With the purpose of clarifying the influence of density and height of moxa cones on the quantity and quality of direct moxibustion stimulation, temperature changes at the bottom of moxa cones the size of a “rice grain” were measured with a thermocouple on an asbestos board.
As a result, the mean peak temperature of each density group (height of 5mm, bottom diameter of 3mm) was between 140°C and 160°C. There was a significant linear regression between density (mg/11.8mm³) and heating temperature duration above 45°C (seconds) (y=1.9+3.2x, r=0.92, p<0.0001). There was no significant difference in the velocity of temperature increase (32-45°C) between two groups of cones of different height and the same density, meaning there is no evidence to indicate that tall moxa cones make patients feel mild heat.
From the results obtained in this experiment, the density of the moxa cone was found to be one of the most important factors affecting direct moxibustion treatment.

[Objective]We report herein the use of acupuncture to counteract gait disturbance in a patient with Parkinson's disease (PD). A portable gait rhythmogram was used to objectively demonstrate gait improvements.
[Case]Case:A 72-year-old woman, who a 64 experienced a tremor of the right hand and was diagnosed with PD. Symptoms improved with anti-PD medication, but at 71 years old, she experienced heaviness of the neck and shoulders and stiffness of the anterior thighs, and her step length decreased. Acupuncture therapy was initiated to relieve these symptoms.
Present illness:On examination, she presented a wobbly gait, cold feet, and reported frequent falling. Heaviness in the neck and shoulders extended from the neck to the suprascapular region, and increasing heaviness resulted in a forward-flexed posture and decreased step length. Muscle hypertonia of the quadriceps muscles was bilaterally observed, explaining the perceived stiffness in the thighs. She was at stage III on the Hoehn and Yahr Scale.
Acupuncture therapy:Acupuncture therapy was performed weekly for 12 weeks to alleviate the muscle hypertonia associated with muscular rigidity. Acupuncture points comprised the points in the muscle hypertonia where tenderness was observed, including BL 10, DU 16, ST 32, SP 10 and ST 34.
Evaluation:A portable gait rhythmogram was used to measure the ground reaction force (GRF), velocity and step length. Dynamic balance functions and PD symptoms, were respectively evaluated using the Timed Up and Go Test (TUGT) and Unified Parkinson's Disease Rating Scale (UPDRS). Evaluations were conducted on initial examination and after the 12th therapy session.
[Results]After the fourth session, perceived stiffness in the neck, shoulder region and thighs decreased. all frequency decreased from 5 times/day to 3times/day (4th session) and then once/day (7th session). There were no falls after the 8th session. Reduction in gait disturbance was objectively observed as follows:Increases were observed in GRF (0.15 to 0.17 m/s 2), gait velocity (49 to 53m/min), and step length (47 to 49 cm), while TUGT time decreased (11.8 to 9.5 s). Improvements in PD symptoms were also observed with decreased UPDRS score (41 to 28 points).
[Discussion and Conclusion]The use of acupuncture therapy achieved improvements in Parkinson-related gait disturbance (objectively demonstrated using a portable gait rhythmogram). Acupuncture improved not only gait disorder but also other PD symptoms.

Chronic obstructive pulmonary disease (COPD) causes severe respiratory dysfunction and severely limits patients' daily activities. We report a case of the patient with COPD whose respiratory symptoms were successfully improved by acupuncture. A 70-year-old man visited Meiji University of Oriental Medicine Hospital complaining of dyspnea during exercise on _??_. Despite strictly controlled medication and a regimen of home oxygen therapy (HOT), his general condition continued to worsen. Then a series of acupuncture treatment was started on _??_. The severity of dyspnea of the patient before acupuncture treatment was determined as level V according to Hugh-Jones classification, and spirometry showed severely disturbed respiratory functions (%VC: 63.5%, FEV₁%: 29.4%, PEFR: 84.8 1/min in the morning and 93.5 1/min at night). The basic combination of meridian points for the treatment of the case was LU1 (Zhongfu), CV12 (Zhongwan), CV4 (Guanyuan), LU5 (Chize), and BL13 (Feishu). The acupuncture needles were retained for ten minutes in each session. The single-subject research design (A-B-A method) was applied to detect the specific effect of the acupuncture treatment on the respiratory functions or the symptoms of the subject. “A” and “B” mean “treatment period” and “no treatment period” respectively. After 60 acupuncture treatments during a 14-month period, both the respiratory symptoms and the VAS for dyspnea showed improvement, which were specifically observed during the intervention period. Improvement was also reflected in the level of the Hugh-Jones classification and respiratory function test. It was suggested that acupuncture treatment might be effective for advanced cases of COPD.

