Shan Han Lun is an ancient Chinese medical book, that is written the acupoints meridian route. The acupoints meridian route is the functional connection route between acupoints Kampo medicine world in Japan has been ignored the exist of the meridian route, because the route is invisible. But if we make out the functional route of the autonomous nerve, we can understand Shan Han Lun sentence well. In addition, from a situation of acupuncture moxibustion treatment, that is important of a point of autonomous nerve. In paticular, the important acupoints is the “well” point secrete adrenalin, the “spring” point secrete IFNγ, the “stream” point secrete PGE 2, et all. It is important that I understand the work to the autonomous nerve as the acupuncture treatment.
Acupuncture ; Medicine, Kampo ; Nerve ; Clinical ; therapeutic aspects

Parkinson's disease is an incurable nerve disease.
We treated two groups randomly assigned to therapy with medications, or therapy with medications and acupuncture in combination.
The first group included 95 patients prescribed L-dopa medications and dopaminergic drugs, and the second group included 103 patients prescribed L-dopa and acupuncture treatment twice a month. We conducted follow-ups using Hoehn-Yahr index surveys and the UPDRS II and III for 5 years from treatment start.
Mean changes in the L-dopa group were 2.1±0.8 for the H-Y index, 12.2±7.2 for the UPDRS II, and 18.2±9.8 for the UPDRS III, while changes in the acupuncture combination group were 1.3±0.4 for the H-Y index, 7.6±5.0 for the UPDRS II, and 11.9±6.8 for the UPDRS III after 5 years.
Each result indicated a significant difference with repetition decentralization and statistical analysis methods.
Therefore, we believe acupuncture is a treatment for Parkinson's disease able to control its progress.

Four patients suffering from akathisia and psychotic symptoms were remarkably improved with Sanou-shashin-to. The first case was a 49-year-old woman with atypical psychosis. The other cases were from twenties to thirties years old women with schizophrenia. All cases were “Jitsu sho” and had constipation. San'o-shashin-to 6.0g (EK-13) a day was administered in all cases and Toukaku-joki-to 7.5g (TJ-61) a day was prescribed in the first case and in the fourth case. In several days, the chief complaint “I can't stand still.” almost disappeared.
These cases suggest that San'o-shashin-to involved Rhei Rhizoma (Rhubarb) may be effective for the treatment of akathisia associated with schizophrenia and atypical psychosis and the total dose was decreased by its use because Rhubarb has psychotropic effects and cathartic action.

A mass screening for early detection of breast cancer has been carried out periodically in Nagano Prefecture since 1981 as a part of our outreach program mobilizing two vans specially designed for this purpose.
For primary screening, palpation and ultrasonographic examination are perfomed. Ultrasonography has been introduced as an auxiliary tool, because palation is not always conducted by experienced doctors.
This auxiliary diagnostic produdure has proved to be highly effective in separating out those examinees requiring thorough examinations fro those who have been found to have tumorous masses.
A total of about 25, 000 people go through the primary chechups annually, of whom 10 percent are subjected to ultrasonic examination. In 1983, 20 persons (0.08%) were diagnosed as having breast cancer. The number was 17 (0.10%) in 1981 and 16 (0.06%) in 1982. These detection rates are nearly equal to those in the “advanced” prefectures in terms of medical service.
In ultrasonographic diagnosis, Polaroid prints are used for primary screening. However, negative films are suitable for workup in the hospital. Our experience has told that in Polaroid photography, biplane scanning is necessary.

During 1962-83, we had a total of 104 ankle fracture cases, of which a half were treated by surgical operation. Since 1981, Zuggurtungsosteosyntheses have been employed in most of the cases for fixing fractures instead of screws.
In this method, special devices are not necessary except for Kirschner steel wires and clamping wires. Moreover, after surgery, external support by the plaster of paris is not necessary, because compression is continuously applied on the surface of the fracture. Exercises to strengthen the injured ankle can be begnu early.
In these cases treated with the Zuggurtungsosteosynthese method, postoperative prognosis has been very good. This paper demonstrates the effectiveness of this modality in the treatment of ankle fractures.
We also discuss the use of tapes which we have recently adopted to immobilize simple and minor ankle fractures not requiring a surgical operation.

This study examined the effectiveness of a communication program in undergraduate medical education in improving communication in physicians' clinical practice. The effectiveness of the program was assessed with a mail survey using self-rated questionnaires 9 years later. Ninety participants were follwed up in late 1994; 57.8% of them replied to the questionnaire. Of the respondents, 60% replied that programs concerned with active listening and role-playing had benefits on communicating with patients and families. In addition, 40% of respondents answered that case studies aimed at teaching comprehensive medicine with the team approach was effective in improving communication with co-medical staff. These results suggest that the communication program in undergraduate medical education is effective in improving clinical communication in clinical practice when students are highly motivated.