What is Ontake Moxibustion


Heated bamboo is applied to the skin rhythmically, using a metronome. This approach integrates traditional acupuncture theory, modern holographic models and research on the meridian frequencies by the renowned 20th-century Japanese doctor Yoshio Manaka.


Ontake Warm Bamboo is a moxibustion technique with two additional components: pressure and rhythm. A short piece of bamboo is filled with moxa wool. When the moxa is ignited, the bamboo gets hot and can be held, tapped, pressed or rolled along the acupuncture channels. Additionally, using a metronome, these techniques can be applied rhythmically at specific frequencies of beats per minute. 


Make a long bamboo tube about 4 cm long, without a joint. The thickness of the bamboo tube wall should be about 3–4 mm. Fill it with semi-pure moxa, leaving a space at both ends of the bamboo. —Makoto Yamashita

Ontake functions in the same way as a traditional moxa box, except it’s far smaller and much more mobile.  In contrast to a moxa box or a moxa stick, it can be rolled on the skin and pressed deep into the soft tissue. It fits comfortably in your hand and can be tapped or rolled rhythmically over any part of the body, including the face.  It allows you to be agile and flexible, treating small or broad areas quickly, and crucially, patients love the experience, which is pleasant and calming.

Any part of the bamboo can be applied to the skin. You can roll with it, knock percussively with the side, tap the lighted end briefly on the skin or press deeply into articulations with the lip.  Even without any theory or training, applying heated bamboo to a painful area can get results.


Ontake has been around for a short time in Japan, perhaps since the 1960s, and historically it was used as a local branch tool. So, for example, if there was tightness or pain at the shoulder, it was applied there. In the last ten years, however, its uses and applications have grown more sophisticated, and it can be applied with a growing number of theoretical models. 


Dr Manaka's wooden needle and hammer

Rhythmic percussion of the meridians has been a tradition in Japanese acupuncture going back to the Mubunryu style in the late 1500s when blunt gold and silver needles were lightly tapped with a wooden mallet on reactive points on the abdomen. In the late 20th century, Yoshio Manaka, a renowned Japanese doctor, acupuncturist and researcher, developed percussive tapping treatments using a wooden hammer and needle.

He then researched specific tapping frequencies of beats per minute for each acupuncture channel. These frequencies advanced the efficacy and range of his methods considerably, and his meridian frequencies became an important part of his routines. Here’s a table listing the twelve channels, and Ren and Du and the frequency of beats per minute that they respond to.


Midline channels (Ren and Du Mai)


Large intestine and liver




Gallbladder, small intestine, kidneys


Heart, lung


Stomach, spleen





Ontake treatment has also proved effective when applied at the meridian frequencies. When heat is applied in this way, there are rapid changes in soft tissue tension, exceeding the effectiveness of the wooden hammer and needle in quite unexpected ways.


Ontake tapping lines for sinus problems

Ontake is a versatile tool for treating symptoms, especially when using yin and yang principles of opposites. For example, when applied on the sacrum, it is effective for sore throat. The throat is superior and anterior, and the sacrum is inferior and posterior.  If the sore throat is central, roll the Ontake on the midline of the sacrum at 104 bpm (Du Mai). If the sore throat is on the left, roll the Ontake more on the right of the sacrum at 112 bpm (bladder), and vice versa. This treatment exploits the relationships between the kidney and bladder channels and the Ren and Du Mai vessels. These principles of treating opposites can be applied not just to sore throat but to midline pain anywhere in the body, for example, pubic symphysis pain, sacral pain and mid-thoracic pain.


There is a tradition in Japanese acupuncture, and especially in moxibustion, of generalised treatments that do not depend on the identification of patterns such as, for example,  kidney deficiency or liver excess. Perhaps the most famous of these in moxibustion is the Sawada protocol, “a formula of points that could be used on all patients, regardless of complaint or condition. This formula fortified the patient’s constitution and strengthened the qi and the defensive and healing energies”.[i]

Ontake can be used in the same way, focusing on the yangming channels of the arm and leg and the bladder channel on the back. This sequence is a powerful whole-body root treatment that stimulates healing responses without focusing on patterns or symptoms.


