2011 Tokyo Declaration on Japanese Acupuncture
 Toward Better Healthcare in Japan and the World in the 21st Century June 19, 2011
I. Preface
The Tokyo Declaration on Japanese Acupuncture was adopted after due deliberation in the
60th Annual Congress of the Japan Society of Acupuncture and Moxibustion and the 39th
Annual Congress of the Japan Traditional Acupuncture and Moxibustion Society, both held on
June 19, 2011, under the theme “Wisdom of Japanese Acupuncture and Moxibustion
Concerning the Mind and Body.” The Congresses were sponsored by the Ministry of Health,
Labor, and Welfare; the Japan Medical Association; the Foundation for Training and Licensure
Examination in Anma-Massage-Acupressure, Acupuncture, and Moxibustion; the Japan
Acupuncture and Moxibustion Association; Zen Nihon Shinkyu Massage Shikai; the Japan
College Association of Oriental Medicine; the Japan Society for Oriental Medicine; The

National Society of the Principals of the School for the Blind; Japan Association of
Massage & Acupuncture Teachers; All Nippon Hospital Physical Therapy Association; theJapanese Society of Oriental Physiotherapy; the Japanese Society of Ryodoraku Medicine, andthe Japan Conference of Clinical Acupuncture Moxibustion.

The Declaration was prepared by the Drafting Committee of the Tokyo Declaration on
Japanese Acupuncture composed of twenty Japanese scientists in related fields. The committee'sdeliberations began in early 2010 and the first draft was published on the website of the Japan
Society of Acupuncture and Moxibustion in May 2011 for collecting public comments. The
second draft prepared by the Drafting Committee was presented at the above-mentioned
Congresses.

The Declaration was addressed to national governments of the world, related associations andacademic societies, and the general public, and presents the current distinctive characteristics ofJapanese acupuncture and moxibustion based on their historical background. It aims to promotethe further advancement of acupuncture and moxibustion as a component of medicine (orhealthcare) in the world.

II. Background

Acupuncture and moxibustion began almost 2000 years ago when the first comprehensive
ancient Chinese medical text “Huangdi Neijing (Yellow Emperor's Classic of Internal

Medicine” was written. The theoretical system of “Huangdi Neijing” is followed by the basic
theories underlying current Japanese acupuncture and moxibustion practices: yin-yang theory,
five phase theory, viscera and bowels, meridians, pathogenesis, and the principle of treatment.
The system of medicine practiced by the Han people who lived in the Yellow River basin in
China has been pervasive in cultures using Chinese characters and has long played an importantrole in health maintenance and treatment of diseases in East Asian countries.

Although acupuncture and moxibustion were formally introduced into Japan in the 6th
century, Chinese medicine probably came to Japan via the Korean Peninsula earlier, sincepeople in Japan and the Peninsula had been interacting with each other prior to the 6th century.
Acupuncture and moxibustion as a branch of Chinese medicine was officially adopted in Japan
before the Nara Period (AD 710 – 784) as evidenced by the presence of the medical system
Ishitsuryo in the Taiho Ritsuryo (Taiho Code), which was enacted in AD 701. The Ishitsuryo atthat time stipulated a 7-year period of training to qualify as an Acupuncturist or doctor of
Acupuncture.

Subsequently Japanese acupuncture and moxibustion were repeatedly devised, improved andadapted to the Japanese climate and culture as well as characteristics and thought of theJapanese people, thereby evolving into the classic form of medicine in Japan known as Kampo
medicine by the Edo era (AD 1603 – 1868). Moreover, it persisted to the present time as part ofthe cultural heritage of Japan. In the Meiji era (AD 1868 – 1912), inspired by the slogan fukoku

kyohei (rich country, strong army), various measures and policies were implemented in all
sectors of society. In the medical care sector, with the advent of Western medicine, there was a
decline in the esteem with which Japanese acupuncture and moxibustion medicine was held as
the classic form of medicine. However, Japan has preserved its unique form of acupuncture andmoxibustion medicine by eclectically assimilating the principles of Oriental medicine andWestern medicine and systematically organizing the both. In recent years, Japanese acupuncture
and moxibustion medicine has developed further into a comprehensive form of medicine byincorporating new findings in modern Chinese and Korean medicine as well as modern Western
medicine (Footnote 1).

