Modified and translated by CFJA
⑤ Retention needle technique 置針術 (Jp. chishin jyutsu) / 即留針術 (Jp. sokuryushin jyutsu)
A technique that involves inserting one or more needles in each acupuncture point, quietly retaining, and removing the needles after 5 to 10 minutes. When inducing a strong stimulation to use the suppression 抑制 or sedation 鎮静 technique, it is good for a patient whose body has weakened or is afraid of needles. Good retention time is from 5 minutes to 1, or 2 hours, and remove the needles when the symptom is relieved. This technique is for 2. suppression needle method 抑制針法 and 3. reflection needle method 反射針法.
(Dr. Seino’s commentary)
The retention needle technique 置針術 refers to the state where two or more needles are inserted because inserting more than two needles forces our hands to release the first needle. This method can be seen in a technique called uniform insertion technique 斉刺 (Jp. seishi) and rising insertion technique 揚刺 (Jp. yoshi) mentioned in the chapter, kanshin hen 官鍼篇, of the book, Lingshu『霊枢』(Jp. Reisu, “spiritual Pivot”). The uniform insertion technique 斉刺, also known as the three-needle insertion technique 三刺 (Jp. sanshi), is a technique that involves inserting a needle in the local treatment area, then later, inserts two more needles right beside it – a technique that involves inserting three needles at the same time. Waichi Sugiyama incorporated this technique into the 18 hand techniques 十八手術 (Jp. jyuhachi syujyutsu), also called jyuhachi no shishin shugi 十八の刺鍼手技 in the Sugiyama Shinden style and called it the three-method hand technique 三法手術の方 (Jp. sanpo shujyutsu no ho). However, this orally passed down method is a technique that involves inserting one needle in three different directions. They might have interpreted the meaning of the three-needle insertion technique 三刺 as inserting a needle in three directions, although there is no way to find out his true intention of why he chose the term three-method 三法 instead of uniform insertion technique 斉刺 or three-needle insertion technique 三刺 (Refer to the additional comment). The rising insertion technique 揚刺 (Jp. yoshi) is a technique that involves inserting the needle into the local treatment area, and later, inserting four more needles around it – a technique that involves inserting five needles at the same time. This technique is used to relieve cold parts of the body or cold body in general. Sorei Yanagiya had researched the Chinese and Japanese acupuncture techniques in great detail. He also calls the retention acupuncture technique 置鍼術 (Jp. chishin jyutsu) as retention technique 留置術 (jp. ryuchi jyutsu). These two terms, retention acupuncture technique 置鍼術 and retention technique 留置術, are presumed to be created based on thoughts such as uniform insertion technique 斉刺, rising insertion technique 揚刺, retention needleおきばり (Jp. okibari) (it has been called as such since the Edo period), etc. Sorei Yanagiya stated that “due to an organism’s natural function, an inserted needle can be pulled into or pushed out of the body. Therefore, this technique should not be used thoughtlessly or excessively as it requires full caution when a needle is inserted and retained in the body.”
Currently, this is the mainstream method in China. They retain the needle for about 1 to 2 hours. This shows that they have been keeping Cheng Dan’an’s teachings. However, this is completely different from Sorei Yanagiya’s method – they do not understand the true meaning of the retention acupuncture technique 置鍼術. When inserting the needle into the body, the human body will significantly react for 8 minutes after the insertion. It is thought that the body is reacting to a foreign body, the needle. The body’s reaction will increase by about 80% and reach its peak at around 30 minutes. From there, it will gradually decrease and suddenly drop after about 50 minutes. The results of the experiment, suggest that it is ideal to finish the treatment within 8 to 10 minutes, a maximum of 30 minutes. It is not certain as to what kind of results they are expecting from retaining the needle for more than an hour. Nevertheless, the current state of using the retention acupuncture technique for any medical condition is different even from the content in Lingshu『霊枢』.
