Volume 1, Number 1 | Spring 2006

Medical History in Japan
Japanese Acupuncture and Moxibustion under the Rule of
GHQ after World War II
Recommendation by the Public Health and Welfare
Section for the prohibition of acupuncture andmoxibustion, and the response of the acupunctureindustry in Japan
Takako Okutsu

Acupuncture and moxibustion were first
introduced to Japan in the 5th Century AD from theKorean peninsula and mainland China. These
therapeutic techniques subsequently developed into anindependent system for Japanese health care based on
the Chinese view of medicine. In the 16th Century,communication between Japan and China entered a
new stage, and as interaction between the two cultures
increased, acupuncture and moxibustion came into
wider use. When the Tokugawa Shogunate came into
power in Japan, acupuncture and moxibustion playeda major role in government policies regarding medical
treatment. However, after the Meiji Restoration in
1868, German medicine became the norm, andtraditional methods such as acupuncture andmoxibustion were placed under specialized andrestrictive regulations in Japan.
The new Meiji government began to issue licenses
to acupuncture and moxibustion practitioners whocould demonstrate a uniform and standard level oftechnical expertise. Acupuncture also gained protected
status as an occupation for the blind, a practice begun
under the Tokugawa Shogunate. For this reason,
acupuncture and moxibustion came to be considered as
an important pillar in the education of the blind. The
attitudes and decisions regarding acupuncture at thattime derived in great part from the outstanding
medical and political contributions to the Shogunatethat were made by Waichi Sugiyama, the gifted 16th
Century blind acupuncturist.
Under the old system of small private classes andapprenticeships that was still in place in prewar Japan,
it was difficult to guarantee the level of acupuncturist
training. It was not uncommon for acupuncturists tofocus on old ideas and to base their practice on limited
knowledge and experience. However, in the 1920s a
few talented acupuncturists who were exceptions tothis norm began a revolutionary movement that led to
the rapid modernization and systematization ofJapanese acupuncture and moxibustion during the1930s and 1940s.

In 1937, Japan began a war of aggression thatdeveloped into World War II and that ended with theunconditional surrender of Japan in 1945. During thewar a number of medical schools were established toprovide short-term intensive training for physicians
who were then dispatched to the battlefields as
military surgeons. However, the growing shortage ofsupplies both at home and at the front created anincreasing demand for acupuncture and moxibustion,
which did not require drugs as part of the treatment
process.
The war ended in 1945, and the rebirth of Japanbegan under the direction of the Supreme Commander
for the Allied Powers (GHQ). The GHQ undertook thedemocratization of all areas of Japanese life, including
medicine.
The department that was charged with reforming
the Japanese medical system was the Public Healthand Welfare Section (PHW). Headed by Brigadier
General C. F. Sams, the medical specialists of thePHW performed detailed surveys of every region in
Japan. Their efforts were aimed at implementing a
medical system based on public health principles andat reforming the educational system to improve thequality of medical practitioners. This overall reform
would be highly respected later by the Japanese people,
who feel a deep debt of gratitude toward Brigadier
General (later Colonel) Sams.

Crawford F. Sams (1902 to 1994)
Military
surgeon,AmericanArmedForces. Stationed inJapan from 1945 to1951 as the director ofthePHW(PublicHealth and WelfareSection) of the GHQ(General Headquarters),
which was establishedin Japan in 1945. He
carried out a fullreform of the postwar
Japanese
medicalsystem, and in later
years was creditedwith protecting the defeated Japanese nation from starvationand disease. Retired in 1955, but continued to be active inresearch. Died in San Francisco in 1994 at the age of 92.
(This photo was supplied by Mainichi Newspapers.)

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

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Volume 1, Number 1 | Spring 2006Among

its

many

responsibilities,

thePHW

Recommendations of the PHW

examined numerous forms of unorthodox "folk"

In Japan immediately after WWII, the field of

medicine, and recommended the elimination of those

acupuncture moxibustion was held in high regard.

that were found to be questionable. Acupuncture andThis was partly because that system provided medical

moxibustion fell into that "questionable" category. The

treatment without drugs, which were in very short

PHW pointed to a number of problems in the field ofsupply during and immediately after the war. The

acupuncture, and suggested that, in light of thosetherapeuticproblems, such treatment should be prohibited. This

moxibustion were not inferior to drug therapy, andrecommendation

tosince treatments could provide substantial therapeutic

acupuncturists as well as to people with impaired

benefits, they gained widespread acceptance first at

vision and those responsible for their education.

the upper levels of government and then throughout

Several well-known physicians and acupuncturists

the country. Practitioners who earned a place forspoke out on behalf of acupuncture and moxibustion,

themselves within the acupuncture and moxibustion

justifying the therapeutic value of this form ofcommunity were self-confident and proud of their jobs.

cameasa

great

shock

treatment. Protests were lodged by trade associations,
includingacupuncturists'

associations

andHowever,techniques

ofacupuncturists

acupunctureatthattimeandwerearegulated under the "Regulation for the Control offederation of schools for the blind. Because of thisTrade in acupuncture and moxibustion Businesses"

public outcry and the dedicated efforts of some(1911). This placed them outside of the ordinary