Diversity is a distinctive characteristic of Japanese acupuncture and moxibustion medicine,owing to the willingness of Japanese practitioners to provide healthcare that utilizes various
theories according to the complex structure of the human body. Currently in clinical settings,
acupuncture and moxibustion are available as medical care that aims to enhance the natural
healing ability of the human body as well as takes advantage of examination techniques used inboth Oriental and Western medicine for individualizing treatment.

Because of these diverse characteristics, acupuncture and moxibustion medicine has been
attracting the attention of medical institutions in Japan, and then opportunities to cooperate with
Western medicine are increasing. Underlying this trend could be the recognition and acceptanceof acupuncture and moxibustion treatment by practitioners of Western medicine.

Kampo medicine and acupuncture and moxibustion, which had played a pivotal role inJapanese medicine until the end of the Edo Period, were supplanted by Western medicine during
the Meiji Period. Consequently acupuncture and moxibustion were placed outside the national
healthcare system and laws applying to them were developed separately. In the late Meiji
Period, a license system for acupuncture and moxibustion practice was instituted. After WorldWar II, the Japanese government ordered a ban on acupuncture and moxibustion in accordancewith recommendations of the General Headquarters of the Allied Forces (GHQ). However, theorder was withdrawn in the wake of intensive opposition by scholars and practitioners ofacupuncture and moxibustion, resulting in enactment of the law which led to the present Act for
Practitioners of Massage, Finger Pressure, Acupuncture and Moxacauterization, etc. Since 1988,

acupuncturists and moxibustionists have been licensed by the Minister of Health, Labor, andWelfare (Footnote 2).

Acupuncture and moxibustion education was based on an apprenticeship system before the
Meiji era and an institutionalized school system during and after the Meiji era. Specificallysince 1947, the laws have undergone multiple changes. Today acupuncture and moxibustion
training is provided at vocational colleges and 4-year colleges to those who graduate fromsenior high schools. Licenses are granted to those who finish the required college course andpass the national examinations for acupuncturists and moxibustionists (Footnote 3).

The current curriculum for acupuncture and moxibustion in Japan is based on a Western
medicine model and includes specialized subjects such as acupuncture and moxibustion. Thus,
the mentality and thought of the Japanese people are combined with those of Western medicine
to serve as a basis not only for the diversification of medical practice which is characteristic ofJapanese acupuncture and moxibustion, but also for the promotion of complementary medicine
and integrated medicine.

A number of basic studies on acupuncture and moxibustion medicine have been published inJapan. These elucidate the mechanism of action as well as provide a certain amount of evidenceof efficacy. These findings should be disseminated through international academic exchanges,
thereby contributing to the advancement of basic research on acupuncture and moxibustion on a
global scale. In clinical research, rather than randomized controlled trials to assess the efficacyof acupuncture and moxibustion are performed. Moreover it is recommended that clinicalstudies be designed in accordance with the innate characteristics of acupuncture andmoxibustion to explore the unique clinical efficacy of acupuncture and moxibustion, and theirresults should be published.

III. Current Status

The medical care system in Japan is modeled solely on Western medicine. Althoughacupuncture and moxibustion and medicine are separate systems, acupuncturists andmoxibustionists have the same right to practice as physicians and dentists. Hence acupuncturists
and moxibustionists may privately practice acupuncture and moxibustion for purposes of healthmaintenance and promotion and the treatment of disease, and play a distinctive role in thehealthcare system of the Japanese people.

Even though the Western medicine-based healthcare system is well established in Japan,
acupuncture and moxibustion have a unique role because they are practiced from both an
Oriental and Western medicine perspective. Thus, Japanese acupuncture and moxibustion are
widely used to treat a range of diseases and symptoms1–10) (Footnote 4).

Because therapeutic measures do not require sophisticated equipment, acupuncture andmoxibustion can be performed in rural areas with inadequate medical facilities as well as insituations where medical facilities have become nonoperational. For instance, after thedevastating Great East Japan Earthquake on March 11, 2011, acupuncture and moxibustion
treatment was offered to victims to maintain and improve their health.

