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?
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.
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)
Staying superficial in Order to Go Deep: Japanese Acupuncture, Classical Channel Energetics, and the Superficial Fascia
Jeffrey Dann, Ph. D., L. Ac
Jeffrey 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.
By Jeffrey Dann Ph.D., LAc.
Jeffrey Dann PhD, LAc is a medical anthropologist and licensed acupuncturist since 1984. He has lectured at the Beijing University of Chinese Medicine on Japanese acupuncture and structural acupuncture. He is an adjunct faculty on the post-doctoral Japanese acupuncture of the Tri-State College of Acupuncture (New York) and the American College of Traditional Chinese Medicine (San Francisco). He studied bodywork and martial arts of the Mito Tobukan where he achieved 4th dan in kendo, nidan in iaido, and shodan in naginatado. His Aloha Wellness clinic is in Boulder Colorado.
There has been a long time simmering discussion within the Meridian Therapy association about the prohibition against treating the Heart and Heart channel. Many Meridian therapists seem to just ignore this edit despite it’s the Meridian Therapy association’s official published stance. Other acupuncturists state that the MT association represents only a small percentage of the total acupuncture practitioners in Japan and therefore this avoidance of treating the Heart represents a minority position.
The international growth of Japanese styles of acupuncture has been dominated by Meridian Therapy and Toyohari teachers. Both of these schools cling to this injunction, often denying the possibility of either Heart deficiency or excess.
As students of Meridian Therapy we are taught only 4 foundational Root acupoint combinations: the Kidney, Liver, Spleen, and Lung. There is no 5 phase mother-child paired Root treatment for the Heart.
The English edition of Traditional Japanese Acupuncture – Fundamentals of Meridian Therapy edited by Koei Kuwahara clearly states “There is no Heart deficiency…The Heart stores the essential Ki known as spirit…and is an organ with a rich abundance of yang Ki…Thus there is no pattern of Heart deficiency” (p.19). Later, discussing Excess conditions, it says, “ There is no Heart excess “ but it recognizes a condition “called Heart heat that is)…generated by a deficiency in the Kidney, Liver or Spleen’ (p.41). I Shudo sensei in his Introduction to Meridian Therapy does describe signs and symptoms of both Heart excess and Heart deficiency (page 120). He also lists 5 phase points for Heart deficiency and excess but he avoids giving a Root treatment for Heart deficiency, So Shudo goes along with the established Meridian Therapy denial of treating the Heart channel.
Generally the Meridian Therapy approach to Heart problems would be to treat the Pericardium or using 5 Phase mother child or controlling points and not directly use Heart channel points.
For many foreign acupuncturists this avoidance of treating the Heart is a confusing and unrealistic cultural medical belief. In my practice and that of many other foreign colleagues we do find Heart imbalances with clear Heart channel palpatory findings, such as deficiency in the HT 7-5 area and excess at HT-3. Also, it’s not uncommon to find spider veins or indurations in the intra-scapular heart zone.
Some say Westerners have a tendency to be “more in their heads” and feel stress more psychologically than the Japanese who have a tendency to abdominally somaticize their stress patterns . Don’t forget it was Descartes who posited for the West, “I think therefore I am” and Freud who opened the Pandora’s box of sublimated and subconscious cognitive contradictions in his patients.
Certainly the Chinese TCM practitioners have no problems in treating the Heart channel directly. I had published in NAJOM an article by Dr. Wang Hong Min clearly describing the differential diagnosis of symptoms comparing the Heart and the Pericardium. As a premier student of the great recently deceased Wang Ju-Yi, Dr. Hong Min also shows the 6 level Shan Han Lun approach to the Heart by regulating the ShaoYin dynamic of Heart and Kidney where both Heart and Kidney channel points are selected.
Certainly the Japanese general population has people who have clear signs of heart organ pathology and or a Heart - Shen imbalances, which needs to be clinically addressed. What is the cultural solution to this clinical dilemma?
