KAIM
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INTERNATIONAL INSTITUTE OF HEALTH AND HUMAN SERVICES,
BERKELEY
Volume 6, Number 3 ･ Fall 2011

Editorial

What Did Happen At That Disaster
Koh Iwasaki

Special ReportJapanese Kampo Medicine after the Great East Japan Earthquake in Miyagi and Fukushima Prefectures
Shin Takayama, Kumiko Watanabe, Koh Iwasaki, Takehiro Numata, Hitoshi Kuroda, Tadashi Ishii and Nobuo Yaegashi

Japanese Acupuncture - Current Research 1

The Support by Acupucnture and Moxibustion for the Stricken Area on the Great East Japan Earthquake
Soichiro Mine

Japanese Acupuncture - Current Research 2

The Role of Acupuncture in the Great East Japan Earthquake
Naoko Maeda, Yuki Uchida, Tomomi Narushima and Shuichi Katai

Clinical Report (Japan)

Acupuncture and Moxibustion Treatment for the Victims of the Great East Japan Earthquake after One and Half Months fromits Occurrence
Raita Takasaki and Takashi Otsuki

Medical History in Japan“Historical Significance of the Standardization of Acupoint Locations”, the Second Japanese Acupoint Committee (3)Makoto Mayanagi

ISSN:1559-033X

College Logos
We believe it is necessary to create a new way of thinking
for the total understanding of "Life, Survival, and Health".
We decided to coin the world "Lifence" to express this.
Lifence means the combination of life sceince and medicine
as well as other disciplines such as health science, psychology,
ethics, etc.
Our college logos symbolizes the above.
The ripple effect represents the ocean and the birth of life.
The rainbow colored sphere represents a safe environment
and a barrier to protect us from negative influences.
The picture by Leonardo da Vinch represents a balanced
body and health.
Completing our logos is a ring which represents the unity ofspace fulfilling the total meanings of lifence.

The Journal of
Kampo, Acupuncture andIntegrative Medicine(KAIM)
Research on Theory, Practice and Integration

Volume 6, Number 3 ･ Fall 2011EXECUTIVE EDITOR

Shuji Goto
Chairman, GOTO College ofMedical Arts & Sciences
Tokyo, JapanEDITOR-IN-CHIEF

Donald Lauda, Ph.D.
Dean Emeritus, College of Health &Human Services
California State University-Long Beach
CA, U.S.A.

ASSOCIATE EDITORS
Shuichi Katai
Ibaraki-ken, Japan

Hiromichi Yasui

TA B L E O F C O N T E N T S
1 Editorial
What Did Happen At That Disaster
Koh Iwasaki

3 Special ReportJapanese Kampo Medicine after the Great East Japan Earthquake in Miyagi and Fukushima
Prefectures
Shin Takayama, Kumiko Watanabe, Koh Iwasaki, Takehiro Numata,Hitoshi Kuroda, Tadashi Ishii and Nobuo Yaegashi

Tokyo, JapanEDITORIAL STAFF

Akihiro Souma
Hiromi Sasaki
Hiroshi Tsukayama
Hitoshi Yamashita
Junko Okubo
Kazunari Ozaki
Kengo Nakata
Masayuki Kashima
Naoya Ono
Noboru Mitsuhata
Sayaka Toda
Takao Namiki
Toshiaki Makino
Toshihiro Togo

11 Japanese Acupuncture - Current Research 1
The Support by Acupuncture and Moxibustion for the Stricken Area on the Great East Japan
Earthquake
Soichiro Mine

17 Japanese Acupuncture - Current Research 2
The Role of Acupuncture in the Great East Japan Earthquake
Naoko Maeda, Yuki Uchida, Tomomi Narushima and Shuichi Katai

22 Clinical Report (Japan)
Acupuncture and Moxibustion Treatment for the Victims of the Great East Japan
Earthquake after One and Half Months from its Occurrence
Raita Takasaki and Takashi Otsuki

PUBLISHER

Shuji Goto
International Institute of Health andHuman Services, Berkeley
2550 Shattuck Avenue, Berkeley
California 94704-2724, U.S.A.

28 Medical History in Japan“Historical Significance of the Standardization of Acupoint Locations”, the Second Japanese
Acupoint Committee (3)Makoto Mayanagi

MISSIONTo disseminate peer-reviewed information on the use of acupuncture and herbs, and integration with western
medicine, based on research from an international perspective; thereby stimulating further research, application of
documented therapeutic measures; and facilitating dialogue among health care practitioners worldwide.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)KOTARO PHARMACEUTICAL introduced in 1957 the world's first Kampo extract
preparations on the market. Later, in 1967, six of our preparations could be covered in Japanfor the first time by the health insurance and after 1976 more than 100 of our preparations
were used in hospitals and clinics. Now it is half a century since we put our Kampo extract
preparations on the market and believe, we made a major contribution to this industry.
In the future we intend to continue working in accordance with our company motto: "Still better
Kampo for still more people" and provide pharmaceutical products of still higher quality.

Origin of the company's name
The company was named "KOTARO" by its
founder Taro Ueda with reference to his birthplace. Close to the ancient city of Nara. Kotaro
is the name of an enormous sheer cliff, 700 m
wide and about 200 m high. Mr. Ueda felt anaffection rising to the heavens for this cliff andthus made it the company's name.

KOTARO PHARMACEUTICAL CO., LTD.
5-23 Nakatsu 2-Chome, Kita-ku, Osaka 531-0071, JAPANURL: http://www.kotaro.co.jp

Volume 6, Number 3 | Fall 2011

Editorial
What Did Happen At That DisasterAround 14:46:18 of March 11 of 2011, an incredibly strong earthquake that measured 8.0 on the Richter scaleattacked our Tohoku district. The earthquake caused massive tsunami, engulfing and destroying a number ofcities and towns on the Pacific coast. Even now, December 2014,the15,889 persons were killed and 2,594 were
missing. In the immediate aftermath, more than 500,000 people abandoned their houses and were forced to flee
for refuge. All of express ways, railroads, and arterial roads, and Sendai International Airport, most of ports,
power stations including Fukushima No. 1 Nuclear Power Plant, the Gas Production Plant of Sendai-city Gas
Department, and many of the sewage treatment plants –these were all destroyed. Electricity, gas, water supplies,
fuel, transportation, telecommunications (information gathering) were disrupted. Not to mention telephones,
Internet and cellular phones did not get through. The city functions of Sendai, a mega city with a one million
population, were completely shut down. People could scarcely get water and meals required for the day. Not
even a single convenience store was open. The reservoirs of heating oil, and gasoline were depleted by quickly.
People in the dark without electricity were listening to radio, the only information source, enduring hunger andshivering in the cold. Having strong earthquakes each and every day, everyone was trembling with fear. Tohoku
University Hospital secured electricity for three days usage by the in-house power generation system. However,water supply systems, laboratory testing facilities, the radiation room, and the operation room were damaged.
All we could do in the condition was to measure hematological blood counts and electrolytes with blood gas
analyzers left scattered to the corners of the dialysis room. The operation of all heaters including the ones in thehospital ward was stopped and even the toilet water did not flush. Food for inpatients started running out ofstock. As well as the University Hospital, Sendai Medical Center, Sendai City Hospital, and Kosei Nenkin
Hospital concurrently suffered a great deal of damage and the medical systems were in the state of crash as awhole.
At this time, tragedies beyond our wildest imaginings were happening from east roads of Hachinohe, Miyako,
Kamaishi, Rikuzentakata, Kesennuma, Shizugawa (Minamisanriku-cho), Onagawa, Ishinomaki, Shiogama,
Sendai-city to all areas on the ocean side, Natori, Iwanuma, Soma, and Iwaki. Following the earthquake, tsunami
waves reaching the highest water level of 38.9m (Miyako-city) travelled through the inland 5-6 kilometers fromthe coast and ran up Kitakami River to the point of 50km from the sea. Everything was swallowed. The lives ofnearly 30,000 people were taken away in a heartbeat. Tidal waves of tsunami cyclically rolled on two or threetimes, continuously breaking down a gigantic breakwater, a several hundred tons ship, plants, petroleum tanks,
and buildings. Ships and tanks were floatedand the crashed concrete lumps were drifting around and completely
destroyed remaining few structures and other things. Furious fires broke out and flames were rising up on thesurface of the water. Coastal plants exploded one by one. Oil leaking from petro tanks and ships covered the water
surface and ignited. Several days after the main quake, people were helpless. No one could do anything and noone could tell who evacuated to where and whether who was dead or alive. There were no roads. As telephone
calls didn’t get through, we here in Sendai had no ways of getting the information about coastal area, Ishinomaki
and Kesennuma. The DMA (Disaster Medical Assistance Team) gathered from all over Japan got stuck at an
airport and could not move at all. In the coastal areas, the buildings of fire fighters, emergency services, police,
and government offices and hospitals were sunken by tsunami waves in a wink, so people could not have amethod of calling for help. Helicopters could not approach the people seeking help on the roofs floating here andthere on the burning water surface. At five degrees below freezing-point Celsius snow was falling thick and fastand survivors died one after another. Nearly five days since the main quake, the water receded at last and thefires went out after burning down everything. Then, a heap of wreckage, ruined houses, and a countless numberof dead bodies - all these were covered with the sludge - were floating in lines of several hundred kilometers on
the water surface in north and south along the Pacific coast in Tohoku.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3 | Fall 2011

On March 16 when the road toward the central city of Ishinomaki, the senter city of coastal region opened up
at last, Tohoku University Hospital dispatched the first group of the medical assistance team. By their reporting,the horrible and devastating situation in the coastal region got through to us here in Sendai as a living reality. Thus
the University Hospital immediately decided to send medical team members on a daily basis. On the following
day (17th), the author headed for the coastal regionas a member of the team. From the day, members of the
Department of Internal Kampo Medicine of Tohoku University Hospital took turns to provide medical assistance;
18th and 19th of March, physician Reina Okitsu who was then a postgraduate student; and 28th March, lecturer Shin
Takayamaf acupuncture and moxibustion. And they still continue to provide medical assistance in the devastatedsites. Kampo was finely effective for many diseases and symptoms that we experienced and acupuncture wasexactly useful to relieve severe stiffness that developed by their lying down on hard floor of the shelters.

