Tales of 100 treatments: Stories of Zen Shiatsu

By Shizuto Masunaga

It is a collection of 58 articles published in the 70-80s in the Japanese magazine “Ningen-Igaku” (Human Medicine). Here there are some lines written by the author in the preface:
“Western medicine scientifically studies abstract phenomena according to disease name. However, even if a same disease name is given, from the Oriental medicine perspective,I often keenly feel that precise treatment is impossible if you do not consider how patients with similar symptoms might differ in constitution, personality, and environment,which involves very different disease mechanisms and required responses. It occurred to me that people might benefit from reading my impressions of practical experience in those kinds of clinical cases”.
These stories are autobiographical and deal intensely with the idea and philosophy of Keiraku shiatsu from the point of view and lifestyle adopted by Masunaga sensei. In this volume, not only he describes the treatments and modalities specific of Iokai, but also the strategy of therapy and the causes of illness, selecting important cases from his own experience.
The contents of this book are still relevant and useful for the growth of all shiatsu practitioners/teachers and are very important to perform the treatments considering sho (oriental diagnosis) and kyo and jitsu according to the indications of Shizuto Masunaga.

• Language: English
• Publisher: SHIATSU MILANO EDITORE
• Release date: Jun 10, 2021
• ISBN: 9791280253064

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子供の足

1

A Child’s Foot

After returning from the army at the end of the war, I went to university while helping my parents’ busy practice. That was the start of my devotion to shiatsu, which has lasted thirty years. I had no intention of staking my youth on the elderly and the sick. I had only sought to help my parents’ business to overcome postwar hardships, and would have attempted running away at any opportunity. However, I was always stopped in my tracks, stopping me from reaching another world. In the end it was decided that I would spend my life in service to sick people. Now I am grateful for being given such a mission. In telling what my life has taught me through giving treatments, I would like to begin with a story about a child’s foot.

Just the other day, a mother came by carrying her four-year-old son on her back for treatment of foot pain. When I asked him to try walking, he tiptoed on his left foot and limped. His Achilles tendon cramped, and his heel could not reach the ground. I said, He probably likes sweets. His mother replied, He doesn’t eat a lot of sweets. An abdominal examination revealed tightness in the liver and peering into his mouth I could see all his teeth were decayed. When I said, Good heavens! He eats too much chocolate, his mother replied, Yes, he loves chocolate and eats it every day.

The bitter aftertaste of chocolate leads some people to thinking that it is not sweet. Many mothers think it is good to feed lots of chocolate to their children because it is nutritious like eggs. There are even doctors who suggest its consumption. So, when I warn about the dangers of sugar, I’m met with distrust and a questioning look. I have convinced some people by asking them to read an article in Ningen Igaku (Human Medicine) from some years ago that clearly states such dangers. I’ve made much use of that issue, and I’d like the article to be repeatedly published.

When I said, His condition won’t improve unless you stop giving him chocolate, she anxiously replied, Can he stop eating something that he likes to eat all the time? So, I informed her, If you explain to a child why something is harmful, then they will surely stop when you ask them to.

That was my experience over many years. When I explain to a mother, her child sits quietly and listens. The next time they come, it is usual for the mother to say with surprise, My child stopped eating it since our last visit. When I praise a child by saying, How smart. You listened well, even small children say proudly, I won’t eat it.

When the mother and son came the following week, I examined his abdomen and found the liver swelling had completely subsided. Since my son stopped eating chocolate, the rest of the family also stopped, because we don’t want to eat it behind his back, the mother said happily. The boy was still limping the day after his first visit, but the following day he was hopping around and playing. Associating Achilles tendon cramping with weak liver is common sense in traditional Oriental medicine. Western doctors do not understand that.

Another child diagnosed with polio, who had received an orthopedic massage for a year, had a distorted ankle joint due to weak liver. That child also recovered thanks to shiatsu and a change in diet. Children are simple and spontaneous, they aren’t born with physiological and emotional issues. I believe parents are the ones who cause such imbalances. Massaging only a leg tendon or removing the part which is cramped as a cure is the reductionist approach of Western medicine who only observe the affected area. By observing a child’s foot, you can see the imbalances in the parents’ lifestyle. A child might limp as a way of shining light on the parents’ lifestyle. The way you walk reflects the way you live, and I have been taught that illness goes away when we are able to properly reflect on that.

