Volume 2, Number 4 | Winter 2007

Introduction of Japanese Acupuncture

The so far described reactions appearing on theConsidering the Therapit’s Hand (8)body surface are each related to some form ofShuichi Katai, Ph.D., L.Ac., Professor
Dept. of Acupuncture and Moxibustion
Tsukuba University of Technology, Ibaraki, JapanVII. Correlation between palpation target andtreatment
The reactions found during palpation represent
some form of vital response. Yet, regarding theclassification

ofpathologic

conditions

theseindividual responses represent, proposals include:
there is still no unified theory. Some of the meridianandacupoint

theorywithinthescienceofacupuncture and moxibustion, the theory of alarmand back transport points, abdominal diagnosis
according to the Gosei-ha (a school of Kampo
medicine in Japan influenced by the medicine of Li
Dong yuan) or Koho-ha (a school of Kampo medicine
antagonistic to the Gosei-ha school, advocating a
return to the practical type of medicine of the Shang
Han Lun), tender points, trigger points etc. Each ofthese has their relevant theories, but a theory
summarizing palpation in general has not yet beenproposed.
Naturally, the meridian and acupoint theory
represents a theoretical systematic correlation
between the internal organs and the skin, but theactual existence of meridians and acupoints has not
yet been thoroughly substantiated anatomically andphysiologically. Clinically, the effective use of
meridians and acupoints is very important, but fromthe standpoint of a "reaction theory" empiricalevidence is desirable.
For this reason it has been considered necessary
to systematically organize the correlations between
pathological conditions and repeatable physicalfindings on the one hand and using those findings
with effective therapies on the other hand.

24

anomaly within the body and as such have beenorganized as (1) organs/viscera-meridian system, (2)Head's zones, (3) tender points, (4) viscerosomaticreflexes

and(5)

propagatedsensation

along

channels or similar phenomena.
I will try to provide some brief explanations about
these below.
(1) Organs/viscera-meridian system
Meridians are the pathways along which Qi
energy, environmental influences enter the bodyfrom the outside as well as the path between
problems arising from organs that are thenpropagated to and expressed on the body surface.
Accordingly, not only the channels and collaterals of
the body surface, but also the vessels extending
from the body surface to the organs are included in
the relevant examinations. These are associatedwith organs and viscera, or else connected to theseorgans and viscera. Therefore, the concept that "theconnection between acupoints, meridians, organs
and viscera is organized into a system allowing
comprehension of the pathological condition(s) andtheir correlation with the therapy" represents thefundamentalsof

theorgans/viscera-meridiansystem. This concept has been described in thesection about environmental qi of the "Su wen"(plain questions) and can be called a fundamental
assumption

notonlyforacupunctureandmoxibustion, but for oriental medicine in general.
The

designation

oforgans/viscera-meridian

system implies that the meridians connect theorgans and viscera with the body surface, i.e., forms
a coordinated connection between the interior andexterior of the body. Katsusuke Serizawa liked touse the above expression in particular because it
can be said to express the point of view of western

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

Volume 2, Number 4 | Winter 2007

medicineandattempts

todefinescientificacupuncture and moxibustion very well. It alsobears some resemblance with the viscerosomaticreflexes concept described below.

These zones have been suggested by Kurakichi
medical facility, and are belt-like zones on the body

The Head's zones have been described by thephysician(4) Twelve Hirata style body surface zones
Hirata, who was a student at the Kyoto University(2) Head's zones
Britishacupoints.

todivided into 12 zones and zones of similar names inhyperalgesic zones apparently associated witheach region are considered to be interconnected.

diseases of internal organs. The underlying nature

Using his "Hirata psychotherapy – hot needlingof this phenomenon is defined as referred pain. The

technique" to develop therapies not relying on

theory holds, that the input of afferent fibers frommoxibustion, he also proposed the "doctor in eachinternalin

family movement" aiming at universal healthdistributions

coverage under which the entire population would

particularorgans

Henryproduces

hyperalgesiainHeadandrefersurface. The head, neck, arms, trunk and legs are

hyperaesthesia,
zonal

corresponding to the innervation of the posterior
spinal roots, so that not only hyperalgesia, but also
reddening and swelling may appear. These zones
are the dermatomes. For this reason it may be said,
as detailed below, the Head has viscerosomaticreflexes.