It’s interesting to look at the cultural Mind/Body differences of “Heart” between Japanese and Western concepts. Westerners have a very clear distinction between head and heart with the head often taking precedence. It could be argued that while the Japanese recognize and utilize clear rational discourse, they also pay deep attention to their “gut” or intuitive sensations.
It’s slightly complicated in the Japanese case because the Japanese Heart (kokoro) is more intimately related and located with the Hara. Symbolically, whereas Westerners and Middle Easterners locate heart sensations in the middle of the chest , the Japanese are more often sensing heart in the abdominal region.
In my research and teaching about structural acupuncture and the importance of the concept of the “koshi” for understanding balance and power in posture and movement, I have often had to explain to Westerners the relationship and differences between “koshi” and “hara” and the lack of correspondence with Western English anatomical terms.
Much has been written about the Japanese concept of Hara including the spiritual and emotional concepts embedded in the Western term ‘abdomen’. Let’s look at some of the very common expressions in everyday Japanese use of the term ‘Hara’.
The most direct association of Hara with Heart is the term haraguroi (a black stomach) “evil- minded” that is clearly translated into the English “black heart”. Where we might say someone is big hearted and small hearted, the Japanese would say the Hara is big or small.
Hara can indicate mind, personality, as well as spirituality. Integrity is expressed whether or not a person has “Hara” hara no aru hito ("person with hara") or hara no nai hito ("person without belly") .The emotions of anger is expressed as the hara standing or rising, hara ga tatsu. When expressing fully understanding something, the Japanese expression might be Hara ga hairu ‘something enters the hara. An accomplished mature person is described as having ‘a completed hara’ while an undeveloped person is described as hara no dekite inai hito ("person who has not completed his hara"). This is just a partial list of common emotional, personality, and mental nuances with the term Hara that strongly overlap with the English terms of heart and mind.
With this understanding of the deep and profound meaning of the term Hara, it is interesting to clinically look at the central place of palpating and treating the abdomen among Japanese practitioners.
It seems like there is not a clear foundation or basis for proscribing using Heart channel points. Stephen Brown, student of Shudo Denmei and teacher of Meridian Therapy, tells me there is nothing in the Nanjing that prohibits treating the Heart. Erhland Truitt , Koei Kuwarahara sensei’s foremost American trained student says Kuwahara does not present a Heart pattern while teaching basic theory. Truitt’s High Desert Hari Society has invited a wide range of Japanese master teachers to New Mexico and Truitt says that Kobayashi sensei in his Shakujyu system does recognize a Heart pattern but that the diagnoses and treats it by addressing the hara. Likewise, Miyawaki sensei, who also has taught several times under Truitt’s invitation, does use HT-5 and HT-7 in his 8 extraordinary vessel treatments but he uses magnets or moxa but never needles. And here again the Heart diagnosis is based on abdominal or hara findings.
Indeed, when we observe almost all advanced Meridian Therapy practitioners such as Shudo, Okada, Funamizu sensei and others, who consciously avoid treating the Heart channel, they always palpate and treat the abdomen, thus actually treat the Heart by treating the hara.
Modern medicine and science are just beginning to recognize the central importance of the gut microbiome for physiological and emotional states, something Traditional East Asian Medicine (TEAM) has profoundly understand about Zang-Fu energetics and emotional states.
There are good grounds for Meridian Therapy oriented practitioners to question the unexamined refusal to treat the Heart channel or the Heart directly. I may be stirring up a hornet’s nest with my Japanese colleagues and teachers by suggesting that in the Meridian Therapy society the embrace of this Heart channel avoidance seemed to occur in the mid 1950’s. This was the post-WWII period of devastation and rebuilding of Japan. There was undoubtedly severe “broken heart” despair to the defeated samurai warrior ethos of wartime Japan. Of course, the wholehearted Japanese embrace of pacifism was a positive and dramatic teaching to the whole world about rejection of militaristic values (something the US could learn from).
