The History of Shiatsu

The History of Shiatsu

By Lynn Kirk 

Although Shiatsu is a form of therapy uniquely Japanese, its roots date back to ancient Chinese philosophical ideas. The oldest text available – The Yellow Emperor’s Classic of Internal Medicine (Han Dynasty 206 BC-AD 25) gives us an inkling of how medicine and philosophy were tied together at that time. The text is a series of dialogues between Emperor Huang Ti, and his physician/minister, Ch’i Po. The emphasis is on how the environment and geography affect one’s health.

Four Classical approaches to medicine were developed in specific geographical regions:

  • In the South, where it was warmer, lots of vegetation grew, making herbal remedies readily available. 
  • The coldness of the North fostered moxibustion, which is the burning of mugwort on acupuncture points. 
  • In the East where the diet was based on fish and salt, stomach ulcers were a problem. This condition responded well to the stone flint needling of precise points on the body (acupuncture)
  • In the Centre of China, many physical techniques, such as massage, breathing, and exercises evolved. The aim was to be in touch with the Tao – the flow of life – “the Way” – the Source of undifferentiated energy.

Around the 6th Century AD, monks brought a combination of Buddhism, Taoism, and Confucianism from China to Japan. Trading opened up communication between China and Japan, and in the 7th Century, a delegation of Japanese students was sent to China by the Prince, to study Chinese medicine and culture.

During the period of Japanese history when the country was under the rule of powerful warlords, martial arts became especially important. At this time resuscitation techniques of Jujitsu proved indispensable to revive martial arts students who had been knocked unconscious while sparring. The techniques consisted of striking vital points.

A form of massage called Anma evolved during the Edo Period (1602-1868) in Japan. This therapy was mainly performed by the blind. Unfortunately, because the means were not available to the blind to receive much education, their medical knowledge was not up to the level of Doctors and Herbalists at the time. Thus, the Anma practitioners fell behind in their knowledge, and Anma came to have a reputation of only being useful for relaxation.

It wasn’t until the early part of the twentieth century that Shiatsu itself was developed. The originator was Tamai Tempaku, who published a book called Shiatsu Ho (finger pressure method) in 1919. His book combined Anma, Ampuku (an ancient form of abdominal massage used in pregnancy and childbirth), and Do-In (therapeutic exercises), with Western anatomy and physiology.

In the Taisho Period (1911-1925) Shiatsu was defined for the first time under the Shiatsu Law. In 1955, Shiatsu was legally approved as part of Anma massage. In 1957, the Japan Shiatsu School was officially licensed by the Minister of Health and Welfare, and in 1964, Shiatsu was finally recognized as a therapy in its own right, as distinct from Swedish Massage and Anma. To this day these three different therapies are regulated under one law in Japan. Today Shiatsu is fully incorporated into the Japanese Health Care System.

To understand the political struggle for the recognition of Shiatsu in Japan, it is necessary to explain the effects the U.S. Occupational Forces had when they took over the country in 1945. A directive was issued to ban all traditional therapies. Thus ensued an extended legal battle by practitioners of Acupuncture, Moxibustion, and Shiatsu, to have their rights to practice re-instated. Practitioners had to water down the traditional principles behind their practices and define their work in Western medical terms, in order to legitimize their therapies to the Powers that Be. Naturally, this compromise took its toll and it may help to explain the divergence of techniques practiced today worldwide under the umbrella of “Shiatsu Therapy.”

It is important at this stage to discuss the enormous contributions to the evolution of Shiatsu made by three Japanese individuals during the twentieth century. These men were:

  • Tokujiro Namikoshi
  • Shizuto Masunaga and
  • Katsusuke Serizawa.

Tokujiro Namikoshi

Tokujiro Namikoshi discovered his system of Shiatsu through trial and error, as a growing boy on Hokkaido, a northern Japanese island his family moved to when he was very young (1905). Due to the climate’s extremes, his mother developed arthritis in her knee which developed into rheumatoid arthritis of many of her joints. The children took turns helping their mother as there was no doctor available. Tokujiro’s hands “felt best” to his mother, and he slowly discovered his treatments were more effective if he increased his ratio of pressing to rubbing techniques. Eventually, her body healed itself. Later Tokujiro was to realize that by pressing on the muscles on either side of the middle region of her spine, he was stimulating the adrenal glands to produce cortisol, the cure for rheumatism!

