s, some acupuncturists felt that it was

Japanese acupuncture and moxibustion developed

their duty to develop this traditional medicine. They

under

these

circumstances

throughmutualgathered like-minded people and started to investigate

cooperation. Yet, the situation changed drasticallythe potential of acupuncture and moxibustion. They

after Japan engaged in World War II.

read of course, the Chinese classics, but also JapaneseDuring the occupation following the war, thebooks on acupuncture and moxibustion. Using thisSupreme Commander of the Allied Powers (GHQ)information, they developed their own style. A newproceeded with a reform of the Japanese medicalgroup of schools was formed. The concepts of thosesystem. In that process, it considered the elimination

schools have been inherited by modern Japaneseof acupuncture and moxibustion and made theacupuncture and moxibustion. The acupuncture andrelevant recommendations to the Japanese Ministry ofmoxibustion of that time can grossly be classified into

Health and Welfare. Please refer to the articles

the following three forms.

"Japanese Acupuncture and Moxibustion under theFirst, a system based primarily on classics like Su
40

Rule of GHQ after World War II" by Okutsu appearing

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

Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

in previous editions of the Journal of KAIM regarding

and Chinese medical schools and then returned to

the reasons for this move.

Japan. These people practice Chinese acupuncture andThanks to the efforts of many people, anmoxibustion and have achieved many remarkable

understanding by the GHQ was achieved andresults. Collectively, they are called the Chinese

acupuncture and moxibustion was thus fortunately

school.

sparedtriggeredits

obliteration.

majorchangesConversely,
in

the

this

event

awareness

Currently, many people practice acupuncture andofmoxibustion based on their own unique concepts outside

acupuncturists. Some people considered scientificof these established schools, so that their style cannot be

evidence of the effects of acupuncture and moxibustion

identified as any of the aforementioned specific styles.

necessary, and therefore, started to measure the

However, each of the above described schools has distinct

electrical resistance of the skin and endeavored tocharacteristics, comprehension of which, will contributeverify the effects of acupuncture and moxibustion

to a deepening of the understanding of Japaneseusing modern scientific methods. Thus the newscientific (neo-scientific) school was founded.
Conversely, the schools emphasizing deficiency
and excess of the channels, believed that the relevant
theoretical foundations should be strengthened andthus put even more effort into the study of the classics.
They maintained the position that therapeutic theories
and skills, as well as the subjective evaluation of theefficacy, should be measured using a different scale.
The members of this school, who originally had alreadybeen practicing channel based therapy, started to
study not only channel therapy, but also included
far-reaching research of the classics in general. For
this reason, the school is sometimes termed the classic
school.
By

the1960s,

theinfluenceof

Chineseacupuncture and moxibustion reached Japan from
China and started to spread through the Japanese
acupuncture and moxibustion community bringing
about numerous significant changes. In particular,
President Nixon's China visit and the simultaneous
world-wide coverage of news about acupuncture
anesthesia, shocked the Japanese acupuncture andmoxibustion community. Chinese acupuncture related
literature was imported via Hong Kong. Japanese
researchers thoroughly worked through this material,
undeterred by the fact that everything was written in
Chinese, in order to incorporate this knowledge into
their own clinical practice. A significant number ofacupuncturists went to China to study acupuncture
and moxibustion in their medical research facilities

acupuncture and moxibustion.
Brief outline of the contents of each school
1. Channel therapy style
This style was introduced in the 1930s by
acupuncturists in their 20s and its theoretical andclinical maturation later developed in parallel with thegrowth of these practitioners. They considered Chineseclassics like Su Wen, Ling Shu, Nan Jing, and Zhen

Jiu Jia Yi Jing to be the foundation of acupuncture andmoxibustion. They attempted to comprehend thecontents of these books from a modern point of viewand based their clinical practice accordingly on theseprinciples.
These practitioners placed particular emphasis on
the diagnosis of deficiency and excess conditions of thechannels (jing mai). For that purpose they performed
meticulous pulse diagnoses and palpation of thechannels to determine which of the channels were in astate of either excess or deficiency. Accordingly,
treating the conditions by administering a suitablereduction of reinforcement treatment. They alsostudied the therapeutic techniques described in theclassics and tried to revive their use.
This required that the acupuncturists who were
trying to do so had to be in command of extraordinary
skills. The members of this school acquired extremely
high level skills. In particular Sorei Yanagidani, Keiri
Inoue, Sodo Okabe and others are representatives ofthis style and at the same time known for theiroutstanding technical skills.

