Most people know that acupuncture is an ancient tradition of holistic medicine that has been practiced continuously in China for more than 2,000 years. What most people don't know is that many other Asian countries have a long history of acupuncture and have developed very vibrant and innovative approaches to this ancient healing tradition.
Japan is one of those countries with a very dynamic tradition of acupuncture and has taken a markedly different approach from that of the Chinese. While Chinese acupuncture has taken the lead in the practice of Oriental medicine in the West, interest is increasing in some of the other traditions, along with a growing movement in Japanese acupuncture.
A Brief History of Acupuncture in Japan
The practice of acupuncture seems to have originated in China roughly around 200-100 B.C. Knowledge of acupuncture appears to have been brought to Japan from China by a physician-monk named Zhicong (Chiso in Japanese) in the year 562 C.E.1 He is said to have brought with him more than 160 volumes of Chinese medical texts which, at the time, represented state-of-the-art medicine. By the 8th century, government-sponsored acupuncture medical schools had been established in Japan and medical knowledge from China continued to be assimilated by the Japanese. However, by the middle of the 10th century, political tensions began to arise between China and Japan, and contact with China became increasingly cut off. It was during this period that Japanese physicians began refining the Chinese system and making their own unique innovations to the medicine.
Around the end of the 17th century, some very interesting things started happening in Japanese acupuncture. It was during this time that a blind acupuncturist named Waichi Sugiyama became famous by inventing a special insertion tube (which still is in use today) that allowed for less painful insertion of the needle. Sugiyama went on to establish the first acupuncture school for the blind in Japan. This was the beginning of what has become one of the most interesting and unique characteristics of Japanese acupuncture: a strong influence by a large contingent of blind practitioners.
The idea of blind practitioners using needles initially may seem somewhat strange to us in the West. However, it commonly is known that with loss of sight comes an enhancement of the other senses. In fact, in recent studies, cognitive neuroscientists have shown that in those people who are born blind, the visual cortex does not atrophy, but rather is functionally relocated to process sound and touch. This extra capacity devoted to the other senses produces superacuity that few sighted people could conceive.2 Thus, the ability of blind practitioners to sense the movement of subtle energies within and around the body is said to be quite extraordinary. This ability allows for highly refined pulse diagnosis and treatment techniques and helps to restore health to those seeking treatment. From the Japanese point of view, the practice of acupuncture utilizes the enhanced tactile skill of the blind and provides a profession in which they may naturally excel. To this day, a large group of blind practitioners continues to influence both the practice and theory of acupuncture and shiatsu massage in Japan. The style of acupuncture that is most strongly associated with the blind is known as the Toyo Hari (Eastern needle) style.
Some Differences Between Toyo Hari and Chinese Acupuncture
Because Japanese acupuncture is based on the Chinese classics, Japanese and Chinese acupuncture share the same meridians and points and many of the same underlying philosophical principles. However, from a clinical perspective, the Toyo Hari style differs from the more common Chinese styles in many interesting and important ways. Generally speaking, Toyo Hari practitioners use far thinner needles than their Chinese counterparts. For instance, most commonly used Chinese needles are about 0.30 mm in diameter, while a typical Japanese needle used by Toyo Hari practitioners is between 0.12 mm and 0.16 mm. The needles usually are not inserted as deeply as they are in Chinese acupuncture. Very often, they are not inserted through the skin at all. When they are inserted, they usually are retained for only a few seconds or minutes. In Toyo Hari, needles are used to either nourish deficient qi (vital life energy) or to move obstructed qi in a very gentle but powerful technique known in Japanese as the ho or sha technique, or in English as non-insertive needling. Because of the difference in approach to needling technique, Toyo Hari acupuncture often is experienced as much more gentle and a lot less painful than most of the Chinese styles. Many Westerners naturally find this approach more appealing.
