日良 自律6号 1(127)

Plenary Lecture at the 1st International Ryodoraku Congress

Oct. 9 , 1988 —Miyazaki—

Chairman Dr. T. Yamato (Japan)

Introduction for Ryodoraku treatment.

Masayoshi Hyodo, M. D.
Department of Anesthesiology,

Osaka Medical College,

Takatsuki—city, Osaka

What is Rodoraku?
In 1950, Yoshio Nakatani found a line similar to the kidney meridian, that had a series of
points in which electroconductivity was higher than the surrounding area, when he was
trying to measure skin resistance in general for edematous kidney inflammation cases.
Then, he checked this phenomenon more carefully in ten kidney disease cases and observed
a similar pattern. Healthy subjects did not show this phenomenon. This was restricted to
kidey disease. Therefore, he named this line kidney Ryodoraku (ryo is good, do is [electro]
conductive, raku is line).
After this, he checked various visceral disorder cases in a simlar manner : he recognized a
Ryodoraku corresponding to the classical lung meridian appearing in lung disease, a Ryo-
doraku corresponding to the classical stomach meridian appearing in stomach disease, and so
on.
Since the meridan point is a good electroconductive point, and Ryodoraku which are quite
similar to classic meridians actually appear in various pathological conditions, Nakatani
concluded that the meridian is a Ryodoraku phenomenon.
Nakatani named meridian points by an easy-to-use method : for example, the merdian
(Ryodoraku) of the hand is represented as H, the foot as F. The meridians are numbered
consecutively—Hi, H2, H3, etc.
Namely, H1 Ryodoraku or lung Ryodoraku corresponds to classical lung meridian. H3
Rodoraku or Heart Ryodoraku corresponds to classical heart meridian. They are alike. But,
not completely same. Ryodoraku were discovered experimentally by the measuring of
electroconductivity on the skin. while classical meridians were drawn on the skin from the
idea of conception.
Recently, we re-examined this phenomena in the same way as Nakatani had investigated
30 years ago. This is a patient suffering from kidney disease (Fig. 1 ). The skin surface
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Fig. 1

electroconductivity of the whole body was measured with Neurometer electrode.

The whole body was stroked by a detecting electrode with identical pressure on the skin.
When a point which has higher electroconductivity than surrounding area was found, that
point was marked. we can notice same markers here and there on the foot and leg. These sites
of the spots appeared just at the same sites of acupoint of classic kidney meridian. So, when
these spots are connected with a line, a kidney meridian like line could be drawn.
This is another kidney patient. In this case, these spots which correspond to the kidney
meridian acupoits were only partly noticed.
We investigated 8 kidney patients. In 3 patients, almost completely kidney meridian like
lines were able to draw. In other 3 patients, partly alike lines were drawn. However, in other
2 patients, we could not draw these similar lines.
This is a patient with stomach disease, A line just like as classic stomach meridian was able
to obtain.
In healthy subjects, no lines which corresponds to a meridian were discovered.
In conclusion, Nakatani's Ryodoraku phenomenon was demonstrated with proof by this re
-examination .
Ryodoraku is a pathological phenomenon. Nakatani states that this mechanism can be
explained by the viscero-skin-sympathetic nerve reflex. The impulses from the viscera
radiate to the spinal cord; the reflex zones where they are then reflected on the skin surface
via the efferent sympathetic nerves appear as a longitudinal connecting system (Fig. 2 ).
Sympathetic nerve blocks such as stellate ganglion block for the hand and lumber sym-
pathetic nerve block for the leg increase considerably the skin resistance in the related area
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Fig. 2

and electropermeable points (REPP) or Ryodoraku phenomenon disappear. This is one

example of the decreases in elecroconductivity at the representative measuring points on 6
Ryodorakus of one side arm after stellate ganglion block (Fig. 3 ). We can notice that there is
no changes of electroconductivity on the opposite side, where no sympathetic block was

performed.

Fig. 3
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Also, the administration of sympathetic nerve stimulants increase electroconductivity in

general. Sympathetic blocking decreases the electroconductivity. As a result, Ryodoraku may

be defined as the "functional route of the excitement of a series of related sympathetic neves
which is caused by visceral discease" or "the linked pathway of the related reactive electro-

permeable points.
When adequate stimulation to a acupoint which has remarkable electroconductivity is

given, an impulse is induced afferently via the sympathetic nerve and autonomic nerve
regulation of the viscera occurs according Mackenzie's Counter-Concept. As a result of this,
electroconductivity at the acupoint is decreased; and the symptom is relieved.
As a matter of fact, Nakatani defines Ryodoraku therapy as measuring skin sympathetic
excitability by means of skin electroresistance and giving stimulation to approach to the
normal excitability renge through the pathway of nerve reflex.

