SHIATSU

Nathaniel Whitmore

PART ONE THEORY

I. General Theory
A. Chi
B. Tao
II. Yin-Yang
A.
B.
C.
D.
E.

Tai Chi Tu
Yin-Yang Correspondences
The Six Divisions
Seven Principles of Yin and Yang
Twelve Theorems of Yin and Yang

III. Five Elements

A. Elements as Symbols of Energy
B. The Five Element Correspondences
C. The Control and Nourish Cycles of
the Five Elements
IV. Five Fundamental Substances
A. Chi
B. Blood
C. Jing
D. Shen
E. Fluids
V. The Twelve Organs
A. Spleen and Stomach
B. Lung and Large Intestine
C. Kidney and Bladder
D. Liver and Gall Bladder
E. Heart and Small Intestine
F. Heart Governor and Triple Burner
VI. Meridians and Points
A. Conception and Governing Vessels
B. Spleen and Stomach
C. Lung and Large Intestine
D. Kidney and Bladder
E. Liver and Gall Bladder
F. Heart and Small Intestine
G. Heart Governor and Triple Heater
H. Twelve General Points
I. Bo Points
J. Yu Points
K. Points for Common Complaints
VII. Assessment
A. Observation
B. Questioning
C. Palpitation
VIII. Pathology
A. The Five Pathogenic Conditions
B. Diet
C. The Seven Emotions

D. Defensive Chi

PART TWO TREATMENT

IX. Aim of Treatment
A. Centering Hara
B. Balancing Meridians
C. Balancing Kyo & Jitsu
D. Balancing the Five Elements
X. Technique
A. Hara
B. Finger Pressure
C. Additional Technique
D. Tonification and Sedation
XI. 50 Minute Routine
A. Supine Position
B. Prone Position
C. Kneeling or Sitting
XII. 75 Minute Routine
A. Supine Position
B. Prone Position
C. Kneeling or Sitting
XIII. 100 Minute Routine
A. Assessment
B. Supine Position
C. Prone Position
D. Kneeling or Sitting
E. Finishing Supine Position

PART THREE HISTORY

XIV.

Origins of Modern Shiatsu

A. Tenpaku Temai
B. Tokujiro Namikoshi

XV.

Chinese Medicine
A. Shamanism & Folk Medicine
B. Traditional Chinese Medicine
C. Tadashi Izawa

XVI.

Macrobiotic Shiatsu
A. Shizuko Yamamoto

XVII.

Endless Mountains Shiatsu

A. Ohashi

XVIII. Zen Shiatsu, Etc.

A. Shizuto Masunaga

I. General Theory
A. Chi - Qi / Ki / Energy / Vital Force
Shiatsu is energy work, not massage. Shiatsu treats the body based on the recognition
that everything is energy.
If ones energy, or chi, is abundant and free-flowing then there is health. If the energy is
deficient or stagnant then there is a lack of health. These two main imbalances are seen
as the underlying causes of ill health.
There is significant discussion on whether or not chi exists. For the shiatsu practitioner,
as for the acupuncturist and Chinese herbalist, this is not a question. As with other Asian
arts, overly intellectual approaches are self-defeating when approaching shiatsu.
Consider Masunagas style name of zen shiatsu. Zen is often defined as the direct
experience of truth satori. Satori (enlightenment) is not found through the intellect, but
must be experienced directly, as is well-known in zen tradition. However, if one does
seek rational explanation (rather than diving in out of blind faith), it should not be hard to
understand that there is a vital energy that governs the process of life.
From the Great Mystery we have been given life. Chi fills the body and mind and
intelligently rules the vital functions. From the beating of the heart, to secretion of tears,
to regulation of blood sugar, to immunity chi knows how to perform infinite
processes of life. Just think if the conscious mind had to release the right amount of bile
for digestion and keep the heart beating at just the right rate! When considered this way,
it is no small miracle that we are alive at all. Why should it be so difficult to assume that
chi exists?

