Acumoxa 2023

In March 2023 I made my way back to Japan with a group of acupuncturists from UK, Ireland and USA. I organised three seminars for us led by diffrent teachers on the themes of paediatric methods, facial moxibustion and the broader uses of moxa as well as an introduction to Toksen, a Thai traditional massage method. We travelled joyfully as a group and all left Japan feeling well nourished, wholly welcomed and longing for more. This short article aims to touch on some of the clinical treasures which we learned as well as to give you a flavour of our journey.

In the Daishi Hari clinic near Osaka which is lead by the 5th generation practitioner Noriko Tanioka Sensei, we were all treated so we got to experience the lightness and deftness of their signature shonishin methods which is like guasha performed by a butterfly. They also specialise in the use of silver and gold inserted needles which are incredibly soft and flexible, leading to less resistance from the body as they’re inserted. Even more impressive is their three edged needle which is used for blood letting without any discomfort at all.

Their clinic has been running for 130 years and has focused on the treatment of children. Often small children and their parents pile into the waiting room and each have a 3 - 5 minute treatment the cost of 1000 yen (about £6.50). It is a joyful place where there’s a play area and a stuffed toy of the hungry caterpillar, and a real gentleness and pragmatism with the treatment delivery. Older children may be treated in an individual bay for longer depending on their age and the nature of their condition. In these treatments moxa and inserted needles are more likely to be used whereas for the younger children it’s mostly only shonishin. The delight we witnessed of the children receiving treatment was encouraged those of us who seldom treat children to increase their presence in our clinics.

Clinically a lot of their methods are used on both children and adults. Masanori Tanioka Sensei, 4th generation practitioner and father of Noriko Sensei, coined the mantra ‘listen to the voice of the surface of the body’ which captures the heart of their diagnostic process. They use very light touch to seek out indurations, or dips in the surface of the body where tonification is required. Their diagnostic methods also include visual diagnosis and abdominal percussion whereby a brightness of sound is saught and dullness treated.

Since having covid myself in early 2022 I had fairly constantly blocked sinuses. Masanori Sensei treated me and used the three edged blood letting needle across the dry parts of the back of my scalp. It felt like light tapping which produced a warm sensation. No blood was visible to the onlookers nonetheless this needle cuts the skin - tiny cuts 3mm wide. The day after was the first day in over a year that I didn’t have to blow my nose first thing in the morning. The treatment principle of listening to the voice of the surface of the body had lead him to want to moisten the skin on my scalp, and this had cleared stagnation/ phlegm in my sinuses.

We had a few days off in Kyoto where we became quite familiar with a our local little onsen (bathhouse) - in a tiny building it offered a lot from organic veg to a tattoo parlour, to a sauna/plunge pool/ hot baths and even an electric bath which was alarmingly luminous green and buzzed with a current of electricity. We had city walks, explored the amazing food markets, enjoyed dried sweet black beans as a snack at Buddhist temples, delighted in the cherry blossom along the Philosopher’s Walk, dipped into sword and knife shops. The exquisite metal work in Japan contextualises the variety of clinical tools and needles somewhat. The evolution from knives and kitchen tools into medical tools and acupuncture needles is almost tangible.

We hired a mini bus and went on a little road trip around Shiga prefecture - going by road you get to see the big and small shrines in every tiny settlement of houses, the orange trees were bejeweled with fruit, and the cloud pruned branches of trees in gardens had seemingly survived the snow. We visited one of the oldest moxa shops - 300 years old and captured in 1880 by famous artist Hiroshige in a woodcut in which you can see the large pile of fresh ground moxa (centre) as well as their mascot statue (right) which is still there. We had a picnic across the road from the shop, grateful for the shade given by a little wooden shelter. We met a few locals there - all elderly, welcoming and grateful for us sharing our lunch with them.

We visited a needle maker whose metal work is full of character - he says you have to see which tools resonate with you - these are the ones you should use. I like this approach because after all, it tends to be what happens in our work whether we are explicit about that or not. With both metal tools and moxa use, the anatomy and dexterity of the physician is absolutely key to the application of those methods. Your physiology as a practitioner is part of your medicine and he encouraged us to celebrate that.

We spent three days staying at a Buddhist temple near Lake Biwa where we had a seminar from Tomoko Sasaki Sensei on moxa and facial rejuvenation. Her visual and structural diagnostic methods are so succinct. She looks a lot at skin creases, lack of lustre, asymmetry in posture. She tends to treat the soft side first and with more cones, to tonify the blood, strengthen the area before then treating the opposite area with one cone of moxa to help alleviate the pain and soften the tension. For instance, she put her pinkies into my ear canals and felt that my left ear canal was under a lot of pressure and tightness. I have had a long history with left sided ear infections so this didn’t surprise me though the feeling of asymmetry which I newly perceived with her fingers in my ears did surprise me! She then used 3x cone moxa on GB2 (ish) on the right side and 1x cone moxa on GB2 on the left side. When she returned to monitor how my ears had responded they felt about 80% more even. That result has remained six months later, what an incredible result from a 3 minute treatment.

We went to Tokyo by Shinkansen and transferred across five different trains before we reached Sangenjaya where Edward Obaidey Sensei’s clinic is. This is a busy suburb with easy access to central Tokyo. We stayed in a house fitted with statuettes of flamingoes and frogs and dogs and a lot of pink. Our first day and a half at Edward Sensei’s clinic was oriented around moxa though it included a lot of needle use and shonishin tool use. On our first day he reminded us:

Moxa is tonifying but it can disperse. If you tonify the Yin you cool the body, this is dispersal. If you tonify the Yang with surface moxa, you warm the body.

We explored different applications of moxa and I came away from his clinic inspired to be clearer in my clinical diagnosis and moxa application so that I can more acurately gauge the efficacy of my moxa treatments through the pulse change and patient sensations.

Our send off from Edward Sensei took us back to the roots of this medicine with an extraordinary demonstration of treatments by a Thai teacher who lives in Tokyo. Chanya Sensei uses Dokusen - a wooden hammer based treatment with a loud and frequent high pitched banging sound. This method looks and sounds quite brutal but feels so incredible, she worked on parts of my body which no one has ever treated like my inner thighs, hammering away she released years worth of tension. Something altogether else to learn… At the end of the day, Edward warned us that we might be exhausted by the treatment but by the time we got back to our accommodation we were all absolutely buzzing and so we had a small party with desserts, wine and a miniature homemade disco.

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