Clinical sense is considered to be a kind of clinical ability by which dynamic managements could be done in the case of various clinical problems. In general, clinical sense is generated on the ground of good balance of three major elements, namely, clinical general knowledge, clinical technique in practice and mindful attitude to the patients. Medical comprehension and ability for communication technique, interview method, psychology of patients, clinical ethics, informed consent, evidence based medicine, clinical pathway and so forth, are necessary as a basis of clinical sense. And also, the special recent medical knowledge and technique are required in each special field.
Each person engaged in medicine should come in contact with a feeling of sympathy, sincerity and service. Clinical sense will be cultivated through the daily clinical training on the clinical cases.

View full abstract

In Japan, acupuncturists generally use Oshide (Japanese style handling of the needle) to insert needles. It means that Japanese acupuncturists frequently handle the needle shaft during insertion and treatment (albeit with sterilized fingers). This everyday practice of Oshide used by almost all Japanese Practitioners differs significantly from the global Safety Standards for medical and acupuncture sterilization procedures. Furthers, practitioners in other countries may report such practices of needle handling as malpractice.
The author introduces the history and status of Oshide in Japan and other countries and hopes that Japanese practitioners will discuss it.

View full abstract

Effects of acupuncture on gastric motility in anesthetized rats
Acupuncture has been used to treat gastrointestinal symptoms in. China for more than 3, 000 years. However, the mechanism of the beneficial effects of acupuncture remains mysterious. Strain gage transducers were implanted on the serosal surface of the stomach to record circular muscle contractions in thiobutabarbialanesthetized rats. Acupuncture on the right lower abdomen caused a transient relaxation of the stomach. Acupuncture-induced gastric relaxations were abolished by guanethidine, propranolol, splanchnic ganglionectomy, spinal cord transection, and spino-medullary transection. In contrast, NG-nitro-L-arginine, phentolamine, truncal vagotomy and ponto-medullary transection had no effect. Acupuncture increased the number of c-Fos immunopositive cells at the rostral ventrolateral medulla (RVLM). It is concluded that acupuncture-induced gastric relaxations are mediated via somato-sympathetic reflex. Its afferent limb is composed of abdominal cutaneous and muscle afferent nerves. Its efferent limb is the gastric sympathetic nerve and the reflex center is within the medulla. RVLM neurons may play an important role in mediating this reflex.
Effects of acupuncture on gastric motility in conscious rats
Of 35 rats studied, 60% showed no cyclic groupings of strong contractions (type A) and 10 rats (40%) showed the cyclic phase III-like contractions (type B) in conscious rats. In 73 % of type A rats, acupuncture on the hind limb (ST36), but not on the back, produced strong cyclic contractions lasting for more than 3 hrs. Acupuncture failed to produce phase III-like contractions in type A rats treated with atropine, hexamethonium and vagotomy. Pretreatment with naloxone significantly shortened the duration of enhanced phase III-like contractions. In 60 % of type B rats, acupuncture suppressed phase III-like contractions. These results suggest that the acupuncture on the ST36 induces dual effects, either stimulatory or inhibitory effects, on gastric motility. The stimulatory effects of acupuncture on the hind limb are mediated via wagal efferent pathway and opioid pathway.
Effects of acupuncture on vasopressin-induced emesis in conscious dogs
Arginine vasopressin (AVP) is a posterior pituitary hormone and recent evidence implies an involvement of AVP in vomiting and nausea of humans and animals. Vasopressin was intravenously infused at a dose of 0.1U/kg/min. Number of retching and vomiting were visually counted during the experiment. Intravenous administration of vasopressin induced retching and vomiting in all dogs tested. Retrograde peristaltic contractions (RPCs) occurred before the retching and vomiting.
Electro-acupuncture (EA) of 10 HZ at PC6 decreased the number of retching and vomiting induced by vasopressin. EA also suppressed the RPCs. EA at the PC6 significantly reduced the number of episodes of retching and vomiting to 20-30 % compared to that without EA, while EA at BL21 had no significant effects on the number of episodes of retching and vomiting induced by vasopressin.
To investigate whether opioid pathway is involved in EA-induced anti-nociceptive effects, naloxone was administered before EA and vasopressin infusion. EA at PC6 had no more inhibitory effects on vasopressininduced nausea and vomiting when naloxone was given. This suggests that anti-emetic effects of acupuncture is mediated via (central) opioid pathway.
Effects of acupuncture on EGG in healthy volunteers
The point of PC6 and ST36 are the common points for the treatment of gastric symptoms. We compared the effect of EA between PC6 and ST36 on gastric myoelectrical activity using surface electrogastrography (EGG). Eight healthy volunteers were fasted for 12 hours. On the separate days, four sessions of EA (1 Hz, 30 min) were randomly performed to each subject. The percentage of normal slow waves and tachygastria, peak dominant frequency (PDF) and peak dominant power

