honchi ho, hyochi ho: root and branch treatment staging in contemporary japanese acupuncture
TRANSCRIPT
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HONCHI HO, HYOCHI HO:
Root and Branch Treatment Staging in
Contemporary Japanese Acupuncture
by
Robert Hayden
submitted April 2, 1996, in fulfillment of major paper requirement
(A572 Major Paper Completion)
Midwest Center for the Study of Oriental Medicine, Racine, WI and Chicago, IL
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Table of Contents
Introduction......................................................................................................................4
Part I: Survey of Paradigms and Clinical Approaches
Paradigms .....................................................................................................................10
! Five-Phase ..........................................................................................................10
! Eight Extraordinary Vessels ................................................................................12
! Biorhythmic/Stem-Branch ...................................................................................13
! Other Paradigms .................................................................................................15
Clinical Approaches .......................................................................................................16
! Approaches to Diagnosis of Root condition ........................................................16
! Methods of Assessment ......................................................................................16
! Systems of Feedback .........................................................................................21
! Approaches to Treatment of Root Condition .......................................................21
! Tools and Techniques ..........................................................................................21
Part II: Comparison of Styles: Toyo Hari & Manaka
Toyo Hari ........................................................................................................................23
Paradigm---Five Phase/ Four Sho Model ......................................................................24
Root Treatment ..............................................................................................................25
! Approaches to Diagnosis ....................................................................................26
! Assessment of Root Condition (Sho Determination) ..........................................26
! Feedback systems.....28
! Approaches to Treatment .28
! Tools and Techniques ...31
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! Assessing Treatment 34
Supplemental (Branch) Treatment ..34
! Methods ..35
! Midnight-Noon 35
! KiKei 37
! Naso & Muno .38
Yoshio Manaka ..40!
Paradigm---Multi-Model 41
Root Treatment 43
! Approaches to Diagnosis ..43
! Assessment of Condition .43
! Feedback systems ..48
! Approaches to Treatment .48
! Choice of Method .48
! Tools and Techniques .49
! Assessing Treatment 51
Supplemental (Branch) Treatment ..51
! Methods ..51
Conclusion .53
Appendices
Comparison of Point Selection of Meridian Therapy Founders ..57
Comparative Symptomology of Extraordinary Vessels 62
Bibliography .74
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Introduction
! An important concept in acupuncture is that of Root and Branch (Chinese: Ben-
Biao). These words that can have a variety of meanings, and be applied to a variety of
situations. For example, concepts of pathophysiology, body areas, or clinical events
can all be subdivided into root and branch. The present study will focus mainly on the
latter, specifically, the way in which acupuncturists in Japan treat what they see as the
root of a given patients problem. The treatments are prioritized in such a way that there
exist specific divisions and guidelines for each stage of a single patient encounter.
These guidelines vary with the practitioner, and are often dictated by the association
with which the practitioner identifies him- or herself.
! The purpose of this paper is to show how the Japanese view the concept of Root
and Branch within the context of clinical practice - which is, after all, the major concern
of the pragmatic Japanese - and to show the root and branch treatments as an orderly
and consistent staging of clinical events, each of which must be satisfactorily completed
according to certain (often palpatory) criteria before proceeding to the next stage. While
opinions differ as to the proper proportions of root versus branch stages, most
practitioners with any classical background will concur that the root stage is very
important and is usually the initial event in treatment.
! We aim to show that:
-Root treatment is important
-It usually occurs first in the staging of the treatment
-It uses different diagnostic criteria than the branch treatment
-It uses different treatment methods than the branch treatment
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-It is usually monitored and measured against some criteria to be judged effective
-It may itself be subdivided into stages
! The paper is divided into two main sections. First is an overview examining the
paradigms, diagnostic and treatment techniques commonly associated with root
patterns. This section will briefly review a variety of paradigms as they are used
clinically in Japan. Major exponents of the various schools will be noted, though some
who may not fit into one or the other may be excluded (Akabane, for example). This list
will of course be limited to practitioners whose styles and ideas have been described in
English-language texts. It should be noted that the emphasis of the paper is on those
schools that acknowledge the classics as a major influence, and not on those schools
that seek a purely scientific approach. Second is a more detailed examination of the
clinical approaches developed by two of the most prominent Japanese acupuncturists of
the twentieth century, Yoshio Manaka and Kodo Fukushima . Appendices follow.
! First, let us consider some points of view on the meaning of root treatment. First,
from the book Acupuncture, A Comprehensive Text, which is a translation of the
Shanghai CTCM textbook:
! In Chinese Medicine, emphasis is placed upon distinguishing the relative
importance of the Root and Branch. In terms of disease, the first to be contracted is
considered to be the Root, and later complications the Branch. Between the Organs and
their pertaining channels, the former are considered the Roots and the latter the
Branches. Points on the limb are Roots, those on the trunk and head are Branches.
Sometimes the Root is treated before the Branch, but at other times this sequence is
reversed. Occasionally, both may be treated simultaneously, or one treated exclusive of
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the other. Generally an acute illness is treated first, a chronic illness second, Exterior
disease first, Interior complications second. However, the more general balance
between the normal and abnormal forces in the body must also be taken into account.
For example, if the Normal Qi is particularly Deficient, i.e., the body is very weak, the
most immediate concern is to support the normal, since the expulsion of the abnormal
Qi from the body depends primarily upon the organisms ability to resist disease.