Koh Iwasaki
Director and Chair, Center for Traditional Asian Medicine
National Sendai-Nishitaga Hospital,
Professor of Clinical Science, Tohoku University Hospital

2

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

Special ReportJapanese Kampo Medicine after the Great East Japan
Earthquake in Miyagi and Fukushima Prefectures(Kampo Medicine after Great East Japan Earthquake)*Shin Takayama1-3), *Kumiko Watanabe4),
Koh Iwasaki5), Takehiro Numata2,3),
Hitoshi Kuroda3), Tadashi Ishii2, 3)
and Nobuo Yaegashi6)*First author and equal contribution
1) Comprehensive
Medicine,

Education

Graduate

SchoolCenterfor

CommunityofMedicine,

TohokuUniversity, Sendai, Japan

were

prescribed.

In

the

outpatient

clinicin

Fukushima Prefecture, patients diagnosed withstress disorder were treated with Kampo medicine,resulting in positive effects on both physical andmental/emotional symptoms. Thus, Kampo medicine
is considered as a useful treatment that can beutilized along with Western medicine for various
medical conditions that emerge after a natural
disaster.

Introduction
The coastal areas of eastern Japan were2) Department of Kampo Medicine, Tohoku University
Hospital, Sendai, Japan
3) Department of Education and Support for Community
Medicine, Tohoku University Hospital, Sendai, Japandevastated by the massive earthquake and tsunamithat occurred on March 11, 2011. Tsunami waves
reached a maximum height of approximately 16 m

4) Department of Organ Regulatory Surgery, Fukushima

at the Miyagi fishery port of Onagawa, sweeping

Medical University School of Medicine, Fukushima, Japan

away people, cars, houses, and even whole

5) Southern Tohoku Research Institute for Neuroscience,

communities (Fig. 1). At first, it was reported that

Sendai, Japan

approximately 26,000 people died or were missing,6) Department of Obstetrics and Gynecology, Tohoku
University Graduate school of medicine, Sendai, Japan
Corresponding auther: Shin Takayama

Keywords:

JAPAN; TSUNAMI; DISASTER;
EARTHQUAKE; KAMPO

schools and community centers converted into
evacuation centers were isolated and prevented
from communicating with other areas due toAfter the Great East Japan Earthquake and hugetsunami, traditional Japanese (Kampo) medicine
was successfully used in the disaster-stricken areasin Miyagi Prefecture and in an outpatient clinic in
Fukushima Prefecture. Here, we report the changes
patients

partially destroyed [1, 2]. More than 400,000 people
were forced to evacuate to evacuation centers. Many

Abstractofand that at least 100,000 houses were completely or

symptoms

inevacuation

centers.

Additionally, we present specific case reports ofpatients who were sucssessfully treated with Kampo
medicine. Infectious diseases, common cold, andhypothermia were the predominant immediately
after the disaster. The incidence of allergies
increased 2 weeks later, and after another 6 weeks,
mental distress increased. Kampo preparations suchas kakkonto and keishito were administered topatients with common cold, whereas ninjinto andtokishigyakukagoshuyushokyoto were used for hypothermia.
Further, Kampo preparations with anti-allergic properties, suchas shoseiryuto, and tranquilizing properties, such as kamikihito,

inundated and severed roads in Miyagi Prefecture.
The

Nuclear

Power

Plant

in

Fukushima

Prefecture was also destroyed by the huge tsunami,
causing radiation problems in the east coast of
Fukushima (Fig. 2). Severe problems on the supplyof air, water, food, and shelter emerged due toradiation pollution. The government urged people
living within 20- to 30-km radius of the Fukushima
Nuclear Power Plant to evacuate to farther and safer
areas (Fig. 2). Everyone in east Japan experienced
anxiety, irritability, sadness, and despair.
After the disaster, the Department of Kampo
medicine in Tohoku University Hospital provided
treatment with traditional Japanese (Kampo)
medicine in the severely stricken disaster areas in
Miyagi Prefecture. Kampo medicine was also used
for patients at the clinic of Fukushima Medical
University (Fig. 2).

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3 | Fall 2011

In this report, we describe the disaster medical
reliefoperation

andmedicalconditions

that

preparations such as kakkonto and keishito were
used,

whereasninjinto

andemerged after the natural disaster that struck

tokishigyakukagoshuyushokyoto were used for the

Miyagi Prefecture, as well as some case reports thattreatment of hypothermia. Moreover, for patientswere successfully treated using Kampo medicine.

with prolonged symptoms despite under the

Medical relief operations using Kampo medicine at
the coastal areas of Miyagi Prefecture (modified
from ref. [3, 4])
Based on the medical records and documents on
the 12-day medical relief operations conducted at theevacuation centers in the Onagawa and Ishinomaki
areas during the first 73 days after the disaster, weretrospectively investigated the data on symptoms
and Kampo treatment (n = 236). Three periods wereassessed: the acute period, starting from the day ofthe disaster up to the 14th day after the disaster; thesub-acute period, which includes the 15th to the 42nd
day after the disaster; and the chronic period, which
covers the 43rd to the 73rd day after the disaster.
Data on symptoms and treatment were collected foreach period. Kampo preparations used in thismedical operation consisted of dried extract granules
prepared from a boiled water extract of multiple raw
materials. Quality control and assurance of these
raw materials was performed by the Japanesepharmacopeia. These Kampo preparations werecovered by the National Health Insurance of Japan.
A list of Kampo preparations used in this operation
is presented in Table 1.
We treated 72 patients during the acute period,
117 during the sub-acute period, and 47 during thechronic period. Figure 3 shows the treatment
conducted at an evacuation center. Many of thepatients had already received Western medicationsprescribed by the Ishinomaki Joint Medical Relief
Team (IJMRT). A comparison of symptoms observed
during the acute, sub-acute, and chronic periods isshown in Figure 4.

treatment of Western medicine, we prescribedshosaikoto and other similar Kampo preparations.
Goreisan was prescribed for the treatment ofenterocolitis accompanied by diarrhea or vomiting
which were not relieved by anti-diarrheal agents orintestinal regulators (Table 1).
During the sub-acute period, allergic symptoms
such as persistent cough, pharyngeal pain, runny nose,and itchy eyes were common (Fig. 4). Although many
patients had already received antihistamines andother anti-allergy medications, many complained ofadverse drug reactions such as drowsiness andimpaired attention. Thus, we prescribed Kampo
preparations with anti-allergy properties such as
shoseiryuto for these patients (Table 1).
During the chronic period, an increase inpsychiatric symptoms such as irritability, anxiety,lightheadedness, and insomnia were observed, as
well as somatoform disorders (Fig. 4). For these
symptoms, we prescribed Kampo preparations withtranquilizing properties, such as yokukansan andkamikihito. Moreover, many patients complained of
constipation,

mashininganorjunchoto

wereprescribed (Table 1).
Cases who received Kampo treatment at anevacuation center in Miyagi Prefecture

A case of fever and shivering
Case patient: A 60-year-old man
Chief complaint: Chills and fever
History of the present illness: Chills and sore throat
developed 2 days prior; the patient was treated by
IJMRT the day before. The result of an influenza test

patients

was negative, an anti-inflammatory analgesic waspresented with the common cold, hypothermia, andprescribed. Intense chills and languor persisted until

enterocolitis (Fig. 4). For patients with recent onset

the next day, and the patient’s body temperatureofshowed over 38°C. Although the patient felt chills, no

During4

thesymptoms

acute

of

the

period,common

many

cold,

Kampo

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

fuel for heat to keep him warm was available. Then,

Tongue diagnosis: The tongue was pale and showed

he requested Kampo treatmemt.

a thin white coating

Physicalfindings:

Body

temperature

showedPulse diagnosis: A sinking, slow pulse

38.1°C; face slightly pale; shivering; mild redness in

Prescription: Kampo preparation of ninjinto

the tonsils but no swelling; no rales in chest(TJ-32,

auscultation

tokishigyakukagoshuyushokyoto (TJ-38, 7.5 g/day,Tongue diagnosis: The tongue was pale and showedfor 2 days), taken orally 3 times a day with hot watera thin white coating

before each meal

Pulse diagnosis: A sinking pulse

Progression:

Prescription:

Kampo

preparation

7.5

g/day,

forApproximately

2

days)

30

min

and

after

of

administration, the patient’s feeling of coldness was

maobusisaishinto (TJ-127, 7.5 g/day, for 2 days),

alleviated and claimed that his vitality hadtaken orally 3 times a day with hot water before

returned. That day, he walked on his own to receive

each meala meal, and the patient was able to consume the food.

Progression: 30 min after administration, theA dministration of Kampo preparations for 2 days

patient sweated and were reliefed from chills. After

couldoral administration for a day, the patient's fever

hypothermia and malaise.

declined to 36.8°C the following day, as well as
dissipation of malaise. He expressed gratitude that
he "received the most effective cold medicine he had

improvethepatient’s

symptomsofA case of allergic symptoms
Case: A 35-year-old man

ever taken."Chief complaint: Persistent nasal discharge

A case of hypothermia

earthquake, the patient left the evacuation center toHistory of the present illness: Following the
go to his home each day to remove rubble and debris.