股関節脱臼

2

Hip Joint Dislocation

There is a doctor who started a campaign to spread awareness about how most hip joint dislocations are caused by putting diapers on in a way that straightens a child’s legs too much, making it difficult to move. That is an interesting way of thinking. He said, Children are naturally bowlegged, and their hips dislocate when parents try to forcefully straighten their legs. Mothers should put diapers on loosely even if they leak a little, without making the child conform to the parents’ idea of convenience. I completely agree. More than among mothers, this urgently needs to be thoroughly spread among nurses at maternity hospitals and people involved in the business side of diapers. It offers many points worth considering to provide relief for children with hip dislocations.

Most hip dislocations heal if they are discovered early and placed in a cast. So some communities wisely (?) conduct group examinations all at once where they can diagnose and treat every case in this manner, even including those open to doubt. However, the treatment takes at least two to three months of daily hospital visits for massage and setting the legs in bowlegged position. In some cases, using a plaster cast makes it difficult for the child to sleep on a bed, so every night the mother has to hold the child while he sleeps. Patients have come to me who were surprised at being told that surgery was necessary after almost a year of the treatment was ineffective.

Just as limiting a child’s movement with diapers is not good, it is also not appropriate to use forceful corrections in treatment. When parents are threateningly told that their child will have a limp for life if they do not comply, they reluctantly endure such ascetic treatments even when the child resists. It is natural that a child whose hip is predisposed to dislocating or has already dislocated will have a limp if they receive no treatment. Even so, immobilizing a child is not the only way.

When I opened my clinic in Tokyo seven years ago, my first patient was a one-and-a-half-year-old girl who had been recommended surgery. Since wearing a band for more than a year had been ineffective, the doctor declared that she had no choice except surgery. Surgery was postponed, and she came to me twice a week for treatment. For the first month she wore a band but afterwards the band was removed, and before six months had passed, she started walking. Now she is healthy and attending school.

My view is that hip dislocation is caused by insufficient joint support due to imbalance of meridians from the abdomen to the lower body. Most patients have gastrointestinal problems, are prone to diarrhea, and are light eaters. Immobilizing their legs makes their GI system even more prone to issues. Conventional diagnosis says that hip dislocation is the cause of inability to spread the legs outwards. However, if the meridians from abdomen to legs are blocked, it is natural for children to resist spreading their legs.

By keeping contact with the abdomen while giving shiatsu to the legs, your fingers can feel the stiffness of cramped muscles. The trick is to not press, but instead let your fingers have a warming and loosening effect. If you loosen the cramp, the stomach and intestines will function better. Therefore, the child will no longer resist spreading their legs. I told the mother with a son diagnosed with polio but whose legs improved that I have successfully treated many patients with that method. When I told her this, she asked me to treat his sister that she was carrying. The girl was in a plaster cast but the mother removed the cast herself. I was told that the decision was made after discussing it over with her husband.

Humans walk with both legs to make their parents’ gait into their own and develop self-reliance. A child’s hip dislocation is often thought to reflect increasing conflict between the parents. I think the recent increase of these types of patients is a reflection of society. We should not try to cure these diseases by only looking at the mechanical condition of bones, but instead consider methods of treatment that start from realizing the meaning of living humans’ legs.

腰痛

3

Lower-back Pain

Recently there are many patients with lower-back pain.

In the past, we used to say lower-back pain in the forties, frozen shoulder in the fifties, and it was considered as a consequence of aging. Nowadays, however, this condition is no longer confined to the old, but can even effect younger individuals.

Moreover, the name lower-back pain includes all sorts of symptoms so, unless we pay close attention to the patient’s specific condition, it is difficult to get to the bottom of the problem.

Lower-back pain can affect the area between the tenth thoracic vertebrae to the coccyx. Furthermore, there are many different kinds of pain: the vertebrae and/or the ribs, the pelvis to the muscles, the subcutaneous induration, sciatic nerve, and visceral reflex.

The causes of lower-back discomfort can vary considerably: sudden back strain from trying to lift up a heavy object in an awkward position; spraining or receiving a blow from slipping or falling from the stairs; some people are able to walk but feel pain when sitting down or standing up; other individuals have no problem when moving but start to feel pain after standing still for an extended period of time; the pain sometimes depends on the position in which one is sitting in; pain can manifest itself when starting to walk but passes after having engaged in the movement; etc. All these above are considered lower-back pain.

