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Dr. Yamamoto presented this method, which originally consisted of five points, for the first time at a Japanese Ryodoraku Congress in Japan in 1973. For twelve years, using these highly effective points, which he termed basic points, he successfully treated stroke patients suffering from pain and paralysis. Taking second place only to ear acupuncture, YNSA (Yamamoto et al., 2010) is today the most widely and frequently used form of acupuncture and is gaining increasing significance. Since 1973, in addition to the basic points, several other points have been discovered namely sensory point, brain points, Y points, extra points, treatment points on the thorax and in the region of the pubic bone, dorsal treatment points and additional peripheral points as well as various diagnostic points. Hardly any other acupuncture system can be described as so fertile since Dr. Yamamoto is untiring in his search for new methods of treatment, points and somatopes in his daily work. In Japan, acupuncture was largely practised by masseurs, which meant that it was not highly regarded in classical medicine nor, in particular, at university medical schools. Interest in and receptiveness to acupuncture is gradually increasing, also at some Japanese universities. YNSA has been the subject of numerous studies and publications. YNSA is also used very successfully in veterinary medicine, for example to treat cats and dogs. A number of research projects and publications on YNSA are eagerly awaited in the near future. 2. Principles of YNSA The basic points are still used successfully in daily practice. Acupuncture needles are applied ipsilaterally at these basic points for pain therapy while for the treatment of central paresis they are applied contralaterally to the paretic side. YNSA is a special form of traditional acupuncture. The method is based on a somatotope on the scalp. In the same way as with ear or mouth acupuncture, the entire organism is projected here on a defined area of the scalp. The locomotor system is at the boundary of the forehead and hair, whereas the internal organs are represented via Ypsilon points on both temples. Scalp acupuncture distinguishes a yin somatotope at the front of the scalp and a yang www.intechopen.com 84 Acupuncture – Clinical Practice, Particular Techniques and Special Issues somatotope at the back of the scalp. With the aid of the special Japanese neck diagnostics, the associated Ypsilon therapy points in the temples or the corresponding cranial nerve points are revealed via pressure-sensitive points in the neck region. As a representative of each meridian, there is a pressure point on the neck and an associated treatment point in the region of the temples. If, for example, the kidney point on the neck is sensitive to pressure the needle is applied to the corresponding Ypsilon point in the temple. If the needle has been correctly positioned in the temple region then the pressure sensitivity in the neck disappears consecutively and thus provides immediate verification for correct positioning of the needle. Fig. 1. Schematic representation of the frontal YNSA basic points. Needles are applied ipsilaterally for the treatment of pain and contralaterally for the treatment of paralysis. www.intechopen.com Yamamoto New Scalp Acupuncture (YNSA): Development, Principles, Safety, Efficacy and Clinical Applications 85 Fig. 2. Ypsilon points. Abdominal or neck diagnosis leads to the selection of the Ypsilon points in a treatment session www.intechopen.com 86 Acupuncture – Clinical Practice, Particular Techniques and Special Issues Fig. 3. The abdominal diagnosis leads to the Ypsilon or cranial nerve points In contrast to the pulse and tongue diagnosis of traditional Chinese medicine, Yamamoto New Scalp Acupuncture (YNSA) is characterized by the special feature abdominal wall and neck diagnostics. These diagnostic procedures enable the acupuncture points to be identified individually in each treatment situation indicating where the needles are to be applied for each individual person in the respective treatment situation. When the needle is correctly positioned, the sensitivity to pressure felt by the physician and patient disappears. This check makes it possible to discover whether the needle is correctly positioned. It is important to investigate the diagnostic points on the arm and neck by shifting the pressure to the side. In doing so, the points are palpated with the tip of the thumb. Applying pressure solely to the points may falsify the results of the examination. In the case of abdominal wall diagnostics, the examination is performed by palpation using the index, middle and ring fingers with gently circling movements. www.intechopen.com Yamamoto