HARI HANDBOOK OF TRADITIONAL JAPANESE ACUPUNCTURE · By The Hari Society instructor, Kuwahara, Koei...

1

HARI HANDBOOK

OF

TRADITIONAL JAPANESE

ACUPUNCTURE

Japanese Meridian Therapy

Instructor:

Kazuto Miyawaki Lic.Ac. (Japan)

T. Koei Kuwahara Lic.Ac

Ehrland Truitt DOM.

Instructor: Miyawaki Kazuto, Lic.Ac. Japan

T. Koei Kuwahara, Lic.Ac. Japan President of the Hari Society (617) 926-6986(w): E-mail: [email protected] www.culia.net Organizer/ Instructor: Ehrland Truitt DOM. (505) 820-8786 President of the High Desert Hari Society Translation: Stephen Brown Lic. Ac.

Location: Santa Fe Woman’s club, 1616 Pecos, NM

(1) SATURDAY, SEPTEMBER 8th, 2012

830 am – 9:00 pm Registration

9:00 am – 9:15 am

HA

RI PR

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1)

Opening words: Ehrland Truitt and Aoun Mantra Self-introduction and Keynote Address: T. Koei Kuwahara, Kazuto Miyawaki

Introduction to the complete Hari system

9:15 am –

10:35 pm

Lecture Ⅰ MIYAWAKI Intro. to Hari

Practice Ⅰ

*Introduction to Japanese Meridian Therapy Definition, Characteristics 1, 2, 3

* Four examination * SHO and Root treatment, Local treatment * Deficiency-tonification and Excess-Dispersion * Classification of basic needling technique

(F9-12) What is Hari?

Tonification Dispersion

Practice: Model treatment by Hari And Basic needling Technique: Shape of Hands

(H3-5) Flow Chart

Tea Break 0:10

10:40 am –

12:00 pm

Lecture Ⅱ: KUWAHARA

Practice Ⅱ

* Pulse diagnosis Pulse quality and Six comparative DX,. Finding the middle/stomach Ki pulse and determining yin/yang pulses.

* Hara DX.

(H8)(H10) Secrets of Pulse

Posture for Pulse and Hara Dx:

12:00 pm –1:30 pm Lunch Break

1:30 pm – 2:30 pm

Lecture Ⅲ: Miyawaki

*SHO/Pattern and Sho determination *Point selection (Nanjing Ch. 69,68) and Location

Supplementation and Draining of the points Significance of points which are "presently alive"

0:10 Tea Break and Breathing EX.

2:30 pm-

Tea Break 0:10

Lecture Ⅳ

Practice Ⅱ

* How do you start 1.Pulse & Hara Dx. 2.Basic needling:

***Hari Demonstration 1. Pulse Dx. and Hara Dx. 2. Basic Hari style needle tech.: Tonification

(H8)(H9)

– 5:15 pm

Practice Ⅲ:

3.Basic needling: 4.Sho and Kozato method

3.Basic Hari style needle tech.: Dispersion Sashide/ Oshide --right/left hand positioning

4. SHO determination and Kozato feedback system

(H4) (H9)

5:15 pm-5:30 pm Q & A Closing

2012-13 HARI PROGRAM, SANTA FE. NM

Hari

Program (1)

Track 1 Subject of study

Track 2 Contents of Lecture

Track 3 Hari Practice

Track 4 # of Handouts, Fundamentals, Keyword and Resources

(2) SUNDAY, SEPTEMBER 9th, 2012

9:00 am – 9:15 am

Mantra (H1,2) and Ki breathing exercise

9:15 am - 10:25 pm LectureⅤ: Kuwahara

* General principle of EV treatment 1. What is it? 2. Match the main pt. and couple pt. in EV systems 3. Dual points Tx. 4. About magnet tester

Show and Tell

EV 2012 Basic Principle

11:00 am – 12:00 pm Lecture Ⅵ: Miyawaki

* Miyawaki style Abdominal EV Dx. 1. Location of an EV examination of abdomen 2. Treatment method 3. About Non-indication

12:00 pm – 1:30 pm Lunch Break

1:30 pm – 2:30 pm Practice Ⅵ

Sho determination with Kozato feedback method.

Demo for Kozato Method

0:10 Tea Break and Breathing EX.

2:45 pm – 5:15 pm

Tea Break 0:10 Practice Ⅷ:

Hari Tx. Demonstration (M. therapy and EV. Treatment) How to Hara EV-Dx. EV Sho determination and Treatment

Essences of Acupuncture

5:15 pm – 5:30 pm Q&A

(3) MONDAY, SEPTEMBER 10th, 2012

9:00 am – 9 :15 am

HA

RI PR

OG

RA

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1)

Ki breathing

9:15 am – 11:00 am Lecture Ⅴ:

Miyawaki

* Advanced EV diagnosis Pulse Dx. for EV tx. EVs Symptomology Flow of the EV vessels

11:00 am – 12:00 pm Lecture Ⅵ:

Miyawaki

* Detailed Clinical Discussion EV sho/pattern and their Symptoms Head, Limbs, Low back, abdomen, etc.

Practice Ⅴ: Diagnosis and SHO determination

12:00 pm – 1:30 pm Lunch Break

1:30 pm – 2:30 pm Lecture Ⅵ

Miyawaki

How do you combine M. therapy and EV treatment in the your clinic

2:30 pm – 3:30 pm Practice Ⅶ: Whole Tx. Demonstration from Miyawaki sensei

3:30 pm – 3:45 pm Tea Break and Breathing EX.

3:45 pm – 5:00 pm Practice Ⅷ:

Advanced Whole Tx. practice: EV and

M. Therapy (Root and Local treatments.) and Tx. that move the blood.

Essences of Acupuncture

5:00 pm – 5:30 pm Q&A

Assignments Read TJA: Fundamentals

Review your notebook and handouts. Read Assignment was indicated in next

month schedule.

Practice: Hara and pulse reading, basic technique on your body or friends and floating apple, Live point location

©Ki Science Institute 2005

Gassho (Worshiping Hands)

Gassho is an expression of the mind-heart of worship in a physical form. Worship meansto unite as in the original meaning of yoga. The life of worship promotes a world in which peoplecooperate and coexist with each other in a well-balanced manner. This is the world of true freedom.Gassho symbolizes the pledge that we shall make efforts to live the life of worship in mind-heart,body, and daily existence.

