Moxibustion causes localized dermal vasodilation and increased capillary permeability, and this is expected to provide the clinical basis for the concept that Oriental medical herb therapies promote physiological activity in general. Hence, moxibustion has been carried out as one of the basic therapeutic methods in Oriental medicine. The aim of this study is to investigate the modulation effect of moxibustion on the local metabolism which was usually experienced as telangiectasia. This effect was evaluated by the hair growth rate and associated with histological findings of the hair root.
CH3/HeNCrJ mice with telogen hairs were used. The dorsal hair was shaved in an area approximately 8cm² at 6 weeks of age, and moxibustion stimulation was carried out at the center of the shaved area. The growth of the hair was examined by the hair length and the HE-stained subcutis preparation up to 11 weeks.
It was concluded that the vasodilation effect of moxibustion lasted for a fairly long period, and the number of hair follicle cells were increased by moxibustion.

Microstructure and elemental composition of dried Artemisa princeps Pamp. (Yomogi) leaves produced in Japan and China were investigated by scanning electron microscopy and X-ray microanalysis. Trichomes and T-foem hairs were found in higher density on the reverse side of the leaf of Yomogi. Cilium hairs were observed in Japanese Yomogi, while those in Chinese Yomogi, were distributed. Concentrations of K, Ca, Si and Cl were determined in plant fibers of the trichome in both Yomogi. In the head-style hairs of Japanese Yomogi, K, Ca, and Cl, S, P, Si were found, while K, Ca, Si, S, Mg and Fe were observed in the Chinese Yomogi.
These results suggest that there were differences in morphological and elemental composition between Japanese and Chinese dried Yomogi leaves. These differences will affect the moxa quality even after the purifying process.

Augmentation of skin flap survival remains one of the principle concerns in the field of reconstructive plastic surgery. Moxibustion was thought to have potential in this area because it is known to induce proliferation of the blood capillaries of the skin. The authors therefore investigated the effects of moxibustion on skin flap survival in rats.
Male Wistar rats of about 200g were divided into four groups: Group I was stimulated before the operation, II after the operation, III both before and after the operation and Group IV served as an unstimulated control. Ten spots were selected for five days of stimulation with moxibustion (Kamayamini) on the skin flap, however, no stimulation was given the day before or the day of the operation. The caudal skin flap (9cm×3cm) was made under pentobarbital anesthesia (intraperitoneal; 26ml/kg).
A significant increase in the survival area in Groups I and II when compared with Group IV. It was therefore concluded that stimulation with moxibustion may be a valuable method of improving skin flap survival. For clinical application, further improvements such as exclusion of scar formation may be necessary.

Although there are many unclear points concerning the functional mechanism of the head meridian points, clinically they are used in the treatment of almost every disease.
Using the visual evoked potential (VEP) as an index we used the points said to effective in the treatment of optical disease, the meridian points on the frontal and posterior head areas, and examined to see whether or not there is any relationship with the VEP.
As points of study we used:
1. Poists such as GB-15, GB-16, GB-16, BL-6, etc., the Chinese names of which make it possible to assume some relationship with the eyes.
2. BL-10, GB-20, etc. points generally used in the treatment of eye disease.
3. BL-8, BL-9, GV-18, points on the aspect of the head located in the periphery of the visual areas.
We classified our selection of points according to these three areas.
For the stimulation of the eyes we used the light stimulation apparatus attached to the encephelograph, set such that 1 stimulation per second was administered according to the signal of the electrical acupuncture apparatus. Records were made using a single induction electrode and double induction electrodes at me ridian points on the scalp.
In the results it was observed that compared with the meridian points in the periphery of the visual areas on the back of the head, (Group 3) the vibration amplitude was less with Group 1 and 2 meridian points however the wave pattern composition, etc., was very similar.
Concerning the appearance of VEP at the anterior head meridian points, from the fact that the latent period of the components was fast it can be thought that this has some relationship with the retina potential. We plan to supply further infomration and report on these facts.

