Seitai (Lymphatic) Shiatsu, Cupping and Gua Sha for a

Healthy Immune System

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First published in 2019
by Singing Dragon
an imprint of Jessica Kingsley Publishers
73 Collier Street
London N1 9BE, UK
and
400 Market Street, Suite 400
Philadelphia, PA 19106, USA
www.singingdragon.com
Copyright © Richard Gold 2019
Foreword copyright © Ted Kaptchuk 2019
Photograph copyright © Kenneth Goff 2019
Chapter 8 translation copyright © Kauko Uusoksa and Kayo Sakurai-Uusoksa 2019
All rights reserved. No part of this publication may be reproduced in any material form (including
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Library of Congress Cataloging in Publication Data
Names: Gold, Richard, author.
Title: Seitai (lymphatic) shiatsu : cupping and gua sha for supporting a
healthy immune system / Richard Gold ; foreword by Ted Kaptchuk ;
photographs by Kenneth Goff.
Description: London, UK ; Philadelphia, PA : Jessica Kingsley Publishers,
2019. | Includes bibliographical references.
Identifiers: LCCN 2018033349 | ISBN 9781848193642
Subjects: | MESH: Medicine, East Asian Traditional--methods | Lymphatic
System | Massage--methods | Acupuncture Therapy--methods
Classification: LCC RM721 | NLM WB 55.F3 | DDC 615.8/22--
dc23 LC record available at https://lccn.loc.gov/2018033349
British Library Cataloguing in Publication Data
A CIP catalogue record for this book is available from the British Library
ISBN 978 1 84819 364 2
eISBN 978 0 85701 323 1
 To my parents, siblings, wife, children and friends,
without whom I would be devoid of love and purpose.

To all my teachers, students and patients,

without whom I would remain empty of knowledge and skills.
 Contents

Foreword by Ted Kaptchuk . . . . . . . . . . . . . . . . . . . . . . . 9

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
1. The Lymph System: Our Silent Protector . . . . . . . . . . . . . . 19
2. Blood Formation According to the Theory of Traditional
Chinese Medicine (TCM) . . . . . . . . . . . . . . . . . . . . . . 23
3. Primacy of Abdominal Therapy (Ampuku), the Omentum
and Interstitium . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
4. A Step-by-Step Guide: Seitai Shiatsu . . . . . . . . . . . . . . . . . 32
5. Gua Sha . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
6. Cupping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
7. Introduction and Disclaimer in Regard to Sensei Kyoshi
Kato’s Treatise . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
8. In Search of New Medical Treatments: Towards a World
Revolution in Medical Science, Pharmacology and Dietetics . . . . 131
9. Additional Resources . . . . . . . . . . . . . . . . . . . . . . . . 169
10. Final Thoughts . . . . . . . . . . . . . . . . . . . . . . . . . . . 171

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
 Foreword

For over 40 years, Dr. Richard Gold has continued to be a pioneer in the Western
encounter with East Asian medicine. He is a fearless seeker who has never been
afraid to transgress disciplinary boundaries and use multiple perspectives to
mutually illuminate each other. He searches deeply.
Dr. Gold has studied with both mainstream practitioners and also with healers
who have transgressed normative boundaries. Dr. Gold’s teachers include Dr.
Tin Yau So (1911–2000), who is often credited with bringing acupuncture to
America. Dr. So was a leading student of Cheng Dan-an (1899–1957), who is
thought to have rescued Chinese acupuncture from superstition and oblivion in
the early 20th century by using modern anatomy to describe acupuncture points
and meridians. (In 1955, Dr. Cheng was the first Chinese doctor to be appointed
to the Chinese Academy of Sciences.) Perhaps at the other extreme, Dr. Gold
looked for nuggets of truth in the unorthodox and daring work of Sensei Kyoshi
Kato’s (1914–1991) approach of using shiatsu and diet to treat patients with
catastrophic and likely fatal illnesses. These two approaches and many other
healing perspectives situated somewhere in between—such as various forms of
traditional Chinese medicine and Japanese medicine, different Asian massage
traditions, Western psychology and critically examined biomedicine—shine
through and are synthesized in his new publication. The extensive and valuable
discussion of Gua Sha and cupping demonstrates Dr. Gold’s abilities to look at the
neglected margins for inspiration to enrich the mainstream.
Dr. Gold’s life work has been recurring cycles of academic learning, then
practice, and finally teaching. He is a founder (1986) and was one of the leading
faculty members of the Pacific College of Oriental Medicine. He has taught
throughout Europe, Canada, Brazil and Israel. His publications clarify, challenge,
perplex and move the reader to examine their overlooked assumptions and
consider new approaches to respond to irreducible uncertainty embedded in the
question of healing.
Ultimately, Dr. Gold’s hands and heart inform his intellectual and scholarly
work. Dr. Gold finds truth with his hands. Hands and hearts defy lofty theoretical

