Shiatsu, as well as Teate, pronounced te-ah-te (which literally stands for "medical treatment" in Japanese), originated in Japan. There were many hands-on therapies called Teate before traditional Chinese therapies such as Acupuncture and Tuina (called Anma in Japan) were introduced to Japan. The term shiatsu may have been first cited in a 1915 book, Tenpaku Tamai's Shiatsu Ryoho.
Tokujiro Namikoshi founded the Japan Shiatsu College in 1940 and systematised a form of shiatsu therapy based on Western anatomy and physiology. In Japan, Namikoshi's system enjoys special legal status, and its adherents often credit him with the development of shiatsu; the story is told that at age seven, Tokujiro Namikoshi developed a technique of pressing with his thumbs and palms as he tried to nurse his mother who suffered from rheumatoid arthritis.
Namikoshi treated many high profile persons such as former Japanese Prime Minister Shigeru Yoshida and other successive prime ministers, the prosecutor for the International Military Tribunal for the Far East, Prosecutor Keenan, as well as celebrities like Marilyn Monroe and Muhammad Ali. In this way, shiatsu became known not only in Japan but also overseas.
Other styles of shiatsu exist; adherents of the Namikoshi system followed generally contend that these are derived from the work of Namikoshi and refer to them as Derivative Shiatsu. It is to be noted, however, that Namikoshi's school was (and continues to be) devoted to reconciling the ancient massage arts of Japan with Western medicine in line with the efforts Japan made since the turn of the 20th century to 'westernise' certain elements of its culture. Masanuga, on the other hand, was intent on reconciling the massage arts with traditional Chinese medicine, whose early texts pre-dated the Taoist classics which influence most Shiatsu styles today by several centuries. Some of the established styles are listed as follows:
Mention should also be made of Tansu, a shiatsu style using Indian Tantric practices, and of those who combine the principles of Feng Shui with the energy field studies of Semyon Kirlian, Robert Beck, John Zimmerman and others in their practice of Shiatsu.
Since 1980 the evolution and development of shiatsu has largely taken place in Europe and North America.
—Japanese medical department of the Ministry of Welfare (current Ministry of Health, Labor and Welfare) in December 1957.
“Diagnosis and Therapy combined” is the ability of the practitioner to use his sensory organs (palms, fingers, and thumbs) to detect irregularities, such as stiffness of the surface of the body, and to promptly correct or heal these problems. To acquire this skill takes considerable experience. The defining difference between shiatsu therapy and modern and Kampo medicine (also known as Traditional Chinese Medicine (TCM), such as acupuncture and moxibustion) is this “Diagnosis and Therapy combined”; the fact that shiatsu does not always require previous diagnosis before commencing treatment.
In modern medicine, the course of treatment can only be decided after a diagnosis has been made. In TCM, it is also necessary to diagnose before treating. In shiatsu therapy, practitioners promote the prevention and recovery of illnesses by stimulating the immune system and natural healing power that people already possess. Therefore, even without a diagnosis or with a language barrier, practitioners can, to quote Tokujiro Namikoshi, treat patients with “thumbs and thin futon” at any time. Treating the body as a whole, so they say, helps to restore the physical functions of the nervous system, circulatory system, bone structure, muscles, and internal secretion and stimulates its alleged natural ability to heal illness. That being said, skilled practitioners can contribute considerably to regional health and medical treatment.
In Japan, anyone who practices shiatsu therapy must be licensed with the Ministry of Health and Welfare. Shiatsupractors are required to study at least three years/2200-hour educational programme of shiatsu therapy in the universities or colleges which are authorised by the Ministry of Health and Welfare and pass the national exam to be licensed.
"Shiatsupractor" is the name given to a recently proposed international standardized shiatsu license. The name Shiatsupractor was first used in British Columbia, Canada in the 1990s. Presently, at the end of 2003, in the regions of North America (United States, and Canada), Europe (member nations of the EU), and Japan, the use of Shiatsupractor is officially protected as a registered trademark. In Japan, the educational standard for Shiatsupractor approval corresponds to that of the licenses for Anma, Massage, and shiatsu practitioners.
Shiatsu originated in Japan and has migrated to many corners of the Earth. As such, every nation and state has devised its own method of certification and licensure, often overlapping with the licences for massage.
In the U.S., one professional organisation for Asian Bodywork Therapy (including shiatsu) is the AOBTA (American Organization for Bodywork Therapies of Asia). This organization is seeking statewide standardisation of Asian Bodywork licensure requirements. To date, the AOBTA has been named specifically in the licensure laws of Illinois and Washington, DC. The AOBTA is also working with the NCCAOM (National Certification Council for Acupuncture and Oriental Medicine) to introduce mandatory, standardized national board certification to the profession.
The AOBTA and NCCAOM require applicants to present a portfolio of training including anatomy and physiology, Chinese medicine, student clinic, primary discipline training, and elective coursework.