Japanese Acupuncture Needling Techniques - Intradermal (Hinaishin) and Press Tacks (Empishin)

Japanese Theory

Japanese Acupuncture Needling Techniques - Intradermal (Hinaishin) and Press Tacks (Empishin)

Intradermal acupuncture needles (Hinaishin) and press tack needles (empishin) are used within Japanese Acupuncture treatments. The information presented below discusses basic theory behind the technique, guidelines for applying the technique and examples of clinical use. Some of the techniques listed here require significant amounts of training to be performed correctly and should only be performed by practitioners who have been trained properly.

  • General Information:
  • Hinaishin - intradermal
  • Come in many different lengths (3-8 mm) as well as metal types (gold, silver, steel)
  • Generally more tonifying - mild and slow tonification of wei qi
  • Empishin - press tack
  • Generally more sedating
  • Simply to apply, just press into the desired point
  • Intradermal Information:
  • Look for induration(s)
  • Mark the area with a pen, teishin, etc.
  • Insert following the creases of the body (for patient comfort during movement)
  • Use 3mm on the ear, hands, T7 and up, near joints and on the face
  • Use 6mm on the upper thigh and arm, T8 and down on the back
  • On the back, follow the Urinary Bladder meridian
  • On the lower back/waist, insert horizontally (for patient comfort during flexion/extension)
  • Generally for tonification, insert intradermal with channel flow
  • Intradermal Technique:
  • Mark the point
  • Pull the skin back, place the intradermal on the skin, release the skin allowing the needle to go into the skin
  • Once inserted, press down on the handle and make sure you can see the tip of the needle raising the skin up
  • Do not insert more than halfway
  • After insertion, place the pillow tape under the head of the needle (this avoids stimulating the entire area)
  • Place the cover tape over the head of the needle (this allows removal by pulling the tape from the tip to the handle of the needle)
  • Instruct patient to remove instradermal after 3-4 days - less if they sweat considerably, exercise a/or during hot weather
  • Specific Treatments:
  • Navel or Jing Treatment:
  • Similar to the whole body treatments w/moxa
  • Useful with autoimmune disorders, fibromyalgia, a/or KD deficient patients
  • Insert 8 intradermals towards the navel, 2 at KD 16 and then at points roughly the same distance from each other surrounding the navel
  • Retain for 10-20 minutes depending on the condition and your treatment plan
  • This can be a root treatment
  • This is an office treatment only, do not send the patient home with these in
  • Scar Treatments
  • Use the "turtle method" (head, tail, 2 arms, 2 legs) around the scar inserting the intradermals underneath the scar tissue
  • Depending on the area of the scar, these needles may left in after the treatment
  • Dr. Manaka's Isophasal Treatments:
  • General treatment method using intradermals on 3 points of the body - 2 microsystems (scalp, ear, hand) and 1 body point
  • Kobe Akabane - Akabane Testing
  • Whole body treatment using Okyu & intradermals
  • Diagnose using the points of the fingers and toes by running a stick of incense from the tip of the nail to the jing well points, going across the nail
  • Count the number of the strokes across the nail required to elicit a response (i.e. the patient feels heat after 10 times across the nail)
  • Fill out the following form to come up with an appropriate treatment:
Channel R L TOT DEV Channel R L TOT DEV
SP LU 10 25 35 15
LV LI 25 17 42 8
  • * Anything above 5-10 is normal - above 10 is deficient & below 5 is excess
    * A deviation over 10 is the channel or channels you would want to treat using the back shu points
    * On the chosen channel(s) you want to moxa the deficient side (above 10 - Left LU) and use an intradermal on the excess side (below 5 - Right LU)
  • Use 5-7 rounds of Okyu (i.e. the patient feels heat 5-7 times, which may be 5-100 or more applications)
  • Retain intradermals for 30 minutes (the length of the treatment)
  • General Kobe Akabane Treatments:
  • Asthma - LU 1, KD 25, KD 26, GB 21, UB 13 (LU Shu), dingchuan plus other related points
  • Toothache - sensitive points on the painful side at or near ST 5 a/or ST 7
  • Diarrhea - sensitive point at or near ST 27 uni- or bilaterally
  • Press Tack (empishin) Treatments:
  • Fullness in the epigastric area - insert up to 4 empishin, depending on reactivity, at CV 12, ST 20 a/or ST 21
  • Cystitis - reactive points at or near CV 3 & KD 12

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:

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

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