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Exploring the Roots of Shiatsu: From Do-in Ankyo to Modern-Day Therapy

Anpuku Zukai image from wikipedia

Shizuto Masunaga, Akinobu Kishi, and many contemporary shiatsu teachers relate to Anpuku as one of the manual arts that gave birth to the therapy that today we call shiatsu.

During ancient times, the practice called "Do-in Ankyo” born in India and developed in central Cina, arrived and spread among Japan including all the manual therapy arts like “Anma," Anpuku, "Do-in" exercises, and also healing techniques using medical herbs. The manual therapy was considered fundamental in traditional Japanese medicine; in particular in Japan, since the 10th century, the abdomen (hara) treatment known as Anpuku or Haratori has kept the most precious and important therapeutical features.

The current sum of Anpuku’s techniques was developed about 1000 years ago in Japan when Anma and Anpuku were given different definitions and characteristics. We first read about Anpuku in the book of a kanpo doctor called Todo Yoshimasu (1702-1773) who wrote about the importance of the abdomen treatment as a way of healing; consequently also Genetsu Kagawa (1700-1777) specialized in obstetrics was working as an Haratori therapist. Then we can find the book published in 1827 by Ota Shinsai titled “Anpuku Zukai” (The illustrated guide of abdomen treatment). The author revealed that the ancient techniques collected in that book helped him to fully recover from an illness that seemed impossible to heal.

Anpuku Zukai was translated into Italian by Tsuya Yamada and Manuela Perardi in 2019, while "Anpuku Zukai" and "Anma Tebiki" (written by Fujibayashi Ryohaku in 1835) have been translated into English and German and condensed into the text “Ampuku, Abdominal Acupressure, the classics at the heart of Japanese Bodywork” by Philippe Vandenabeele on 2020.

The ideograms of Anpuku 按腹 can be translated as “abdomen treatment” but if we analyze the etymology of these two kanjis we can understand that the first ideogram 按 An contains both the meaning of deep listening and healing (we can read the kanji like the hand that give peace or harmony).

The second one 腹 Fuku (the same kanji used for Hara) indicates the abdomen, where Hara is one of the essential concepts for the oriental tradition, going further from the anatomic concept of the word, but identifying the “center of the mind, body, and soul which itself synthesize and give the definition of humanity” (cit. Sei Ki - A. Kishi). Man is the only living being who stands between the sky and the earth: symbolically the legs represent our roots while the arms are the way we act in this world; Hara is exactly in between, between Yin and Yang, and is the place where this two opposites meets and are harmonized.

So Hara is the nucleus of our being and for this reason, showing the abdomen to the therapist is an extreme act of faith. “The Hara diagnosis (called Fuku-shin) through which we can read the abdomen of the patient consists in understanding the calling of the person who is trying to communicate to the doctor from the bottom of the soul without words, but explaining his or her discomfort by swelling the abdomen” (cit. Keiraku to shiatsu vol.2 - S. Masunaga).

Masunaga goes further saying that it is a privilege for the therapist to receive this honor and faith from the patient. So as we can understand the relationship between the therapist and the patient is the heart of the healing process, and by practicing Anpuku we can touch the center of the disharmony and understand the deepest origin of the illness to start the healing process.

The Hara treatment arrives deep in the soul of human beings, so of course we have to be very careful and respectful of the amazing being revealed to us through the touch. Normally, what the patient needs first is to be listened to and understood in his or her difficulties, and this can be only done through the deepest and most profound listening of body and soul. In this way, the person can discover diseases he or she was not conscious of having.

The Anpuku techniques illustrated by Shinsai Ota in the text in which we cured the translation from Japanese into Italian for the Italian edition, are easy to perform. This book was written not only for the therapists but for everyone. What is determining is the attitude of the therapist, who is supposed to be in a meditative mood, to be present, and to have a deep ability of perception: these make these simple manual techniques very effective.

As Shiatsu operators we can say that the 3 Treasures and the 13 Techniques developed in Shinsai Ota’s book are very useful and easy to integrate in a shiatsu session, we can choose among them the ones better for our receiver and for the disease we’re trying to cure. Anpuku is not only the treatment of the abdomen but is a method to work on the entire body holistically.

The 3 treasures for example are manual techniques useful to establish contact with the physical and energetic structure of our patient, preparing him or her to receive shiatsu pressure and to awaken in the person the perception of himself/herself as an entire spiritual and physical body. Among the 13 techniques, some are simple to adapt at opening or closing a session because they lead us to establish contact with the deepest part of the person, so allow us to enter very gently, “on tiptoe” we say in Italy, in the sphere of our patient.

Some techniques can be used to activate the abdomen's energy and to remove the superficial tensions; others can be used to treat specific diseases like for example stomach disharmony, intestine problems, anxiety and panic states, insomnia, female diseases, etc. Our trip in Anpuku started with the translation of the book by Shinsai Ota: we were involved by Roberto Palasciano who wanted to translate and publish this manual in Italy under the suggestion of Haruiko Masunaga, with the intent of discovering Shizuto Masunaga’s original shiatsu.

