The use of complementary and alternative medicine (CAM) is increasing rapidly. CAM, as defined by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA, is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional Western medicine. NCCAM classifies CAM therapies into five categories, or domains; 1. Alternative Medical Systems (Traditional Chinese medicine, Ayurveda, Homeopathic medicine, Chiropractic, Naturopathic medicine, etc.), 2. Mind-Body Interventions (Meditation, Prayer, Mental healing, Art, Dance, Music therapy, etc.), 3. Biologically Based Therapies (Foods, Herbs, Vitamins, Dietary supplements, Aromatherapy, etc.), 4. Manipulative and Body-Based Methods (Chiropractic or Osteopathic manipulation, and Massage, etc.), and 5. Energy Therapies (Qi Gong, therapeutic touch, electromagnetic fields). In the USA, CAM use increased from 33.8% in 1990 to 42.1% in 1997. In Japan, 65.6% of adults used CAM. Furthermore, in the USA, 61.5% of the CAM users did not tell their doctors while 78.9% of the CAM users in Japan did not tell theirs. In Japan, the domain of dietary supplements is most important, followed by aromatherapy, traditional Chinese medicine (Kampo), Ayurveda, and electromagnetic fields. An Agaricus blazei Murill is the most popular dietary supplement. Many cancer patients take this mushroom. The aim of this paper is to determine the actual status of dietary supplements in Japan.

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In the present paper, the author reviews acupuncture clinical practice and the research scene in Western countries, and discusses problems in Japanese acupuncture.
The use of acupuncture is increasing in the West, but many more people have received this treatment in Japan. Although regulations on acupuncture depend on the country, many EU countries limit acupuncture practice to medical doctors. Regarding the style and theory of acupuncture, Traditional Chinese Medicine is overwhelmingly dominant in the world.
In recent years, the worldwide prevalence of the concept of evidence-based medicine (EBM) has facilitated randomized controlled trials on acupuncture in the West. However, there is a bigproblem in setting a sham acupuncture group. Pragmatic clinical trials should be considered more in the future.
If the researchers of “Japanese acupuncture” pursue only reductionistic research methodology, they might lose something important that traditional medicine has brought for many years. Although we should employ the concept of EBM, we, at the same time, should discuss what Japanese acupuncture is and how we evaluate the aspect of the “art” of acupuncture medicine more intensely.

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Prof F. Shirota passed away on Jan 23rd in 2005 at the age 63. We, the trainees instructed by him at the Oriental Medicine Training Center, Nissan Tamagawa Hospital, have been stray sheep ever since.
I am very happy to have the chance to report on the true value of acupuncture & moxibustion clinic taught by him at the 55th Annual Meeting.
To understand this theme, I asked the help of colleagues taught by him at the Center for 26 years and got a final report in cooperation with them. The report is composed of his books, his speeches, his words of instruction at the clinical site, his special lecture as his last words at the 50th Annual Meeting at Kobe, and reports and suggestions given to me by 18 former trainees at the Center.

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A symposium was held to focus attention on the position of the meridian point GV 14, which has been con-troversial over the centuries.
To summarize the symposium opinions : (1) Since the positions of meridian points have changed with time and culture and according to the therapeutic target, objective, and instruments, the changes of the position of GV 14 from above the spinous process of the second cervical vertebra to between the spinous processes of the 6 th and 7 th cervical vertebrae and to between the spinous processes of the 7 th cervical and the 1 st thoracic vertebrae are not exceptional. (2) If the position of GV 14, which is a standard for the determination of meridian points on the back, changes, its clinical value is nullified. It should be, therefore, standardized as being between the spinous processes of the 6 th and 7 th cervical vertebrae. (3) The 6 th cervical vertebra is important in body surface clinical science, and the 7 th cervical vertebra is important in the mobility and anatomical segmentation of the spine. However, in consideration of the development processes of acupuncture, it is more reasonable to determine the position of GV 14 on the basis of clinical effects. (4) The proposed international standardization of the position of GV 14 as between the spinous processes of the 7 th cervical and 1 st thoracic vertebrae is acceptable, because there has been no objection from China or Korea.
No agreement was reached in this symposium, but the position of GV 14, which bears great clinical significance, must be evaluated further.

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It is indicated in this Symposium that a goal of Japanese Acupuncture Study is to establish culture-based medicine. However, because of insufficient understanding of modern medicine among acupuncturists in Japan, systematic postgraduate training has become one of the most urgent programs. Acupuncturists in Japan should be included in the medical system as co-medical staff such as nurses, PTs, and so on, in the near future.
All speakers emphasized that Japanese acupuncture and moxibustion have developed their identity using various methods in the past, although there a healing was popular in the public apart from the main medical field. It is, therefore, agreeable to standardize the educational system in its present medical field in Japan.
On the other hand, it is interestingly accepted for foreign researchers that Japanese acupuncture and moxibustion are well recognized as characteristic treatment with specifically delicate and fine techniques and tools. Even so, they originated from Traditional Chinese Medicine over twenty centuries.
Since the recent introduction of Oriental Medicine to the regular curriculum of modern medical education in all Japanese Medical Colleges, acupuncture and moxibustion as well as Kampo have born an important role as a holistic medicine with a recognition of an illness perceived by the patient in the 21 st century.

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The standardization of acupuncture point locations has been a pending matter for ages and considered the difficult challenge ever since the nomenclature of meridians and collaterals and acupuncture points, including the eight extra meridians and extra points, was standardized internationally at the Geneva Meeting in 1989. 14 years since then, in 2003, the Informal Consultation on Development of International Standard Acupuncture Point Locations by Japan, China and Korea commenced under the initiative of the WHO Western Pacific Regional Office (WPRO).
The discussions were held 9 times in 3 years, making great progress toward accomplishing the standardization. The objective will finally reach fruition at the Meeting on Development of International Standard Acupuncture Point Locations which is to be held at Tsukuba-city, Japan, in the fall of 2006.
The developments thus far and future issues are summarized and reported.

