The Change in Coloration of Aluminum Silicate Hydrate with Silicon Dioxide to Bright Blue when Cinnamon Bark and Atractylodes Rhizome are Combined / 日本東洋医学雑誌

The change in color tone of crude drugs during storage of decoctions is one of the factors leading to poor drug compliance of decoctions. We experienced a case of a decoction including Aluminum Silicate Hydrate with Silicon Dioxide (Kasseki) turned into bright blue color after it was combined with goreisan. We therefore examined to find out possible causative crude drugs using an airtight container and performed a component analysis by the TLC. As a result, we found the following: Kasseki under the coexistence of Cinnamon Bark (C. Bark) and Atractylodes Rhizome (A. Rhizome) turned into a bright blue color in several hours. In this coloration, aluminum silicate hydrate, cinnamaldehyde and atractylon, which derive from these 3 crude drugs, were involved. This coloration change of Kasseki under coexistence of C. Bark and A. Rhizome was a vivid and sharp reaction generated in several hours. From the perspective of maintaining medication compliance, it is important to provide a full explanation to patients about the change in coloration of Kasseki, when decocting crude drugs that contain C. Bark, A. Rhizome, and Kasseki. To avoid coloration, it is considered useful to put Kasseki in a separate sachet, isolated from other crude drugs in storage, and to mix in Kasseki just before decocting.

Four Cases of Anxiety Disorder Effectively Treated with Combination Use of Keishikaryukotsuboreito and Kanbakutaisoto / 日本東洋医学雑誌

We report four cases of anxiety disorder where psychiatric symptoms were effectively treated with combination therapy utilizing keishikaryukotsuboreito and kanbakutaisoto, which are two herbal formulas. The patients had common symptoms and experienced episodes leading to emotional stress. Moreover, in all four cases aggravation of psychiatric symptoms due to emotional stress, re-experience and memory retrieval were commonly observed. Additional treatment with kanbakutaisoto was effective for such aggravation. On the objective assessment, rapid pulse, deficient pulse, weak abdominal strength and brisk pulsation in the supraumbilical region were present. Yawning was not necessarily present. There are many patients with anxiety disorder or mental disorder associated with emotional stress, and Kampo treatment is often considered to be effective for these cases. However, a single administration of Kampo extract formulae does not often provide adequate results. When a single Kampo administration is ineffective, the combination of keishikaryukotsuboreito and kanbakutaisoto may be useful.

Two Cases of Refractory Hiccups Effectively Treated with Acupuncture at the Lump of Infraspinatus Muscle (Terasawa Point) / 日本東洋医学雑誌

Hiccups can sometimes become intractable. We report two cases of hiccups in which acupuncture practices to the lump of the infraspinatus muscle (Terasawa point) were effective. Case 1 was an 85-year-old male, an inpatient with bacterial pleuritis. His hiccups had persisted for 11 days. Several pharmacotherapeutic approaches were partially effective, but the hiccups were not completely abolished. In situ acupuncture therapy to bilateral Terasawa points was done, and his hiccups disappeared the next day. Case 2 was a 68-year-old male. He experienced insufficient sleep due to hiccups. We inserted needles into bilateral Terasawa points and heated the surrounding area with an electrothermo-acupuncture device using a curved heating plate. When this combination therapy was done, his hiccups disappeared during treatment. Acupuncture at the Terasawa point is one of the therapeutic approaches for hiccups and a rapid effect can be expected.

<b>Screening for Idiopathic Mesenteric Phlebosclerosis in Outpatients Undergoing Long-Term Treatment at the Department of Kampo Medicine</b> / 日本東洋医学雑誌

<p>Idiopathic mesenteric phlebosclerosis (IMP) is a rare chronic ischemic intestinal disease, mainly in the right hemicolon, characterized by dark purple mucosa on colonoscopy and calcifications of the intestinal wall and mesenteric veins on abdominal radiography and computed tomography. In recent years, many patients who developed IMP over the long-term administration of Kampo medicines have been reported. However, the present status of IMP in patients under long-term treatment with Kampo medicines in departments specializing in Kampo therapy is unclear. We surveyed whether there were any IMP outpatients followed for 5 years or more at the Department of Oriental Traditional Medical Center, Suwa Central Hospital. We detected 2 of 257 (0.8%) patients having IMP. Both patients had undergone long-term treatment with Gardenia fruit. One of them underwent surgery due to acute abdomen, but the other was asymptomatic. The etiology and pathogenesis of IMP are still unclear. However, in patients undergoing long-term treatment with Kampo medicines, particularly containing Gardenia fruit, the possible presence of IMP should be taken into consideration, and active screening using imaging examinations is necessary even in asymptomatic patients.</p>