Case: A 80-year-old man
Chief complaints: Feeling of malaise and decline inmotivation
History of the present illness: The patient was athome when the disaster struck, and nearly drowned
when a portion of the first floor was flooded bytsunami waves. Somehow, his family was able torescue him and they were evacuated and stayed in
the evacuation center; he was wrapped in blankets
while still wearing his dirty clothes. Although thepatient ate his meals during the next several days,
he gradually felt fatigue and appatite loss. He
experienced intense malaise and was lying in thecorner of a room in evacuation center.
Physical findings: Body temperature showed 34.8°C;
no abnormal sounds heard in chest auscultation; face
was pale; no shivering despite complaints of feelingcold; coldness in the trunk and limbs; redness in thethird and fourth toes of both feet

Two weeks prior to presentation, he complained ofpersistent nasal discharge; he received treatment
from the IJMRT, which prescribed him an antiallergy agent, but it failed to relieve the symptoms.
He felt drowsiness after administration, which hethought was a side effect of the anti-allergy agent.
He thus requested Kampo treatment.
Physical findings: A slender body type; bodytemperature showed 36.2°C; no redness or swellingin the tonsils or throat; no abnormal sounds heard
in chest auscultation
Tongue diagnosis: Tongue was swollen and showed
tooth marks
Pulse diagnosis: A thin, fast pulse
Prescription: Kampo preparation of shoseiryuto (TJ19, 9.0 g/day, for 7 days), taken orally 3 times a daywith hot water before each meal
Progression: One day after oral administration, the

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3 | Fall 2011

patient reliefed from the symptom of nasal discharge,

Prescription: She was prescribed the Kampo

despite the cessation of the anti-allergy agent.

preparation of saikokaryukotsuboreito (TJ-12, 7.5

Further, the patient no longer felt drowsiness, andg/day, for 7 days), taken orally 3 times a day before

thus showed an increase in work efficiency.

each meal

Cases who received Kampo treatment at theoutpatient clinic of Fukushima Medical University

Progression: 2 days later, she returned to work on
the day shift. Despite having some anxiety, she nolonger felt a sensation of floating and her

A case of insomnia, anxiety, dizziness, and floating
sensation

palpitations stopped. On day 4, she had to visit her

Case: A 41-year-old woman

the disaster, and complained of being very anxious,

Chiefcomplaints:

Insomnia,

anxiety,floating

relative's home that had been heavily damaged by
but later reported that she was able to go and returnsensation, and palmar sweatinghome without flashback sensation. Presently, she

Occupation: Nurse

has resumed her normal workload without taking

History of the present illness: The disaster struck

any medications.

while the patient was working at a hospital. As
frequent aftershocks continued, she took rounds
checking the safety of patients in each ward. On the
day of the disaster, she was unable to return homeand stayed at the hospital overnight; however, shebegan to feel as though her body was constantly
shaking. The sight of herself shaking caused her toexperience anxiety, fear, palmar sweating, andpalpitations. After she returned home, she had toget back to work at the hospital for the night shift,

Discussion
During our medical relief operations in various
evacuation centers, we have observed that the mostcommon symptoms occurring in the first 2 weeks
after the natural disaster included the common cold,
hypothermia, and enterocolitis. The incidence of
these symptoms may be related to the cold, winterweather and the unavailability of electricity, gas, andhot water to keep them warm. In addition, theevacuees were laid on cardboard and tarpaulinwhere she felt the same symptoms. Thus, shesheets placed on the floor; these evacuation centersdeveloped a fear of going to work and was concerned

had obviously depleted supply of blankets andthat this fear would interfere with her work; hence,

bedding for them. Enterocolitis accompanied byshe joined the consultation 2 weeks after thevomiting or diarrhea was prevalent mainly indisaster.

children. During this period, it was difficult to obtain

Physicalfindings:

Body

temperature

showeddrinking water; no water was available for washing

36.2°C; blood pressure, 150/90 mmHg; favorable

hands. Occasionally, impure water from swimming

appetite; frequently dreams while asleep; languor

pools was drawn for use, and thus, the unsanitaryand swelling in the legs; no redness or swelling inconditions in the evacuation centers could havethe throat and tonsils; no abnormal sounds in chest

influenced to the increase of enterocolitis cases.
Approximately 2 weeks after the disaster,

auscultation
Tongue diagnosis: Reddish at the tip, some toothcomplaints of persistent cough, pharyngeal pain,

indentations, and showed a thin white coating

runny nose, and itchy eyes increased. At this time,

Abdominal

thediagnosis:

Abdominal

examination

outsidetemperature

gradually

increased.

indicative of kyokyokuman (chest side painfulness),

Further the sludge and dirt that were brought in bysaijoki (palpitations above the umbilicus), andthe tsunami had dried and polluted the air. Thissaikafujin (numbness below the umbilicus)

period also coincided with the pollen allergy season.

6

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

These environmental factors may have influenced to

medicines administered to patients affected by thisthe symptoms such as coughing and allergic

particular natural disaster, such as maoto forreactions.

common colds or influenza, shosaikoto for prolonged

Approximately one month after the disaster, ancommonshoseiryuto

colds,

forrhinitis,andincrease in psychiatric symptoms such as insomnia,

yokukansan for psychiatric diseases, have been

irritability, lightheadedness, and anxiety, as well as

previously reported [5-9]. Ninjinto has been used tosomatoform disorders was observed. This may betreat hypothermia and diarrhea [10], and goreisan

attributable to fatigue that was related to thehas been administered to patients with nausea andextended stay of the evacuees at the evacuation

diarrhea [11]. According to the book, “Discussion ofcenters and to the stress that they experienced from

Cold Damage,” originally edited by Zhang Zhong-recurring aftershocks. In addition, many patients

Jing,

complained of constipation, possibly related withshosaikoto, and goreisan have been used as

the composition of the meals, which mainly

treatment for infectious diseases or hypothermia

consisted of carbohydrates.

since ancient times [12]. The efficacy of Kampo

kakkonto,

maoto,

ninjinto,

shoseiryuto,

In this disaster medical relief operation, we

medicines has thus been proven by its extensive

observed that Kampo treatment relieved thehistory of clinical use. Kampo preparations are

symptoms of the patients. Kampo treatment isincluded in future medical relief supplies forgenerally applicable after taking the history of thedisaster victims and that Kampo treatments arepatient’s

applied for treating a wide range of medical

illnessandconductingaphysicalexamination [5]; it was a useful tool for thisconditions.

particular natural disaster, when commonly used
medical supplies were insufficient. The powder

Conclusion

extract preparations of Kampo medicine have been

Kampo medicine is a useful treatment that may

used widely in Japan. Oral Kampo preparations

complement Western medicine during extensive

administered to treat cold sensitivity and tonatural disasters.

ultimately increase the feeling of warmth in the body,which are based on the unique concepts of Kampo
medicine, were effective to treat patients of

Acknowledgments
We

express

ourdeepestappreciation

andhypothermia. Moreover, Kampo preparations for

gratitude to the people throughout the world who

severe cold symptoms, anti-allergic agents that dooffered their generous support and help after the

not cause drowsiness, and antitussive agents forearthquake and tsunami that affected the eastern

persistent cough were effective treatments thatcoast of Japan. We have no conflicts of interest tocomplement Western medicine. There were alsodeclare.

occasions in which Kampo preparations were also
used to treat symptoms during the chronic period,

Referencessuch as psychiatric disorders and constipation.

[1] The Fire and Disaster Management Agency: The

Kampo therapy imparted beneficial effects on both

Tohoku Pacific Ocean Earthquake (Great East Japan

physicalEarthquake) in 2011 (115th report).

andmental/emotional

symptoms

in[2] Furukawa K, Arai H: Earthquake in Japan. Lancet

patients.
Clinical evidence for the effectiveness of Kampo

2011; 377 (9778): 1652.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3 | Fall 2011[3] Takayama S, Okitsu R, Iwasaki K, et al.: The Role

[8] Baba S, Takasaka T, Inamura N, et al.: Double-blindof Oriental Medicine in the Great East Japan

clinical trial of Sho-seiryu-to (TJ-19) for perennial nasal

Earthquake Disaster. Kampo Medicine 2011; 62(5):allergy (in Japanese). Jibiinkokarinsho 1995; 88(3): 389-405.

621-626 (in Japanese).
[4] Takayama S, Okitsu R, Iwasaki K, et al.: Role oforiental medicine in the great East Japan earthquake.
GermanJournalofAcupuncture

andRelatedTechniques 2012; 55(2): 15-18 (in German).

[9] Iwasaki K, Satoh-Nakagawa T, Maruyama M, et al.: A
randomized, observer-blind, controlled trial of the
traditional Chinese medicine Yi-Gan San for improvementof behavioral and psychological symptoms and activities of[5] Yuzo Sato, Toshihiko Hanawa, Makoto Arai, et al.:daily living in dementia patients. J Clin Psychiatry 2005;

Introduction to KAMPO, Elsevier Japan K.K. 2005; 53-62.

66(2): 248-252.

[6] Kubo T, Nishimura H: Antipyretic effect of Mao-to,[10] Lui G, Lui C, Donald L, et al.: Fundamentals of Formulas

a Japanese herbal medicine, for treatment of type Aof Chinese Medicine. Hua Xia Publishing House 2007; 65.

influenza infection in children. Phytomedicine 2007;[11] Robert R: Japanese Herbal Medicine. Avery

14(2-3): 96-101.

Publishing Group 1999; 120.

[7] Kaji M, Kashiwagi S, Yamakido M: A double-blind,placebo-controlled study of TSUMURA Shosaikoto (TJ-9)
for common cold. Rinsho to Kenkyu (Japanese Journal of
Clinical and Experimental Study) 2001; 78: 2252-2268 (inJapanese).

8[12] Volker S, Dan B, Andrew E, et al.: Chinese Herbal
Medicine Formulas and Strategies 2nd Edition. Eastland
Press 2009; pp7-9, pp19-21, pp212-4, pp104-109, pp257260, pp724-728.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

Table 1: A list of Kampo preparations mainly prescribed
during the current medical relief operation
PeriodSymptoms

Application of
Kampo extract
granulesKeishito

Commoncold

Kakkonto

Contents ratio(JP: The JapanesePharmacopoeia)

3.0

JP Cinnamon Bark(4.0g)
JP Peony Root(4.0g)
JP Jujube(4.0g)
JP Glycyrrhiza(2.0g)
JP Ginger(1.5g)

3.75

JP Pueraria Root(4.0g)
JP Jujube(3.0g)
JP Ephedra Herb(3.0g)
JP Glycyrrhiza(2.0g)
JP Cinnamon Bark(2.0g)
JP Peony Root(2.0g)
JP Ginger(2.0g)

Maobushisaishinto

1.5

JP Ephedra Herb(4.0g)
JP Asiasarum Root(3.0g)
JP Powdered Processed
Aconite Root(1.0g)

Kikyoto1.25

JP Glycyrrhiza(3.0g)
JP Platycodon Root(2.0g)

5.0

JP Gypsum(10.0g)
JP Bupleurum Root(7.0g)
JP Pinellia Tuber(5.0g)
JP Scutellaria Root(3.0g)
JP Platycodon Root(3.0g)
JP Jujube(3.0g)
JP Ginseng(3.0g)
JP Glycyrrhiza(2.0g)
JP Ginger(1.0g)

