In 1989 the Japan Acupoints Committee decided upon standard locations for acupoints based upon a rational method of proportional distribution and points of the same names but different locations were expressed by attaching the location indicator before the name such as _??__??__??_. However as study of the naming of points of the same names and different locations is yet incomplete it remains as a topic for further investigation. As one aspect of this investigation I examined related literature from ancient China through the Edo Period in Japan to determine how points of the same names but different locations were expressed and named in an effort to consider how they should be called hereforth.
An analysis of the modes of expression in the investigated literature showed that in Japan through the Edo Period for the most part the location of the point was read using the Japanese reading of the Chinese character and the helper article “NO” (meaning of or belonging to) was inserted between the location and the point name, however methods of expression in many cases were not unified. No tendency toward an effort for unified nomenclature was observed, rather points seemed to be named independently.
Now that nomenclature is being unified, when we consider the expressions for points of the same names but different locations I propose that we should consider the reading of the special anatomical name, the reading adopted by WHO and the reading of the names of other acupoints compositely, and name the points according to the tonal reading of the Chinese character, for example “Shusanri” for what we have heretofore referred to as Te No Sanri (LI10).

Using 69 patients afflicted with arthralgia of the shoulder joint accompanied by motor limitations as subjects we conducted research to determine to what extent the nature of the shoulder arthralgia could be assumed based upon clinical observations centered around interview and palpation tests.
Our method was to determine guide symptoms for various shoulder joint diseases and make assumptions as to the origin of the patient's condition based on the rate of occurrence of these symptoms.
Results revealed 34 (49%) cases of adherent inflammation of the articular capsule, 12 cases of inflammation of the synovial bursa of the acromion and 9 cases of tendonitis of the long head of the biceps brachii muscle. In addition cases of tendinitis of the rotator cuff tendonits of the supraspinatus muscle and inflammation of the coracoidal process were assumed. In some cases there was pain in the posterior area of the shoulder and tenderness was observed in the tendon of the triceps brachii muscle in 5 cases. It was shown that assumptioons such as these based upon clinical observation are to some extent helpful in diagnosis.

Making external reference observations the object of our study, we attempted to assume the root disease in 60 subjects afflicted with cervical brachialgia.
Results showed 3 cases of cervical-spinal disease symptoms assumed from sensory disturbances of the upper and lower extremities or gait disturbances, etc.; 27 cases of cervical nerve root symptoms determined by the Spurling Test and pain and tenderness with backward flexion of the cervical vertebrae; 18 cases of thoracic outlet syndrome determined through the Wright Test, and Morley Test, etc. 5 cases of cervico-scapulo-brachial syndrome did not show the above mentioned disease conditions and 7 cases were undetermined.
The above was not conclusive diagnosis but it did help in assuming an outline of the disease conditions. From the point of view of therapeutic results it was observed that acupuncture therapy was not appropriate for spinal symptoms, appropriate to a degree for nerve root symptoms and appropriate for thoracic outlet syndrome.

In order to determine acupuncture point locations, basic points are used as indicators and a standard local scale expressed. In the classic text SENKINPO the individual finger can is described as an easy method for determining a standard local scale. To determine whether the can explained in the original text where 7 SHAKU 5 CUN is used as a standard for the body height, and the individual finger can measurements taken on the middle fingers and thumb correspond, we measured the height and bilateral middle finger and thumb lengths of a mixed group of 242 male and female subjects. Following are our results:
1. On male and female adults both left and right middle finger can measurements corresponded well. Results with school age children were similar however correlation was not as favorable as with adults.
2. Correlation with thumb can measurements was not good.
3. Classics state that for males the left hand is to be used, for females the right hand. In the adult group which showed high correlation these were compared however no significant differences between sexes was proven.
4. We compared the adult middle finger can with the body height however the local scale which varies individually also varles with the length of various parts of the body. It was shown however to be useful in point localization in precise short areas.

During and after the LI4 and LI10 Acupuncture, the volume elastic modulus Ev in the basal phalanx of finger arteries were measured. Ev values were noninvasively obtained using a new type of plethysmograph called the “electric impedance-cuff” which can detect indirect arterial pressure and volume change in the artery. After 15 minutes of rest, 2 minutes acupuncture on LI4 and LI10 were carried out in 16 healthy subjects, respectively. Volume elastic modulus showed a significant decrease (p<0.01) during and after the LI10 Acupuncture. Its decrease were maintained at least 20 minutes after the withdrawal of the needle. While the Ev values did not show the typical change during and after the LI4 acupuncture. These date suggest that the elasticity of the peripheral wall was lagely affected by the LI10 acupuncture, and the effect was caused not only by peripheral reflex but by other factors.

With the internationalization of acupuncture the worid unification of meridians and points basic to acupuncture medicine has become essential. At the present studies are underway aimed at the internationalization of meridians and meridian points. To aid in this effecrt we conducted research on the standard location of points in the scapular region and on the hands. Using the classic Writings from the SOMON thru the SHINKYU SHUEI and adopting as far as possible older classics we obtained the following results. In this study there was no need for the classic standard local scale however the distance from TE13 to the inferior angle of the scapuiar converted according to height of 6.6 fcun was established as a clinical scale. In the scapular area with the exception of SI11 all points- LI16, TE15, SI12, SI13 and G21 could be determined anatomically. On the hands thanks to protrubences, bulges, joints and so on it was possible to determine all points anatomically. This included on the Yin meridians, 2 points on the Lung Meridian, 2 points on the Pericardium Meridian, 2 points on the Heart Meridian. On the Yang meridian it included 4 points on the Large Intestine Meridian, 2 points on the Triple Warmer Meridian, 4 points on the Small Intestine Meridian. Among these the well points on the tips of the fingers were determined as 1/10 middle finger fcun above the angle of the margin occultus unguis on the respective fingers.