This rejection, fear, or avoidance and treating heart issues may have a broader influence than just the Meridian Therapy’s position. This is perhaps seen in contemporary Japanese culture by the ‘Hello Kitty” culture where everything is ‘kawaii’ (cute) and fun, while avoiding or bringing difficult emotional issues to public discourse. One wonders if these cultural behaviors and fear of finding a Heart deficiency or excess might be part of a post WWII PTSD pattern? Certainly, as an American looking at our own national and cultural challenges of southern Confederate states opposition to northern political and economic dominance , I see an unconscious emotional response of ptsd from having lost the civil war over 150 years ago. While this supposition may be true, it is a side topic from the central issue of opening discussion on the prohibition of treating the Heart and Heart channel.
As a practitioner who largely follows standard Meridian Therapy doctrine, I and many other foreign acupuncturists do find value and clinical effectiveness in treating the Heart. I would like to challenge Meridian Therapy teachers who teach foreigners as well as domestic students to investigate the appropriateness of treating the Heart and clinically acknowledging protocols for treating Heart deficiency and excess.
We do know that the Heart is an essential organ and energetic center and that, in modern life both physiologically and emotionally the Heart must be treated in some way. How do Heart avoidance proponents get around this this dilemma? I, suggest they by-pass this problem to treating the Heart by treating the Hara, which, for the Japanese, cultural body-mind map is the equivalent of treating the Heart itself.
By Heather "Maya" Suzuki
Maya is a certified acupuncturist in two continents and is passionate about spreading and healing via Japanese acupuncture.
As acupuncturists in the west we are required to go through a rigirous study program. We memorize facts about both western and eastern medicine and how to combine them. We practice our knowledge on real life cases via hundreds of clinical hours. We are mentally prepared to practice our medicine. Are we physically though?
Yes, clinical hours prepare us for real life cases and allow us to put the medicine to practice. Allowing us to become confident in our knowledge but possibly not our technique. This is because acupuncture programs throughout the U.S. put heavy emphasis on book study and virtually none on continuous, hands-on, needle and moxa instruction.
This is why I am so excited to be part of the In-Touch tour because we give extremely capable and intelligent acupuncturists technique hints that boost their abilities to a whole new level. Helping them to heal that many more people in their own practice.
I truly believe that Japanese acupuncture technique is the force that will truly revolutionize our industry. Come join us this year on the 2018 tour to be awe inspired and fully immersed.
I truly believe that Japanese acupuncture technique is the force that will truly revolutionize our industry.
Please check out our 2018 tour page to see this years line-up.
We are finalizing the 2018 IN-TOUCH tour details right now!
Please stay tuned and make sure to sign up early as we sold our in under a month last year.
BY HILARY KEYES | JUNE 2, 2017
Reprinted from https://savvytokyo.com/5-rules-eating-healthy-japan/
apanese food is viewed as being one of the healthiest in the world, and rightly so — if you can stick to a traditional diet and avoid making a few major mistakes!
When I recently witnessed a close friend of mine’s father being diagnosed with Type-2 diabetes, suddenly founding himself making major dietary changes, I came to realize two things about the Japanese cuisine — one, not every Japanese food is healthy, and two, it’s in fact hard to eat healthy in Japan if you’re counting the calories.
Think about it: The average serving of tempura can come in at anywhere from 200-700 calories; katsudon (fried pork cutlet on rice) starts at about 900 kcal for a small portion, while ramen can come in at anywhere from 500-800 kcal depending on the soup base and size. Sushi, perhaps the healthiest sounding of all, averages out at roughly 75 kcal per piece, depending on topping, (which could explain why most Japanese celebrities’ Insta feeds are full of only only sushi piece), while yakitori, grilled chicken, fluctuates from 24 kcal per skewer (for nankotsu or cartilage) to 165 kcal for kawa (chicken skin) skewers, and further depends on whether you order your yakitori prepared with salt or tare(sauce). So, basically, if you want to go out and enjoy a meal, you’re going to end up taking in way more calories than you should. Yet, Japan’s eating out market is so widely accessible — and so common.
Triggered by the recent discovery, I spoke with a few medical experts and a couple of chefs to get some professional insight into eating smart in Japan. And here is what I found out: if you want to still enjoy food and stay healthy at the same time, there are five main rules you should follow when it comes to dining in Japan.
