Despite the recent progress in physiological studies of acupuncture, few morphological studies from the viewpoint that acupuncture stimulation produces with a small tissue injury have been reported. In this study, we evaluated the mechanism of acupuncture stimulation by a histopathological approach. First, we confirmed the tissue structure from the skin to the muscle layer in a corpse. In the human body, free terminals (endings) of unmyelinated nerve fibers (1.5μmin diameter, Group III or Group IV) were present subcutaneously or in the endomysium of muscle tissues. Next, the extent of tissue injury caused by insertion of needles 0.20-0.95mm in diameter evaluated in human and animal tissues. The extent of the injury was in proportional to the diameter of the needle. These confirmed that acupuncture stimulation is clearly a small tissue injury. Also, the free terminals (endings) of unmyelinated nerves similar to those observe in the human tissue were obsurved in the endmysium near the injury site. These morphological findings suggest that acupuncture stimulation is related to Group III or Group IV fibers.

Recently, magnetic resonance imaging (MRI) has brought significant advancements in the diagnosis of spinal disorders. But there is much debate about the abnormalities detected by MRI clinically. In this study, we try to clarify the correlation between spinal abnormalities detected by MRI and physical signs in 45 patients with neck, shoulder, and low back pain. Physical signs were segmental sensory disturbance, amyotrophy, and radicular pain, and the abnormalities of MRI were bulging, protrution, extrution, and osteophytes. MRI showed a symptomatic change, that is a false positive (abnormality of MRI^* (+), physical sign^** (-)), in 26 of the 45 patients (57.7%), a true positive (+, ^**+) in 15 of 45 patients (31.1%), a true negative (^*+, ^**-) in the remaining 5 patients (11.1%).
These results suggested that the physical signs are more important than the abnormalities of MRI in patients with neck, shoulder and low back pain. We think that the acupuncture therapist should carry out a more detailed physical examination of the patients clinically.

Treatment by acupuncture and moxibustion and by orthopedic medicine have both been found to be effective against lower back pain. The time required for the treatment to become effective has been found to correspond with the Weibull distribution. Using the parameters arrived at by the distributon a sequential comparison of both treatments was conducted using the Monte Carlo simulation, using randomized numbers from the distribution. Although there are problems involving the estimated value of the distribution based on complete data, and the difference in quality of the subject groups, it has been found in 100 trials (inolving 100 pairs of subjects) that acupuncture and moxibustion tend to take effect significantly faster (p=0.07) than orthopedic medicine. I present these results as a hypothesis to be used in randomized clinical trials. Furthermore, I propose a new method of clinical evaluation, involing simulation derived from the investigation of models, in cases where it is difficult to form control groups for comparison.

Introduction
We tried to prove the effectiveness of acupuncture against unidentified syndrome.
Method
Subjects were women complaining of unidentified syndrome and divided into the control group and test group. Galenicals extact was given to all of them and acupuncture was administered to the test group. The examination was a sequential medical trial in a restricted design (2α=0.05, 1-β=0.95, θ₁=0.90 and N=19). Acupuncture was applied twice a week for two weeks. We evaluated their subjective symptoms, difficulties in daily life and so on with MPI-test and MV-test.
Conclusion
Among the two groups, patients were randomly paired off into ten couples. Thus, a subjective comparison was possible. Global improvement rating by patients was effective for the symptoms of 60% of the test group, and 10% of the control group (p<0.05). As to the difficulties in daily life, it was effective for 70% of the test group, whereas only 20% of the control group. About subjective symptoms, there was a significant difference in the stiffness in shoulder (p<0.10). On MV-test, the test group of five pairs showed an increase in theta waves (p<0.05) and a decrease in beta waves (p<0.10).

Yokukansan (YKS), one of the traditional Japanese “Kampo” medicines, is a mixture of extract powders from seven kinds of medicinal herbs (Atractylodis Lanceae Rhizoma, Hoelen, Cnidii Rhizoma, Uncariae Uncis Cum Ramulus, Angelicae Radix, Bupleuri Radix, and Glycyrrhizae Radix). YKS has been administered to fragile habitus patients who show symptoms such as emotional irritability, neurosis and insomnia, and to infants who suffer from night crying and convulsions. In recent years, YKS has been reported to be effective against pain disorders such as headache and chronic pain, but the mechanism underlying these beneficial effects is still unclear. In this study, the effect of YKS on chronic inflammatory pain and stress caused by pain were investigated using rats with adjuvant arthritis.
Male Wistar rats were injected with complete Freund's adjuvant into the plantar surface of the right hindpaw, and then pain thresholds and stress markers were measured. The thermal pain threshold measured with the plantar test significantly decreased, and the level of salivary chromogranin A (CgA), which is used as a mental stress marker, was significantly increased in this model. The administration of YKS controlled the activation of spinal microglia involved in the expression of chronic pain, and significantly reduced a decrease in the pain threshold. Moreover, an increase in the level of salivary CgA was significantly inhibited. The authors concluded that YKS has effects in reducing chronic inflammatory pain and the stress caused by pain.