9
10 SEITAI (LYMPHATIC) SHIATSU, CUPPING AND GUA SHA

commitments to abstract truth and certainty; the truth is in the practice. This new
volume opens up challenging intellectual doors but ultimately it points to the
hand-heart connection that underlies healing. The book is a treasure of insight
and practical information that provides concrete ways for us to help our patients
on their journey.
Ted Kaptchuk
Author of The Web That Has No Weaver: Understanding Chinese Medicine
Cambridge, Massachusetts 2018
 Preface

It is health that is real wealth and not pieces of gold and silver.
Mahatma Gandhi

The first wealth is health.

Ralph Waldo Emerson

These quotes speak to a truth from ancient times that has remained true all
throughout human history up until today and will remain true even through
an infinite number of tomorrows. The equating of health with wealth has been
a truism even before a single medication or procedure could cost thousands of
dollars, which is the insane situation we face today in much of the Western world.
Excellent, vibrant health is priceless.
The pursuit and maintenance of health and the prevention of disease has been
my lifelong mission, both personally and professionally. I am a firm believer in
the precept expressed since ancient times in East Asian medicine that the human
body is endowed with the ability to resist the invasion of pathogenic factors
(the anti‑pathogenic factors). The greatest importance in theory and practice of
the East Asian traditional medical systems is focused on these anti-pathogenic
factors. A crucial aspect of this is the strengthening of the immune system. In
distinction, modern Western medicine is much more focused on pathogenic
factors, those factors that can cause disease such as bacteria and viruses. Western
medicine seeks to identify and destroy pathogenic factors, often regardless of the
deleterious secondary effects of this approach.
Clearly, human beings are always facing multiple pathogenic factors with the
capacity to create illness. Thankfully, most of the time most people are able to
ward off and destroy the pathogens and remain healthy. This ability to remain
healthy is the result of our anti-pathogenic factors, primarily our immune systems
and, in terms of East Asian medicine, the balance of our innate bio-energies, Qi or
Ch’i. We remain healthy not because medicine can overcome disease, but because

11
12 SEITAI (LYMPHATIC) SHIATSU, CUPPING AND GUA SHA

our body’s innate wisdom has the capacity to ward off pathogens and restore
balance, culminating in good health.
In the winter of 1986, I set off for Asia to deepen my life experience and my
knowledge of healing approaches and with the hope of meeting a teacher(s). I
had no set agenda nor had I enrolled in any specific program. I was full of hope,
trust and naivety. I am grateful that my experiences actually exceeded my dreams.
At the risk of sounding clichéd, I was led to my teacher, Sensei Kyoshi Kato
(b.1914–d.1991) the founder and leader of Kenko Saisei Kaikan (The Center for
the Restoration of Health). At that time, there were three Kenko Saisei Kaikan
residential treatment centers in Osaka, Japan. These three centers together had
the capacity to house approximately 80 individuals. Thankfully, Sensei Kyoshi
Kato recognized that I was a serious student and worthy of his time. From the
first moment I entered the Kenko Saisei Kaikan #2 residential treatment center in
Osaka I felt a profound sense of connectivity and belonging. All the residents of
the Kenko Saisei Kaikan were terminally ill individuals. They had all been released
from their medical doctors’ care after all measures (chemotherapy, radiation and
surgery) had failed to stop the spread of cancer. They had all been sent home
to die. Even with this “death sentence” always present, the Kenko Saisei Kaikan
environment was filled with love, light and hope. The core treatment strategies
at the Kenko Saisei Kaikan centers included Seitai Shiatsu, controlled diets and
deep emotional processing. Residents received two Seitai Shiatsu treatments daily
during their three-week residency at the Kenko Saisei Kaikan. The emotional
processing took the form of open group therapy sessions. The controlled diet
approach I will discuss in Chapter Seven of this book.
I met many remarkable individuals at the Kenko Saisei Kaikan. In the constant
presence of death, radiant hope and love permeated the environment. One day a
week, “alumni” of the program came to share their stories with current residents
and potential new residents. Individuals who were supposed to be dead years ago
voluntarily returned to share with others their stories of survival and life.
As amazing and life changing as my time at the Kenko Saisei Kaikan and
with Sensei Kyoshi Kato was, the purpose of sharing this information in this
book is not to promote a cancer treatment. There are many legal and ethical
issues surrounding the treatment of cancer that does not follow the accepted
treatment protocols of Western medicine. I choose not to challenge these rules and
regulations. As a licensed practitioner and teacher of traditional Chinese medicine
and acupuncture, I abide by this ancient Chinese proverb:
Superior doctors prevent disease
Mediocre doctors treat impending disease
Inferior doctors treat actual disease
 Preface 13