<b>The Investigation of Metrological Standard in “</b><b><i>Songban Shanghanlun</i></b><b>” :Focus on the Absorbed Liquid in the Decoction Residues and the </b><b>Extraction Efficiency of Ephedra-alkal / 日本東洋医学雑誌

The dosage of crude drugs described in the <i>Shanghanlun </i>has long been discussed, and a conversion ratio for 1 liang in the <i>Songban Shanghanlun </i>into modern grams has not been established yet. <i>Ekisai Kariya</i>, a bibliologist in Edo period Japan, claimed that the formulas in the <i>Songban Shanghanlun </i>could not be decocted when weighed with the “Han shu (lu li zhi)” scale (1 liang = 14 g, “regular scale”), and the weight scale in the text should be “Scale of Shen nong” (1/10 scale of the regular scale). This claim leads to the standards for Kampo prescription dosages. We inspected this matter by focusing on the amount of liquid absorbed by decoction residues, and demonstrated that the formulas in <i>Songban Shanghanlun </i>could actually be decocted when weighed with the “regular scale”. In addition, we calculated the quantities of Ephedra-alkaloids in the one-time dose of “Ma huang tang” of the several books written in the Song period, and the <i>Songban Shanghanlun </i>text, with results showing that Chinese doctors in the Song period recognized 1 liang in the <i>Songban Shanghanlun </i>as 14 grams in modern terms, and that the “regular scale” could be applied clinically. This strongly suggests that the metrological standard in the <i>Songban Shanghanlun </i>should be the “regular scale”.

The Weights in <I>Ben Cao Jing Ji Zhu</I> (Dun Huang Version) and the Volume of a <I>Fang Cun Bi</I> (One Cun Square Spoon) : Weights and Measures in the Period when the <I>Shan Han Lun</I> was Written / 日本東洋医学雑誌

For the purpose of investigating weights in the era when the <i>Shan Han Lun </i>was set forth, the weight and measures described in the <i>Ben Cao Jing Ji Zhu</i>, written in the period slightly after the <i>Shan Han Lun</i>, were studied. Some descriptions of the metrological standards are confusing in the <I>Ben Cao Jing Ji Zhu</i>. We focused on the measuring container, whose volume is equal to that of the one cun square spoon (fang cun bi), shown in the dun huang version of the <i>Ben Cao Jing Ji Zhu</i>. The volume of this measuring container was calculated on the assumption that the measures in this text follow those of the <i>Han Shu Li Li Shi</i>, and a result of 5.07 cm³was obtained. The result was confirmed by using the actual measured values of the crude drugs. The result was also considered to support measurements of the volume in the <i>Ben Cao Jing Ji Zhu </i>as following the <i>Han Shu Li Li Shi</i>. With those results, descriptions of the density of honey and lard were examined, and the weight in the <i>Ben Cao Jing Ji Zhu </i>was clarified to follow that in the <i>Han Shu Li Li Shi</i>.

<b>Differences in Water Hardness when preparing Ephedrae Herba Decoctions : Special Focus on a Comparison of Tap Water </b><b>in Japan and China </b> / 日本東洋医学雑誌

Decoctions of Ephedrae Herba were prepared using tap water sampled in Changping District, Beijing City(China), tap water sampled in Niigata City (Japan) and some mineral water samples sold in markets. Various dissimilarities were found between drug extracts prepared using tap water in Japan and China, and the extraction efficiency of the alkaloids with Beijing tap water was approximately 80% of that with Niigata tap water. It is suggested that these dissimilarities result from concentrations of temporally hard components, such as calcium and magnesium bicarbonate salts, in the water. In addition, when Zizyphi Fructus and Ephedrae Herba were decocted together in hard water, the state of the decoction, ephedra-alkaloid content included, was found to come close to that of single Ephedrae Herba decoctions prepared using soft water. It was suggested that Ziziphi Fructus might possibly play roles as a softening agent in decoctions prepared using hard water.

<b>Successful Treatment of Three Cases with Chronic Obstructive Pulmonary Disease or Interstitial Pneumonia Symptoms Using Ninjinto </b> / 日本東洋医学雑誌

We prescribed ninjinto for 3 patients with chronic obstructive pulmonary disease or interstitial pneumonia.Markers for assessing the efficacy of this formulation included dull sensations in the stomach and diarrhea.These markers rapidly improved following the administration of ninjinto. The 3 patients experienced 2 com mon features, including an obstructive and a cold feeling in the pit of the stomach. Moreover, a cessation or significant decrease in cough and sputum was observed following ninjinto administration. Ninjinto is usually used to treat digestive disorders. However, these findings suggest that ninjinto may also be used for the treat ment of respiratory disorders.

