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A little late on the updates but the 9th Annual In-Touch Japan Seminar is well underway! We have already had three full days of seminars in Tokyo and are currently half way through our 4th day of lectures. Our second location in Shikoku is beautiful! Tokyo is a blast but it is so nice to get out of the city!! By Heather "Maya" Suzuki, L.Ac.Maya first fell in love with acupuncture when she was 14. She went to school and became a certified practitioner of Acupuncture and Moxibustion in 2011 in Tokyo, Japan at Toyo Shinkyu Acupuncture and Moxbustion School. She has recently translated her license to Colorado, USA where she owns a thriving Japanese pediatric practice and runs the Japanese foundational acupuncture and moxibustion study group. Palpation. It is one of the common factor in all Japanese acupuncture techniques. In Japan you learn palpation for day one and continue everyday for three years. There are entire semesters of classes devoted specifically to palpation. Different styles, different methods and different teachers offer approaches that fill a tool box for years to come. That is why I am so excited to showcase Miyakawa Sensei's incredible palpation techniques. He breaks down the mystery and gives hints on how to master the subtle and gentle in seconds. For those of you who are coming to Japan this year: You're in luck because you will have the chance to study with the incredible teacher. The following video shows just a tidbit of Miyakawa Sense's palpation instruction from 2017. Enjoy. Check out this incredible technique! Tsuda Sensei was incredible last year teaching contact needling technique after technique. I am really excited to learn even more on how he applies this to traeting cancer and refining some of the skills I learned last year. Want to learn with me? Then hit the link below for more information! Check out this incredible technique! Tsuda Sensei was incredible last year teaching contact needling technique after technique. I am really excited to learn even more on how he applies this to traeting cancer and refining some of the skills I learned last year. Want to learn with me? Then hit the link below for more information! Ehrland Truitt, DOMDr. Ehrland Truitt, DOM is an acupuncturist in Santa Fe, NM and has been practicing for 18 years. He graduated from International Institute Of Chinese Medicine in 2000 and specializes in acupuncture. He is a repeat student of the In-Touch tour and the founder of the High Desert Hari Society. Miyawaki Sensei’s ki sensitivity and palpation skills are highly refined and his knowledge and insight are profoundly useful to the study and practice of acupuncture.
His subtle needling techniques and highly refined palpation methods help increase ki sensitivity and allow for rebalancing of the meridian system with very subtle treatments. He is a joy to learn from; his sense of humor and deep understanding of meridian therapy make his classes a thoroughly enjoyable experience. Due to his blindness, Miyawaki Sensei has developed a high level of ki sensitivity and the insights he shares allow all students to learn from his years of experience. Miyawaki Sensei, and his wife and clinic assistant Yukari-San, will share insights from their busy clinical practice. He has authored a bestselling Extraordinary Vessel textbook in Japan and is a professor at Morinomiya University of Medical Science. It has been a great pleasure to host Miyawaki Sensei in the United States and to share in his generous teaching. My palpation skills have improved dramatically thanks to his clinical insights and subtle, refined sense of touch. Class with Miyawaki Sensei is never dull. His puns and word play can give translators fits and keep the class laughing throughout the day. Miyawaki Sensei is one of the most exciting Meridian Therapy teachers with whom I have had the opportunity to study. Miyawaki Sensei’s ki sensitivity and palpation skills are highly refined and his knowledge and insight have been profoundly useful in improving my clinical skills. His subtle needling technqiues and palpation skills have helped me increase my sensitivity and improved my treatments. He is a joy to learn from; his sense of humor and deep understanding of meridian therapy make his classes a thoroughly enjoyable experience. Jeffrey Dann, Ph. D., L. AcJeffrey currently teaches and practices in Boulder, Colorado. He practiced for many years on the Big Island of Hawaii. His previous training was in cultural and medical anthropology. He conducted fieldwork in Japan where he also studied Kendo, Shiatsu, and Seitai-ho at the Mito Tobukan Dojo in Ibaraki Prefecture. He attained the rank of yondan in Kendo. He is currently president of the Traditional Japanese Acupuncture Foundation, and has played a key role in networking and promoting Japanese acupuncture and bodywork.Write something about yourself. No need to be fancy, just an overview. Ehrland TruittDr. Ehrland Truitt, DOM is an acupuncturist in Santa Fe, NM and has been practicing for 18 years. He graduated from International Institute Of Chinese Medicine in 2000 and specializes in acupuncture. He is a repeat student of the In-Touch tour and the founder of the High Desert Hari Society. Miyawaki Sensei’s ki sensitivity and palpation skills are highly refined and his knowledge and insight are profoundly useful to the study and practice of acupuncture.