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

41

Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

Therapeutically, they followed the instruction

establishment of channel therapy were also trying togiven in a paragraph of the "69th difficult issue" of thereach even deeper levels of understanding. The result

Nan Jing, which advises to reinforce the mother in

was the development of forms different for eachcase of deficiency and reduce the child in case ofindividual.
The basic form of channel therapy is to identify

excess. This forms the foundation of the therapy

any imbalances there might be of the channels,

advocated by this school.
Following this principle, they selected acupoints

carefully placing one needle at a time and applying

for reinforcing or reducing, based on the identification

either reinforcement or reduction in order to correctof conditions of deficiency or excess in certain

the imbalance. The needling techniques applied herechannels. This may take either the form of selecting

have been handed down since the time of the Yellow

acupoints for reinforcing or reducing conditions ofEmperor's Classic of Internal Medicine (Huang Di Nei

deficiency or excess in a single channel and reinforcingJing). For example, a needle had to be inserted at aorexcessive

particular point to specified tenths of an inch (fen),

channels. A summarization of the acupoints forretained for respiratory cycles and various techniques

reinforcing or reducing of a single channel is presented

had to be applied for either the reinforcement or

below.

reduction. Even today, this procedure is carried on andreducing

multiple

deficiencies,or

has not changed its place as the “mainstream of< Table 1 >Acupoints used for reinforcing or reducing in case of
deficiency or excess of the various channels

channel therapy”.
Sodo Okabe’s new method

Excess / Deficiency

Sodo Okabe (1907-1984) is one of the founders ofHand Tai Yin Lung Channel:

LU5 / LU9

the above mentioned channel therapy and had been a

Hand Yang Ming Large Intestine Channel:

L12 / LI11

distinguished person in command of the most

Leg Yang Ming Stomach Channel:

ST45 / ST41

outstanding technical skills. In the latter half of theHand Tai Yin Spleen Channel:

SP5 / SP2

1960, he suddenly developed a new system and

Hand Shao Yin Heart Channel:

HT7 / HT9

introduced it into his therapy. This was characterized

Hand Tai Yang Small Intestine Channel:

HT3 / SI3by

Leg Tai Yang Bladder Channel:

BL64 / BL67

distributed over the entire body. Moreover, he also

Leg Sho Yin Kidney Channel:

KI1 / KI7

needled some of the five transporting points on the

Hand Jue Yin Pericard Channel:

PC7 / PC9four extremities to achieve reinforcement or reduction.

Hand Shao Yang Tripple Warmer Channel:

TE10 / TE3

Okabe himself did not elaborate on this method, andHand Shao Yang Gallbladder Channel:

GB38 / GB43

while neither his family nor his students received any

Leg Jue Yin Liver Channel:

LR2 / LR8explanation they used this method for their treatment.

This table provides only the principle. In actual
clinical practice, suitable points are selected fromamong the listed ones, or depending on the conditions,additional points are used. Since the acupoints are
sometimes selected depending on symptoms, thetherapy

becomesquite

complexandrequiresexperience to achieve good results.

42

involvedinneedlesatvariouskey

acupoints

An explanation of the method is presented below:
Initially the patient assumes a dorsal position for
the treatment. The therapist starts then needling fromthe head. GV20, BL2, GB6, ST5, CV12, ST25, CV4.
Depending on the status of repletion or deficiency ofthe channels, essential points on the arms and legs arealso needled. At this point, the question arises, whichof the channels is deficient, whereas it is not really of
any concern as to which channel is replete (rare).

Various forms of channel therapy
Individuals

insertingtheresearchandAccordingly, assuming that the kidney channel has
been diagnosed as deficient, LU5 on the arms, KI10The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

and KI7 on the legs are needled. Other points are

perform his treatment at his place and wished he wereneedled similarly and the needles retained. On the legs

able to perform a similar treatment himself. Sawada

ST36 and SP6 are added.

systemized a number of acupoints as commonly used

After retaining the needles for 15 to 20 minutes

points and thus established a holistic therapy. Basedthey are removed and the patient is instructed toon this concept, the various parts of the body cannot beassume a prone position. The therapist then stands

considered apart from the whole and their very

next to the back of the patient and starts needlingpresence necessitated that they have some correlationfrom the head downwards. GB20, BL10, GB21, several

with the whole. Sawada used the following basic(for example BL13, BL15, BL17, BL23, BL52 andpoints.

under certain circumstances BL32) as well as BL40*

abdomen: CV12

are needled and the needles retained for 15 to 20*

back: GV12

minutes.