The goal of this text is to promote preventative approaches to maintaining health

and vitality. The same theories and approaches that Sensei Kyoshi Kato taught and
practiced in the treatment of terminal illness are totally applicable in the pursuit of
health and the prevention of disease.
Mounting evidence supports the concept that cancer is generally a polygenic
multifactorial disease, which makes environment an important modifier in the risk
of cancer, stated Kari Hemminki, Karolinska Institute. It is estimated that only 1
percent of cancers are caused by “cancer syndromes” and up to 5 percent result
from highly penetrant single-gene mutations; thus, the majority are polygenic.
Unquestionably, cancer is intertwined with environmental factors including diet.1
This refers to changes in gene function and expression that do not involve
changes in the actual DNA sequencing. The environment that exists in and around
our cells can have a dramatic effect on the expression of the DNA. This can
be an important contributing factor to many cancers.2 Individual cancer cells
are a common occurrence in human beings. Our immune system is engineered
to identify, target and destroy these aberrant cells. This amazing physiological
activity takes place in the lymphatic system, specifically the lymph nodes. In order
for the immune cells to attack aberrant cells effectively, they must be able to “see”
and identify the distorted cells. For this to happen, the lymphatic system must not
become overly sluggish and stagnant. Keeping the lymphatic system moving
and non-stagnant is at the core of an effective immune response. If the
immune cells are unable to destroy the initial cancerous cell, this cell will divide
and multiply and express its aberration. This begins the process of tumor growth.
The lymphatic system can easily become stagnant, especially for individuals
who live a highly sedentary lifestyle. Yet, there is another challenge that we all
face that actually arises from another key function of the lymphatic system. The
lymphatic system is also the “sewage system” of the body at the cellular level. All
cells (with the exception of the brain and spinal cord) are bathed in lymph. Cells
release the waste byproducts of their cellular metabolism through the cell walls
into the circulating lymph. The lymph is then responsible for carrying these waste
materials away from the cells to be eventually excreted from the body. In cases of
lymph stagnation, these waste products linger in the body, inhibiting the immune
response, causing local inflammation and inhibiting the delivery of nutrients to
the cells. This is the type of environment where cancer can develop and flourish.
Health and the ability to overcome disease are dependent upon a highly
functioning lymphatic system and immune response. The single biggest

1 www.ncbi.nlm.nih.gov/books/NBK220897
2 www.cancer.gov/about-cancer/causes-prevention/risk/substances
14 SEITAI (LYMPHATIC) SHIATSU, CUPPING AND GUA SHA

