In the acupuncture-moxibustion clinic there are cases in which acupuncture insertion in the lumbar-sacral area on patients with coldness of the lower limbs results in a feeling of warmth in the legs.
We formerly reported that based on observations of the peripheral temperature, the fluctuation curve of the profound temperature and the hunting reaction we learned that acupuncture-moxibustion stimulation at LV-3 and SP-6 improved circulation in the lower limbs. This time we examined the influences of acupuncture insertion in the sacral area on the circulatory system. The insertion area was BL-32 (posterior sacral foramen II). After the patient had rested in a prone position for 30 minutes insertion of a stainless steel 1.6 TSUN 3 needle was administered to the depth at which the acupuncture sensation toward the lower limbs was felt. Pecking techniques were administered several times followed by 30 minutes of stationary insertion.
The objects of measurement were cutaneous temperature (Back of 1st toe, KI-1, BL-59) the subcutaneous (1cm) profound temperature (Center of bottom of foot, BL-56 at the center of the gastrocnemius muscle), pulse (2nd toe) and heartbeat. Also using a water plethysmograph the amount of blood circulating in the entie leg was measured. The cutaneous temperature was measured using a thermo-couple. the profound temperature using the KOATEMP by Thermo. A recorder was attached and temperature reading recorded continuously beginning 20 minutes before acupuncture insertion and continuing until 20-30 minutes after withdrawal. The number of subjects was 14.
The results of the experiment showed differeces in about half of the cases. A step style increase of 0.3-1°C in the temperature of the feet during stationary insertion was indicated. A tendency for bradycardia in the heartbeat 10 seconds-several minutes after acupuncture insertion was also indicated.
From the above results it was learned that acupuncture insertion and stationary insertion at BL-32 served to expand the peripheral blood vessels of the lower limbs and improve circulation in some cases.

To determine the effect of moxibustion on blood flow in the gastric wall, gastric blood flow was measured seven times by H² clearance method at 30 minute intervals in 14 anesthetized female rabbits. Moxibustion stimulation was performed 3 times at one acupuncture point on the left hindleg (S 36 zusanli) just before the third measurement.
The level of gastric blood flow was high during the initial measurement after induction of anesthesia, and then gradually decreased in both groups. In the control group (without moxibustion: n=6) the blood flow showed a continuous decrease, but in the stimulation group (n=8) it tended to increase momentarily by about 1.5ml·min^-1·100g^-1 at the third measurement (just after moxibustion) and 2.0ml·min^-1·100g^-1 at the fourth measurement, amounting to 22.7±2.4ml·min^-1·100g^-1 at the third measurement (control group: 18.9±1.9) and 23.2±2.9ml·min^-1·100g^-1 at the fourth measurement (control group: 18.0±2.2). The increase in the blood flow was observed in 5 of 8 cases in the stimulation group. However, there was no increase observed in the control group. The increased blood flow in the stimulation group began to gradually decrease, but the values remained higher than the values in the control group until the last measurement. Significant difference, p<0.05, was found between the changes in the blood flow in the two groups.
Since the increment of the blood flow after moxibustion was supposed to be due to the vasodilation, it is suggested that moxibustion may cause the dilation of the gastric blood vessels owing to excitation of the vagal nerve and/or inhibition of the splanchnic nerve.

Health conditions were surveyed among elderly persons (over sixty five years old) living in two towns in Kyoto prefecture in 1994. In this study, a second survey of symptoms was conducted among elderly persons in one town, and ADL (activity of daily living) disorders were simultaneously surveyed. Questionnaires were distributed and collected by mail. Nine hundred and thirty five elderly persons completed and returned the questionnaires.
Upon investigation it was found that the elderly living in this town had many symptoms and ADL disorders. The incidense of these symptoms was over two times greater than the mean value in the general elderly population nation wide. Symptoms noted included low back pain (43%), shoulder stiffness (34%), low back and lower limb pain (25%), knee joint pain (24%), heavy sensations in the lower limbs (24%), numbness (22%), heavy sensations in the low back (18%), shoulder pain (18%), foot pain (16%), lower thigh pain (13%), thigh pain (11%) and arm pain (11%) in descending order of frequency. Concerning ADL disorders, pain while going up or down stairs (34%), slight pain while walking (28%), difficulty while walking without stopping to rest (19%), impossibility in walking due to pain (5%) were also reported by many elderly people.