His subtle needling techniques and highly refined palpation methods help increase ki sensitivity and allow for rebalancing of the meridian system with very subtle treatments. He is a joy to learn from; his sense of humor and deep understanding of meridian therapy make his classes a thoroughly enjoyable experience. Due to his blindness, Miyawaki Sensei has developed a high level of ki sensitivity and the insights he shares allow all students to learn from his years of experience. Miyawaki Sensei, and his wife and clinic assistant Yukari-San, will share insights from their busy clinical practice. He has authored a bestselling Extraordinary Vessel textbook in Japan and is a professor at Morinomiya University of Medical Science. It has been a great pleasure to host Miyawaki Sensei in the United States and to share in his generous teaching. My palpation skills have improved dramatically thanks to his clinical insights and subtle, refined sense of touch. Class with Miyawaki Sensei is never dull. His puns and word play can give translators fits and keep the class laughing throughout the day. Miyawaki Sensei is one of the most exciting Meridian Therapy teachers with whom I have had the opportunity to study. Miyawaki Sensei’s ki sensitivity and palpation skills are highly refined and his knowledge and insight have been profoundly useful in improving my clinical skills. His subtle needling technqiues and palpation skills have helped me increase my sensitivity and improved my treatments. He is a joy to learn from; his sense of humor and deep understanding of meridian therapy make his classes a thoroughly enjoyable experience. Bhavna Dagia (Switzerland)Bhavna Dagia has two decades of experience in the field of Chinese medicine, particularly, Acupuncture. She has trained in the UK, Canada, China and Japan as well as New York and has been practicing in UK and Canada currently in Switzerland since 10 years. Bhavna also has been practicing Tai Chi for around 30 years and occasionally teaches small classes. She is also a repeat In-Touch Japan participant. To say that the study trip to Tokyo and Shikoku was an awe-inspiring experience, would be an understatement. The level of teaching has been second to none and the generosity of all the Senseis was commendable. The students that took part come from all over the world, (USA Norway, Spain, Switzerland, Israel, UK) with varying backgrounds, and no doubt an eclectic knowledge base and equally eclectic specialties. In any case we all looked forward to this unique learning experience offered to us. Needless to say, we were not let down.
When studying Japanese style acupuncture, one receives a flavor of precision and perfection. However, because of our existing knowledge base, it is up to us as to how we choose to implement these refined techniques. The best I can describe is, imagine you are a in a top notch, high class restaurant and before you lie a plethora of dishes, which are exquisitely displayed before your very eyes. No doubt your mouth is watering and your eyes cannot get enough. Your first instinct is not even to disturb this table of perfection that lays before you. However, slowly you plunge in. Based on ones’ refined taste, each one will experience the menu differently. Some will compare to the flavors that we had before, others will experiment and mix up the dishes, while others will embrace the dishes for what they are and focus on the experience here and now. Whichever way one goes, we all will feel richer for the experience. So, what was on the menu in Japan in November 2017? Tokyo We were honored to have on day one, wonderful Miyakawa Sensei teaching Abdominal Diagnosis in Qi, Blood and Fluid differentiation for treatment of women. This was an interesting approach to abdominal palpation, diagnosis, finding patterns followed by treatment protocol using Hybrid TCM, meaning the amalgamation of TCM and traditional Japanese abdominal diagnosis. Sensei Miyakawa emphasized using gentle, painless techniques, including moxa, when people exhibit stressful signs and looking for ways to resolve counterflow patterns. The following day we were equally honored to be taught by Tusda Sensei on Tohokai method. This day concentrated on contact needling and using acupuncture in Palliative care. We learned the subtle techniques of ‘feeling’ the arrival of Qi and appreciating the gentle approach such as stroking and scatter needling, while keeping a clear head and staying focused. As patients with cancer can react strongly, and can get exhausted easily therefore gentle contact needling works well and helps soothe anxiety. There was a chance to also work with gold and silver needles. The third day at Goto College, Tokyo was with the ever charismatic Funamizu Sensei wielding his beautifully hand-made teishins with grace and finesse and making it look so easy. This day was all about using gentle techniques on people with psychological issues such as depression, anxiety, insomnia, ADHD and so on. Sensei Funamizu described how using teishins