B. Tao Way / Path

Shiatsu is as much of an art as it is a science, or more so. In shiatsu, the practitioner must
learn the meridians and the points (tsubos), and the various techniques used to encourage
the balanced flow of energy through the points. Once all such technicalities are
understood, the shiatsu student learns how to use the hara to guide the act of giving
shiatsu.
The hara is the abdomen in a general sense, and is a particular point just below the navel
in a specific sense. The hara is considered to be the center of the body, both physically
and energetically. In martial arts (including chi gung and tai chi), dance, and shiatsu,
practitioners learn to make every movement from the hara. The martial artist does not
learn to break bricks using mere physical strength, but learns to cultivate chi and to guide
movement with the hara. In shiatsu we do not look to hurt anyone, and we care little
about breaking bricks. But we do want to have our sessions be as powerful as possible.

Rather than just pushing points, therefore, we use our hara so that healing chi is used to
apply pressure to the points.
I have noticed that the feedback I receive from shiatsu clients directly corresponds to how
centered in my hara I am when giving shiatsu. The more centered I am and the more
each movement comes from the hara, the better I feel while giving shiatsu and the better
the feedback is from those who received shiatsu.
The Tao is important regarding shiatsu because giving a good shiatsu session depends on
being tuned in to yourself, your client, and healing energy. There is a way to do shiatsu
that makes it powerful. Remember, shiatsu is intended to be therapeutic. The aim is to
move stagnant energy and nourish deficient energy, which is to say in a more general
sense that the aim of shiatsu is to balance energy.
When giving shiatsu, imagine yourself being in tune with a higher power and with
healing energy. Imagine yourself in communication with your client. And imagine
yourself nourishing and moving energy.

II. Yin-Yang
A. Tai Chi Tu The Yin-Yang Diagram

B. Primary Yin-Yang Correspondences

Yin: The Dark Side of the Mountain
Yang: The Sunny Side of the Mountain

Heaven
Earth

Female
Male

C. The Six Divisions (The Eight Principles)

Yin:
Yang:

Cold
Hot

Deficiency
Excess

Interior (Chronic)
Exterior (Acute)

D. Seven Principles of Yin and Yang

1.
2.
3.
4.
5.
6.
7.

One Unity is the source of Yin and Yang in infinite manifestations.

Everything changes.
Everything is interrelated.
Nothing is identical.
What has a front has a back.
The bigger the front, the bigger the back.
What has a beginning has an end.

Water
Fire

E. The Twelve Theorems of Yin and Yang

1. Yin and Yang are the two poles of infinity.
2. Yin and Yang are produced infinitely.
3. Yin is centrifugal; Yang is centripetal. Yin, centrifugal, produces expansion, lightness,
cold, etc. Yang, centripetal, produces constriction, weight, heat, light, etc.
4. Yin attracts Yang, Yang attracts Yin.
5. All things and phenomena are composed of Yin and Yang in different proportions.
6. All things and phenomena are constantly changing their Yin and Yang components.
Everything is restless.
7. There is nothing completely Yin or completely Yang. All is relative.
8. There is nothing neuter. There is always Yin or Yang in excess.
9. Affinity, or force of attraction between things, is proportional to the difference of Yin
and Yang (potency) in them.
10. Yin expels Yin; Yang expels Yang. Expulsion or attraction between two things Yin or
Yang is in inverse proportion to the difference of their Yin or Yang force.
11. Yin produces Yang, Yang produces Yin at the extremity.
12. Everything is Yang at its center and Yin at its periphery.

III. Five Elements

A. Elements as Symbols of Energy
Most, if not all, indigenous cultures used the elements of nature to symbolize aspects of
life and qualities of energy. Following are some examples. The Chinese Five Elements
are used in shiatsu. Sometimes the terms phases or transformations are used instead
of the word elements because they indicate a more dynamic, alive quality rather than a
static image.
Chinese:
Japanese:
East Indian:
Tibetan:
Greek:
English:
Early American:
Native American:
African:

Five Elements:
Five Elements:
Five Elements:
Five Elements:
Four Elements:
Four Elements:
Four Elements:
Four Elements:
Five Elements:

Wood/Tree, Fire, Earth/Soil, Metal, & Water

Earth, Water, Fire, Air, & Heaven
Earth, Water, Fire, Air, & Ether
Earth, Water, Fire, Air, & Space/Ether
Earth, Water, Fire, & Air
Earth, Water, Fire, & Air
Earth, Water, Fire, & Air
Earth, Water, Fire, & Air/Wood
Earth, Water, Fire, Mineral, & Nature