To unite means that all those who developed different characteristics create a mind-heart ofoneness with each other. This is a world in which people trust each other unconditionally. Allliving creatures have an instinctive wish to experience life as joyful and pleasurable. In order tofulfill this wish, we make our way through life together by making our mind-hearts one, by shakinghands in joy with each other, by making gassho to each other, and by living in harmony with eachother. This is the true way of human life. In short, gassho means to live with a mind-heart thatworships each other. If people interact with each other with such a mind-heart, they will realize thejoy in their lives that they long for from the bottom of their hearts.

Gassho teaches us that we are all one, that there are no distinctions between one's self andothers. This is expressed in Zen Buddhism with the words jiko and tako. Jiko means to recognizeyourself within yourself, and tako means to recognize yourself within others. When you can seeeverything as yourself, then you can realize the meaning of peace and love, and will also understandhow to live your life such that you will experience them.

Mantra (Holy Sound)

In the religions of the world there are many kinds of mantras. In addition to the aoum mantra ofyoga, countless people have since ancient times chanted mantras such as amen, namu amida butsu, andnamu myō hōrenge kyō, etc. Whatever the mantra, its profound and true meaning is imbued in thepledges, wishes, and prayers to put into practice a mind-heart of unconditional gratitude, repentance,humility, devotion, and love.

Since aoum is believed to be the original sound resonating throughout the universe, it is referred to asthe holy sound. In yoga it is always chanted, whether voiced or unvoiced, as a practice for concentratingone's consciousness and unifying it with the universe. The three parts have the following psychologicaland physiological meanings and effects.

A is voiced with an open mouth. When this sound is made to resonate throughout the body there is apsychological feeling of release, the tension in the arms and upper body relaxes, the body naturally bendsslightly backwards, body heat is radiated off, and the blood becomes more alkaline. (For example, whenit is hot we naturally say, "Ahh, it's hot," releasing heat from the body.)

O is voiced with a pursed mouth. When this sound is made to resonate throughout the body thetonicity of the body increases, the body naturally bends slightly forward, body heat is retained, strengthflows into the hands, and the blood becomes more acidic. (For example, when it is cold we naturally say,"Ohh, it's cold," thereby retaining heat.)

UM is voiced with a closed mouth. When this sound is made to resonate throughout the body theshoulders drop down and become even, power naturally gathers in the hara, and the blood becomes neutral.This sound unifies the mind and body and arouses one's innate abilities.

When these three sounds are voiced continuously in a repeating pattern they will resonate in harmonywith the vibration of the universe, thereby revitalizing all the cells in the body, gradually enhancing thebalance of the autonomic nervous system, and stabilizing the mind and body.

* Since the length of everyone's breath differs, you should breathe at your own pace. Also, the length ofeach individual sound (a-o-um) will be different for each person. The general principle is that you shouldelongate the sound that feels the best for you and is the easiest to make vibrate throughout your body.Also, the transition between sounds should be slow and gradual.

←… The length of breath …→

←--------------------→

A－ O－ UM－

←----→

Inhale

←… The length of breath …→

←--------------------→

A－ O－ UM－

Start Exhale End Start Exhale End

© Ki Science Institute 2004

©The Hari Society 2006/01/03

Basic Japanese Meridian Therapy(KeirakuChiryo)

Tx(step1):“healthier”sideor

♂→Ⓛ+♀→Ⓡ

LUShoSx: Kiprob.,emotionalprob.,weakimmunesystem,breathingprob.,chestdiscomfort,respiratoryprob.(cough,asthma+etc.),shoulderstiffness,tightnessbetweenscapulas,dry,roughskin,skinprob.,thumbprob.(tendonitis),constipation,hemorrhoids,frequenturination,cystitis,whitecomplexion.Dxarea: ① Depression,soft,roughon L RⓇ costal(LR14)area +tight,pressurepain,andpulsingon Ⓡ ST24-27area.② LU１,GV12,LU9.Ⓟ 1̊ →DeficiencyontheLU+SP 2̊ →LR

SPShoSx: Allkindsofdigestiveprob.,constipation,diarrhea,diabetes,cravingforsweets,breastprob.(painand/orswelling),soresonlips+gums,fatigue,heavylimbs+body,emotionalprob.,neurosis,overthinking,swollen+redeyelids,bunion,flatfeet,HDTprob.,palpitation,irregularpulse,angina,HTattack,yellowishcomplexion,jointpain, Ⓛ shoulderpain.Dxarea: ① Soft,deficient,moist,possiblydepressed L RtorighttouchonCV12aroundnavelarea.② Slighttension(notstrong)on Ⓛ costalarea,SP3,4,13,15.Ⓟ 1̊ →DeficiencyontheSP+HT 2̊ →KDorLR

KDShoSx: Developmentprob.,Ob-GYNprob.,bonesbreakeasily,osteoporosis,dentalprob.,jointprob.(knee,ankle,+etc.),urinaryprob.,chronicconstipationand/ordiarrhea,lowerbodyedema,RBCprob.,memoryprob.,tinnitus,hearingprob.,coldhand+feet,coldlowerabdo.,coldabove+coldbelow(counterflowKi),fearfulness,hairfallsouteasily,grayhair,lowerbacksore+colddeficient,tiredaftereating,darkcomplexion,esp.darkbeloweyes.Dxarea: ① Soft,coolordeficient(lighttouch)on L RKD16,CV5.7.8.,+lowerabdo.area.KD2,3,CV7,KID16,puffinessaround② SlighttensionontheSTlineonlowerabdo.area.Ⓟ 1̊ →DeficiencyontheKID+LU. 2̊ →SP