on the scalp helped many victims of the devastating Tsunami in 2011 in Japan. With all the countries facing traumatic situations, clearly there is scope to expand such a treatment protocols. There was an emphasis on learning how to make the teishins an extension of one’s hand with softness and yet allowing the flow of Qi with appropriate speed and strength and steadiness. To reiterate, the Sensei made it look effortless. We had to remind ourselves that these techniques take years to refine and continued practice is key. Shikoku Island The study trip continued for the rest of the days in Utazu at the Shikoku Acupuncture and Moxibustion Medical College. Here we were warmly welcomed by the eminent president of the college, Oasa Sensei and Yoko Oasa Sensei. Some of us were lucky to have a day on Meridian based Cosmetic Acupuncture delivered by Yoko Oasa Sensei. She showed us the method of helping rejuvenate the face with message and needle techniques and it was clear that we all felt beautiful and relaxed by the end of the day. So needless to say, the highlight was to see the master of masters, the extraordinary Shudo Sensei and his wonderful disciple, Murata Sensei. Shudo Sensei continues to share his art of super superficial techniques and making it look flawless. More than the techniques, he shared many words of wisdom, epitomizing his ethos of ‘simple is the best’. The idea of emptying the mind and not forgetting why we practice acupuncture, in that not to forget that the “patients come first”. Shudo Sensei also reminded us that being an acupuncturist is all in the mindset and attitude. All the Senseis emphasized the importance of Hara/ abdominal diagnosis and refining our palpation skills, including honing in on the pulse diagnosis. Another point that was salient was that once the treatment was completed, reassess the pulse and palpation and make sure an effect was achieved. If not, repeat as needed. Variation of the superficial needling and use of teishins were taught with incredible level of mastery and panache that left some of us awestruck. However, the practice sessions allowed us to develop these skills and get firsthand feedback from all the masters. At this point the masters really helped us to get a handle on the techniques. Practice, practice, practice…. these three words did not fall on deaf ears. Some students also had the pleasure of learning the Iyashi no Michi Japanese style acupuncture from the laconic Yasuda Mukan Sensei who used the words of Bruce Lee to encapsulate his teachings, ‘Don't think, feel!” This protocol works with being in tune with the patients’ rhythm and working with their undulations and following through. It goes without saying that the translations, especially, by wonderful Stephen Brown, as well as ever patient, Maya Suzuki, and kind-hearted Jeffrey Dann and always funny Yasuo Tanaka made the experience worthwhile. This is because they conveyed not only the essence of the subject but transmitted the personality of each Senseis allowing the subject matter to come alive. To have these talented people as part of the team was indeed a gift we were all grateful for. The Japan experience was not all about being cerebral, as we had been honored with banquets and dinners. People could unwind at Onsens and visit shrines and temples. Going shopping and discovering intricate Japanese souvenirs. As well as those who dared, we indulged in Karaoke evening, singing renditions of Do do do dada da da (the Police) and it’s a Sin, and Ain't no Mountain high enough….and thoroughly enjoying the experience even though off key, (well, I speak for myself actually). I finish by saying that if you have an opportunity to go on such a wonderful, enriching journey, it will be an unforgettable and worthwhile experience for your self-development and ultimately your patients will merit from the fruits of your learning. Maya Angelou (famous American poet and writer) once said that: “I have learned that people will forget what you said and people will forget what you did, but people will never forget how you made them feel.” Japan experience is just that, you will remember how you felt, and what's more, it leaves you wanting more. My hope is that our patients will also remember how the treatments will make them feel. Bhavna Dagia (Switzerland) Jeffrey Dann, Ph. D., L. AcJeffrey currently teaches and practices in Boulder, Colorado. He practiced for many years on the Big Island of Hawaii. His previous training was in cultural and medical anthropology. He conducted fieldwork in Japan where he also studied Kendo, Shiatsu, and Seitai-ho at the Mito Tobukan Dojo in Ibaraki Prefecture. He attained the rank of yondan in Kendo. He is currently president of the Traditional Japanese Acupuncture Foundation, and has played a key role in networking and promoting Japanese acupuncture and bodywork. This article originally appeared in the March 2007 issue (Vol. 14, No. 39) of the North American Journal of Oriental Medicine. It is reprinted here with special permission.