B. The Five Element Correspondences

Aspect:
Wood:
DirectionUpward
Cardinal Dir.- East

Fire:
Outward
South

Earth:
Downward
Center

Metal:
Inward
West

Water:
Floating
North

SeasonSpring
Summer
Life StageBirth
Early Adult
Plant Growth- Sprout
Flower
Solid Organ- Liver
Heart
Hollow Organ-Gall Bladder Small Int.
TissueTendonVesselsMuscle
OrificeEye
Mouth
SenseSight
Touch
Part of Face- Mid. Brow
Nose
PathologyWind
Heat
FoodsSprouts
Leaves
TasteSour
Bitter
ColorGreen
Red
Pos. Emotion- Patience
Joy
Neg. Emotion-Anger
Anxiety
DiseasesJaundice
Hypertension
Gall Stones High Chol.
Shaking
Poor Circ.

Indian Sum. Autumn

Winter
Adult
Elder
Death
Seed
Root
Dormancy
Spleen
Lung
Kidney
Stomach
Large Int.
Bladder
Skin
Bone
Mouth
Nose
Ear
Taste
Smell
Hearing
TongueCheeks
Under Eyes
Dampness
Dryness
Cold
Grains
Roots
Beans
Sweet
Pungent
Salty
Yellow
White
Blue
Love
Courage
Calmness
Worry
Grief
Fear
Hypoglycemia Cough
L. Back Ache
Diabetes
Constipation Fatigue
Bleeding
Skin Disease Reprod. Issue
Digestive Ill.
Growth Prob.
C. The Control and Nourish Cycles of the Five Elements
The Nourish Cycle:
Wood nourishes Fire > Fire nourishes Earth > Earth nourishes Metal >
Metal nourishes Water> Water nourishes Wood
The Control Cycle
Wood controls Earth > Earth controls Water > Water controls Fire >
Fire controls Metal > Metal controls Wood

The control and nourishing cycles help to explain the interconnectedness of the meridians
and body functions of the Five Elements theory. When one element is out of balance, it
often corresponds to related imbalances in other elements.
Although the star shaped diagram is a visually balanced representation of the elements,
the realities of element imbalances are quite dynamic. Each element has its own
tendencies for imbalance. The water element, for instance, tends to suffer from
deficiency, while wood tends to suffer from excess.

IV. Five Fundamental Substances

A. Chi
Sources of Chi: parents, air, food, environment, thoughts
Chi Deficiency: lack of chi in general or a chi def. associated with a particular meridian
Chi is particularly associated with the kidneys, the lungs, and the spleen.

B. Blood
Blood provides nourishment. Blood deficiency often occurs with Chi deficiency and is
the result of poor diet. Nutrient dense foods are emphasized to correct the condition.
C. Jing Reproductive Energy / Reproductive Fluids
Jing is responsible for reproduction / procreation. At the moment of conception one
receives a certain amount of jing from the parents. It is difficult to nourish the jing
through life; it is mostly supplemented by nourishing chi.
Jing controls growth and development, and dwindles with age. Unhealthy lifestyle
practices, stress, and the like deplete jing. Longevity practices are aimed at nourishing
and protecting the jing.
Jing is associated with the kidneys.
D. Shen Spirit
Shen is the spirit or the mind. Mental and emotional imbalances are considered to be
disturbed shen.
Shen is associated with the heart.
E. Fluids
The body Fluids nourish and lubricate the body. Often called yin, the fluids are the
cooling principle of the body. Yin Deficiency refers to dryness, or the lack of fluids.
Fluids are associated with the Kidneys and the Earth element.
Fluids are symbolized by the element water (yin), which is in a complementary and
antagonistic relationship with fire (yang). Fire dries water, while water puts out fire
they keep the other quality in check. Too much fire results in inflammatory disease. Too
much water results in diseases of dampness.

V. The Twelve Organs

A. Spleen and Stomach
The spleen (and pancreas) is associated with the digestive system, the blood and lymph,
and the energy of the center and of holding. The stomach is responsible for encasing
food during one of the initial stages of digestion. The spleen and stomach are very
important for digestion and pathologies associated with the spleen and stomach often
involve digestive problems, such as dampness of the spleen.