Holographic mappings on the arm and leg to treat the face

The late Dr Richard Tan was well known for relieving pain rapidly using channel pairings and different holographic models. He called his approach Acupuncture 1 2 3. This  approach can be adapted to Ontake: identifying the sick channel, finding a dynamic paired channel and rolling or tapping with bamboo on the paired channel using Tan’s holographic mappings to inform the location. Ontake has the advantage of being needle-free, and the heat creates dynamic and long-lasting changes, arguably more effective than needling.


Hot Needle Therapy (Nesshin Kairyo Jutsu) was a Japanese holographic system of treatment. It was developed by Kurakichi Hirata (1901–1945), who developed a unique dermatome moxibustion system using a heated probe.  His goal was two-fold: to develop a system that triggered the body’s healing response and was simple enough to be used at home by lay people. His heated needle never caught on in the West, but Ontake is a safe and effective substitute, breathing new life into this remarkable method, supercharging your sessions and empowering patients to continue treatment at home.

My second book was called Hirata Zone Therapy with the Ontake Method, but shortly after it was published it dawned on me that  HZT doesn’t roll of the tongue very well, whereas Hirata Ontake Therapy creates the irresistible acronym HOT! So don’t be confused. HZT and HOT are one and the same. 




Ontake Warm Bamboo is a simple and elegant new moxa device, cheap to buy and easy to make yourself. It can be adapted to any clinical practice that uses the meridian system,  and it can be used with a variety of theoretical models. Finally, it can empower patients to self-treat safely.  

Helpful Hirata Zone Therapy Book Review

Maya Suzuki is the acupuncture and moxibustion mover and shaker behind Shinkyu University, which she created to help practitioners deepen their knowledge and practice of Japanese acupuncture. I am delighted to share her review in the Journal of Chinese Medicine of my second book, Hirata Zone Therapy with the Ontake Method.

If you’d like to know to read the book, you can buy it here in the Ontake Shop, on Amazon or order it through your regular bookstore.

Helpful Moxa in Motion Book Review


Moxafrica co-founder Jenny Craig. Jenny really ‘gets’ Ontake and her enthusiasm speaks for itself. This book review of Moxa in Motion was first published in the European Journal of Oriental Medicine (EJOM) Vol 9, No 6, 2021. www.ejom.co.uk

Read the book

If you’d like to read the book, you can buy it here in the Ontake Shop or via Amazon.


Image of Hirata wearing a suit



The twelve zones repeat over the six regions comprised of the arm, leg, torso and (not pitctured here) the face, neck and head.

Kurakichi Hirata 平田内蔵吉

Hot Needle Therapy (Nesshin Kairyo Jutsu) was a Japanese holographic system of treatment. It was developed by Kurakichi Hirata (1901–1945), who developed a unique holographic mapping system of the body that he treated with a heated probe.  

Hirata’s holographic mappings predate Nogier’s microsystem of the ear and all the holographic systems that have come since. Hirata should therefore be seen as a pioneer in the field of acupuncture, creating the first holographic mapping of the modern era.

Dissatisfied with conventional medicine, Hirata wanted to develop an accessible system of self-treatment. He designed a system that was simple for the public to learn and apply by using a heated tool that, unlike acupuncture needles, required little skill to use. He wrote several books, developing his treatment model to a high level, integrating it with ideas from TEAM. Sadly, this young prodigy died during the Second World War.

Hirata’s general ideas on health are quite familiar to practitioners of TEAM. He believed that when the organs are harmonised and balanced, there is no disease. When something becomes imbalanced at the core level, disease develops. It is therefore more important to treat the core than address specific symptoms.

Hirata’s model of disease was strongly influenced by the TEAM idea of “Heaven, Humanity and Earth”. He saw the skin as the interface between human beings and the natural world—the place where disease enters and where reactions take place. For this reason, Hirata emphasised diagnosing and treating at the level of the skin, and his method focused on stimulating the skin with heat.

He developed a hologram composed of twelve horizontal dermatomes (or zones). These twelve zones are mapped out in six different regions, namely, the head, face, neck, torso, arms, and legs. Zones in each region resonate with and reflect the same zone in another region.