challenge the lymphatic system faces is stagnation, a lack of flow and movement.
An important way to recognize early stages of blood and lymph stagnation is
tenderness and pain to touch. Persistent muscle tension is both a cause and a
result of blood and lymph stagnation. For example, when even moderate pressure
is applied to the upper shoulder region, many if not most people feel some level
of pain. This is generally accepted as normal. It is commonplace, but should not
be accepted as normal. It is actually an indication of stagnation and inflammation.
When this type of stagnation is also examined from an energetic perspective, it
indicates blockage of energy flow. Blocked energy flow (obstruction of Qi flow)
is yet another way to describe underlying mechanisms of disease processes. The
essential goals of the techniques presented in this text are to promote blood and
lymphatic movement, prevent stagnation, relieve inflammation and enhance the
flow of vital energy (Qi). This is the root of preventative health care.
Also included in this book are two highly effective and easy-to-learn
techniques that are part of traditional East Asian medical tradition: Gua Sha
and cupping. Both of these techniques help relieve stagnation in the lymph and
myofascial tissues. Both of these techniques are appropriate for lay people to
provide for their family and friends. Knowledge of medical theory is not required
to practice these techniques safely and with positive effect. Specific indications
and contraindications are presented in the text. Both techniques work very
synergistically with Seitai Shiatsu.
The techniques described in this book are for everyone, not only health care
providers.
The primary subject, Seitai Shiatsu, is a profound and effective preventative
approach to health. No previous study of Shiatsu theory or technique is required in
order to practice this method safely and effectively. No knowledge of acupressure
points or meridian flows is required. Neither Eastern nor Western medical
knowledge is required. (Certainly, awareness of contraindications is required and
this is discussed.) The one crucial understanding that remains as a mantra to effective
practice is that all lymph flows back to the heart. Beyond that fact, all other
physiology, anatomy and pathology is of interest, and is fascinating, but is not
required for the effective practice of Seitai Shiatsu. In addition, Seitai Shiatsu is
performed with the client clothed. No oils or any other lubricant are utilized. A
certain level of friction upon the recipient’s skin is required for the techniques to be
effective. Also, Seitai Shiatsu does not require the use of a treatment table, although
the procedures can be done on a treatment table. Traditionally, the treatment is given
utilizing a padded futon or mat positioned on the floor or a low platform.
The essential point I seek to communicate is that lymph and blood
stasis is at the root of a compromised immune system. Lymph and
blood stasis renders the human body weakened in its ability to ward off
pathogens and also contributes to premature aging.
 Preface 15

I first and foremost want to acknowledge my teacher and the creator of Seitai
Shiatsu, Sensei Kyoshi Kato. To this day, it is very unusual for a foreigner (much
less one who does not speak Japanese) to be welcomed into a healing teaching
environment in Japan. That Sensei Kyoshi Kato welcomed me and shared his
vast knowledge and clinical experience with me still astounds me and fills me
with gratitude. Additionally, I want to offer my deepest thanks to Kauko Uusoksa
and Kayo Sakurai-Puerto, senior students and translators of Sensei Kyoshi Kato,
who welcomed me into their home in Osaka and served as my primary tutors
and translators. Their knowledge, friendship, language skills and patience were
crucial for my acquiring the skills and understanding of Seitai Shiatsu. I want
to thank all of the severely ill patients and their families at the Kenko Saisei
Kaikan residential centers in Osaka who allowed this “gaijin” (foreigner) into their
lives at such a sensitive and vulnerable time. I want to thank my first students in
San Diego who helped me refine my ability to share this work in a manner that
suited typical American students. This includes, especially, Skip Kanester, Majid
Mohkberry and Beth Spong. I want to thank and acknowledge Dr. Tin Yao So, the
primary instructor at the New England School of Acupuncture when I attended in
1977–1978. Dr. So provided me with my first experience of Gua Sha and inspired
me in my development as a practitioner of Chinese medicine and acupuncture. I
am very grateful to my editor at Singing Dragon, Claire Wilson, and her entire
team who recognized the importance of this work and helped bring this book to
fruition. A big thanks to the models, Gavin Garcia, Karyn Tammaro and Pnina
Riter, and our photographer, Kenneth Goff. I am honored that one of my first
teachers of Chinese medicine and now a leading light in academic placebo research
at Harvard Medical School, Dr. Ted Kaptchuk, contributed the foreword. I extend
a special thanks to Emily Sabolsky who provided skilled editorial assistance and
Denise Paccione for her help with the photo shoot. Finally, I am eternally grateful
for the love and support of my wife, Pnina, and our children, Ella and Roee.
For readers interested in contacting the author, please email: richardmgold17@
gmail.com.
 INTRODUCTION