B. Lung and Large Intestine

The lungs and large intestines both gather and disperse. The large intestine gathers water
from the chyme and releases stool. The lungs gather fresh air and release what the body
does not need. The lungs are very important for the gathering of chi from the air.
C. Kidney and Bladder
The kidneys are associated with the reproductive system and ones constitutional energy,
in addition to their well-known function of filtering blood and creating urine. Many
alternative therapies focus on cleansing the kidneys, but in Oriental medicine, the
kidneys are nourished in order to promote health and longevity.
D. Liver and Gall Bladder
The liver works very hard to filter the blood, constantly breaking down toxins and
nutrients. It often becomes overworked and stagnant, creating liver heat. The gall
bladder stores and releases bile, which is produced by the liver in order to eliminate
cholesterol and produce a substance that will emulsify fats in digestion.
E. Heart and Small Intestine
The heart and small intestine disperse nutrients throughout the body. The heart works
very hard and is damaged by yin and susceptible to heat. The small intestine relates to
digestion.
F. Heart Governor and Triple Heater
The heart governor is associated with circulation. The triple heater is the metabolism of
the body and chi. The three burners are the three energy centers of the body- the lower
abdomen (the place of the hara), the upper abdomen, and the chest.
The heart governor is also known as the heart constrictor or the pericardium.

VI. Meridians and Tsubos

A. Conception Vessel and Governing Vessel
The conception vessel travels from the point just in front of the anus (CV1) to the mouth.
The governing vessel travels from the mouth, up over the head, down the back, and to the
point just in front of the anus.
CV3, CV4, and other points in the lower abdomen are treated for menstrual problems.

Several bo points are located along the conception vessel (see below). CV3 is the bladder
bo point, CV4 is small intestine, CV5 is triple heater, CV12 is stomach, CV14 is heart,
and CV17 is heart governor.
GV20 is an important point that corresponds with the crown chakra.
B. Spleen and Stomach
The spleen meridian travels from the big toe, up the inside of the leg, to the abdomen.
The stomach meridian travels from just below the eye, down the front of the body, and
branches before the 2nd and 3rd toes.
SP6 (three yin meeting point) is a very important point for menstrual problems and
other problems relating to the spleen energy. SP10 is also important.
ST36 is an important point for fatigue and stomach energy in general.
C. Lung and Large Intestine
The lung meridian travels from the chest to the thumb.
The large intestine meridian travels from the index finger to the nostrils.
LG1, LG2, LG10, and LG11 are all especially important for treating lung diseases.
LI4 is important for constipation and other large intestine imbalances, and for headaches.
LI20 helps to open the sinuses and lungs.
D. Kidney and Bladder
The kidney meridian starts behind the ball of the foot (KD1, bubbling spring), travels
up the leg, up in front of the torso and along the sternum.
The bladder meridian starts at the inside corners of the eyes, travels up over the head and
down the neck, divides into two branches that run down the sides of the spine and back of
the legs, reconnects at the knees, continues down the back of the legs, along the dises of
the feet, to the pinky toe.
KD1 is a very important point for kidney problems and fatigue. KD3, KD5, KD8, and
KD 10 are also very important.
The bladder points along the spine, called Yu points, are very important (see below).
BL13 corresponds to the lungs, BL14 to the heart governor, BL15 to the heart, BL16 to
the governing vessel, BL17 to blood, BL18 to the liver, BL19 to the gall bladder, BL20 to
the spleen, BL21 to the stomach, BL22 to the triple burner, BL23 to the kidneys, BL24 to
chi, BL25 to the large intestine, BL27 to the small intestines, and BL28 to the bladder.
BL1, BL2, BL36, BL40, and BL67 are also important points.
E. Liver and Gall Bladder
The liver meridian starts at the big toes and travels up the shin and inside of the leg to the
abdomen.
The gall bladder meridian starts at the temples, zig-zags down the sides of the head and
body, and continues down the sides of the legs to the fourth toes.
LV2 and LV3 are important points.

