The textbooks edited by the 'Japan College Association of Oriental Medicine' are utilized by numerous vocational schools and universities specializing in acupuncture, moxibustion, anma, massage, and shiatsu. The committee responsible for preparing teaching materials within the association reviews the contents' outlines and produces these textbooks. In recent years, the restructuring of three textbooks - 'Acupuncture Theory,' 'Clinical Theory of Oriental Medicine,' and 'Anatomy and Physiology' - has been undertaken. However, the background detailing how each textbook was created, restructured or revised, including its purpose and method, hasn't been adequately communicated to the individuals using these resources. During this symposium, the three individuals involved in the reorganization and revision of the textbooks presented the purpose, process, and key points to consider regarding three recently revised textbooks across four subjects.

[Introduction] Needle penetration of the skin without pain and smooth insertion of needle to deep structures are considered important skills for adequate acupuncture therapy. Physical resistance during needle insertion has been considered an important factor for smooth needling, however no experimentation has been conducted. In the present study, the relationship between insertion resistance and respiratory rhythm was quantitatively analyzed.[Methods] Seven subjects who gave informed consent were used. Insertion resistance was measured by a specially developed device. The acupuncture needle was attached to the holder of the motor drive unit which inserted the needle at a constant rate of depth, and changes of resistance were monitored by the strain-gage attached to the base of the needle holder. The subjects lay in prone position and the resistance meter was set on the back or thigh. They were asked to maintain a stable rhythmic respiration, or to hold at inspiratory or expiratory state during insertion resistance measurement. Surface electromyogram (EMG) was at the nearby needle insertion loci were recorded.[Results] Rhythmic changes in insertion resistance at the lumbar area accompanying respiratory rhythm were clearly detected. These rhythmic changes of insertion resistance disappeared when the respiration was held and reappeared with rhythmic respiration. No change in insertion resistance accompanying respiration was observed at the femoral region. No EMG activities accompanying rhythmic respiration was detected by surface electrodes at lumber areas.[Discussion and Conclusion] The present study clearly demonstrated that needle insertion resistance rhythmically changed with respiration and low insertion resistance was observed during the expiration phase. These facts suggest that needle insertion during the expiration phase is easier than in the inspiration phase. These changes in insertion resistance disappeared with holding of the respiration. It is reasonable to assume these insertion resistance changes are caused by direct muscular tonus changes or through autonomic nervous functions during respiration. Our attempts at EMG recordings could not detect electrical activities of the lumber muscles, so other mechanical influences produced by the respiratory movement might be a possible factor in the insertion resistance changes.

[Objectives] The increase in skin temperature due to acupuncture treatment has been reported visually using thermography and other techniques. In this study, we measured the main acupuncture temperatures of the whole body before and after treatment, captured the characteristics of the correlation between pre- and post-treatment temperatures, and discussed the mechanism of cooling improvement. [Methods] Eight women who were aware of their coldness, who gave informed consent, were treated during a particularly cold season (December X to X+1 February). As a whole body treatment, five minutes of acupuncture was applied to CV12, ST25, and CV4 in the abdomen, BL10 and GB20 in the cervical region, BL17, BL18, BL20, and BL23 in the back, and BL40 and BL58 in the feet. Before and after treatment, the temperatures of the acupuncture points of the whole body (CV22, CV14, CV8, CV4, GB26, PC6, TE5, BL15, SP6, KI1, GV12, GV9, and GV4) were measured with a non-contact thermometer. Subsequently, for each acupuncture point, a graph plotting the temperature before and after treatment was created, and temperature changes before and after treatment were assessed by t-testing, and the presence or absence of attribute trends in pre-treatment acupuncture point temperature was assessed by linear regression analysis.[Results] For the abdomen, medial upper extremity, and medial lower extremity, transapical temperature increased significantly after treatment, uniformly independent of pre-treatment temperature. For the dorsal, lateral upper extremity, and lateral lower extremity, the acupuncture temperature did not rise uniformly after treatment; the lower pre-treatment temperature increased after treatment, but the higher pre-treatment temperature decreased after treatment. The temperature of the lateral abdomen and the soles of the feet increased significantly after treatment, and the degree of increase was greater in people with lower pre-treatment temperatures. And this balance of heat was found to promote blood flow to the tip of the foot.[Discussion] After the whole-body treatment as in this study, it is thought that by confirming the temperature measured before and after the treatment, in addition to the subject's subjective awareness of the warmth of his or her body, it is possible to convince the subject of the meaning of the treatment and to improve his or her main complaint. I thought it could be introduced as a method of examination.

[Objective] In Chinetsukyu, a burning moxa cone is removed when the patient begins to feel heat or warmth. As a standard for removing moxa, the burned ratio was used, but the range of the ratio is wide from 70% to 90%, and the temperature is considered to be different. 　In this study, in order to remove the moxa at the target temperature, the relationship between the temperature and the combustion height is clarified by using moxa with different shapes and hardness.[Method] The moxa cones had a conical shape with bottom diameters of 20 mm and 10 mm. The height and density were changed. The temperature at the center of the bottom of the moxa was measured using a K-type thermocouple. The target value of the rising temperature (ΔT ) to feel warmth was set to 15℃. The burning time is the period from ignition to 15℃, and the heating time is the period from 1℃ to 15℃. The combustion height is the distance from the bottom of the moxa to the combustion area.[Results] As the moxa height increased, the burning rate and burning and heating times all increased. As the moxa density increased, the burning rate decreased, and the burning and heating times increased. The combustion height for ΔT =15℃ was less dependent on moxa height and density and became half the bottom diameter. In order to investigate the relationship between the combustion height and the moxa shape in detail, the rising temperature was formulated. If the moxa was high or density was low, the combustion height for ΔT =15℃ was higher than half the bottom diameter. If the moxa was high or density was high, the amount of heat per second of radiant light decreased.[Conclusion] In order to remove moxa at ΔT =15℃ as the target warmth, the height of the moxa and density of the moxa dependencies on the combustion height were small. As the standard to remove the burning moxa at ΔT =15℃, the combustion height of half the bottom diameter could be used. If the moxa height is high or density is low, the moxa should be removed slightly before the target height. It is considered that the smaller or softer the cone, the larger the amount of heat per second, and the better the heating characteristics.