LRShoSx: Bloodstasisprob.(pigmentation,moles,vascularspiders,+etc.),hormonal+endocrineprob.,bleedingdisorders,skindisorderswithraisedbumps(acne,boils,etc.),tightmuscles,swollenmuscles,muscularimbalance,acutebackpain(strain,sprain,slippeddisc,+etc.),Rshoulderprob.(stiffness+tightness),Llegprob.,neuralgia(sciatica),hernias,jointdeformities,emotionalsensitivity,stress,emotional/mentalprob.,neurosis,irritability,anger,insomnia,visionprob.ingeneral,nailprob.ingeneral,aversiontowind,windcausestightstiffsoremuscles,sexorganprob.,urinaryprob.(cystitis),bigtoeprob.,goat,subcostal/costalpain+discomfort,swollenribs,sinus+nasalprob.,H/A(esp.chronic,esp.crown+aroundeyelids,migraine) dizziness,frequentfainting,constipation,asthma,.Dxarea: ① SoftanddeficientontheⓁ +Ⓡ ASIS.② Ⓛ LR9-SP10area,tight, L Rsoreonthe Ⓛ(heatP.) Ⓡ(ExcessP.)subcostalarea.Ⓟ 1̊ →DeficiencyontheLR+KD. 2̊ →LUorSP

Step1Tonifytoni.Pt.of1̊ meridian+HoraryPt.ofmothermeridian.

LU9+SP3

SP3+PC7

KD7+

LU8orLU5

LR8+KD10

Step2Tx2 .̊Deficient→tonifyExcess→disperseTxoppositesideofStep1

LR3

KD3orLR3

SP3

SP3orLU9

Step3 ❶TonifyDefi.LuoorSourcePt.ofYangmeridian.Samesideofbodyaspulse.✩IfallyangareDeficient.→Toni.ST36orTW4bilaterallyFindDeficientPt

Left

SI4or7GB40or37BL64or58

Right

LI11,4,or6ST36,42,or

40TW4or5

OkyuTxOkyu(sesamesize)onDuMaiandBack-ShuPtPressure painand/ordeficient (corncaved) Pt

Pxw/softandsilky(smooth)skinPxw/verysensitivetoheat

Pxw/averageskinDeficient,sticky, and/orflaccid Pt

Rough, tightanddeficient (corncaved) withindurations Pt

❷DisperseExcessLuoPt.ofYangmeridian.SamesideofbodyaspulseorSxside

Left

SI7GB37BL58

Right

LI6ST40TW5

#ofOkyu

x3

x5

x7

"The posture of the mind and body for acupuncture"

By The Hari Society instructor, Kuwahara, Koei

Acupuncture is an art whose goal is to heal diseases by moving and balancing Ki

through the use of needles. In order to reach that goal, one needs various types of practice and training.

When it comes to the needling, the first step is perhaps learning a correct posture.

The needling stance can be discussed from two dimensions.

First, you might consider needling posture in the physical sense, such as stance, breathing technique,

and the position of the center of gravity.

Second, there is a certain frame of mind or consciousness the practitioner should have when needling.

For instance, the practitioner's consciousness must be clearly different when applying tonification and

dispersion techniques. To move, Ki, the practitioner's frame of mind and physical posture are very

important. Though mind and body cannot be separated, in this article, let us begin by discussing

physical posture first.

If acupuncture works only because of the stimulation generated by the penetration of

the patient's skin by the metallic needle, there should be no need for the discussion of the proper

needling posture. Yet, based on the collective experimentations by the Hari Association using the Ki

feedback methods by pulse, the inner workings of acupuncture is not so simple. We have discovered

that at the moment the practitioner changes his/her posture, even though the practitioner is only

placing his/her Oshide/Protecting hand on the patient's acupuncture point without needle, the patient's

pulse, skin condition, and breathing change without fail. Sometimes, the observer can detect those

changes even if the practitioner's hand is out of contact with the patient. This phenomenon suggests

that there is something already at work even before the needle, as the primary acupuncture instrument,

contacts a point and Ki starts moving.

Why does this occur, and what is at work?

With our commonsense, we can easily understand that there are postures that would

lead the acupuncturist to health and there are also postures that would make him/her unhealthy. For

instance, if you are in the habit of working in a slouching posture or always working at the desk in a

stooped over position, it will oppress your internal organs over a long period of time. Moreover, It can be

easily understood that this kind of habitual bad posture will eventually result in disorders either in the

form of pain, or abnormal curvature of the spine.

The relationship between posture and health has been studied since ancient times, and

we have no trouble finding various ways to study it. For example, you can take courses on Ki Ko

exercise, Aikido, Yoga, Tai Chi Chuan, Alexander Therapy, etc. These specific examples are the ones

that I, myself, have studied, and there are many more. However, the point is that in both Asian and

European traditions, there are many disciplines whose teachings are designed to benefit health and

longevity, and essentially their teachings have to do with learning the correct posture for each stance or

technique.

To put it differently, by changing posture, the acupuncturist's Ki can change to the type of Ki that can

heal or the Ki that causes illness, and this change will be directly transmitted to the patient. I don't

meant to rub it in, but I'd like to stress that this change in Ki occurs within the acupuncturist. The

acupuncturist's hand may or may not be in contact with the patient's body, so we have to assume that it

is the Ki that's being emitted by the acupuncturist that influences the success or

failure of the patient's healing process.

It is easy to understand the reason why the good needling posture is

important, and it is also easy to understand how to make a good posture in-concept.

However, to actually master the proper needling posture and incorporate it in your

everyday practice can often take a long time. In order to address this problem, we

use the Ki feedback methods by pulse, which makes it possible to learn the correct

"Ki-generating needling stance" in a very short time.

We have developed our training method for mastering the correct needling posture

from our experiences as Hari instructors. So, in the following section, let us review

each step and the criteria involved. For actual practice of the needling stance, you

should check your performance of each step by using Ki feedback methods by pulse.

As the most basic rule, is your natural self.

Do nothing. Don't attempt anything. Don't try to "generate" or "emit" Ki. Don't

think that "I" will "heal" the patient. Don't tinker with the patient's body too much.

Simply be natural.

The correct posture:

(1) is a posture or action (form) in which your mind and body can utilize its

capacity,

(2) is a posture in which there are no parts of the body strained or stressed,

(3) should have no excess tension or over-relaxation,

(4) is a posture you can naturally hold for a long duration.

(5) You can naturally breathe deeply, and also you will feel fine and your

mind would be at ease.

(6) The correct posture can create a state in which your spirit feels joyful.