1. Follow the “hara-hachibu” principleEat until you’re 80 — not 100 — percent full is key to a healthy diet.
Most of us were taught as kids to clean our large plates and make sure there are no leftovers. In other words, full or not, eat everything that’s been served. But what if it’s actually better to put your forks down before taking that last bite — or have a smaller portion and try to get satisfied with it?
When first looking at meals in a Japanese restaurant, one of the first comments people make is that “it looked bigger in the photo.” Japanese portion sizes are much smaller than those served overseas – and this is a good thing. The Japanese have a saying that you should eat hara hachibu (or hara hachibun-me) — eat until you’re 80 percent full. The amount of food on your plate shouldn’t be intimidating; it should allow you to enjoy the flavor of the food without having to unbutton your jeans afterwards. Following this principle is enough to keep you going and won’t leave you feeling uncomfortable afterwards. Before you take that last bite, think about it — will it make you full? If you’re comfortable without it, then drop it.
2. Avoid ready-made dishesYou’ll find plenty of delicious foods in Japanese supermarkets and department stores, but over-relying on them is not necessarily healthy.
So it’s nearly 9 p.m., you’re going back home from work completely exhausted and nothing on this earth can make you frown more than the idea of spending another 30 minutes cooking. So you head to the deli section of your local Japanese supermarket and smile at the tons of ready foods, discounted at nearly half price at that time of the day.
Ok, stop right there! These foods, for the most part, are the equivalent of fast food, and if you’re stocking up on these to satisfy your hunger, you may find that you’re experiencing some nasty bloating or adding on a little weight as the months go by. These ready foods contain much more oil and preservatives that you’d think they do, so over-consumption is highly risky not only for your waist, but your health too.
Avoid shopping when hungry and refrain from picking up your dinner when the supermarket is closing — the steep discounts on food can lead to feasts of deep-fried, starchy or carb-heavy items that are definitely not going to improve your health, and might even make it worse over time. Instead, why don’t you prepare the ingredients for your dinner before leaving home in the morning — the actual cooking process will then take no more than 10 minutes.
3. Watch out for carbs, sodium and sugar-overdosed mealsRamen, Japan’s soul food, is full of carbs, sodium and depending on the flavor – sugar, too.
The three evils of Japanese food are carbohydrates, sodium and sugar, and while they are necessary for a healthy diet in certain amounts, it’s essential to be very careful with them.
Most Japanese meals include soy sauce (loaded with sodium), regardless of whether you can see it or not. Miso soup, the staple of many set menus in restaurants, also contains a good amount of sodium, some with nearly 1,000 mg of it packed into a single serving. If you’re relying on teishoku (set meal courses) to stay healthy, be very careful about your sodium levels, and watch your blood pressure if you have a family history of heart problems. When buying at the store, look for the following terms to help you identify sodium-reduced products: 塩分カット (enbun katto), 減塩 (genen), 塩分〇〇％カット(enbun 00 % katto).
Carbohydrates are everywhere and even soba isn’t safe as most store-bought or cheap soba shops use noodles that are made with up to 60 percent refined wheat flour instead of buckwheat. If you’re trying to avoid extra carbs in your diet, then freshly made soba noodles (which usually come in a 80 percent buckwheat, 20 percent wheat mix), or noodles made from konnyaku or shirataki, which are also high in fiber, are your best options.
Sugar is the least visible, but perhaps most nefarious of the lot. Did you know that most savory Japanese dishes contain sugar in one form or another to help balance out the flavor? I didn’t until I watched some Japanese home cooking programs — there is sugar in most sauces, stews, curries, some types of karaage (fried chicken), and even in ramen to an extent. So if you’re trying to watch your sugar intake, you will unfortunately have to sacrifice some of the authentic Japanese flavor of dishes in favor of your health.
4. Don’t trust miracle foodsThe “banana diet” from several years ago is just one example of the many diet trends in Japan.
