The Annual Seminar of Shakujyu Therapy Introduction

Reprinted and revised from NAJOM September 2008
By Cynthia Quattro P.A., DAOM, L.Ac.

The summer of 2008, I attended the 5th annual Shakujyu Therapy seminar. It was held at the New England School of Acupuncture (NESA) in Newton, Massachusetts.

Shoji Kobayashi Sensei, the founder of Shakujyu therapy, generously shared his life’s work to a group of more than 40 attendees, some new to Shakujyu, others devoted practitioners of his work.

The five-day seminar reviewed basic theory and techniques of Shakujyu therapy plus an introduction to supplementary treatments for the upper body. Mornings were filled with lectures and in afternoon the group practiced on each other with assistance of experienced Shakuju practitioners from Japan.

This year also marked another milestone. Kobayashi Sensei’s English edition of his explicit book, Acupuncture Core Therapy was now available through Redwing Book publisher. This book provides a thorough study of the core theory principles, basic introduction to Shakuju therapy, and advanced techniques.

In the book’s introduction, Kobayashi sensei quotes, “Acupuncture Core Therapy holds the concepts of qi and yin and yang as the core. We diagnose and treat patients according to these concepts” It further explains that the goal of Shakujyu therapy is to tonify or strengthen the Jing qi or essence and remove cold in the body.

This was my third opportunity to study with Kobayashi sensei. He travels to the U.S. only one or two times each year. During the first seminar I attended, I learned that an essential element of Shakujyu therapy is using focused intention while holding a pure silver acupuncture needle to the prescribed points. No needle insertion is required for the therapeutic effect expected from an acupuncture treatment. I recognized that staying focused on the movement of qi through the needle offered me another dimension to follow the progress of my patient’s treatment.

I was so moved by the changes I saw in my patients and in how I became more engaged with the treatment using this therapy that I decided to study with Kobayashi Sensei in his clinic in Tokyo, Japan. I wanted to see how he incorporated this into his clinic and the scope of his patient treatments.

In his clinic, Kobayashi Sensei filled his day was filled with a wide variety of patients experiencing a variety of medical conditions. Regardless of the diagnosis, he used the methodical sequence of Shakuju therapy on each one of them occasionally using a bleeding technique or shiraku. Many of his patients had been seeing him for a long time and some were bringing their family members for an initial treatment.

After consistently practicing this technique I have seen consistent and at times profound results. For example, one of my patients who has chronic progressive Multiple Sclerosis and Lyme disease, found that her peripheral neuropathy markedly improved after receiving Shakujyu therapy treatments. I have seen many where I notice with the addition of the Shakuju treatments, their core vitality increases and their medical condition improves more quickly.

In each Shakujyu therapy seminar I attend the learning deepens. Each time I learn more about palpation and the subtle signs of diagnosis. In observation, the analogy, “less in more”, seems to apply to these techniques. By applying the more gentle treatments of Acupuncture Core therapy, the effects only seem to be have longer lasting effects.
Shakujyu Therapy Seminar

With my renewed enthusiasm, this year’s seminar could not have come soon enough.
The seminar at NESA was held for five days. The first two days were introductory lectures and practice for first time attendees or anyone who wanted to attend as a review.

The introductory lectures reviewed concepts about core vital energy. The basic concept implies that all disease originates from internal cold or heat. Wherever qi or blood is congested there is cold which further hinders the generation and circulation of Jing qi or essence. The amount of Jing qi reserve is thought to be equivalent with the status of one’s vitality and health.

Shakujyu therapy is first a systematic diagnostic approach to search for signs of congestion of qi and blood. The English translation of shakujyu is “accumulations” and “gatherings” which refer to areas of hardness, pulsations, and discomfort found by palpation of the abdomen. The depth of the congestion or “shaku” indicates the complexity of the condition.

Kobayashi sensei emphasizes a sequence of steps to follow to evaluate and treat each patient.

Basic Shakujyu Therapy Protocol

Step One

Observation and inquiry
This is the time to talk to the patient to hear and observe while they explain their chief complaint.

