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HARI HANDBOOK OF TRADITIONAL JAPANESE ACUPUNCTURE

Japanese Meridian Therapy

Instructor: Kazuto Miyawaki Lic.Ac. (Japan) T. Koei Kuwahara Lic.Ac Ehrland Truitt DOM.

Hari Program (1)


Instructor:

2012-13 HARI PROGRAM, SANTA FE. NM

Track 1 Track 2 Track 3 Track 4

Subject of study Contents of Lecture Hari Practice # of Handouts, Fundamentals, Keyword and Resources

Miyawaki Kazuto, Lic.Ac. Japan T. Koei Kuwahara, Lic.Ac. Japan President of the Hari Society (617) 926-6986(w): E-mail: takamaharanayasa@gmail.com 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 Womans club, 1616 Pecos, NM

(1) SATURDAY, SEPTEMBER 8th, 2012 830 am 9:00 pm 9:00 am 9:15 am


Registration Opening words: Ehrland Truitt and Aoun Mantra Self-introduction and Keynote Address: T. Koei Kuwahara, Kazuto Miyawaki Introduction to the complete Hari system *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 Tonification Dispersion Practice: Model treatment by Hari And Basic needling Technique: Shape of Hands

9:15 am 10:35 pm
HARI PROGRAM (1)

Lecture MIYAWAKI Intro. to Hari Practice

(F9-12) What is Hari?

Tea Break 0:10

(H3-5) Flow Chart

10:40 am 12:00 pm

Lecture : KUWAHARA Practice

* Pulse diagnosis Pulse quality and Six comparative DX,. Finding the middle/stomach Ki pulse and determining yin/yang pulses. * Hara DX. Posture for Pulse and Hara Dx: Lunch Break *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"
Tea Break and Breathing EX.

(H8)(H10) Secrets Pulse of

12:00 pm 1:30 pm 1:30 pm 2:30 pm


Lecture : Miyawaki

0:10 * How do you start 1.Pulse & Hara Dx. 2.Basic needling:

2:30 pmTea Break 0:10

Lecture Practice

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

(H8)(H9)

Practice :

5:15 pm 5:15 pm-5:30 pm

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 Q & A Closing

(H4) (H9)

(2) SUNDAY, SEPTEMBER 9th, 2012


9:00 am 9:15 am 9:15 am - 10:25 pm
Lecture: Kuwahara Mantra (H1,2) and Ki breathing exercise * 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 * Miyawaki style Abdominal EV Dx. 1. Location of an EV examination of abdomen 2. Treatment method 3. About Non-indication Lunch Break Practice Sho determination with Kozato feedback method. Demo for Kozato Method EV 2012 Basic Principle

Show and Tell

11:00 am 12:00 pm 12:00 pm 1:30 pm 1:30 pm 2:30 pm

Lecture : Miyawaki

0:10

Tea Break and Breathing EX.

2:45 pm 5:15 pm
Tea Break 0:10

Practice :

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

Essences of Acupuncture

5:15 pm 5:30 pm

(3) MONDAY, SEPTEMBER 10th, 2012


9:00 am 9:15 am 9:15 am 11:00 am
Lecture : Miyawaki * Advanced EV diagnosis Pulse Dx. for EV tx. EVs Symptomology Flow of the EV vessels * Detailed Clinical Discussion EV sho/pattern and their Symptoms Head, Limbs, Low back, abdomen, etc. Diagnosis and SHO determination Lunch Break Lecture Miyawaki Practice : How do you combine M. therapy and EV treatment in the your clinic Whole Tx. Demonstration from Miyawaki sensei
Tea Break and Breathing EX.

Ki breathing

11:00 am 12:00 pm

Lecture : Miyawaki Practice :

12:00 pm 1:30 pm 1:30 pm 2:30 pm 2:30 pm 3:30 pm


3:30 pm 3:45 pm

HARI PROGRAM (1)

3:45 pm 5:00 pm
Practice :

Advanced Whole Tx. practice: EV and M. Therapy (Root and Local treatments.) and Tx. that move the blood. Q&A

Essences of Acupuncture

5:00 pm 5:30 pm

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

Gassho (Worshiping Hands)


Gassho is an expression of the mind-heart of worship in a physical form. Worship means to unite as in the original meaning of yoga. The life of worship promotes a world in which people cooperate 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 of oneness with each other. This is a world in which people trust each other unconditionally. All living creatures have an instinctive wish to experience life as joyful and pleasurable. In order to fulfill this wish, we make our way through life together by making our mind-hearts one, by shaking hands in joy with each other, by making gassho to each other, and by living in harmony with each other. This is the true way of human life. In short, gassho means to live with a mind-heart that worships each other. If people interact with each other with such a mind-heart, they will realize the joy 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 and others. This is expressed in Zen Buddhism with the words jiko and tako. Jiko means to recognize yourself within yourself, and tako means to recognize yourself within others. When you can see everything as yourself, then you can realize the meaning of peace and love, and will also understand how to live your life such that you will experience them.