Every once in awhile you’ll be flooded with information on how eating that one product will make your life so much better. During my time in Japan, I have lived through the banana, black garlic, natto, umeboshi (pickled plum), kimchi/yakiniku, and a host of other fad diets that all promised the same miracle results. But no specialists will advise you to go for a single food item, no matter how healthy it is. Tofu and green tea are often touted as being “miracle foods” overseas, but they are nothing more than standard parts of the traditional diet, and their effects are not nearly as miraculous from this perspective — if over-consumed or consumed at the absence of other dishes. Which leads us to rule No.5:
5. Variety is keyAdding variety to your meals will keep you energized and in good shape.
If you’ve had the chance to enjoy a traditional Japanese meal at a hot spring or while visiting Kyoto, you may have noticed that there were a number of small dishes filled with numerous different foods from both land and sea. A traditional Japanese meal is usually made under the ichijyu sansai principle (one soup with three vegetable dishes plus rice and fish) to assure good balance, and this, according to everyone I spoke with, is the key to a healthy Japanese diet. These small portions feature well over 15 different foods per day or even per meal, and include numerous legumes, seafood, and vegetables, with little rice, noodles or meat involved, which altogether provide all vitamins and minerals the body needs. For every meal of the day, try to include several different products in small portions.
Thank you Wikipedia!
Children's Day (こどもの日 Kodomo no Hi?) is a Japanese national holiday which takes place annually on May 5, the fifth day of the fifth month, and is part of Golden Week. It is a day set aside to respect children's personalities and to celebrate their happiness. It was designated a national holiday by the Japanese government in 1948. It has been a day of celebration in Japan since ancient times.
The day was originally called Tango no Sekku (端午の節句?), and was celebrated on the fifth day of the fifth moon in the lunar calendar or Chinese calendar. After Japan switched to the Gregorian calendar, the date was moved to May 5. It was originally exclusively male celebrating boys and recognizing fathers, but has since been changed to include both male and female children, as well as recognizing mothers along with fathers.
Until recently, Tango no sekku was known as Boys' Day (also known as Feast of Banners) while Girls' Day (Hinamatsuri) was celebrated on March 3. In 1948, the government decreed this day to be a national holiday to celebrate the happiness of all children and to express gratitude toward mothers. It was renamed Kodomo no Hi.
CelebrationOn this day, families raise the carp-shaped koinobori flags (carp because of the Chinese legend that a carp that swims upstream becomes a dragon, and the way the flags blow in the wind looks like they are swimming), with one carp for the father, one for the mother, and one carp for each child (traditionally each son). Families also display a Kintarō doll usually riding on a large carp, and the traditional Japanese military helmet, kabuto, due to their tradition as symbols of strength and vitality.
Kintarō (金太郎) is the childhood name of Sakata no Kintoki who was a hero in the Heian period, a subordinate samuraiof Minamoto no Raikou, having been famous for his strength when he was a child. It is said that Kintarō rode a bear, instead of a horse, and played with animals in the mountains when he was a young boy.
Mochi rice cakes wrapped in kashiwa (oak) leaves--kashiwa-mochi (mochi filled with red bean jam) and chimaki (a kind of "sweet rice paste", wrapped in an iris or bamboo leaf)—are traditionally served on this day.
By Jeffrey Dann
(This article is a slightly modi ed version of my presentation at Dr. Wang Ju-Yi’s Channel Theory Symposium, Beijing 2013.)
I would like to discuss several topics stimulated by the signi cant publication into English of Dr. Wang Ju-Yi’s book with Jason Robertson, Applied Channel Theory in Chinese Medicine. I believe it is the most important book in English on TCM in the past 25 years. This book may have a profound impact on how standardized TCM is taught in the United States and Europe.
The work of Dr. Wang returns acupuncture to the domain of manual medicine where the presence and aware precise of touch of the doctor engages the living tissue of the patient rather than merely nding a switch, like a motor point or xed ana- tomical acupoint and turning it on or off.
His brilliance is theory rooted in the classics yet backed by a current understanding of modern anatomy and physiology. He sees the channels in the context of the most modern understanding of fascial planes and the dynamics of capillary and extra-cellular matrix uids.