[Purpose] It is generally known that the acupuncture treatment to the low back is useful for lumbagoand lower limb pain. It is considered that improvement of blood flow to the muscle, connective tissue and/or nerve is associated with the effect of acpuncture. However, the effect of acupuncture on blood flow to the nerve has not clarified. So, this study was performed to clarify the effect of acupuncture on microcirculation in the sciatic nerve trunk.
[Method] Twenty-nine rabbits (weighing 2.1 to 3.5kg) were used. The rabbits were anesthetized withpentobarbital sodium (30mg/kg, i.v.). Then, the sciatic nerve was exposed and an electrode for blood flow measurement was inserted in the interfascicular space. An catheter was inserted into the common carotid artery to measure blood pressure, and thermister thermometer was placed in the anus to monitor body temperature. Blood flow was measured 6 times every 15 min. by the H2 gas clearance method. In the stimulation groups, acupuncture needles were inserted 1 cm from interspinous process (between the vertebra lumbalis 3 and 4. : A group, and between the vertebra lumbalis 7 and vertebra sacralis 1. : B group). Acupuncture stimulation by the “sparrow pecking” was performed immediately before the third measurement and by the “retaining needle” for 15 min., then the needles were removed just before the fourth measurement.
[Result] S In the stimulation groups (A and B groups), a significant increase in blood flow occurred afteracupuncture stimulation, compared to that in the control group. The increase in blood flow to the sciatic nerve in the stimulation groups was maintained until the final measurement. Arterial blood pressure and body temperature did not change. The changes in blood flow values from the second to the third measurement were -1.5 ± 0.4 (mean ± S.E, ) in the control group (n=10), +2.4 ± 1.2 in A group (n=11), and +4.0 ± 2.0 ml/min/100g in B group (n=8).
[Discussion] Blood flow increased after acupuncture stimulation, although there was no change inarterial blood pressure. Therefore, the increment in blood flow seems to have been caused by vasodilation of the blood vessel in the sciatic nerve trunk due to a parasympathetic nerve response. However, because the interfascicular blood flow in the present study was measured, change in the intrafascicular blood flow is not clear. It is necessary to measure the intrafascicular blood flow in future.
[Conclusion] As a result of this study, it was demonstrated that acupuncture stimulation near the vertebra lumbalis induced increased interfascicular blood flow to the sciatic nerve trunk. It was suggested that the increase in blood flow to the nerve is also associated with the effect of acupuncture treatment for lumbago and lower limb pain.

To clarify the effect of acupuncture on the skeletal muscle blood flow, measurements of muscle blood flow by hydrogen gas clealance method were taken on the left anterior tibial muscles of thirty rabbits (weighing about 2.5 to 3.3 kg) anesthetized with pentobarbital sodium (35mg/kg, i.v.). Arterial blood pressure in the common carotid artery and body temperature were also measured.
Blood flow was measured 6 times every 10 min. In the stimulation group, acupuncture needles were inserted into the center of the anterior tibial muscle before the third measurement and “sparrow pecking” was performed, then the needles were removed. In the denervation group, the sciatic nerve was cut to observe the influence of denervation on the effect of acupuncture.
In the stimulation group (n=12), a significant increase in blood flow to the muscles occurred after acupuncture stimulation, compared with the control group (n=12). The increase in blood flow in the stimulation group was maintained until the final measurement. Arterial blood pressure and body temperature did not change.
The blood flow values in the second and third measurements were 18.1 ± 2.2, and 17.6 ± 2.4, respectively, in the control group, and 17.8 ± 1.8 and 25.9 ± 2.2 ml/min/ 100g (mean ± S.E.) in the stimulation group. The changes in blood flow values from the second to the third measurement were -0.5 ± 0.3 ml/min/100g in the control group, and +8.2 ± 2.0 ml/min/100g in the stimulation group. An increase in blood flow after acupuncture stimulation also occurred in the denervation group (n=3).
Despite there being no change in arterial blood pressure. blood flow was increased after acupuncture stimulation, and the increment of blood flow after acupuncture stimulus was also observed in the denervation group. Therefore, the increment of blood flow seems to have been caused by vasodilation of the blood vessels induced by axon reflex.

Objective : To investigate the utilization of Acupuncture and Moxibustion therapy (AMT) in nursing homes (NH), we gathered information through questionaires.
Method; We sent questionaires to 1, 237 NH that were in 6 prefectures in the Kinki area and 5 prefectures in the Kanto area.
Results : We obtained replies from 321 NH (26%). Sixteen NH (14%) were already utilizing AMT, 9 NH were planning to utilize AMT soon and 79 NH were considering utilizing AMT sometime in future. The results suggest that AMT utilization will increase in 46 NH which are already utilizing it, 22 NH (48%) employed acupuncturist and other nursing homes relied on volunteers or visit. About 1/3 of NH had privaterooms for AMT while the other NH had a rehabilitation room which also serves as an AMT. The cost of AMT was borne directly by patients in 8 NH (7%) while it was free in 29 NH (52%) and paid by public funding or medical insurance in 14 NH (30%). One reason for non-utilization of AMT is the costs for treatment and or personnel. Another reason is that questions remain about the necessity of AMT and its effects on disease. The most apparent of AMT in nursing homes were improvements in activity of daily living (ADL), feeling and expression. On the other hand, the problems of AMT in NH were time limits for treatment, indistinct effects, AMT and cost.
Conclusion : Given these results, we concluded that to promote the utilization AMT in NH, it is necessary to instruct elderly residents as well as medical doctor, nurses and workers in NH, about AMT.