4.0

JP Jujube(5.0g)
JP Cinnamon Bark(3.0g)
JP Peony Root(3.0g)
JP Japanese Angelica
Root(3.0g)
JP Akebia Stem(3.0g)
JP Glycyrrhiza(2.0g)
JP Evodia Fruit(2.0g)
JP Asiasarum Root(2.0g)
JP Ginger(1.0g)

Acute

Tonsillitis

Hypothermia

Ploronged
common cold

Shosaikotokakikyosekko

Tokishigyakukagoshuyushokyoto

Shosaikoto

Rikkunshito

Subacute

4.5

JP Bupleurum Root(7.0g)
JP Pinellia Tuber(5.0g)
JP Scutellaria Root(3.0g)
JP Jujube(3.0g)
JP Ginseng(3.0g)
JP Glycyrrhiza(2.0g)
JP Ginger(1.0g)

4.0

JP Atractylodes Lancea
Rhizome(4.0g)
JP Ginseng(4.0g)
JP Pinellia Tuber(4.0g)
JP Poria Sclerotium(4.0g)
JP Jujube(2.0g)
JP Citrus Unshiu
Peel(2.0g)
JP Glycyrrhiza(1.0g)
JP Ginger(0.5g)

2.0

JP Alisma Rhizome (4.0g)
JP Atractylodes Lancea
Rhizome(3.0g)
JP Polyporus
Sclerotium(3.0g)
JP Poria Sclerotium(3.0g)
JP Cinnamon Bark(1.5g)

2.5

JP Processed Ginger(3.0g)
JP Glycyrrhiza(3.0g)
JP Atractylodes Lancea
Rhizome(3.0g)
JP Ginseng(3.0g)

5.0

JP Pinellia Tuber(6.0g)
JP Processed Ginger(3.0g)
JP Glycyrrhiza(3.0g)
JP Cinnamon Bark(3.0g)
JP Schisandra Fruit(3.0g).
JP Asiasarum Root(3.0g)
JP Peony Root(3.0g)
JP Ephedra Herb(3.0g)

Enterocolitis
GoreisanNinjinto

Rhinitis

Itchy eyes

Driedextract
glanulesin dailydosage(g)

Shoseiryuto

Dry coughEppikajutsuto

Bakumondoto

Mashiningan

3.25

JP Gypsum(8.0g)
JP Ephedra Herb(6.0g)
JP Atractylodes Lancea
Rhizome(4.0g)
JP Jujube(3.0g)
JP Glycyrrhiza(2.0g)
JP Ginger(1.0g)

6.0

JP Ophiopogon
Tuber(10.0g)
JP Pinellia Tuber(5.0g)
JP Jujube(3.0g)
JP Glycyrrhiza(2.0g)
JP Ginseng(2.0g)
JP Brown rice(5.0g)

2.25

JP Hemp Fruit(5.0g)
JP Rhubarb(4.0g)
JP Immature
Orange(2.0g)
JP Apricot Kernel(2.0g)
JP Magnolia Bark(2.0g)
JP Peony Root(2.0g)

1.5

JP Rehmannia Root(6.0g)
JP Japanese Angelica
Root(3.0g)
JP Scutellaria Root(2.0g)
JP Immature
Orange(2.0g)
JP Apricot Kernel(2.0g)
JP Magnolia Bark(2.0g)
JP Rhubarb(2.0g)
JP Peach Kernel(2.0g)
JP Hemp Fruit(2.0g)
JP Glycyrrhiza(1.5g)

3.25

JP Jujube Seed(10.0g)
JP Poria Sclerotium(5.0g)
JP Cnidium
Rhizome(3.0g)
JP Anemarrhena
Rhizome(3.0g).
JP Glycyrrhiza(1.0g)

3.25

JP Atractylodes Lancea
Rhizome(4.0g)
JP Poria Sclerotium(4.0g)
JP Cnidium
Rhizome(3.0g)
JP Uncaria Hook(3.0g)
JP Japanese Angelica
Root(3.0g)
JP Bupleurum Root(2.0g)
JP Glycyrrhiza(1.5g)

5.0

JP Astragalus Root(3.0g)
JP Bupleurum Root(3.0g)
JP Jujube Seed(3.0g)
JP Atractylodes Lancea
Rhizome(3.0g)
JP Ginseng(3.0g)
JP Poria Sclerotium(3.0g)
JP Longan Aril(3.0g)
JP Polygala Root(2.0g)
JP Gardenia Fruit(2.0g)
JP Jujube(2.0g)
JP Japanese Angelica
Root(2.0g)
JP Glycyrrhiza(1.0g)
JP Ginger(1.0g)
JP Saussurea Root(1.0g)

5.0

JP Astragalus Root(4.0g)
JP Atractylodes Lancea
Rhizome(4.0g)
JP Ginseng(4.0g)
JP Japanese Angelica
Root(3.0g)
JP Bupleurum Root(2.0g)
JP Jujube(2.0g)
JP Citrus Unshiu
Peel(2.0g)
JP Glycyrrhiza(1.5g)
JP Cimicifuga
Rhizome(1.0 g)
JP Ginger(0.5 g)

Constipation

Junchoto

Insomnia

Irritation

Sansoninto

Yokukansan

Chronic

Anxiety

Fatigue

Kamikihito

Hochuekkito

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

9Volume 6, Number 3 | Fall 2011

Figure1: The seismic center of the Great East Japan
Earthquake and the location of Miyagi and
Fukushima prefecture

Figure 3: Kampo treatment at an evacuation center

Others
Irritability, anxiety,fatigue and insomnia
Constipation
Rhinitis and itchy eyes
Cough
Vomitting, diarrhea
And abdominal pain
Common cold,
Pharyngeal pain andhypothermia

Acute

Figure 2: The location of Tohoku University Hospital in
Miyagi prefecture and Fukushima Medical University
Hospital in Fukushima prefecture10

Sub-acute

Chronic

Figure 4: Comparison of symptoms during the acute(1st to 14th day after the disaster, n = 72), sub-acute(15th to 42nd day, n = 117), and chronic (43rd to 73rdday, n = 47) periods, modified from the references 3
and 4

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

Japanese Acupuncture - Current Research 1
The Support by Acupuncture and Moxibustion for the
Stricken Area on the Great East Japan Earthquake

done

by

practitionersofacupunctureandmoxibustion in the areas affected by the Great East
Japan Earthquake, the process of clarifying theSoichiro MineThe Forum of Social Sciences of Acupuncture and Moxibstion

whole picture is still under way.
[Purpose]

Research Report[Preface]
In the wake of the Great East Japan Earthquake
occurred on March 11, 2011 and the subsequent
Tsunami disaster, support services from various
medical areas were provided. Practitioners ofacupuncture and moxibustion from all over Japan
also provided support in the affected areas throughacupuncture and moxibustion.

To investigate and clarify the general picture ofwhat kinds of support activities by the Japanesepractitioners of acupuncture and moxibustion were
implemented for the disaster caused by the Great
East Japan Earthquake.
[Research overview]
1. Subjects
Groups that provided support services in theaffected areas using acupuncture and moxibustion

The author conducted research to find out what

treatment after March 11, 2011 and the active period

support activities the practitioners performed in thefor one time or the total duration of activities wasaffected areas during the period from June to July of

five days or more.

2011. In writing this paper, the author additionally

2. Methods

searched four journals relating to acupuncture and(1) Method of subject selection

moxibustion published during the period from April

1) Subject sampling and information gathering on

2011 to September 2012 (“The Journal of Ido no

the Internet.

Nippon,” “Shinkyu Journal,” “Clinical Journal of
Traditional

Chinese

Medicine,”

and“Shinkyu

The Internet site http//www.google.co.jp was
searched with the keywords of “Great East JapanOSAKA”) for information about the time of activity

Earthquake,”

and areas of activity of the groups that were notactivities,” “medical support,” and “group.”

known in the aforementioned research.

2) Information gathering from informants

This paper is to report the results of theseinvestigations.
In addition, it was found by searching theInternet and from informants that there werevarious forms of support activities other than thosefound by on-site research and the Internet search,
including personal activities and non-continuous“acupuncture,”

information about the support activities withacupuncture and moxibustion was posted by Japan
Society of Acupuncture and Moxibustion and otherassociations and those who had the information wereasked to provide the information as informants andthen research subjects were extracted.
3)

investigation were those of groups that were

acupuncture and moxibustion

however,

that

group

researchrequirement

searchthroughjournalsof

To find out the group names and their activity
time that were not known from 1) and 2) above, fourasacupuncture and moxibustion related journals

investigation subjects. The author would give an

published during the period from April 2011 toadditionalisNovember 2012 (“The Journal of Ido no Nippon,”considered that many supportive activities were

“Shinkyu Journal,” “Clinical Journal of Traitional

here

were
that

satisfying

Informationtheremarkactivities“localIn parallel with the web search, a request for

one-shot activities. The subject activities of thisperformed continuously. There was the possibility,“volunteer,”notchosenalthoughit

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

11

Volume 6, Number 3 | Fall 2011

Chinese Medicine,” and “Shinkyu OSAKA.”) werethat there were two types of groups that performed

used .

activities of disaster medical care with acupuncture
and moxibustion in the aftermath of the Great East

(2) Search period
The information search period through theInternet and the informants were two months from
June to July 2011.
Search through magazine media was done in
December 2011.
The continuity of the activities was confirmed bymonitoring their activity reports on the Internet.
(3) Research method
An e-mail questionnaire was sent to the groups
selected as subjects by 1) and 2) above.
Questionnaire items were unified in principle.
However alterations were made where applicable so
as to making it a top priority to clearly bring out theactual situation about the activities.

Japan Earthquake; the ones formed based on
existing organizations (Table 1), and the others
organized for the purpose of providing support to theaffected areas (Table 2).
The activities started at the earliest on March 17
and most of them ended in the year of 2011, except
two groups that were continuing their activities at
the time of December 2012.
The areas of activities were Fukushima refecture,
Miyagi prefecture, and Iwate prefecture. As for
Fukushima prefecture, the places of activities wereinland areas designated as the evacuation areas dueto the nuclear plant accident. In Miyagi prefecture
and Iwate-prefecture, areas of activities were
centered in those affected by the tsunami (Figure 1).

