Acupuncture and Moxibustion in Hospitals—How have General Hospitals Changed after Introducing Acupuncture and Moxibustion in Routine Care? / 日本東洋医学雑誌

Although it is not yet common, certified Kampo (traditional Japanese medicine) doctors and acupuncturists are cooperating with each other to provide traditional medical treatment for patients in some general hospitals in Japan. In other hospitals, however, Kampo and acupuncture-moxibustion have not been introduced, and doctors only treat patients using modern Western medicine. Many doctors must already be aware that modern Western medicine is not the only approach for the treatment of patients, but they do not make any efforts to improve the situation by adopting traditional medicine. Here, we give some examples of hospitals in which acupuncture treatments are routinely provided, having a favorable effect on both patients as well as the hospitals themselves. We believe that these examples give us a good opportunity to consider the future of an ideal medical system in which modern Western medicine and traditional Japanese medicine are successfully integrated.

<b>Difference Between Moxa Floss Made in Japan and in </b><b>China</b> / 日本東洋医学雑誌

<p>Direct moxibustion has been a common used moxibustion method in Japan, has required moxa floss of high-quality, and has promoted the development of a moxa floss manufacturing method unique to Japan. At the same time in China, because indirect moxibustion and the stick moxibustion method has been commonplace, low moxa floss of a purified standard has been produced with a simple manufacturing method. However well-refined moxa has become available in China recently, and it is now more similar to that in Japan.<br>In this study, we investigated the difference between highly-refined moxa made in Japan and China based on reports from Japanese clinicians on the usability of moxa in firsthand practice. We performed a questionnaire survey with the country of manufacture blinded in 265 moxibustion clinicians. The number of valid responses was 164 (61.9%).<br>To the question asking what the difference between the two types of moxa was, 54.9% of clinicians responded there was “a little difference,” and more than half responded with “better usability” and “favorability” for the Japanese moxa. Of 119 clinicians who performed moxibustion, 85 (71.4%) selected “comfort” for the Japanese moxa.<br>We therefore conclude that Japanese clinicians recognize moxa refined with the Japanese manufacturing method as more suitable for direct moxibustion treatment.</p>

<b>Current Status of Moxa Manufacture in Japan </b> / 日本東洋医学雑誌

In Japan, moxa floss has long been produced by traditional methods. It has a high degree of purity and is incomparable to that in other countries. On the other hand, mugwort (leaves) are being imported from China now, and used to make the product sold in recent years. However details on this current situation have not been reported publicly.<br>Therefore we sent a questionnaire 14 major Japanese manufactures involved in the manufacturing, processing or domestic wholesale of moxa. The questions were both multiple choice and freely-written descriptive types, consisting of 29 items in 15 fields, about the current situation and problems faced in moxa manufacturing. The questionnaire was sent by return mail on 16 th November, 2011.<br>As a result, 12 out of 14 makers (85.7%) responded. Stocks wise, mugwort from Japan was 88 t, and import from China was 45 t. Moxa floss from Japan was 13 t, and import from China was 50 t. Manufacturing season started in late November and ended in late March. Stone mills, grain fans, and <i>nagatoshi </i>were used for manufacturing and many of these apparatus were made by craftsmen at their company. This survey enabled us to examine delivery and export systems for mugwort leaves and moxa floss, current moxa manufacturing and apparatus status, as well as problems and the future outlook for Japanese moxa floss makers.

The Power of Moxibustion / 全日本鍼灸学会雑誌

At the symposium, "The Power of Moxibustion", four panelists discussed the mechanism, clinical effectiveness, and current conception of moxibustion in Japan with an aim to explore the potential role of moxibustion in the future. <BR>Mika Ohta noted that a bioinformatics approach could select basic research for the effectiveness of moxibustion. She also reported an example result of bioinformatic analysis focusing on the "heat"which can be produced by moxibustion and it can predict the mechanism of moxibustion. <BR>Keiko Tsujiuchi, an acupuncture and moxibustion practitioner, has been promoting moxibustion since 1980s.She has engaged in clinical research on obstetrics and reported a variety of favorable outcomes from using moxibustion in that field. <BR>Motoko Otsuka presented Ehime's cultural inheritance of moxibustion as a "healing tradition."She reported cases in which the patients received important interventions from moxibustion for their life, measured by chronological analysis, by introducing clinical practice including acupuncture and moxibustion treatment in the Acupuncture and Moxibustion Care Unit, East Asian Traditional Medicine, Ehime Prefectural Central Hospital, and instruction in self-moxibustion at the Perinatal Medical Center for mother and child health. <BR>Sachiko Y. Itaya, from the United States, reported activities and results of Moxafrica, which is using direct Moxibustion as an adjunctive treatment for tuberculosis in South Africa and Uganda. She emphasized that the role of moxibustion could be expanded much further as shown by the achievements of Moxafrica.