There are twelve zones, which for the most part, correspond to the twelve yin and yang organs of TEAM theory. However, as Hirata’s model was medicalised, at least at the beginning, there are no correspondences for triple burner or pericardium. Instead, there are new correspondences at the very top and bottom of the hologram for the bronchi and the reproductive organs. The gall bladder zone and spleen zone also reflect and treat the exocrine and endocrine functions of the pancreas, respectively.

1.               Bronchi

2.               Lungs

3.               Heart

4.               Liver

5.               Gall bladder and exocrine gland of the pancreas

6.               Spleen and endocrine gland of the pancreas

7.               Stomach

8.               Kidney

9.               Large intestine

10.           Small intestine

11.           Bladder

12.           Reproductive organs

Each region is a hologram of the body, and therefore, each region reflects the same physiological and pathological processes in the same way. For example, Hirata believed that an imbalance in the liver organ manifests in reactions on the liver zone in each region.

This synergistic action means that the same twelve zones can be examined or treated in any or all of the six regions; thus, the head, face, neck, arms, legs, and torso can be used both diagnostically and therapeutically.


The arm region and leg region are mirrors of each other, with the flow and numbering of the zones going the opposite way.

Rather than have the zones as an abstraction, let’s start by exploring two regions, the arm and the leg. The zones of the arm form a holographic image, numbered from 1–12, from the top of the shoulder to the tips of the fingers. The twelve zones can be grouped simply into four on the upper arm, four on the forearm, and four on the hand. A little bit like the back-shu points, the arm reflects its anatomical neighbours, with the upper jiao zones in the upper part of the arm, the middle jiao zones in the middle section, and the lower jiao points in the hand. Take thirty seconds out from reading this article to divide your upper arm, forearm and hand each into four segments each. Try counting down from 1–12.

The leg region is similar to the arm region, in that it is divided into four zones in each segment. However, it is a reverse mirror of the arm, in that zone 1 is at the fingers and zone 12 is at the thigh. Try counting the zones up from 1–12.

The torso region repeats the pattern of the arm, with the twelve zones flowing from top to bottom in the same order. The twelve zones also repeat on the head, face, and neck,  but in these regions, as on the leg,  they count from the bottom up.

Yoshio Manaka 間中喜雄

One of the most influential practitioners to investigate and take up Hirata’s ideas was the renowned Japanese medical doctor and acupuncturist, Dr Yoshio Manaka (1911–1989).

Dr Manaka combined scientific research skills with a fascination for traditional methods of healing. He studied Hirata’s books, and enthusiastically adapted his methods, eventually publishing his own book about them in 1982, Hiratashiki Junihannotai Nesshin Shigeki Ryoho (Hirata’s Heated Needle Stimulation Treatment).

Stephen Birch

British acupuncturist, author, and teacher, Stephen Birch, became acquainted with Dr Manaka in the 1980s. This international collaboration led to the publication of Chasing the Dragon’s Tail, written by Birch with Manaka’s input and guidance. It was a seminal book on acupuncture and acupuncture research, and contained some of the first explanations of Hirata Zone Therapy (HZT) in English.

Birch became a conduit for Japanese acupuncture thinking and ideas, teaching Manaka-Style Acupuncture (MSA) globally. However, when teaching, his classes did not cover HZT in any detail. We can guess that the reasons for this were pragmatic.


By today’s standards, the original asbestos-lined, alcohol-fuelled, open-design Mind Therapy Device would not be regarded as safe.

In the old days, HZT involved stimulating the zones with a cone-shaped metal instrument lined with asbestos and filled with burning ethyl alcohol, called the shinryoki or Mind Therapy Device. Few of these remain in existence now, and they would be considered unsafe to use for many reasons.

Manaka developed an electrically heated blunt probe called the tenshin kyu (spiked moxibustion device), but this was not mass-produced and once again, few of these remain in existence. Contemporary Hirata practitioners use a more sophisticated electronic hot probe called the hirata-kun but its retail price puts it out of the range of most acupuncturists.

Thus, we can conclude that HZT never really caught on in the West because there was no safe or affordable device available to deliver the heat. Teaching HZT would have been an academic pursuit with no practical application. Acupuncture students are nothing if not pragmatic—if there’s no application, there’s no value!