Even in a society where highly sophisticated medical technologies are widely available,
medical care that is familiar and readily available to people is still necessary. In this regard,
acupuncture and moxibustion can perfectly fulfill this need, provided that their usefulness iswell supported by mounting academic evidence.

Today in Japan, acupuncture and moxibustion are actively studied and the number andquality of research papers is increasing.11–15) Areas of research have also been expanded toinclude medical education, classical diseases, gynecological diseases, geriatric diseases, andcancers. Acupuncture and moxibustion research in Japan has thus been advancing; however,research findings have not been adequately disseminated. Hence international exchanges ofinformation will be needed to advance the practice of acupuncture and moxibustion medicine aswell as promote research. In addition, improved systems of education, training, and the likeshould be implemented to improve practical techniques and the quality of acupuncture andmoxibustion medicine available to the people of Japan.

In clinical practice in Japan, many acupuncturists are using minimal invasive methods
involving soft and tender stimulation such as thin needles, shallow insertion, and stimulation toskin without needle insertion, which have been well received by patients. Such acupuncturetechniques have been appreciated globally.

Diagnostically, palpation is valued; most acupuncturists touch the skin and select acupuncture
points and treatment sites on the basis of the responses of patients. Consequently acupuncture
and moxibustion are increasingly thought of as individualized treatments.

On the other hand, in Europe and the U.S., large-scale clinical studies that are not clarify
individualized treatment have been conducted in recent years.16, 17) Although the efficacy of
individualized treatment has been demonstrated in some Japanese studies,18, 19) the evidence
remains inadequate. Unlike Western medicine which has an emphasis on etiology, acupuncture
and moxibustion treatment takes various entangled factors into account. Hence it is not easy tofind specific efficacy in current clinical research settings.

Consequently, a methodology of clinical research which focuses on characteristics ofacupuncture and moxibustion is needed. Specifically for Japanese acupuncture and moxibustion
which use soft and tender stimulation, it is critical to develop study designs as well as newtechnical methods to evaluate the efficacy of interventions involving individualized treatment asa main component. Such efforts should academically contribute to modern medicine focus on
individualized medicine. Thus, there is an urgent need to publish highly detailed results ofclinical research on acupuncture and moxibustion.

IV. Future Issues and Proposals

1. Future Issues

Japanese acupuncture and moxibustion date back more than 1000 years when the acupuncture
and moxibustion therapy of ancient China migrated to Japan via the Korean Peninsula. Devising
unique techniques to suit the Japanese climate and the individual needs of the Japanese people
and even integrating Japanese acupuncture and moxibustion with the newly introduced methodsof modern Western medicine have resulted in distinctive practices. With globalization ofacupuncture and moxibustion, all professionals responsible for Japanese acupuncture andmoxibustion should deepen their knowledge of Japanese acupuncture and moxibustion as well
as share their knowledge and experience globally.

In clinical settings, commonalities of diversity should be clearly identified. To this end, focus
should be placed not only on techniques of diagnosis and treatment but also on body view,
philosophy, professionalism, mission and sense of ethics which underlie acupuncture andmoxibustion, so as to establish a consensus view of the entity of Japanese acupuncture andmoxibustion.

As a matter of course, acupuncture and moxibustion should contribute to prevention andtreatment of disease. In addition, if death is the consequence of life, Japanese acupuncture andmoxibustion should address not only the quality of health, but also the quality of processes
leading to death (i.e., quality of life) in an aging society. Data must be gathered on demerits ofmedical care without acupuncture and moxibustion and merits of medical care with acupuncture
and moxibustion.

With regard to research, approaches that not only focus on some local responses toacupuncture and moxibustion stimuli, but also evaluate holistic responses occurring in mind andbody should be promoted. Besides, efforts should be made to improve the quality of evidence(i.e., by conducting randomized controlled studies), and research using epidemiological
techniques should also be conducted to demonstrate that acupuncture and moxibustion
contribute to the treatment of mibyo (the presymptomatic state).