However, all these cases are diagnosed by doctors as either a displaced disk or a sciatic neuralgia. Often, they do not even inquire about details of the condition nor try to feel the painful area, but they diagnose the disease based on what they see on the X-ray.

At the department of internal medicine, they give injections or administer medicine. At the orthopedics, the main treatment consists of traction or a plaster cast, and it is not unusual to repeatedly go in and out of the hospital for several months.

This has caused an increase in therapists and unofficial remedies, but unfortunately these cures don’t allow a complete diagnosis; these therapies consist in treating individuals in an identical manner without considering their precise condition in a whole.

The chiropractic approach, for example, often consists in examination of bone structure, but it doesn’t fully consider the nature of the lower-back pain.

Acupuncture and moxibustion, or osteopathy are also methods that merely have the goal of resolving the pain.

Before asking doesn’t the treatment for the lower-back pain consist of relieving the lower-back from its pain?, I would like you to listen to what I have to say.

There is a hairdresser next to my clinic in Ginza.

They asked me to examine one of their customers who had just slipped in front of their salon and seemed to be unable to walk.

I automatically assumed that the person had simply hurt her hip bone and made her lie down on one of the hairdresser’s beds and examined her lower-back.

Touching her around the meridians from the pelvis to the legs, I noticed that she was stiff all over.

I tried to loosen and relax the stiff areas thinking that that must have been the reason why such a small fall had caused so much damage. I then, however, noticed that she had no strength whatsoever in her left leg: I then realized she had fractured the head of her femur.

While calling the hospital, I noticed cold sweat trickling down my neck.

Worried, I returned to my clinic and I then received a phone call from the hospital doctor, who congratulated me on my choice of treatment. I was so relieved that I hadn’t made an embarrassment of myself!

In the case of lower-back pain, these kinds of episodes can often occur.

It’s true that nowadays people don’t put enough care into exercising their legs, and use of ‘seiza’ (traditional Japanese sitting position, which literally means ‘to sit correctly’, in which one kneels on both legs) has led to a general weakening of the lower limbs, among individuals and particularly the Japanese.

These habits have caused people of all ages to suffer from lower-back pain, and despite being caused by the slightest odd movement, sometimes lead to sever discomfort.

Moreover, we continuously resort to medication even for treating mild symptoms such as cold, abnormal blood pressure, or indigestion. These medications often ‘hide’ the symptoms related to lower-back pain, keeping us from getting to the root of the problem.

In Japan, the lower-back is considered to be a crucial area for being able to perform all movements. In Japan it’s called a 要(kanamè), rather a point from which all movement originates. The ideogram represents the act of a woman who puts a traditional Japanese belt around her hips. The pivot of a folding fan corresponds precisely to this letter. This area needs to be taken care of, as it is very important. The hip (koshi), and also the neck (kubi) are kanamè: crucial areas for the control of the body’s movements.

This means that root of lower-back pain is not necessarily caused by the lower-back itself.

When one observes patients with lower-back pain, their symptoms and causes vary. The treatment also differs accordingly, but it becomes obvious that all depends on the patient’s lifestyle, eating and drinking habits, stress, and excessive physical exercise.

Therefore, I often say to patients: You are probably thinking that if it wasn’t for this lower-back pain, you would be able to work much more, or you’d like to get rid of the pain as soon as possible in order to be able to work normally, and are fed up with suffering. That is utter nonsense. If you had not suffered from lower-back pain, you would have continued to put yourself under excessive stress, until you ended up coming down with something serious. My hands can feel clearly that your internal organs have reached its limits. You should be grateful for this lower-back pain. This is God ordering you to take some rest so that you can reflect on your own conduct. That is why you must not try to take away the pain in haste. Once your body has regained its strength, and distortion in your life has been eliminated, the lower-back pain will subside, and you’ll start to feel fit and healthy again. I give this kind of treatment.

First, for lower-back pain one must not forget the golden rule to treat the abdomen with the utmost care.

The stiffness or contortion of the muscles which support the hip from the back could sometimes be the cause, but this is merely a part of the lower-back.

