In Japan, acupuncturists generally use Oshide (Japanese style handling of the needle) to insert needles. It means that Japanese acupuncturists frequently handle the needle shaft during insertion and treatment (albeit with sterilized fingers). This everyday practice of Oshide used by almost all Japanese Practitioners differs significantly from the global Safety Standards for medical and acupuncture sterilization procedures. Furthers, practitioners in other countries may report such practices of needle handling as malpractice.
The author introduces the history and status of Oshide in Japan and other countries and hopes that Japanese practitioners will discuss it.

The birth of Oriental Medicine, including Acupuncture and Moxibustion, is attributed to Chinese civilization and is thought to have occurred in the Yellow River valley 2000 years ago. The contributing factors establishing Oriental medicine included the development of city-states designed to unite the country under a single authority. The governors of these city-states wisely designed policies to make the health of the people a top priority.
In the middle of the 6th century Acupuncture and Moxibustion spread into Japan. From the enactment of the "Taiho Code"(701 AD) until the promulgation of the "Modern Medical System"(1878) these modalities were recognized as the National Medicine of Japan.
During the Nara and Heian period (8-12 c), Japanese practitioners mainly accepted and learned the Chinese style of acupuncture and moxibustion. After the Kamakura period (13-14 c), during the Muromachi and Azuchi Momoyama periods (15-16 c), and into the Edo period (17-19 c), the original character of Japanese-style acupuncture and moxibustion began to develop unique characteristics.
Here, I have to specifically mention that a Portuguese ship arrived at Tanegashima Island in 1543, after which the cultures of Spain and the Netherlands influenced Japanese culture. Of course these foreign influences spread to the field of Acupuncture and Moxibustion.
During the Edo period, Japan closed its borders to foreign influences. During this time Japan traded only with China, Korea and the Netherlands. These trade routes, the merchandise, and exchange of information did not directly or immediately influence Japan, but they did play an important role in future cultural trends. Especially in the medical field, through trade with China, and Korea, Japan continued to accept information about Oriental Medicine. Likewise, through trade with the Netherlands, Western medical innovation gradually became popular.
In this way, Japan received the latest medical information from the forerunners of the world's medicine of that period. Naturally, the use of both traditional and modern modalities increases. As a result, Japanese Acupuncture and Moxibustion practitioners deepened their knowledge of classic texts, and made good use of the information from China and Korea. Significant innovations of this period include the concept of inserting acupuncture needles through a guide tube, more thorough abdominal diagnoses according to Chinese theories, and increasing acceptance of Western medicine theories. During the Edo period, developments in Japanese Acupuncture and Moxibustion would sustain the progress of these medical fields up to and into the Meiji era.
These developments included changes in the medical system, education, and research of Japanese acupuncture and moxibustion.

In Japan, moxa floss has long been produced by traditional methods. It has a high degree of purity and is incomparable to that in other countries. On the other hand, mugwort (leaves) are being imported from China now, and used to make the product sold in recent years. However details on this current situation have not been reported publicly.
Therefore we sent a questionnaire 14 major Japanese manufactures involved in the manufacturing, processing or domestic wholesale of moxa. The questions were both multiple choice and freely-written descriptive types, consisting of 29 items in 15 fields, about the current situation and problems faced in moxa manufacturing. The questionnaire was sent by return mail on 16 th November, 2011.
As a result, 12 out of 14 makers (85.7%) responded. Stocks wise, mugwort from Japan was 88 t, and import from China was 45 t. Moxa floss from Japan was 13 t, and import from China was 50 t. Manufacturing season started in late November and ended in late March. Stone mills, grain fans, and nagatoshi were used for manufacturing and many of these apparatus were made by craftsmen at their company. This survey enabled us to examine delivery and export systems for mugwort leaves and moxa floss, current moxa manufacturing and apparatus status, as well as problems and the future outlook for Japanese moxa floss makers.