! Helpful comments from Denmei Shudos excellent Japanese Classical
Acupuncture: Introduction to Meridian Therapy, in which he quotes other sources:
!Root treatment is performed in accordance with the pattern of the disease, and
symptomatic treatment in accordance with the symptoms of the disease. The first
priority is to correct the abnormal relationships of deficiency and excess among the
meridians. To do this we must determine the overall picture of the disease known as the
pattern by identifying and analyzing those relationships of deficiency and excess among
the meridians and organs that are abnormal, and those that are not. (Yamashita, 1971)
! (Root treatment) is the treatment in which the imbalances in the meridians,
which are the essence of the disease, are corrected by tonification and dispersion using
the five-phase points and five essential points. Symptomatic treatment is the treatment
rendered according to the...complaints of the patient by treating localized
areas. (Fukushima, 1979)
! (Root treatment) is the correction of imbalances in the meridians by using the
essential points on the four limbs in accordance with the primary pattern, which is
derived from the various diagnosis and analysis of the symptomology. Symptomatic
treatment is performed simultaneously in accordance of the symptoms by directly
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unique approach introduced with meridian therapy, it is naturally presented as the more
important aspect of treatment. All practitioners of meridian therapy agree that root
treatment comes first, and symptomatic treatment second. (all italics mine)
! Yoshio Manaka provides an excellent definition of root treatment in his
posthumously published work, Chasing The Dragons Tail:
-As the procedure performed first, it serves to clear the way for the procedures that
follow. When successful it can be sufficient in itself, and at the very least, it simplifies
the rest of the treatment.
-Specific factors, such as individual and constitutional differences, can be taken into
consideration.
-It requires some simple, verifiable diagnostic confirmation.
-Such checks allow selection of points for patients who are otherwise difficult to
diagnose by other means.
-The method of treatment can de decided for incipient diseases that are beyond
detection by means that depend on symptoms.
-Problems and imbalances can be detected and treated at preclinical or functional
stages before a pathology becomes evident. In ancient China, there was a tradition that
the superior physician treated diseases before they occurred.
! While it is difficult to generalize about Japanese acupuncture, given the vast
array of approaches developed there since the Second World War, it is fairly certain that
each acupuncture association has developed its own root style, with its own diagnostic
requirements and treatment techniques. The majority of Japanese schools use more
gentle treatment methods than their PRC counterparts, and often it is necessary to have
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a system of feedback to monitor the progress of therapeutic events. It is not uncommon
that the root treatment requires confirmation of efficacy before the treatment is allowed
to proceed to the next step, i.e., the practitioner must pass a sort of test before
entering the next grade. As Shudo explains it, After the root treatment...is completed,
there must be some way to determine if the desired effect has been achieved. In root
treatment, unlike symptomatic treatment, relief from symptoms is not the primary
indicator of success. Nonetheless, after tonifying a point, one still needs to know if the
needling accomplished its objective.
!These he sums up into various indications, having to do with the relative balance
between pulse positions and changes in pulse quality, changes in the abdomen and the
skin in general, disappearance of abnormal palpatory findings such as pressure pain,
increase in circulation to the extremities and in digestive motility, and subjective
improvements such as relief from symptoms in the patient. He continues, The
immediate, subtle response of the body to needling sends a very important message to
the practitioner about the correctness of the treatment.
! Even if we accept Shudos assertion that the present emphasis on root treatment
began with the meridian therapy school, we shall see that the concept has spread
outside their stylistic boundaries to a wide range of different practitioners and their
philosophies. It is important to note the scope of acupuncture practice in Japan, and to
realize that the present paper will only hint at the diversity of techniques and models
that are found there. In many cases, the various practitioners involved will adapt each
others methods.
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least the Huang Di Nei Jing Su Wen , and it is the model of choice for what is probably
the most classically-oriented of all styles of acupuncture in Japan today, Keiraku Chiryo
(Meridian Therapy) .
! Among those schools in Japan that claim adherence to classical principles,
perhaps none is as widely known as the Meridian Therapy movement, founded in the
1930s and 1940s in Tokyo. Traditional medicine had been largely supplanted by
modern theories of anatomy and physiology which had been introduced in Japan by the
Dutch as early as the seventeenth century . An acupuncturist and philosophy scholar
named Seisuke Yanagiya (also known as Sorei Yanagiya) was dissatisfied with the
prevailing Westernized methods being practiced at the time and sought an approach
that was more grounded in classical theory. He began to attract students. Two of them,
Fukuji Okabe (also known as Sodo Okabe) and Keiri Inoue, joined forces with
journalist-turned-acupuncturist Shinichiro Takeyama; the three of them are considered
to be, along with Yanagiya, the founders of the Meridian Therapy style .
! The classics they used were primarily the Huang Di Nei Jing Su Wen, the Huang
Di Nei Jing Ling Shu, and, most prominently, the Nan Jing. The Nan Jing was made the
basis for the clinical practice of Meridian Therapy, Shudo says, because of its antiquity
and because it presents a systematized and self-contained system of acupuncture
treatment. Paul Unschuld, perhaps the most prominent Nan Jing scholar writing in
English, calls the work the mature classic of systematic correspondence. In the history
of this particular conceptual system it occupies a prominent place since it appears to be
the only work we know of that combines a high degree of innovative thinking with a
consistent - in the Chinese sense - body of thought. . The clinical procedures outlined
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in the Nan Jing were largely based on the Five Phase paradigm, and made extensive
use of the Five Transporting points ; thus their prominence in Meridian Therapy.
! Perhaps the greatest contribution of the Nan Jing to Meridian Therapy - and
indeed, it is arguable, to the art of acupuncture as a whole - is the concepts it introduced
regarding radial pulse diagnosis. The idea that the pathophysiology of the organs and
meridians could be determined largely from the radial pulse revolutionized the practice
of medicine in China and continues in some form in virtually all systems of acupuncture
extant today. So, too, the treatment principles revealed in Difficulty 69, from which
developed the four-needle technique and other point selections derived from it. This is
the mother-child principle, which is the foundation of not only the Meridian Therapy
associations, but others such as various Korean and European schools. A third strong
Nan Jing influence in Meridian Therapy is the abdominal mapping based on Difficulty
16, about which more will be said below.
! It is perhaps worth noting that this model, though very influential in Japan and
other parts of Asia, has fallen out of favor in the PRC. In the U.S., many schools today
barely teach this paradigm, which at one time was central to the practice of
acupuncture. It doesnt fit well with the eight guiding criteria, and is largely discarded
as an anachronism, a pseudo-mystical historic curiosity no longer relevant to the
practice of Chinese medicine. Thus, it is not well understood by many (if not most) of
those who have graduated from acupuncture schools in this country. In Japan,
however, extremely sophisticated principles of point selection and treatment have been
developed and used with outstanding clinical results; these reflect a deep understanding
of the principles of Five-Phase dynamics.
