PROBLEM: The Ishinomaki Red Cross Hospital is the only designated disaster hospital in the Ishinomaki Medical Zone, Japan that was undamaged from the Great East Japan Earthquake in March 2011. The tsunami completely destroyed a large part of the Ishinomaki Medical Zone.

CONTEXT: The Ishinomaki Red Cross Hospital was designed with the capability to respond to disasters. An instruction manual for responding to disasters had been developed and was exercised through drills.

ACTION: In accordance with the manual, the hospital disaster task force was established. The Ishinomaki Zone Joint Relief Team coordinated medical support from organizations such as physicians associations, dental associations, self-defence forces medical teams, pharmacists associations, the Japanese Red Cross and relief teams from hospitals all over the country. In three days, the joint relief team directly visited all emergency shelters to make an initial assessment and to collect information about the number and state of health of evacuees, provision of food and drinking water and the availability of electricity, water and sewerage.

OUTCOME: Initial assessment revealed that 35 emergency shelters lacked a sufficient food supply and that 100 shelters had unsanitary conditions. The joint relief team provided the Miyagi Prefecture government and the Ishinomaki municipal government with information about emergency shelters that did not have sufficient food supply. As of 30 September, the activities of the joint relief team were completed, and there was no outbreak of communicable diseases in the Ishinomaki Medical Zone. A total of 328 shelters with 46 480 evacuees were managed by the Ishinomaki Zone Joint Relief Team.

DISCUSSION: Advanced preparation to quickly establish an initial response system, expertise, and decision-making ability and the ability to get things done are required for disaster response management.

Most doctors in community hospitals are clinicians and differ in many ways from physician-scientists in university hospitals. However, conversion from clinician to clinician-educator requires various innovations and endeavors such as the establishment of clinical clerkship, dissemination of EBM, progressive disputation, sufficient accountability, cooperation with co-medical. Undergraduate medical education in community hospitals should be focused on primary care, general internal medicine and emergency medicine. Achievement in our hospital is discussed.

When I think pollinosis from a viewpoint of the Oriental medicine, I judged it is an abnormal symptom of the lungs system and the large intestine system.
So I burnt moxa on an effective spot, “Tsubo” of above mentioned systems of the pollinosis patients.
On this report, I want to report two other things. One of them is about the change of the symptoms of the patients against increase or decrease of flying pollens.
I examined ten Japan cedar pollinosis patients, whom I burnt moxa on each one spot selected from “Daitsui”, the lungs system and the large intestine system……on three spots. As a result, the symptoms of the patients have been steadied regardless of number of flying pollens. So I thought moxa cautery can control the symptom of pollinosis.
The other examination is about nasal congestion of the patients.
Nasal congestion of pollinosis patients is caused by expansion of a blood vessel. If the patient keeps the skin heat of the root of a nose lower, he can prevent expansion of a blood vessel.
This time I took this skin heat of the patients, and made an index from it. And the index I made showed that moxa cautery is effective for the cure of nasal congestion of the pollinosis patients, too.

From a viewpoint of the Oriental Medicine, I judged that pollinosis is an abnormal symptom of the lungs system and the large intestine system. So I burnt moxa on some effective spots “Tsubo” of above mentioned systems of the pollinosis patients. About the remedial value, I reported on my first report “MOXIBUSTION THERAPY FOR POLLINOSIS I”.
This time I compared and examined the symptoms of two patient-groups. One group consists of 9 moxibustion therapy patients, and the other consists of 5 medicinal therapy patients who took antiallergic.
A term of treatment was from February to March in 1990.
The effective spots “Tsubo” of moxibustion therapy patients on which I burnt moxa are three spots selected from “Daitsui” and the lungs system the large intestine system of right and left arms. Quantity of moxa is a half grain of rice size, and I burnt the quantity of moxa three times without a break on the same spot. I tried this treatment four times a week.
As the remedial value, the symptoms of moxibustion therapy patients as well as medicinal therapy patients didn't get worse and were steadied on the days when a large number of pollens flew.
When I continued to burn moxa, each symptom of the patient got better in the latter half of the term of treatment.
So I think moxa cautery for pollinosis patients was effective on controling the symptoms.