Japanese bureaucrats, traditional acupuncture mix

medical system, and acupuncturists were generally

techniques were not abolished, but were allowed toconsidered to be a part of the service industry rathercontinue. Those involved with this movement tothan the medical profession. Partly as a result, noprotect acupuncture and moxibustion then began toeducational

re-examine the status of this system in Japan, and toacupuncturists. Although there were some small

think carefully about improvements that were needed,private schools that provided a very high-level

which has led to the modernization of acupuncture andcurriculum, the certification examination was open tomoxibustion in Japan.

anyone who could provide proof of having worked as asystem

hadbeenestablishedfor

This article describes the path of developments

trainee for at least four years in an acupuncture

between the time when the PHW published its

moxibustion facility. The apprenticeship system was

Recommendations for the Prohibition of Acupuncture,

still widely practiced, and acupuncturists did not hold

Moxibustion and Massage and the time when Law No.

a prestigious position in Japanese society.

217, the Law for Business of Massage, Acupuncture,

In order to move forward from that situation and to

Moxa-Cautery, Judo-Orthopedics etc., which formally

improve the social status of acupuncturists as medical

established the position of Japanese acupuncturists,practitioners, it was necessary to establish legislation

went into effect. Background research has been based

for the regulation of acupuncture and moxibustion

on source documents from the period. The effects ofpractitioners, and to reform the educational system.

PHW policies on the current status of acupuncture andMeanwhile, with Japan still under occupation by themoxibustion in Japan have also been investigated.

Allied Forces, the Constitution of Japan was proclaimed

Named

Japanese

in 1947 to replace the Constitution of the Empire ofacupuncturists, the PHW recommendation describedJapan (the Meiji Constitution of 1889). Under the newabove was a major and unforgettable landmark in theconstitution, the old regulations governing businesspost-World War II history of acupuncture moxibustion

became null and void as of December 31, 1947, and it

in Japan.

was necessary to establish new laws in their place.

28

the"GHQwhirlwind"

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

Volume 1, Number 1 | Spring 2006Those leaders in the acupuncture and moxibustion

and the Japanese government and the acupunctureindustry who had been working to improve the status ofindustry interpreted it as an "Order for the Prohibition

acupuncturists saw this as a golden opportunity, andof Moxibustion and Acupuncture."
Those involved with acupuncture and moxibustion

began a movement toward establishing legal status forfelt that the future of traditional medicine in Japanacupuncture and moxibustion practitioners.
At the same time, as part of its independent survey

was at risk, and a movement arose to prevent the lossof Japanese folk medicine, the PHW had completed aof this medical resource. The Japanese government,

detailed survey of acupuncture and moxibustion, andcaught between the requirements of working with thewas summarizing its findings unrelated to Japanese

GHQ and the need to respond to the acupuncture

thoughts and opinions. The PHW concluded that theindustry, concluded that "Without changes in the laws

traditional therapeutic system of acupuncture andthat provide the basis for the acupuncturist system, it

moxibustion should be prohibited for reasons including

will be difficult for acupuncture and moxibustion to"inadequate disinfecting procedures," "lack of ancontinue." From that point on, governmental efforts

establishedfocused on legislative reform.

educationalsystem,"and"barbarictreatment methods." These conclusions were conveyed
to the Ministry of Health and Welfare as a

Predictions and strategy of Professor Ishikawa

recommendation for the Prohibition of Acupuncture,Moxibustion and Massage.

Professor

Hidetsurumaru

Ishikawa,

Professor

Emeritus of Kyoto Imperial University and President

Those who were affected by this recommendationof Mie Prefectural Medical School (now Mie University

remember it as a dash of cold water in the face ofSchool of Medicine), was one of the first to recognize

Japanese acupuncture. It came as a major shock to thethe risk to acupuncture moxibustion.

acupuncture industry, which had expected a bright
future for acupuncture and moxibustion after the war.

At Kyoto University School of Medicine, Professor
Ishikawa

hadtaughtphysiology,andat

Mie

This directive was prepared by the GHQ staff,

Prefectural Medical School, he continued his study ofwhose point of view was based on Western medicine.

the autonomic nervous system, which led him toStaff members had little knowledge of Japaneseacupuncture research. As a young man, Professor

traditions, and no understanding of the theories ofIshikawa had studied in Germany and Russia, andEastern medicine upon which acupuncture andfrom his perspective as a physician, he predicted earlymoxibustion are based. From the Western perspectiveon that "Acupuncture is far removed from Westernat that time, Japan was an exotic country of the Far

medicine, and includes procedures that will be seen as

East, and the medical traditions of acupuncture andbarbaric," and that the GHQ would raise questions

moxibustion

toregarding "inadequate disinfection procedures," "lackunderstand, both medically and culturally. It isof uniformity in acupuncturists' knowledge base andnatural for countries and peoples to have different

technical proficiency due to the lack of an establishedviewpoints, and seen in that light, it was also quite

educational system," and "ambiguity and vagueness ofnatural for the GHQ to perceive problems withtheacupuncture and moxibustion.