Making the needling posture

*Spread your feet slightly wider than your shoulder width. It varies

with the height of the treatment table, but this is the basic distance

between your feet.

*Sustain the weight of your body at the center of each foot. Tile

center of the foot can be interpreted as UNA-point. Stand at UNA

and also breathe through UNA. Be conscious of them.

*Slightly bend your knees. You only need to bend a little. Again,

depending upon the height of the treatment table, you'll have to

adjust how much to bend.

*Place the center of gravity of your whole body at Dan Tian (or "Tan Den" in Japanese--located in area

around CV-4). This might be little difficult. To do it correctly, move your pelvis slightly posterior and

upward and adjust the position by moving your pelvis forward again to find the best position for you.

Find the position in which you can hold the most strength in the Dan Den. When you do. You will feel

as if a small sphere has been created in the Dan Den. Point the posterior portion of your pelvis (coccyx)

slightly upward, so that your Dan Den is pointing at the ground at about 20 degrees, so that you can

naturally withhold Ki energy (as if you are pumping air into a balloon situated in Dan Den) not from

muscular strength, but from the natural consequence of your posture itself. Memorize this position.

Your abdomen must not be tense.

It should be relaxed and supple. Place your finger on CV-4 and confirm the concentration of the energy.

*Make an energetic triangle with your UNA and Dan Den in the lower half of your body

*For your upper body, at first correct your stoop, then your mouth should be closed, and be conscious of

GV-20. Connect the healing universal Ki (healing type of Tian Qi) to your GV-20 as if you are

connecting a rope brought down from heaven to your GV-20. As the rope is connected to GV-20, then

pull the rope up. Then, lower your upper body that's now suspended by the rope from heaven on to your

lower body, which is forming a triangle with your Dan Den and UNA s.

*At this point, this posture should feel quite natural and comfortable to you.

*Check to confirm if you are relaxed. Relax your face. Your eyebrows should be relaxed and loose, and

the outer corners of your eyes should be slightly pointing downward, and the corners of your mouth

curled a little upward with I (sounds I; e as in “easy”, the teeth remain closed they are always made by

biting the teeth very lightly.). Smile as if you are Buddha. The shape of your lips is such that if you

exaggerate it more, you'll almost start drooling.

*Let's try and practice sitting, standing, and walking with this posture.

Make a circle with yours arms as if you're holding a big balloon.

*As the result of practice, when you feel confident with this posture, then proceed to the next step,

which incorporates the needling into the posture described above. Make a circle with both arms in front

of your body. Then, put your fingers of both hands close together. Do you feel the Ki going in and out

through your fingers? If your fingers are not emitting the Ki yet, loosen your shoulders, elbows, and

wrists. Make your whole body more soft and relaxed, and then try to run some energy through your

fingers. You must have surely felt Ki by this time. If you haven't. Then close your eyes and check every

part of your body from the beginning, and most importantly, get rid of all unnecessary strains in your

body. Being too relaxed and too loose is not good either. Just try to exist in a pure sense. As you are able

to confirm this state of natural existence, you bring your Ki--consciousness-- to the tips of your fingers.

The next step is breathing technique.

The correct physical stance is something that can be improved for a short period of time, but one would

return to one's bad habitual posture quite easily. This is because there is nothing that sustains the good

posture from within. Once you notice in the collapse of your posture, your mind can send out an

instruction to correct your posture again to your body, but if your posture is not sustained and held by

the correct breathing from within, your effort to hold good posture is only temporarily successful.

The correct posture is meant to be maintained naturally through deep breathing. Being natural

is the best, or put in a different way, you can't practice deep breathing without a natural frame of mind.

If you are irritated your breathing becomes shorter than normal, fear would make your inhalation

stronger, or if you are nervous and tense, your breathing is being stopped and withheld within your

chest, and so on--these are a few examples of the mind/breathing interaction. First, you need to realize

the nature of the relationship between the mind and the breathing, and correct your mind, or if you

notice the unnatural or undesirable frame of mind within you, by breathing in the manner that is the

opposite state of mind, try to control your emotions and desires. Of course it is easier said than done. If

you overanalyze the relation between the breathing and the mind, before you are able to control it, you

might get suffocated. To prevent that, the easiest way to control your emotion through breathing is if

you realize that you are being emotional, first of all start breathings slowly and deeply with nothing

else in mind. Compared to just waiting for your mind to calm down without doing anything, with this

method, your mind will be regulated and regain calmness much faster, along with a good posture.

In my clinic, usually I am not much concerned about the breathing, but concentrate more on the

state of the consciousness as I treat my patients. However, I practice the following method of building a

good hara (abdomen) regularly everyday.

First, inhale deeply through my nose as I inflate my lower abdomen. As I finish inhaling, inject the

breath with an imaginary pump into the Dan Den. It spread in every direction to the front, back, and

sides as if I were pumping air into a soccer ball situated in the area around CV-4. As I feel that I have

pumped enough air into the Dan Den, hold it there for a long time as you can with relaxed body and

Buddha smile.

Then, after a while, exhale slowly through my mouth. While I am exhaling, if I am aware that I have

some Jaki (evil Ki) in my mind, put them together and exhale them strongly with my breath.

As a result of your everyday training, if you reach the point in which you feel the existence of

the soccer ball in your lower abdomen without conscious effort to breathe, that means you have become

an expert oriental medical physician. Most likely, your mind is clear too, and you must be in the good

posture all the time, and you are able to make good judgment in any situation.

At this time, you will begin using a needle,

You will start needling from the posture I finished describing above. Hold the needle at the tip of the

round ring you have formed with your arms, and bring down the needle naturally and softly to the

acupuncture point of the patient as if you are lending your whole arms gently to the patient. Please

experiment with this technique and fine-tune it in your own way.

©The Hari Society 06/01/03

Ⅰ Ⅱ Ⅲ Ⅳ

Cold and Heat

Age andGender

Acute orChronic

Deficient orExcess

Prognosis

LocalTreatment

Selection ofTreatment

Pulsediagnosis

Yin Yang & Five Phase

Etiology and Stage ofdisease

Symptomology

Distinguishing the meridianAnd Pathology

Treatment Principles

Selection of points forTonification, Dispersion

Nan Jing Chapter69,75,68,49, and other.