Ontake to the Rescue


In 2010, I was introduced to Ontake, a little-known moxibustion tool.  Ontake is comprised of a short piece of bamboo filled with moxa wool. When the moxa is ignited, the bamboo gets hot and can be applied to the skin. The bamboo can be held, tapped, pressed or rolled rhythmically along the acupuncture channels and on specific points.

After reading my first paper on Ontake in 2011, Birch immediately saw its potential, encouraging me to experiment with it to see if it could be applied to the Hirata zones.

"Oran, I've got this little idea. Why don't you go and research using Ontake for the Hirata zones? It won't take long! Honest!


HZT is a unique system of dermatome moxibustion that has almost been lost. Birch’s suggestion that I should study HZT and integrate it with Ontake became a mission—a mission to discover how Hirata worked, how Manaka redeveloped his findings, and how almost ninety years later, we can achieve the maximum benefit from these ideas. The mission ended up as a book, aiming to place the system into a pragmatic modern context so that Western practitioners and their patients can easily learn and apply it.



The model for treatment in HZT has developed over time. When Hirata first started it, it was a relatively simple model, what I call Basic HZT, which used only the zones for treatment. By the time of Hirata’s death, the model was more complex, integrating the twelve channels of acupuncture, although Hirata declined to call them that, naming them instead, “reactive lines”. He gave each of these twelve reactive lines a number, calling the yin channels kussen “flexion lines”, and the yang channels shinsen “extension lines”.

Manaka further refined this integration of the channel system, what I call Intermediate HZT. Today, contemporary practitioners such as Taku Yokoyama in Japan, who studied with Manaka, or members of the Kokusai Nihon Onnetsu Ryoho Kenkyukai, (International Japanese Thermotherapy Association), practise what I call Complex HZT, integrating many other ideas into the HZT model.

In this article, I’ll discuss only Basic HZT. Basic HZT is so simple, anyone can practise it, even laypeople who know nothing of acupuncture. No meridians are involved, so all you need to perform Basic Hirata is the following:

  • A good grasp of the location of the zones in all six regions, especially the neck, torso, arms, and legs.
  • An understanding of how to load, light, and apply Ontake.


Male, 32

Symptoms: Persistent cough and occasional lower backache.

Generally quite healthy and robust, this patient had developed a “mystery” intermittent cough that he was unable to shake. On questioning, however, the timing suggested that the yearly cycle of air pollution in Kuala Lumpur was to blame.

He had also developed some intermittent lumbar pain. Hirata’s prescriptions for cough typically focus on zone 1 (bronchi). According to the location of the back pain, the affected zones were 9 and 10 (large and small intestine). Palpation revealed marked tension on the leg region at zones 9 and 10 (mostly on the stomach channel above the knee), and a few slightly rough patches of skin on the chest and arms at zones 1 and 2 (bronchi and lung).

Treatment consisted of tapping with Ontake on the deficient areas on the chest and upper arms on zones 1 and 2 until the skin felt more even, then rubbing, pressing, superknocking (a brisk percussive stroke with the side of the warm bamboo), and rolling on the thighs until the tension on zones 9 and 10 was relieved. After he turned over, we tapped on the upper back, identifying and treating more dry or rough areas in zones 1 and 2.

No other treatment was given. Following the session, he reported that some stiffness in the back of his legs and knee pain, which he had not previously disclosed, felt much better. This maintained. The cough also cleared for a few days, but when the pollution got even worse at the end of that week, it returned.


Female, 30

Symptoms: Lumbar and buttock pain, and abdominal distension.

She had been coming for back pain for a few weeks and had been feeling much better, but she had a relapse after a long flight home from an international conference. According to the location of the back pain, the affected zones were 9, 10, and 11 (large intestine, small intestine and bladder). According to TEAM theory, abdominal distension relates to zones 6 and 7(spleen and stomach).

There was marked tension on both anterior thighs at zones 10 and 11. Bamboo was applied with pressing and rolling on the right. After the muscles released (within two minutes), her left leg was also much more relaxed, so this was treated the same way for a shorter time. After this, she walked around the room and reported that the pain was much reduced. Zones 10 and 11 were then rolled on the back of both hands. After testing once more, the pain was gone.