considered to be the most important element ofseemedstrangeanddifficultmethod'sscientificfoundations,whichareHowever, at that time the GHQ had absoluteWestern medicine." He also predicted that the future ofauthority in Japan. The GHQ directive was strongly

acupuncture and moxibustion could be at risk,

worded, apparently denying the theoretical basis anddepending on how the Japanese government and thetechniques of acupuncture and moxibustion andacupuncture industry responded to these issues.

devaluing traditional elements of Japanese customs,

Immediately after the war ended, Professor

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Volume 1, Number 1 | Spring 2006

Ishikawa began to tell the acupuncturists with whom
he worked, "With Japan's defeat, there is a risk that
acupuncture and moxibustion may be prohibited.
However, fortunately the American people have aparticularly high regard for science. Acupuncture has
a much better chance of surviving if we can show thatit has a scientific basis. We need to begin preparing forthat now. So if you are interviewed or investigated byany of the Occupation forces (GHQ), I want you to say,
Ask Dr. Ishikawa at Mie Prefectural Medical School.1)
With this, he began to build a rational strategy for
responding to the GHQ.
Professor Ishikawa's statements appear to havebeen founded on two premises. First, was his rather
egotistical view that, with his mastery of both Western
medicine and acupuncture, he was the only person
who could protect acupuncture and moxibustion fromthe GHQ. The second was the very real fear that
acupuncture and moxibustion could be prohibited
immediately by the GHQ because of some naïve
demonstration or explanation of techniques by apractitioner who was not versed in Western medicalthought.

Hidetsurumaru Ishikawa (1878 to 1947)
Physiologist.

After

graduating from theFaculty of Medicine,TokyoImperialUniversity,

hetraveled to Germany,England, and Russia
forfurther

research

beginning in 1908. At
the age of 36 he wasappointed

asaprofessor

intheSecond Department ofPhysiology, Faculty ofMedicine,

Kyoto

Imperial University.
Accomplished researcher in the area of the autonomic nervoussystem. Served as President of Mie Prefectural Medical School(currently Mie University School of Medicine) from 1944,
directing considerable energy into scientific research onacupuncture and moxibustion. Died in 1947 at the age of 69.

30

Professor Ishikawa's Demonstration to the Mie
Military Government
On July 1, 1947, Professor Ishikawa was called inby the Mie Military Government of the GHQ, and washanded a list of 15 acupuncture-related questions. On
the following day, he responded to those questions
before First Lieutenant P. A. Weizmann, a militarysurgeon, and concluded his presentation by outlining"plans for the reeducation of current practitioners andthe raising of quality standards, to culminate incollege-level training."
The Military Government started that day bycitingacupuncture-related
issuesregarding"inadequate disinfection procedures," "the lack of anestablished educational system," and "barbaric
treatment methods", and announced that regulations
and restrictions would be applied to current
practitioners of acupuncture and moxibustion.
However, after the conversation with Professor
Ishikawa, they asked him to pursue further researchand to quickly provide them with a comparison ofacupuncture and modern medicine.
On July 7, Professor Ishikawa and one of his mosttalented acupuncturist assistants, Mr. Higuchi,
provided the Mie Military Government with ademonstration of an actual acupuncture treatment. In
front of six military personnel led by Surgeon
Lieutenant Weizmann, Ishikawa and Higuchi
scrubbed and disinfected as if they were preparing forsurgery. During the actual demonstration ofmoxibustion, they explained that treatment wasperformed with extremely small amounts ofmoxibustion, and that burns from moxibustion could
be avoided by using the combustion ash.
Ishikawa and Higuchi then suggested that
Surgeon Lieutenant Weizmann try an acupuncture
treatment. The lieutenant agreed, and confirmed thatthe treatment was painless and that he experienced
changes in sensory perception. Acupuncture was thenperformed on other members of the audience, some ofwhom reported with considerable enthusiasm that "Itdidn't hurt, and the tension in my shoulders is gone!"That day's demonstrations achieved Professor
Ishikawa's objectives quite successfully.

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Volume 1, Number 1 | Spring 2006

Next, on September 7, Professor Ishikawa took Mr.
Higuchi and other acupuncturists to Tokyo, where they
met with the Medical Affairs Office of the Ministry ofHealth and Welfare (now the Ministry of Health, Labor,and Welfare). Professor Ishikawa explained that theoffice would soon need to respond to queries from theGHQ. He bolstered the confidence of individual staff
members by describing the data from his years ofacupuncture research, which provided a scientificbasis for acupuncture. He also demonstrated the safety
and effectiveness of acupuncture treatment, using
Ministry staff members as his subjects.
This was how physicians, acupuncturists, andthose involved with acupuncture kicked off their"defensive war" against the "GHQ whirlwind."(To becontinued)

Surgeon Lieutenant Philip A. Weizmann

References
1.

Sugihara M: The footsteps of Mr. Naofumi Yamazaki,First President of Our School and Pioneer inAcupuncture and Moxibustion Education. Publicationof the Alumni Association of Meiji School of OrientalMedicine

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