The purpose of understanding and performing the techniques shown in the text by few and sometimes enigmatic words and illustrations was fundamental to study the meaning hidden under the ideograms, and experience it helped by Tsuya Yamada; also the help of Toshi Ichikawa, who deepened and experimented for long time this book in its original version was valuable. In our experience as a shiatsu therapist, we can say that since we met Anpuku on our path our competencies as therapists were enriched and changed so much that all our sessions now contain it so we like to call Anpuku Shiatsu our way to performing shiatsu.


Akinobu Kishi – Sei-Ki life in resonance (ENG-ITA-FRA)

Shizuto Masunaga Keriaku to shiatsu – shiatsu e medicina orientale vol.1 e vol 2 – (ITA)

Shinsai Ota - Anpuku Zukai (ITA-FRA)

Philippe Vandenabeele – Ampuku, abdominal acupressure (ENG - DEU)

Ivan Bel – L'Esprit du Shiatsu Edition Edition Cariot d'Or (FRA)

The European Shiatsu Federation offers you a comprehensive list of Shiatsu book titles in many different languages. A valuable tool for all Shiatsu practitioners:


About The Authors:

Manuela Perardi:


I studied Asian Languages (Hindi, Pali, Sanskrit, and Japanese), Asian culture, and philosophy at Torino University, specializing in Japanese language at Ishikawa Japanese Center of Kanazawa (Japan). After winning a university scholarship, I kept perfecting my Japanese language at Kyoto University of Foreign Languages (Kyoto Gaikokugo Daigaku).

After returning to Italy, I put together the two most significant interests of my life: health and Asian culture. I studied Reflexology and Nutrition at Firenze Institute of Reflexology, (Istituto di Riflessologia di Firenze); and I studied as a Shiatsu Therapist at Shiatsu International School (Scuola Internazionale di Shiatsu Italia) in Milan where I also studied Shiatsu, Macrobiotics and Chinese Medicine. During my Shiatsu training, I had the pleasure and the honor to meet and attend seminars with Kumiko Kanayama Sensei, Haruiko Masunaga Sensei, Toshi Ichikawa Sensei, and Ivan Bell.

In 2018, I began my collaboration with Shiatsu Milano Editore Publisher, translating books from Japanese into Italian. I already collaborated with the translation of Shinsai Ota's Anpuku Zukai, a book about the treatment and diagnosis of the abdomen, written in 1827, and the 1st volume of Shizuto Masunaga's Keiraku to Shiatsu. In July I completed the translation of Keiraku to Shiatsu, and in September the 2nd Volume has been published.

Together with the Shiatsu Milano Editore Team, I teach classes explaining the abdominal treatment and diagnosis described in Anpuku Zukai through the meanings of Japanese ideograms. I believe that to enter Shiatsu profoundly, it is fundamental to learn it through the analysis of the ideograms, which hold the philosophy of Japanese culture and medicine. I co-founded a Japanese Cultural Association called Okami Kumo, located on the hillside of Biella. Okami Kumo intends to spread Japanese culture, medicine, and philosophy through classes and workgroups.

I've always paid attention to working with mind and body during my entire life, improving my self-evolution. I practiced Kung fu, Karate, Yoga, and Acro-yoga. I attended Bert Hellinger's Family Constellation groups, discovering the basic orders of life, which Hellinger called "Orders of Love". I've experimented with Rebirthing Therapy, a therapeutic technique used to revisit the trauma experienced during birth. For 12 years, I've been following a women's traditional Talking Circle, a sharing and introspection practice rooted in Ancient Native American teachings. For the last two years, I've attended seminars and master of Feng Shui, I-Ching, and Numerology to complete my formation on Asian culture.

Serena Trotti:

FB @serenatrotti

FB My name is Serena Trotti, I am 56 years old and I live between Milan and the mountains of Valtellina. Since I met shiatsu I cannot imagine my life without this wonderful art.

I Graduated in Shiatsu in 2011, and I have never stopped deepening it with the help of Italian and international masters. I have attended courses in Keiraku Shiatsu with Haruiko Masunaga Sensei, Certification The Five Lights Center with Kumiko Kanayama Sensei, several courses and deepening in Anpuku Zukai and Hara to Koshi with Toshi Ichikawa Sensei, intensive seminars with Ivan Bel in France and Italy. Sei-Ki shiatsu Heart Touch with Anthony Fidler; in-depth training in Traditional Chinese Medicine with Dr. R.Crepaldi. Master in therapeutic Feng-shui and quantum physics with Anton Gerona.

I have collaborated, with Manuela Perardi and Roberto Palasciano, on the edition of the book "Anpuku Zukai" by Shinsai Ota in Italian and the two volumes of "Keiraku to shiatsu," an Italian translation of Shizuto Masunaga Sensei's text.

I am an expert in Anpuku (the ancient Japanese art of abdominal treatment that I practice and teach)

Co-founder of Okami Kumo (Association for the Dissemination of Japanese Culture) based in Netro (Biella).

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Your thoughts remind me of Who Can Ride the Dragon. The experience of weaving philosophy and information with shiatsu technique. True inspiration.

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