[Objective] The Zang-Fu and the meridians, which are one of the foundations of modern acupuncture and moxibustion medical education, appeared in "Lingshu" in the "Meridian" section. However, the Zang-Fu and the meridians each has a history of independent development in ancient China Before the Common Era. The purpose of this study is to investigate the process by which the meridians came to be associated with the Zang-Fu, drawing from descriptions in "Suwen", which was compiled Before the Common Era.[Method] The source literature of this study is "Revisions and Extensive Notes on the Huangdi Neijing Suwen", with reference to "Acupuncture and Moxibustion Medicine and Classic Research" by MARUYAMA Masao to classify compilations of "Suwen". The research items are the names of the Zang and the Fu, the relationships between the Zang and the Fu, and the piao-li relationships of the Zang-Fu and the three Yin and three Yang of the hands and feet. [Result] The names for the Zang were Liver, Heart, Spleen, Lungs and Kidneys, and for the Fu were Small Intestine, Bladder, Gallbladder, Large Intestine, Stomach, and Sanjiao. The Zang-Fu relationships were Lungs-Large Intestine, Spleen-Stomach, Heart-Small Intestine, Kidney-Bladder, Liver-Gall Bladder, and Chronic Illness-Sanjiao. The piao-li relationships of the Zang-Fu and the three Yin and three Yang of the hands and feet were Foot Thai-Yang and Shao-Yin, Foot Shao-Yang and Chueh-Yin, Foot Yang-Ming and Thai-Yin, Hand Thai-Yang and Shao-Yin, Hand Yang-Ming and Thai-Yin, and Hand Shao-Yang and Heart. The Liver is treated by Foot Chueh-Yin and Shao-Yang, the Heart is treated Hand Shao-Yin and Thai-Yang, the Spleen is treated by Foot Thai-Yin and Yang-Ming, the Lungs are treated by Hand Thai-Yin and Yang-Ming, and the Kidneys are treated by Foot Shao-Ying and Thai-Yang. There was the expression "太陰陽明表裏為脾胃脈也" that Hand-Foot, Yin-Yang and the Zang-Fu were grouped by their Piao-li relationships. And there were the expressions saying "Shao-Yin is the Kidneys" and "Yang-Ming is the Stomach", although these were not in complete form. [Discussion] The Zang-Fu meridians, combining the Zang-Fu and the meridians, started from the Spleen-Stomach. There were other expressions combining the Zang-Fu with the meridians, although these were also not in complete form. While medicine at that time was being organized and integrated with the Yin-Yang and Five Elements theories, the relationships between the Zang-Fu and the meridians were also established. And it is inferred that the process of combining these and developing them into a new medical system existed during this period. [Conclusion] The relationships between the Zang-Fu and the meridians were established in "Suwen", which was compiled Before the Common Era, and the expression combining them started from "太陰陽明表裏為脾胃脈也".

The Medical Safety Committee has conducted various activities for patient safety in Japanese traditional Kampo medicines. In this study, we conducted a questionnaire survey to promote the prevention of medical accidents and their recurrence. We received responses from 15 of 19 facilities specializing in Kampo medicine and collected a total of 247 incident and accident cases in the field of Kampo medicine. Cases of side effects included interstitial pneumonia caused by Kampo prescriptions containing Scutellariae Radix, aconite poisoning, and licorice-induced pseudoaldosteronism. Furthermore, we also collected decoction-specific cases, which are unique to facilities specializing in Kampo medicine, for the first time. From the results, we included the following seven points for risk management in the field of Kampo medicine : 1) insufficient recognition to the side effects of Kampo medicines, 2) misunderstanding of the dosages of Kampo products, 3) errors due to similarities in Kampo formulas and crude drug names, 4) preconception of frequently used Kampo prescriptions, 5) contamination in the decoctions, 6) errors related to crude drug items and their dosages that are frequently added or subtracted, 7) errors in hospital wards.