Reference points
Key acupuncture points are palpated as a reference to identify meridian stagnation and degree of discomfort.

Step Two

Pulse analysis
The first pulse analysis gives a first impression of the diagnosis

Contact needling of the abdomen
Using a #2 silver acupuncture needle, the abdomen is tapped starting from the upper right quadrant across the surface crisscrossing finally to the lower left area and repeated until a qi reaction occurs.

Pulse analysis and adjustment
The pulse is observed for any changes and adjusted by treating the source point on the indicated meridian.

Abdominal palpation
The abdomen is gently palpated to find where there is discomfort, hardness or pulsations. Where the hardness is deeper the qi is more congested. A shaku pattern is identified and serves as the diagnosis to determine the treatment pattern on the back shu points.

Step Three

Contact needling of the back
The back is observed and palpated for areas of discomfort. Acupuncture point UB 52 is a key reference point to determine which side of the back is treated before performing sequential contact needling of the back.

Shakujyu therapy

A selected form is chosen based on the diagnostic indicators including the pulse, reference point sensitivity and abdominal shaku. A series of back shu points are treated on the healthy side using a #2 silver needle. The needle is gently held on the surface of the skin while applying focused intention deep into the organ layer until a qi reaction occurs.

The sequence is repeated or it may shift to the Governing Vessel (GV) in the case of a more chronic condition. Supplemental treatments using moxibustion may also be used if indicated.

Step four

Abdominal palpation
With the patient face up the abdomen and the reference points are reexamined for any remaining shaku. Supplementary treatments are applied if necessary.

Pulse pattern
A final pulse is taken to confirm a change has taken place.

Step five

With the patient in a seated position, supplementary points are treated mainly Gallbladder 21using the silver needle. A final visualization of the entire body completes the treatment.

After the introductory sessions, we observed Kobayashi sensei treat patients at the clinic.
Each patient was treated by the same sequence regardless of their chief complaint. The predominant Shakuju pattern was identified and treated with contact needling according to the appointed form. There are four sequence forms to choose from. Each one determines in which order the shu points will be addressed. Form one is the most common and is indicated for early stages of disease, which usually appears as a yin vacuity syndrome. Forms two, three and four are used as an illness progresses to yin repletion, yin and yang repletion, and yang vacuity.

(Refer to NAJOM July 2008. Katoh Hirohito, Treating Catamenial Pneumothorax with Shakujyu therapy for further details of the four forms of treatment)

Throughout the rest of the seminar, details of each of these steps were discussed followed by practice sessions on one another. A group of colleagues accompany Kobayashi sensei each year when he travels to a seminar. This group of experts was available to provide us with close supervision while we practiced the techniques. They were patient and generous with their knowledge and guidance.

Observing them as they gave treatments gave us more opportunities to see how the treatments were performed.

After three days of supervised practice, I was able to fill in the gaps where I needed the most improvement in my diagnostic skills. I was shown how to find where the qi was most congested and how to recognize when it had successfully changed.

Overall, between a bit of humor and focused intention plus some help from our skillful translators we were able to enjoy learning and treating each other.

Supplementary Treatments

During the last two days of the seminar, Kobayashi sensei discussed the use of supplementary treatments.

First, he introduced a point he called “behind Stomach 7”. This particular point located anterior to San jiao 21, is useful especially in cases of head and neck trauma, dental disorders, and jaw syndromes. It can be treated with the silver needle, a teishin, or moxa.

Another supplementary treatment pertaining to the Conception Vessel (CV) was introduced. Moxa was applied on the sternum at specific points for indications such as chronic cough, frozen shoulder and some heart conditions. This should be done only after treating the back shu points using the same form as was used for the back treatment.

On the last day, we celebrated the completion of a successful seminar and honored Kobayashi sensei for his great accomplishment of his new book, Acupuncture Core Therapy. We parted with a hopeful outlook that we will see Kobayahsi sensei again even before the next annual Shakujyu seminar.

Acupuncture Core Therapy

The book is divided into basic theory, diagnostic skills including pulse and abdominal palpation, treatment techniques and case studies.