Questionnaire items were as follows:

The answers to the questionnaire indicated thata. Place of activities
b. Activity time

actualc. Subjects to be treatedevacuation centers, private houses, administratived. Accumulated number of treated persons

facilities, fire-fighting facilities to welfare facilities.

e. Accumulated number of treatment providers
joinedg. Existence or non-existence of cooperation withhealthcare

professionals

andmedicalinstitutions. If existing, please let us know thecooperated partners or the kind of occupation.

ofactivities

rangedfromtheSubjects to be treated included, in addition to thedisasterf. Complaints frequently made.
otherplacesevacuees,“sufferedrescuer”

whothemselves were also victims of the disaster (staff
members of the evacuation centers, and employeesof fire-fighting and the local medical institutions,etc.) as well as volunteers in the evacuation centers.

h. Existence or non-existence of the accepting

As to cooperation with other medical professions,organization in the local area and linkages with thelinkages with the medical staff in the places of refuge

local municipalities and their external bodies. If

accounted for a major portion of the relevant

existing, please let us know the contact address.

answers, except for the groups whose activities werecomposed of varieties of medical professions.

[Results]
Ten groups were extracted as research subjects
trough the Internet and the information provided by
the informants. Of them, nine groups returned theanswers to the questionnaire. In addition to thesegroups, one group was found in the additional searchusing journals.
From the above investigation, it was confirmed

12

As to cooperation with local organizations, they weremade mainly with institutions such as local
municipalities, local welfare councils and volunteer
centers. In the case there were confusions at theacceptancecounters,

negotiations

were

made

directly with individual refuge places.
Common chief complaints were stiff shoulders, painin the neck and shoulders, and low back pain, and

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

other complaints were difficulty sleeping andsings of serious illness or worsening underlying

constipation (Figure 2).

diseases, and then the care can be taken over by anassociated health team or an associated physician,[Consideration]
The research has revealed that medical support
activities

were

acupuncture

performed

andbypractitioners

moxibustion

with

of

certaincontinuity in the affected areas and that their

which suggests the Japanese style acupuncture andmoxibustion have the possibility of functioning as
primary preventive medicine.
[Conclusion]

activities were not limited to the evacuation centers.

It has been confirmed in the Great East Japan

This suggests that there are needs for acupuncture

Earthquake, medical support by practitioners ofand moxibustion in affected areas after theacupuncture and moxibustion in the affected areas

occurrence of a disaster.

was provided and the continuous activities mainly in

In general disasters, the acute phase in which
treatment of life-saving and trauma is significant isfollowed by the chronic phase in which continuous
health care of affected people becomes a problem.
The earthquake disaster in the East Japan, however,is characterized by the extremely short acute phase.
Coupled with medical institutions being devastatedby the tsunami, evacuees with chronic diseases wereforced to interrupt the treatment, their daily livings
were isolated from their usual time, and disastervictims who acted as “suffered rescuer” worked hard
– all these caused problems from an early period

the areas affected by the tsunami. The subjects to betreated included not only the disaster sufferers but
also “suffered rescuer”who were also disaster victims
in various places of refuge. It can be considered fromthis that medical support in the affected areas by thepractitionersofacupunctureandmoxibustion

responded to treatment needs for unidentifiedcomplaints caused by the disaster experience andthe subsequent life of evacuation. And this alsosuggests that acupuncture and moxibustion will beable to have some role in primary preventive
medicine.

such as complaints relating to motor organs,

Meanwhile, for possible disasters, it is required toconstipation, difficulty sleeping, which accounted forverify the possibility of providing medical support bya large portion of the chief complaints in thepractitioners of acupuncture and moxibustion inquestionnaire answers. So, it can be considered that

affected areas, the limitations of their activity, andhandling these health problems that disaster victims

issues and problems.

have will contribute to medical support in affectedareas.
There was at least one group of the survey
subjects that created a manual and had it available
for measuring blood pressure, pulse rate, and bodytemperature if necessary. Measurement vital signs
and the practice of Japanese style acupuncture and[Lastly]
I extend my heartfelt condolence to those who diedin the Great East Japan Earthquake. I also express
my heartfelt sympathy to those who are still missing
and many people who lost their acquaintances andare forced to go through all kinds of privations.

and

I wish to express my sincere gratitude to Prof.

temporary houses where sufficient medical support

Shuichi KATAI of National University Corporation

is inaccessible – characterized by it that spends a

Tsukuba University of Technology for your valuable

certain amount of time one-on-one with a patient,cooperation and guidance he provided to me intouching her or his body while treatment is being

writing this paper.

moxibustion

in

the

evacuation

centers

performed - enables the practitioner to detect the

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3| Fall 2011

Group Names

Areas of Activity
Fukushima-prefecture:
Koriyama-city
Iwaki-city
Aizuwakamatsu-city
Ono-machi

Fukushima-prefecture Shinkyu-shi Kai

Tohoku University Hospital Kampo Internal
Medicine
AMDA
Tokyo Rojyo Hari-Kyu Team
Hokkaido College of High Technology
Saigai Fukko Shin-Kyu / Jusei Volunteer Team
Acupuncture Moxibustion & Orthopedic Clinic
TAIU
Morinomiya University of Medical Sciences
Graduate School of Health Sciences Team

Fukushima-city
Fukushima-prefecture:
Aizusakashita-machi
Miyagi-prefecture:
Ishinomaki-city
Shichigahama-machi
Iwate-prefecture:
Otsuchi-cho
Fukushima-prefecture:Soma-city
Miyagi-prefecture:
Yamamoto-cho
Miyagi-prefecture:
Kesennuma-city
Iwate-pref.:Ofunato-city
Fukushima-prefecture:
Iwaki-city
Miyagi-prefecture:
Kesennuma-city

Activity Period

3/17/2011 - 6/19/2011

End Mar - June/2011

3/28/2011 - Ongoing (Otsuchi-cho)
4/16/2011 - 6/12/2011(Soma-city, every Sunday, total 10 times)
5/22/2011 - August/2011 (Yamamoto-cho)
4/30/2011 - 5/5/2011

4/23/2011 - 5/22/2011 (every week end)
4/30/2011 - 5/6/2011

Table 1 Groups formed based on the existing organizations

Group Names

Areas of Activity
Miyagi-prefecture:
Iwanum-city

Saigai Shin-Kyu Massage Project

Volunteers from Shiga-ken Shinkyu-Shi Kai
Volunteers from Hanada College Almni
Team of Shiga-ken H Sensei

Active Time

Natori-city

3/27/2011 - 5/12/2011 (Iwanuma-city)
4/6/2011 - 5/12/2011 (Natori-city)

Shiogama-city

4/16/2011 - 5/11/2011(Shiogama-city)

Kesennuma-city

5/1/2011 - 6/30/2011 (Kesennuma-city)

Ishinomaki-city
Minamisanriku-cho(For Kesennuma and7/17/2011 - 9/28/2011 (Ishinomaki-city)
5/28/2011 - 12/6/2011(Minamisanrikucho)

Ishinomaki, dispatch request
was made by PCAT.)
Miyagi-prefecture:
Ishinomaki-city
Onagawa-cho
Miyagi-prefecture:
Ishinomaki-city

4/28/2011 - 5/7/2011
6/3/2011 - 6/6/2011
7/15/2011 - 7/19/2011
Ongoing intermittently.

Hisai-Sha Shien Project Team Oriental
Medicine

Miyagi-prefecture:
Higashi-Matsushima-city
Miyagi-prefecture:
Ishinomaki-city
Miyagi-prefecture:
Shichigahama-cho
Miyagi-prefecture:
Onagawa-cho

April/2011 Ongoing

Table 2 Groups newly formed for providing medical support in affected areas.

14

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

Figure 1 Areas of Medical Support Activities by Practitioners of Acupuncture & Moxibustion

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3| Fall 2011

8
7
6
5
4
3
2
1
0

Figure 2 Major Chief Complaints

16

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

1. Period and Place of Questionnaire
We volunteered acupuncture and moxibustion andconducted a questionnaire survey at the sametime: on April 17 in Community Center in Nakacity for 5 hours, on May 1 in Seishounen-Kaikan
in Mito-city for 5 hours, on May 4 in Civic
Gymnasium/evacuation shelter in Kita-Ibaragicity for 1 hour, on the same day in Maternity CareIto for 3 hours, on June 16 in Takahagi Kyodo
Hospital in Takahagi-city for 5 hours and July 31
in Kyu-Tokai-village Community Center for 2
hours (Table 1).
2. Questionnaire subjects
The subjects were 148 persons who received
acupuncture and moxibustion by 5 volunteer
practitioners (total 13 practitioners) in the central
Ibaragi and northern Ibaragi.

5.1

3

5.4

4

6.16

5

7.31

Treatment hours

2

No. of practitioners

4.17

Response rates

Introduction
Nine months have passed since the Great East
Japan Earthquake of March 11, 2011. This was themost powerful known earthquake ever to have hit
Japan, followed by repeated shocks as powerful as
the principal one. The earthquake triggered
powerful tsunami waves, causing a number ofnuclear plant accidents. The damage by bothdevastating earthquake and mega Tsunami was
exceptionally massive and reconstruction from thedevastation has not made the desired progress.
After the disaster, we performed acupuncture andmoxibustion as volunteers in Ibaragi-prefecture
designated as a semi-devastated zone. At the time
we conducted a questionnaire and gathered opinionsof other volunteer practitioners who had been
continually providing acupuncture and moxibustion,
which are summarized as follows:[Method]1

No. ofquestionnaires

2) Ayumi Midwife Clinic, Ayumi acupuncture and moxibustion Clinic3) National University Corporation, Tsukuba University of Technology

Place1) Center for Integrative Medicine, Tsukuba University of Technology

Time

Naoko Maeda1)2), Yuki Uchida1), Tomomi Narushima3)
and Shuichi Katai3)Treatment

Japanese Acupuncture - Current Research 2
The Role of Acupuncture in the Great East Japan Earthquake

No. of treatment
recipients

Volume 6, Number 3 | Fall 2011

25

25

100

3

5

48

47

97.9

4

5

26

23

88.5

3

4

36

36

100

1

5

12

12

100

2

2

148

143

96.6

13

Nako-city
Community Center
Mito-city
Seishounen Kaikan
Kita-Ibaragi-city
Civic Gymnasium,
Maternity Care Ito
Takahagi-city
Takahagi Kyodo Hospital
Tokai-village
Community Center

Total

Table 1: Place of Questionnaire and Response Rates

3. Method
The questionnaire was anonymous. Before thevolunteer work began, the volunteer recipients
received the questionnaire sheet together with a
medical interview sheet at the reception. At theend of the treatment, the practitioners urged therecipients to cooperate with us by answering thequestionnaire. The questionnaire was completed
in a separate room and collected.