Ki Science Institute 2005

Mantra (Holy Sound)


In the religions of the world there are many kinds of mantras. In addition to the aoum mantra of yoga, countless people have since ancient times chanted mantras such as amen, namu amida butsu, and namu my h renge ky , etc. Whatever the mantra, its profound and true meaning is imbued in the pledges, 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 as the holy sound. In yoga it is always chanted, whether voiced or unvoiced, as a practice for concentrating one's consciousness and unifying it with the universe. The three parts have the following psychological and physiological meanings and effects. A is voiced with an open mouth. When this sound is made to resonate throughout the body there is a psychological feeling of release, the tension in the arms and upper body relaxes, the body naturally bends slightly backwards, body heat is radiated off, and the blood becomes more alkaline. (For example, when it 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 the tonicity of the body increases, the body naturally bends slightly forward, body heat is retained, strength flows 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 the shoulders 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 harmony with the vibration of the universe, thereby revitalizing all the cells in the body, gradually enhancing the balance 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 of each individual sound (a-o-um) will be different for each person. The general principle is that you should elongate 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 Start O Exhale UM End ---- Inhale The length of breath -------------------- A Start O Exhale UM End

Ki Science Institute 2004

Basic Japanese Meridian Therapy (Keiraku Chiryo)


Tx(step1): h e a l t h i e r side or +
LUSho Sx: Kiprob.,emotionalprob.,weakimmunesystem,breathingprob., chestdiscomfort,respiratoryprob.(cough,asthma+etc.),shoulder stiffness,tightnessbetweenscapulas,dry,roughskin,skinprob.,thumb prob.(tendonitis),constipation,hemorrhoids,frequenturination,cystitis, whitecomplexion. Dxarea: Depression,soft,roughon L R costal(LR14)area +tight,pressurepain,and pulsingon ST24-27area. LU,GV12,LU9. 1 DeficiencyontheLU+SP 2 LR SPSho Sx: Allkindsofdigestiveprob.,constipation,diarrhea,diabetes,craving forsweets,breastprob.(painand/orswelling),soresonlips+gums, fatigue,heavylimbs+body,emotionalprob.,neurosis,overthinking, swollen+redeyelids,bunion,flatfeet,HDTprob.,palpitation,irregular pulse,angina,HTattack,yellowishcomplexion,jointpain, shoulder pain. Dxarea: Soft,deficient,moist,possiblydepressed L R torighttouchonCV12aroundnavelarea. Slighttension(notstrong)on costalarea, SP3,4,13,15. 1 DeficiencyontheSP+HT 2 KDorLR KDSho Sx: Developmentprob.,Ob-GYNprob.,bonesbreakeasily,osteoporosis, dentalprob.,jointprob.(knee,ankle,+etc.),urinaryprob.,chronic constipationand/ordiarrhea,lowerbodyedema,RBCprob.,memory prob.,tinnitus,hearingprob.,coldhand+feet,coldlowerabdo.,cold above+coldbelow(counterflowKi),fearfulness,hairfallsouteasily,gray hair,lowerbacksore+colddeficient,tiredaftereating,darkcomplexion, esp.darkbeloweyes. Dxarea: Soft,coolordeficient(lighttouch)on L R KD16,CV5.7 .8.,+lowerabdo.area. KD2,3,CV7,KID16,puffinessaround SlighttensionontheSTlineonlowerabdo.area. 1 DeficiencyontheKID+LU. 2 SP LRSho Sx: Bloodstasisprob.(pigmentation,moles,vascularspiders,+etc.), hormonal+endocrineprob.,bleedingdisorders,skindisorderswith raisedbumps(acne,boils,etc.),tightmuscles,swollenmuscles, muscularimbalance,acutebackpain(strain,sprain,slippeddisc,+etc.), Rshoulderprob.(stiffness+tightness),Llegprob.,neuralgia(sciatica), hernias,jointdeformities,emotionalsensitivity,stress,emotional/mental prob.,neurosis,irritability,anger,insomnia,visionprob.ingeneral,nailprob. ingeneral,aversiontowind,windcausestightstiffsoremuscles,sex organprob.,urinaryprob.(cystitis),bigtoeprob.,goat,subcostal/costal pain+discomfort,swollenribs,sinus+nasalprob.,H/A(esp.chronic,esp. crown+aroundeyelids,migraine) dizziness,frequent fainting,constipation,asthma,. Dxarea: Softanddeficientonthe + ASIS. LR9-SP10area,tight, L R soreonthe (heatP .) (ExcessP .)subcostalarea. 1 DeficiencyontheLR+KD. 2 LUorSP

Step1 Tonifytoni.Pt.of 1 meridian+ HoraryPt.of mothermeridian.