In a previous paper, we reported that acupuncture on the equivalent loci to human CV-12, BI-12 and ST-36 inhibited rat's stomach ulcer induced by water immersing stress. In this paper, we report the influence of acupuncture on the equivalent loci to human BL-21 and ST-36.
Method
15 male Wister rats of about 200g in weight were divided into the test group (6 rats) and the control group (9 rats), and acupuncture was administered to the test group on the equivalent loci to human BL-21 and ST-36 every other day. The next day after the sixth acupuncture, they were immersed in the water of 23°C to their chests 7 hours and the stomachs were extirpated from them and the gastic glands were sliced and stained in hematoxylin-erosion. Making a microscopic examination of these slices, we evaluated the number of mucoclasis classified by strength, depth and width.
Effect
More than 90% of mucoclasis showed erosion of tissue. It was less than 2/4 in depth and less than 500μ in width.
1. Erosion in each slice numbered 20.3±5.6:34.1±9.5 in average between the two groups and it showed significantly small number in the test group (p<0.01).
2. The number of erosion in depth was much smaller in the test group (p<0.01, p<0.05).
less than 1/4…19±4.2:28.1±6.1
less than 2/4…1.3±1.5:5.3±4.0
3. The number of erosion in width was also much smaller in the test group (p<0.05)
10μ-500μ…10.3±4.7:19.8±9.4
Conclusion
It was showed that pre-acupuncture inhibited stress erosion.

Effects of acupuncture stimulation and painful stimulation on the bone marrow circulation were studied by observing the bone marrow pressure in the femur.
Experiments were carried out on 5 adult rabbits anesthetized with urethane. Painful stimulation was given by the pinch method with a forceps.
The results obtained were as follows:
1. Immediately after the acupuncture needle was thrusted deep in the inguinal region, the bone marrow pressure of the femur of the same side showed remarkable reduction and after a few minutes, gradual rise was observed.
2. Three patterns of the rise of the bone marrow pressure were observed. First, the pressure increased monophasically and recovered to the control level. Second, the pressure rised by 7-9mmHg higher than the control value and recovered to the control level after keeping this high pressure for a few minutes. Third, after the initial fall, the pressure was regained but did not reach the control level and stayed at the lower level.
3. The stimulation to the nutrient artery with the acupuncture or the pinching caused change in the bone marrow pressure in the similar manner as the case of the acupuncture to the deep part of the inguinal region, but the stimulation on the opposite side did not cause a marked change in the pressure.
4. The painful stimulation on the inguinal region with pinching the skin reduced the pressure, but the magunitude of the reduction was smaller than those of the acupuncture stimulations given from surface to the deep part or the stimulation to the nutrient artery.
5. Stimulations on the lateral and anterior region of femur or on the opposite side produced only a slight reduction of the pressure.

Acupuncture has been recognized as an useful treatment for muscle pain, muscle fatigue and muscle hypertonus in sports medicine. This study developed an experimental model to investigate the effect of acupuncture on muscular disorders.
Twenty-seven rabbits, anesthetized with pentobarbital (i. v.) were used. The anterior tibial muscle was exposed, and the distal end of the tendon was cut then attached to the push-pull gauge and tension during the isometric contraction induced by electrical stimulation of the muscle was recorded.
The tension was measured immediately before and 15, 30, 45 and 60min after the electrical stimulation. The frequencies of 1, 10, 20, 30, and 50Hz were used as the conditioning stimulation (1ms in duration, 60s).
Tension was decreased after the conditioning electrical stimulation of muscle. High frequency of stimuli tended to induce a marked decrease in tension.
Acupuncture stimulation (leaving the needle in place for 10min) reduced the decrement of the evoked tension by 30Hz tetanic stimulus significantly (p<0.05), and enhanced the recovery. Occlusion of the blood vessel supplying the muscle potentiated the decrement of evoked tension, and acupuncture stimulation still reduced the initial decrement of the evoked tension, suggesting that acupuncture acted on the blood flow in the muscle. After transection of the nerve innervating the muscle, acupuncture stimulation still demonstreted the same effect.
These results suggest that the acupuncture stimulation induces vasodilatation by axon reflex and the subsequent increase in blood flow to the muscle induces the recovery of reduced tension by tetanic contraction.

Health conditions were surveyed in elderly Persons (over sixty-five years old) liveing in two towns in Kyoto prefecture. The questionnaires were handed out and collected later. Seven hundred and sixty five elderly persons living in Hiyosi-cho, an area of agriculture and forestry, and six hundred and eight elderly persons living in Tango-cho, an area of agriculture and fishery, turned in the questionnaires.
On investigation it was found that elderly people living in the two towns had many symptoms or diseases. The incidence of these symptoms and diseases was over two times as high as the mean value discovered in the general elderly population nation wide. Symptoms and diseases noted included low back pain, shoulder stiffness, foot pain, hypertension, pollakiuria, cold feet, knee joint pain, eye diseases, shoulder pain and arm pain in descending order of frequency. Low back pain was noted in about 46 per cent.