Total Functional Adjustment and General Ryodoraku Regulation Therapy

In oriental medicine, adjusting the basic and essential functions of the whole body in
general by considering the physical constitution is called "total functional adjustment" . In
contrast, treating symptoms only locally called "local treatment" .
Balancing fullness and emptiness on meridians is, after all, total functional adjust. Accord-
ing to Ryodoraku, abnormalities on each meridian or Ryodoraku, can be observed objectively
by the measurement of electroconductivity of certain points on the skin. Then, by stimulating
the therapeutic points on the abnormal Ryodoraku, homeostasis occurs and restores its
normalcy.
Currently, the diagnosis of the disurbance of so-called autonomic nervous on each Ryo-
doraku system is imprecisely rendered. However, Ryodoraku recognizes abnormality and can
treat them properly.
In Ryodoraku theory, an abnormal Ryodoraku has either higher or lower elec-
troconductivity, when compared with other Ryodoraku. For this purpose, one calculates the
mean value of one Rodoraku by summerizing the amount of the electroconductive values of
the reactive electropermeable points (REPP) along a RyOdOrake, and dividing by the sum of
the total number of reactive electro-permeable points.
In other words, there are twelve eletctro-permeable points (meridian points) along the LU
H1RyOdOrake. After calibrating the electroconductivity measuring device, one can obtain the
electroconductive value for each meridian points and calculate the sum of the twelve
electroconductive values. Then, the H1 RyOdOrake average electroconductive value can be
obtained by dividing the sum by 12 (Fig. 4 ).
Similary, one can calculate the average value for all of the 24 RyOdOrake.
If the average value of H1 RyOdOraku is extremely higher than the others, H1 RyOdOraku is
excited (ie, the HI sympathetic branch is excited). If extremely lower than the others, it is
sedated.
Now, if one gives a stimulation at a gilven point, a subtle change occurs in the elec-
troconductivity of REPP in the entire body. By observing the changes of the 12 REPP on HI
in this way, it was found that the REPP of H1 3 showed the average change of the 12 points.
Therefore, each time one need not measure the values of 12 points. One can simply measure
日良 自律6号 5(131)

a. A

2 5 7 p. A -"r 1 2 = 2JILA

HI Ryodoraku

Fig. 4

the Hi 3 electroconductive value and thus observe the average change of H1 elec-
troconductivity. This point was named the "representative measuring point (RMP)" on H1.
In this manner, each RMP was found on the 24 Ryodoraku. Intresting enough, most of these
points corresponded to the classical primary meridian point of each meridian.

An example of R-chart for a whiplash injury patient

Fig. 5
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Ryodoraku Chart (R-chart)

Readings from the meter at 24 representative measuring points in total are recorded on the
Ryodoraku Chart. Figure 5 is an example of a whiplash injury, The left LU-H is 120 gA ; and
the right LU-H is 135 g A, etc.
Secondly, the sum of the 24 points' electro-conductive values are divided by 24. Then, the
mean is given, However, clinically this calculation may be troublesome. Thus, a mean line
roughly can be drawn. This figure shows a line of about 75 gA in mean value. Then, one can
draw two lines with a 1.4 cm width from the midline (two lines being 0.7 cm apart from
midline respectively).
This width is called as the physilogical range. When the reading for each Ryodoraku
deviates from the physiological range, that Ryodoraku is abnormal. Therefore, select the
therapeutic point to excite or select according to the low column of the chart. Then, using
them, perform general Ryodoraku regulation therapy.
In the healthy subject, after eating or bowel movement, the electroconductivity on Ryo-
doraku changes. This allowance is a physiological range; the width of 1.4 cm is a statistical
result. When all readings of electroconductivity on each Ryodoraku are within this physi-
ological range, then, the autonomic nervous function is well balanced and healthy. Actually,
patients' readings are quite scattered initially; however, with improvemint of the symptoms,
the scattered points tend to meet the physiological range.
Clinical statistical studies of many cases show what symptoms are indicated by abnormal
readings of Ryodoraku. For instance, when KI-F3 Ryodoraku electroconductivity is low
(depressed), the patient has less energy or impotent. When HC-H2 is higher, (excitation or
hyperstate) the patients complain of upperback stiffness on seven out of ten cases. The
statistical results may be seen in this "Ryodoraku symptom table"
According to the table, Ryodoraku syndromes, one can try a socalled "before-quenstioning
diagnosis." For instance, when HC-H and LU-H are higher and LV-F2 and KI-F3 lower, one
can question the patient as follows : "have you had upper-back stiffness or impotency
recently? " The symptom will be diagnosed with very good probability.
This "before-questioning diagnosis" is a vely valuable aid in daily practice.
According to the treatment, deviations from the normal physiological range are gradually
diminished. Then, the various symptoms are actually relieved. These findings are valuable in
judging the prognosis and therapeutic results, as well as the patient's psychological response.