<b>Report on Four Cases of Chronic Renal Failure Effectively Treated with Astragali R</b><b>adix </b> / 日本東洋医学雑誌

Chinese herbal medicine has historically been used for the treatment of renal disease. There are some medi cines such as rhubarb and Ompito that delay the need for dialysis. However, they only attenuate the 1/Cr-time slope but cannot reduce the Cr level. In this study, four chronic renal failure (CRF) patients who had not responded to any Western medicine were treated effectively with Astragali Radix, a traditional herbal medi cine. Serum creatinine (Cr) was clearly improved, and necessity for dialysis was delayed. In two patients, Cr was controlled stably over four years. There were no adverse effects, and no noteworthy changes in the lev els of serum phosphorus, potassium and uric acid between before and after treatment were observed. This study suggests that Astragali Radix is a useful agent in the treatment of CRF.

Four Cases Report of Dumping Syndrome Effectively Treated with Keishito and its additional Prescription / 日本東洋医学雑誌

We report four patients suffering from dumping syndrome treated effectively with Keishito and its additional prescription. Case1was a 57-year old male who received subtotal gastrectomy 30 years ago. After the operation he felt shaking sensations and eyes flickering after meals for10minutes to 4 hours. These symptoms tended to occur along with hunger. After taking Keishito, these symptoms improved. Case 2 was a 63-year old male who received subtotal gastrectomy 7 years ago. In recent years, he has had noticeable sweat and fatigability 20-30 minutes after meals. After taking Keishito, these dumping syndrome symptoms disappear. Case 3 was a 71-year old female who received subtotal gastrectomy 9 years ago. Thereafter, cold sweats and dizziness came to appear regardless of what she ate. After taking keishikashakuyakuto or shokenchuto the aforementioned symptoms disappeared. Case 4 was a 72-year old female who received subtotal gastrectomy 2 years ago. Sweats and hot flushes began to occur after meals for 30 minutes to 3 hours, from last July. These symptoms were improved simply by licking candy. After taking Keishito, these symptoms also disappeared.

Effect of Keishibukuryogan on Silent Brain Infarction over 3 Years / 日本東洋医学雑誌

The purpose of this study was to evaluate the effect of keishibukuryogan (KB) against the cognitive symptoms associated with silent brain infarction in a prospective cohort study. The subjects were 93 patients with silent brain infarcts who visited the Department of Japanese Oriental Medicine, University of Toyama, and its allied hospitals. They consisted of 24 males and 69 females, mean age (± S.E.) 70.0±0.8.Group SK (n=51) consisted of patients who used KB extract for more than6months per year. Group SC (n=42) consisted of patients who did not use Kampo formulas. The NS group (n=44) consisted of elderly subjects who had no silent brain infarction, 21 males and 23 females, with a mean age (± S.E.) of 70.7±0.7 years. Among the three groups, the revised version of Hasegawa's dementia scale, apathy scale and self-rating depression scale were compared between the study start and after three years. In the SK and SC groups, these scores, and the subjective symptom levels (head heaviness, headache, dizziness or vertigo, stiff shoulder) were also studied. The results showed that the self-rating depression scales at study start for the SK and SC groups were significantly higher compared to the NS group. In spite of the scores for the NS group increasing after three years, the SK group scores were significantly decreased compared to the SC and NS groups. KB was effective against head heaviness, which often complicates silent brain infarction. In the above mentioned, KB was effective in treating cognitive disorders and subjective symptoms related to silent brain infarction.

Sho, the Diagnostic Basis of Kampo Medicine ---Classical Concept vs. New Concept--- / 日本東洋医学雑誌

The practice of Chinese medicine has continued for more than 2,000 years, based on its long record of effectiveness. In this regard, Kampo medicine has also been used successfully for these many years, and it is still equally effective today, reflecting the fact that humans have changed little during that duration. In fact, it is said that humans have not undergone much evolutionary change in the last four million years. In contrast to this, however, are the ongoing changes in our environment and surroundings, which are giving rise to a host of new diseases, including many that are allergy-related.In the Japanese system of Kampo medicine, the pathophysiological diagnosis (Sho) and treatment are decided on the basis of two venerable texts, Shokanron and Kinkiyoryaku. There is, as a matter of fact, a prevailing, and possibly too extreme, opinion among Kampo practitioners that Kampo methods and medications not found in these two manuals are not to be applied. However, it is thought that changes had already been made to these texts in 1065-1066 by Rinoku et al., and possibly also by others earlier during the Song Dynasty (960-1279). Furthermore, two other texts, Ishimpo and Taiheiseikeiho, present many points that differ from those found in Shokanron. Thus, it is highly likely that Sho is also based on other revisions possibly carried out on these texts (originally authored by Cho Chukei) before Rinoku et al., if not on their own revised versions. From this, it must be realized that revision itself is not a bad process, and rather that the changes for which Rinoku et al. were responsible are quite in harmony with the present age.We must not be afraid to break with an old style. From the early days of Kampo medicine, Sho was assessed on the basis of the four available examination methods (visual examination, examination according to hearing and smell, questions and answers, and palpation). The field of medicine has since undergone some remarkable transitions, and its current state is one of tremendous development. As part of these newly acquired abilities, elevated levels of leucocytes and CRP as reflecting the state of the disease, for example, can be incorporated into the assessment of Sho. In this sense, Kampo practitioners should adopt and apply useful methods also originating from Western medicine. As a matter of fact, this is in line with the preface of Shokanron, which states that useful medications and methods should be gathered as broadly as possible ( ?? ).