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and right wrists are divided along their length into three sections, with the middle section
usually centered somewhere in the proximity of the styloid process of the radius. These
are the six positions. In addition, the pulse may be divided into Yin and Yang areas
according to the depth to which one presses when palpating. Thus, the twelve
meridians may all be examined from the palpable portion of the radial artery. In
addition, the arrangement of the positions makes it relatively easy to detect imbalances
along the generating and controlling cycles of the Five Phases, further contributing to its
status as the root examination in Meridian Therapy. Shudo cites Sodo Okabe, who
gives a further interpretation of root and branch in the four examinations: Pulse
diagnosis is the root and the other examinations are the branches. Even if a certain
grouping of symptoms is found through looking, listening and questioning, it is very
difficult to put them in a uniform pattern [without pulse findings]. ... In meridian therapy,
pulse diagnosis is the foundation and all other findings are secondary.
! Pulse diagnosis is less commonly used in Extraordinary Vessel Therapy (KiKei
Chiryo); although some theorists have devised methods for finding disturbances in the
Extraordinary Vessels from pulse palpation, many practitioners contend that a workable
system has yet to be found . One notable exception is Michi Tokito, a modern Japanese
practitioner whose diagnostic framework and treatment protocols are outlined in
Extraordinary Vessels by Matsumoto and Birch. Tokito operates within the now-
standard six-position pulse scheme; however, she concentrates largely on the left and
right proximal positions at the depth of the Yin meridians. She compares the balance
between them, and decides on one of two patterns of Master-Coupled point pairs, one
of which is further differentiated by the balance between the left and right middle
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positions at the superficial level. She apparently uses this method exclusively, and no
mention is made of anyone else who has adopted her innovations .
Palpation of the abdomen (Hara) and meridians
! Among practitioners of Meridian Therapy, the prototype for abdominal diagnosis
comes from the Nan Jing, Difficulty 16 (see diagram). Most practitioners of Meridian
Therapy follow some variant of this scheme.
! One example of variation comes from the Toyo Hari association, a large
organization of Meridian Therapy practitioners, about which more will be said in part II:
Abdominal diagnosis (fukushin) is based on Meridian Therapy theory. The tone of the
abdomen is noted, and palpation is to find the presence of Kyo or Jitsu, warmth or cold.
The luster or dullness of the skin is noted. The left palm lightly touches the abdomen.
The navel is the starting focus.
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techniques unique to the Toyo Hari. Similarly, the intradermal needles (hinaishin)
developed by Akabane and used by him as the primary method of treatment become a
symptom-control tool for Yoshio Manaka, to be used only at the conclusion of a
treatment. The direct moxibustion that forms the sole method for the treatments of
Sawada (though, curiously, not for the style that has evolved bearing his name, in which
needles may be routinely used) becomes a supplementary technique in Meridian
Therapy and Manaka styles, and is not used at all in other systems, such as those of Ito
or Tokito. The Toyo Hari association has even developed a method which combines
direct moxa with M-P principles, though, again, it is not considered part of the root
treatment.
! In the next section, we will examine more closely two approaches to treatment
staging, each with its own definitions of which stage constitutes root and branch and
each with its own unique methods for root treatment.
Part II: Comparison of Styles: Toyo Hari & Manaka
Toyo Hari
! The Toyo Hari Gakkai (East Asian Acupuncture Medical Association) was
founded in 1959 by Kodo Fukushima, a student of Inoue. Fukushima, blinded during
the Pacific War, had originally formed the organization for blind Meridian Therapy
practitioners. The methods he and his association developed were based on extremely
delicate and refined techniques of examination (largely palpatory) and needle
technique. As the association continued to grow, sighted members were trained in
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these methods. The organization is now well integrated, and has begun to grow
overseas as well.
! The Toyo Hari method differs from other Meridian Therapy schools in several
respects; these are in many ways related to the origins of the association. Since the
Meridian Therapy movement was founded by sighted practitioners, blind acupuncturists
wishing to study this material encountered obstacles in a system that was not designed
for them. Fukushima and other founders of the Toyo Hari association at first developed
their own methods of learning until they could be integrated more fully into the Meridian
Therapy movement. In this way, their theories and methods, though similar to and
largely inspired by those of Yanagiya and especially Inoue, for example , grew into an
emphasis on clinical research and didactic methods that set them apart and are very
much responsible for the strength and flexibility of the organization today. In recent
times, unique theories, such as Sokoku harmonization, and even entire subsystems of
acupuncture, such as Naso therapy, have emerged from the Toyo Hari Gakkai. In this, it
is perhaps not representative of other Meridian Therapy associations, but it is
nonetheless a fascinating system with which the author is well acquainted. A basic
overview with some specific examples follows.
Paradigm---Five Phase/ Four Sho Model
! The primary paradigm in Toyo Hari, as in other schools of Meridian Therapy, is
that of the Five Phases. It is imbalance in the Five Phases that is seen as the cause of
morbidity in humans, and it is this imbalance that is addressed in the root treatment.
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Other paradigms, such as Extraordinary Vessels, may also be used, but are assigned a
secondary role in the hierarchy of therapeutic methods.
! In the process of diagnosis and treatment, special attention is paid to the state of
the Yin Meridians, and the pathology associated with them is generally though to be one
of vacuity. As Shudo states, ...in this school of acupuncture the basic pattern of
imbalance is always defined in terms of a deficiency of a yin organ or meridian...the yin
organs or meridians have a tendency to become deficient, and the Yang organs and
meridians to develop excessive conditions. From these patterns of deficiency of the
Yin organs associated with the Five Phases come the four Sho (Chinese: Zheng) or
patterns. The Sho number four rather than five because of a view that the Heart itself
will rarely be vacant, and if it is, consequences are so serious that acupuncture therapy
will be of little avail.