GB1, GB2, GB20, GB21, GB30, GB34, GB40, and GB44 are important points. GB20
and GB21 are important for stiff neck, wind invasions, and sinus congestion; and are
contraindicated for pregnancy.
F. Heart and Small Intestine
The heart meridian starts in the armpits and travels to the little finger.
The small intestine meridian starts at the little finger and travels up the back of the arm,
over the scapula, and to the area in front of the ear.
HT1 is an important point for shoulder problems.
SI3, SI10, SI11, SI14, and SI19 are important points. SI10 and SI11 are very good for
shoulder and upper back discomfort.
G. Heart Governor and Triple Heater
The heart governor meridian starts parallel to the nipple and runs along the arm to the
middle finger.
The triple heater meridian starts on the back of the ring finger and travels along the arm,
up over the ear, to the end of the eyebrow.
HG1 and HG8 are important points for the heart and cirulation.
TH17, TH21, and TH23 are important points. Be careful treating TH17.
H. Twelve general points (LI4, ST36, SP6, SI10, BL40/54, GB20, GB21, GB30, LV3,
CV4, CV17, GV20)
LI4 union valley ~ good for constipation, headaches, fatigue, wind invasion, et cetera
ST36 leg three li ~ good for ST and SP disorders, and for fatigue
SP6 three yin meeting point ~ good for SP disorders and menstrual disorders,
especially stagnation. Contraindicated for pregnancy.
SI10 upper arm shu ~ good for shoulder problems
BL40/54 bend middle ~ good for low back, leg, and knee pain and for BL disorders
GB20 wind pond ~ good for internal and external wind, including stiff neck
GB21 shoulder well ~ good for internal and external wind and shoulder problems
Contraindicated during pregnancy. Used to promote labor.
GB30 jumping round ~ good for sciatica, back pain, and arthritis
LV3 great surge ~ good for LV disorders, digestive disorders, eyesight, et cetera
CV4 origin pass ~ good for menstrual disorders. Bo (or Mu) point for SI.
CV17 chest center ~ good for HT and LG disorders. Bo point for HG.
GV20 hundred convergences ~ good for headaches and internal wind
I. Bo Points
Bo points are also known as mu points, gathering points, alarm points, or
collecting points. They are generally located on the abdomen and chest. Many are
located along the conception vessel.

The liver bo point is LV14, gall bladder is GB24, heart is CV 14, small intestine is CV4,
heart governor is CV17, triple heater is CV5, spleen is LV13, stomach is CV12, lung is
LG1, large intestine is ST 25, kidney is GB25, and bladder is CV3. In general, the bo
points are in the location of the associated organ.
Assessment and treatment of the bo points located on the abdomen (and sides) can be
integrated into hara work.
J. Yu Points
Yu points are also known as shu points, associated points, or back transporting
points. They are located along the bladder meridian. (The location and association of
each point is listed above under the description of the bladder meridian.)
The yu points are very important. They are treated for localized back pain/soreness and
for problems associated with the associated meridian. Upper back problems are often in
the area of the lung, heart, or heart governor yu points. The soreness, tension, or
weakness of the area may be associated with problems of the lungs or heart. Likewise,
lower back problems are often associated with the kidneys or the intestines.
Look to other areas of assessment to confirm problem assessment in the yu points- hara,
facial, verbal complaints, etc. For example, if there is generalized soreness in the lower
back (a very common problem), you might also find that the kidney yu point (BL23) is
especially sensitive, the lower hara is kyo, the client has circles under their eyes, and that
kidney 1 and 10 are also sensitive.
When a problem is discovered in a yu point it is often beneficial to treat the meridian of
the associated organ. This is especially true when there are other reasons to suspect an
imbalance in that aspect of the body.
K. Points for Common Complaints
Shoulder problems can be treated with LI15, GB20, GB21, SI9, SI10, SI11, SI12, SI13,
SI14, SM15, BL13, BL14, and BL15.
Lower back problems can be treated with BL23, BL28, BL40, BL60, and KD1.
Digestive problems can be treated with ST36, SP6, LI4, BL18, BL19, BL20, and BL21.
Menstrual problems can be treated with SP6, KD1, BL23, BL28, CV3, CV4, and CV5.

