Beliefs and values in Japanese acupuncture: an ethnography of Japanese trained acupuncture practitioners in Japan
Background: Japanese acupuncture is gaining international recognition. However, previous research has failed to comprehensively describe the characteristics of Japanese acupuncture by notinvestigating it within the Japanese clinical environment. This study aimed to identify unique and routine elements of Japanese acupuncture, describe these elements in detail, and examine how the current beliefs and attitudes of Japanese acupuncture practitioners related to philosophical concepts in their practice.
Methods: Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. Japanese trained acupuncture practitioners were recruited by chain referral and emergent sampling. Data were collected through participant observation, interviews, and by analyzing documents. Thematic analysis was used to critically evaluate the data.
Results: Thirty-eight participants were recruited. Of these participants, 22 agreed to clinical observation; 221 treatments were observed with 172 patients. Additionally, 17 participants consented to participate in formal semistructured interviews and 28 to informal unstructured interviews (fieldwork discussion). Besides “knowledge,” “beliefs and values” was a major theme interpreted from the data. Subthemes—including Zen Buddhism, effect through technique, instant effects of treatment, anatomical areas of significance, resolution of abnormalities, minimal stimulation, and patient comfort and customer service—were identified.
Conclusion: Beliefs and values are an underrepresented, yet extremely important aspect of philosophical concepts influencing acupuncture practice in Japan. Uniquely Japanese beliefs and values that do not rely on a commitment to any spiritual or religious affiliations or proprietary knowledge of traditional or biomedicine may be successfully exported from Japan to advance acupuncture education, research and practice in international contexts.
The Confirmation Of Treatment Effects In Japanese Acupuncture
Objectives: The aim of this research was to identify any unique and routine procedural elements of clinical acupuncture as practiced by professional practitioners and educators in Japan. Additionally, to describe these methods in detail and examine how they related to philosophical concepts, diagnostic methods and treatment principles. Methods: An ethnographic methodology was employed to collect data during long term fieldwork in Japan. Participants were recruited through chain referral and emergent sampling. Data was collected by observing and interviewing practitioners and educators of acupuncture in Japan. Patient records and other relevant documents were also collected and together with recordings from observations and interviews, were analyzed thematically. Results: Over four years, 32 participants were recruited from prefectures all over Japan. Of these, 19 agreed to clinical observation, 16 to participate in formal interviews and 14 in informal interviews; 217 treatments were observed with 168 different patients. In relation to treatment principles, one especially interesting theme was interpreted from the data: practitioners tended to confirm the effects of interventions during treatment. Effects were confirmed on three different levels of timing and location: micro, meso and macro. Important markers for change included practitioner perceived needle sensations and muscle tension. Discussion/Conclusion: Micro, meso and macro level confirmation play different roles during the therapeutic encounter. That treatment effects can be can be almost immediately palpated or observed influences a number of clinical factors including point selection methods, treatment tool manipulation techniques and needle retention time. The solicitation of tangible change demonstrates pragmatism and importance in practitioner skills as a catalyst for therapeutic change in Japanese acupuncture.
Cross-Cultural Differences in Acupuncture: A Review
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.
Cross-cultural differences in acupuncture: A review: Short title: Acupuncture styles in TEAM
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.
Contact Tools in Japanese Acupuncture: An Ethnography of Acupuncture Practitioners in Japan
This study aimed to identify procedural elements of Japanese acupuncture, describe these elements in detail, and explain them in terms of the key thematic category of treatment principles. Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. In total, 38 participants were recruited by chain referral and emergent sampling. Data was collected through participant observation, interviews, and by analyzing documents. A total of 22 participants agreed to clinical observation; 221 treatments were observed with 172 patients. Seventeen consented to formal interviews and 28 to informal interviews. Thematic analysis was used to critically evaluate data. One especially interesting theme was interpreted from the data: a variety of contact tools were applied in treatment and these were manipulated by adjusting elements of form, speed, repetition, and pressure. Tapping, holding, pressing/pushing, and stroking were the most important ways contact tools were used on patients. Contact tools are noninvasive, painless, can be applied in almost any environment, and may be easily accepted by patients worldwide. Contact tool theory and practice may be successfully integrated into acupuncture curricula outside of Japan, used to inform clinical trials, and contribute to an expanded repertoire of methods for practitioners to benefit individual patients in international contexts.