! The four Sho are the foundation of Meridian Therapy theory; without them, one
may not properly treat with acupuncture. Shudo elaborates: The four basic patterns in
meridian therapy are the simplest expressions of the most common and fundamental
types of imbalances in the meridians, all of which involve deficiency of Qi. One or
another of these basic patterns can be utilized in every clinical situation... The
assumption which underlies meridian therapy is that all imbalances, no matter how
complex, initially begin with a deficiency in one of the Yin organs that is reflected in its
corresponding meridian.
! Fukushima, using the Japanese alternate term akashi (instead of Sho, which is
a Japanese pronunciation of the Chinese Zheng): Symptoms are the manifestation of
disease and represent the condition of the body. Akashi is of a higher level. It is the
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-In the first step of Sho selection, one considers the Yin or Yang constitution of the
patient, Yin or Yang nature of the disease, and selects appropriate techniques of
tonification or dispersion with appropriate needles in an appropriate quantity. Determine
the patients constitution; decide what kind of needle to use; what kind of stimulation and
how much; how many points to treat.
-In addition to five-phase diagnosis, you must determine if they are of Yin or Yang
constitution. Look at the pathology...is it Yin or Yang? Old or New? Slowly-developing or
Quickly-developing? Yin diseases are often inapparent, while Yang diseases are often
apparent.
-In the second step, one collects signs and symptoms and correlates them to the twelve
meridians.
-Finally, pulse diagnosis is used to determine the primary pattern or Sho. Palpate the
pulse, hara and the meridians. By now you already have some sense of what to look for.
Determine the Sho based on these findings.
-It is very important to follow all these steps in order to correctly determine Sho.
! !
! Signs and symptoms are largely derived from the symptomology described in the
Ling Shu. They are not very different from those described in modern TCM texts, but
they become weighted in terms of their importance by the subsequent step of the
diagnosis. Thus, the diagnostic process is not simply counting up how many symptoms
are those of the Spleen, Kidney or whatever; and the state of the body fluids or
substances is not of great concern. What is being addressed is the quality and
circulation of the Ki-Ketsu (Qi and Blood) of the body.
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Tools and Techniques
! As Shozo Takahashi-sensei, vice-president of the Toyo Hari Medical Association,
said in conversation with the author, technique is everything in Toyo Hari . In general,
the techniques rely on very delicate manipulation of fine needles (usually .16 or .18mm
in diameter, and 25-40mm in length), characteristically made of silver and sometimes
gold. In contrast to the techniques used in the PRC, which are aimed at eliciting a
strong sensation of distension or soreness (called deqi or obtaining Qi) by deep
insertion and pronounced manipulation, the Toyo Hari practitioners advocate subtle
techniques in which the needle is manipulated in ones consciousness as much as with
ones fingers. The needles are often not inserted (i.e. they do not penetrate the
epidermis) but are held with the tip either just touching or slightly above the skin. Even
in more dispersing techniques where the skin is broken, the needle rarely reaches a
depth of more than a few millimeters. Needles are seldom left in situ; once the arrival
of Ki (C: Qi dao, J: Ki itaru) is felt - by the acupuncturist rather than the patient - the
needle is withdrawn in a strictly prescribed manner according to the findings gleaned
during selection of Sho.!
! All one really needs when treating patients is a needle and one s own two hands.
The right hand, called sashide, holds the handle of the needle and is used to insert and
manipulate. The left hand, called oshide, holds the tip of the needle and is used to
stabilize the needle and keep the Ki from leaking out. Both are important but the
formation of a good oshide is considered crucial, especially during tonification. The
thumb and index finger are brought together in an o shape; the profile should be flat
and there should be as much contact as possible between the very tips of the thumb
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speeds up the process...In terms of the overall care of the patient...its value is far less
significant than that of Fundamental Healing.
! I feel it is further necessary to comment upon what the Toyo Hari training
methods call supportive treatment, and to differentiate this from the more commonly
held notion of branch treatment as local. While it is true that supportive treatment
targets symptoms and that the goal is the elimination of same, the treatment is often as
not conducted upon locations remote from those where the symptoms may be found.
Thus (as noted above) the branch treatment in Toyo Hari may employ the same
methods used by other associations as a root treatment. In addition, the affected body
areas themselves may be treated in a more standard local treatment. The majority of
methods outlined below more closely match the definition of supportive treatment rather
than local treatment.
Methods
Midnight-Noon (ShiGo)
! ShiGo (Chinese: Zi Wu) is a system of point selection based on the circadian
rhythm of the the twelve meridians as outlined in the Ling Shu. The cycle is said to
begin with the Lung meridian at 3:00 a.m. and progress through the meridian circuit as
follows:
3-5 a.m.: Lung
5-7 a.m.: Large Intestine
7-9 a.m.: Stomach
9-11 a.m.: Spleen
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11 a.m.-1 p.m.: Heart
1-3 p.m.: Small Intestine
3-5 p.m.: Bladder
5-7 p.m.: Kidney
7-9 p.m.: Pericardium
9-11 p.m.: Triple Burner
11 p.m.-1 a.m.: Gallbladder
1-3 a.m.: Liver
!When opposite sides of the diagram are combined, a Yin-Yang/hand-foot
meridian pair is created. For example, 3-5 a.m. is the time designated for the Hand
Taiyin Lung meridian. This would be combined with the opposite time on the clock,
namely 3-5 p.m., which is the active period for the Foot Taiyang Bladder meridian. The
meridians are paired thus:
Lung-Bladder
Large Intestine-Kidney
Stomach-Pericardium
Spleen-Triple Burner
Heart-Gallbladder
Small Intestine-Liver
! Problems affecting a given meridian may be treated by needling its ShiGo paired
meridian, i.e., for pain along the Heart meridian, the Gallbladder meridian would be
treated. The most common indications for ShiGo treatment are either symptoms that
recur during a specific time (patient awakes every night at 2 a.m., for example) or
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and intestinal or urogenital problems with Muno). They are essentially the same
procedure: knots or lumps in the tissues are palpated, a needle is inserted until it
reaches the knot, manipulated until the knot loosens, withdrawn and another knot in the
area is sought. The Toyo Hari categorize the various lumps according to the degree of
hardness, and correspondingly harder needles and techniques are employed for each.
