Volume 4, Number 2 | Summer 2009

Book Review“Acupuncture Core Therapy – Shakuju Chiryo”
Written by Shoji Kobayashi and Translated by Dan Kenner
Reviewed by Robert B. Gracey
MAc, DiplAc (NCCAOM), LAc.
Acupuncture Core Therapy (ACT) is theculmination of over 30 years of study and clinicalexperience by Shoji Kobayashi and his first booktranslated into English. Kobayashi Sensei
explains his unique style of Japanese
acupuncture, starting with a discussion of its
roots in classical Chinese and Japanese medicineand ending with a presentation of treatment
protocol.
In the west, ACT is referred to as Shakuju
Therapy (SJT) and I will use SJT to refer to thisstyle of acupuncture.
I will offer a brief overview, shed light on
Shakuju Therapy, summarize SJT’s key concepts
and show how these concepts work clinically. I
recommend reading Acupuncture Core Therapy
along with its companion DVD. Attending a SJTseminar is another way to learn more. Contacts
for purchasing Acupuncture Core Therapy and its
companion DVD and for SJT seminars can befound at the end of the article.
An Explanation of Cold (hie)The concepts of qi and yin-yang form thefoundation of SJT, as in other styles ofacupuncture. However, SJT also asserts thatdisease or disharmony stems from fundamental
jing qi deficiency or pathological cold/hie. The
cold/hie extends the concept of yin qi deficiency. It
embodies the sensation of physical cold to include
a more fundamental concept of jing qi deficiency.
How does cold/hie and the concept of jing qi
deficiency manifest? Over the course of one’s life,
there is a slow but steady depletion of jing qi.
During times of good health, the body canmaintain warmth reasonably well, until near32

death, where cold steadily overcomes the bodyand systems breakdown. Upon death, jing qi
becomes so depleted that the body becomes verycold. When we suffer from an imbalanced state,even before pathology manifests, a gradualdepletion of jing qi also takes place. Left
untreated, jing qi depletion can lead to disease.
Cold accelerates the normal, more gradualdepletion of jing qi, and in cases of serious disease,the outcome can be rapid leading to a total declineof jing qi or death.
The goal of SJT treatment is to return the bodyto a state of normal expenditure of jing qi toinsure a normal, healthy lifespan.
A Unique Diagnostic Approach
In SJT, cold manifests as imbalance,
congestion or stagnation of qi and blood which istermed shakuju, or “accumulations (shaku –deeper)” and “gatherings (ju – more superficial).”Diagnostically, the shakuju pattern is primarily
determined from areas of hardness, pulsations
and discomfort/pain on the palpated abdomen.
The deeper the congestion or shaku, the more
complex or serious the disharmony. See Exhibit Afor division of Abdominal Five Phase Zones.
SJT provides a unique symptom and signpattern classification used in evaluation of thepatient’s condition. This breaks from Traditional
Chinese medicine symptom-sign complexes withconventional disease names. As noted before, SJT
predisposes that the root of disharmony or
disease is jing qi or yin deficiency. To understanddisease patterns, the broader concept of jingqi/yin deficiency is explained within the context ofvacuity (deficiency) and repletion (excess) and theyin-yang paradigm. SJT groups these terms into
five symptom categories that can classify any
pathological condition. They are in progression ofsevereness: (1) yin deficiency, (2) yang excess, (3)yin excess, (4) yin and yang excess, and (5) yangdeficiency. The symptoms and signs within each

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Volume 4, Number 2 | Summer 2009

category are determined through consultationand examination of the patient. While beyond thescope of this introduction, please keep in mind
that they reflect various degrees of yin or jing qi
deficiency.
Shaku Ju Therapy Treatment
Kobayashi Sensei’s takes this concept of coldand offers a comprehensive, yet relatively simple
root treatment to restore body/mind/spiritbalance. His treatment protocol is typicallyapplied to four of the five treatment zones
mapped on the back.
SJT treatment strives to correct the energetic
imbalances by warming the cold in the body, or
putting power (tonifying) into the jing qi. The
treatment follows a series of systematic steps toboth diagnose and treat the pattern of imbalance(shaku). It starts by working to correct thesuperficial imbalance, or ju, then moving deeper
to rectify the core level of disharmony, or shaku.
Diagnosis requires that the practitioner remainaware to past medical history and observational
stimuli, ranging from such things as birth trauma
to what the patient looks like to how he/shesounds and feels through palpation.
Treatment entails a high degree of focused
intention
andconnection
betweenthepractitioner’s and patient’s fundamental coreenergy or consciousness. This feature to SJTcannot be overstated. ACT clearly explains thefundamentals of directing consciousness inconcrete terms. ACT also offers easily understoodand fundamental suggestions in how to cultivate
qi through exercises, such as qi gong practices.
In treatment, a practitioner uses single needle(or teishin) and moxibustion to warm the body.
The needle helps “gather” qi, resulting in a morebalanced state of being, and ultimately revitalizes
jing qi. Most needling with SJT is non-insertiveby virtue of the technique. Because it is so gentle,