4. Questionnaire
The questionnaire had the respondents pick ananswer from a given number of options for sevenquestions of sex, age, damage situation, physicalcondition on the day, effectiveness of thetreatment, their desire whether to receive
treatment next time and publicity. As for two
items of good points and points to be improved
about volunteers, the respondents were free togive any answer.

5. Procedures of volunteer practiceTreatment/care was provided for 20 minutes perperson. After a brief medical interview, physicalfindings were obtained with palpation. Then,
Pyonex press-tack needles were applied into
reactive points after careful preliminary massage.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3| Fall 2011

Other parts

Buttocks

Arms

Head

Extremities

Back

Low back

1. Response rates
The total number of respondents was 143 out of
148 with the overall response rate of 96.6%. The
response rates at the first time treatment/care were100%, 97.9% at the second time, 88.5% at thethird time and 100% at the fourth time and fifth
time (Table 1).
2. The143 respondents consisted of 25 males and
118 females. Generation breakdown was 2
respondents in their 10s, 15 in their 20s, 68 in their30s, 30 in their 40s, 14 in their 50s, and 12 in their60s. The male-female ratio was 17.5% for maleand 82.5% for female (Table 2).

Shoulders

Results

Table3: Painful or Discomfort Regions

1
2

Female

3

Male

4
5
10s

20s

30s

40s

50s

60s

Undescribed

Table 2: Generation Ratio of Treatment Recipients

3. Somatic complaints
The painful or discomfort regions on the day were(multiple answers) shoulders in 104 (72.7%), lowback in 62 (43.4%), broad of the back in 48 (33.6%),
extremities in 24 (16.8%), head in 16 (11.2%), andarms in 11 (7.7%). Three respondents gave noanswer on this question. Two respondents gave
the answer of having no special symptoms (Table3). In view of each care, there were no majordifferences in their complained conditions fromthe first care through to the fifth care (Table 4).

18

Table 4: Complained Conditions by Number of Care

4. Characteristics by generation
As the fourth time treatment was for healthcare
professionals, data of four times treatments only
from women were counted excluding those of
professionals. Symptoms of 84 women (2 without
name and 2 in their 10s were excluded from thetotal 88 volunteer recipients) were categorized
into shoulders in about 80% of women with 54.5%of those in 60s, and the dorsal region in about 40%
in 20s, 30s, and 40s and about 15% in 50s and 60s.
Many of those in their 20s, 40s, and 60s had
symptoms in the low back region. Symptoms of
the head were complained by 13 women, of which
10 were in their 30s.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

5. Effect of treatment/care
Care effects in all recipients were “very muchrelieved” in 62 (43.4%), “relieved” in 67 (46.9%),and “remained same” in 3 (2.1%), of which 2
claimed that they had originally had no special
disorder. One (1) respondent answered “became
worse, taking it a response for a change for the
better.” The respondent said that when writing
answers, lassitude had already appeared. Ten (10)respondents (7.0%) gave no answer and one (1)answered “do not know yet” (0.7%).
Effects are grouped for each time of volunteer
care: the 1st time, very much relieved in 17(68.0%), relieved in 7 (28.0%), and no changes in
1 (4.0%). The 2nd time, very much relieved in 26(55.3%), relieved in 19 (40.4%), more painful in 1
(2.1%), no answer in 1 (2.1%). The 3rd time, verymuch relieved in 11 (47.8%), relieved in 10(43.5%), and no answer in 2 (8.7%). The 4th time,very much relieved in 4 (11.1%), relieved in 24(66.7%), no change in 2 (5.6%), no answer in 5
(13.9%), and “do not know yet” in 1 (2.8%). The
5th time, very much relieved in 4 (33.3%), relievedin 7 (58.3%), and no answer in 1 (8.3%) (Table 5).

questionnaire survey. Our goal was to perform
acupuncture and moxibustion to ensure they become
pleasedandrelaxed,thequestionnaire

wasconducted for the purpose of recording volunteer
acupunctureandmoxibustion.

Therefore,

thequestionnaire was not carried out in the way thatcanrigorously

showeffectiveness.

Whether

conducting a questionnaire in the aftermath of thedisaster is appropriate or not is being argued widely.
We conducted it 1-4 months after the earthquake,but there have been no complaints received. There
were three months between the first time practiceand the 5th time practice. However, there were no
major differences in the painful regions in different
times of treatment.
With this e volunteer treatment, continuous care
could not be provided to specific persons, so options
concerning unexplained physical complaints andmental health complaints were not provided on thequestionnaire. Therefore they were not reflected in
the analysis of the questionnaire. When treatment
recipients began to talk about the disaster during
the course of treatment, individual practitioners
responded to them. Because of difficulties providing
continuous care, prior discussion had been madebetween the volunteer practitioners and it had been
determined that volunteer practitioners would not
discuss mental health matters. Whether volunteer
practitioners should get involved in unidentified

Relieved:
67
recipients(46.9%)

Relieved
much: 62
recipients(43.4%)

complaints or psychological matters was difficult todecide as this largely relates to whether or not thepractitioners get themselves ready for handling suchmatters. However, psychological health problems areimportant subjects after the disaster. To what extent
the practitioners should be involved, opinions may be

Table 5: Effect of Treatment/Caredivided and discussions will arrive at the conclusion

Consideration
We provided acupuncture and moxibustion as
volunteers for the people who suffered damages fromthe East Japan Earthquake and conducted athat mental health matters should be responded on acase-by-case basis.
For psychological problems after the disaster,
conditions were classified into three phases, (i.e. acute

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3| Fall 2011

phase, subacute phase, and mid to long term phase

A few months after the disaster, earthquakes haveand problems are handled in many cases according tooccurred in many parts of the world. Japan is well

the classification). This time, the author, et al.

known for earthquakes. However, every one of us who

performed acupuncture and moxibustion for those inare engaged in health care does not know how to

the subacute phase and obtained effects. We became

respond to the people in need of care when a disasterconvinced

andoccurred. As there are no published guidelines ormoxibustion is sufficiently beneficial for keeping thebooklets, the author worked in the dark to make thedisaster victims in good physical condition.

plan for volunteering acupuncture and moxibustion

that

care

with

acupuncture

The disaster of the earthquake of this time which
was unprecedentedly large accompanied by themassive damage by Tsunami disaster had a special
progression. The utmost priority during the acutephase is lifesaving. In the mid-long term phase,reconstruction starts but the victims have a feelingof helplessness and a feeling of weariness. The
characteristics of this phase are problems for eachindividual

tendedtobeforgotten

so

that

psychological problems are prone to arise
Sleeplessness

develops

andphysical1).

condition

becomes bad. Anyhow, we think it important to study
how acupuncture and moxibustion can get involvedin each of the phases. We expect related parties ineach region will conduct such studies.
Acupuncture and moxibustion related magazines
carry articles on volunteer practice of acupuncture
and moxibustion after the disaster of the earthquake

and actually implement it. If I have done volunteer
work on a regular basis, it could be a little different.
And I felt it necessary to take an interest in how to
respond to an emergency situation. Although ageneral “Disaster Response Manual” has alreadybeen preparedvolunteer8)-11),

I consider that creating a

programimplementation

manualofacupuncture and moxibustion is also necessary.
Several organizations sent volunteer practitionersof acupuncture and moxibustion to each of the affectedareas. These volunteers made reports of results. They
also report that acupuncture and moxibustion can playa part of medical treatment. The records of volunteer
acupunctureandmoxibustionby

individual

practitioners will be valuable. In organizing the date,
we will see the role of acupuncture and moxibustion
and issues in disasters.

and tsunami. These articles report the status

Studying the role of acupuncture and moxibustion

immediately after the disaster and the condition ofat the time of disasters and getting prepared for its

four months later2)-7).

implementation for the future is also necessary.

20

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

References (Only Japanese versions are available.)

1. Gaishou-sutoresu-kanren-Shougai nikanrensuru
Kenkyu-kai. KIN Yoshiharu. Shinteki Torauma
no Rikai to Kea 2nd version. Kabushikikaisha
Jihou. 2005; 85-86
2. Higashi Nihon Daishinsai no Hinansha wo
Sapooto suru Shinkyushi tachi. Ido no Nippon;
2011; 812:23-28
3. “Temomin” de Dekirukoto. Oriental Medicine
Journal of Acupuncture and Moxibustion;
2011.23:69-72
4. Fukushima-ken no Hinanjyo niokeru Shinkyu
Boranthia Houkoku. Oriental Medicine Journalof Acupuncture and Moxibustion; 2011.22:68-69
5. Shiogama-shi niokeru Boranthia Katsudou
Houkoku. Oriental Medicine Journal of
Acupuncture and Moxibustion; 2011.22:70-73

6. Hisaisha Shien Purojyekuto Chiimu, Toyo Iryo
Micchaku
Report.
Ido
noNippon;2011.(816):116-121
7. Daishinsai to Shinkyu no Yakuwari. Oriental
Medicine Journal of Acupuncture andMoxibustion; 2011.22:50-65
8. “Ibaragi-ken Hoken Fukushi-bu Saigaitaisaki Manual”
http://www.pref.ibaraki.jp/bukyoku/hoken/koso/disaster_manual/digest/all_files.pdf
9. Jishin Taisaku Manyuaru Sakusei no Pointo
http://www.tokiorisk.co.jp/risk_info/up_file/200402057.pdf
10. Ninsanpu/Nyuyouji wo Mamoru Saigaitaisaku
Gaidorain, Tokyo Metropolitan Government
11. Kousei Roudousho kara Hasshutsushita Tsuuchi(March 18, 2011)
http://www.mhlw.go.jp/stf/houdou/2r98520000015ks
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Volume 6, Number 3| Fall 2011

Clinical Report (Japan)
Acupuncture and Moxibustion Treatment for the Victims of
the Great East Japan Earthquake after One and Half Months
from its Occurrence
Raita Takasaki and Takashi Otsuki
Department of Acupuncture, Morinomiya University of Medical Sciences

submerged knee-deep under water. During our visit
to the site we were led to areas where the road used
for removing the wreckage had to be raised byseveral dozen centimeters as a measure against
submersion. Wreckage around buildings had alreadybeen removed, but the rescue activities did notproceed due to insufficient heavy machinery and

1. Introduction
A friend of one of the authors, Takazaki, lost apersonnel (Photo 1). The acquaintance who guided us,

factory for processing shark fins that had been run

stopped his car near a pachinko (vertical pinball game)by the family for three generations through theparlor at the entrance of the bay and explained, thattsunamiJapan

there are still people in there, that have not been

Earthquake. Sparked by this event he planned torescued. In the vicinity there were also other shops

initiate acupuncture and moxibustion volunteer

where rescue activities had not yet been carried out

work as part of the recovery and reconstruction

and over the entire area hung an intense stench ofprocess in the region where victims of thesludge and other materials (Photo 2).

caused

by

the

Great

East

earthquake disaster live. Treatment location was the
Kesenuma general sports facility (K-WAVE), thelargest refuge in the region. Immediately after theearthquake disaster about 1,000 people sought
refuge here, but when we visited the site on April 30
about 600 still sought shelter there. Many of thesepeople suffered from a high level of disaster induced
stress. Moreover, the unfamiliarity of cohabitationand the restoration work caused many people tocomplain about mental and physical symptoms.
While describing in this paper one of the moststriking of these symptoms, we also give an outlineof our activities on site.