<b>Acupuncture and Moxibustion in Hospitals—Acupuncture Practitioners Should Participate as Hospital Therapists </b> / 日本東洋医学雑誌

Acupuncture and moxibustion are not fully or well-utilized in the medical system, particularly in the hospitals of Japan. If they were more commonly practiced in hospitals, disorders and disease conditions that are not improved by modern Western medicine might be better treated. In addition, collaboration between acupuncturist and Western medical doctors would promote the research of acupuncture, moxibustion, and related techniques.<br>However, to achieve these aims, improvements in the quality of acupuncture and moxibustion education would be needed. Also, hospitals that are presently using acupuncture and moxibustion for routine treatment would have to demonstrate their usefulness and how this is contributing to patients' health.<br>Having acupuncture and moxibustion therapists (AMT), as a defined occupation in hospitals, was proposed in 1981, although this has not yet been realized. However, we believe that hospital AMTs would be necessary for the progress of acupuncture and moxibustion, as well as for national health care and the medical system in Japan.

Standardization development in ISO/TC 249 related to acupuncture and moxibustion / 全日本鍼灸学会雑誌

It has been five years since TC 249 was established as a new Technical Committee (TC) at the International Organization for Standardization (ISO), specializing in the field of Chinese traditional medicine. In the second Plenary Meeting held in Den Haag (2011), five working groups (WGs) were established within the TC, two of which specialize in standard development of acupuncture needles (WG3) and other medical devices used in traditional medicine (WG4). Japanese delegates have participated in the discussion within these WGs, paying close attention so as to keep the proposals under discussion consistent with existing Japanese standards and certification standards regulated by the Ministry of Health, Labour and Welfare. However, since most of the participants in TC 249 are clinicians or researchers engaged in medical practices, and not experts on domestic/international standards, discussions on harmonization of the submitted projects often become complicated. In this manuscript, four experts (two from academia and two from companies that manufacture acupuncture needles and moxibustion devices) who attended the fourth plenary meeting held in Durban, South Africa, in May 2013, report on the stage of progress of standardization development in WG3and WG4.

Assessment and future development of the WHO/WPRO standardization of acupuncture point locations / 全日本鍼灸学会雑誌

[Introduction] In 2006 the WHO and WPRO agreed on standard acupuncture point locations. To promotepagate these standards, in 2009 the Second Japan Acupuncture Standardization Committee published a Japanese edition of 'WHO STANDARD ACUPUNCTURE POINT LOCATIONS FOR THE WESTERN PACIFIC REGION.' Based on this Japanese edition, a new textbook was published by the Japan Association of Massage & Acupuncture Teachers and the Japan College Association of Oriental Medicine. Since one year has passed since the start of education based on standard acupuncture point locations at Japanese universities, colleges, vocational schools and training centers for anma (Japanese traditional massage), massage, and shiatsu (acupressure); acupuncture; and moxibustion therapies, we administered a questionnaire survey as an evaluation of international standardization and the problems of introducing standard acupuncture point locations .<BR>[Subjects and methods] Subjects were mainly teachers and included a small number of researchers, clinicians, and other groups concerned with acupuncture and moxibustion. We used a questionnaire that we originally created at the Second Meeting of the Japan Standardization of Acupuncture Point Locations Committee.<BR>[Results] Among the 180 institutions surveyed, we obtained answers from 149 people from 93 institutions in total. Agreement on the question of standard acupuncture points, "functional existence" (44.3%) was most common, and "anatomical existence" came next at 26.6%. For the question on acupuncture treatment, 82.4% replied with "use ofboth acupuncture points and reaction points." For the answers to agreeing with international standardization, "no opinion" was 41.7% and 51.7% for "appreciate." However, both of those groups appreciated globalization of acupuncture and moxibustion by a common　language. There were many opinions on proportional bone measurement. Specifically, opinions indicated a change "from the cubital crease to the wrist crease" (from 10B-cun to 12B-cun) and a need for proportional bone measurement of the upper arm. Whereas, for individual acupuncture points, opinions expressed the difficulty of locating application points and not understanding reasons for change and notations including body surface segments.<BR>[Discussion] We were able to classify the opinions collected into the following groups: (1) problems that can be corrected immediately, including typographic errors, (2) problems that need to be reviewed at the next international gathering, and (3)problems that need to be understood by making full use of related documents.<BR>[Conclusion] We were able to determine primarily for a wide range of teachers, problems understanding individual acupuncture point locations, including consideration of acupuncture points, evaluation of standardization of acupuncture point locations, and other guidelines

