Amid Ise-Shima’s ancient groves of cypress giants lies the most revered Shinto shrine in Japan, the Ise Jingu shrine. With over 2,000 years of history, it is dedicated to a goddess considered the predecessor of the Imperial family and the supreme deity among the countless deities of the Shinto faith.
About 450 kilometers away, on a quiet street in Tokyo’s Sumida Ward, the lesser-known Ejima Sugiyama Shrine sits, dedicated to a man known as the god of acupuncture. In Shintoism, gods are believed to reside in objects of the natural world — rivers, mountains, and animals — even in ordinary human beings, whose spirits are enshrined in some of the 80,000 shrines in Japan.
One such ordinary man, Waichi Sugiyama, made extraordinary contributions to the field of acupuncture. Born in 1610, he went blind at an early age after contracting smallpox. For the blind in Japan at the time, the primary jobs available were acupuncturist or traditional massage therapist. At 18, he traveled to Edo (now Tokyo) to apprentice for a famed blind acupuncturist.
As the story goes, while out, Sugiyama tripped on a rock and fell to the ground. What happened next gave way to an idea that would change the practice of acupuncture. As he fell, a pine needle, sheathed in a bamboo reed, pierced the skin of his leg. Literally struck by inspiration he realized the bamboo had helped guide the pine needle deep into the skin.
He later devised a needle insertion technique using a small pipe to help guide the acupuncture needle vertically into patient’s skin. Guide tubes enabled acupuncturists, blind and sighted both, to insert needles with stability and ease. Sugiyama’s guide tube invention revolutionized the practice and continues to be used today. It was as much a benefit for practitioners as it was for patients, as guide tubes lessened the pain of needle insertion.
After Sugiyama successfully treated Shogun Tsunayoshi Tokugawa for a chronic illness, he served as court physician until his death. Today, the Ejima Sugiyama Shrine honors its namesake, whom locals consider the god of acupuncture, and whom the rest of the world considers the father of Japanese acupuncture. He is attributed with establishing the first acupuncture, moxibustion (burning of dried mugwort) and massage school for the visually impaired.
Sugiyama’s contributions paved the way for the practice of blind acupuncture to present day. Currently, 19 percent of the roughly 90,000 licensed acupuncturists in Japan are visually impaired. They are subject to the same licensure and rights and regulations as sighted practitioners.
Japanese clinicians use more palpation during treatment than those trained outside Japan. Feeling toughness, tenderness, warmth, moisture and so on is important before, during and after treatment to assess patients’ health and efficacy of treatment. This Japanese style developed thanks to the historical background that the occupation was equivalent to social security for the visually impaired to be financially independent.
The long history of visually impaired acupuncturists brought emphasis to Japanese acupuncture. Their success can be attributed to the development of certain senses — touch and smell — in ways that sighted people rarely appreciate. In a hands-on profession like acupuncture, fingers are deemed the second eyes. With a heightened sense of touch, blind acupuncturists pick up on minute sensory stimuli that sighted practitioners may overlook, including sensations of firmness and softness, hot and cold, thickness, sharpness and resistance of a patient’s body.
Passing on the art
Every twenty years, the Ise Grand Shrine is ceremonially dismantled and entirely rebuilt. The practice, representative of Shintoism core ideals, is a symbol of renewal and continuity. Rebuilding every twenty years allows the time-honored skills in carpentry, and metalwork to be passed on from one generation to the next. Similarly, practitioners of acupuncture and moxibustion, called hari-kyu, pass on their skills to young practitioners to keep this ancient art form alive.
At a college in central Tokyo, a group of about 30 students, dressed in identical white lab coats, partner up and practice with acupuncture needles on each other. Another group in the corner practices moxibustion by timing the burning of fine cones of moxa (dried mugwort) on a paper grid. It’s the afternoon, and having completed a day in classes, the students remain voluntarily to practice on each other even though it is not counted as academic credit. Their instructor attentively watches over the group, showing proper needle insertion, stance and posture.
Like other certified hari-kyu institutes across Japan, the school prepares its students for the national acupuncturist and moxibustionist exams. Examinees are required to not only memorize 361 basic acupuncture points, but also have a firm grasp on both Eastern and Western medicine, anatomy and physiology, sanitation, and clinical and rehabilitation practice.
Currently in Japan, there are about 4,000 students learning acupuncture at college, of whom 300 are visually handicapped. They are in three-to-four-year programs in preparation for the national exams. In the past decade alone, huge steps have been made to develop educational guidelines, revise textbooks and curriculum, and increase the level of clinical training at these institutions. The continuous renewal is needed to match the needs of 21st century medicine for sustainable social and health care structure. Meetings to revise curricula are held at the Ministry of Health, Labor and Welfare every few months.
As with any field of medicine, professionals learn invaluable skills through clinical practice that a textbook cannot teach. Students are trained to have a profound understanding of the art of hari-kyu. This is evidenced as students’ fingers deftly glide over each others’ skin, determining point location with anatomical landmarks and measuring with their hands. For these young practitioners, this is just the beginning of mastering the age-old art of hari-kyu and its rich diversity of methodology.