*

low back: BL20, BL23, BL32

The treatment is then completed by removing the*arms: LI11, left TE4

needles. Treatment duration is a little less than one*

legs: KI3

hour. The patients should relax mind and body

Shirota made some minor revisions, omitting theregardless of the kind of disease treated, returning

left TE4 and K13 points, often adding GV20 on thehome with a feeling of exhilaration.

head and among the back shu points (BL15, BL17) andFor this treatment the patient rests while thesimilar points. Currently, Shirota's method is stillneedles are retained, which has relaxing effects onfrequently used. While Sawada applied moxibustion toboth mind and body. Moreover, during the treatment

all points, Shirota used acupuncture and moxibustion

period, the conditions of excess and deficiency are

as required by the circumstances. Moreover, by adding

either reduced or reinforced by needling importantor removing points to or from the set of basic points, hepoints on the arms and legs and thus allow the balance

described the application of his holistic treatment for atopointsnumber of representative diseases (Bunshi Shirota:

appropriate for the condition at hand are not used too

Clinical Practice of Acupuncture and Moxibustion

much or too little, after the treatment, the satisfaction

Based Mainly on Case Studies Vol I, pp. 60-66,

of the patient is very great.

Sogensha Inc., 1966).

berestored.

Since

the

therapeutic

2. Schools originating from the Taikyoku Therapy(Tai-ji Therapy)
Ken Sawada (1877-1938) had extraordinary skills,
but was an unknown acupuncturist. His rise to fame
was the result of a journalist introducing him in themass media. Mr. Sawada was a master of inspection.

These concepts gained wide acceptance, butcurrently more scientific methods have become themainstream, so that they ceased to be the central topic
of academic conferences. Yet, when thinking about thereal nature of acupuncture and moxibustion, they arestill important.

Apparently he could often identify the symptoms of the

3. Scientific schools

patients who entered his consultation room without

Among the scientific schools there are numerous
schools which differ slightly from each other. Westernscientific elements were introduced in Japan toacupuncture and moxibustion in the 1930s. Professorof physiology Hidetsurumaru Ishikawa at the medical
faculty of Kyoto University, started to study
acupuncture and moxibustion via his research into
autonomous nervous function until he died in 1947.
Individuals like his students Kazuo Komai and Yoshio

asking them any questions. Yet, he did not justvaguely stare at the patients, but rather inspected andpalpated the condition of specific back shu points to
examine which organs and viscera or channels were
disturbed and then applied moxibustion to thenecessary points distributed over the entire body. Thiswas called his Taikyoku Therapy (Tai-ji Therapy).
Bunshi Shirota (1900-1974) observed Mr. Sawada

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

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Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

Nakatani, who had developed the Ryodo Raku system,
were also outstanding researchers in the field ofacupuncture and moxibustion. In Tokyo, Takeshi
Itakura conducted research at the Toho ResearchLaboratory with content that could be comprehended
by western scientists too.
After World War II, the GHQ ruling Japan tried
to eradicate acupuncture and moxibustion, but at thistime Ishikawa and Itakura used scientific evidence tooppose that movement. Ishikawa's son, Tachio, who
was a professor of pathology at Kanazawa University,
continued the research into acupuncture andmoxibustion according to his father's dying wish. He
investigated the correlation between acupoints and theelectrical resistance of the skin and subsequently
called points of low electrical resistance "electrodermal
points". Through a detailed examination of theelectrodermal point patterns associated with various
disease, he was able to develop a map.
Bunshi Shirota practiced the Taikyoku Therapy of
Ken Sawada which he developed himself into a holistic
therapy, yet sought in addition to his practice scientificexplanations. For this he was intrigued by Ishikawa
electrodermal points, so that he started commuting toKanazawa to conduct joint research with Dr.
Ishikawa. As a result, he found that the electrodermal
points often also represent therapeutic points andtherefore used them for his treatments. On his way
back from his trip to Kanazawa he frequently stopped
at the house of Shiro Hosono in Kyoto. Hosono was aphysician noted for his skilled use of Kampo medicine
and the first pioneer promoting the establishment of
the scientific foundation of Kampo. Simultaneously healso used acupuncture. They frequently spent thenight discussing acupuncture and moxibustion related
topics and gained a lot from each other. The most
famous discovery of these two people is probably"carotid sinus needling". This is a technique where theneedles are inserted so that they come in contact withthe carotid sinus, retained in this position for
approximately ten seconds and then removed.
Recently, progress has been made in research on the
carotid sinus in which sympathetic nerves have
surgically been removed from its vicinity. This
provided the observation, that this procedure may be