History of Japanese Acupuncture and Moxibustion / 全日本鍼灸学会雑誌

The birth of Oriental Medicine, including Acupuncture and Moxibustion, is attributed to Chinese civilization and is thought to have occurred in the Yellow River valley 2000 years ago. The contributing factors establishing Oriental medicine included the development of city-states designed to unite the country under a single authority. The governors of these city-states wisely designed policies to make the health of the people a top priority.<BR>In the middle of the 6th century Acupuncture and Moxibustion spread into Japan. From the enactment of the "Taiho Code"(701 AD) until the promulgation of the "Modern Medical System"(1878) these modalities were recognized as the National Medicine of Japan. <BR>During the Nara and Heian period (8-12 c), Japanese practitioners mainly accepted and learned the Chinese style of acupuncture and moxibustion. After the Kamakura period (13-14 c), during the Muromachi and Azuchi Momoyama periods (15-16 c), and into the Edo period (17-19 c), the original character of Japanese-style acupuncture and moxibustion began to develop unique characteristics.<BR>Here, I have to specifically mention that a Portuguese ship arrived at Tanegashima Island in 1543, after which the cultures of Spain and the Netherlands influenced Japanese culture. Of course these foreign influences spread to the field of Acupuncture and Moxibustion.<BR>During the Edo period, Japan closed its borders to foreign influences. During this time Japan traded only with China, Korea and the Netherlands. These trade routes, the merchandise, and exchange of information did not directly or immediately influence Japan, but they did play an important role in future cultural trends. Especially in the medical field, through trade with China, and Korea, Japan continued to accept information about Oriental Medicine. Likewise, through trade with the Netherlands, Western medical innovation gradually became popular.<BR>In this way, Japan received the latest medical information from the forerunners of the world's medicine of that period. Naturally, the use of both traditional and modern modalities increases. As a result, Japanese Acupuncture and Moxibustion practitioners deepened their knowledge of classic texts, and made good use of the information from China and Korea. Significant innovations of this period include the concept of inserting acupuncture needles through a guide tube, more thorough abdominal diagnoses according to Chinese theories, and increasing acceptance of Western medicine theories. During the Edo period, developments in Japanese Acupuncture and Moxibustion would sustain the progress of these medical fields up to and into the Meiji era. <BR>These developments included changes in the medical system, education, and research of Japanese acupuncture and moxibustion.

Effect of taking acupuncture and medicine together for scleroderma: A case report / 全日本鍼灸学会雑誌

[Case Report]A female in her fifties complaining of numbness on her face and stickiness in the month who was diagnosed with scleroderma.<BR>Although some other symptoms were improved by the administration of medicine, her main complaints did not change. We applied acupuncture aiming at adjusting the autonomous nerves and it had a little effect for face numbness, Raynaud and KL-6 but numbness on her face did not change since suspending treatment. We changed the method of acupuncture in regards to palpation and it was more effective for her main complaint. <BR>[Method]Watching the change of the patient's subjectivity of a numbness on her face, frequency of sleeplessness and Raynaud, quantity of medicine, and the result of a blood test.<BR>[Result]Both her general condition and numbness on her face were relieved after acupuncture treatment. Especially acupuncture in regard to palpation for general care was more effective. There was no change in stickiness in the mouth.<BR>[Conclusion]We suggest that acupuncture treatment with medicine might be effective for symptoms of scleroderma. These changes will relieve anxiety for their disease and the secondary effect of medicine.

Report of 2009 WFAS University Cooperation Working Committee and WFAS Standard Working Committee / 全日本鍼灸学会雑誌

The WFAS University Cooperation Working Committee and WFAS Standard Working Committee were held during 2009 WFAS World Acupuncture Congress at European Parliament in Strasbourg, France on 6 November 2009. Publishing an International Textbook of Acupuncture and Moxibustion was proposed in the WFAS University Cooperation Working Committee. Also establishing Making WFAS standards on acupuncture needles, nomenclature and location of auricular points, manipulation of moxibustion, and manipulation of scalp acupuncture were discussed and proposed in the WFAS Standard Working Committee.