Photo 1

2. Situation in the disaster area at that time
In addition to the devastating damage a giant
tsunami in the city Kesenuma located in thenorthern part of the Miyagi prefecture, caused heavy
oil from the oil tanks installed at the entrance of thebay spilled and caught fire. This fire continued toburn for 2 days and spread up to the area wheremarine product processing factories were located,
destroying those almost completely. Further, theKesenuma shoreline subsided by around 80 cm, sothat during high tide the various areas are

22

Photo 2The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

The refugees in K-WAVE were living on a very

helped to set up and maintain a treatment booth

limited space and tried to stave off the cold by

and devoted his efforts to collect information.

covering the floor with blue sheets, blankets or

Moreover, we were also able to obtain thecorrugated cardboard. Most of the refugees hadcooperation of local acupuncturists, enabling us tonothing that could be used to separate their spaces

obtain even more detailed on site information andand thus could not maintain any privacy, thusachievebeing forced to live in an environment requiring aregarding the treatment. The additional support

lot of consideration regarding their surroundings

we received in form of materials and financial help

(Photo 3). They had been complaining aboutfrom various manufacturers of acupuncture andunwellness from the beginning of their shelter life.

moxibustion products, as well as help from many

There were also frequent afterquakes strong

other people enabled us to conduct our activities.

a

still

betterinformationexchangeenough to be felt physically. According to therecords of the department for earthquakes and3. Case reportvolcanoes of the Meteorological Agency there had

75-year old woman.

been 189 afterquakes with a seismic intensity of

Height 160 cm, weight 50 kg.

more than 1 during the 7 days of our stay. K-WAVE

Blood pressure 154.0/69.5 mmHg (average)

was

the

refugeproviding

the

best

livingChief complaint was low back pain and left knee

environment within the Kesenuma city region andpain, accompanied by insomnia and constipation

supported by a medical team comprised of manyas accessory symptoms. Movement of the low backvolunteers, physicians, nurses and members of thewas particularly bad upon rising in the morning

self-defense forces.

and the patient also complained of fatigue andpain of the extremities. She underwent surgery forcolon cancer about 2 years earlier. Before thedisaster

she

used

to

take

Halcion,Magmitt,Excelase and similar drugs. She had noexperience with acupuncture and moxibustion
treatment. Her parents had hypertension. During
this earthquake disaster she had been swept awayby the tsunami and struggled in the water. Whenshe by accident found something to hold on to, shemanaged to surface and was miraculously rescued.
She reported having had the feeling at that timethat her intestines would be squeezed out of her
Photo 3

mouth by the water pressure.

Our volunteer activities on this occasion
required facilities willing to let us conduct those
activities, an understanding of the people on site1) Treatment
We

performed

treatment

simulations

inand their cooperation. Our acquaintance in theadvance, guided by acupuncture and moxibustion

affected area served us as mediator, arranging

teaching staff employed at the university andparking space, accommodations and food for us,

acupuncturists who had experience with volunteer

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3 | Fall 2011

guided by acupuncture and moxibustion teaching
staff

employedattheuniversity

andacupuncturists who had experience with volunteer
work after the Han‐Shin Awaji Earthquake
Disaster. Since this patient received acupuncture
and moxibustion treatment for the first time andwas considered to be weakened by physical andmental fatigue, we tried a treatment using weakstimulation. Details of the treatment and its
course were as follows.
First through fourth treatment (April 30 – May 3)
Prone position: scatter pricking of the lumbar
region (40 mm, No. 16 needles), retaining
needles for 10 minutes at BL22 (50 mm, No. 18

Figure 12) Course
During the first interview we obtained anneedles)
BL40, BL51, BL56, BL57 (40 mm, No. 16

informed consent from the patients and then carriedneedles)out a treatment of about 30 minutes. The first to

Supine position: single short insertions at ST34,

third treatments targeted the chief complaints,

SP10, ST36, SP9 (40 mm, No. 16 needles)

while the accessory symptoms were addressed from

Moreover, on May 3 we added a needle retained

the fourth treatment onwards. By the sixth

at GV20 for 10 minutes (40 mm, No. 16
needles).

treatment the overall condition, her sleep and bowel
movements had improved, so that she reported

Fifth treatment (May 4)
Prone position: GV20, GB21, BL22, BL56,
BL57, retaining the needles for 10 minutes (50mm, No. 18 needles), after that scatter pricking
Sixth treatment (May 5)
Prone position: GV20, GB21, BL22, BL56,
BL57, retaining the needles for 10 minutes (50mm, No. 18 needles)
Regarding the choice of treatment points forthe individual symptoms acupoints for which
there is some evidence of their effectiveness forthat particular symptom were given priority.

regarding the latter effect a feeling of increased
intestinal activity during the treatment. With each
additional treatment the rhythm of her movements
became smoother and the frequency of her showing
a more cheerful expression and using more pleasantconversational topics increased.
3) Overview of all patients
During the 7 days of our stay we treated 69
persons (28 men and 41 women) a total of 196 times
with acupuncture and moxibustion. Classified by

Areas likely to be affected like muscle groves or

symptoms men complained more about shoulder

areas of the transition from muscle into tendon, as

stiffness and low back pain, while in women thewell as indurations and tender points were also

most frequent symptom was shoulder stiffness

needled (Figure 1). In all cases disposable(Figurestainless steel Seirin needles were used.

frequent accessory symptoms. Of the 69 patients 26

2).

Constipationandinsomnia

were

have had acupuncture and moxibustion treatment
24

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

before, while 40 had no prior experience with it andin 3 the situation was unknown (Figure 3). Amongthe 26 patients having prior experience withacupuncture and moxibustion treatment there wasone 90-year old patient, who had only one
acupuncture and moxibustion treatment about 70
years ago. Based on these results we may conclude,that acupuncture and moxibustion is probably not
yet really established in the Kesenuma region.
After the treatment 23 patients reported "could
sleep well", 7 said "the hip feels much better", 5
reported a "feeling of relief" of the shoulder stiffness,

4. Discussion
During talks with the patients insomnia andmaking the improvement of insomnia the mostworries caused by the disaster were frequently

frequently observed effect. (Figure 4).

encountered, so that in many people the presence ofreported "I do now have bowel movements", 4a post-traumatic stress disorder (PTSD) wassuspected. Afterquakes and the unfamiliarity of
cohabitation resulted in psychogenic stress, while
the work associated with the restoration led tophysical fatigue, or else may also have triggered
other symptoms. At K-WAVE the medical care was
beginning to be managed mainly by physicians andnursing staff. Yet, there were insufficient means toprovide relief from psychosomatic suffering, so thatthe acupuncture and moxibustion treatment wasconsidered to be extremely helpful not only for the
alleviation of pain and fatigue, but also for theprovision of mental care.
The acupuncture and moxibustion booth set up
within K-WAVE was converted after 6 o'clock in theevening into sleeping quarters for the medical staff
and volunteers. We were thus able to obtain some
space

under

these

conditions

thankstotheunderstanding and cooperation of the local people. In
the face of deteriorating sanitary conditions using
disposable needles and trays, hand rub disinfection,
finger cots etc. to demonstrate the hygienic nature of
our work to establish and improve understanding by
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3 | Fall 2011

and communication with not only the patients but

Photos 6, 7 show the last day of the acupuncture

also the medical staff was both essential and very

and moxibustion volunteers. We were bid farewell

effective to that end. (Photos 4, 5).

by many grateful patients. One other patient thanthe one described above told us, seeing his house
being washed away in front of his eyes and a tanker
riding on top of the current has cast him into
darkness (deprived him of the hope of living).
Through the conversation during the acupuncture
and moxibustion treatment he now reported to havefound the light of living again. Finally he thanked
us with a heart-felt: "Thank you".

