Tohaku Ishi Five Element Japanese Acupuncture Treatment Protocol

The Tohaku Ishi five element Japanese acupuncture protocol is part of our Circadian, or "Chinese Clock" treatment section. The circadian treatments are grounded in the same theory as the Five Phase and Extraordinary Vessel treatments.

tohaku ishi five element treatment abdominal presentation

  • General Information:
  • Theory by Tohaku Ishi
  • Good initial treatment
  • Use light touch and observation on the abdomen
  • If pulsing is felt all the way up to the Fire area, poorer prognosis

  • Diagnosis:
  • Light touch
  • Look for stasis, vascular spiders
  • Bloated a/or sunken areas
  • Temperature/texture differences
  • Tapping (use the middle finger on the joint of other middle finger on the abdomen) - empty/hollow sounds indicate deficiency.

  • Treatment:
  • Use the meridian time and hara diagnosis to choose 5 element point:

  • Example 1:
  • Patient comes in during Pericardium time
  • Patient has vascular spiders on the earth area
  • Treat the earth point on the pericardium meridian (PC 7)

  • Example 2:
  • Patient comes in during Heart time
  • Patient has a sunken Fire area
  • Treat the fire point on the fire meridian (HT 8)

Sources and More Information

The information on our site is drawn from our own lecture notes and clinical experience. The following lecture notes were used within this section:

  • Feldman, Marty: New England School of Acupuncture, Five Phase Techniques Lecture Notes
  • Iuliano, Diane: New England School of Acupuncture, Extraordinary Vessel Techniques Lecture Notes
  • Kuwahara, Koei: New England School of Acupuncture, Advanced Japanese Techniques Lecture Notes

For a complete list of valuable resources, see our Japanese Acupuncture Resources section. The most recommended texts are below:


cover of Hara Diagnosis: Reflections on the Sea cover of Chasing the Dragon's Tail: The Theory and Practice of Acupuncture in the Work of Yoshio Manaka cover of Extraordinary Vessels cover of Japanese Acupuncture: A Clinical Guide cover of Japanese Classical Acupuncture: Introduction to Meridian Therapy cover of Traditional Japanese Acupuncture: Fundamentals of Meridian Therapy