Meanwhile, with respect to research methodologies including control group selection,interindividual differences, and difficulties arising out of the clinical trial environment should be
actively discussed. In the past, a press report on acupuncture anesthesia triggered intensive
research on pain, resulting in a quantum leap forward in that area. Likewise, it is expected that
there will be more discussion about reactions to weak Japanese acupuncture and moxibustion
stimuli and the placebo effect. The Japan Society of Acupuncture and Moxibustion along withindividual researchers are obliged to disseminate these new findings and concepts.

In the area of education, a core curriculum should be drawn up for human resource
development. However, not only knowledge and technique, but also following the philosophy ofJapanese acupuncture and moxibustion needs to be clarified. And the quality of instructors
needs to be enhanced to ensure the quality of education. To this end, postgraduate andcontinuous education for instructors and clinicians should be more actively carried out.
Finally, a database which offers the general public and healthcare professionals easy access tobasic knowledge and clinical evidence of Japanese acupuncture and moxibustion should also be
maintained. Such a database should help promote the understanding that acupuncture andmoxibustion are a very promising part of not only primary healthcare but also other areas ofcare including rehabilitation and palliative care.

2. Proposals

The historical background and current social status of Japanese acupuncture and moxibustion
were analyzed prior to preparing this Declaration. The great significance of this Declaration will
be recognized by promoting an understanding of the characteristics and future issues ofJapanese acupuncture and moxibustion among professionals in acupuncture and moxibustion
medicine, and in healthcare and healthcare administration. We hope that such an understanding
would influence the development of acupuncture and moxibustion throughout the world in the
future.

We hereby declare the following:1.

We shall extensively publish new findings in acupuncture and moxibustion to the
medical community and the general public for further comprehension and appraisalof acupuncture and moxibustion.

2.

We shall establish a study design capable of demonstrating the clinical significance ofacupuncture and moxibustion in order to contribute to the advancement of researchworldwide on the clinical efficacy and safety of acupuncture and moxibustion.

3.

We shall secure the appropriate position of acupuncture and moxibustion in theJapanese healthcare system.

4.

We shall promote understanding of acupuncture and moxibustion as part of Japan’s
precious cultural heritage and familiarize the public with the therapy.

5.

We shall facilitate exchanges among the acupuncture and moxibustion communities ofJapan and other countries, regard for their characteristics and make deeper
understandings of acupuncture and moxibustion one another, and endeavor tomaintain and inherit the diversity of acupuncture and moxibustion practices globally.

6.

We shall take a holistic approach in offering acupuncture and moxibustion therapy,
thereby further contributing to maintenance and improvement of health as well as
prevention and treatment of disease.

Contents of the Tokyo Declaration shall be subject to change over time as acupuncture andmoxibustion develop and evolve in the future.

Description of the Declaration

Items 1 and 2: Further expanded use of acupuncture and moxibustion treatment ascomplementary care for chronic pain diseases and age-related locomotive diseases and disorders
 that do not respond adequately to modern Western medical treatment  will improve qualityof medical care and bring great benefits to patients. The specific of acupuncture andmoxibustion treatment can also be adequately utilized in primary healthcare and primary caresettings because of its diagnostic and treatment methods. Moreover contributing to
improvement of quality of life (QOL) will be necessary by demonstrating the value of thesemethods in diverse areas including palliative care of cancer patients,. To this end, high quality
evidence showing the clinical value of acupuncture and moxibustion in Japan and othercountries needs to be collected and presented to healthcare professionals and the general public
in order to promote the use of acupuncture and moxibustion. A number of papers reporting
results of basic medical research on acupuncture and moxibustion in Japan have been published.
These elucidate the mechanism of action as well as provide some evidence of efficacy. Thesefindings should be disseminated through international academic exchanges, thereby contributing
to the advancement of basic research in acupuncture and moxibustion. Meanwhile in clinicalresearch, randomized controlled trials to evaluate efficacy of acupuncture and moxibustion
should be performed as well. It is recommended that clinical studies be designed in accordancewith innate characteristics of acupuncture and moxibustion to explore their unique clinicalefficacy, and that the results be published. It is also necessary to promote the understanding that
acupuncture and moxibustion treatment is reliable and safe which is the accepted fact.20–22)
Particularly use of disposable needles and clean needle technique should be actively promoted.
Accumulation of evidence is continued for the safety of equipment used in treatment anddevelopment of safer equipment is also continued; thereby Japan is playing a leading role in theworld in improving equipment safety.