For the Yang Meridians on the feet we adopted the point locations described in the classics using the classics chronologically and expressed the point locations on the surface of the body in anatomical terms. When this was not possible they were expressed proportionately in terms of their location between standard points. The standard local scale for the foot was calculated through actual measurement using 3 fcun as the standard distance from the lateral malleolus to the ground. The altered scale of 2.5 fcun from the lateral malleolus to the ground and the 6.5 fcun used for the location of points between S44 and S41 in the KOITSU and a clinical local scale were used. Thus according to the 2.5 fcun measurement from the lateral malleolus to the ground for B63, B61 was determined as 1/3 of the way from the ground and B62 as 1/3 of the way from the lateral malleolus. B64, B65, and B66 were determined anatomically on the lateral superior border of the 5th metatarsal and the 5th toe. G41, G42 and G43 were determined anatomically on the dorsal aspect of the foot between the 4th and 5th metatarsals. Stomach Meridian, S44 on the dorsal aspect of the foot between the bases of the 2nd and 3rd proximal phalanges was established as a standard point and using S41 researched previously as a standard point, S44 was located 1/4 of the way posterior and S43, 1/3 of the way anterior. B67, G44 and S45 were located behind the nails on the 4th, 5th and 2nd toes.

With international standardization of location of meridian points which are fundamental to acupuncture as a goal we studied the location of meridian points on the Yang meridians of the crus. The method of research was to adopt the descriptions of point locations round in the classics using the classics chronologically and adding to this information based on actual measurement, conduct our studies. As a standard local scale for Yang meridians on the crus, as in the KOTSUDO chapter the distance from the height of the knee split point to the lateral malleolus is 16 fcun and the distance from the fold line in the popliteal fossa (B40) to the superior border of the calcaneus is given as 16 fcun, point locations which could not be explained anatomically were proportionally distributed with in the local scale. Thus on the Stomach Meridian as the classic locations of S36 and S41 can be assumed and expressed anatomically and the other points lie between S35 and S41, S37 was determined 2/5 from S35, S38 and S40 in the middle and S39 2/5 from S41. On the Gall Bladder Meridian, G34 and G40 are determined anatomically and the other points between the knee split point and the lateral malleolus, G35 and G36 in the middle front or back, G37 1/3 from the lateral malleolus, G38 1/4 from the lateral malleolus and G39 1/5 from the lateral malleolus. On the Bladder Meridian between B40 and the superior border of the calcaneum protrubence, B55 is 1/8 from B40, B56 is 1/3 from B40, B57 and B58 midway medially or laterally and B59 1/5 from the calcaneum protrubence.

In order to determine the standard locations of acupuncture points in the brachial region I studied the actual descriptions of point locations as recorded in ancient texts. In the REISU the length from the shoulder to the elbow is indicated as 1 SHAKU, 7 SUN, however there are two theories about the interpretation of shoulder, the GV-14 DAITSUI theory and the shoulder tip theory. Examining the point further we find that distribution of acupuncture points on the Large Intestine Meridian from LI-15 to LI-11 covers 10 SUN. In this case based on the description depicting the position of the arms as horizontal and turned outwards, actual measurement of each location on the 120 arms of 60 subjects proved that when the “shoulder” was interpreted as GV-14, the upper arm measurement was 10 SUN. (The measurement from GV-14 to LI-15 is 7 SUN thus accounting for the 1 SHAKU 7 SUN.)
Using this 10 SUN as the criterion for the upper arm and determing the proportional distribution of acupuncture points between the shoulder and the elbow based on the lengths indicated in ancient texts 9 points are defined: LI-13 and LI-14 on the Large Intestine Meridian, TE-11, TE-12 and TE-13 on the Triple Energizer Meridian, L-3 and L-4 on the Lung Meridian, P-2 on the Pericardium Meridian, and H-2 on the Heart Meridian. There were 12 points for which the locations could be determined anatomically: LI-11, LI-12, LI-15 on the Large Intestine Meridian, TE-10 and TE-14 on the Triple Energizer Meridian, SI-8, SI-9, SI-12 on the Small Intestine Meridian, L-5 on the Lung Meridian, P-3 on the Pericardium Meridian and H-1, H-3 on the Heart Meridian.

In recent times it is generally customary to assume that the HACHIRYO points correspond with the posterior sacral formina. In order to find a way to locate these points in accordance with this general practice we took X-rays of the sacral area of 23 subjects and conducted this study. Results showed that the standard height for the distribution of the HACHIRYO points was a point halfway between the spinous process of the 5th lumbar vertebra and the superior ridge of the middle sacral crest. We called this point the “17th vertebra”. Also the midpoint between the inferior ridge of the left and right sacral angles was determined as the “sacral angle midpoint”.
One-fourth of the way from the 17th vertebra to the sacral angle midpoint was considered the height of B-31. In the same area onetenth of the way from the sacral angle midpoint to the 17th vertebra was determined as the height of B-34. The area between B-31 and B-34 is divided into thirds to determine the heights of B-32 and B-33.
Next to determine the lateral distribution the area between the inferior ridge of the posterior-superior iliac spine and the posterior median line is used. The point laterally 3/4 of the way between these which coincides with the predetermined height of B-31 is the location of B-31. Likewise the point halfway between the inferior ridge of the posterior-superior iliac spine which coincides with the determined height of B-34 is the location of B-34. Next a slanted line is used to connect B-31 and B-34. The points along this line which coincide with the previously determined heights of B-32 and B-33 are considered the locations of these points.