It begins with a foundation of the concepts of qi, yin and yang, and the five phases. It explains that beginning with tai ji, as the origin of all things, yin and yang are derived.

When yin and yang are further divided into the yin and the yang within the yin, and the yin and yang within the yang plus the origin of tai ji, these are the five phases. Each of these five phases have special characteristics and each is expressed as an element, such as yin within yin as water, yang within yin as wood, yang within yang as fire, yin within yang as metal plus tai ji as earth. Understanding these elements in relationship to the diagnosis influences how to choose the form in which the back shu points are treated.

The book further highlights specific treatments indicated for several diseases. For example, in the condition of anemia, with a low red blood cell count, it is considered a loss of heat and therefore a yang vacuity condition. The degree of which depends on the status of the jing qi or essence. Form four, also called the Reverse Sequence is applied to the back shu points (Water-Metal- Fire–Wood). Additionally the use of moxa is applied on the Governing Vessel (GV). Since there is a lack of heat production with anemia, it is purposeful to keep the body warm and use warming treatments.
There are a number of interesting case studies outlining the course of treatment for several diseases. At the end of the book, an illustrated appendix is included describing each of the treatment modalities discussed and how the instruments are used.

And finally, an extensive index references individual acupuncture points, historical and theoretical concepts, treatment modalities and disease listings.


The book concludes with the author’s remarks. He states that the ultimate task in therapeutic treatment is to track the movement of qi as the primary method to follow the constantly changing pathological conditions and not to see diseases as fixed entities.

Kobayashi sensei quotes, “If we stimulate the body at the surface of the skin, it is an excellent treatment technique by which to feel and “take hold” of qi. Acupuncture Core Therapy is conceived and rooted in this paradigm.”

The concept of treating the skin in order to “take hold of the qi” and then treat the organs below can be viewed by considering the physiology of the skins surface. If contact needling releases qi congestion on the wei qi layer of the skin, what structures is it affecting? This is an ultra thin layer of skin within the epidermis and although it is only 1.5mm thick, it is rich with microcirculatory vessels, lymph channels, nerve receptors and sensory proprioceptors. By rhythmically tapping the surface of the skin, all of these physiologically active elements are stimulated and brought into harmony increasing blood and lymph circulation, and stimulate nerves that course the entire body and connect to target organs. Without a doubt, this direct signaling encourages an active healthy physiologic change deep below the skin’s surface into the core of the internal organ function.

On each occasion that I study with Kobayashi sensei I feel a deep sense of appreciation. His generous wealth of knowledge presents a practical application to treat complex conditions. It combines refined diagnostic techniques observing the subtle qi movements of the body and a method of practice to track treatment results. I find that besides applying my attention to the precision of the techniques while I am treating, it also requires development of my own qi gong practice. I have noticed that my acupuncture practice has become more satisfying and feels more in harmony with the elements that affect disease and influence health. With consistent focus of intention, it ultimately brings the practitioner and patient closer to the same realm of consciousness and inevitably can magnify the outcome of each treatment.
Shoji Kobayashi sensei’s book Acupuncture Core therapy, is a great asset for those who are just becoming familiar with Shakujyu therapy or for those who are experienced. It offers in depth explanations of traditional concepts of acupuncture, the five elements and the effects of qi gong. Its core concepts draw these theories together in a concise method to effectively treat the underlying causes of disease. It attempts to explain how the progression of cold in the body causes imbalance and how to correct it from the core.

I would like to thank Mizuntani sensei and the editors of NAJOM for the opportunity to write this article.

Cynthia Quattro received her Doctor of Acupuncture and Oriental Medicine from Oregon College of Oriental Medicine in 2007. She graduated from American College of Traditional Chinese Medicine in San Francisco in 1990. She is a Physician Assistant and teaches Integrative Medicine at the Acupuncture and Integrative Medicine College in Berkeley, CA. She lives in Santa Cruz, CA where she has an Integrative Medicine practice since 1995.


©2009, 2011,2014 DR. CYNTHIA QUATTRO