Volume 1, Number 3 | Fall 2006

Introduction of Japanese Acupuncture

Moreover, the contents of the medical treatment

Considering the Therapist’s Hand (3)and the identified findings are strongly regulated by

Shuichi Katai

therapeutic methods. Depending on whether you use
acupuncture,moxibustion,manipulation

oranyIII. Training of the therapist's hands

combination of these, determines which findings are

From the author’s perspective the role of palpationin current acupuncture and moxibustion should berevised and the training of clinicians who haveacquired excellent palpation skills remains animportant task. The "training of the hands" thattraditionally has been emphasized in Japanese
acupuncture and moxibustion should be subject ofre-education during clinical acupuncture andmoxibustion training. To this end, solutions to thebelow listed tasks are urgently needed (table).

gathered. It is meaningless to gather findings for

Tasks pertaining to the improvement of palpation skills
1. Organization of the biological responses identified
through palpation
2. Establishment of palpation skills to identify
responses
3. Establishment of appropriate stimulation methods
to modify these responses
4. Establishing the theoretical role of responses,
response identification and induction of modifications
within acupuncture and moxibustion theory
5. Establishment of educational methods and practices
to acquire the above mentioned
1. Organization of the biological responses identified
through palpation
There are an infinite number of biologicalresponses. Attempts at identifying these responses
through palpation inevitably are marked bypronounced subjective trends. Doubtlessly, efforts are
made to identify the findings in an "objective" mannerand reported accordingly. It cannot be denied thatthese are nevertheless extremely subjective.
Information
pertainingtoacupuncture
andmoxibustion (not restricted to acupuncture andmoxibustion) is gathered for specific purposes based on
advanced determined therapeutic theories or medicalsystems; in other words, following the yin-yang or fivephase patterns, and then classified according topurpose.

parameters that cannot be changed and findings thatarenotsubject

totherapeuticintervention

orevaluation. That is because findings and therapies will
become organized in a system of mutual correlations.
Identification of findings that will not be the subject oftherapeutic interventions for some time is still notmeaningless, but rather needs to be incorporated as areaction within the system.
Muscle tonus is a representative palpatory finding
observed

duringacupunctureandmoxibustion

treatment and emphasized in Japan. In association
with it indurations and similar changes are alsomentioned as well as: swelling, feeling of warmth, pain
and other signs of inflammation, and of course theirrespective opposites like feeling of cold, muscle atrophyand similar responses. These findings reflect thestrong integration of physical therapy in current
Japanese acupuncture and moxibustion.
However, if palpation is performed based onclassical theory, findings that need to be mentioned
include muscle tonus, indurations, stiffness etc. thatwould be classified as "excess" conditions; contrasted
with "deficiency" conditions marked by findings likelack of muscle elasticity, popularly termed lack ofstrength. Moreover, when based on classical theory,
there are problems preceding the level of muscles thatneed to be emphasized. This refers to a lack of skintensionandelasticity,

tonusofsubcutaneous(connective) tissues and indentations due to a lack ofstrength. These are essential when considering"acupoints" and may be regarded as an extension of
the body surface reactions presented in the "Lin Shu"(Spiritual Pivot). When these findings are classified
accordingto

theYin-Yang

concept,

they

areinseparable from the concepts of tonification andsedation in clinical acupuncture and moxibustion andin this sense may require to be arranged anew.

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

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Volume 1, Number 3 | Fall 2006

For example, when considering treatment for2. Establishment of palpation skills to identify

increased muscle tonus, the condition of muscles,

responses
The technique of palpation varies depending on

tendons, and bones should be well understood and an

the kind of reaction that is sought. During theappropriate palpation should allow one to discriminate

establishment of the palpation skills, the reactions to

between them. Also, inducing contractions or extensions

be identified must be classified and systematicallyof muscles may make it easier to determine their status.

organized. Attempts at the palpation of the above

Thus, considerations of patient position and exercise

described reactions raise the question as to how toinstructions must be integrated into the theory.
For the establishment of palpation based on

develop the relevant technical skills. For the palpation
moxibustion

deficiency-excess, tonification-sedation the palpation

treatment it is ultimately important to find andshould be performed based on the correlation between

determine the sites that are to be stimulated. The sites

skin - connective tissue - muscles - bones in order toeligible for acupuncture stimulation include the skindetermine the condition of the respective tissues.

or connective tissue and muscles (occasionally thePalpation in Japanese acupuncture and moxibustionbones). Moreover, stimulation methods for the various

concentrating on locomotor organs like muscles orsites differ, so that the needle stimulation techniquesbone and tendons are, as has already been described,

for the pathologies manifesting at those various sites

is strongly influenced by physical therapy. The

also need to be classified accordingly.

performance of treatments using contact acupuncture

performed

duringacupunctureandThus, target pathologies are classified and theor

extremely

shallowneedlestimulation,also

palpation skills for their determination established.

represent an important field of Japanese acupuncture

During this procedure, patient stress (pain orand moxibustion. Therefore, organization of body

discomfort) should be kept at a minimum, while

surface information from tissues located shallower

maximum efforts should be made to avoid subjective

than muscles or bones is also essential.

evaluations. Occasionally, when only the pathology isYet, most importantly, it is necessary to carefully

identified without troubling oneself with any further

first pick up the individual physical reactions (actuallydetails, a possibly increased burden of the patientsobserving the body) in order to establish a system ofwith pain or discomfort tends to be neglected. Thispalpation without restricting oneself to the above

possibility should be kept in mind and not forgotten.

mentioned therapeutic aims or theories.

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