Episodic angioedema with eosinophilia (EAE) is an idiopathic condition characterized by recurrent symptoms such as angioedema, urticaria, and eosinophilia. We report a case of a 25-year-old woman with the non-episodic variant of this condition (NEAE) who was treated with acupuncture.
The patient presented with a two-week history of generalized itching and angioedema. Erythema, bilateral limb edema, and swelling and pain of both wrists and ankles were noted. As antiallergic medication administered for several days was ineffective, she was admitted to our hospital. Hematologic investigations revealed a white blood cell count of 11850/mm³ with 64.2% eosinophils (7610/mm³). Histopathologic examination of a cutaneous biopsy specimen indicated an eosinophilic infiltration localized around blood vessels in the superficial dermal layers. NEAE was diagnosed on the basis of these findings. Acupuncture treatment was performed according to Traditional Chinese Medical theory. Itching was alleviated following acupuncture treatments and relapsed on days when acupuncture was not administered. However, edema and itching gradually diminished between acupuncture treatments, in parallel with resolution of the peripheral eosinophilia. In this case, acupuncture treatment was effective for alleviating itching in NEAE.

The tender points treatment has been widely used for both treatment and diagnosis, but there have been very few studies that have examined its diagnostic usefulness. Thus, the purpose of this study was to clarify the diagnostic importance of tender points. The subject was a patient who had osteoarthritis of the knee of Meiji University of Oriental Medicine Hospital. The relationship between pressure pain thresholds (PPTs) and symptoms in osteoarthritis of the knee (painful knee motion) were evaluated with the Japanese Orthopaedic Association scale (JOA scale), a knee scale and the subject's knee pain diary (starting pain, flexion pain, walking pain and total pain Wong-Baker faces pain rating scale). After 40 acupuncture treatments, improvement was noted in the symptoms and PPTs. The changes in PPTs were related to the symptoms of the knee (flexion and walking pain). This suggests that changes in PPTs (around the knee) are a useful indicator for evaluating knee pain.

[Purpose] We report a case treated by acupuncture in a health care facility for the elderly to evaluate the effect of acupuncture on severe pulmonary emphysema.
[Case and methods] A 88 year-old man visited Meiji University of Oriental Medicine Hospital with dyspnea in March 2000 and was diagnosed with pulmonary emphysema. He was hospitalized in October 2002 because his chronic respiratory failure was worsening : oxygen therapy was started. After discharge from hospital, he entered a health care facility for the elderly and acupuncture treatment for lumbago was initiated. Thereafter, acupuncture treatment for dyspnea and stiff shoulder started. He was determined to be grade V according to Fletcher-Hugh-Jones classification of dyspnea. Spirometry of the patient before acupuncture for dyspnea showed 88.0 % in %VC, 38.2 % in FEV 1 %, and 30 % in %FEV 1, and the patient was diagnosed with chronic obstructive pulmonary disease of serious grade. Acupuncture treatment was performed once or twice a week, and acupuncture treatment for dyspnea was performed 21 times (total of 33 treatments).
[Results] Subjective symptoms of lumbago, stagger of the legs, and shoulder stiffness were evaluated with Numerical Scale or Pain Scale. The state of dyspnea was evaluated with Numerical Scale and Borg Scale, and exercise tolerance was evaluated with 6 min of walking. After 33 acupuncture treatments, dyspnea on exertion, exercise tolerance, and the findings of spirometry were not improved. But dyspnea on rest had disappeared with improvement in lumbago, stagger of the legs, and shoulder stiffness. These results indicate that acupuncture as a general treatment is effective for the improvement of dyspnea, especially in elderly patients whose general state of health is not good because of restriction in their ability to exercise in the course of daily life due to dyspnea of exercise such as lumbago, stagger of the legs, and shoulder stiffness.