It is said that lower-back pain is the consequence of two legs supporting the hips and sustaining the upper part of the body. However, if this is so, then all humankind should suffer from lower-back pain.

The necessary structure must already be in place in order for a man to stand and walk on two legs.

The principal parts of this structure are iliopsoas muscle, psoas major muscle which are attached from the lumber spine to ventral region and on to interior part of the legs. When these muscles are contorted or get a cramp, the whole physical posture goes haywire.

We must take note that these muscle group associating with the abdominal internal organs enormously affect lower-back pain. For the lower-back pain, one must first treat the abdomen with the utmost care.

五十肩

4

Frozen Shoulder

The saying fourties’ lower-back has disappeared since the range of people that suffer from lower-back pain has widened. However, frozen shoulder in the fifties is so well known for its peculiar symptoms that the word is thought as an official medical terminology. Apparently, the academically correct name of the ailment is scapulohumeral periarthritis, but its symptoms have specific age-oriented characteristics. In the case of athletes, one can have shoulder joint troubles due to an occupational overexertion. However, other cases have no clear acute cause. The shoulder movement deteriorates without the individual knowing, and they start to feel a sharp pain shooting down their when performing basic movements. This is when one really started feeling the effects of aging.

Another peculiarity is that normal daily movement is not particularly challenging. Somebody can simply have difficulties putting on a jacket or trying to reach for something positioned high up. Common treatments such as shots or massages have almost no effect. Doctors sometimes just say coldly It will heal itself naturally within half-a-year to a year. The fact is, in several cases, the pain heals naturally without one even realizing it.

Why on earth do we suffer from such an ailment? Since the cause is not clear, we tend to put it down to one’s age. This is why calling it 50 Year Shoulder seems to be ideal. Among all the joints in the human body, the shoulder joint allows the largest range of motion. It can move in almost all directions. That explains why Japanese expressions like the hands can reach wherever there is an itch it can take care of almost anything perfectly." are probably expressing the almost ‘unlimited’ movement of the shoulder joint. However, people today no longer lead a life that requires such extensive movement of the arms.

Most of day-to-day work consists of meticulous tasks which just require finger tips, so we seldom need to perform big movements with our shoulders. We may occasionally swing our arms in circles, but this does not still use the maximum capacity of the shoulder movement. It is surprising to notice how large our shoulders can rotate when we use tools or hold onto something.

Just as machines become rusty when we don’t use them, organisms also have something called atrophy. It is a tendency of an organ (most often muscles) to lose its proper function and weakens when it is not used. When we lead a routine lifestyle and have a steady fixed job, the only kind of physical activity we do as we grow old is limited hand movements. As a consequence, other movements become harder to perform – an example consists in the stiffening of the shoulder. Moreover, interestingly toothache is closely related to upper limb nerves and inflammation of the gums also affects the arms without one being aware. Since tired eyes are also closely linked to hand and finger movements, they also contribute to stiff arms and shoulders.

Since the shoulder joint has a large range of motion, its structure is quite complex. Therefore, the subluxation of this joint is extremely difficult to diagnose.

However, if you lay a patient down on his back, the shoulder with the problem does not touch the ground. Even if it is not visually obvious, if you gently push down both shoulders and try to make them touch the ground at the same time, the patient may feel the pain in one of the shoulders.

This will allow us to tell the difference between the two shoulder joints. The back is supported by the shoulder blades, and these tend to roll forwards (inwardly); the patient will have a kind of ‘closed’, slouched posture.

Moreover, there are cases where the misalignment of the spine causes the back slouch, and this keeps the chest from bending backward. As a result, the shoulders are pushed forward.

In this case, forced correction of the shoulder joint and the massage of the affected tendon, with the goal of loosening up the the stiff area with shiatsu, and performing forced exercise to prevent the contracture of the shoulder joint are all methods that should not be used. If we were to use aggressive treatments, inducing intense pain to the patient, we’d cause them excessive psychological stress, and they’d tense up even more, making treatment even more difficult.

We must not consider frozen shoulder as a mere aging process of the shoulder joint. Taking a closer look at the kyo/jitsu of the meridians around the shoulder joint, we’d find that the patient has unbalances in their life caused by internal organ issues. In other words, the origin of the problem is clearly identified as coming from an ill state of the organs. Patients who complain only about shoulder pain and are practically unaware of the ailing organs, wish only to stop the arm hurting and to be able to move it again as soon as possible.