Ryodoraku therapy
Ryodoraku therapy consists of 3 modalities of treatment.
The first one is General Rugulating Point (GRP), which stimntates Tonic Points and
Sedative Points.
On each Ryodoraku, there are two kinds of points. One is the point which has the tendency
to increase the excitability of the Ryodoraku and the other point has the tendency to decrease
it. The former is called the Excitation or Tonic Point and the later the Dispersion or Sedative
Point.
Nakatani noticed that the Tonic Point corresponds to the excitation point applied for the
emptiness symptoms and the Sedative Point corresponds to the despersion point applied for
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the fullness symptoms as described in classical literature.

As is seen figure 5 , R-chart of one case of whiplash injury, the therapeutic points for each
abnormal Ryodoraku are shown in the below column.
The second is the local treatment. Electrical acupuncture (EAP) is most effective for local
treatment.
The third is the settled acupoints stmulation treatment. Therapeutic acupoints suited to the
symptoms or diseases can be decided according to "prescription." This is described later.
Electrical acupuncture (EAP) is performed with the needle as a stimulative electrode
utilizing primarily direct current electricity. The indifferent electrode is held in the hand.
In a localized pain syndrome, sufficient and prompt analgesic effects are usually obtained
by up-and-down manipulation of a needle (sparrow's pecking manipulation). This sparrow's
pecking is thought to achieve strong manual stimulation.
When; different types of stimulation are used with the needle, e.g., heat or low frequency
electric energy, the results differ greatly from simple manual mechanical stmulation. Among
the many stimulative techniques mild direct current to the needle has proven the most
adequate and effective for producing analgesia. Some physiological studies have shown that
electric energy has an effect 10,000 times greater than that of mechanical energy. Electric
energy is, therefore, most effectively used for nerve stimulation.

Procedure for Electrical Acupuncture Therapy

A cotton swab soaked in saline or alcohol solution is placed in the detecting probe.
By contacting the moist electrode with the grip electrode, about 200 /IA current in a 12 volt
power supply should be obtained when adjusting the calibration control.
The patient grips the grip elecvode (cathode) in his hand. The detecting electrode is used to
find the very point of maximum conduction. The highest electroconductive reading is the
therapeutic point.
Holding the needle holder firmly, press down slightly on the therapeutic point. Tap the
plunger head with a finger tip. The needle will be inserted in the tissue. The dose of electricity
is about 200 /IA with a 12 volt power supply for about seven seconds.
If strong stimulation is required, "a sparrow's pecking" motion (up-and-down) with the
plunger is indicated, one strok per second is an adequate frequency.