Direct moxibustion has been a common used moxibustion method in Japan, has required moxa floss of high-quality, and has promoted the development of a moxa floss manufacturing method unique to Japan. At the same time in China, because indirect moxibustion and the stick moxibustion method has been commonplace, low moxa floss of a purified standard has been produced with a simple manufacturing method. However well-refined moxa has become available in China recently, and it is now more similar to that in Japan.
In this study, we investigated the difference between highly-refined moxa made in Japan and China based on reports from Japanese clinicians on the usability of moxa in firsthand practice. We performed a questionnaire survey with the country of manufacture blinded in 265 moxibustion clinicians. The number of valid responses was 164 (61.9%).
To the question asking what the difference between the two types of moxa was, 54.9% of clinicians responded there was “a little difference,” and more than half responded with “better usability” and “favorability” for the Japanese moxa. Of 119 clinicians who performed moxibustion, 85 (71.4%) selected “comfort” for the Japanese moxa.
We therefore conclude that Japanese clinicians recognize moxa refined with the Japanese manufacturing method as more suitable for direct moxibustion treatment.

Although the etiology and pathogenesis of nocturnal enuresis are still unclear and no definite theory has yet been established, treatment by acupuncture has been applied for a long time and its effectiveness have also been reported. However, there are very few reports on the findings on body surface (chill and KORI-stiffness/tonus/tension, etc.-of the body surface), which are important in Oriental Medicine, so we have focused on such findings in this report.
A total of 15 patients (11 boys, 4 girls) ranging in age from 4 to 13 years (8.4 years old in average) were examined. Their parents were instructed to fill out questionnaires concerning at the first examination and subsequently record daily frequency of urination and urine volume at each urination. Skin temperatures of the areas ranging from the face to the foot were measured by thermography in a supine position and abdominal regions were palpated using the techniques of Oriental Medicine.
1) Acupuncture treatment was remarkably effective in 5, effective in 5, slightly effective in 2, and ineffective or induced aggravation in 3, of the 15 patients. In summary 12 patients (80.0%) benefited from the acupunture treatment to a greater or lesser degree.
2) Ten out of 13 patients exhibited swelling and tension of the suprapubic regions, six of the ten patients experienced reduced swelling and tension after treatment, and all six patients also showed improved nocturnal enuresis.
3) The patients with nocturnal enuresis whose skin temperature in the suprapubic region was within the range of 32 to 34°C on initial examination recovered from nocturnal enuresis in contrast to those patients whose temperature was out of that range.
4) Six out of the 13 patients were found to have chill of pedal fingers on initial examination because of their temperature being under 26°C. After treatment, however, the skin temperatures of all 13 patients were above 28°C.
5) Among the five patients whose nocturnal enuresis did not respond to the acupuncture treatment, four had a pedal finger temperature below 26°C on initial examination.

This study was conducted to observe autonomic nervous system reactions in the cardiovascular system caused by the new transcutaneous electrical nerve stimulation apparatus CONVALES^®
Autonomic functions were evaluated before and after stimulation of 10 male students between 19 and 42 years of age. The dynamic observation method of autonomic functions proposed by Nishijo et al. was used for evaluating autonomic responses. The activity levels of both the sympathetic and parasympathetic systems were found to increased after stimulation. Neither significant changes in blood pressure nor adverse effects of stimulation were observed.
These results suggest that the apparatus used in this study causes autonomic responses similar to those caused by acupuncture with shallow needling during exhalation phase while sitting, or by laser acupuncture. This study also suggested that this therapeutic method is safe for short periods.

[Purpose] To evaluate the state of moxibustion therapy education.
[Methods] Investigation with a questionnaire at 66 vocational colleges of acupuncture and moxibustion in Japan based on the list issued by the Foundation for the Training and Licensure Examination in Anma-Massage-Shiatsu, Acupuncture and Moxibustion in April 2004.
[Results] The rate of valid responses was 62.1% (41/66). Basic practical moxibustion skills are taught in the first year of the three year program. For this class, 36.6% (15/66) of colleges gave students two credits. Most colleges devote more class time to direct moxibustion compared to indirect moxibustion. Students must learn to prepare a small, perfect shape, smaller than a grain of rice. The direct moxa cones are typically burned only 70∼80% to reduce the chance of burns.
More than 80% of colleges responded that moxibustion therapy was very available. The biggest problem is afflicting burns. Although more than 90% of colleges teach direct moxibustion with one's fellow students, the problem of burns remains. Colleges in eastern Japan tend to teach lower temperature moxa stimulation than western ones.
[Conclusion] The state of Japanese moxibustion education in vocational colleges of acupuncture and moxibustion is clear. In the future it is important that we consider new methods of moxibustion therapy based on safety and patient comfort, while maintaining traditional Japanese methods. Further it is necessary to investigate the state of Japanese moxibustion therapy at the clinical bed side.