44particularly beneficial for patients with asthma. They
found that inserting a needle here could achieve
similar effects as the surgical procedure, and it became
clear, that the maneuver had other effects too.
Among the channel therapy schools were also
scientifically orientated schools. Masao Maruyama
observed in certain patients that a specific sensation
occurred, that followed upon needling the courses of
the channels as they are described in the classics. He
then needled the source points of each channel andrecorded the resulting feeling in the form of a map.
This proved to coincide almost completely with thedescriptions in the classics. This treatise was latertranslated into Chinese. The phenomenon he had
discovered was called the "Xun jing gan chuan
phenomenon".
Attempts to apply western science to acupuncture
were made in the field of research as well as in clinics.
The use of additional electrical stimulation may becited here as an example. The technique has also beenused in acupuncture anesthesia and could successfully
be applied to various neurological diseases anddiseases associated with pain. It is still widely used
today. However, in Japan many acupuncturists
consider it to be the wrong course and do not appraise
it at all.
From the latter half of the 1990s, the concept of
EBM became established in the medical world which
affected acupuncture and moxibustion. Evaluations oftherapies were not acknowledged any longer as they
had in the past based on subjective views, but had to
be based on evidence. This resulted in a situation,
where preference is given to therapies anybody can
perform by following certain protocols and a tendency
toward disregard of mastership.
Yet, something should be noted here. ManyJapanese acupuncturists generally do not insert theneedles very deep, so that this depth often is about thesame used with sham acupuncture. Regarding
research into acupuncture, controlled studies are used,in particular, comparing ordinary treatment withsham acupuncture. Yet, sham acupuncture itself may
be a valuable treatment, so that some Japanese
acupuncturists consider this research method asrather meaningless.

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

Volume 1, Special Edition | Current Japanese Acupuncture and Moxibustion 2010

5. Other schools

4. Chinese medical schools
Since the latter half of the 1960s, the new Chinese
medicine has been introduced to Japan from China in theform of books. During the 1970s American President,
Richard Nixon, visited China His news about
acupuncture anesthesia amazed the world. Since then
the number of people starting to study Chinese medicine
has been increasing in Japan and study groups were
established everywhere. Some of the researchers ofJapanese acupuncture and moxibustion went to China to
study Chinese acupuncture. When they returned toJapan they used the Chinese style for their treatment
and made efforts to spread those methods. In 1990
Chinese medicine was included in the standardized
teaching material of Japanese schools for acupuncture
and moxibustion and students had to become familiar
with this knowledge before their graduation.
Not all new acupuncturists are familiar with
Chinese medicine based acupuncture and moxibustion
therapy, but the relevant knowledge built up during
their training will in some form or other be integrated
into their clinical practice. Naturally, there is also a
substantial number of acupuncturists who specialize in
Chinese medicine. This Chinese medicine has alreadybecome established in Japan and may be said to haveformed one particular school.

In Japan, there are also several other concepts
and therapies. For example, "pediatric acupuncture"
has spread mainly in the area around Osaka and ischaracterized in that the needles here do not
penetrate into the body, but stimulate specificacupoints on the surface of the skin. Or else the skinis stroked along the channels in this therapy. This isa special skill and not a school, but represents one ofJapan's unique acupuncture techniques.
Micropuncture to let blood has been in wide use
in Japan for about 250 years. Recent research has
been conducted by the "Nihon Shiraku Gakkai"(Japanese Blood Letting Society) and actively
announced during

relevant conferences. Many

conditions can dramatically improve through this"Shiraku" (blood letting). Moreover, the "Dashin"method, that had its origin about 400 years ago,
seems to have experienced a revival and there iscurrently a group of practitioners who use it.
Since acupuncture and moxibustion treatment
is largely influenced by the technical skills of thepractitioner, it may be stated that there are as manystyles as there are practitioners of acupuncture andmoxibustion.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)45