Tonification, Dispersionneedle techniques

Finish Treatment

(1) Selection of Basic ShoConfirmation

Selectionof point

Tonificationand

Dispersion

Looking

Listening

Asking

Abdomen

Touching DX

Checking pulse & evaluationof treatment

Treatment Flow Chart for Meridian Therapy

(2) Secondary andHeat/Cold Sho

Selectionof point

Root Treatment

©The Hari Society Page 1 3/16/2006

Order of the Treatment

Step 0[A] Thoracoabdominal Region and Supplementary points[B] Affected Area[C] Harmony points

Step 1Root Treatment Primary pattern

Step 2Root Treatment Secondary Pattern

Step 3Root Treatment Yang Meridian

Step 4[A] Back and Supplementary points[B] Affected Area[C] Harmony points

Step 5[A] Finish needling[B] Moxibustion[C] Home treatment


Step 0 Supplementary (Alarm) points, affected area and Harmony points

[A] Treating the Thoracoabdominal Region and Supplementary (Alarm) points

1. Sometimes a light sanshin or scatter needling technique is used on the abdomen at towards the

beginning of the examination. This is done when the pulse is difficult to read, and is more a part of

the examination than the treatment.

2. Use a tonifying scatter needling technique on the thoracoabdominal region when there is an

insufficiency of yang ki

3. If the circulation of ki and blood is judged to be poor due to water stagnation or blood stasis in

the thoracoabdominal region, retained needles or a single needle technique can be used, aiming at

indurations and areas of resistance or pain on pressure. The standard length of time to retain these

needles is 15 to 30 minutes.

[B] Treating the Affected Area

Treatment given on the affected area is performed while the patient is in a relaxed position.

Retained needles are often used, but a single needle technique can be used afterward.

When using retained needles on an affected area on the anterior aspect of the body, they are often

inserted at the same time that the abdomen is being treated while the patient is in a supine position.

In the case of severe symptoms, treatment can begin with the affected area in order to ease the

patient's condition as soon as possible.

[C] Harmony points: See the handout of the Harmony points

Step 1 Root Treatment: Primary Pattern

Treatment should begin with the root treatment on the yin channels. Tonification should

be used on the meridians to which essential ki is deficient.

The order to follow is given below.

A. Start by tonifying Essential Ki Deficiency that is the primary pattern of imbalance and theunderlying cause of the illness. If both deficiency and excess are involved, start by tonifying the

deficiency and then disperse the excess at the step 2. Sometimes tonification will be sufficient and it

will not be necessary to use dispersion.

B. then tonifying the "Mother" Meridian and Point


"The mother" refers to the generating cycle of the five phases and the relationship between each

pair of phases. Next, within each meridian there are points that are divided according to the five

phases.

Step 2 Root Treatment: Secondary pattern

Treatment for Effects on the yin meridians from Essential Ki deficient it is showing as

heat and cold. Tonification and/or dispersion should be used on the meridians to which cold and

heat are spreading.

Step 3 Root Treatment: Yang Channel pattern

Tonification and/or dispersion should be used for effects on the yang meridians to which

cold and heat are spreading.

Step 4 Supplementary (Alarm) points, affected area and Harmony points

[A] Treating the Back Points and Supplementary (Back Transport) Points

Areas of the back transport points reflect deficiency or excess according to the cold and heat

symptomology of each pattern of imbalance. After verifying the deficiency and excess of the

meridians and acupuncture points on the back, use retained needles or a single needle technique

from the upper to the lower back. However, depending on the pattern of imbalance, there are times

when only a single needle technique is used, just as with the thoracoabdominal region. The standard

length of time to retain these needles is 15 to 30 minutes.

[B] Treating the Affected Area

Treatment given on the affected area is performed while the patient is in a relaxed position.

Retained needles are often used, but a single needle technique can be used afterward.

When using retained needles on an affected area. If they are being used on the posterior aspect of

the body, they are often inserted at the same time that the back is being treated while the patient is

in a prone position.

[C] Harmony points: See the handout of the Harmony points

Step 5 Sanshin, Moxibustion and other

[A] Finish Needling

1. A Sanshin, tonifying or dispersing scatter needling technique can be used over the whole back

and dorsolateral of the lower limb after the retained needles have been removed. The purpose of this


is to tonify or disperse the external yang ki that flows through the greater yang channel. This will

mend any mistakes that were made during the treatment.

[B] Moxibustion

1. Direct moxibustion and cone moxibustion can be applied at the same time as the abdomen or

back is being treated or after.

2. Some acupuncture points will develop depressions or indurations due to a deficiency of

nutritive ki (blood) and fixed pressure pain from blood stasis. Acute disorders that are accompanied

by heat and that suppurate are also caused by nutritive ki (blood) deficiency. Moxibustion is

appropriate in any of these cases to deliver result.

[C] Other

Intradermal needle, Press tug, Press boll

Give them homework and suggestions for improvement of living

General Rules for Treatment

1. As a general rule, the above-mentioned treatments begin and focus with the root treatment that

is a treatment of the greatest importance, but that is not a rigid rule. The necessary steps must be

taken according to the situation. That is, all parts and kinds of treatment have equal value. Moreover,

while there is in actuality a temporal sequence to treatment, to the practitioner it feels as if

everything is being done at the same time. That is why it is said that the root and local treatments

are two faces of the same coin, a harmonious whole.

2. The order of local treatment is given while thinking about yin and yang. For instance, treatment

starts on the lower limbs if the affected area is in the upper body, and begins in the upper body is

the affected area is in the lower limbs. Treatment begins on the back if the affected area is in the

abdomen and beings on the abdomen if the affected area is in the back.

The determination of a Sho

Examination determines the Sho in Meridian Therapy. To decide which Sho is present,

consider pathogenesis, symptomology, and the four examinations (Looking, Listening,

Asking, and Touching).

In this way, by finding the principal Sho, you can start treatment immediately. This

form of examination and treatment is called Zui-Sho therapy, and it is the hallmark of

Japanese medicine. (Diagnosis followed by treatment)

A Sho is not a name attached to neither a specific syndrome nor the enumeration of

mere symptoms.