Report on an international symposium for developing acupuncture standard of WFAS (18 May 2010, Beijing, China) / 全日本鍼灸学会雑誌

An International Symposium for Developing an Acupuncture Standard of WFAS was held at the WFAS Office Building in Beijing on 18 May 2010. The aim of this meeting was to make the WFAS Industry Standard and to further develop the International Standard of Acupuncture and Moxibustion.<BR>JSAM dispatched two representatives to the meeting as informal observers. The reason why JSAM did not send representatives formally is that there was a serious discrepancy regarding the resolution of the EC meeting between WFAS and JSAM. However, after the several discussions with WFAS, JSAM eventually decided to send informal representatives who have a right to speak. JSAM presented the necessary information about Japanese moxibustion as well as its techniques.

Acupuncture and Moxibustion in Hospitals / 日本東洋医学雑誌

Acupuncture and moxibustion were introduced to Japan from China in the 6 th Century. Since then our ancestors adapted these unique techniques and knowledge to our climate and ethnicity, and eventually developed the Japanese system of acupuncture and moxibustion.Whether acupuncture and moxibustion therapy is successful or not depends on the knowledge and skill of the individual acupuncturist. However, in recent years, the role of medical doctors, nurses, physical therapist and other medical professionals working as a team has become particularly important, with some acupuncturist starting to work in university hospitals as part of these teams, and contributing to patient well-being.In this paper, to elucidate the roles of acupuncture and moxibustion in modern medicine, we show how acupuncture and moxibustion are applied in university hospitals, and how acupuncturists evaluate the effectiveness of their acupuncture and moxibustion.

Acupuncture and Moxibustion in Hospitals-Current roles of acupuncture and moxibustion in Japan- / 日本東洋医学雑誌

Acupuncture and moxibustion were introduced to Japan from China in the 6 th Century. Since then our ancestors adapted these unique techniques and knowledge to our climate and ethnicity, and eventually developed the Japanese system of acupuncture and moxibustion.<br>Whether acupuncture and moxibustion therapy is successful or not depends on the knowledge and skill of the individual acupuncturist. However, in recent years, the role of medical doctors, nurses, physical therapist and other medical professionals working as a team has become particularly important, with some acupuncturist starting to work in university hospitals as part of these teams, and contributing to patient well-being.<br>In this paper, to elucidate the roles of acupuncture and moxibustion in modern medicine, we show how acupuncture and moxibustion are applied in university hospitals, and how acupuncturists evaluate the effectiveness of their acupuncture and moxibustion.

Commemorative Lecture Meeting for Publication of "WHO Standard Acupuncture Point Locations in the Western Pacific Region" / 全日本鍼灸学会雑誌

The (First) Japan Acupuncture Point Committee was established in 1965 and the nomenclature for meridians and acupuncture points was standardized at the meeting in Geneva in 1989. After that the first Informal Consultation on Development of International Standard Acupuncture Points Locations was organized by WHO/WPRO and held in Beijing (2003). In Japan the (second) Japan Acupuncture Point committee started April in 2004. Japan, China and Korea held nine meetings and made a draft for the Locations of Acupuncture Points. According to the draft made at the official meeting of 'the Development of Standard Acupuncture Point Locations'held in Tsukuba, Japan (2006), Acupuncture Point Locations were further standardized. Finaly, the book "WHO Standard Acupuncture Point Locations in the Western Pacific Region"was published on May 16th, 2008. Here, we want to report on the Commemorative Lecture Meeting for Publication of WHO Standard Acupuncture Point Locations held on May 30th, 2008.

Ideas for Safer Acupuncture Practice (2) / 全日本鍼灸学会雑誌

Continued from the previous year's theme of our workshop, we collected various information and ideas for safer acupuncture practice. Subjects and presentations of the present workshop were as follows:<BR>1. Literature review of papers on adverse events published between 2003and 2006<BR> 1) Papers in domestic journals (by Ishizaki and Egawa)<BR> 2) Papers in foreign journals (by Yamashita and Umeda)<BR>2. Debate on wearing sterilized fingerstall or glove<BR> 1) Present status of the use of fingerstall in acupuncture practice (by Katai and Minowa)<BR> 2) Practical side of clinical education of acupuncture using fingerstall (by Hatakeyama and Furuya)<BR> 3) Problem of using individual fingerstalls in acupuncture practice (by Handa and Miyamoto)<BR>We will continue to provide information and discuss solutions in order to reach a common understanding and specific methods for safer acupuncture practice.