Needle sensation along the meridian may be felt here, but in contrast to the cramping or
distending sensation of TCM acupuncture, a warming sensation in the affected area or
meridian is considered a positive sign. As in other techniques in Meridian Therapy,
strong needling is avoided and is considered detrimental to proper treatment.
! Naso itself has grown and developed over time into a unique system which
strongly corresponds with the Sho. Clinical research has indicated reflex zones which
may be palpated to confirm the Sho, and/or treated to extend the Root treatment still
further. Originally viewed as roughly correlating to the muscle meridians in the neck
area, they are increasingly being refined to the extent that Naso can hardly be called a
local treatment anymore. It has become a whole-body treatment, a complex micro-
system of acupuncture in which virtually any complaint may be addressed.
! Local areas themselves are often treated by fast and light touching
needle (sanshin) techniques, and other types of implements such as the rounded
needle (teishin, which may be used in diagnosis and root treatment as well), and
curiously shaped needles designed to stroke or scratch the cutaneous meridians
(zanshin, enshin, shonishin) are routinely employed in the clinic. The Toyo Hari
association also uses other techniques more familiar to other Japanese styles, such as
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practiced these modalities from 1960s on. He founded Manaka hospital in Odawara,
Japan in 1945 and was its director until his death in 1989. Thus, he had resources to
experiment and collect data to test his theories. He studied as many styles of traditional
medicine as he could, and evaluated each according to his own research.
! As he went on in his career, he gravitated more to the subtle methods of those he
studied, and developed his own unique paradigm to explain the profound effects such
methods could elicit. This he called the X-signal system; he described it as a primitive
information system in the body that has embryological roots, but is masked by the more
advanced and complex control (regulation) systems... cannot be explained by
neurophysiology because it manifests and is manipulated clinically with minute stimuli or
influences that cannot be clearly said to affect the nervous system... we feel it is a
biological system as yet undiscovered by biologists and anatomists.
Manaka developed devices to affect this system without stimulating the nervous system;
the most famous and widely used of these is the ion-pumping cord, described in
greater detail below. It is worth noting that his work in this field has influenced most of
the use of magnets and other polarity agents in acupuncture.
Paradigm---Multi-Model
! Manakas model is based on a number of paradigms, refined by his own
research. The Extraordinary Vessels were of particular importance, especially during
the initial developments of his approach. Later, he began to add the polar meridian
pairs, i.e. the hand-foot -Yin-Yang pairs formed by opposing meridians on the Chinese
clock (see above section on ShiGo). Musculoskeletal imbalances were framed in the
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context of the meridian sinews (jing jin). He developed indications for each paradigm,
and treated according to what he found. If the findings were inconclusive, he had a
paradigm for that too. The biorhythmic open point could be treated, or moxa could be
applied in a whole-body approach that Manaka adapted from master moxibustionist
Sawada. Unusual treatment methods, such as shining colored LED lights on five-phase
points or applying sonic stimulation at various frequencies to different meridians, were
also routinely employed.
! Manakas clinical protocol is lengthy and involved; Stephen Birch has noted that
it may be done in 45 minutes, if youre brisk . Manaka
s protocol is constructed in five
steps, the first three of which he considered the root treatment and the remaining two
the supplemental treatment.
! The protocol can roughly be charted as follows:
Step One:
Treat the Yin (front) side of the body
Paradigms:
Extraordinary Vessels; Polar Meridian Pairs; Biorhythmic Methods; Taiji Moxibustion
Methods:
Mainly Ion Pumping Devices (see below)
Step Two:
Treat the Yang (Back) side of the body
Step Three:
Treat the Meridian-Sinew imbalances
Paradigms:
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Related Back-Shu points (Step Two); Reactive points along Yang Meridians
Methods:
Kyutoshin (Needle Moxa); Fire Needle; Moxibustion; Sotai exercise
Manaka observes that Step Two and three often overlap, as their goals are similar.
! The examination would generally begin with palpation, usually starting with the
abdomen. Manakas Mu points would be pressed, and the Extraordinary Vessel
configurations would be tested. Reactive Mu points that appeared in polar meridian
combinations would be confirmed with palpation of relevant areas on the gastrocnemius
muscles. Any findings regardless of paradigm could be confirmed by positive o-ring
test. If both polar meridian findings and Extraordinary Vessels findings occurred during
the examination, the more appropriate of the two paradigms would be determined; step
one treatments generally used only one paradigm. If no positive findings occurred and/
or the examinations were otherwise inconclusive, biorhythmic open points from any of
the three commonly-used methods outlined above could be employed. Another
possibility would be the Taiji moxa treatment developed by Sawada and refined by
Manaka.
Treatment staging I: Root Treatment (Steps 1, 2 & 3 )
Approaches to diagnosis
Assessment of Condition
! In his book, Chasing the Dragons Tail, Manaka offers this explanation of akashi
(or Sho, as described above) as opposed to diagnosis in the modern biomedical sense:
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! Akashi is a collection or pattern of signs and symptoms that center on a
treatment adaptation or method. Thus, depending on what treatment method is
selected, the akashi will be different, where in Western biomedical terms, several cases
might all be the same disease entity, regardless of treatment possibilities.
! Akashi can be said to depend on the intentional consciousness with which we
observe the patient... However, this makes the akashi dependent on the style,
experience sensitivity, and ability of each practitioner.
! In Manakas style, the main method of assessment is palpation, and the primary
site of palpation is the abdomen. Manaka determined his own set of Mu-Alarm points
for the various Zang-Fu (see Table), as well as zones of reactivity for the various
Extraordinary Vessel pairs (see Table). The polar meridian pairs are indicated by
reactive Mu point combinations, along with a system of palpation of reactive zones on
the gastrocnemius muscles (see Table).