The Philosophy and Practice of Japanese Acupuncture
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.
The Characteristics of Japanese Acupuncture
Objectives: The purpose of this ethnographic study was to describe the philosophy and practice of acupuncture practitioners in Japan and to explain philosophical concepts, diagnostic methods and treatment principles. This article summarizes the characteristics of Japanese acupuncture.
Methods: Between August 2012 and October 2018, ethnographic fieldwork was conducted in Japan. Thirty-eight participants were recruited by chain referral and emergent sampling. Data was collected through participant observation, interviews and by collecting documents. Twenty two participants agreed to clinical observation; 225 treatments were observed with 175 patients. Seventeen participants consented to formal interviews and 28 to informal interviews. Thematic analysis was used to critically evaluate data.
Results: Japanese acupuncture can be described in terms of philosophical concepts, diagnostic methods and treatment principles. Regarding Traditional East Asian Medicine knowledge, Ki, channels and the 8 principles are emphasised in Japanese acupuncture. Inquiry and palpation are the most significant diagnostic methods. These diagnostic methods often result in simple patterns of disharmony or the location of abnormal body tissue. In treatment, tool manipulation and stimulation is performed in small amounts over many treatment locations. Needle and moxibustion methods are minimally intrusive and dependent on immediate feedback to gauge treatment success.
Conclusion: Japanese acupuncture is a unique system of traditional medicine that stands apart from Chinese acupuncture. An enhanced understanding of Japanese acupuncture could benefit acupuncture at government, research, education and clinical levels, with the goal of providing better care for individual patients all over the world.
Medical Models in Japanese Acupuncture
Japan integrates Traditional East Asian Medicine (TEAM) with mainstream western health services, most notably seen in the controlled national health insurance coverage of acupuncture, Judo Therapy (unique orthopaedic techniques developed by judo practitioners [Suzuki 2004]), and herbal medicine. The following discussion is based on four years of ethnographic research in Japan as part of a PhD dissertation and highlights some ways "western" and "eastern" medical philosophical concepts interact, specifically in relation to acupuncture and Judo Therapy. It will do this by examining how "western" and "eastern" medical philosophies shape the practice of Japanese acupuncture. This article also aims to promote awareness about how medical models manifest in clinical actions and inform clinical reasoning in Japan which may also have parallels with the practice of acupuncture in other countries.
The confirmation of treatment effects in Japanese acupuncture
Background: Japanese acupuncture is gaining international recognition. However, previous research has failed to comprehensively describe the characteristics of Japanese acupuncture by not investigating it within the Japanese clinical environment. This qualitative ethnographic study aimed to identify unique and routine elements of Japanese acupuncture, describe these in detail and examine how they related to treatment principles. Methods: Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. Participants were recruited by chain referral and emergent sampling. Data were collected through participant observation and interviews as well as by analyzing documents. A total of 38 participants were recruited. A total of 22 agreed to clinical observation; 221 treatments were observed with 172 patients. Seventeen participants consented to participate in formal interviews and 28 to informal interviews. Thematic analysis was used to evaluate data. Results: That practitioners tended to confirm perceived effects of interventions during treatment, was a major theme interpreted from the data. Confirmation was performed continually throughout treatment and at three different levels of timing and anatomical areas (micro, meso and macro). Many markers signified treatment effects which were in general, perceived by observing and/or palpating body tissue. Belief in the instantaneous effects of treatment and the value of effect through technique exemplify the philosophical foundations of confirmation. Continually monitoring treatment results at a range of time and body location increments is an important element of Japanese acupuncture. Conclusion: This effect confirmation practice model promotes a system of constant feedback gained by repeated intervention and confirmation. This may be a unique feature of Japanese acupuncture.