Over the years I have struggled to understand the differences between Chinese TCM acupuncture and Japanese styles (TJM) represented by Meridian therapy and Toyohari schools. Each impacts the body in very different ways and in at different levels. TCM acupuncture uses thick heavy gauge needles (28 -32 gauge) with relatively deep insertions (more than 30 mm) into the muscle layer, with vigorous techniques to elicit a deep aching sensation in the patient (known as “deqi” or “obtaining qi.”) The pulse is generally taken only once at the beginning of the session, and rarely are abdomen or distal points palpated for assessment. Needle insertion is traditionally done freehand, without a guide tube. TJM , on the other hand, is characterized by the use of thin needles (38 -42 gauge), with superficial insertion (0-7mm) and with gentle stimulation that seeks to have the practitioner sense a sensation known as “the arrival of qi”. TJM is also differentiated from TCM by its careful use of the left hand (oshide) to palpate and prepare the point, as well as to sense the “arrival of qi.” Point selection for root treatments is derived from the classical five phase points. In addition TJM frequently palpates for re-confirmation in the pulse, abdomen, and treated channels to determine if the point selection and techniques of stimulation were appropriate. The contemporary teachers of Meridian Therapy and Toyohari Japanese acupuncture emerged from the mid 20th century “Return to Classics” movement. They emphasize: 1) clinical reference to the classics (Suwen, Lingshu and the Nanjing), 2) refined palpatory diagnostics of pulse, abdomen, and meridians, 3) varieties of superficial needle stimulation, and 4) feeling the “arrival of qi.” These acupuncture styles focus on listening through touch - by “staying on the surface” with very little deep palpation or needle insertion. Shudo Denmei’s most recent text, “Locating Effective Acupuncture Points,” distinguishes various needle depths as follows: 1) contact and super-superficial insertion, 0 - 1 mm 2) superficial insertion, 1-5 mm 3) shallow insertion 5 – 30 mm 4) deep needling, more than 30mm I want to look at the anatomical structures that comprise the zones of contact from 0 to10mm. Shudo Sensei’s first three levels describe the terrain of the skin and superficial fascia Think of the skin as the outside of the brain. It is like a wet suit layer given shape by bundles and compartments of connective tissue (fascia). It is filled with a liquid crystal fluid, the extra-cellular matrix, which brings blood and nutrients to the surface and takes away waste products. It is our protective barrier. The skin has many specialized cells and receptors that communicate to the brain our interaction with the outside world. It is here that the Ying qi and Wei qi interact around the channels. The brilliant medical historian, Shigehisa Kuriyama, notes that the ancients had a concept of structured depths of the body’s anatomy and pathophysiology. Their way of plumbing these depths, Kuriyama says, was to “gaze” upon the surface and palpate its terrain. The inner essence is hidden and mysterious but it can be apprehended in the flowering manifestations on the surface, just as a master gardener can tell the health of a plant by looking at its luster and feeling the texture of the leaves. The Suwen says, “It is through the external manifestation (Biao) that we know the intimate reality (Li)” The “arrival of qi” is not a metaphysical concept. The ancients carefully palpated the superficial structures on the skin, the interstices (cou li) through which the Ying qi and Wei qi course. They described a highly differentiated system of network channels, cutaneous channels, large and small vessels (sun, miao) and finally the meridian pathways themselves. The body-mind is a vibrating pulsating field that, like the breath, reflects state of being and reactivity to internal and external conditions This can actually be palpated anywhere on the body, not just at the radial pulse. And the energetic physiologic shift induced by acupuncture can also actually be felt. Shudo Sensei describes this as the arrival of qi and both the classics and modern physiology can describe this phenomenon. In classical texts, traditional surface energetics starts with the Wei qi. SUWEN: 43 “The Wei qi is the defensive qi that is formed from the same foodstuff (Ying); this qi is different; it is fast and smooth. It cannot travel in the blood vessels but flows between the skin and the muscles. It circulates through the chest and remains outside of the channels and vessels.” Healthy surface conformations are presented when Ying qi and Wei qi are in harmony. The Wei qi, to some extent, is governed by the Lungs and has a rapid circulatory cycle of 50 circuits being most active on the surface during day and deeper and more quiescent at night in the lower Jiao. The Wei qi moves between the skin and the superficial fascia, the cou li or interstices. The Wei qi acts as first layer of defense against external pathogens. It regulates skin functions of peripheral body temperature and fluid balance by regulating the pores and sweat glands. When in harmony with the deeper nutritive Ying qi, vascular and lymphatic circulation