Based on meridian theory, we can analyze the condition of a patient with a variety of

diseases. The Sho allows us to simplify myriad symptoms into four principal patterns

of disharmony.

In this way, the principal Sho determined at the end is denoted by the form of a LR

Deficiency Sho, a LU Deficiency Yang Excess Sho or a SP Deficiency LR Excess Sho, etc.

With a LR deficiency Sho, one can tonify a Liver meridian immediately -- etc. --the Sho

encompasses the treatment principle.

Furthermore, it determines what kind of treatment you perform, what point of which

channel should be used, and needling technique.

However, clinically, it is important to determine prognosis initially before beginning

treatment. In the case of symptoms which indicate an incurable illness or a condition

which is beyond your ability, it is important to warn the patient before starting a

treatment. Then, you can proceed with examination and Diagnosis.


©The Hari Society 1/3/2006 1

JAS: Advanced Treatment Strategies: Meridian Therapy with Cold and Heat

[1] The Difference in the Generation Mechanism of Cold and Heat

① Liver Deficiency Heat Pattern, Spleen Deficiency Heat Pattern, and Kidney Deficiency Heat Pattern

Endogenous, Food and Drink, Fatigue, Exogenous

Basic Patterns

SP Deficiency

LR Deficiency

LU Deficiency

KD Deficiency

Generation of

Cold and Heat

Deficiency of blood

Df. of ki, blood, fluid

Deficiency of ki

Deficiency of fluid

Zang-Fu

Meridian

LR, GB

HT, SI

PC, TW

SP, ST

LU, LI

KD, BL

Chief

Complaints

Deficiency,

Excess, Cold,

Heat

Deficiency or

Excess of Ki,

Blood Fluid

Constitutional Factors

Essential ki deficiency

of the five zang organs

Occurrence of

cold or heat

symptomology

due to deficiency

or excess of yin

or yang

Pathological deficiency

Liver Deficiency Heat Pattern Spleen Deficiency Heat Pattern

(Add. Stomach deficiency heat)

Kidney Deficiency Heat Pattern

Yin deficiency heat, or

simply deficient-type heat

The condition becomes chronic the heat will go down,

making it mistakable with a cold pattern.

Pathological deficiency

Heat

Cold

The differentiation of cold patterns and heat patterns is not all

that difficult if you conduct the questioning examination of the disease

process and symptomology by following the pathology, and tie this in

with the diagnosis based on the pulse picture and abdominal pattern.



In a Liver deficiency cold pattern, there is heat in

the chest, because of which it is common to

develop a rapid pulse. Conversely, the area of

the body that has heat could be the affected area.

That can make it easy to mistake as a heat

pattern, but it should be simple to differentiate

between a cold and heat pattern if you take into

account the disease process and symptomology,

as well as the pulse picture and abdominal

pattern

② Spleen Deficiency Heat Pattern and Lung Deficiency Heat Pattern

③ Liver Deficiency Cold Pattern and Kidney Deficiency Cold Pattern

Spleen Deficiency Heat Pattern

(Add. Stomach deficiency heat)

Lung Deficiency Heat Pattern

Weak production, circulation, and

diffusion of yang ki

Yang ki stagnates in the related

yang meridians

In the greater yang channel or yang

brightness channel when there is

Lung deficiency

invade all the way to the Stomach and

Intestines

invades inward to the Stomach and

Intestines it is called a Spleen

deficiency Stomach excess heat pattern

Generation of heat

When the Spleen becomes deficient

Cold is generated due to an insufficiency of

yang ki, which was caused by an insufficiency

of blood and fluids

A Kidney deficiency cold pattern is easily

recognizable because there are mainly

symptoms of cold, but occasionally there

could be a case of true cold false heat, and

so care must be taken to not mistake this

pattern for yin deficiency heat or yang

excess heat.

Contradictory findings from Jueyin syndrome and other PC excess pattern

Yin deficiency heat

The condition becomes chronic the

heat will go down, making it

mistakable with a cold pattern.

Cold pattern Cold



④ Spleen Deficiency Cold Pattern and Lung Deficiency Cold Pattern

.

SHO/Pattern and Pathology

Yang Excess Yang Deficient

Pathology: External excess heat

Symptom: External (surface) Excess heat; fever,

acute heat disease with chill

Pulse: Floating, Fast, Excess

Treatment: After tonifying yin, disperse yang by

shallow insertion.

SHO: Heat sho (Yang excess heat sho)

Pathology: External deficiency cold

Symptom: Cold on the exterior (surface), lower limbs,

pain due to cold

Pulse: Sinking, Thin, Deficient

Treatment: After tonifying yin, tonify yang by shallow

insertion.

SHO: Cold sho *This condition changes to Internal

cold, because of the Yin nature of cold.

Yin Excess Yin Deficient

Pathology: Internal excess heat

Symptom: Excess heat symptom inside of body.

Heat invades and stagnates, causing blood stasis

and internal organ symptoms.

Pulse: Sinking, Excess

Treatment: After tonifying yin, disperse by deep

insertion the yin meridian that has excess.

SHO: Heat sho (Yin excess heat sho/pattern)

Pathology: Internal deficiency heat

Symptom: Deficiency heat symptom inside of body,

stiffness of neck and shoulder, dizziness, headache,

insomnia, head, neck and shoulder pain due to heat

Pulse: Floating, Big, Deficient

Treatment: After tonifying yin, when heat remains on

the yang meridian, disperse it by shallow insertion.

SHO: Heat sho (Deficient heat sho/pattern)

Cold Weak production, circulation,

and release of yang ki.

Patients who by nature have a Stomach and

Intestines that easily become chilled and who

have a low production of ki and blood tend to

develop these patterns of imbalance.

Spleen deficiency

cold pattern

An increase in symptoms of cold due to little

production of yang ki caused by a chilling of the

Stomach and Intestines

Lung deficiency

cold pattern

An increase in symptoms of cold due to weak

circulation and release of yang ki



Establishing Deficiency and Excess through point, pulse and symptoms

This method is for judging whether tonification or dispersion would be the better treatment in the

case of a systemic disorder, such as an acute febrile disease, in which it has been determined to which

meridian(s) cold or heat is spreading. As a rule, dispersion is chosen if the pulse quality is excess, and

tonification is chosen if the pulse quality is deficient. However, the decision is often made in connection

with the symptomology. If the decision still cannot be made, make the determination based on the state

of the palpated acupuncture point(s).