Items 3 and 4: Acupuncture and moxibustion are branches of traditional Japanese medicine.
At the same time they are part of the precious cultural heritage of Japan and have been
identified with Japan. These facts should be publicized to facilitate advancement of Japanese
acupuncture and moxibustion. In China and Korea, acupuncture and moxibustion medicine has
been duly regarded as traditional forms of medical practice. Likewise acupuncture andmoxibustion should be appropriately incorporated into the Japanese healthcare system.

Item 5: Owing to globalization, acupuncture and moxibustion are no longer traditional
medical practices limited to East Asia. Under the circumstances, there is a push for international
standards of acupuncture and moxibustion. However, countries where acupuncture andmoxibustion have been practiced as traditional medicine have established their own standards ofacupuncture and moxibustion in the course of history. Therefore it is critical to promoteexchanges with other countries including China and Korea and to respect the standards of eachcountry. As acupuncture and moxibustion medicine progresses in each country, the diversity ofpractice will be both maintained and developed throughout the world.

AppendixFootnote 1

In the Edo era, the Gosei school continued to play a leading role, although the Koho schoolcame to the forefront in and after the middle of this era. Throughout the Edo era, Western
medicine was brought to Japan from the Netherlands, which influenced Kampo medicine aswell as gave rise to the Sechu school which blended traditions of Kampo medicine and Dutch
medicine in the later Edo era. It was after the Meiji Restoration in 1868 that Western medicine
became mainstream.

In the development of acupuncture between the Azuchi Momoyama era (AD 1568 – 1600)
and the early Edo era, kanshinho (a method of needling using a guide tube) was devised, whichbrought about a distinct shift to soft and tender stimulation methods involving the use of fineneedles and guide tubes. Meanwhile, highly refined moxa was produced by using stone mills
and winnowers. This development facilitated utilization of moxibustion because stimulation
could now be carried out with less heat.

During the Edo era, Japan was closed off from the outside world to avoid pressure from
Western European countries. However, Japan voluntarily adopted customs not only from China
and Korea but also the Netherlands. Conversely Japanese acupuncture and moxibustion
techniques including kanshin-ho (needling with tube method) and dashin-ho (needling-tapping
method) were introduced to Europe via the Netherlands.23) As a result, Japan was able todevelop its unique culture and civilization without being totally isolated from the world andeven achieved landmark success in medicine and developed innovative treatment methods.
These circumstances brought about qualitative changes in Japanese acupuncture andmoxibustion (i.e., adaptation to the culture and climate of Japan). Such qualitative changes may
have led to the modernization of Japanese acupuncture and moxibustion based on the Huangdi
Neijing system after the Meiji era.

Today there are many acupuncture and moxibustion practices in Japan: classic acupuncture
and moxibustion following the Huangdi Neijing system which is based on the yin-yang and fiveelement theories, modern Chinese medical acupuncture and moxibustion influenced by modern
Chinese medicine, modern medical acupuncture and moxibustion based on modern medicine,
treatment on the basis of tenderness and response, and specialized acupuncture and moxibustion
including sports and cosmetic acupuncture and moxibustion. Although current Japanese
acupuncture and moxibustion practices vary widely, they also seem to reflect past practices andare assumed to play similar roles in treatment.

Footnote 2

The first law governing acupuncture and moxibustion was stated in Article 53 of the Isei
(medical system) which was promulgated in 1874. Although Article 53 stipulated that
acupuncture and moxibustion should be put under the control of Western medicine, the Article
was never executed. However, the ethos of the law has been incorporated into subsequent laws
and is presently still apparent. With the adoption of Harijyutsu Kyujyutsu Eigyo

Sashiyurushikata (an act controlling acupuncture and moxibustion practice) in 1885, thepractices of acupuncture and moxibustion were formally accepted. In 1911, a license system
was introduced upon adoption of the regulation of Acupuncture and Moxibustion Practice.