Topical cooling effects at the site of vibratory stimulation were studied using vibration-induced flexion reflex (VFR), which was induced simultaneously in both hands, as an indicator for assessment.
As a result, it was found that the inhibition of ipsilateral and contralateral VFR related to topical cooling of the palmar vibratory site on one side was caused by cooling within a limited area of the palm where the vibratory element contacted. Application of acupunctural electrical stimulation of disrupting nature in place of topical cooling to the vibratory stimulation site on one side also effectively inhibited VFR on both sides.
Although the skin temperature did not decrease on the side contralateral to the side that had been cooled, VFR was completely inhibited on both the cooled and uncooled sides.
These results suggest that the peripheral impulses which arise from cooling the vibratory site on one side act on spinal interneurons and alpha-motor neurons, which contribute bilaterally to the VFR expression, thus inducing a neurogenic inhibitory effect on VFR.

It is said that the key to effective acupuncture is to perform appropriate stimulation of the best combinations of meridian points which directly or indirectly affect the disease.
In order to determine the difference in the efficacy between combinations of clinically important meridian points, this study examined the effect of two-point acupuncture stimulation on the exteroceptive vibration-induced finger flexion reflex (Eklund et al., 1978).
METHOD
Subjects were six healthy adults of both sexes between 20 and 35 years of age. Two-point combinations were made of IC₄ Hegu (standard point) with each of the following points: IC₆ Pianli, P₇ Lieque, C₃ Shaohai, TM₂₀ Baihui, VU₁₃ Feishu, VU₂₅ Dachangshu, G₃₆ Zusanli. Perception threshold electrical stimulation of each combination was performed at 45Hz for 5min. using subcutaneous needles. The finger flexion reflex was induced by a tapping vibrator applied to the palm and recorded through a pressure transducer.
RESULTS
1) The combination of adjacent points on the hand: Stimulation of Hegu together with Pianli, both of which are on the Large Intestine meridian, caused a strong inhibition of the reflex. The inhibition lasted about twice as long as that caused by stimulation of Hegu alone. However, neither Hegu and Lieque not Hegu and Shaohai stimulation caused prolongation of the inhibition.
2) The combination of the hand and the back: Neither Hegu and Feishu nor Hegu and Dachangshu stimulation caused any prolongation of the inhibition.
3) The combination of the hand and the leg: Hegu and Zusanli stimulation caused marked inhibition, which lasted about four times as long as that caused by Hegu-alone stimulation.
4) The combination of the hand and the head: Hegu and Baihui stimulation caused no or much less inhibition that caused by Hegu-alone stimulation.
5) Examination of difference among stimulating methods: Electrical stimulation through surface electrodes (A), Retained subcutaneous needles (B), Electrical stimulation between a subcutaneous needle and the indifferent electrode. (C), Electrical stimulation between subcutaneous needles (D). The intensity of the inhibition effect of these methods can be expressed as follows:
D>C>B>A
DISCUSSION and CONCLUSION
The reflex inhibition caused by the standard point stimulation was strengthened or weakened by simultaneous stimulation of an additional point. Based on our examination of the characteristics of the inhibition, it was thought that not only mutual interference of impulses at the spinal level but also humoral factors and some polysynaptic reflex mechanism in the higher center level participate in this effect.

More than 3 years have passed since the guideline for infection prevention at acupuncture and moxibustion clinics was issued. We studied changes in the attitude toward sanitization of the environment and consciousness about infection prevention at acupuncture and moxibustion clinics during this period. The subjects were members of the Acupuncture and Moxibustion Societies of Kyoto and Osaka (n=349). About 70% of the subjects felt anxiety about infections, and nearly 80% of them were interested in sanitizing the clinics. More than half (57%) of the subjects were using both disposable and reusable needles, and about half the subjects disposed of used needles without sterilization. Concerning the linen, pillow covers were changed for every patient by about 70% of the subjects, but towels and sheets were changed by only 20% and 10%, respectively. White coats were changed within 1 week by about 70% of the subjects. Most subjects answered that the clinics were cleaned everyday, but less than a half of them sterilize slippers. About half the subjects answered that curtains were washed every 3-6 months. Autoclaves were placed in only 90% of the clinics. Attention to preventive measures against infection of therapists tended to diminish with increase in the clinical experience.

