PROBLEM: In the Taro District (population: 4434), the great tsunami of 11 March 2011 destroyed the central region including the clinic, the sole medical facility (one physician, 13 nurses and other staff) in the district, and many citizens were forced to live in evacuation centres.

CONTEXT: The Taro District experienced massive damage during the tsunamis of 1896 and 1933. Since then countermeasures to tsunamis have been implemented. The great tsunami on 11 March 2011 caused catastrophic damage to the lowlying areas where approximately 2500 people lived; 1609 buildings were completely destroyed, and approximately 200 people died or were missing across the district.

ACTION: The Taro National Health Insurance Clinic, the sole medical facility in the Taro District, was required to play a central role in a variety of activities to care for residents in severely affected areas. First of all, evacuees needed to move to neighbouring hospitals or safer evacuation centres because lifeline services were cut off to the first evacuation centre. Then, the clinic staff worked in a temporary clinic; they visited the evacuation centres to assess the public health and medical situation, cared for wounded residents, managed infection control and encouraged a normal lifestyle where possible. Additional medical, pharmaceutical and logistical support was received from outside the district.

OUTCOME: There was no noticeably severe damage to health, although there was manifestation of and deterioration in lifestyle-related diseases (e.g. diabetes, hypertension, obesity). Health care activities gradually returned to their pre-disaster levels. At the end of July 2011, the evacuation centres closed, and all evacuees moved to temporary accommodations.

Discussion: Isolated rural health practitioners were required to be involved in a wide variety of activities related to the disaster in addition to their routine work: e.g. preventive health (public health and safety activities), routine medical care, acute medical care, psychological care, post-mortems and recovery of medical facilities. Although the whole health care system returned to near-normal six months after the disaster, it is important to plan how to develop more resilient medical systems to respond to disasters, especially in rural areas. This article describes my experience and lessons learnt in responding to this disaster.

Influenza is one of most common acute viral infections in humans. It is estimated that seasonal epidemics affect 10–20% of the population, resulting in 250 000 to 500 000 deaths every year. In addition to seasonal influenza epidemics, antigenically distinct viruses originated from animal species tend to emerge in the human population every 10 to 40 years. Since most the human population does not have immunity to such viruses, global epidemics with significant impact, i.e. influenza pandemics, have occurred in the past.

Fifty-five infants aged two or less suffering from stridor were treated with Shin'i-seihai-to (Tsumura's extract preparation). The results were very favorable. The formulation was found to be very effective in 26 infants, effective in 16, and ineffective in three. No statistically significant differences were noted in accompanied sinusitis or concomitant use of other drugs. Management of infantile stridor is often difficult, and the effect of Shin'i-seihai-to merits attention.

Changes of abdominal diagnosis were examined in 28 cases of normal healthy children who received abdominal examinations three or more times within one year after birth. Abdominal diagnosis was done within a week after birth, and thereafter during infants' regular physical examinations. There were 19 cases of Kyoukyoukuman (fullness, tenderness or discomfort of the hypochondrium): neither resistance of the upper abdomen nor Seijouki were evident. There were 17 cases of strain in the rectus abdominas muscle recognized in all age groups (0-12 months of age). Softness of the lower abdomen was identified in 15 cases in all age groups, but the positive coefficient dropped along with age. Only one of the 15 cases occurred in infants in the 7-10 month age range. As a result of softness of the lower abdomen and Seichushin, it appears that Jin (kidney) develops rapidly by one year after birth. In all 21 cases, the abdominal strength was 2.5-3/5 for all ages.

The Purpose of this paper is to give consideration to the Ttought Underliying the clinical practice of Moxa treatment before Meiji period.
I investigated the literature on the therapy from a point of “technological thought”.
My study reveals that in Japan they had atlached more and more importance to the “Ying-yang and Wu-xingTheory” (_??__??__??__??__??_), that was not originally emphasized in China.

In the present paper, the author reviews acupuncture clinical practice and the research scene in Western countries, and discusses problems in Japanese acupuncture.
The use of acupuncture is increasing in the West, but many more people have received this treatment in Japan. Although regulations on acupuncture depend on the country, many EU countries limit acupuncture practice to medical doctors. Regarding the style and theory of acupuncture, Traditional Chinese Medicine is overwhelmingly dominant in the world.
In recent years, the worldwide prevalence of the concept of evidence-based medicine (EBM) has facilitated randomized controlled trials on acupuncture in the West. However, there is a bigproblem in setting a sham acupuncture group. Pragmatic clinical trials should be considered more in the future.
If the researchers of “Japanese acupuncture” pursue only reductionistic research methodology, they might lose something important that traditional medicine has brought for many years. Although we should employ the concept of EBM, we, at the same time, should discuss what Japanese acupuncture is and how we evaluate the aspect of the “art” of acupuncture medicine more intensely.