Step2 Tx2 . Deficient tonify Excess disperse Txoppositesideof Step1

Step3 TonifyDefi.Luoor SourcePt.ofYang meridian. Samesideofbody aspulse. Ifallyangare Deficient. Toni.ST36or TW4bilaterally FindDeficientPt

DisperseExcess LuoPt.ofYang meridian. Samesideofbody aspulseorSxside

LU9+SP3

LR3

Left SI4or7 GB40or37 BL64or58 Right LI11,4,or6 ST36,42,or 40 TW4or5


OkyuTx
Okyu(sesamesize) onDuMaiand Back-ShuPt Pressure pain and/or deficient (corn caved) Pt

Left SI7 GB37 BL58 Right LI6 ST40 TW5

SP3+PC7

KD3orLR3

#ofOkyu

KD7 + LU8orLU5

SP3

Pxw/softand silky(smooth)skin Pxw/verysensitive toheat Pxw/averageskin Deficient, sticky, and/or flaccid Pt Rough, tight and deficient (corn caved) with indurations Pt

x3

x5

x7

LR8+KD10

SP3orLU9

The Hari Society 2006/01/03

"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.

Treatment Flow Chart for Meridian Therapy

Prognosis

Age and Gender


Acute or Chronic Deficient or Excess

Asking Listening Pulse diagnosis Abdomen

Yin Yang & Five Phase

Etiology and Stage of disease Symptomology

Looking

Touching DX

Root Treatment

Cold and Heat


(1) Selection of Basic Sho Confirmation (2) Secondary and Heat/Cold Sho Selection of Treatment

Distinguishing the meridian And Pathology Treatment Principles

Selection of points for Tonification, Dispersion Selection of point

Nan Jing Chapter 69,75,68,49, and other.


Tonification, Dispersion needle techniques

Local Treatment

Selection of point

Tonification and Dispersion

Checking pulse & evaluation of treatment The Hari Society 06/01/03 Finish Treatment

Order of the Treatment

Step 0 [A] Thoracoabdominal Region and Supplementary points [B] Affected Area [C] Harmony points Step 1 Root Treatment Primary pattern Step 2 Root Treatment Secondary Pattern Step 3 Root 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

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Step 0
[A] 1.

Supplementary (Alarm) points, affected area and Harmony points

Treating the Thoracoabdominal Region and Supplementary (Alarm) points 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. 3. Use a tonifying scatter needling technique on the thoracoabdominal region when there is an If the circulation of ki and blood is judged to be poor due to water stagnation or blood stasis in insufficiency of yang ki 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 the

underlying 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

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"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
[A]

Supplementary (Alarm) points, affected area and Harmony points

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 Sanshin, Moxibustion and other

Step 5
[A] 1.

Finish Needling 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

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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] 1. 2. Moxibustion Direct moxibustion and cone moxibustion can be applied at the same time as the abdomen or Some acupuncture points will develop depressions or indurations due to a deficiency of

back is being treated or after. 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.

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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.

Japanese Meridian Therapy

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

Constitutional Factors

Endogenous, Food and Drink, Fatigue, Exogenous

Essential ki deficiency of the five zang organs Zang-Fu Basic Patterns LR Deficiency SP Deficiency LU Deficiency KD Deficiency
Pathological deficiency

Deficiency, Excess, Cold, Meridian Generation of Cold and Heat LR, GB HT, SI PC, TW SP, ST LU, LI KD, BL Chief Complaints Deficiency or Excess of Ki,
cold or heat symptomology due to deficiency or excess of yin or yang

Heat

Deficiency of blood Df. of ki, blood, fluid

Occurrence of

Deficiency of ki Deficiency of fluid

Blood Fluid

[1] The Difference in the Generation Mechanism of Cold and Heat Liver Deficiency Heat Pattern, Spleen Deficiency Heat Pattern, and Kidney Deficiency Heat Pattern
Liver Deficiency Heat Pattern Spleen Deficiency Heat Pattern Kidney Deficiency Heat Pattern

(Add. Stomach deficiency heat)


Pathological deficiency

Yin deficiency heat, or simply deficient-type heat

The condition becomes chronic the heat will go down, making it mistakable with a cold pattern.

Cold

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Heat

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.

Japanese Meridian Therapy Spleen Deficiency Heat Pattern and Lung Deficiency Heat Pattern
Lung Deficiency Heat Pattern Spleen Deficiency Heat Pattern

(Add. Stomach deficiency heat)


Weak production, circulation, and diffusion of yang ki invade all the way to the Stomach and Yang ki stagnates in the related yang meridians invades inward to the Stomach and Generation of heat In the greater yang channel or yang brightness channel when there is Lung deficiency Intestines it is called a Spleen deficiency Stomach excess heat pattern Intestines

When the Spleen becomes deficient

Liver Deficiency Cold Pattern and Kidney Deficiency Cold Pattern


Yin deficiency heat The condition becomes chronic the heat will go down, making it mistakable with a cold pattern.