New Scalp Acupuncture (YNSA): Development, Principles, Safety, Efficacy and Clinical Applications 87 Fig. 4. Neck diagnosis is used to find the treatment points of the patient 2.1 Relevance of the YNSA cranial nerve points The cranial nerve points are highly active acupuncture points on the frontal scalp. Using these points, disorders of the corresponding meridians and the cranial nerves can be treated. For example, the lung cranial nerve point, the glossopharyngeal point is used for the treatment of the swallowing disorders after stroke as well as pulmonary disorders of different origin. Based on the YNSA-Yin basic point A, 12 cranial nerve points are located in a row in the dorsal direction up to DuMai20 for approximately 6-8 cm. For the practical use, the cranial nerve points are identified by the adbdominal or neck palpation technique. The painful abdominal or neck points show the way to the corresponding cranial nerve points. After correct acupuncture of the relevant cranial nerve points, the pain intensity of the abdominal or neck sites should be reduced, similar to the Ypsylon points. Similar to the other YNSA points, the cranial nerve points display small treatment areas, which are www.intechopen.com 88 Acupuncture – Clinical Practice, Particular Techniques and Special Issues identified using careful palpitation. Acupuncture is then performed at the point with the highest pain intensity. Similar to the basic, brain and Ypsilon points, a careful palpitation is necessary and important for the localization of the cranial nerve points. The known Ypsilon and cranial nerve points can be used alone and in combination. It is important that the treated acupuncture point is reported as painful by the patient. A site which is not painful should not be treated. The cranial nerve points have shown to be very suitable for treatment of motor and other neurological symptoms. Fig. 5. The cranial nerve points and brain points with Yin-basic-point A www.intechopen.com Yamamoto New Scalp Acupuncture (YNSA): Development, Principles, Safety, Efficacy and Clinical Applications 89 Fig. 6. Master key points for tinnitus, upper and lower body with hoarseness points www.intechopen.com 90 Acupuncture – Clinical Practice, Particular Techniques and Special Issues Fig. 7. Yamamoto New Chest Acupuncture In the Yamamoto New Chest Acupuncture pain is treated ipsilaterally, hemiparesis contralterally. Very effective is especially the treatment of distubances of the locomotor system. www.intechopen.com Yamamoto New Scalp Acupuncture (YNSA): Development, Principles, Safety, Efficacy and Clinical Applications 91 3. On the safety of acupuncture in the Thoracic region Numerous references to side effects caused by acupuncture treatment can be found in medline. The investigation presented here was motivated in particular by reports of pneumothorax after acupuncture. After an autopsy on a corpse, the depth of various acupuncture needles penetrated into the thorax was investigated. The study was performed on a female corpse. For unknown reasons, the patient had been subjected to resuscitation and due to this measure had suffered a series of fractured ribs on the right-hand side. Issue investigated: Is it possible to apply acupuncture treatment safely in the thoracic region, in particular intercostally? Observations: Acupuncture in the thoracic region involves a greater or lesser degree of risk depending on the thickness of the subcutaneous fatty tissue. The longer the needle, the greater is the risk. In view of the fact that in some places the intercostals muscles are only 2 to 3 mm thick, the ribs themselves in the present case are 3 to 4 mm thick and the skin is 1 to 2 mm thick, in the case of a slim or cachectic person an acupuncture needle 1 cm in length can potentially lead to pneumothorax if applied intercostally. In order to ensure the greatest possible safety in acupuncture, it is necessary to choose needles that are as short and thin as possible and to apply them tangentially at the flattest possible angle. Additional safety can be achieved by moving the tip of the needle towards the rib or corpus sterni. If, as for example in the case of thoracic Yamamoto New Chest Acupuncture, the needles are to remain in position in the patient so that further physiotherapy measures can be applied, then they must be secured by a good adhesive plaster. It appears safest to apply the needles above the ribs and only above the xiphoid process, the corpus and manubrium sterni. Fig. 8. Acupuncture needles of various lengths. In comparison: The depth of penetration into the subcutaneous fatty tissue can be seen. Penetration depth of the needles with respective lengths of 10, 15 and 25 mm in relation to skin and subcutaneous tissue. www.intechopen.com