A major turning point was 1945 when the Department of Health and Welfare of the
Occupation Forces, the GHQ recommended a total ban on medical practice other than that byqualified medical doctors. An active nationwide campaign for continuing the practice ofacupuncture and moxibustion was carried out and led to adoption of the Practice of AnmaMassage-Acupressure, Acupuncture, Moxibustion, Judo Therapy, etc. Act in 1947 andintroduction of the practitioner licensing system. However, acupuncture and moxibustion were
not incorporated into the healthcare system. The law has undergone multiple changes and the
Act for Practitioners of Massage, Finger Pressure, Acupuncture and Moxacauterization, etc. wasenacted in 1970. In 1988 a major revision of the law was carried out and administrative
authority for licensing was transferred from the prefectural governor to the Minister of Healthand Welfare (presently the Minister of Health, Labor, and Welfare).

Footnote 3

Modern acupuncture and moxibustion education was started early after the Meiji Restoration.
In 1903, the Tokyo vocational training school for the Visually and Hearing Impaired wasestablished to initiate a training program for teachers of acupuncture, moxibustion, and massage

at schools for the visually impaired. This training is now conducted at the Acupuncture andPhysical Therapy Teacher Training School, University of Tsukuba (authorized by the Ministryof Education, Culture, Sports, Science, and Technology). On passage of the Regulation forControl of Acupuncture and Moxibustion Practice in 1911, licenses to practice were granted tothose who graduated from elementary school and completed a 4-year training program at adesignated school. Thus, a parallel apprenticeship system to meet the training needs of student
acupuncturists was started. Subsequently, enactment of the Practice of Anma-MassageAcupressure, Acupuncture, Moxibustion, Judo Therapy, etc. Act in 1947 brought about a majorchange; training of all acupuncturists and moxibustionists was transferred to specialized
schools, special-needs schools, etc. The Act underwent minor and major revisions in 1970 and
1988, respectively, and the latter revision introduced a credit system and matriculation for 3
years (earning of 86 or more credits [basic courses, 14 credits; pre-requisite field-specificcourses, 27 credits; field-specific courses, 45 credits]) for senior high school graduates. Higher
education began with the establishment of the Meiji College of Acupuncture and Moxibustionin 1978, which subsequently became a university with a graduate school of acupuncture andmoxibustion (offering masters and doctoral degree courses). Meanwhile Tsukuba College ofTechnology, Tsukuba University of Technology, and Tsukuba University of Technology
Graduate School of Health Sciences (offering masters degree programs in Acupuncture andMoxibustion) were established in 1987, 2005, and 2009, respectively. Thus acupuncture andmoxibustion training in higher education facilities is now available to people with or withoutvisual impairment.

Footnote 4Japanese acupuncture and moxibustion are characterized by six distinctive features. The firstis that “touch” is the most important concept. Diagnostically, palpation is valued; especiallypulse diagnosis has been emphasized. The typical example is “meridian treatment” that resulted
from the development of a pulse diagnosis of six-position pulse diagnosis based on a uniqueinterpretation of pulse diagnosis. Besides, a variety of palpatory techniques including abdominal
diagnosis beyond the Chinese classic medical book “Nanjing (Classic of Difficult Issues)”,
Chapter 16 have been newly developed and have evolved gradually. In clinical settings,
emphasis has been placed on touching the skin and selecting acupuncture points on the basis ofresponses of the points as well as practicing treatments frequently on the sites of cutaneous andsubcutaneous indications such as tenderness and induration.

The second is that the development of acupuncture and moxibustion treatment along withdiagnostic devices is advanced from the Western medicine perspective. Actually, tools forobjective diagnoses  such as meridian patterns of Ryodo-raku (Ryodo meridian therapy,
Ryodoraku Medicine), electro-dermal points, and sadenten (potential difference point)  andacupuncture point detector have been developed in parallel to the development of therapies.
Particularly to the diagnosis of locomotive disorders, manual test (physical examination) has
been applied, suggesting the emphasis of objectivity. In addition, scientific clinical and basic
researches have progressed into practical utilization in Japan. Given these facts and a very large
number of patients with locomotive disorders, which are more likely to be treated withacupuncture and moxibustion (rather originated from Western medicine), valuable needle
insertion method for local regions have evolved.

