Background: Over time, Chinese medicine spread throughout Asia and developed into distinguishable styles of acupuncture in China, Japan, Korea and possibly Taiwan. Aims: This study sought to classify, clarify and describe acupuncture styles in China, Japan, Korea and Taiwan. Methods: A systematic search was conducted using: University of New England e-search resources, CINAHL (1998 to January 2015), ProQuest (1980 to January 2015), PubMed (1980 to January 2015) and Google Scholar (1980 to January 2015). Data was collated and coded into philosophical concepts, diagnostic methods and treatment principles. Patterns of relationships between styles were examined. Results: Twenty-eight articles met the inclusion criteria. Features of Chinese acupuncture include pattern identification and syndrome differentiation as well as the four diagnoses. The solicitation of 'De-qi' during needle stimulation is typical. Although encompassed in Chinese acupuncture as well, emphasis in Japanese acupuncture is placed on the theory of five phases, meridians and collaterals, palpation and relatively light needle stimulation. Korean acupuncture is based on a constitutional model and uses systematic treatments with substance injection into body loci and microsystem acupuncture. Taiwanese acupuncture was described as analogous to Chinese acupuncture. Conclusion: There is a variable degree of consistency and reliability in the literature addressing acupuncture styles internationally. There appears to be a common pool of philosophical concepts, Chinese in origin, which are fundamental across all styles and have influenced the respective diagnostic methods and treatment principles in varying degrees. Japanese and Korean acupuncture styles have evolved from this, whereas details of a Taiwanese acupuncture style is limited and is assumed to be Chinese.

Traditional Japanese Medicine (TJM) acupuncture is gaining recognition as an alternative to Traditional Chinese Medicine acupuncture in Western countries. However, previous research has failed to comprehensively describe the characteristics of TJM acupuncture by not investigating it within the social and cultural context of Japan.
The purpose of this ethnographic study was to describe the philosophy and practice of TJM acupuncture practitioners in Japan and to explain philosophical concepts, diagnostic methods and treatment principles; additionally to determine if TJM acupuncture is a distinct style. In Japan, participants were recruited by chain referral and emergent sampling. Over four and a half years, data was collected through participant observation, interviews and by gathering documents. Thematic analysis was used to evaluate data.
Findings indicate that TJM acupuncture knowledge is strongly based in biomedical science. Regarding Traditional East Asian Medicine knowledge, Ki, meridians and the eight principles are emphasised. The instantaneous effects of treatment, effect through technique and patient comfort are important beliefs and values influencing clinic operations. Inquiry is one of the most significant diagnostic methods. Perception and sensitivity are also valued attributes, often applied to pulse palpation or in searching for body tissue abnormalities on the skin or abdomen. Furthermore, esoteric, biomedical and orthopaedic diagnostic methods are utilised. Diagnostic methods often result in simple patterns of disharmony or the location of abnormal body tissue. Slightly long, thin filiform needles inserted with guide tubes are common. Additionally, small amounts of higher grade moxa floss, non-inserted contact tools, machines and manual methods are applied in treatment. Using the pressing hand to prepare the skin for tool application, monitor the patient’s and maintain intervention accuracy is important. That tool manipulation and stimulation is performed in small amounts over many treatment locations is distinctive of TJM acupuncture. Many needle and moxibustion methods are minimally intrusive and dependent on immediate feedback to gauge treatment success on micro, meso and macro levels of confirmation. TJM acupuncture emphasises practical skills and tangible phenomena by relying on the palpated qualities of treatment locations and techniques used at them.
This study described TJM acupuncture in terms of routines and analysed how practitioner beliefs and behaviours connected with the cultural context of Japan. TJM acupuncture is a unique style with defining features; this study suggests that an enhanced understanding of TJM acupuncture could benefit acupuncture at government, research, education and clinical levels, with the ultimate goal of providing better care for individual patients.