Optimum Stimulation Dose

The analgesic mechanisms of physical stimulation therapy are drastically different from
that of local analgesics in pain relief. To obtain the most effective and desirable clinical
results in stimulation therapy, one must consider three major principies of stimulant.
The optimum results are based on the type and strength of the stmulation techniques as
well as the susceptibility of the patient. When the type of stimulation is constant, "dose x
susceptibility reaction" . Therefore, one must acquire exprienced hand in order to deter-
mine the optmum dosage of stimulation on the basis of susceptibility. The standard dose for
electrical acupuncture therapy is a seven second duration according to individual susce-
ptibility with 200 A. However, this is only the standard and may be varied.
When seriously considered, the optimum dose is a very complicated problem. However, the
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purpose of stimulation physical therapy is to elicit an effective body response against the
disease or disorder. In regard to this, the body has great tendency towards homeostasis; a
slightly inadequate stimulative dose can be adjusted by the body itself.
For the location of therapeutic acupoint, some oldfashioned clinicians insist that the point
should be strictly taken from the anatomical aspect by measuring the exact distance from
certain spot of the body.
Occasionally, the patient is asked to assume a specific position in order to identify exact
location.
However, even though the precise acupuncture point is taken as mentioned above, practical
difficulty is involved in hitting the true physiological or functional acupuncture point.
Therefore, in practice, the therapeutic point is taken with reference to tenderness or indura-
tion by digital palpation.
In Ryodoraku theory, physiologically true acupoint can be objectively found. According to
Nakatani's reactive electro-permeable point, a relatively higher meter reading on the skin
indicates the acupuncture points. Therefore, in Ryodoraku treatment, the anatomically exact
location of each meridian point does not have great significance.
This concept for finding acupuncture points can be applied to local treatment of the painful
area or trigger points. For instance, to find the local therapeutic point for upper back stiffness,
frozen shoulder, or lumbago, one need not necessarily look for the exact classical meridian
points. Good results can be ontained by treating only the reactive electr-permeable points.
The electro-permeable points, the spot of maximum conductance in the area, are located by
the detecting electrode with 21 volt current.
Conductivity at the electro-permeable point is related to sympathetic excitability. Con-
ductivity is much greater at this point than in the surrounding area. When there is some
abnormality underneath the skin or viscera, the sympathetic nerve excitability related to the
skin surface is higher. As a result, the electro-permeable point is clearly discerned.
Many points have relatively higher electro-conductivities when measured at 21 volts.
However, only those exhibiting a conductivity higer than the surrronding area measured at
12 volts are named reactive electroconductivity points (REPP, Hann() Ryodo point).
Electro-permeability is often influenced by perspiration on the skin. When using a metal
detecting electrode on even mildly perspired skin, electropermeability is delicately changed.
However, the electro-permeability is not changed significantly when using a moist electrode.
This phenomenon should be noted because the excitation of the sweat gland is the state of
cell depolarization. Therefore, heavy perspiration, by causing relatively higher elec-
troconductivity, interferes with the search for REPPs.

Some Suggestions on Locating the REPP.

REPP is defined as the point that has higher electro-permeability than the surrounding
area measured at 12 volts. Therefore, the absolute value ( "How much ktA" ) on the meter
reading is unimpotant. Also, the exact borderline between "reactive electro-permbable

points" and relatively high electro-permeable points cannot be set, as it is similarly difficult
to distinguish clearly between healthy and sick people. As shown in figure 6, A to G points
are all REPPs. Of course, A to G can all be used as therapeutic points, but general A,C,E, and
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Fig. 6

F points are clinically taken as REPPs.

For a first treatment or for very sensitive patients, treatment must be limited to the use of
A and C points as therapeutic poins.
REPPs are not clearly observable in some cases in 12 volts. In those instances, change the
device to 21 volts or turn the calibration control clockwise at 12 volts.
In contrast, if the meter reading is too high to recognize REPPs, decrease the control to
reach the reading level.
In general, electro conductivity is higher in upper part of the body : and lower in lower part
of the body (Fig. 7 ). Therefore, if sound detector is used,we can find many REPPs in upper

part of the body.

Fig. 7
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Basedow's Disease

lateral to protuberance of larynx and on

the pulse of the carotid artery.

anterior margin of sternocleidomastoid

muscle.

depression above superior margin of

manubrium.

between trapezius muscle and sternocleidomastoid.

.origin of trapezius muscle.

Hi8
Shaku-taku

radial side of tendon of biceps brachii on

the cubital articular region.

Fig. 8
日良 自律6号 11(137)

However, it is REPP that counts.. REPP is the site, where electrical conduction is much
higher than surrounding area.
REPP is often influenced by extraneous conditions that sometimes cause misjudgments.
Perspiration changes electro-permeability as described before; scarring of the skin lessens
eleftro—permeability. In contrast, dermatitis, skin dressings, warming, or scabbing heightens
electroconductivity. Also, after needling the skin, the point shows considerably higher
electroconductivity as an artificial REPP.
Electro-permeability tends to rise when the searching electrode is pressed strongly on the
skin. Therefore, pressure applied by the searching electrode should be equal on every spot.

Treatment according to the prescribed acupoints suited to each disease

The illustrations show the therapeutic points specially allotted to each disease or symptom,

integrated by the author in reference to various ancient and recent literatures. One example

in Basedow's disease is shown in figure 8.

Main and secondary points are represented, so that even laymen can readily practice as

authorities.

All points shown for each disease are not meant to be therapeutic ponts for one session. The

most important meridian points are underlined. In the initial treatment, one should try only

those ; adding or changing to other therapeutic points after evaluating the results.

In order to locate the most important point, it is recommended to identify it with reference

of REPP. DC electro—therapy to that REPP gives satisfactory result, especially for painful

diseases.