The quote from Lingshu『霊枢』states, “斉刺は寒気の小深なるものを治す (Uniform insertion technique 斉刺 cures cold-qi in the small-deep” and “揚刺は寒邪の博大なるものを治す (The rising insertion technique 揚刺 cures cold-evil of the wide-large.” Accordingly, Dr. Seino argues that only three needles (uniform insertion technique 三刺), in other words, only a couple of needles should be used to treat the area that is locally (小 – character meaning small) very cold (深 – character meaning deep). Also, five needles should be used, in other words, multiple needles should be used to treat the area that is widely (博 – character meaning wide) cold on the whole body (大 – character meaning big), cautiously monitor the body temperature increasing, and immediately remove the needle as soon as the treatment effect has been attained. Clinically, using the retention acupuncture technique 置鍼術 to patients with spontaneous pain or night pain, the symptom will aggravate or exacerbate. Using the retention acupuncture technique 置鍼術 on a patient with a strained back (acute lower back pain) with the feeling of heat will increase the pain and the likelihood of the patient not being able to walk is very high (Note that the practitioner with insufficient needle insertion technique not only is incapable of making the patient better but also incapable of making the patient worse. In short, an unskilled practitioner will not cure nor harm the patient). For any medical condition, the patient with acute symptoms will not go to a practitioner who does not use acupuncture techniques other than the retention acupuncture technique 置鍼術. There are tons of practitioners who mainly treat the patient with retention acupuncture techniques 置鍼術 around the world. Some of the reasons why many practitioners nowadays are using retention acupuncture technique 置鍼術 is because students are required to learn TCM to obtain a licence and pass the board exam in countries other than Japan, and compared to the period when the needle was expensive and valued, it is now possible to mass-produce cheap needs. Dr. Seino argues that this is also one of the reasons why it is difficult to tell the benefit of acumoxa therapy.
Waichi Sugiyama focuses on the fact that cold-qi-small-deep 寒気小深 (Jp. kanki shoushin) in Lingshu『霊枢』is interpreted as cold-heat 寒熱 (Jp. kannetsu) in the text, shinkyu ko otsu kyo『鍼灸甲乙経』. The body generates heat (self-healing ability is activated) by rebelling against cold (寒 – character meaning cold). This is called inner-heat 内熱 (Jp. nainetsu). As a method of removing the cold 寒 by using the heat that has been generated in the body, Waichi Sugiyama might have noticed that inserting the needle into two directions increases the treatment effect. Also, Waichi Sugiyama is blind. We think that he probably came up with this method since it was difficult for him to take his hands off the needle for needle retention.
⑥ Intermittent technique 間歇術 (Jp. kanketsu jyutsu)
After inserting the needle to a certain depth, once in a while, twist and move the needle, perform oscillation technique 提挿 (up and down) a couple of times, briefly retain the needle, once again twist and move the needle, perform oscillation technique 提挿 a couple of times, retain the needle, and repeat this process a couple of times. This technique is an activation method 興奮法 that is applied for an expansion of blood vessels (vasodilation) or muscular and skin relaxation. It can be considered as a suppression method 抑制法 when inducing a strong stimulation. This technique is for 1. activation needle method 興奮針法 and 2. suppression needle method 抑制針法.
(Dr. Seino’s commentary)
The intermittent technique 間歇術 is also known as the interval technique 間代法 (Jp. kandaiho). Shingo Yamamoto introduced this technique in the 44th year of the Meiji period. Insert the needle to a certain deep level, pull the needle to an appropriate level – called the retreating method 退法 (Jp. taiho) – leave it for some time without moving the needle up and down, after a while, insert the needle tip to the same depth as the first time, and retain the needle for a certain period. Similar to the geyser, it is a technique performed by giving it some intervals in between. It is used for the suppression 抑制 of blood vessel expansion, muscle relaxation and nerve excitability. Although this method induces strong stimulation, Cheng Dan’an said to move the needle after it is inserted at a certain depth. Therefore, it induces stronger stimulation. Although the name of this method is the same as the technique in Japan, it is clear that they are different techniques – at the very least, this technique is meant to obtain De Qi.
The technique practiced in Japan involves pulling up the needle after insertion. This is a very difficult technique. Until the sensation of the fingers is keen, it is very likely to pull out the needle completely. Without using oshide 押手 (supporting needle hand), it will induce pain because as the needle is pulled up, it will also cause the skin to pull up. Hence, Cheng Dan’an has modified the technique to make it easier for the practitioner who only uses sashide 刺手 (inserting needle hand). However, although De Qi can be felt this way, shinmyo 鍼妙 (mysterious acupuncture sensation) cannot be felt. It can be said that the treatment effect is not even half of what can be obtained through the Japanese techniques.
