1. Determining the Therapeutic Range Acupuncture-Moxibustion There have been innumerable reports on this subject, but in Japan it is most important that the results heretofore reported be summarized so that questions such as, according to modern medicine for which diseases acupuncture-moxibustion are most effective, for which diseases the therapeutic effects are still questionable, for which diseases are ineffective and moreover for which they are impairing may be answered. It is best if the therapeutic effect is indicated empirically. The problem then is whether or not the therapeutic effects can be appreciated according to modern medical classifications. 2. Medical Mishaps with Acupuncture-Moxibustion The most feared accident other than such mechanical mishaps as broken needles or injury to profound tissue is infection from the needles. The prevention of such infection and genseral rules must be undertaken by the acupuucture association. 3. Concrete Measures to Be Taken by Western and Eastern Medicine How should medical doctors, acupuncture-moxibustion therapists and blind therapists be regulated. As the blind therapist request on the sense of touch, treatment can considered to be more precise that of the normal therapist. As the acupuncture-moxibustion therapist deals specifically with this therapy, his technique may sometimes be superior to that of the therapy his technique may sometimes be superior to that of that of the physician whose main concern is disease. The medical doctor's perception of basic medicine and clinical experience and test is profound. The three have their individual strong points. How can the coopereration of three groups be realized? The application of medical insurance and other practical medical problems must be solved. 4. Internationalization of Acupuncture-Moxibustion Progress in this field will be made through international cooperation. For this purpose the fundamental medical consciousness of Japanese acupuncture-moxibustion, that is the international unification of the mastering of skills, nomenclature, etc., should be dealt with at once. 5. Principles of Acupunture and Moxibustion Acupuncture anesthesia research sprang originally from pharmaceutical research and has greatly advanced. The main object of acupuncture hower should be its therapeutic effects for disease. In spite of this there has not been much progress made in understanding the involved mechanism.. There is a circulatory transmission phenomenon along the meridians; it is also known that the electrical resistance and impedance changes at various acupoints. There has been almost how-ever about why such points are effective as therapeutic points. The cooperation of acupuncture-moxibustion therapists is greatly wanted.
Introduction: There are two types of phenylalanine, one of the essential amino acids, D-Type and L-type. Phenylalanine in itself has shown no clear analgesic effect in human beings, however, as we reported previously, D-type phenylalanine (DPA) when administered prior to acupuncture analgesia in human beings lengthens the analgesic effects of acupuncture. At this time then, using volunteers in whom acupuncture analgesia failed to raise the pain threshold (PT) we experimentally studied whether or not DPA has any influence. Methods: Subjects were divided into an acupuncture anesthesia effective group (a rise in PT was observed due to acupuncture) and an acpuncture anesthesia ineffective group (no rise in PT). 4.0g. DPA was administered orally in both groups 30 minutes prior to acupuncture anesthesia. For acupuncture anesthesia right and left LI-4 and right and left ST-36 were used with low frequency electric current administered for 50 minutes. For the determination of PT a radiant heat pain meter was used. The PT was measured when DPA was administered, during acupuncture anesthesia and at every 30 minutes for 3 hours after the needles were withdrawn. Results: In the acupuncture anesthesia effective group, a rise in the PT was observed in 4 of the 5 cases and, the rise was much faster than when acupuncture anesthesia was used alone. In the acupuncture anethesia ineffective group, there were cases in which a remarkable rise in PT was observed or in which no rise in the PT occured during acupuncture stimulation but occured after the discontinuation of the acupuncture and some cases in which no rise occured during or after anesthesia. Discussion: 1. In the acupuncture anesthesia effective group due to DPA pre-medication, the rate of PT rise quickened. 2. After operations the PT rise was lengthened. 3. The individuality of the acupuncture effectiveness in human beings was partially eliminated.