Manakas Mu Points
Lungs - LU 1 to LU 2 area
Percardium - PC 1
Heart, Pericardium - CV 17
Heart - KD 23
Heart - At the sides of CV 14
Liver - LV 14 to GB 26 (esp right subcostal)
Gallbladder - GB 24 to GB 29 region
Stomach - Beside CV 12 (including ST 21)
Spleen - GB 26 to SP 21 region
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Kidneys - KD 16 (occasionally GB 25)
Triple Warmer - ST 25 (or slightly lateral)
Upper Warmer - CV 17
Middle Warmer - CV 12
Lower Warmer - CV 5
Small Intestine - ST 26 (or slightly lateral)
Large Intestine - ST 27 (or slightly lateral)
Urinary Bladder - KD 11
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! The pattern selected for Step One usually sets up the rest of the procedure
through Steps Two and Three. Points on the back would be selected which strongly
correspond to the assessment for step one. For example, if Step One were an
Extraordinary Vessel pattern, step Two would follow thus:
! -Yinqiao Mai-Ren Mai, kyutoshin (moxa-needle) on UB 23 and/or 25
! -Yangqiao Mai-Du Mai, kyutoshin on UB 27 and/or 28
! -Yinwei Mai-Chong Mai, kyutoshin on UB 18 and/or 20
! -Yangwei Mai-Dai Mai, kyutoshin on UB 19 and/or 22
!-Cross-Syndrome, kyutoshin on UB 18 and/or 27, 25, 23
All of these may be supplemented or supplanted by points of pressure pain.
! Step Three generally hinges on examination of leg and arm lengths and
muscular imbalances on the sides of the spine. If these are present, further
examination typically reveals the following associated with organ patterns:
With Liver problems, the paravertebral muscles on the right between UB-17 to 20 may
be tight or swollen; problems with the right shoulder and left low back may appear.
Problems of the Spleen may show paravertebral problems to the left, from UB-18 to
22, and problems in the left shoulder.
Lung problems often result in shoulder and intrascapular tension, as well as stooped
shoulders and upper back.
Kidney problems often manifest as lumbar problems from UB 23 to 52.
! Often step three could be completed with a simple exercise combined with direct
moxa or fire needle to UB-18 (the Liver Shu, as the Liver controls the sinews).
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Feedback systems
! Feedback in this style is largely gauged through the relief of pressure pain or
tightness in the previously palpated abdominal or gastrocnemius zones. Omuras o-ring
test is also employed. This is an applied kinesiology test, developed by Yoshiaki Omura
MD, in which the patient holds their right index finger and thumb tips together in an o-
ring shape while the left index finger touches a diagnostic point on their own body. The
therapist attempts to separated the fingers in the o-ring and gauges the resistance given
by the patient to this action. The test is considered positive when the resistance is
weaker than usual. A number of points may be tested this way, and in certain cases the
presence of pathology may be evident only with this technique. Stretching exercises in
step three would begin and end with range-of-motion tests to gauge the extent to which
the imbalances in the meridian-sinews have been corrected.
Approaches to treatment
Choice of Method
! Manakas view of root treatment was fairly broad: Treatments that take
advantage of the signal system are considered root treatments. Treatments utilizing
channel characteristics, five-phase points and extraordinary vessels are root treatments.
Treatments that harmonize Yin and Yang are also root treatments. In our experience,
for root treatment, selecting from classical channel therapy, channel sinew therapy,
extraordinary vessel therapy, or biorhythmic treatments has provided the greatest
effectiveness and utility.
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! Step One treatments, as noted above, are chosen primarily from Extraordinary
Vessel or Polar Meridian pair models; barring clear indications of either of these,
biorhythmic open points or Sawada/Manaka Taiji moxibustion treatments may be used.
Taiji moxibustion, as practiced by Manaka, would consist of tiny direct moxa on CV-12,
ST-25, CV-4 or CV-7, TB-8, Manakas own 3-yin crossing point (above SP-10), K-7,
LV-3, LV-4, GV-12, GV-20, UB-18, UB-20, UB-23, UB-32, UB-52, GB-31, GB-34, GB-40.
! As is evident from the above quote, Manakas definition of root treatment was far
more open and encompassing than that of the Meridian Therapy schools. As we have
seen, the Toyo Hari Gakkai would consider the classical channel therapy (Mr. Birchs
translation of the term Keiraku Chiryo, implying a five-phase paradigm) alone as
constituting proper root treatment; the channel sinew, extraordinary vessel, or
biorhythmic treatments would all be seen as supportive treatment.
! In this way, Manakas root treatment concept could be spread over three stages
of clinical events, so step Three of a five-step plan is as much a root treatment as step
one.
Tools and Techniques
! In Manakas system, tools are generally more important than techniques; this is
especially true in the first step of treatment, in which the polarity agents do the work that
in other systems would be accomplished with manipulation of the needle or other forms
of tonification and dispersion.
! Step one treatments are generally done with ion-pumping devices, instruments
invented by Manaka himself. There are three varieties, developed over time. The
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oldest, ion-pumping cords, were developed during the second World War to treat burn
victims, but their use in subsequent years has been confined to the field of acupuncture.
They consist of one or more pairs of cords of thin copper wire, each with an alligator clip
at either end. The clips are partially covered in colored rubber; one clip is black and the
other red. The red clip contains a germanium diode which allows the current to flow in
only one direction. As Manaka states: Theoretically, attaching the positive and
negative clips of an ion cord to two needles...will create a polarity between the needles
and electronic and ionic currents will begin to flow inside the body . The needles to
which they are attached are inserted shallowly (2-3 mm) with no manipulation. They are
retained for ten to twenty minutes, after which the abdominal reactions should improve.
! Newer (and costlier) alternatives which use no needle insertion and save
considerable time are the ion beam apparatus and the electrostatic adsorbers. The ion
beam consists of a small electronic box into which two small cylindrical coaxial
conductors are plugged; the conductors, also colored red and black, conduct very weak
negatively and positively charged electrical current (beams). They are touched to the
relevant points for twenty to sixty seconds to produce the desired effect. The
electrostatic adsorbers are metal rods with built-in ceramic capacitors, connected by a
cord and also designated red and black; the device withdraws static electrical charges
that are caught or stored in body tissues and redirects them via a diode similar to the
ion pumping cords. Again, they need only be touched to the skin for twenty to sixty
seconds to accomplish their mission.