VII. Assessment
A. Observation

In shiatsu, much importance is placed on observation as it relates to understanding the

clients energy. The face, the body and posture, movement, and the tongue can all be
visually observed in order to provide clues to ones constitution and condition.
Facial diagnosis is one of the first interactions between practitioner and client. Sadness
or happiness can be seen in the face, as can the condition of the inner organs. In facial
diagnosis redness indicates heat; paleness indicates cold and deficiency; and purple, blue,
or green indicate stagnation. The heart is reflected on the nose, the lungs on the cheeks
and around the nostrils, the kidneys under the eyes and in the ears, the intestines on the
lips and on the forehead, the liver between the eyebrows and in the eyes, the spleen on
the cheeks and the bridge of the nose , and the gall bladder on the temples. When there is
little time for assessment before a treatment, facial diagnosis could be particularly
helpful.
Tongue diagnosis is an important form of assessment. The tongue especially reflects the
digestive system and the heart. Looking at the tongue is like looking inside the body- it is
very revealing. If the tongue is swollen (often indicated by tooth marks), has thick
moss (the coating), and/or is covered by lots of saliva it indicates dampness. If it is
thin, dry, and without moss it indicates dryness. Redness indicates heat and paleness
indicates cold and deficiency. Cracks and indents indicate deficiency. Red spots indicate
heat. Yellow moss indicates heat. The heart is reflected in the tip of the tongue, the lungs
just behind the tip, the spleen in the middle, the kidneys on the back, and the liver on the
sides.
B. Questioning
Much information can be gained through questioning. Voice tone, pace, volume, et cetera
are important indicators of the clients condition. Questions relating to illness, lifestyle,
diet, and the like are very important. Questions about heat and cold are important (does
the client like hot or cold weather, et cetera). Simply asking your client how the
temperature in the room feels often reveals much about their condition, as they will often
make comments like, I am always cold. or I dont like it hot.
Sometimes there is not much time for questioning. It is most important to know if there
are any conditions (including medications, recent surgeries, or recent injuries) that would
make certain techniques inappropriate, and if there are any problem areas that could use
special attention (such as tight shoulders). Since shiatsu is a therapy that takes into
consideration the whole picture of a clients health, more extensive questioning than what
is mentioned above can be helpful.
(In TCM listening and questioning are two distinct forms of assessment. Together with
observation and palpitation, they create The Four Pillars of Diagnosis.)
C. Palpitation
There is a saying that in shiatsu treatment is diagnosis and diagnosis is treatment.
When certain points are sensitive, it indicates certain imbalances. Also, lumps, rashes

and other palpable imbalances can provide important information towards understanding
your clients underlying imbalances.
Pulse diagnosis is often the main form of assessment used by acupuncturists. The
various pulse qualities and their indications are numerous, but the basics can be
understood very easily. There are three positions to read the pulse on each wrist, and
three depths at each position. A pulse that is fast, strong, and close to the surface
indicates heat. A pulse that is slow, deep, and thin indicates cold and deficiency. From
the wrist to the elbow on the left hand is reflected the heart, liver, and kidney yin; on the
right hand is the lung, spleen, and kidney yang.
Hara (abdominal) diagnosis is perhaps the most important form of assessment in shiatsu.
The shiatsu session starts with the hara both for diagnosis and for centering. Starting the
session with your hand on your clients hara, you can calm and center yourself through
deep breathing and can sink your energy into your hara. Sinking into your hara is very
important because the shiatsu technique should come from the hara. During hara
diagnosis, the practitioner and client are hara to hara. Assessment and treatment,
therefore, can happen on a deeper level, with ones being rather than just understanding
on a mental level.
In general, the upper hara reflects the upper burner, the center hara reflects the middle
burner, and the lower hara reflects the lower burner. Specific areas on the hara also
reflect the condition of specific meridians. The specific hara point is in the lower
abdomen, 2 finger widths below the navel.
When palpitating the hara the practitioner feels for two qualities in particular, called jitsu
and kyo. Jitsu is yang. It is excess, stagnation, or hyperactivity of the meridian. Kyo is
depletion of energy or hypoactivity of the meridian. In general shiatsu is balancing for
the meridian, but special techniques can be used to sedate a jitsu condition or nourish a
kyo condition.
When the condition is jitsu, shiatsu technique should be somewhat quicker and perhaps
deeper. This causes the energy to disperse. People who tend toward jitsu conditions tend
to be able to tolerate more pressure and benefit from it. Often, people suffer from
hardness in the upper hara. This shows that the bodys center is off balance, probably due
to excess thinking, dwelling on grief or other emotions, or the lack of physical activity.
The energy is excess in the upper burner do to a lifestyle that is oriented more towards
thinking and emotional realms. In this case the chi should be brought down.
In the case of kyo, shiatsu technique should be slower as holding points longer is more
nourishing. Kyo people tend to be more sensitive. Treatment can still be deep, but the
practitioner should be more careful when applying pressure.