His scholarship illuminates, for Western students, the rst clear theoretical and clinical uses of six- level pathophysiology. Acupuncture students of course learn the names of the six levels that relate to each same named zang-fu channel such as hand tai yin lung and foot tai yin spleen.
I would like here to take a small piece of Dr. Wang’s work, that of understanding the signi cance of the tai yin level. This functional energetic pair of spleen and lung opens new vistas to the exte- rior and super cial physiological meaning to the shared interaction of the lung – wei qi and the spleen - ying qi in the cutaneous (dermis) and subcutaneous levels.
Where the qi dynamic is disordered, where ying and wei are not in harmony, we see alterations
in the interstices (couli) and extracellular uid quality. The super cial fascia begins to demon- strate palpable aberrations such as swelling, depressions, nodules, or bands. It is there, in the interstitial uids and connective tissue structures that the tai yin dynamic regulates the ying and wei surface layers. It is at the tai yin level that we see the signs of health, the luster of the skin, the sparkle of the eyes, the tone of the tissues, the quality of movement.
There are numerous references in the Ling Shu and Su Wen to a well-differentiated sense of tissue textures and levels. Su Wen 5 says, “The most skilled healer treats the surface ...and those doctors are those who disperse (the pathogens) before they sweep inward. The healer next in skill treats the subcutaneous tissue (jifu). The healer next in skill after that treats the sinews and ves- sels. The healer next in skill treats the six hollow fu viscera. The healer next in skill after that treats the ve solid zang viscera.”
Blockage of qi occurs where transformation of blood and uids lack free ow (通 tong). Im- balances in the tai yin super cial layers of the body represent a pathophysiology involving the lung’s ability to move qi or the spleen’s inability to transform and move blood. Without free ow, the connective tissue bers and the extracellular uid movement through the fascial planes begin to demonstrate structural change. Skin tonus, tex- ture, and temperature begin to alter at the exterior. Qi dynamic (qihua) pathology affects the spaces between the couli; they become sore, aching, and can exhibit varying degrees of brotic change.
I saw my Japanese teachers carefully assessing by touch two super cial layers of the body – the skin and the underlying super cial fascia. Their touch was light, quick, and highly sensitive. Their clini- cal practice of identifying changes in super cial and muscular tissue textures was highly re ned but there was no clear theoretical premise that was usually offered. There was mention of wei and ying levels but again without their classical physiology and pathophysiology. Dr. Wang’s book suddenly explained the theoretical basis of what I had observed in the Japanese precision and detailed attention to surface conformations and their varied treatments.
Many Japanese styles have paid attention to the super cial tai yin level for a long time, in part because of the profound in uence of blind prac- titioners. Today the guide tube, developed by the blind acupuncturist Sugiyama Waichi in the mid 17th century, is the standard tool for needle insertions throughout the Western countries. There are many advantages to having a guide tube compared to freehand insertion.
However many people do not realize that the guide tube was invented in part as a device to carefully measure the depths of super cial insertions. Be- cause the needle-handle projects 4 mm above the guide tube, the acupuncturist can become very precise at more minute levels of stimulation from 0-1mm to 2-3 mm, to 4-5mm. With very ne thin gauge needles, 0.12-.20 mm, emphasis is placed on the acupuncturists sense of “arrival of qi” (气 至 qi zhi), rather than the patient’s felt sense of deqi (得气)“obtaining of qi.”
Japanese teachers feel that there have been growing de ciencies in people now living in urban mega-city environments with cyber stimulation, highly processed food, stationary jobs, family alienation, mass transit and more, which all create a variety of de cient conditions.
Furthermore, needle techniques that are not insertive, that are minimally insertive, or that are only just under the skin and do not reach the muscle level are highly developed in the Japanese styles known as Meridian therapy and Toyohari. The foundational classic references for them is Nan Jing 71, Nan Jing 78, Nan Jing 80, and Ling Shu 9.
Here are some of classical highlights that inform the Japanese practitioners sensitivity to reading and treating the super cial layers of the body.