View full abstract

In Japan we are rushing into an era of aging society. People will need acupunctureand moxibustion more and more in the future. ”So, to be loved by people indeed, therapists have to setour sights on“ People have acupuncture and moxibustion on a high level at any therapist. ”And we have to makeeffort to progress our stuff and technique that therapists are made of. At first, we have to make it in mind“ Do non-pain acupuncture ”to dispel anxieties and dread of patients and to feel good for their treatment. On that account, therapists have to devote aurself to our studies of traditional Japanese medicine and delicate Japanese acupuncture with Japanesque fine needles. I believe the true acupuncture and moxibustion should be the medicine to work on the life force with the technique of “Ho” and “Sha” to the acupoints on the meridians. And I believe that we should send this all over the world as a Global Standard for acupuncture. I know it is possible to have clinical effect without pricking needles, through my long experience. I can evidence it with Bi-Digital O-Ring Test. I can get clinical effect with only affixing aneedle in a specific direction. With this treatment, patients feelcomplete non-pain because they don't be pricked.I call it“ Vector Effect Needle (VEN) ” I deliver a lecture on this acupuncture.

View full abstract

Moxibution therapy, along with acupuncture and herb therapies, has long been one of major traditional therapies in East Asia. It has history of over two thousand years. Since ancient days Artemisia, the material of moxa was gathered up in early May and used for the purpose of protection against outer evil materials.Some of the medical texts excavated from Mawangtui tomb _??__??__??__??__??_ in 1973 suggest that around 2 B.C.fumed moxa was used for disinfection of the operated parts in body. We can also find in the Mawangtui medical texts the first description on moxibution therapy based on meridian theory. But it is not until the publication of Zhenjiu Jiaouyijing _??__??__??__??__??_ that detailed correspondence between diseases and treating points (acupoints) was made clear.
Qianjinyaofang _??__??__??__??_ and Waitaimiyaofang _??__??__??__??__??_, both published in Tang period, left a strong in-fluence over the practice of moxibution therapy in later period. Qianjinyaofang has a lot of articles indicating superiority of moxibution to acupuncture therapy. It also gave moxibution therapy a new concept, ’Yangsheng (prophylaxis) _??__??_’.Wangtao_??__??_, the author of Waitaimiyao, depended much on Qianjinyaofang for hiswriting, and recorded only moxibution therapy. Ishinpo _??__??__??_, the first comprehensive medical text in Japancompiled by Tanba Yasuyori (_??__??__??__??_) in the late 10th century, is wealthy of excerpts from these twobooks. In medieval Japan, moxibution therapy achieved dominant position in the cure of disease while acu-puncture was applied mostly for surgical operation.
The influx of medical books from Ming China since the 16th century enabled Japanese physicians to domore detail and careful analysis of moxibution therapy. Leijingtuyi _??__??__??__??_ and Huangdimingtangjiujing_??__??__??__??__??__??_ were the main objects of their research. It is also notable that in Edo Japan, the therapy waspracticed not only by physicians, but practiced also among the commonality for the purpose of their health care. Actually, in many parts of Japan moxibution therapy has been practiced among families as an annual event in community.
The discovery of the New Continent in the late 15th century brought many Westerners to East Asia. The knowledge of moxibution therapy was transmitted to Europe by the Jesuit priest and physicians who were in-terested in the natural history of Japan. In Nippojisho _??__??__??__??_, a Japanese-Portuguese dictionary printed in1603 at Nagasaki, we can find some words regarding moxibution. Engelbert Kaempfer, a German physician who did botanical research in Japan in 1690-92, published in 1712 Amoenitatum Exoticarum in which he in-troduced moxibution therapy. In this best selling book, he made very interesting comparison between Japanese moxibution and the similar therapies practiced in Arabic world. He also inserted a chart of moxibution points, reprinted from a kind of pamphlet on moxibution, Kyushokagami _??__??__??_.
Erwin von Baeltz, a German physician who stayed in Japan for more than thirty years in the second half of the 19th century and contributed much to the foundation of western medicine in Japan, left a photo of a male patient with Hansen’s disease with many burning dots of moxibution on his body. Though it was already reported in the 17th century by Willem ten Rhijne that moxibution was applied to Hansen’s disease in Japan, Baeltz’s photo is quite rare proof of the practice.