From our point of view, we perceive that the shoulder pain is an opportunity to closely examine the organs in their entirety. However, it is very difficult to convince the patient of this fact.

There is a Japanese expression te ga mawaranai, which means that something is more than one can handle. It implies that one is too busy and there are many tasks which cannot be dealt with. Among busy people, it’s common to find many of them with frozen shoulder problems. If I say, You have suffered from the frozen shoulder because you have difficult jobs that are more than you can handle. So, this means that you must take some time off and rest., it is easier for the patients to understand.

Occasionally, there are people who mutter to themselves Just because you force too much work on me, doesn’t mean I can handle all of it. They are expressing psychological frozen shoulders.

Also, sometimes, people who are selfish, who only think of themselves, and who don’t bother to help other people, could suffer from frozen shoulder.

In either case, in my view the correlation between amount of work/ stress and this ailment mustn’t be overlooked, and we can conclude this chapter by saying that having too much to do, as emphasized by the Japanese saying not getting around to doing something, can be a possible cause of shoulder pain.

胃潰瘍

5

Stomach Ulcer

Among job-related acquaintances or at job-related gatherings, there are many occasions to drink alcohol. When somebody gets into the habit of drinking, it can happen that they’ll continue on drinking again and again. While young, this may not be so much of a problem owing to physical strength and fervor of youth. However, as we become older, towards middle age, responsibility and accumulating stress start to pile on, followed by complicated human relationships, and people start to experience stomach pain before and after meals. This is the typical premonitory symptom of a stomach ulcer. Among these individuals, some are not aware of any apparent symptoms until all of a sudden, they vomit blood or have an acid flux. They end up being hospitalized for and must undergo an operation. On the other hand, however, others start to have pain at a regular interval after meals. In those cases, we can presumably identify the location of the formation of the ulcer.

There was a person who took a long bath before and after meals, and before going to bed. As this decreased the pain, he continued to drink. After a while, he ended up having black stool, and this caused him to rush to hospital in panic.

After examination, he was told that it was certainly an ulcer, but probably it is not yet necessary to have an operation. One of his colleagues who had already had the same problems advised him to do the operation, that way he could carry on drinking like before, without worrying about the stomach ulcer.

Feeling fed up with the constant pain that plagued him daily, he started thinking that perhaps if he underwent the operation, he would feel better and have peace of mind.

When a family member of his told me a story, I was shocked: nobody likes to be put under the knife, but maybe this was just due to the Japanese’s slightly impatient way of being.

However, if one suffers from constant pain, or if one is told that their condition may lead to cancer or that it may lead to serious illness with a possibly fatal outcome, one may choose to remove the stomach completely.

The surgical standard of the Japanese who are skillful with their fingers are among the best in the world, and many live a normal healthy life after the surgical operation. So, instead of continuing medical treatment which requires a lot of time, it may seem reasonable to have an operation right away.

Many doctors easily recommend surgical operations by telling how minorly invasive and simple it is. There are also doctors who will assert that it will not heal without cutting it off. It disappoints me to think that this kind of medical climate has taken root.

The fact that the stomach could be removed so easily could imply that it’s not crucial for survival, but even the heart, nowadays, can be transplanted or helped by a proper system (i.e. dialysis). So, is it better to undergo a surgical operation and so get rid of the problem, rather than having to live with a potential time bomb such as gastric perforation or peritonitis? Of course, if someone no longer has a stomach, they won’t have the problem of getting a stomach ulcer, but then, according to this logic, we could so that if one dies, they can’t fall ill: this doesn’t seem to me like a logical way of thinking.

There are people who have recovered well after having removed their tonsils, the appendix, or their stomach. This is probably due to the fact that the operation caused such a shock to the body that it changed certain physiological mechanisms; the most logical explanation is that the patient made significant changes in their lifestyle, obtaining results that are merely the consequence of these changes.

Cutting open and sewing up a living body will never be something positive in somebody’s life. Not to mention that a surgical operation invented by human beings will never provide full benefits to the quality of life. I don’t have a stomach, so I can drink as much as I want, is a completely illogical way of thinking. Excessive amounts of alcohol or stress can literally cause the formation of holes in the stomach, but that doesn’t seem to matter to some people – they’re just happy they can carry on drinking. Moreover, the next organ to ‘fail’ after the stomach will be an important organ that cannot be removed, and it will be impossible to recover without making drastic lifestyle changes.