is free flowing and the skin is lustrous and its texture is resilient and healthy. Luster or vitality can be seen and felt in the skin and superficial tissues: this reflects the ability of the Lungs to infuse and move the blood. Recent studies of the skin show a vibrant active immune function, the result of specialized lymphoid cells known as Langerhan cells and other structures. They may stick to the external pathogen, alerting T-cells to it, and thereby activate other immune protective reactions. The superficial fascia is the zone in which Wei qi and Ying qi interact. Donald Kendall describes the classic Wei-Ying relationship in terms of modern immune physiology: “Defensive substances can leave the blood circulation through the walls of the capillaries to fight off an external assault, or respond to tissue trauma the defensive interaction takes place s place due to an interplay of nutrients (Ying), which include blood coagulation system proteins, and defensive substances (Wei), which include immune cells and complement proteins. Suwen 5 is particularly descriptive of this precise anatomical awareness. “The most skillful healer treats the surface hairs (pimao)…and those doctors are best who disperse them before they sweep inward. The healer next in skill treats in the subcutaneous tissues (jifu); The healer next in skill after that treats the sinews and the vessels; the healer next in skill treats the Six Fu (hollow viscera); the healer next in skill after that treats the Five Zang (solid viscera). Lingshu 75 says: “First, attentively observe and differentiate…By pressing with the fingers, using sliding techniques, also rubbing and flicking the points. Then, attentively, watch the response and reactiveness “ What does it mean to “watch” the response? The classics suggest one can actually feel and sense the balancing of qi. In describing how to apprehend the “arrival of qi”, Shudo Sensei often refers to Lingshu 9: “Reside deeply in a place of stillness, divine the comings and goings of the spirit with one’s (sensory) doors and windows shut…”Successfully transform the patient’s spirit; when the qi arrives then one stops”. This is very different from causing a deqi sensation or doing qi propagation through the needle as done in TCM. Shudo Sensei interprets this listening as being in a centered place, not talking, not thinking extraneous thoughts, but carefully listening and sensing to the shift. He resonates with this shift and has said he sometimes even salivates when the qi arrives. This indicates a clear parasympathetic response of increased saliva secretion. This is a complete oneness with the patient, needle, and oneself. It’s like the kendo (art of swordsmanship) expression “ki – ken – tai itchi,” the mind-sword-body are one. This arrival of qi is an actual sensation that can be sensed in the change in fascial tissue texture, or a subtle sensation that is the result of the stimulus-response to the acupuncture needle skillfully and sensitively wielded. The work of neurophysiologist-acupuncturist Helen Langevin, studying the relationship of acupuncture stimulation upon the fascial structures confirms that a bioelectric discharge occurs when the acupuncture needle interacts with the stressed collagen fibers. This piezoelectric discharge moves through the liquid crystalline structure of the extra-cellular matrix. This activates lymphatic, vascular, hormonal, and autonomic shifts. Langevin proposes a new theory of acupuncture mechanisms that goes beyond the more common Western gate control theory describing stimulation of neurological pathways. She proposes that acupuncture meridians follow connective tissue planes. Acupoints, in fact, occur at the convergence of connective tissue planes. Qi is defined as the sum of all body energetic phenomena (e.g. metabolism, movement, signaling, information exchange). Meridian qi is the connective tissue biochemical–bioelectric signaling system. This theory is supported by the research of Mae-Ho Wan’s research on the liquid crystalline communication signaling system of the extra-cellular matrix fascial net. I propose that the” Return to Classics” superficial acupuncture approach of TJM creates a different response and regulation of qi and Blood than the deep needling of TCM. Superficial needling activates what is known as a Diffuse Non-Specific Regulatory Response (DNSRR). Because the surface of the skin has so many more specialized receptors, its activation with acupuncture sends a different array of signals to the brain. Superficial needling activates those signals that cross over to the other hemisphere rather than going straight up to the pain interpretation center, the thalamus. These cross over sensations and messages often have to do with making finer discriminations and exploratory sensations. I’m not a neurologist but I think there is a lot of interesting research for them to do. I like to open this discussion and I look forward to hearing from those that know much more about this subject than I do. The real purpose at the heart of this article is to encourage us to develop our sensitivities, to listen ever more closely, and help our patients by being better acupuncturists. |
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