We encountered two patients complaining of hiccups following the resection of subaural tumor or subarachnoid hemorrhage. In one patient, we measured the autunomic nerves of Ryodoraku, and placed grains of silver on Ryodoraku points which showed abnormal values. We also used the in situ needle technique on acupoints which were considered to be closely related to the phrenic nerve. Furthermore, we inserted round-head subcutaneous needles in auricular acupoints such as “Kaku”, “Shinmon”, “Hishitsuka”, and “Jichu”. After repeating the above treatment twice, the hiccups disappeared completely. In the other patient who had difficulty even taking off clothes, a subcutaneous needle was inserted into “Kaku”, which was repeated twice a week. After five months, the hiccups disappeared completely.
Based on our experience with the two patients above, we had the impression that auricular acupuncture is particularly effective. “Kaku” was the main acupoint used, which is believed to influence the diaphragm. We believe that this technique can therefore be used clinically in the future.

A new therapy was recently developed by combining low frequency in situ needle acupuncture with Body Sonic Pad therapy. With this therapy, the patient lies on a bed fitted with Body Sonic Pads which vibrate slightly, in synchrony with the low-pitched sounds of the music which is played during the therapy. The patient listens to music and can feel the music-synchronized vibration of the pads while receiving in situ needle acupuncture. We recently assessed the effectiveness of this combined therapy.
The subjects were 30 patients with chronic shoulder stiffness who visited our department of anesthesiology. These patients received each of the following 5 treatments at different times in random order: (1) Method M (listening to music without any other therapy), (2) Method B (Body Sonic Pad therapy without listening to music), (3) Method MB (Body Sonic Pad therapy while listening to music), (4) Method L (conventional continuous low-frequency (3Hz) in situ needle acupuncture), and (5) Method MBL (continuous low-frequency (3Hz) in situ needle acupuncture combined with Body Sonic Pad therapy while listening to music). The direct therapeutic effect and the degree of comfort during treatment were compared among these five methods. The acupuncture therapy for shoulder stiffness consisted of stimulating the standard points in the shoulder and neck region with 30mm acupuncture needles (No. 20). The electrical stimulation lasted for 20 minutes. The music used for Body Sonic Pad therapy was primarily classical music selected according to the desire of the patients. The effectiveness was rated by the patients on a 4-point scale (markedly effective, effective, slightly effective and ineffective). Effective or markedly effective cases were regarded as responding to the therapy. The level of comfort during treatment was rated on an 11-point scale.
The number of patients who responded to the therapy was 7 (23%) for Method M, 6 (20%) for Method B, 10 (34%) for Method MB, 18 (60%) for Method L and 23 (77%) in Method MBL. The response rate was significantly higher for Method MBL when compared to Method M or MB. The mean level of comfort during treatment (rated on a visual analog scale; 0=most uncomfortable; 10=most comfortable) was 6.3±2.1 for Method M, 6.0±2.1 for Method B, 7.0±1.6 for Method MB, 7.2±1.9 for Method L and 8.3±1.6 for Method MBL. Thus, low frequency in situ needle acupuncture combined with Body sonic Pad therapy was slightly superior to the other therapies.

During the 23 years since this pain clinic was founded, 29, 458 patients have been treated here (about 385, 000 patient visits in total). In the earlier days, patients with whiplash injury (posttraumatic neck syndrome) were predominant. More males than females visited our clinic in those earlier days. Several years after this clinic opened, the percentage of female patients became higher (55% or more) than the percentage of male patients. Reflecting the social trend of an increase in the percentage of elderly people in the total population, the percentage of patients between 60 and 80 years of age has been increasing. Patients who visit this clinic live primarily in Osaka Prefecture. However, it is not uncommon that patients living in other prefectures of the Kinki district visit this clinic. Although patients visit our clinic because of various complaints, they often suffer from chronic, intractable complaints, such as low back pain, combined pain of the lower back and legs, and postherapuetic neuralgia. They often visit our clinic as a last resort for healing, after having consulted many other institutions. The duration of sickness among patients who visit our clinic is long (often over 5 years). Although the methods of treatment and the patients' responses vary, depending on their diseases, the combination of nerve block with acupuncture seems to be more effective on pain. We have utilized various techniques of acupuncture, including the in situ needle acupuncture, low-frequency therapy, SSP therapy, laser therapy and hyperthermia.

In the present paper, we examined differences in therapeutic effectivenesses of venous methods of acupuncture, ranging from filiform needle to EAP, LFEA, laser and SSP, in cases with shoulder stiffness. The immediate and delayed effect of each method, comfortableness during treatment session, changes in temperature, blood flow, and the oxygen density at the Jianjing and Hegu point were examined.
Significant improvement was seen in every therapeutic method. Electrical acupuncture using direct current was most effective. No difference were evident among SSP, low-frequencey electro-acupuncture and filiform needle. There was a correlation between confortableness and the improvement rate in electrical acupuncture using direct current and laser acupuncture. Deep temperature, blood flow and the degree of oxygen saturation of the stimulated part tended to increasd in each case.