People who get better with the operation are those who can become even healthier without surgery if they decide to put in as much time, effort, and limits into their lifestyle. A stomach ulcer is said to be caused by gastric acid, but the real cause lies exactly with the fact that there is an anomaly of the stomach lining, which is usually quite strong.

Excessive stress on the stomach, imbalance of the autonomic nervous system, insufficient blood circulation to the stomach lining, all of these things are the result of bad lifestyle habits. Furthermore, disturbance of acid-base balance in the blood due to diet and psychological condition also have a huge effect. By ignoring all these problems, whatever the method we use to stop the ulcer, the organism is in no way out of danger since the ulcer is not the only disease that exists.

Even by just performing shiatsu in an appropriate manner, there are cases of advanced state of ulcer which improve and the bleeding stops. This does not mean that shiatsu is a miraculous technique, rather the individual possesses an extraordinary capacity and predisposition to recover. The view that there is nothing to be done once the gastric lining is perforated, is a materialistic view sustained by scientists who examine it as a permanent state using X-rays and a gastro-camera.

We must not forget that we as human beings we are living organisms, not just some observable, static object. We’re active, dynamic beings, with spirit within. We aren’t to be confused with an object that can be simply analyzed. We should perhaps realize that that alive spirit within us, through the ulcer, is trying to warn us about something, that it’d be absurd to remove a piece of ourselves just so we could carry on drinking.

After having listened to this story, the family member said she will talk it over with the person in question. However, I guessed that probably the patient would go through with the operation, nonetheless. Most likely the cause wasn’t just work stress, but also stress at home with the family, with whom he didn’t feel entirely comfortable, and for this reason carried on drinking. If a patient isn’t confident that they’ll recover, it’s pointless: that’s why I believed it was highly unlikely that the family will be able to persuade him not to have the operation, and change his mind.

I later on discovered that he underwent the operation and that he returned to work quite content; the root of his problems, however, had not been solved at all.

胃下垂

6

Gastroptosis

The patient didn’t have particularly serious symptoms, but his doctor, after examined the x-ray of his patient, told him that his stomach had been moved down to his pelvis. I have often been consulted by disheartened patients about this problem, asking me whether the stomach will ever move back up to where it’s supposed. When I examined the abdomen, his stomach muscles were weak and hollow, almost shaped like a ship’s bottom. Furthermore, his expression lacked vitality, almost as if he was carrying the weight of his stomach sinking down to his pelvis. He seemed to be troubled more by the expression hanging down than the stomach discomfort. He asked me I suppose with such a stomach I have to eat food that is easy to digest and must lie down after meals while the food moves toward the intestine? He must have been told so by the doctor, this seemed logical, given the position of the stomach.

There are doctors who say "Gastroptosis I-no-chi¹ should not even be considered an illness given that a significant percentage of the Japanese population suffer from this condition." However, it mustn’t be pleasant being diagnosed with this condition. To make matters worse, the type of person who often gets gastroptosis is someone who gets easily nervous and who tends to brood over things. For this reason, we can imagine the possibility of that person having a nervous breakdown on the account of the diagnosis given. If this is not an illness, then rather than give such a diagnosis, it is much more beneficial for the patient to be informed of the possible methods to make the stomach stronger.

Sometimes it seems like exams and medicinal visits, in Western medicine, are useful only to the doctor, and that the ultimate aim of diagnosis is that to acquire points for insurance.

We say, stomach is emotion. As this saying goes, the fact that the stomach directly reflects our emotions can be confirmed by observing the patient whose stomach is having issues. There are old sayings such as The stomach may be the root of all kinds of illnesses. or Blood from the stomach is life. This should be of no surprise if we reflect that life cannot continue if food, which is what nourishes us, is not digested in the stomach. Stomach conditions are easily noticed, so it makes a good criterion for evaluating a person’s state of health.

A scientist pointed out that if we observe the way animals obtain food, we’d see how they exercise strenuously in order to capture their prey. After eating their quarry, they tend to rest until they get hungry again. Humans, however, do the exact opposite in their life. Many workers skip breakfast and begin to feel exhausted already when having to deal with morning traffic, or get stressed