[Purpose] This study investigated the safety of acupuncture and moxibustion in Japan. A questionnaire about infection control was developed based on the “Guidelines on basic training and safety in acupuncture” published by the World Health Organization (WHO) in 1999.
[Method] The questionnaire was sent to the members of the Japan Society of Acupuncture and Moxibustion (JSAM) and the Japan Acupuncture and Moxibustion Association (JAMA) in August 2000 and in September 2001, respectively. The items on the questionnaire were “a clean working environment”, “clean hands of the practitioner”, “preparation of the needling sites”, “sterile needles and equipment, and appropriate storage”, “aseptic technique” and “careful management and disposal of used needles and swabs”.
[Result&Conclusion] The questionnaire response rate was 49.6% (443/894). The results suggest that approaches to infection control are better than those in our previous report in 1996. However, the rate of using disposable needles was still low and most acupucturists held the needle with bare hands during inserting. It is necessary to improve pre-and postgraduate education regarding safety in performing acupuncture and moxibustion, including the infection control.

This symposium was held as the second in a three part series at Kagawa Conference (June 6-8, 2003). During the Tsukuba conference (2002), distal area treatment was the topic of focus. The criteria and evidence for the effectiveness of distal area treatments were presented. Three symposists and one minor speaker reported on the effectiveness of distal area treatments from clinical and basic viewpoints. However, another symposist showed the superiority of local area treatments and denied the effectiveness of distal area treatments. There fore, we decided that a succinct and definitive discussion on distal area treatments (etc) should be presented during the second symposium. To this end, long time members of JSAM were given a questionnaire survey prior to the conference. Respondents were asked to define their own use of local and distal treatment, to hypothesize on the curing mechanism involved and to state which practice methods they use most.
Mr. Ogawa reported that, as a result of analyzing the questionnaire survey no distinct differences were found in the definitions stated by respondents from several different schools. The standard images of “the local area” were the area where pains were felt when pressure is applied, the areas which transmit special sensitivity or the area where a disorder is found. Also, the images of “the distal area” were the areas which have some relationship to the local area, such as meridians and collaterals, nerves, reflex points, tender points, or related points which induce a clearly recognizable physical reaction.
Mr.Shinohara showed the superiority of distal area treatments according to the muscle meridian theory by utilizing the 3 arm crossover examination. Furthermore, he established the delayed myalgia as a model of the illness on a specific muscle meridian region. He investigated the effect of intradermal needling. He observed that after a weight bearing exercise on the biceps brachii, the threshold of tenderness on the Lung meridian decreases. He proposed the possibility of using the points in extremities which had selectively responded by manifesting of the delayed myalgia.
Mr. Moriyama, one of the minor speakes, explained, using the theory of biomechanics, the possibility of in-fluences of distal area disharmony on the local area. He introduced the Meridian Test as one clinically useful method for finding disharmony which is typically difficult to discern and may contribute to the disorder. He proposed that a microscopic “eye” to be used to see the local area and the macroscopic “eye” b used to see the whole body in medical examination and treatment. Using the “eyes” in synthesis and not separately, he concluded, must be the basic state for treatment.
Another minor speaker, Mr.Shiraishi reported on analyzed results of the experiments on lumbago patients. Applying Yuandaoci (distant needling) reduced a response on points of the trunk (BL 23, Shenshu, Jinyu) in stimulating points, i.e, BL 40 (Weizhong, Ichu), BL 57 (Chengshan, Shozan) BL 58 (Feiyang, Hiyo) BL 60 (Kunlun, Konron) GB 34 (Yanglingquan, Yoryosen) varying in many ways and confirming the peculiarity of each point, meridian and collateral. Based on these findings he supports the effectiveness of distal meridian area treatments.
Mr. Ozaki, also, another minor speaker proposed, from the outcome of animal experiments. Stimulation by acupuncture at either adjacent or distal areas can affect motor reflex. So from this point of view, insertion at adjacent and distal area has some recordable effect. He added that stimulation given either at adjacent or distal areas would converge to the same neuron and the same modification would occur. From this point of view, the difference in processing information at the neuron level would control the manifestation of the effect and thus investigations on these treatments should be discussed as a synthesis, including, not