The early and mid-1980s were a very busy time for me. Beginning in 1981, I was
on the Board of Directors and Faculty of the International Professional School of
Bodywork (IPSB), an early leader in the field of somatic education and massage.
By the end of 1983, I had completed four years of graduate studies in psychology
and defended my doctoral dissertation to earn my Ph.D. in psychology. In addition,
I completed the required coursework in traditional Chinese medicine required
by California and successfully passed the California licensing examination to
earn my license as a primary care practitioner to practice Chinese medicine and
acupuncture. In 1985, with two dear friends (Alex Tiberi and Joseph Lazzaro), we
established the Pacific Center of Health, a professional medical corporation and
an integrative health center. Finally, to top things off, Alex, Joseph, Ana de Vedia
and myself founded the Pacific College of Oriental Medicine (PCOM), a state-
approved graduate school of traditional East Asian medicine. At PCOM, I served
on the Board of Directors, the academic faculty and the clinical faculty.
As 1986 approached, I knew deep down in my bones that I needed a change
of scenery.
Additionally, I knew I needed to deepen my understanding of healing. I
recognized that I needed to actively return to the role of student and to seek out
teachers. Therefore, I planned a four-month self-funded sabbatical to travel to
Asia, including Hong Kong, Taiwan and Japan. I did not enroll in any specific
program but went with the idea of being open to whatever opportunities arose.
At the time of my departure, I only had one scheduled meeting with Dr. Yoshide
Hagiwara in Osaka. (Dr. Hagiwara was the original investigator and inventor
of a health‑food nutraceutical product known as Green Magma. Green Magma
had been instrumental in helping me regain my health and vitality. I wanted to
meet and express my thanks and gratitude to the originator. Thankfully, by being
persistent, I was able to gain an introduction to Dr. Hagiwara and a meeting was

16
 Introduction 17

scheduled for early February 1986.) It was this meeting that brought me to Osaka,
which, coincidentally, was the same city where I would meet Sensei Kyoshi Kato.
I arrived in Hong Kong in the last week of December 1985. I had a letter
of introduction from a former classmate and friend, Dr. Randall Barolet, to meet
Dr. C. K. (Gary) Butt, a well-respected practitioner and author in the field of
Chinese medicine. Thankfully, Dr. Butt was very open to having me observe in his
clinic. Dr. Butt spoke fluent English. This facilitated my learning process greatly.
His practice was an interesting mix of people from Hong Kong and European and
American expatriates. His office was in a great location, just off Nathan Road on
the Kowloon side of Hong Kong, quite near the Peninsula Hotel and Star Ferry.
From my first day in the clinic with Dr. Butt, he made a point of wanting me to
meet a mentor of his, Dr. Lam, a retired physicist and Qi Gong (breath exercises)
master. Thankfully, Dr. Lam stopped by the office during my first week. At that
time, Dr. Lam was teaching Qi Gong to bed-ridden and paralyzed patients in a
local hospital. He explained to me that to achieve the “Qi Gong effect,” movement
was not necessary as long as the mind and breathing were highly focused. To this
day, I find this to be a profound teaching. When Dr. Lam learned that I would be
traveling to Osaka, without me knowing it, he set in motion a series of events that
would be life changing for me.
It turned out that Dr. Lam’s sister was married to a Japanese man and was
living in Brazil. She had been diagnosed with breast cancer and had received
treatment in Brazil. Unfortunately, the treatments had been unsuccessful, the cancer
had metastasized and she had been told her condition was terminal. In desperation,
she had returned to Japan and sought out the treatment protocol developed by
Sensei Kyoshi Kato. These natural treatments were being administered in residential
treatment centers known as the Kenko Saisei Kaikan, first established in 1969, and
by 1986 they had grown into three residential facilities scattered around Osaka.
Under the care of Sensei Kyoshi Kato, Dr. Lam’s sister’s cancer went into
remission. This wonderful result so impressed Dr. Lam that he sought out Sensei
Kyoshi Kato and developed a personal and professional correspondence. It was
from this relationship that my life path was steered into an unexpected direction.
Dr. Lam encouraged me to meet Sensei Kyoshi Kato and, as the two men had
never met in person, to share a personal thanks and a letter. Unbeknownst to
me, Dr. Lam had also written directly to Sensei Kyoshi Kato, introducing me and
requesting that he accept me as a student to learn his healing methods.
By the time I reached Osaka a month later and called the training center, I
was already a known and welcomed person. When I called the number Dr. Lam
had given to me and spoke in English, my call was immediately transferred to
Kauko Uusoksa, who was a senior student of Sensei Kyoshi Kato and spoke fluent
English. Kauko, who is a Finnish national, invited me to come the next day to