Tokujiro opened the Shiatsu Institute of Therapy on Hokkaido, in 1925, after completing his studies of Anma and Western massage. He left the school in Hokkaido under the supervision of some of his students in 1933 and went to Tokyo to form a Shiatsu school there. It took several years and the cooperation of others, but by 1940 he opened the Japan Shiatsu Institute in Tokyo. Two years after Shiatsu was legally approved as part of Anma, in 1957, the school was legally licensed by the Minister of Health and Welfare, under the new name, the Japan Shiatsu School. This School proved to be very successful. Tokujiro’s son Toru spent seven years teaching Shiatsu in Europe and the US, contributing greatly to its worldwide expansion.

The Namikoshi style of Shiatsu involves a very thorough whole-body treatment, but perhaps due to Tokujiro’s focus on getting Shiatsu legally recognized in Japan by appealing to Western medical theories, he does not incorporate meridian theory into his style. His style requires a thorough knowledge of the musculoskeletal structure of the body, and the nervous system, emphasizing neuro-muscular points.

Shizuto Masunaga

In the latter part of the twentieth century, Shizuto Masunaga brought Shiatsu back to its Eastern roots, emphasizing meridians and the Five Element theory. He was a student of Western psychology and Chinese medicine, very interested in the spiritual, psychological, and emotional aspects of individuals. This led to his creation of Zen Shiatsu reflecting the simple and direct approach to Spirituality exhibited by Japanese Buddhist monks. Zen Shiatsu introduced a diagnostic system known as Kyo/Jitsu, which explains energy imbalances in meridians, according to deficiencies (Kyo) and excesses (Jitsu). It also introduces the Makko-Ho exercises, which are specially designed exercises to help individuals correct imbalances in the flow of Ki energy through their own meridian systems. Masunaga opened the Iokai Shiatsu Centre in Tokyo.

Masunaga also developed a form of abdominal diagnosis known as Hara diagnosis, and he extended the traditional acupuncture meridians to include some supplementary meridians. After his death, his work has been carried on, not only in Japan but also in Europe and the US. His sensitivity towards all the ways of working with Ki has made this style of Shiatsu very popular worldwide.

Katsusuke Serizawa

The third noteworthy figure in the development of Shiatsu in this century is Katsusuke Serizawa, who concentrated on the Tsubos (effective points on the meridians). He was able to prove the existence of Tsubos using modern electrical measurements of the skin. He called his system Tsubo therapy and advocated the use of any kind of stimulation of the Tsubos, from moxibustion to acupuncture or acupressure. A style of Shiatsu known as Acupressure Shiatsu is a Western derivative of Tsubo Therapy.

There are many modern off-shoots of these three main forms. Each form combines components of these traditional styles in one way or another. What the methods all have in common is the manipulation of Ki, and all the methods involve “leaning” in one way or another to apply Shiatsu to the body.

  • Namikoshi (or Nippon Shiatsu), the form most often found in Japan – Whole body routine, incorporating stretches. Emphasis more on points than meridians. Can be vigorous.
  • Zen Shiatsu – Emphasis more on meridians. Can be vigorous or gentle. Intuition and connecting with client’s Ki is important.
  • Healing Shiatsu – Meditation, the emphasis tends to be gentle (similar to Zen).
  • Shiatsu-Do – More stretches and movement than in Zen. Vigorous/dynamic.
  • Movement Shiatsu – Works with the meridian system incorporating light pressure on points, gentle manipulations, and guided movement to bring awareness to energy patterns in the body and to resolve inner conflicts.


  • Beresford-Cooke, Carola, Albright, Peter, MD, Acupressure, Macmillan, New York, 1996
  • Cowmeadow, Oliver, The Art Of Shiatsu, Element Books, Ltd., Great Britain, 1992
  • Liechti, Elaine, Health Essentials – Shiatsu, Element Books, Ltd., Great Britain, 1992
  • Liechti, Elaine, The Complete Illustrated Guide to Shiatsu, Element Books, Ltd., Great Britain, 1998
  • Lundberg, Paul, The Book of Shiatsu
  • Namikoshi, Toru, The Complete Book of Shiatsu Therapy, Japan Publications, Inc., New York, 1994