Whilst in supine position, bamboo was applied on zones 6–10 on the abdomen from the midline to the midaxillary line, tapping and rolling lightly. Branch treatment finished with local rolling on the back. By then, she was very relaxed.

The session concluded with very light Toyohari-style acupuncture root treatment.

Male, 32

Symptoms: Sudden onset of redness and itchiness to the right eye, which was beginning to close up.

Zone selection was according to TEAM theory, namely that the liver opens into the eyes. Ontake was applied to zone 4 (liver) on the head, arm, back, and leg regions, simply tapping each zone for about one minute until the skin felt warm to the touch. On the limbs, only the right side was treated but on the head and back, both sides were treated. The eye infection reduced in intensity within minutes and cleared up within two hours.


These examples show how it is possible to use Basic HZT with very simple selection and treatment criteria. If there’s a problem in the lungs such as cough, treat the lung zone. If there’s a problem in the back, treat the zones where the pain is. If there’s a problem in the eyes, treat the liver zone because of the relationship of the liver to the eyes. Western medical correlations, anatomical location, TEAM theory, and of course, palpation all helped with the choice of zones, and bamboo was applied without thought to treating affected channels.


I have found that HZT brings extra healing momentum to what I normally do. Thus, if I treat the kidney channel with meridian therapy methods, I can add Ontake on the kidney zone in different regions as an adjunctive treatment. If I treat with MSA, perhaps choosing a Mixed Yin pattern, I can accelerate the release of tight areas on the abdomen by tapping the liver and kidney zones. Whatever system of root treatment I apply, I can focus on the digestion by tapping on the spleen and stomach zones, or improve lung function by tapping on zones 1 and 2.

Palpation is another useful area for HZT. Palpation of the zones of the arm and leg regions always conveys a wealth of diagnostic information. For example, if there are shoulder, upper back or heart and lung channel issues, zones 1 and 2 on the arm will often present with tightness or induration.

As zones 8 and 9 cover the lumbar region and zones 10 and 11 traverse the sacrum, the anterior thigh is a rich area to pick up information about what is happening in the lower back. Tension above SP-10 and ST-34, at the intersection of zones 9 and 10,  is nearly always indicative of lumbar stiffness or pain.


Basic HZT is an elementary treatment model that can easily be integrated into your everyday workflow or adapted for home use by patients.

More sophisticated models of treatment integrate the channel system, and channel pairings, as well as Dr Manaka’s meridian frequencies, tapping the zones with Ontake using a metronome set to specific frequencies of beats per minute.

Deeper study of HZT, integrating its concepts with channel theory and other treatment models, reveals its great potential.

Hirata’s original goal was to create a people’s medicine that treated the core energy of the body. In so doing, he created the first holographic system of acupuncture in the modern age. His influence has declined over time but now, with the integration of Ontake, we can find new uses for his ideas in contemporary practice. All you need is a lighted Ontake and you can start!

Palpation is another useful area for HZT. Palpation of the zones of the arm and leg regions always conveys a wealth of diagnostic information. For example, if there are shoulder, upper back or heart and lung channel issues, zones 1 and 2 on the arm will often present with tightness or induration.

As zones 8 and 9 cover the lumbar region and zones 10 and 11 traverse the sacrum, the anterior thigh is a rich area to pick up information about what is happening in the lower back. Tension above SP-10 and ST-34, at the intersection of zones 9 and 10,  is nearly always indicative of lumbar stiffness or pain.


  • In the 1930s, Hirata developed a twelve-zone holographic system of dermatome moxibustion.
  • The twelve zones repeat over six regions: the head, face, neck, torso, arms, and legs.
  • In the 1980s, Manaka researched and developed this system further, integrating it into MSA.
  • Birch wrote about this in the West, but as no tool was available to treat the zones with heat, the method did not catch on.
  • Ontake started to become better known in 2010 as a new tool that could deliver heat safely, thus enabling it to be adapted to treat the Hirata zones.
  • The zones can be used to add a new level of palpatory awareness.
  • HZT can be used as a standalone treatment or integrated into your standard workflow.

My new book about the Hirata zones is launching on January 24th. Would you like to help out? Check out the post about joining the launch team or just click the button below to know more