※Shingo Yamamoto is one of the members who edited the foundational textbook of acupuncture and moxibustion from the end of the Meiji period to the Taisho period.
⑦ Trembling technique 振顫術 (Jp. shinsen jyutsu)
After needle insertion, it is manipulated by slightly moving up and down as if it is trembling, scratching the needle handle with nails several times, or lightly tapping with the index finger many times and swaying the top of the needle handle. This is an immediate activation method 興奮法 mostly used for patients with unrelaxed blood vessels, muscles, and nerves. This technique is for 1. activation needle method 興奮針法 and 3. reflection needle method 反射針法.
(Dr. Seino’s commentary)
Also written as shinsen jyutsu 震顫術, ryushi jyutsu 留指術or saishin jyutsu 細振術. The technique involves grasping the needle body or handle, which had already been inserted to a certain depth, with the thumb and index finger of sashide 刺手 (supporting needle hand) and tremble sashide 刺手to tremble the needle. When grasping the needle body, touching the thumb and index finger of oshide 押手 (supporting needle hand) with the thumb and index finger of sashide 刺手 will help tremble rhythmically. Trembling by grasping the needle handle allows for a weak trembling effect. Also, there are other methods such as flicking the needle handle with a finger or tapping with a guide tube.
It is clear that Cheng Dan’an made a technique to induce a large impact on the needle to obtain De Qi (one of shinkyo 鍼響 vibrational acupuncture sensations). Since thick needles are used, the manipulation technique is very different from Japan. In fact, it is a rough and coarse technique. The technique in Japan involves carefully inserting a thin and soft needle into the body and the sensation felt during the needle manipulation is very sensitive and delicate. Valuing shinmyo 鍼妙 (mysterious acupuncture sensation) will greatly expand the scope of medical conditions one can treat. Practitioners who only use thick and hard needles will never be able to understand this sensation. This method is a combination of chisho jyutsu 地升術, tenun jyutsu 天運術, ryutokan jyutsu 竜頭管術, ryuto jyutsu 竜頭術 from the Sugiyama Shinden style.
⑧ Random needle technique 乱針術 (Jp. ranshin jyutsu)
After inserting the needle to a certain depth, immediately pull up the needle to the level underneath the skin, insert the needle again, fast or slow, forward or backwards, left or right, and deeply insert the needle in any way with the discretion of the practitioner, which will become a strong stimulation. This method is used for induction 誘導 or relieving congestion or stagnation of blood. This technique is for 4. induction needle method 誘導針法.
(Dr. Seino’s commentary)
Also known as ranshi jyutsu 乱刺術, ranshi ho 乱刺法, kyochoku ho 強直法. This method is from the Sugiyama Shinden style. This technique uses several different types of techniques without following a specific procedure and induces a strong stimulation – this technique does not have any rule. Since a thick and hard needle is easy to manipulate, if one’s objective is to merely induce a strong stimulation, then this would be the perfect technique. In Japan, there are many techniques which allow for free needle manipulation such as the rotation technique 回旋術, shisen teni ho 針尖転移法, shishin tenko ho 刺鍼転向法. In order to freely handle and manipulate the needle, the practitioner must be able to sense and feel the condition of the tissue where the needle is inserted. This sensation is indeed, shinmyo 鍼妙 (mysterious acupuncture sensation). If the practitioner is performing random/rebelling/disordered needling 乱針 and failing to sense the patient’s sensitive small change, the patient who dislikes the feeling of De Qi will think that the practitioner has gone mad 乱心 (random/rebelling/disordered mind). This means that even for a technique that involves a random directional change of the needle, a firm skill and technique are required.That is all for 8 techniques that were introduced by Cheng Dan’an. The names of 8 techniques are the same as the 17 techniques that are currently being taught in Japan. Although the technique is similar to the ones in Japan, since the techniques do not generally involve oshide 押手 (supporting needle hand), the treatment effect is limited.