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.

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.
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.
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.
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.
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.
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.
These developments included changes in the medical system, education, and research of Japanese acupuncture and moxibustion.

This study was conducted to observe autonomic nervous system reactions in the cardiovascular system caused by the new transcutaneous electrical nerve stimulation apparatus CONVALES^®
Autonomic functions were evaluated before and after stimulation of 10 male students between 19 and 42 years of age. The dynamic observation method of autonomic functions proposed by Nishijo et al. was used for evaluating autonomic responses. The activity levels of both the sympathetic and parasympathetic systems were found to increased after stimulation. Neither significant changes in blood pressure nor adverse effects of stimulation were observed.
These results suggest that the apparatus used in this study causes autonomic responses similar to those caused by acupuncture with shallow needling during exhalation phase while sitting, or by laser acupuncture. This study also suggested that this therapeutic method is safe for short periods.

We reviewed case reports of bilateral pneumothorax after acupuncture treatment from the point of view of clinical acupuncture. A paper showing pathological findings based on autopsy suggests that, in more cases than we had expected, acupuncture needles penetrate the lung or the pleura. We speculate a portion of these cases develop into pneumothorax and a few of these become serious. By means of literature search, we have found that 23 cases of bilateral pneumothorax after acupuncture have been published in Japan and other countries. We must learn from these case reports. Further, we should reassess the contents of clinical acupuncture education and introduce the concept of failsafe treatment.

[objective] Using a questionnaire survey, we investigated the state of clinical training for Anma-Massage-Shiatsu, Acupuncture and Moxibustion at Japanese acupuncture school training centers (included were schools for the blind and colleges for the non visually impaired)
[DesignandMethods] We sent a 5 point questionnaire consisting of 49 questions concerning the state of clinicaltraining to 121 acupuncture schools in Japan. All these schools are listed in the 2002' List of Colleges published by the Foundation for Training and Licensure Examination in Anma-Massage-Shiatsu, Acupuncture and Moxibustion.
[Results] The response rate was 82.6% (100/121). Ninety-two schools have Acupuncture clinics open to the publicand 7 schools have Western Medical Clinics. Twenty-four percent of the schools in the survey have not registered their acupuncture clinics with the Governor of the Prefecture. Of the schools that responded 93.1% used disposable acupuncture needles, although 85.2% of the schools did not use needles only once, as recommended. While 49.4% (42/85) of the schools reported some adverse events at their clinics, 49.0% of the schools hold a liability insurance. Many acupuncture clinics at schools for the blind were established before the 1930's. During their clinical training, students at these schools are responsible for the majority (93.8%) of the patients' treatments. Clinical fees at these acupuncture clinics were under 525 yen. On the other hand, most of these clinics at acupuncture colleges for the non visually impaired were established in the 1990's after an amendment in the Law. Therapists at these colleges are largely responsible (82.1 %) for clinical treatments during the students' clinical training. Fees at these clinics were between 1576 yen and 2100 yen.
[Conclusion] The state of clinical training for Japanese Anma-Massage-Shiatsu, Acupuncture and Moxibustion education was only elucidated to a small extent. Clinics must improve safety precautions and reassess risk management strategies. Another survey is necessary to define global standards of clinical acupuncture and moxibustion styles. In order to suggest standard policies for clinical management further study is necessary.

[Objective] We analyzed the transition and state of Japanese 141 colleges, schools and training centers for anma-massage-shiatsu, acupuncture and moxibustion therapists in 2004.
[Methods] We collected a basic data from Japanese 141 colleges, schools and training centers and several sources : a list published by the foundation for the Training and Licensure Examination in Anma-Massage-Shiatsu, Acupuncture and Moxibustion, an investigation of the state of Japanese schools for the visually impaired students, the 10th Anniversary report of Oriental Medicine Colleges Association and school guides of each school. We considered and analysed this basic data.
[Result] Data was collected from 141 different sources : 5 universities and colleges, 61 schools for the visually impaired students, 66 vocational colleges and 9 training centers for the visually impaired students. Most of the schools and training centers for the visually impaired students are public. All colleges for the non-visually impaired students are private. We analysed and verified 3 periods in the history of these institutions of 141 colleges, schools and a training centers. The 1 st period concerns the establishment of schools for the visually impaired students the early 1900's. The 2nd period is concerns the establishment of older vocational colleges after World War II in the 50's. And the 3 rd period is a sudden increase of new vocational colleges following the 1998 Fukuoka district court judgement.
[Conclusion] We analyzed the changes and the situations regarding 141 Japanese colleges, schools and training centers for anma-massage-shiatsu, acupuncture, moxibustion therapists from their foundation to the present. The rapid increase of vocational colleges for acupuncture and moxibustion represents a phenomenon we have never experienced. With this condition, acupuncture and moxibustion markets must expand. In the future Japanese anma-massage-shiatsu, acupuncture and moxibustion education should be researched and hopefully we will benefit from this new situation.

Although the etiology and pathogenesis of nocturnal enuresis are still unclear and no definite theory has yet been established, treatment by acupuncture has been applied for a long time and its effectiveness have also been reported. However, there are very few reports on the findings on body surface (chill and KORI-stiffness/tonus/tension, etc.-of the body surface), which are important in Oriental Medicine, so we have focused on such findings in this report.
A total of 15 patients (11 boys, 4 girls) ranging in age from 4 to 13 years (8.4 years old in average) were examined. Their parents were instructed to fill out questionnaires concerning at the first examination and subsequently record daily frequency of urination and urine volume at each urination. Skin temperatures of the areas ranging from the face to the foot were measured by thermography in a supine position and abdominal regions were palpated using the techniques of Oriental Medicine.
1) Acupuncture treatment was remarkably effective in 5, effective in 5, slightly effective in 2, and ineffective or induced aggravation in 3, of the 15 patients. In summary 12 patients (80.0%) benefited from the acupunture treatment to a greater or lesser degree.
2) Ten out of 13 patients exhibited swelling and tension of the suprapubic regions, six of the ten patients experienced reduced swelling and tension after treatment, and all six patients also showed improved nocturnal enuresis.
3) The patients with nocturnal enuresis whose skin temperature in the suprapubic region was within the range of 32 to 34°C on initial examination recovered from nocturnal enuresis in contrast to those patients whose temperature was out of that range.
4) Six out of the 13 patients were found to have chill of pedal fingers on initial examination because of their temperature being under 26°C. After treatment, however, the skin temperatures of all 13 patients were above 28°C.
5) Among the five patients whose nocturnal enuresis did not respond to the acupuncture treatment, four had a pedal finger temperature below 26°C on initial examination.