View full abstract

INTRODUCTION : It has been suspected that the BL40 (Weizhong, Ichu) point could be used as a remote acupuncture stimulation point for the effective treatment of lumbago, because traditional remote acupuncture stimulation has shown, on occasion, dramatic effects for relieving chronic pain, especially lumbago, headaches and shoulder pain. We have reported that remote acupuncture point stimulation, such as “BL40-to-BL23 (Shenshu, Jinyu)” might be useful in the treatment of lumbago. An experiment was designed to identify the most effective points on the Bladder Meridian.
METHODS : We tested the electrical stimulation of BL57 (Chengshan, Shozan), BL58 (Feiyang, Hiyo) and BL60 (Kunlun, Konron) as far-points on the BL23 (Shenshu, Jinyu) in patients with slight to mild cases of lumago (24 adults, average age 31.2 y-o), who had given their informed consent beforehand. RESULTS : It was found that the respondent value (96.4 ± 4.8V, n=12) of BL40 on pre- stimulation in the male group was lower than that in the female group (86.1± 4.7V, n=12; p=0.07). When BL57 of lumbago patients was stimulated, the responsiveness of BL23 increased significantly in the male group (y=-0.04x+94.99; r=0.35, p<0.05), but declined in the female group (y=0.07x+102.55; r=0.44, p<0.01). When BL58 was stimulated, it had no apparent effect on the responsiveness of the male group, but that of the female group was reduced (y=-0.13x+99.00; r=0.85, p<0.001). In contrast, the responsiveness of BL23 to BL60 stimulation did not change in the male group but increased in the female group (y=0.12x+100.24; r=0.71, p<0.001). These results indicate that the stimulation on BL57, BL58 and BL60, which are far-points from BL23, had widely different effects on the responding pattern of BL23 in patients with lumbago.
CONCLUSION : The results confirm that remote acupuncture point stimulation might be valuable in the treatment of lumbago.

View full abstract

[Purpose] Elderly patients with chronic low back pain have often been treated by acupuncture andmoxibustion therapy, using the traditional acupoints for low back pain. But there are some patients who do not get a clinical effect. Therefore, we tried to treat three such patients with three sessions of trigger point acupuncture therapy, instead of using the traditional acupoints for low back pain.
[Methods] The patients were aged 74, 71 and 66, and had low back pain for at least 6 months. They hadround backs, but there were no extraordinary findings in their neurological examinations.
[Results] During and after the previous therapy using the traditional acupoints for low back pain, there wereno remarkable clinical effects on low back pain. But during and after the present therapy using trigger points, there were remarkable clinical effects on low back pain, as evaluated by the visual analogue scale (VAS) and the pain disability assessment scale (PDAS).
[Conclusion] These results suggest that the trigger point acupuncture therapy may be more effective on lowback pain in elderly patients than acupuncture therapy which uses the traditional acupoints.

View full abstract

It is generally known that oriental medicine is based on the concept of deficiency and excess to explain disease in a complex living system. However, a disease model based upon the expression of the relationship between the rhythm of the five basic elements and the living body's control system has not been proposed. Therefore, we investigated this relationship by modeling “Kyo-Ja” and “Jitsu-Ja” on abnormal rhythms of the five basic elements.
We constructed models that always reflect changes in the rhythm of the five basic elements to show that disease occurs by breaking these control systems. The present model suggests that treatments of disease should not only incorporate the characteristics of the five basic elements but should also consider the course of a disease and the patient's overall condition.

View full abstract