VIII. Pathology

A. The Five Pathogenic Conditions

Heat Yang; inflammation
Cold Yin; lack of movement, circulation, and/or energy
Dry Yang; lack of Fluids (yin), or the result of Heat
Damp Stagnation of Fluids; typically due to Yang Def. or Cold
Wind Movement, occurs with other pathologies; Internal and External Wind
Assessment is organized by the concept of the Six Divisions or the Eight Principles:
Yin:
Cold
Deficiency
Interior (Chronic)
(Damp)
Yang:
Heat
Excess
Exterior (Acute)
(Dry)
Wind occurs with other pathologies (cold, heat, damp, or dry) and is either of an interior
or exterior nature. Interior wind is usually due to liver imbalance.
B. Diet
The health or lack of health of ones being is nourished by diet. Diet includes food, of
course, along with other sources of energy such as air and vibrations from the
environment. If a persons diet is warming, then diseases of heat will result. If the diet is
cold, then diseases of hypofunction, dampness, and deficiency will result.
C. The Seven Emotions
The seven emotions are joy, anxiety, anger, pensiveness, grief, fear, and fright. Joy is
obviously a healthy state. As a pathology, excess joy (overexcitement) damages the
heart. Anxiety also harms the heart, as well as the lungs. Anger (and frustration) are the
result of liver stagnation and heat. Pensiveness (along with worry, indecisiveness, and
the like) is associated with the spleen. Grief (and sadness) is related to the lungs. Fear is
related to the kidneys. Fright is related to the heart and damages the kidneys.
In the case of emotional imbalances, the associated meridian(s) should be treated.
D. Defensive Chi
Defensive chi (wei chi) is associated with the immune system. Wei chi defends the
system against diseases of an external nature. In herbal medicine diaphoretics (surface
relieving herbs, or herbs that promote sweating) are used to boost defensive chi at the
onset of colds and fevers. Since external pathogens enter the back of the neck, GB20 and
GB21 are particularly beneficial for external illnesses. LG1 can also be very helpful. In
general the lung meridian should be treated, and probably the spleen and kidney
meridians also.

IX. Aim of Treatment

A. Centering Hara
The ultimate aim of a shiatsu session is to settle a person into their hara.
B. Balancing Meridians
Shiatsu encourages a balanced flow of energy through the body.
C. Balancing Kyo & Jitsu
Balancing energy involves encouraging energy to flow through meridians that are
underactive (kyo) and sedating meridians that are overactive (jitsu).
D. Balancing the Five Elements
If a certain element is out of balance associated meridians are treated.

X. Technique
A. Hara
All movement should come from the hara. Pressure is not applied merely with the
muscular strength of the arms or fingers, but flows from the hara. This quality of
treatment is transferred to the recipient and encourages their energy to gather in the hara.
B. Finger Pressure
Finger pressure is the quintessential technique of shiatsu (it is, after all, what the name
means). The principle is to apply pressure perpendicular to the body. This allows the
whole body or the hara to be behind the pressure.
C. Additional Technique
Pressure can be applied with the palms, fist, elbows, knees, and feet. In order to move
energy and open up the meridians, shaking, tapping, rotating, massage, stretching, and a
variety of other techniques can be used. Palm healing fits very nicely in a shiatsu session
when there is enough time and it seems appropriate. Generally palm healing, or reiki, is
not a major part of a 50 minute session, but longer sessions can include a significant
amount of palm healing work.
D. Tonification and Sedation
Tonification is used for kyo. When meridians are weak and deficient they benefit from
tonification, which is a slower, deeper style. Sedation is used for meridians that are
overactive (jitsu).