The text here clearly differentiates between the wei and the ying levels and states that to treat the
super cial wei the needle should be shallow or “lying down” and that to treat the slightly deeper nutritive ying layer, the point or area must be pre- pared by manual techniques to move the wei qi so as not to damage it while accessing the ying layer.
Nan Jing 78 states the importance of using the left hand: “knowledgeable practitioners put faith in the left hand. Practitioners who do not know put faith in their right hand.” But in any case, before insertion, it is necessary to prepare the point by pressing and kneading.
Nan Jing 80 opens the discussion of sensing the “arrival of qi” and the critical sensations of the assisting left hand. The cultivation of awareness of the arrival of qi represents a highly developed sensibility to feeling the qi dynamic. “When it is seen” refers to when the qi is felt to be at its full- est the needle should be extracted. This is what is meant by “when it is seen, enter, and when it is seen leave.”
Ling Shu 9 is also a foundational text both for 9
Japanese and Dr. Wang who place emphasis on cultivating awareness of the qi dynamic when an area is needled correctly.
深居静处。占神往来。闭户塞牖。魂魄不散。 专意一 神。 精气不分。 毋闻人声。以守其精。 必一其神。 令志在针。神志之专一也
浅而留之。微而浮之。以移其神。气至而休。 This critical text describes the deep “open atten- tion” that the acupuncturist must hold, without distracting thoughts, to grasp the moment, to grasp the dynamic (the moment of qi transforma- tion) to appropriately tonify or disperse without overstimulating.
Furthermore, it says “[In this way, the practitioner may skillfully practice] shallow insertion while re- taining the needle, or gentle, super cial insertion so as to successfully transform the patient’s spirit to (以移其神) and as the qi arrives then one stops”.2
Acupuncture and Cultural Change
Japanese teachers I have studied with, such as Shudo Denmei, repeatedly emphasize that in the modern lifestyle people are becoming more and more de cient, and as such they require more delicate and supportive strategies to bolster their fundamental de ciencies. To this end con- temporary Japanese practitioners have developed consistently gentler means of toni cation with shallow insertions and a varied repertoire of non- insertive contact or touch needling.
We also nd de ciencies in our American patients, much of this rooted in our modern lifestyle. The excesses of modern urban life can create deep de ciencies. Many live in a state of adrenal exhaus- tion (kidney de ciency) with insomnia and sleep disturbances, lack of exercise (liver de ciency) and obesity and poor diets (spleen de ciency), and also deal with respiratory problems due to smoking and air pollution (lung xue). People live longer but without great vitality surviving on a com- plex polypharmacy of drugs. In our acupuncture schools many nd Chinese styles of acupuncture too stimulating, too painful, and do not continue treatments. Even acupuncture school clinics are nding that Japanese-style treatments are much better tolerated with satisfactory results for de - cient patients, hypersensitive patients, and very old and young patients.3
The Beijing that I studied in in 1981 was very dif- ferent from the China I see today. The transforma- tion in lifestyle and abundance is dramatic. Most people back then rode bicycles and walked a lot to get around. Houses did not have air conditioning or heat in each room; unlike today they had to internally adjust to environmental changes. Most people ate simple locally grown foods without all
the sugar and highly re ned foods with arti cial preservatives and high-fructose corn syrup. Obesity was rare. Most were laborers or farmers, hard-working people; even city life was spartan and simple. And when Mao integrated acupuncture into the national health care system, and for free, the clinics were swamped with waiting patients. Doctors did not have time to carefully palpate; they needed a quick assessment from the pulse and history, and a quick strong treatment plan to move the qi and stagnation from these hard labor- ing bodies. Acupuncture since the founding of the PRC was developed as a mass system for hard- working hard-body patients. The nationalization of free medicine forced TCM doctors to develop a streamlined strong treatment style to meet the great demand for care.
Today, even in China we see the rise of obesity, the development of metabolic syndrome and the growing problems of the excesses of modern post- industrial urban life styles such as hypertension, diabetes, and high cholesterol.