1-4Deficiency, Excess, Cold, and Heat of the Meridians and Acupuncture

Points on which the Local Treatment is Performed

Cold

The meridians and acupuncture points are flaccid, depressed, or slightly

tense. There is dulled perception. The body is frigid both inside and

out. Pressing feels good. Applying heat feels good. The pulse is

sinking and deficient.

Deficiency

Heat

The meridians and acupuncture points have protuberances that become

depressions when pressed. Pressing feels good. If pressing an

induration feels good, it indicates deficiency. The perception is

abnormal. The surface of the body feels hot to the touch. The pulse is

floating and deficient.

Cold

The surface of the body is frigid, but there are internal indurations and

resistance. Pressing causes an increase in pain. There is constant

spontaneous pain and constipation. The pulse is sinking and excess.Excess

Heat

The surfaces of the body feel hot to the touch. Pressing causes an

increase in pain. There is spontaneous pain and no sweating. There is

little urination. The pulse is floating and excess.



Table 1-5: Standards for Treatment

ClassificationNo. of Points Treatment

Length

Needle Depth No. of Moxi.

Applications

Children Few Short Shallow Few

Male / Female Many for females Long for females Deep for females Many for females

Def. Cold Pat. Few Long Shallow Few

Def. Heat Pat. Somewhat many Somewhat long Somewhat deep Somewhat many

Exs. Cold Pat. Many Long Deep Many

Exs. Heat Pat.Few Short Shallow, but

dispersion

Few, but

dispersion

LU Def. Pat.Few Short Extremely

shallow

Very few

SP Def. Pat. Somewhat few Somewhat short Shallow Somewhat few

LR Def. Pat. Somewhat many Somewhat long Somewhat deep Many

KI Def. Pat. Many Long Deep Very many

LR Exs. Pat. Very many Very long Very deep Very many

The outline of Pulse Diagnosis

A long time ago it was said "I have had my pulse taken" when you received a Treatment

from a doctor. In Japanese medicine, they attached great importance to Pulse Diagnosis.

Pulse Diagnosis serves as an indicator from the start of an examination and diagnosis to the

end of treatment in Meridian Therapy. Determine the guidepost of SHO by the four

examinations; Looking, Listening, Asking, and Touching. This and Pulse Diagnosis determines

the primary SHO. In a treatment, whenever a point is needled, we review the pulse and check

the suitability again.

Pulse Diagnosis in Meridian Therapy is a six-position pulse diagnosis which has a Pulse

Quality Diagnosis and a comparative pulse diagnoses within it.

We judge whether a pulse is floating or sinking, slow or fast, deficient or excess, and its size.

The technique and procedure of needling is determined with Pulse Quality Diagnosis.

In comparative pulse diagnosis, feel for the pulse on the right-left, Distal-Middle-Proximal

and six positions, fully compare and examine right and left, yin-yang, and creative and control

relationships to determine the deficiency-excess of the twelve meridians, and the Primary SHO.

1．Method of Pulse Diagnosis

Ask the patient to lie on the table, and the Acupuncturist should stand on a patient's left

side. It is based on clinical experience to do Pulse Diagnosis on the right-and-left

simultaneously.

Lean out a little on the patient's body, and stretch your left elbow to the outside. Try to keep

equal pressure on the fingertips of the right and left which touch a pulse position, and start by

using both hands together. (Photography 1)

Photograph 1 Fig. 4 Each pulse position

2．How to place fingers

Place the middle finger inside the wrist on the styloid process of the radius, and place your

index and ring finger to either side of the middle finger to perform Pulse Diagnosis. (Photograph

2 and 3)

The index finger touches the distal position, the middle finger touches the middle position,

and the ring finger touches the proximal position, in Japanese they are called Sun, Kan, and

Shaku. In each pulse position (Fig. 4) the five phases, each Zang-Fu and a meridian are

linked. (Fig. 5) When you perform Pulse Diagnosis, use your finger pads to feel. Also let the

thumb location be near TW4.

Let the patient's wrists curve slightly, and place the patient's arms lightly on the abdominal

region.

Photograph 2 Photograph 3

3．Superficial , Middle, and Deep level

It is important to feel the middle pulse first. The middle pulse is the place where one feels the

pulse of stomach Ki and can diagnose the postnatal original Ki.

The middle pulse should sink a finger slowly, and is where the pulse feels best on all three

fingers.

When you feel the middle pulse, sink your fingers to diagnose the Yin-pulse below the middle

pulse. From the middle pulse, float your fingers to diagnose the Yang-pulse above the middle

pulse.

When you diagnose the Yin-pulse, don't push too strongly and don't disturb the flow of the

pulse.

For the Yang-pulse, diagnose in the near side which a finger tends to depart from the pulse.

When you are checking the middle pulse, it is good for the distal finger to be a little lighter, and

to let your proximal finger be a little heavier, and to take the balance of downward pressure of a

finger into consideration.

Fig. 5 Zang Fu and Meridian in pulse position

4．Shape of pulse

Floating-sinking, slow-fast, and deficient-excess are the Six Basic pulse qualities.

Floating pulse floats and is felt on a superficial level. Therefore, the pulse will be felt shortly

after applying a finger. A Sinking pulse is felt on a deep level. This pulse cannot be felt unless

deeper pressure is applied. However, the standard of the depth of a pulse is a middle pulse.

The depth of the pulse corresponds

to the depth of needling; it is shallow

with a Floating pulse, and deeper

with a Sinking pulse. A Slow

pulse indicates cold at three or less

beats per breath. A fast pulse

indicates heat at five or more beats

per breath. (Fig. 6 Zang-Fu,

Meridian relation in pulse position)

The number of beats in a normal pulse is four per breath. As a general rule for needle technique,

with a slow pulse, insert the needles slowly, for a fast pulse, quickly.

Deficiency is indicated by a soft pulse, and a hard pulse shows excess. Use a Tonification

method for deficiency and use a Dispersion method for excess.