[Objective] The effect of indirect moxibustion on cold symptoms was examined in elderly subjects living in a nursing home.
[Design] A single-case experimental design that enables clinical trials in small a number of subjects was used in this study.
[Methods] Two elderly subjects living in a nursing house participated for 16 weeks. The experimental periods were allocated at random as treatment periods and control periods of eight weeks each. During the treatment periods, subjects were treated with indirect moxibustion GV 14 and BL 12 (both sides) 3 units each, 3 times a week. Rating scores with 4 and/or 5 grades were used to evaluate common cold symptoms.
[Results] Concerning the presence of common cold, there were no significant differences between the treatment and control periods. Moreover, concerning common cold symptoms, there were no significant differences between treatment and control periods.
[Conclusion] Effects of an indirect moxibustion on the common cold symptoms were not detected in this study. We speculated that the living environment of these subjects and the intensity of stimulation were factors. Furthermore, we suspected that a single-case experimental design was unsuitable for common cold research.

[Aim] Acupuncture has traditionally been used in Japan in the treatment of bronchial asthma and is being increasingly applied. However, although there are many published studies on acupuncture and asthma, few meet the scientific criteria necessary to prove the effectiveness of acupuncture. Therefore, this study presents the clinical results of acupuncture treatment for adult bronchial asthma.
[Design] Single-subject research design (N-of-1 method).
[Setting] Department of Internal Medicine, Acupuncture and Moxibustion Center, Meiji University of Oriental Medicine, Japan.
[Participants] Six patients of both genders (mean age, 49.0 years old) with moderate-to-severe persistent bronchial asthma.
[Intervention] Six patients received 10 sessions of acupuncture treatment (once per week) for 10 weeks. The basic combination of meridian points for the treatment of the patients were LU 1 (Zhongfu), LU 5 (Chize), LU 9 (Taiyan), CV4 (Guanyuan), CV 12 (Zhongwan), BL 13 (Feishu), BL20 (Pishu) and BL23 (Shenshu).
[Measurements] Primary outcome was the symptom of asthma at the end of the 10 treatment sessions. Secondary outcomes were the Dyspnea Visual Analogue Scale (DVAS), respiratory function, Peak Expiratory Flow Rate (PEFR), blood, the use of asthma drugs. The effect of the intervention on eosinophils in blood was assessed.
[Main results] Late effects of asthma patients showed significantly better results compared with the base line on outcome measures after the 10 weeks. In this study, symptoms of asthma and dyspnea VAS in patients with asthma were significantly improved by acupuncture.
[Conclusion] This study indicated that acupuncture was effective in asthma symptoms and respiratory functions.

The skin has a special significance in acupuncture. In acupuncture, the skin is both a site of both examination and treatment while providing an interface for information exchange with the external world. Various findings that appear on the body surface should not simply be understood as dermatologic findings, but considered as a reflection of the internal condition of the body, the external world and the mental condition. From this perspective, although acupuncture treatment use only simple stimuli, such as needles, and stimulate only specific sites on the body surface, they can produce therapeutic effects and regulate physical and mental functions
In this symposium, we reviewed the relationship between skin and acupuncture by examining acupuncture and moxibustion treatments for specific dermatologic diseases and their clinical effects. As a result, we were able to reaffirm the above relationship from the perspective of an acupuncturist.
The methods and clinical effects of acupuncture and moxibustion treatment were introduced for atopic dermatitis (by Egawa), tinea unguium (by Dr. Menjou), and the dermatologic symptoms of connective tissue diseases (by Dr. Kasuya). Moreover, Dr. Kagawa presented his research results related to the effects of acupunctural stimulation on the condition of the skin. Based on these research results, the possible effects of acupuncture treatment were discussed based on extensive application in fields such as dermatology, cosmetics, and anti-ageing. Regarding the significance of the skin (body surface) within the practice of acupuncture, it was reconfirmed that the skin reflects the condition of the organs and the mind, and examination of the skin may elucidate both mental and physical health. In addition, we also discussed the body surface as a site of both examination and treatment, and investigated the efficacy, potential for further development, and significance of acupuncture, which connect the skin with systemic functions.