Photo 4

Photo 6

Photo 5-1

Photo 7
Based on these experiences it seems reasonable
Photo 5-2

26

to assume, that the volunteer activities on thisoccasion did not only prove the effectiveness of the
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011means of5. Conclusion
Care for victims of the Great East Japan

collecting information, but the attitude of listening

Earthquake suffering from PTSD will remain a task

and empathy apparently also contributed to thefor a long time to come. The volunteer activities onprovision of relief from high stress levels, insomnia,

this occasion strongly suggested, that although both

physical and mental pain (Figure 5).

pharmacologicalacupuncture and moxibustion treatment and theimportance of history-taking as aandpsychotherapy

are

very

important for excessive stress, fear, sense ofhelplessness, flash-backs, sleep disorders etc., there
is

a

high

possibility

thatacupunctureandmoxibustion treatment may at the same time offer amajor contribution to the relief of PTSD related
symptoms.
References
Takasaki R, Otsuki T. A report on acupuncture
volunteer activity in Kesen-numa. Ido-No-Nippon
Figure 5(Jpn J Acupunct Manual Ther) 2011; 814: 94-96.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3| Fall 2011

Medical History in Japan“Historical Significance of the Standardization of Acupoint
Locations”, the Second Japanese Acupoint Committee (3)“Detailed Guide to the Location of Acupoints” from thecalssics to the WHO standardization”, pp411-422, Tokyo,
Ishiyaku Publishing, June 2009 (partially revised)
Makoto Mayanagi
Graduate School of Humanities
Ibaraki University(continued from KAIM Journal vol.6 no.1 and no.2)

5. Acupoint charts up to the Tang period and changes
in acupoints
Since acupoints are located on the body surface
theirvisualization

throughillustrations

undoubtedly started from an early point in time.
Therefore, the "Ming Tong Illustrations" haveprobably been drawn around the creation of theoriginal "Ming Tong Jing". Because no directly
derived drawings exist, there are no concrete clues,
but

it

can

be

imagined

based

on

Figure 7 Huáng Dì Xiā Má Jing

acupoint

illustrations up to the Tang period.
The oldest extant text with acupoint charts
currently known is the Yellow Emperor's Toad
Prohibitions

for

Moxibustion&

Cauterization(Huáng Dì Xiā Má Jing) (Figure 7). Based on theworks listed in the Record of the Bibliographic
Catalogs of the Sui dynasty it seems likely that theroots were established in the 3rd century. Not
surprisingly, similar to the "Ming Tang”, these havebeen scattered and lost in China and have beenpreserved and handed down only in Japan. The oldmanuscripts were discovered during the late Edo
period by Mototsugu Taki of the Shogunate Medical
School. Figure 7 shows a replica of the Shogunate
Medical School's copy and names of acupoints along
the hairline or Renying (ST9) can be seen. Moreover,it includes a description that like the imaginary toadand rabbit on the moon moxibustion treatment ofsome acupoints should be avoided in correlation withthe waxing and waning of the moon.

28

Figure 8 Ishinpo

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

In the Heian period Yasunori Tamba compiled thedescribes the location of the "human-spirit" elements

text "Ishinpo" based mainly on works from before thecorrelated to the suitability for treatment as

Sui and Tang periods and presented this to theregulated by the oriental zodiac signs characteristicemperor in 984. In the 22nd volume are illustrations
for each of the 10 months of pregnancy, for each anillustration of a naked pregnant woman, fetus,
viscera and bowels, meridians and acupoints all ofof the birth year, seasons, months and days, while atthe end there is a transcription of the year 861. Thus,
this book shows clearly that during the Tang period

which are derived from the Chang Jing. Among theseprior the year 861 textbooks about moxibustion had

the contents related to the correlation between fetal

already been published in Xi'an. At the same timedevelopment

this is also the oldest extant medical book publishingandviscera-bowels-meridiansoriginates and has been transmitted from the "Tairecord.

Chan Jing" (text on fetuses and birth), placing its
origin extremely far into the past. The date ofcreation of the Chang Jing quoted in the Ishinpo is
not clear, but considering the 5th century appears tobe acceptable and most likely. Figure 8 shows a
reproduction of the "National Treasure Seikido
Library [12], but the book of the Seikido library is anassociated book that has diverged from the Nakarai's
national treasure book during the Edo period. It
cannot definitely be concluded, that the red lines
indicating meridians are actually derived from the"Chang Jing".
A text with acupoint charts of the Tang period wasunearthed in Dunhuang. Figure 9 shows the Stein
Text No. 6168 from The British Library in London
andiscalledthe"Illustrated

Moxibustion

Technique" of the "Moxibustion Scripture". Like the
Xia Ma Jing no meridians are drawn and only points
not used today like "Shou Suikong" or " Wuzhou"
have been marked. Also, the Pelliot text No. 2675
[13], which is in the possession of the La
Bibliothèque nationale de France, mentions at the

Figure 9 Stein Text No. 6168
(London, The British Library)

beginning a "First Volume of the New Adorned

On the other hand, paying attention to the hair

Scripture of Moxibustion for Acute conditions". Instyle shown in Figures 7-9 reveals that although only

other words this texts was a reproduction of the one

Figure 8 shows a woman, all are very much alike.

volume work " Xinxiu Beiji Jiujing" published by the

The drawing style of the bodies too is strikingly

Li family living a business area in the eastern

similar. This shows, that until the Tang period themarket of the capital (today called Xi'an). On the

acupoint charts adopted a standardized style. Also ofbackside of the paper the second half of this booksignificance in Pelliot's text No. 2675 there is a large

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 6, Number 3| Fall 2011

inscription of "Ming Tang" above the body, revealing

the following year based on that work created a 3-that acupoint illustrations have been called "Mingdimensional figure, that was "newly cast" and heTang". If that is so, the "Ming Tang Tu" prepared inrevised the 14 meridians and 354 acupoints in 1026,

the third century too was drawn in this style andpublishing the "Illustrated Meridians" as the 3-

later presumably followed until the Tang period.

volume work "(Newly casted) Tong Ren Shu Xue
Shen Jiu Tu Jing [14].

Yet, changes occurred in the acupoints. The
points" Shou Suikong" or " Wuzhou 2 shown in

The Northern Song editions of the time used

Figure 9 are not found in the "Ming Tang", and incharacters of coin size and even B4 paper size large

Pelliot's text No. 2675 the point GB21 jianjing (肩井)characters, were mostly luxury books for the court

is called bo jing (膊井), the point TE20 jiaosun (角孫)and government officials and consequently too

is recored as yin hui (陰会), the point GV23 shengting

expensive(神庭) is called zhu shen (住神) and the point between

Therefore, subsequent publishing of small print

the eyebrows EX-2 yin tang is called guang ming.

editions for the general population was common forDuring the time following the "Ming Tang" toomedical books. Yet, trying to create a small printed

different names for acupoints and new acupoints

version of the "Tong ren shu xue shen jiu tu jing"appeared and different schools and theories using

makes it difficult to contain the bronze figure

those names continued to be established.

illustrations. Presumably this seems to have beenforordinary

peopleorphysicians.

the reason why there has been no small print edition
6 Tertiary standardization – unification on aof this work, but the government had this booknational level

carved as a stone relief that was then erected in the

After the Tang period and through a period of 5

capital of Bianjing (today's Kaifeng) and spread bygenerations of confusion, China was reunited underhaving people make rubbed copies of it. The casting

the Northern Sung government, and maybe also dueof this bronze figure and publishing of the book, andto the emperor's pursuit of a civilian controlled policy,

again the rubbed copies obtained from the stone

attached great importance to medical policies. On

relief were used as a means for the careful spread of

this foundation "Su Wen", "Ling Shu" and similar

this knowledge and had the purpose of achieving

medical classics were revised, books on herbology

unification on a national level. It is no exaggeration

also enlarged and revised a large portion of medical

to call precisely this the tertiary standardization.

encyclopedias newly compiled and using the wood-

Incidentally, quotations in the "Xia Ma Jing" orblock printing technique that had spread at that

"Ishinpo" derived from the "Chang Jing" or Pelliot

time governmental editions were published. The

text No. 2675 show that the discourse pertaining toeffects of acupuncture and moxibustion too were

the determination of the type of meridian or the

acknowledged by the emperor himself, so that heacupoints to be avoided depending on the location ofordered the medical officer Wang Wei Yi to correct

the human spirit was very popular until the Tangthe confusion about meridians and acupoints. By

period. Whether this view already prevailed from theimperial command Wei Yi prepared his "Illustrated

stage of the "Ming Tang " is unknown, but they are

Meridians" (illustrations and descriptive text) and inreferred to twice in the "Illustration of the Brass

30

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 6, Number 3 | Fall 2011

Man Acupuncture and Moxibustion". Apparently,
the widespread discourse could not be neglected.

Figure 11
Figure 10

Rubbed copy of a gravestone

Bronze figure (Tokyo National Museum)

Figure 11 shows a rubbed copy of the stone relief

Figure 10 shows the bronze figure at the Tokyo

immediately after it had been set up in Bianjing [16]National Museum, which had originally been cast inand "First Volume of the Newly Cast Bronze Figure

Northern Song and had been called "Tensei dojin".

Illustration of Acupuncture and Moxibustion" isThis originates according to Chen cunren theory tofound in the left lower corner. This stone relief was

the joining of the Japanese army when the allied

moved during the Yuan period to Beijing and hadforces of eight countries attacked Beijing during thethere been preserved until the Ming period. This

Boxer Rebellion and carried it away from the oldparticular stone remnant was discovered duringpalace in Beijing. However, Professor Hiroshi Kosoto

excavations at Beijing's castle wall and a portion of

from Kitazato University showed beyond any room

it is now on display on the 6th floor of the The Chinesefor dispute that this particular bronze figure had

Academy of Sciences in Beijing. Further, the Ming

been cast by the acupuncture medical officer Jizen

government also completely replicated the Northern

Yamazaki upon order from the shogunate during theSong stone relief because of damage and wear andEdo period by the end of the 18th century and been inallowed to make rubbed copies of it to spread thethe possession of the Edo Medical School [15].

knowledge. The library of the Imperial Household
Agency is in the possession of a complete rubbed copy

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Volume 6, Number 3| Fall 2011

from the Ming period that originally had been
together with the bronze figure shown in Figure 10
in the possession of the Edo Medical School.

32

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)Make the most of Kampo in modern medicine

Foundation: 1905
A century of tradition ――――We are a manufacturer consistently controlling the entire process fromthe import of crude herbs to the manufacture of Kampo extracts and assuch have contributed to the development of Japanese Kampo.
We sincerely hope to continue in the future with our contribution tomodern medicine through "Kampo".

OHSUGI Pharmaceutical Co., Ltd.

1-1-2 Tennojicho, Minami, Abeno-Ku, Osaka, Japan
Phone: +81-6-6693-3301

The crude drugs like many other creatures on earth areraised by bountiful NATURE.
Humankind earns as well grace from Mother Natureand is blessed as a member of natural world.
PROFILE of

TOCHIMOTO

Since Tochimoto was appointed as aJapan-China friendship trading firm in
1963, we have expanded our businessoverseas, mainly with China.
We import a variety of quality-controlled
natural resources from all over the world
for maintaining wellness.

TOCHIMOTO TENKAIDO CO., LTD.
3-21 Suehiro-cho, Kita-ku, Osaka 530-0053, JAPANwww.tochimoto.co.jp