I see the rise of super cial and gentle needle technique as being more appropriate to the qi deficiencies of modern post-industrial cyber urban life. The growth and interest in Japanese- style acupuncture in America and Europe is in part a reaction to the harsher TCM styles that have dominated the foreign acupuncture school curriculum and licensing for the past 30-40 years. Numerous people who love and appreciate acu- puncture dislike the TCM experience but take it as “bitter medicine.” Soft bodies with entrenched yin de cient conditions do not tolerate strong deqi needle techniques. They do not have enough essential qi and blood to handle strong qi moving techniques, deep insertions with vigorous lifting and thrusting to obtain deqi.
In closing I would like to ask the question of my esteemed teacher, Dr. Wang Ju-Yi and his stu- dents and colleagues here in China. How do you see changes in treatment for your modern urban Chinese compared to those patients of 30 or 40 years ago? How are the bodies, by palpation, different for those now raised in post-industrial urban desk work compared to the past? How does acupuncture therapy vary and change with changes in environment and lifestyle and what are the historical precedents for the changes in acupuncture by era and by country?
1. Translation from Paul Unschuld, Nan-Ching: The Classic of Dif cult Issues, 1986, Univer- sity of California, Berkeley.
2. This translation is from the Charles Chace article “On Greeting a Friend, an approach to
NAJOM vOlume 21 number 61 NeedleTechnique”publishedinTheLantern,
vol 3. No.3.
3. Elizabeth Talcott, “Enhancement Of Trad- itional Chinese Medical Education With Japanese Meridian Therapy”, 2013, Doctoral Capstone thesis, Paci c College of Oriental Medicine, San Diego, CA.
1. Langevin HM, “Mechanical signaling through connective tissue: a mechanism for the thera- peutic effect of acupuncture.” FASEB J. 2001 Oct;15(12):2275-82.
needle manipulation transmits a mechanical signal to connective tissue cells via mecha- notransduction
2. Langevin HM, “Relationship of acupuncture points and meridians to connective tissue planes.” Anat Rec. 2002 Dec 15;269(6):257- 65.
acupuncture points and meridians can be viewed as a representation of the network formed by interstitial connective tissue. ...80% correspondence between the sites of acupuncture points and the location of intermuscular or intramuscular connective tissue planes in postmortem tissue sections
3. Langevin HM, “Tissue displacements during acupuncture using ultrasound elastography techniques”. Ultrasound Med Biol. 2004 Sep;30(9):1173-83.
4. Langevin HM. “Dynamic broblast cytoskeletal response to subcutaneous tissue stretch ex vivo and in vivo.” Am J Physiol Cell Physiol. 2005 Mar;288(3):C747-56
5. Langevin HM. “Connective tissue broblast response to acupuncture: dose-dependent effect of bidirectional needle rotation.” J Altern Complement Med. 2007 Apr;13(3):355-60.
6. Staying Super cial in Order to Go Deep: Japanese Acupuncture, Classical Energetics, and Staying Super cial in Order to Go Deep: Japanese Acupuncture, Classical Energetics, and the Super cial Fascia
Jeffrey Dann, Ph. D., L. Ac.
7. This article originally appeared in the March 2007 issue (Vol. 14, No. 39) of the North American Journal of Oriental Medicine. the Super cial Fascia
Jeffrey Dann, Ph. D., L. Ac.
8. This article originally appeared in the March 2007 issue (Vol. 14, No. 39) of the North American Journal of Oriental Medicine.
9. Liquid crystalline meridians. M.W. Ho and D.M. Knight. The American Journal of Chinese
July 2014 NAJOM Medicine 26, 251-263, 1998.
10. The acupuncture system and the liquid crystalline collagen bers of the connective tissues. Ho MW, Knight DP. Am J Chin Med. 1998 26:251-63. Review.
Jeffrey Dann began studying seitaiho and shiatsu in Japan in 1972 while training at the Mito Tobu- kan. He has been an acupuncturist since 1981 and has a practice in Hawaii and Boulder Colorado. His interests are in movement therapy and os- teopathic palpation. He teaches internationally and around the US and is on the faculty for the Japanese Acupuncture doctoral program at the Tri-State College of Acupuncture in New York City.
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