The Practice of Japanese Acupuncture and Moxibustion
Ikeda Masakazu. Translated by Edward Obaidey Published by Eastland Press, 2005 Paperback, 319 pages, £30. DVD £70.50
(Reviewed by Marian Fixler, EJOM Vol. 5 No. 3)
This is the first English language edition of a book by Ikeda Masakazu, a proponent of Japanese acupuncture for over forty years, who has written many books in Japanese. Though living and practising in Japan, he also has a following of students in the west, predominantly in America and Australia.
With a current working knowledge of a number of systems of Japanese acupuncture as well as a background in TCM, I was interested to explore Ikeda’s teachings, particularly as it had been promoted at a recent seminar as the system that brings together all other systems of acupuncture, drawing on classical literature, including the Nei Jing (Yellow Emperor’s Classic of Internal Medicine), Nan Jing (Classic of Difficulties) and Shang Han Za Bing Lun (Treatise on Cold Damage and Miscellaneous Disease) in particular. Edward Obaidey, a teacher in his own right, who lives and practises in Japan, emphasises that Ikeda believes that these are ‘not different traditions that should be kept separate, but rather merely different aspects of an integral whole that inform each other’.
The foreword gives a helpful overview of Japanese acupuncture and the historical influences that have both enabled it to flourish in its diversity and that have also threatened its traditional classical approaches. The book begins with an extensive translator’s introduction by Edward Obaidey, Ikeda’s main ambassador in the West. This is a welcome and essential section as it outlines the theoretical background to Ikeda’s system of acupuncture, an explanation of the pathological processes involved, including how disease manifests and travels through the meridian system. An interesting strand running through this section is the differentiation between organs and meridians and their specific functions e.g. the liver organ has a spreading centrifugal flow; by contrast, the main direction of the liver meridian is centripetal, leading blood towards the liver. Though based primarily on the Japanese system of meridian therapy, (with its emphasis on the use of the meridians to diagnose and treat disease), this system claims to be a synthesis of different schools of traditional classical theory.
Meridian therapy is primarily concerned with the patterns of deficiency and excess in relation to the five phases. Deficiency of the essence of the yin organs is at the root of all disease. Deficiency is due to a lack of qi in the organs, meridians and corresponding areas of the body. Excess, in meridian therapy, is seen as the presence of pathogenic qi (xie qi in Chinese, or jia ki in Japanese). Ikeda defines this as a build up of heat or blood; conversely a build-up of cold is not considered to be an excess condition but an overabundance of yin. He describes heat patterns of both an excess and deficient nature, but only describes cold patterns of a deficient nature. This further differentiation into yin and yang deficiency and excess, and heat and cold patterns, is an interesting difference between Ikeda’s system and other forms of traditional meridian therapy (for example, as outlined by Shudo Denmai). This further differentiation of patterns is more akin to eight principles. However, my knowledge of TCM did not always help me to understand the patterns using these differentiations. Ikeda says that not everything should be explained as students should work it out for themselves. Though I subscribe to this approach, this can lead to confusion, particularly where similar patterns exist in other systems of acupuncture.
The introduction gives a comprehensive outline of the four main diagnostic factors to be considered when formulating a treatment. The important role of palpation, central to the diagnostic process, and a common characteristic of Japanese acupuncture, is emphasised here. Consideration is given to the depth of needling, number of needles and duration of needling, based on the constitution of the patient and the patterns being treated. This emphasis on dosage is one that I have mainly come across in texts on Japanese acupuncture systems.
The many varieties of needle technique are described, and, though they follow the principles in the classical texts (regarding direction of needling, opening or closing the hole, and speed of the technique), it is the accompanying DVD that helps to understand their clinical application. The moxibustion techniques are not described in much detail, yet are varied and could do with clearer descriptions.
In the following chapters, Ikeda details thirteen main syndromes, quite different to the four basic patterns of meridian therapy. The pathology and associated symptoms are described together with the relevant findings on the pulse and abdomen and visual presentations. In the section on treatment for each pattern, the book assumes a basic knowledge of meridian therapy theory with regard to the root treatment points and further explanations are offered regarding the choice of points.
The main bulk of the text is then devoted to looking at the treatment of a wide range of conditions using this system. Ikeda describes the main presenting patterns that can be expected, together with a differentiation of symptoms and pulse and abdominal patterns. Treatment also explores the possibilities for branch treatment using acupuncture, moxibustion and blood letting. For each condition, Ikeda includes a case study for consideration, taking the reader through each of the stages from diagnosis to treatment and outcome. Some of these sections, such as neuro-musculo-skeletal diseases, are covered in considerable detail, whilst other sections, such as women’s diseases, are much briefer.
Ikeda also gives advice for patients. At times this is practical in nature, but at other times, this goes beyond the scope of acupuncture and into the (at times dubious) realms of psychology. In the section on children, for example, a large section is devoted to truancy, which Ikeda says can be considered to be a type of neurosis and indicative of something more serious, such as schizophrenia, particularly at university level! I am not sure what evidence there is for such statements beyond Ikeda’s own clinical experience.
Unlike the humility of Shudo Denmai, who in his book describes how it took him about 25 years to feel the arrival of qi, Obaidey’s quote of Ikeda does not give quite the same impression: ‘I am just practising medicine as outlined in the classics. I am doing nothing special. It is just that most people nowadays are performing below-average treatment.’ Obaidey’s conclusion also makes reference to other styles of meridian therapy that he claims do not consider the physiology and pathology of the patient to the extent that is required in this ‘system’. This kind of criticism of other systems does not sit comfortably within such a text. In spite of emphasising that this is not just another ‘style’ of acupuncture, but the mere following of classical principles, anyone who has delved into Paul Unschuld’s Nan Jing, will be aware that there is no one interpretation of any of these texts.
Marian Fixler Marian Fixler qualified in 1991. For many years she was a senior lecturer at the University of Westminster. She is President of the UK branch of the Toyohari Association and has trained extensively in Japanese acupuncture systems since 1998. She teaches as a guest lecturer at the London College of Traditional Acupuncture and is involved in running and teaching Japanese acupuncture courses at a postgraduate level both here and in Amsterdam. She works in private practice in London.