In medieval Japan there were a lot of ideas about where disease came from. One text called the Harikikigaki written in 1568 talks about different types of microscopic creatures that are causative agents of disease. The text even describes them in intricate detail and gives color diagrams to show what they look like. Luckily, as bizarre and scary as these little creatures are, the Harikikigaki explains how they can be treated with either acupuncture or herbal medicines.
The theory that tiny fanciful and colorful animals cause disease in the human body was quite different from how the Chinese practiced acupuncture or herbal medicine. It also didn’t really last as a widely held medical belief into the modern period. However, there is an interesting lone hold out in modern Japanese acupuncture practice – the concept of Kan-no-mushi (疳の虫).
Kan-no-mushi originally was one type of microscopic creature that was thought to lodge itself in a victim’s spine. Today the word Kan (Gan in Chinese; 疳) in Asian medicine refers to a type of pediatric disease characterized by malnutrition due to digestive problems or parasites. In modern Japanese acupuncture this disease has also become an exclusive problem of early childhood. Even though we no longer think of the condition as actually being caused by microscopic animals, the term is used to describe functional problems. Young children are prone to a host of non-specific complaints such as mild digestive disturbance (although sometimes this can be more severe such as with colic), emotional upset or mood swings, a propensity to irritability, hyperactivity, and growing pains. These general and quite common discomforts of early childhood in Japanese acupuncture are all called Kan-no-mushi. Just as the original Kan-no-mushi was treated with acupuncture, so too in modern Japan childhood Kan-no-mushi is treated with acupuncture.
In China young children were rarely treated with acupuncture since needling is rarely tolerated in such young patients. Beginning several hundred years ago Chinese physicians developed a type of massage called pediatric tuina (小孩推拿). Even though massage is better tolerated than needling, sometimes even pediatric tuina can be a bit vigorous! In Japan physicians came up with an alternative strategy. Generally the Japanese are known for their very gentle approach to all acupuncture, so Japanese approaches are better tolerated by very young children. Starting about 400 years ago Japanese acupuncturists began experimenting with different forms of needles especially designed for kids. However, unlike normal needles, these pediatric “needles” are medical implements used to gently stimulate the surface of the child’s body by tapping, rubbing or pressing. In other words, they don’t pierce the surface of the body at all. This specialized approach to acupuncture is called Shonishin (小児鍼) in Japanese.
Shonishin is also quite different from conventional acupuncture in its basic approach to the body. Very young children are physically different from adults. The basic structure of their channels (the lines used in acupuncture treatment) is not completely formed, and certain organ systems internally are still in different states of maturity. Simply stated, because of this normal acupuncture is not as effective in very young patients. Shonishin’s unique approach starts by balancing the general circulation of Qi (Ki in Japanese), and then second addressing specific symptoms or complaints usually by stimulating zones of the body rather than very small acupuncture points. Most importantly, the therapist chooses these areas for treatment by actually touching the child’s body to feel subtle changes in temperature, texture or tonicity. These subtle changes are indicative of the imbalances that need treatment and guide the specifics of the treatment session. And one of Shonishin’s specialties is the treatment of Kan-no-mushi.