Cold pattern

Cold

Cold is generated due to an insufficiency of yang ki, which was caused by an insufficiency of blood and fluids

Contradictory findings from Jueyin syndrome and other PC excess 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 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.

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Japanese Meridian Therapy Spleen Deficiency Cold Pattern and Lung Deficiency Cold Pattern Cold
Weak production, circulation, and release of yang ki. An increase in symptoms of cold due to little production of yang ki caused by a chilling of the Stomach and Intestines 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

Lung

deficiency

An increase in symptoms of cold due to weak circulation and release of yang ki

cold pattern

SHO/Pattern and Pathology Yang Excess Pathology: External excess heat acute heat disease with chill Pulse: Floating, Fast, Excess Yang Deficient Pathology: External deficiency cold pain due to cold Pulse: insertion. SHO: Cold sho *This condition changes to Internal cold, because of the Yin nature of cold. Yin Excess Pathology: Internal excess heat Yin Deficient Pathology: Internal deficiency heat Sinking, Thin, Deficient

Symptom: External (surface) Excess heat; fever, Symptom: Cold on the exterior (surface), lower limbs,

Treatment: After tonifying yin, disperse yang by Treatment: After tonifying yin, tonify yang by shallow shallow insertion. SHO: Heat sho (Yang excess heat sho)

Symptom: Excess heat symptom inside of body. Symptom: Deficiency heat symptom inside of body, Heat invades and stagnates, causing blood stasis stiffness of neck and shoulder, dizziness, headache, and internal organ symptoms. Pulse: Sinking, Excess insomnia, head, neck and shoulder pain due to heat Pulse: Floating, Big, Deficient

Treatment: After tonifying yin, disperse by deep Treatment: After tonifying yin, when heat remains on insertion the yin meridian that has excess. SHO: Heat sho (Yin excess heat sho/pattern) the yang meridian, disperse it by shallow insertion. SHO: Heat sho (Deficient heat sho/pattern)

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Japanese Meridian Therapy 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).

1-4

Deficiency, Excess, Cold, and Heat of the Meridians and Acupuncture Points on which the Local Treatment is Performed The meridians and acupuncture points are flaccid, depressed, or slightly Cold tense. out. There is dulled perception. Pressing feels good. The body is frigid both inside and The pulse is Applying heat feels good.

sinking and deficient. Deficiency The meridians and acupuncture points have protuberances that become depressions when pressed. Heat abnormal. Pressing feels good. If pressing an The pulse is induration feels good, it indicates deficiency. floating and deficient. The surface of the body is frigid, but there are internal indurations and Cold Excess Heat resistance. Pressing causes an increase in pain. There is constant spontaneous pain and constipation. The pulse is sinking and excess. Pressing causes an There is The perception is

The surface of the body feels hot to the touch.

The surfaces of the body feel hot to the touch. increase in pain. little urination. The pulse is floating and excess.

There is spontaneous pain and no sweating.

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Japanese Meridian Therapy


Table 1-5: Standards for Treatment Classification Children Male / Female Def. Cold Pat. Def. Heat Pat. Exs. Cold Pat. Exs. Heat Pat. No. of Points Treatment Length Few Many for females Few Somewhat many Many Few Short Long for females Long Somewhat long Long Short Shallow Deep for females Shallow Somewhat deep Deep Shallow, dispersion Few Short Extremely shallow Somewhat few Somewhat many Many Very many Somewhat short Somewhat long Long Very long Shallow Somewhat deep Deep Very deep Somewhat few Many Very many Very many but Needle Depth No. of Moxi.

Applications Few Many for females Few Somewhat many Many Few, dispersion Very few but

LU Def. Pat. SP Def. Pat. LR Def. Pat. KI Def. Pat. LR Exs. Pat.

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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.

1Method 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 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) the right-and-left

Photograph 1

Fig. 4

Each pulse position

2How 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

3Superficial , 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

4Shape 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. Distal Middle Left hand Superficial Small intestine Gallbladder Bladder Deep Heart Liver Kidney Right hand Superficial Large intestine Stomach
Triple warmer

Deep Lung Spleen


Ming Men

Proximal

5Zang-Fu, Meridian relation in pulse position

Right-hand-Distal-Deep level LU, Superficial level, is large intestineProximal are Ming men and TWLeft-hand Distal are HT and SI, Middle is LR and GB, Proximal are KD and BL. (Fig. 6)

6Comparative 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-anddrinking, 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 patients pulse.

TJM HARA Diagnoses

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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