5．Zang-Fu, Meridian relation in pulse position

Left hand Right hand

Superficial Deep Superficial Deep

Distal Small

intestine Heart

Large

intestine Lung

Middle Gallbladder Liver Stomach Spleen

Proximal Bladder Kidney Triple

warmer

Ming

Men

Right-hand-Distal-Deep level LU, Superficial level, is large intestine、Proximal are Ming

men and TW、Left-hand Distal are HT and SI, Middle is LR and GB, Proximal are KD and BL.

(Fig. 6)

6．Comparative pulse diagnosis

First of all, compare the deficiency-excess of the whole pulse on each side, and compare the

difference of the deficiency-excess of a yin-yang next. Look for what is most deficient.

Here, I will explain a fundamental pulse pattern. Basic pulse pattern in "Nan Jing" Chap. 69,

LU deficiency Sho. With a LU deficiency Sho, LU-Metal and SP-Earth are deficient. HT-Fire

and LR-Wood are excess. At the yang meridians, large intestine and stomach are excess, and the

small intestine and the gallbladder are deficient. The kidney is a Calm pulse.

Thus, in a Yin meridian, line up with "Calm, excess, excess, deficient, and deficient" according to

the sequence of the five phases from the next Calm pulse. Extrapolate similarly about a SP

deficiency Sho, a LR Deficiency Sho, and a KD Deficiency Sho.

(Note) "About the relationship of the life gate of the right Proximal, it is [whether a life gate

has a vital spirit in a sufficiently or there is nothing, and] a learn place." In "Nan Jing Chp.18" ,

the right Proximal serves as a PC. (Katsu Haku Jin "Shinnka Suyo")

The PC is connected in the original book with the life gate. However, clinically, PC is treated as

vicarious execution of HT. The right Proximal is the ministerial fire and it is considered the life

gate and the Yang Ki of KD.

7. Pulse of HanKan

There are patients whose pulse can't be felt in the normal position, but deviates toward Large

Intestine meridian where a pulsation exists. In the classic, this is called pulse of HanKan. In

addition, similarly, the radial artery can be deviated in some pulse positions, or sees various

teratisms rarely, either.

When you find such a patient, whose pulse you cannot feel, it can be deficient or it could be

diagnosed as a hidden excess. However, take the other methods of examination into

consideration, and perform the Sho determination. While advancing treatment, you may feel

[right] pulsation.

As a special case similar to this, a patient's wrist may also come upon one of the two, or if

there is both nothing, the patient's wrist may be covered with a cast.

The procedure of Tonification and Dispersion for deficiency-excess

In Meridian Therapy, if a principal Sho is found, Tonification and Dispersion will be performed

immediately according to the deficiency-excess.

It is called treatment according to a Sho, - a ZuiSho treatment.

The treatment in Traditional Japanese Acupuncture can be called balanced if described with the

words "deficiency-excess and Tonification- Dispersion."

The Tonification method for deficiency

Deficiency means lacking or losing life force. A patient's body feels feeble, dim, dry, chilled and

has lost vital energy.

Their pulse is weak and touches a fingertip faintly, which indicates insufficiency of Ki and blood.

With such a patient, both a Root treatment and a Local treatment must tonify the life force by using a

Tonification method.

Next, I will describe the Tonification method in a Root treatment. Hold the needle head of

comparatively fine needles (No. 1 or 2) very lightly, angled with the flow of the channel, and

advance the needle to a depth of (2 or 3 mm) aimed at obtaining the Ki gradually.

Within a classic acupuncture text, this was expressed as "mosquito stops -- as -- ". You will stop, if

the target depth is reached, and watch for Ki. Try to obtain ki.

Close and tighten your fingertips (Oshide), and remove the needle quickly in the twinkling of an eye.

At once you close the needle hole like an arrow is fired from a bow.

Therefore the Tonification method supplements the life force. With a coarse technique, Ki diffuses

and you cannot obtain a good pulse. In order to prevent this, you fasten the fingertip of

Oshide/Supportive hand on right and left.

This is called right-and-left pressure.

The Dispersion method for excess

Excess is the state where Evil Ki fills and blocks the work of the life force. Palpation reveals

hardness, rising, protuberances, redness, and swelling, accompanied by heat. The shape of the pulse

can be felt with the fingers violently, firmly, and strongly.

What are Ouki-Jitsu and Jaki-Jitsu? Ouki-Jitsu is excess caused by Ouki (climax) of the other

channels caused by the distortion of a meridian flow, and the pulse felt will be strong accompanied

by roundness and gloss.

Jaki-Jitsu has the shape of a pulse which is affected by Ja of the wind, summer heat, eating-and-

drinking, fatigue, cold, and dampness from outside, or Jaki of an inner injury piles up, and appears.

This feels violent and strong.

Now, first use a suitable technique for an Ouki-Jitsu shape pulse.

You add Yu-Sha (Move the Ki and it will flatten) from the yang meridian and control-related main

point.

Moreover, with Ja-Excess, you firmly hold the handle of a comparatively thick needle (No. 2 or 3),

and advance needle 2 or 3-mm against the flow of the channel. Repeat in this way, push and stop,

with the needle. If you feel the resistance of the needle point loosen, withdraw the needle while

applying downward pressure.

After the needle separates from the skin, you breathe once and detach your Oshide/-Supporting hand

from the acupuncture points.

Thus, the of all the Tonification and Dispersion procedures must use delicate maneuvering,

properly applied according to the patient’s pulse.

TJM HARA Diagnoses © The Hari Society 2005

LR sho Heat Excess LR sho Cold KD sho Heat KD sho Cold

SP sho ST Excess Heat SP sho ST deficient Heat SP sho Cold Upper warmer Dif. pattern

SP sho LR Excess Heat SP sho LR Excess LU sho LR Excess Lower warmer Dif. pattern

HARI HANDBOOK OF TRADITIONAL JAPANESE ACUPUNCTURE · By The Hari Society instructor, Kuwahara, Koei...

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Transcript of HARI HANDBOOK OF TRADITIONAL JAPANESE ACUPUNCTURE · By The Hari Society instructor, Kuwahara, Koei...