We have frequently obtained good results with difficult pain using an improved acupuncture anesthesia method, cutaneous meridian stimulation, in which the patients himself can administer stimulation. However we have had a great variety of experience using these methods. There have even been cases in which therapy had no effect whatsoever. It has long been known that the effects of stimulation produced analgesia, (SPA) one form of acupuncture anesthesia, vary remarkably from person to person. In one hand it has been indicated that the pain-killing effects are related with the endogenous morphine-like substances however recently Takeshige and colleagues, believing that the individual differences in effect are based on the activity of the individual's amino peptidase, administered the peptidase interferrent, D-phenylalanine (DPA) and proved experimentally that so doing causing a change from ineffective to effective in SPA results. We studied the effects produced by DPA on the cutaneous pain threshold using transcutaneous nerve stimulation, by administering DPA in cases in which the pain threshold did not rise due to transcutaneous electric nerve stimulation alone. The subjects of the study were 9 healthy volunteers between the ages of 24-30 with no neurological diseases and 8 stubborn pain patients. The stimulation points were 2, right LI-4 and right LI-10. Stimulation was administered using a spike-type conductor rubber external electrode. Results 1. Looking at changes in the pain threshold due to transcutaneous electric nerve stimulation only, it was observed that in 11 of 17 cases there was almost no change or slight fluctuation around the pain threshold. 2. Upon administering 4g. DPA to the 6 cases in which the pain threshold did not change and administering transcutaneous electric nerve stimulation in the same manner as before, the threshold rose in 1 case. 3. The serum concentration of phenylalanine increased 5 times that of pre-medication levels.
In the acupuncture-moxibustion clinic there are cases in which acupuncture insertion in the lumbar-sacral area on patients with coldness of the lower limbs results in a feeling of warmth in the legs. We formerly reported that based on observations of the peripheral temperature, the fluctuation curve of the profound temperature and the hunting reaction we learned that acupuncture-moxibustion stimulation at LV-3 and SP-6 improved circulation in the lower limbs. This time we examined the influences of acupuncture insertion in the sacral area on the circulatory system. The insertion area was BL-32 (posterior sacral foramen II). After the patient had rested in a prone position for 30 minutes insertion of a stainless steel 1.6 TSUN 3 needle was administered to the depth at which the acupuncture sensation toward the lower limbs was felt. Pecking techniques were administered several times followed by 30 minutes of stationary insertion. The objects of measurement were cutaneous temperature (Back of 1st toe, KI-1, BL-59) the subcutaneous (1cm) profound temperature (Center of bottom of foot, BL-56 at the center of the gastrocnemius muscle), pulse (2nd toe) and heartbeat. Also using a water plethysmograph the amount of blood circulating in the entie leg was measured. The cutaneous temperature was measured using a thermo-couple. the profound temperature using the KOATEMP by Thermo. A recorder was attached and temperature reading recorded continuously beginning 20 minutes before acupuncture insertion and continuing until 20-30 minutes after withdrawal. The number of subjects was 14. The results of the experiment showed differeces in about half of the cases. A step style increase of 0.3-1°C in the temperature of the feet during stationary insertion was indicated. A tendency for bradycardia in the heartbeat 10 seconds-several minutes after acupuncture insertion was also indicated. From the above results it was learned that acupuncture insertion and stationary insertion at BL-32 served to expand the peripheral blood vessels of the lower limbs and improve circulation in some cases.
In spite of the fact that the functional mechanism of acupuncture therapy is almost completely unknown its effect is widely accepted. Does acupuncture work as the result of body fluid factors or of nerue factors? There is still no conclusive evidence either way. We measured variations in body temperature (deep body temperature) one area in which it is said fluctuation due to acupuncture therapy can be expected, and studied the acupuncture therapeutic results. The subjects of the study were healthy adults who had no cervico-scapulo-brachial disorders. The deep body temperature on the right and left 2nd fingers (between DIP and PIP on the back of the hand) was measured using a DCC-1 type apparatus manufactured by Thermo Co.. Stationary insertion was performed at LI-4-TH-5 on the right hand and electrical current administered for 5 minutes. Before and after electrical stimulation the right and left deep body temperature was measured.
In the normal internal medicine outpatient cline clinic acupuncture therapy has been accepted. A scientific system of acupuncture-moxibustion therapy which could not have been imagined 20 years ago has developed. This development into a wonderful academic science should indeed be a cause for rejoicing. With the faster than fast speed of developement it is perhaps natural that some mistakes and evils have also come along. There is no need to mention that the acupuncture therapist is not a doctor. Thus he has absolutely no right to make a diagnosis or to prescribe medication. The acupuncture therapists of today have attained prosperity through their own endeavors. It is also the fact that the acupuncturists are in part treating patients who have been deemed hopeless by Western medicine. This is thanks to the characteristic system of our country. Looking back over this acupuncture-moxibustion society which has developed so rapidly in view of the fact that ethical practices in part at least of modern acupuncture therapists are considered arrogant and distasteful by those of the medical profession, I am daring, at this time, for the sake of the acupuncture therapists, to make note of this fact, inviting the comments and criticism of my colleagues.