SJT is especially appropriate for children, seniors,
patients with chronic conditions and theneedle-phobic. Moxibustion is used when qi is in
short supply or when cold or illness is more
serious. In these cases, moxibustion helps gather
heat externally.
Treatment steps are briefly outlined below:
1. Observation and inquiry
2. Initial pulse analysis
3. Check reference points (supine position:inner leg region)
4. Contact needling of the abdomen
5. Pulse diagnosis and adjustment
6. Abdominal
palpationandpattern
diagnosis
7. Check reference points (prone position:
primarily jaw, back, neck, legs and feet)
8. Contact needling of back9. Treatment of back-shū points
10. Re-examination of the abdomen (palpatefor positive changes)
11. Supplemental treatment (if needed)
12. Re-examination of pulses
13. Treatmentofshoulderregion(GB-21/TW-15 area) in seated position
The needle used in SJT treatments consists ofa #3, 40mm SJ-type filiform needle with anoval-shaped point, designed by Kobayashi Sensei.
This blunted point allows for painless assessment
and stimulation in contact needling and ofindividual acu-points. Treated back-shū points
generally follow the outer/inner Bladder lines, theHuatuojiaji lines (vertebral edge line of the spine)
and/or the Governing Vessel (GV) that are foundin five element regions (see Exhibit B for divisionof Back Five-Element Zones). Treatment
sequencing follows four forms that follow thecreative cycle. All individual acu-points aretreated on the healthy or less reactive side (Steps5, 8, 11 and 13 as shown above).
In SJT, a practitioner checks reference points

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Volume 4, Number 2 | Summer 2009

which are exhibited as symptoms and signs. They
include the patient’s complaints and what apractitioner observes with the senses — sight,sound, touch, pulse, palpation, etc. Reference
points mirror fundamental cold. During
treatment the practitioner re-checks thereference points for change. For example, apatient comes in with back pain and during thetreatment the pain lessens which means that
there is less cold in the body and that the jing qi
has been successfully tonified. Because thepractitioner rechecks reference points during thetreatment process, he/she can alter strategies
resulting in a better outcome.
Contact needling begins the core of thefundamental treatment process starting with theabdomen and moving to the back. The SJT needle(or teishin) is used to lightly stimulate theabdomen from superior to inferior in a zigzag
fashion without regard to acupuncture points orchannels. It looks similar to sanshin, a touchingneedle technique, but its effect is one oftonification rather than dispersion. Contact
needling is best understood by its visualpresentation in the DVD.
Much of SJT’s diagnostic and treatment
perspectives were originally published in myarticle from the North American Journal of
Oriental Medicine— Shakuju Therapy Seminar(Part 2): Clinical Application, NAJOM, Volume 16,
Number 45 (2009, March), pp. 34–37.
Clinical Perspective
ACT offers clinical strategies and cases
illustrating its approach to treatment. This
information is helpful to both the novice andexperienced practitioner. It offers perspectives
that enhance treatment flow and nuances that
may be overlooked. The DVD helps to paint aclearer picture of the diagnostic and treatment
process discussed in ACT.

34Conclusion

Shakuju Therapy offers a unique approach toacupuncture. It is guided by the premise thatdisharmony/disease can be classified as an
expression of cold/hie, resulting in jing qi
deficiency. The treatment approach is systematic,
simple, and entails minimal stimulation to thepatient. Its goal is to restore balance by warming
the cold in the body through tonification of jing qi.
Furthermore, the practitioner can easily refine
treatment by repeatedly checking for patient
feedback through reference point evaluation. The
results foster longer-lasting healing than any
other form of acupuncture I have practiced orwitnessed.
Kobayashi Sensei’s book and DVD provides athorough basis for understanding this uniqueform of acupuncture and is an excellent reference
for all those looking to add it to their practice.
In conclusion, I wish to express my deep
gratitude to Kobayashi Sensei, as well as theeditors of KAIM for the opportunity to write thisarticle.
Book, DVD and Seminar Information
Book Reference and DVD: Kobayshi, Shoji.
(2008). Acupuncture Core Therapy – Shakujyū
Chiryō, Translated and Edited by Dan Kenner.
Taos, New Mexico: Paradigm Publications.
Contact Redwing Books to purchase the book andDVD http://www.redwingbooks.com/Browse.jmdx.
Seminar: Ellen Leifman, Shakuju Association ofNorth America eleifman@gmail.com

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Volume 4, Number 2 | Summer 2009

Exhibit A

Exhibit B

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