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The immunological research committee for acupuncture and moxibustion, which was primarily organized in 2004, has investigated previous reports on basic research describing the immunological effect with acupuncture and/or moxibustion treatment.
According to the on-line database, we firstly selected 724 reports by keyword searches, which were finally narrowed down to 52 reports on experimental animal tests and 42 reports on clinical tests (72 English articles and 22 Japanese articles) by careful sorting. Then, we analyzed information such as the condition of acupuncture and/or moxibustion stimulation, subject of the test, and immunological parameter for assessment in the 94 reports.
The findings showed that the previous research was performed under inconsistent methods that were difficult to organize, and it is suggested that more comparable and reproducible experiments are required for the progression of this research area in the future.

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A seminar was held with “the development of research on auricular acupuncture” as the main theme. In this seminar, the recent development of auricular acupuncture in Japan and abroad, its action mechanism, and clinical effects were reviewed, and the findings were comprehensively evaluated.
Concerning basic research on the effects of auricular acupuncture on obesity, the relationship between the auricle and hypothalamo-autonomic system and individual variation associated with differences in the condition of patients receiving the treatment were reported. As for the action mechanism, leptin expressed in white adi-pose tissue (WAT) due to acupuncture stimulation of the auricle was reported to bind to leptin receptors (Ob-R) in both peripheries and the center and suppress food intake.
Concerning clinical effects of auricular acupuncture, the results reported in Japan indicating its effectiveness for the treatment of obesity were presented. However, no overall conclusion was reached, because papers published abroad were not consistent in the therapeutic procedure or evaluation parameters. Auricular acupuncture appeared to be clinically effective for analgesia and the treatment of drug addiction but ineffective as an anti-smoking treatment.

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[Objective] For an objective investigation of symptomatic changes in indefinite complaints accompanying sleep disorder (6 participants), efficacy of acupuncture treatment was investigated using charts on indefinite complaints developed by Yasuzo Kurono, the chief of the indefinite complaint section in the Japan Society of Acupuncture and Moxibustion, research committee.
[Design] Case reports providing descriptive research
[Methods] Single acupuncture was administered by Taikyoku therapy (basic meridian points for total adjustment according to the Kurono style), and topical therapy (CV 17, ST 36) using 30-mm 18-guage needles. The treatment times were from 14 to 21 times.
[Results] Improvement of indefinite complaints was observed, and effect assessment using the charts on indefi-nite complaints showed marked improvement (1 participant was very effective, 5 participants were effective). Improvement of symptoms associated with sleep disorder was also observed.
[Conclusion] Efficacy of acupuncture treatment for indefinite complaints accompanying sleep disorder and themselves were suggested by the improvement of symptoms associated with sleep disorder.

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[Objective] To examine the effect of moxibustion treatment for reducedpain during activity due to hallux valgus.
[Methods] The subjects were five young females with pain due to hallux valgus. Indirect moxibustion treat-ment was carried out on the region of maximum pain to relieve pain. Moxibustion was performed once per day for 2 weeks, for a total of 14 times. Evaluation used the number of side steps performed and the pain (Numerical Rating Scale) at the time of a side step.
[Results] After moxibustion treatment, pain improvement was observed in all subjects at the time of a side step. At the same time, the number of side steps increased. Repeated measurements before and after moxibustion indicated that there was no significant learning effect.
[Discussion and Conclusion] It became clear that the pain due to hallux valgus is mitigated by moxibustion over a fixed period, while athletic ability with respect to side steps is also improved. These results suggested the pain during activity due to hallux valgus is controllable with moxibustion treatment. By controlling pain, moxibustion treatment also temporarily improves athletic ability.

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[Objective] To confirm the validity of chronic pain model due to a soft tissue lesion, we examined and compared pain behaviors occurring at the site of the lesion and a remote area.
[Methods] To produce muscle lesion in rats, lipopolysaccharide (LPS, 2 μg/kg, 100 μl) and 6% hypertonic saline (HS, 100 μl, five consecutive injections at 90-minite intervals) were injected into the unilateral gastrocnemius muscle at 24-hour intervals. Then, measurements for the muscle pain threshold and mechanical hypersensitivity of the hind paw were performed bilaterally.
[Results] A combined treatment with LPS and HS to the unilateral muscle developed long-persisting pain behaviors in the hind paws bilaterally, lasting more than 10 weeks. On the other hand, pain behavior at the injected site disappeared within 1 week after treatment.
[Conclusion] The pain behavior occurring beyond the site of the lesion persists even after the disappearance of pain in the muscle, showing a similar pattern in the development of chronic pain seen in humans.

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[Objective] To report the activity by the athletic trainer in a collegiate boxing club, focusing on acupuncture for medical treatment.
[Methods] The athletic trainer was Japan a Japan Sports Association certifiedathletic trainer who was a practitioner of acupuncture and moxibustion. Subjects were twenty-seven collegiate boxers who participated for one year from April, 2004 to March, 2005.
[Results] The activity by the athletic trainer was performed for thirty two days. Medical treatment was performed up to 2.2 times a day. Seventy-one people were treated by the athletic trainer. Medical treatments were acupuncture 28 (39.4%), massage 24 (33.8%), taping 4 (5.6%), and partner stretch 3 (4.2%). Thirteen people (48.1%) had acupuncture. In acupuncture, fifteen people (50%) had a chief complaint in the hand.
[Discussion] Acupuncture was requested by the boxers. The continuation of the activity by the athletic trainer was required for boxing.

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