[Objective]To investigate the effects of acupuncture on sports activities of athletes[Methods]A total of 1,804 athletes were targeted. The method used was a collective survey. Questionnaires were administered after obtaining consent from the participants; online questionnaires were also provided. The questionnaire evaluated profile (sex, age); sensation immediately after acupuncture treatment, duration of stimulus sensation, stimulus intensity, stimulus sensation, and therapeutic effect; timing of acupuncture treatment; and questions related to acupuncture as to whether the acupuncture caused any adverse effects on play (movement) or showed any positive effects.[Results]In total, 1,525 (84.5%) valid responses were obtained. The survey analyzed 841 subjects (55.1%) who underwent acupuncture. The most common response after acupuncture treatment was that the subjects felt lighter and were able to move more easily; 43.9% of subjects gave this response. In addition, 10.6% of respondents said that they continued to feel pain similar to the sensation during acupuncture treatment and 7.7% said they felt weak. The most common response at 59.8% was that the sensation felt during acupuncture disappeared quickly after treatment was ended, 58.6% of subjects said that the sensation felt after acupuncture was optimal, and 48.3% responded that the sensation from treatment remained and a positive effect was observed. The most common timing for receiving acupuncture for 21.8% of subjects was after practice or a match: [Discussion and Conclusion]Acupuncture for athletes should be performed according to the guidelines, taking into account the competition schedule and type of competition and the appropriate amount of acupuncture stimulation, thereby preventing problems during competition.

The Medical Safety Committee analyzed the case reports of minor incidents from the pharmacies last time as part of an activity to promote patient safety in Japanese traditional Kampo medicine. This time, we analyzed the case reports of medical accidents and minor incidents from the medical institutions. We extracted 626 reports related to Kampo products from the public database, which the Japan Council for Quality Health Care has established based on the collected information related to the medical accidents and minor incidents. The medical accident information includes case reports related to drug-induced liver injury. The minor incident reports include prescribing error due to misinterpretation related to the quantity of one sachet of Kampo extract product, dispensing error due to similarity of product appearance, number or name, and administration error due to judging the medicine only by Kanji characters or product company names without checking the Kampo formula name. Additionally, the minor incidents were often discovered by people belonging to different professions or patients themselves. In order to promote patient safety, knowledge about these incidents should be shared among the people involved in the same or different professions.

[Objective] The purpose of this cross-sectional questionnaire-based study is to investigate the challenges of adverse events during treatment by acupuncture and moxibustion to an athlete. [Methods] In total, 1,804 subjects, including athletes who participated in marathons and university athletes were enrolled in this study. The survey was conducted by distributing the questionnaire or via online questionnaire to the athletes who fit the criteria for the study. The questionnaires were collected after consent was received from the participants; online questionnaires were also collected. The questionnaire was examined for age, sex, and type of competition, purpose of the acupuncture treatment and the actual effects, and treated area, content of adverse event, number of times the subjects received acupuncture, and informed consent, and free description of adverse events.[Results] In total, 1,525 (84.5%) valid responses to the questionnaires were received. The survey analyzed 841 subjects (55.1%) who experienced acupuncture and moxibustion. The following responses about adverse events of acupuncture were obtained: "pain at time of needle insertion"; 17.0%, "subcutaneous-bleeding"; 10.1% and "pain and feeling of heaviness due to the needle": 10.0%, among others. For moxibustion, responses included "burns"; 5.9% and "malaise"; 5.8%, among others. In the free description, there were 17 descriptions of discomfort due to excessive stimulation and difficulty in movement during exercise. Of the questions regarding whether or not they received informed consent, 215 were received orally (25.6%), 34 were received in written form (4.0%), 99 were received both orally and in written form (11.8%).[Discussion and Conclusion] Acupuncture for athletes causes a certain rate of adverse events. It was suggested that guidelines for athletes to receive acupuncture safely and training and education for practitioners are important.

The Japan society of oriental medicine created a committee of medical safety in 2017. The first activity was to summarize the representative side effects of Kampo medicine and to enlighten members of our society about them. In this report, we documented the knowledge to keep in mind at present on pseudoaldosteronism, drug-induced liver injury, and drug-induced lung injury. Since these three major side effects may cause clinically severe conditions, it is very important to detect them early and take appropriate measures. Therefore, proper examinations at the right time are necessary while taking Kampo medicine.

The number of acupuncturists and moxibustion therapists has rapidly increased since around 2000. If they can be regarded as new healthcare resource investments, it is of great significance to evaluate their social impact. Here, we conducted a regional correlation study in different prefectures by using the extension of average life expectancy as an evaluation index. The results revealed an increase in “acupuncturists (human healthcare resources)” and in “facilities for performing acupuncture and moxibustion therapy (physical healthcare resources)” to show a weak but statistically significant positive correlation with the extension of average life expectancy for elderly men. Due to methodological limitations, however, this study cannot confirm a causal relationship between them. The author strongly hopes that public service corporations involved in the provision of acupuncture and moxibustion will henceforth serve as a bridge to allow researchers, acupuncturists, and moxibustion therapists to collaborate and conduct multicenter joint studies, in order to create an even greater social impact of acupuncture and moxibustion.