be able to become healthier.
(5) Viscerosomatic reflexes
Viscerosomatic reflexes are reflexes mediated via
autonomic nerves and theoretically express thestatus of internal organs on the body surface (skin,muscles etc.). The pain appearing on the ulnar side(3) Tender pointsof the left arm in case of heart disease is aThis is a concept that was pointed out in therepresentative example. These autonomic nervous

1920s and refers to locations on the body surface

reflexes appear within the dermatomes, and so theythat are painful when pressed. The underlying

are theoretically easy to comprehend.

nature of this phenomenon is mainly a correlation

Again, there are also autonomic nerve reflex

with internal organs in which anomalies may havemediated somatovisceral reflexes, so that the theory

arisen. Most of these points are named after theabout viscerosomatic and somatovisceral reflexes

person who discovered them, for example Boas point

may be considered, from a western medical position,or Onodera's gluteal point.

very important for explaining acupuncture and

It is unclear how the concept of these tendermoxibustion effects.

points has evolved, but they resemble the acupoints

Research into somatovisceral reflexes started inobserved in oriental medicine. However, acupoints

Japan with research into heart rate and later

form groups of points that are related to each otherreports dealing with digestive organs (stomach andvia channels, whereas for all tender points theintestines), gallbladder, kidneys, uterus and the likerelationship is completed between the point and thehave been published.

internal organ. In this regard tender points may besaid to resemble the transport and alarm points
defined within the hypothesis of meridians and(6) Propagated sensation along channels
Reports on the propagated sensation along

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

25

Volume 2, Number 4 | Winter 2007

channels have been published in China [雄渾社].
The quality of the provided images is extremely poorand there may be often signs of modifications madeafter pictures were taken, so that their contents
cannot be considered acceptable but with some ofthese pictures the idea still comes through to acertain degree.
Masao Maruyama et al. performed "research into
Hibiki (needling sensation)" in Japan prior toresearch into the propagated sensation alongchannels phenomenon performed in China. InJapan Shoji Yoshimoto followed these lines andpresented

later

hisbook

illustratedwithphotographs, but subsequent research has not been
affected by it.
There is no doubt that lines are appearing on thebody surface very closely resembling the course of
the meridians, but further investigations in thefuture are necessary to determine what pathologicalconditions

theyrelatetoandwhatclinicalsignificance they have. In other words, etiologic
factors and their reflection on the body surface(reactions), as well as the correlations between
these reactions and the treatments performed in
response to their need to be systemized. Since thisline of reasoning represents the fundamental
theoretical system for the training of the hands oftherapists, it needs to be established as soon as
possible.

26VIII.
Conclusion to this series
The reactions identified during palpation
represent some form of vital physical response. Yet,
unless it is clear to what pathological conditions thebody is reacting, this cannot be applied
therapeutically. And, in the past many different
systems of reactions have been proposed, but there
is still no unified theory.
Naturally, the theory of meridians and acupoints
represents within the system of acupuncture andmoxibustion a systematic theory of the correlation
between internal organs and body surface, but theactual existence of meridians and acupoints has notyetbeensubstantiatedanatomicallyandphysiologically. Unless there is at least some
empirical evidence, this theory cannot be evenlightheartedly expounded based on the prevailingassumptions.
For this reason the relationship between
pathologic condition and reaction on the one hand
and reaction and therapy on the other hand should
be systematically organized and a suitable theory
established. Once this has been accomplished, theclinicaldevelopmentofacupunctureandmoxibustion will most probably advance to the nextstage. Future studies dealing with these questions
are desirable.
This being said, at the present moment theconcepts pertaining to meridians and acupoints
offer us an enormous wealth of possibilities.
Although we should not accept the practicalconcepts without question, they definitely serve as avaluable reference and may well be used to achieve
reproducible clinical results.

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