Strong emphasis on touch
An acupuncturist who practices Japanese acupuncture will probably be a lot more interested in palpating your abdomen than looking at your tongue.
Historically in Japan, largely due to Waichi Sugiyama’s influence, acupuncture was a profession for the blind. Even today, a significant percentage of acupuncturists in Japan are blind. While in China acupuncture is closely aligned with herbal medicine, acupuncture in Japan is thought of more in the realm of massage, both requiring a refined sense of touch.
In addition to using abdominal palpation as a key diagnostic tool, Japanese acupuncturists feel around a lot before needling acupuncture points. Some might even “test” certain points, holding a finger on an acupuncture point while simultaneously pressing another (usually painful) part of the body to see if it alleviates symptoms in that area.
A natural outcome of this approach is that there tends to be a lot of interaction between acupuncturist and patient. Feedback is critical to guiding the treatment.