Despite an increasing interest in healing in pre-modern Japan, most scholarship has tended to focus on Buddhist actors, thus neglecting the contributions of physicians from the Bureau of Medications to the therapeutic arena. Even when those activities have been examined there has, however, been a tendency to emphasize an epistemic divide between physicians and other technicians involved in forms of ritual healing. While the activities of physicians have largely been understood through the lenses of the contemporary concept of “Traditional Chinese Medicine,” in this paper I will look at the portrayal of physicians in ancient and early medieval sources to question the correspondence between ijutsu and “Traditional Chinese Medicine,” and clarify how the separation between ijutsu and therapeutic rituals conducted by Buddhist monks and onmyōji has been mischaracterized in epistemological terms. Based on the critical examination of ritsuryō codes, the Engi shiki, the Ishinpō, and courtiers' diaries, I will show that there is no evidence of physicians practicing moxibustion until the tenth century, while acupuncture was not used throughout the period in question; and that ijutsu as articulated in the Ishinpō incorporated ritual elements from multiple continental traditions, with evidence from courtiers’ diaries showing that, especially during pregnancies, court physicians actually conducted some of those rituals. I will conclude by introducing the idea of “ritualization of (daily) life” as an analytical tool to look at ancient and early-medieval Japan, in order to emphasize the porousness of contemporary taxa (e.g., medicine, religion) vis-à-vis the epistemological breaks theorized by modern scholarship.