Third, promoted development of acupuncture and moxibustion treatment using less burdened
and soft and tender stimulation has resulted in realization of kanshin-ho (needling method using
a guide tube), thin and shallow tender needling, contact needling, infant needle, intradermal
needle, thumbtack needle, laser acupuncture and electro-moxibustion.

Fourth, acupuncture and moxibustion practitioners in Japan are most commonly taking a
middle course between Western medicine and classical medicine (based on the Chinese classic
books “ Suwen [Plain Questions]” and “ Lingshu [Miraculous Pivot]”) in diagnosis, therapy,
technique, and philosophy. The reason may be the flexibility of Japanese people. In fact, toolassisted treatment such as hyperthermia and electrotherapy, massage, chiropractic, judo therapy,
and combination therapy with Western medicine are very popular.

Fifth, moxibustion treatment is highly thriving. Particularly the practice of tonetsu-kyu(diathermic moxibustion) is quite unique technique in the world. This may be attributed toexcellent moxa with low burning temperature that has been developed with delicate technology
capability.

Finally, the treatment of the presymptomatic state referred to as ‘mibyo’ follows. At any
acupuncture and moxibustion clinic, practitioners treat not only affected patients but also a
considerable proportion of healthy or apparently healthy people with mibyo for health control
and promotion, as is known by yojo no kyu (moxibustion for life nurturing) and sanri no kyu(moxibustion to legs, ST 36).

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The Drafting Committee of Tokyo Declaration Member

Shuji Goto*１, Ph.D., Chairman, Goto College of Medical Arts and Sciences

Shuichi Katai*２, Professor, Course of Acupuncture and Moxibustion, Department of
Health, Faculty of Health Sciences, National University Corporation Tsukuba
University of Technology

Ayumi Sakamoto*３, M.D., Ph.D., Chairman, Kuretake College of Medical Arts andSciences

Katsumi Ishihara, Director, Toumeidou Ishihara Acupuncture and Moxibustion Clinic

Kazunori Itoh, Associate Professor, Department of Clinical Acupuncture andMoxibustion, Meiji University of Integrative Medicine

Takayoshi Ogawa, Lecturer, School of Teaching Certificate Program for L.Ac, Tokyo
Eisei Gakuen College

Kenji Kawakita, Professor, Department of Physiology, Meiji University of Integrative
Medicine

Hiroshi Kitakoji, Professor, Department of Clinical Acupuncture and Moxibustion,
Meiji University of Integrative Medicine

Hideto Komatsu, Director, Jyujido Acupuncture and Moxibustion Clinic

Shoji Shinohara, Professor, Department of Traditional Acupuncture and Moxibustion,
Meiji University of Integrative Medicine

Masami Senoh, Director, Acupuncture and Moxibustion Clinic of Hakko Ryoin

Daiki Takahashi, Faculty, Tokyo Eisei Gakuen College

Toshihiro Togo, Ph.D., Associate Professor, Department of Acupuncture andMoxibustion, Faculty of Health and Medical Sciences, Tokyo Ariake University of
Medical and Health Sciences

Masao Togasaki, Director, Hou Treatment Center

Fumihiko Fukuda, Associate Professor, Department of Clinical Acupuncture andMoxibustion, Meiji University of Integrative Medicine

Takahiro Funamizu, Faculty, Kuretake School of Integrative Medicine

Tetsuji Murakami, Faculty, Tokyo Therapeutic InstituteTadashi Yano, Professor, Department of Health Promoting and Preventive
Acupuncture and Moxibustion, Meiji University of Integrative Medicine

Satoru Yamaguchi, Lecturer, The Center for Oriental and Integrated Medicine,
Saitama Medical University

Hitoshi Yamashita, Professor, Morinomiya University of Medical Sciences* 1 President, The Japan Society of Acupuncture and Moxibustion* 2 President, The Japanese Traditional Acupuncture and Moxibustion* 3 Chairperson, The Drafting Committee of Tokyo Declaration