! Alternative Step One modalities include the use of colored lights and pens on the
five phase and source points; these may be used to confirm diagnoses (repalpate after
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applying colors) or to treat, in some cases. Briefly, the colors used follow the classical
five-phase associations: green/blue for Wood, red for Fire, yellow for Earth, white for
Metal, black for Water, and orange for Source points.
! Step two treatments are done with kyutoshin, moxa-needle. Back-shu points
relevant to the akashi (for example, UB-18 for cross-syndrome or Liver-Small Intestine
polar meridian pair) are needled and moxa is burned on the handle of the needle. This
is the most common technique for step two, although moxa is not always used. Step
three is accomplished with the fire needle (Chinese: Fa zhen) or direct moxa, utilizing
simultaneous stretching of the affected meridian or specific exercises chosen from the
Sotai system developed by Keizo Hashimoto .
Assessing treatment
! Treatment may progress from step one to step two when the abdominal reactions
noted during the diagnostic process are reduced or eliminated. A positive o-ring test
may also confirm that the treatment has achieved its purpose. As noted above,
distinctions between steps two and three are often blurred, as their goals are similar,
and sometimes one or the other is eliminated.
Treatment staging II: Supplemental (Branch) Treatment (Steps 4 & 5)
Methods
! Manaka referred to his branch methods as symptom control; sometimes the
root treatment would provide sufficient relief, and further treatment would be
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involved are so subtle, one must be able to increase one s perceptivity in the clinical
context.
! Didactic approaches from Japan, such as the Toyo Hari associations Kozato
method, can lead to new ways in which to teach acupuncture in this country. The
Japanese emphasis on hands-on training enables the student to feel the subtle
differences in tissues and gain the tactile understanding crucial to effective point
location, for example. Learning the methods of feedback can help to discriminate core
issues in treatment and keep the therapy on track, instead of chasing symptoms.
!Mark Seem, in his book Acupuncture Imaging, notes ...the tremendous
importance of Kiiko Matsumotos own work in this country, as she tries to engage
American practitioners in...a phenomenological approach...intervening in terms of the
patients own present condition whether or not it fits some preconceived clinical
syndrome or pattern...When a practitioner probes the patients body very carefully,
showing that he knows where to palpate, this reinforces the patient s own internal
knowledge and awareness that her signs and symptoms are all connected to the same
underlying imbalance...
! An understanding of Japanese methods is not only advantageous for the student
and educator; longtime professionals may gain new insights and benefits as well. As
the practice of acupuncture turns more towards complementary medicine (with
consequent time constraints), more efficient methods of assessment may be needed;
the empirical palpatory styles of Japan offer ways to rapidly combine assessment and
treatment virtually at the same time. As a greater variety of people curious about
acupuncture begin to seek treatment, the practitioner can only benefit from cultivating
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physical therapy cage in which many earnest practitioners find themselves. Perhaps
further scientific research will bring us closer to Manakas X-signal hypothesis, or a
similar validation of the subtle, intangible effects of acupuncture and moxibustion that
seem at once unprovable yet impossible to deny. What is certain, though, is that
Japanese styles, with their respective Roots and Branches, are becoming more a part
of Oriental Medicine in North America and will make their unique imprint on practitioners
here as the art continues to evolve.
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Appendix II
Comparative Symptomology of Extraordinary Vessels
REN MAI
Manaka: Gynecological problems; hemorrhoids; asthma; bronchitis; lung problems;
neurosis; toothache; ear, nose and throat problems.
Nagatomo: Emphysema; catarrh; asthma; lower abdominal diseases; skin diseases.
Bachmann: Respiratory tract diseases; lower abdominal diseases; diabetes; eczema;
tumor.
Fukushima: (with Yinqiao; Nin/In-kyo) Symptoms along the courses of the meridians;
tooth and gum pain in the front of the mouth; coughing; asthma; phlegm disorders;
epigastric pain; nausea and vomiting; distension and pain in the epigastrium, middle or
lower abdomen; general pain; diarrhea; constipation; urinary incontinence, anuria or
hematuria; general gynecological disorders; birthing difficulties; special circulatory
problems particular to women; nervous disorders; hemorrhoids; anal prolapse; cold or
hot feet; kidney diseases; general lack of vigor.
Shanghai CTCM: Pathological symptoms of the Yin channels, especially Liver and
Kidneys; uterine disorders; infertility; urogenital disorders; leukorrhea; irregular menses;
colic.
Feit/Zmiewski: (repletion) menstrual disorders; vaginal discharges; male urogenital
disorders; head and neck pain; abdominal distension and pain; mouth and tongue
abscesses. (depletion) pruritis; heaviness of loins and lumbar area; shan qi pain.
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YANGQIAO MAI
Manaka: Whiplash; epilepsy; speech disorders; shoulder pain; lumbar pain; unusual
sweating; trigeminal neuralgia.
Nagatomo: Any bleeding problem; stroke; hemiplegia.
Bachmann: Any skin bleeding disorder; edema; swelling; CVA; hemiplegia; tinnitus.
Fukushima: (see Du Mai)
Shanghai CTCM: Eye diseases; tightness and spasms along lateral leg muscles with
flaccidity of medial leg muscles; lumbar pain and stiffness.
Feit/Zmiewski: (repletion) General weakness of Yin organs and functions with
corresponding tension of Yang organs and functions; aggravations at the end of the day
and at night; nocturnal congestions, pains or crises; tightness and spasms along lateral
leg muscles with flaccidity of medial leg muscles; nocturnal epileptic seizures; dry or
itchy eyes; restless sleep or insomnia. (depletion) Aggravations during the day that
improve at night; fatigue, lassitude or weakness during the day.
YANGQIAO MAI (palpation)
Fukushima: ...can be thought of as the Bladder meridian. Its diagnostic points are
FuBun (UB-41), KoKo (UB-43), IChu (UB-40), ShoZan(UB-57), FuYo (ST-19), and
BokuShin (UB-61).
Manaka: Pressure pain or reaction may be found on: ASIS; alongside the cervical
vertebrae; around SI-9 and SI-10; K-11; the Bladder meridian, especially between
GB-29 and UB-36; UB-62; GB-21.