The State of Moxibustion Education on Japanese Vocational College Education / 全日本鍼灸学会雑誌

[Purpose] To evaluate the state of moxibustion therapy education.<br>[Methods] Investigation with a questionnaire at 66 vocational colleges of acupuncture and moxibustion in Japan based on the list issued by the Foundation for the Training and Licensure Examination in Anma-Massage-Shiatsu, Acupuncture and Moxibustion in April 2004.<br>[Results] The rate of valid responses was 62.1% (41/66). Basic practical moxibustion skills are taught in the first year of the three year program. For this class, 36.6% (15/66) of colleges gave students two credits. Most colleges devote more class time to direct moxibustion compared to indirect moxibustion. Students must learn to prepare a small, perfect shape, smaller than a grain of rice. The direct moxa cones are typically burned only 70∼80% to reduce the chance of burns.<br>More than 80% of colleges responded that moxibustion therapy was very available. The biggest problem is afflicting burns. Although more than 90% of colleges teach direct moxibustion with one's fellow students, the problem of burns remains. Colleges in eastern Japan tend to teach lower temperature moxa stimulation than western ones.<br>[Conclusion] The state of Japanese moxibustion education in vocational colleges of acupuncture and moxibustion is clear. In the future it is important that we consider new methods of moxibustion therapy based on safety and patient comfort, while maintaining traditional Japanese methods. Further it is necessary to investigate the state of Japanese moxibustion therapy at the clinical bed side.

Current Circumstances and Future of the WHO Standard Acupuncture Point Locations / 全日本鍼灸学会雑誌

1. Introduction<br>The Meeting on Development of International Standard Acupuncture Point Locations hosted by WHO/WPRO was held between Oct. 31 th and Nov. 2 nd in 2006 at the International Congress Center in Tsukuba City, Japan. The delegates came from nine countries, e.g. Australia, China, Japan, Korea, Mongolia, Singapore, UK, USA, Vietnam, and two organizations, e.g. WFAS (World Federation of Acupuncture Societies), AAOM (American Association of Oriental Medicine). The total number of delegates was twenty. The draft of Standard Acupuncture Point Locations, which had been discussed between three countries, Japan, China and Korea during the previous three years, was officially decided.<br>2. Agreement for Acupuncture Point Locations<br>Three hundred and sixty one Acupuncture Point Locations were decided at the meeting, the number is 7 more than the number that has been taught so far in the educational field of Japanese acupuncture. The points which differ from the current Japanese text book are 7. These points had been considered “extra points” located along meridians as well as points requiring special attention. 6 points had been the subject of debate, and as a result two locations for each point have been decided. These are LI 19, LI 20, CV 24, PC 8, PC 9, and GB 31.<br>3. Future Plan of WPRO<br>We attempted to standardize the Acupuncture Point Locations at the official meeting in Tsukuba. Moreover WHO/WPRO intends to standardize (1) Oriental Medical Terminology, (2) Oriental Medical Information, (3) Guidelines for research of Acupuncture and Moxibustion, and general thoughts, points of view, and an outline of Oriental Medicine. Then WHO hopes to encourage application of these standards to research and practice of Oriental Medicine.<br>4. The themes after deciding the Acupuncture Point Locations<br>Subjects for further discussion include: (1) Research on acupuncture point locations, (2). Encouraging the use of Standardized locations, (3). Clarifying “Japanese Acupuncture” and its supporting its use all over the world, etc.

Ideas for Safer Acupuncture Practice (1) / 全日本鍼灸学会雑誌

We have been collecting various ideas on safer acupuncture practice from participants in our workshop as well as members of the committee. Subjects and presentations of the present workshop were as follows:<br>1. Forgotten needles<br>  1) Ideas of prevention based on a questionnaire survey (Egawa and Ishizaki)<br>  2) Effect of incident reporting system (Yamashita)<br>2. Cleaner method of needle insertion and Oshide (needle-supporting fingers)<br>  1) Merits and demerits of sterilized fingerstall and glove (Miyamoto)<br>  2) History of the clean needle development (Umeda)<br>  3) A novel clean acupuncture needle device (Imai and Ishizaki)<br>Although there was not enough time for discussion, we collected some useful ideas from the participants. A novel clean needle invented by Imai gave a strong impression to the audience. We should continue to discuss a diverse impact when such new devices and concepts become widespread in traditional acupuncture practices. We welcome more ideas and opinions from relevant facilities, clinics and fields in order to further improve safety of acupuncture.

The Aim of WHO and the Circumstances and Prospects of Activity of the Second Japan Acupuncture Points Committee / 全日本鍼灸学会雑誌

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). <BR>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. <BR>The developments thus far and future issues are summarized and reported.

Proposal for Japanese Acupuncture Study-An Issue of Education, Research and Socio-Medical System- / 全日本鍼灸学会雑誌

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. <BR>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. <BR>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. <BR>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.