I recently had the pleasure to speak with Brenda Loew, LAc, president of the Toyo Hari Association of North America and one of the senior Toyo Hari practitioners in the United States. I asked her what sets Toyo Hari apart from other traditions of acupuncture. She answered, "I would definitely say that the finesse of the approach and the very delicate techniques are what set Toyo Hari apart from other traditions." When I asked Brenda if there were other more philosophical differences, she said, "The fundamental purpose of Toyo Hari acupuncture is to bring the underlying energy of the patient into balance. Of course, you have to treat the symptoms as well because that's why the patient comes to see you. However, the emphasis in Toyo Hari is not on treating the symptom, but on balancing the underlying energy and creating a deep sense of wellness. This is what we call the root treatment. There are a lot of acupuncture styles that focus on helping the patient feel better, but not necessarily on nourishing the energy at the deeper level."
There are some other interesting differences between Toyo Hari and Chinese acupuncture. For example, it is quite common for a Chinese-style acupuncturist to insert the needles into the patient and leave the room while the patient is left "to cook." In the Toyo Hari system, the practitioner usually remains in the room throughout the treatment, tinkering with the flow of qi in one way or another until the pulses become balanced.
This leads to another important difference: Because the blind Toyo Hari masters have such a highly developed tactile sense, their school of acupuncture utilizes this skill and incorporates more palpation, touch and pulse-listening for both the diagnosis and treatment of disease. The radial pulse and the abdomen are heavily relied upon for diagnosis and they are used as an instant feedback mechanism to monitor and direct the course of treatment. Treatment is broken up into several stages, beginning with what Brenda Loew referred to earlier as the root treatment and ending with symptomatic control. The main focus of treatment is centered on the root causes of the disease, and the underlying imbalance always is directly addressed. The root treatment begins first by balancing the yin meridians and then balancing the yang meridians. Any deficiencies of qi are nourished and deficient meridians are strengthened; any obstructions in the flow of qi are broken up much like logjams on a river. In this way, the flow of qi in the body becomes smoother. Both the yin and the yang aspect are brought into balance and health and well-being can then be achieved. Patients often report being surprised at feeling subtle sensations of qi flowing in their bodies as the treatment unfolds.
Toyo Hari acupuncture also has some philosophical and spiritual differences from the Chinese styles that are more commonly practiced today. While Chinese acupuncture is steeped in the tradition of 2,000 years of Taoist and Confucian thought, it is Maoist and Chinese Communist ideology that has exerted a more recent influence on Chinese acupuncture, both in China and here in the West. Many of the spiritual aspects of the medicine were discarded by communist ideologues in favor of a more scientific approach. Toyo Hari has largely been free of this kind of political and ideological influence and has instead remained true to its traditional Taoist and Zen Buddhist roots. Many of the Toyo Hari teachings emphasize the importance of clearing the mind, focusing intention and developing stillness, while working with the patient's qi.
Another unique aspect of the Toyo Hari masters and the tradition they have created is that it is a living, evolving system. They have a commitment to ongoing study and the evolution of the techniques, as they continue to learn and improve. Brenda Loew told me, "One of the things that I most admire about Toyo Hari that I haven't encountered in any other system is the emphasis of ongoing training and study. The masters in Tokyo practice kazato method (group practice method) and learn from each other, and they never stop learning. Even Yanagishi-sensei (a sensei is a teacher or a master), who is 72-years-old, continues to study in the group setting and improve his skill."
Of course, China is the birthplace of acupuncture and should be honored for its great gift to the world. There are many gifted and compassionate practitioners who work in many different traditions of acupuncture and this article is not trying to suggest that any one style is better than any other. Rather, my intention is to educate the public about the wonderful diversity of styles available to us here in the West. I suggest that those who are interested in seeking out the many therapeutic benefits of acupuncture try a variety of styles and practitioners to find out firsthand which works best for them.
Birch S, Ida J. Japanese Acupuncture: A Clinical Guide. Taos, NM: Paradigm Publications, 1998.
Sacks O. "The Minds Eye: What the Blind See." The New Yorker, July 28, 2003.
Robert Weinstein is self-employed as a licensed acupuncturist and herbalist at The Healing Arts Studio in Seattle. He can be reached at