Various acupuncture stimulations were given to a 60 year-old housewife with a distinct meridian phenomenon to observe subsequent PSM. Clear PSM was induced either by finger pressure, press needle or low frequency press needle stimulation of Guanchong (terminal point). Scarless moxibustion applied to a source point induced clearer PSM than that to a terminal point. Comparing the propagating speeds of the PSM induced by press needle stimulations of the terminal points of the twelve meridians, those of liver, kidney and spleeen were the fastest (about 70cm/sec) and those of heart and large intestine were the slowest (1cm/sec). The propagation of PSM was blocked by 50-60mmHg of manchette pressure or by about 400g/cm local pressure using a pressure meter.

The therapeutic effect of a cordless mini TENS on shoulder stiffness and painful diseases and patients' favorite intensity of stimulation were studied. Effect of this apparatus on peripheral circulation was also examind using a laser Doppler measuring instrument. The 114 cases with shoulder stiffness used the TENS only once (SS group), and the 53 cases continuasly (SC group). The 65 cases with painful diseases used the TENS only once (PS group) and the 53 cases continuasly (PC group). A great majority of the patients prefered stimulation with moderate frequency and high intensity. Effectiveness was seen in 76% of SS group and 87% of SC group, and in 75% of PS group and 91% of PC group. Peripheral circulation was significantly increased after the stimulation of the apparatus.

In the previous paper, we reported a clinical study on laser irradiation stimulation for pain diseases. In the present study, we examined the effect of laser irradiation stimulation on peripheral blood circulation and its clinical effectiveness in the treatment of shoulder stiffness.
[METHOP] Five healthy adults were irradiated with low energy semiconductor laser (Ga-Al-As, 70mw, 830nm) at the Jianjing (VF21) for ten minutes. Skin blood flow near the stimulated point was measured using Laser-Doppler method before and after (for 20min.) irradiation.
Clinical effectiveness was examined for 50 patients with clonic shoulder stiffness who visited Anesthesiological Department of Osaka Medical College Hospital. The patients were randomly devided into two groups: laser irradiation group (L group) and Non-irradiation group (C group). To the C group, the apparatus was set but no laser was irradiated. Stimulation points were Tianzhu (VU10), Jianjing (VF21), Jianwaishu (IT14) and other points commonly used for shoulder stiffness. According to the numerical scale of subjective symptom reported by the patients immediately after the stimulation, therapeutic effictiveness was rated into four grades: “marked improvement” “improvement” “slightJimprovement” and “no change”. “Marked improvement” and “improvement” were regarded as effective cases.
[RESULTS] After laser stimulation, blood flow increased several times heigher than the original level but it tended to decrease back to the original level within the measuring period. The incedence of effective cases was 58% for L group and 40% for C group.
[CONCLUSION] Laser irradiation stimulation has been reported to have same effect as acupuncture, and gathering attention as stimulation method with less adverse effects. Our study demonstrated that laser stimulation induced transient improvement of local blood circulation.

The authors have been studied the effects of low energy semiconductor laser on capillary blood flow of the skin. In the present paper, we report a comparative study of acupuncture, low energy He-Ne laser and semiconductor laser.
[SUBJECT & METHOD] Subjects were five healthy adults. Two types of laser irradiation and in situ acupuncture using No. 20 needle, 30mm in legth, were separately applied to the right Hegu (IC4) for 10minutes. Two laser types were low energy He-Ne (632.8nm, 8.5mW) and low energy semiconductor MR-180Is (830nm, 30mW). Capillary blood flow of the skin was measured at the palmar center of right index fingertip before, during and 30 minutes after stimulation using a laser doppler blood flow velocity meter (LDV, ALF2100). Measurement was carried out after 20-minute rest in a room maintained at the temperature of 25±0.5°C.
[Result] After the acupuncture stimulation, blood flow rose to 140% of the original level and it was retained throughout the measurement period. By He-Ne or semiconductor laser irradiation, blood flow rose to 111% and 107%, respectively, but it showed tendency to decrease and reached below the original level 30 minutes later.
[CONCLUSION] Acupuncture stimulation demonstrated heigher effect in improving the peripheral blood circulation than He-Ne laser or semiconductor laser irradiation.

In this research we conducted a comparative study on the pain threshold elevation resulting from “exercise” work loads, ie. running and cycling, and acupuncture anaesthesia. 10 subjects participated throughout our research; whereas, additional subjects only participated in selected experiments. It was found that the pain threshold increased for both exercise work load and acupuncture anaesthesia; however, no significant correlation was found between the pain threshold elevation percentages resulting from exercise work load and acupuncture anaesthesia.
Therefore we propose, although it has been ascertained that the elevation of pain threshold involves the endomorphin mechanism, that there must be other important mechanisms involved as well.