[PURPOSE] To examine the safety of acupuncture treatment for breech presentation. [PARTICIPANTS AND METHODS] A retrospective study of cases in which acupuncture in the pelvic position was performed on hospitalized pregnant women with preterm labor in the pelvic position during the period March 1, 20XX-11 to December 28, 20XX was conducted. The survey items included maternal background, maternal and fetal status (including Non stress test), change in drug dosage for preterm labor, outcome of acupuncture treatment, and any adverse events due to acupuncture treatment. [RESULTS] There were 23 pregnant women who qualified for the study. All were receiving standard management of imminent preterm labor. The median number of acupuncture sessions was 7 per patient, for a total of 157 sessions. There was no significant increase in the number of uterine contractions within 24 hours of acupuncture treatment, and in no case was the fetal status assessed as non-reactive before delivery. There was no significant increase in drug dosage within 24 hours of acupuncture treatment. The rate of correction to the cephalic position was 39.1% (9/23 cases). Two adverse events (Grade 1) due to acupuncture treatment were observed, with a frequency of 1.3% (2 cases/157 sessions) per treatment. In addition, there were two cases in which ritodrine hydrochloride was increased within 24 hours of acupuncture treatment.[CONCLUSION] In our study population, there were no signs of fetal distress or worsening of uterine contractions. In the acupuncture treatment methods of our department, the possibility of adverse effects on the mother or fetus was considered low. However, there were two cases in which ritodrine hydrochloride was increased after acupuncture treatment. When providing acupuncture and moxibustion treatment to pregnant women, it is necessary to collaborate with obstetricians.

[Objective] Herein, we report a case of a remarkably effective combination of acupuncture and daily olfactory training for treating postinfectious olfactory dysfunction that had not improved for years.[Case] A 45-year-old woman complained of decreased sense of smell and inability to smell properly. She had postinfectious olfactory dysfunction four years ago, which resulted in olfactory deglutition. She continued taking zinc preparations prescribed by the hospital; however, they showed no therapeutic response. She discontinued a yearlong hospital visit and received approximately 10 acupuncture sessions. Her odor problems gradually recovered to some extent after the acupuncture treatment, but dysphoria appeared. Her symptoms showed no significant changes over the next 3 years.[Results] The pretreatment olfactory VAS score was 38mm and the self-administered odor questionnaire score was 30%. Acupuncture treatment was focused on the facial area; thus, she was instructed to perform daily olfactory training by smelling various odors. Consequently, the olfactory VAS score improved to 97mm and the self-administered odor questionnaire score improved to 97.5% after 18 acupuncture sessions for 18 months.[Conclusion] The results indicated that the combination of acupuncture and daily olfactory training could improve postinfectious olfactory dysfunction that had not improved over the years.

[Introduction] What is a medical-like practice as defined in Article 12 of the Act on Anma, Massage, Shiatsu, Acupuncture, and Moxibustion Practitioner, etc.? Are Anma, Massage, Shiatsu, Acupuncture, and Moxibustion included in the medical practice? This article examines medical-like practice based on the above questions.[Objective & Method] First, the medical practice, which is the premise for practice similar to the medical practice, was clarified. Next, we interpreted the wording of the articles of the law. We then organized the literature, Ministry of Health and Welfare notifications, and judicial precedents to depict the contours of medical-like practice. Finally, we examined how medical-like practice are positioned in the medical care system, in relation to the Medical Practitioners Law, and in comparison with the medical practice.[Result] Regarding the medical practice, medical practice could be defined as an act that "may cause health hazards unless it is performed by a physician" based on the assumption that it is now "an act with medical relevance" based on notifications and judicial precedents. From the interpretation of the wording of the relevant articles of the law, it was concluded that the natural interpretation is that kind of practice is included in acts similar to medical practice. Through the literature, notifications, and judicial precedents, the content and direction of the understanding and interpretation of the medical profession-like practice have been clarified and refined over time, and the latest Ministry of Health and Welfare notifications and judicial precedents confirm that the law is currently being applied as a medical profession-like practice. The study examined the medical profession-like practice in relation to the Medical Practitioners Act and in comparison with the medical practice, and concluded that although the medical practice is performed by medical doctor, if one focuses only on the act, the medical profession-like act can be said to be part of the medical profession, albeit to a limited extent.[Discussion] However, it is extremely limited compared to treatment performed by medical doctor, and is different from medical practice in terms of the interpretation of the article, the Ministry of Health and Welfare's opinion, and judicial precedents. However, if that practice is to play a role in the advancement of medical treatment, the practitioner as a "medical-like practice" must keep pace with the progress of the "medical practice" and have progress and deep medical insight.