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CHONG MAI
Manaka: Heart problems; neurosis; stomach problems; gynecological problems; cold
feet; liver/gallbladder problems; problems of anus.
Nagatomo: Painful diseases of the abdomen or chest; non-fixed rheumatic symptoms.
Bachmann: Pain that moves; late menses causing suffering of the heart and
palpitations that lead to insomnia; intestinal spasms.
Fukushima: (with Yinwei; Sho/In-i) Symptoms along the course of the meridian; swollen
and sore throat; chest or heart pain or discomfort; epigastric pain; general pain;
abdominal distension or pain; pain, cramping, palpitations or upward flushes on the
sides of the abdomen (Spleen) or around the umbilicus (Kidney); nausea or vomiting;
diarrhea; constipation; bleeding affiliated with the stomach, kidneys or large intestine;
gynecological diseases; endocrine disorders; menopausal ailments; hemorrhoids.
Shanghai CTCM: Gynecological disorders; male sexual disorders including impotence;
abdominal pain; colic.
Feit/Zmiewski: (repletion) Weakness of abdominal organs; menstrual block or
irregularity; ! insufficient lactation; nervous or motor atony; impotence.
(depletion) Lower abdominal spasms or pain; prosatitis; urethritis; orchitis; seminal
emission; metrorrhagia, menorrhagia; hematemesis.
CHONG MAI (palpation)
Fukushima: ...thought of as the Spleen meridian in the legs and feet and the Kidney
meridian in the chest and abdomen. Diagnostic points are KiSha (ST-11), KoYu (K16),
SanInKyo (SP-6) and KoSon (SP-4).
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disorders; distension of the ribs and lower abdomen; general pain; coldness and pain in
the lower back; irregular menses; abnormal vaginal discharge.
Shanghai CTCM: Fullness in the abdomen; irregular menstruation; leukorrhea; lumbar
pain; weakness and motor impairment of the lower limb.
Feit/Zmiewski: (repletion) Superficial repletion of Yang channels; lumbar and loin pain;
pain in lower extremities; weakness of shoulders and upper extremities on opposite
side; weakness of opposite eye, breast or ovary. (depletion) Cold or heaviness or
weakness in lumbar and loins; white vaginal discharge; uterine prolapse; abdominal
distension; pain and inflammation in opposite shoulder, upper extremity, eye, breast or
ovary.
DAI MAI (palpation)
Fukushima: ...can be thought of as the Gall Bladder meridian. Its diagnostic points are
ShoMon (LIV-13), TaiMyaku (GB-26), GoSu (GB-27), YuiDo (GB-28) and KyoRyo
(GB-29).
Manaka: Pressure pain or reaction may be found on: K-16 or around the umbilicus in
general; the Dai mai, including LIV-13, ST-25, GB-26, GB-27, GB-28 and GB-29;
Gallbladder meridian, particularly GB-41; UB-23.
YANGWEI MAI
Manaka: Dizziness; headache; whiplash; sweating problems; trigeminal neuralgia;
fatigue; eye and ear problems.
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Additional Toyo Hari KiKei Combinations
(NOTE: In addition to the classic Extraordinary Vessel combinations, the Toyo Hari
Gakkai has added two point combinations to it s Extraordinary Vessel treatments: LI-4 is
combined with ST-43, and HT-5 is combined with LV-3. Occasionally LV-3 will be
combined with HT-7 or PC-6, depending on specific symptoms.)
GOKOKU / KANKOKU (LI-4/ST-43)
Symptomology: Symptoms along the course of the meridians; growths and abcesses on
the face, neck, arms or back; stye or pinkeye; inflammation of oral mucosa; swelling and
pain in teeth and gums; sore throat; stomach pain and distension; diarrhea; skin
diseases; acute emotional disorders.
Palpation:GoKoku point is affiliated with the Large Intestine meridian. Its diagnostic
points are GoKoku(LI-4), OnRu (LI-7), KenGu (LI-15), TenTei (LI-17) and GeiKo (LI-20).
KanKoku point is affiliated with the Stomach meridian. Its diagnostic points are
KanKoku (ST-43), ShoKyu (ST-1), ShiHaku (ST-2), KetsuBon (ST-12), TenSu (ST-25)
and Ashi SanRi (ST-36).
TAISHO / TSURI (LV-3/H-5)
Symptomology: Symptoms along the course of the meridians; vertigo; Alzheimers
disease; emotional disorders; eye afflictions; disorders of the endocrine system; thoracic
or flank pain and distension; muscle cramping; sweling; coldness; lack of motivation.
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Papers
Birch, Stephen. Dr. Manakas Yin-Yang Balancing Treatment (Parts 2 & 3), North
! ! American Journal of Oriental Medicine, Vol. 2, No. 3, March 1995, p 4-6;
! ! Vol. 2, No. 4, July 1995, p 5-7
Kuwahara, Koei. If You Dont Try to Fix it, it Fixes Itself North American Journal of
! ! Oriental Medicine, Vol. 2, No. 5, November 1995, p 22-25
Manaka, Yoshio. Japanese and Chinese Acupuncture: Similarities and Differences,
! ! North American Journal of Oriental Medicine, Vol. 1, No. 2, November
! ! 1994, p 5-9
Nakada, Koryo. Basic Needling Techniques of Toyo Hari North American Journal of
! ! Oriental Medicine, Vol. 2, No. 4, July 1995, p 24-26
Romano, Augusto. Toward your own style of acupuncture, American Journal of
! ! Acupuncture, Vol. 20, No. 2, 1992
Shima, Miki. Looking Forward, North American Journal of Oriental Medicine, Vol. 2,
! ! No. 5, November 1995, p 5
Van der Poorten, Nancy. A Visit by Dr. Iriye to Toronto, North American Journal of
! ! Oriental Medicine, Vol. 2, No. 5, November 1995, p 35
Other Sources
Shima, Miki. JAAF Video Series: Mysteries of the Needle, Japanese American
! ! Acupuncture !Foundation, Corte Madera, CA, 1992
Stephen Birch lecture at AAAOM convention, Austin, TX, 1990 (unpublished audio tape)
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