Four Cases of Symptoms with Dryness in the Throat Successfully Treated with Hyakugokokinto / 日本東洋医学雑誌

We prescribed Hyakugokokinto for four patients suffering from dryness in the throat. Dry throat improvements were observed in all patients, while improvements in insomnia were observed as well. Thus, insomnia may be a further indication for the use of Hyakugokokinto.

Study of Shuchi-Bushi, a Powder Type of Aconiti Tuber after being Autoclaved, Especially Concerning Side Effects-Usage and Dosage of Shuchi-Bushi from This Study- / 日本東洋医学雑誌

<i>Aconitum carmichaeli</i> debeaux is an essential herbal medicine that possess anti-inflammatory, analgesic, and cardiotonic effects. Five hundred ninety-three subjects were treated with Shuchi-bushi (a powder type of this aconiti tuber that has been autoclaved) added to Kampo extract granules, between the years 1996 and 2002. The patient population consisted of 153 men and 440 women with an average age of 54.5 years. Four patients showed adverse reactions such as hypertension, nausea and hot flashes with Shuchi-bushi. There were no serious adverse effects, and the toxic symptoms disappeared quickly by reducing the Shuchi-bushi dosage, or cessation.<br>Shuchi-bushi has been used in small quantities because of its highly toxic alkaloids. However, this study indicates that Shuchi-bushi can be used more actively.

Case Reports of Diabetic Foot Successfully Treated with Kigi-kenchu-to with Additional Ingredients / 日本東洋医学雑誌

We report on three patients suffering from diabetic foot successfully treated with. Kigi-kenchu-to with additional ingredients.<br>Case 1 was a 68-year-old female with diabetes mellitus and rheumatoid arthritis The bilateral foot sole ulcers present were diagnosed as diabetic gangrene. Her condition had not improved, in spite of Western medical treatment. The ulcers of bilateral foot improved, however, after administration of Kigi-kenchu-to-ka-bushi, while rheumatoid indices also became negative.<br>Case 2 was a 66-year-old male with diabetes mellitus and a history of subarachnoidal hemorrhage. Kigi-kenchu-to-ka-bushi medication, in this instance, caused recurring ulcers of the big toe to disappear.<br>Case 3 was a 72-year-old male. Gangrene of bilateral toes set in, during treatment of diabetic nephropathy. And even though the toes were amputated, recovery was delayed because of poor blood flow to the feet. After administration of Kigi-kenchu-to-ka-hanbi, granulation formation progressed and the patient's outlook improved.<br>We consider that Kigi-kenchu-to, with additional ingredients, may serve as an effective cure for diabetic foot.

Clinical Experience of Dai-Kankyo-gan / 日本東洋医学雑誌

Dai-kankyo-gan has traditionally been used for great resistance for tenderness upon pressure in the epigastric region (Shinkahiko) and rigidity of nape (Kohai-kyo). We treated two cases with Dai-kankyo-gan for years.<br>Case 1 was a 75-year-old male patient. He had been experiencing shortness of breath after slight exertion since 1986, and had been treated with theophyline, bronchodilator, and expectorants, as well as prednisolone for emphysema and pneumoconiosis. After receiving Dai-kankyo-gan, the patients Kohai-kyo and dyspnea improved and he was able to stop taking prednisolone. It is well known that Dai-kankyo-gan makes Shinkahiko and Kohai-kyo better. In this case, it improved throat discomfort as well.<br>Case 2 was a 56-year-old female patient who had been suffering from stiff shoulders and headaches. After receiving Dai-kankyo-gan, Kohai-kyo improved and the thick coating on the tongue was normalized.<br>Shinkahiko, which depends on stasis of body fluid, is usually normalized with the improvement of subjective symptoms. But in these cases, it was not cured.

Clinical Experience of Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu Decocted with Rice Wine SAKE / 日本東洋医学雑誌

Recently we treated two patients with Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu decocted with 400ml of water and 400ml of rice wine SAKE for 60 minutes.<br>Case 1 was a 46-year-old female patient. Feelings of coldness prevented her from sleeping, and she could not get to sleep without warming up the room and heating her arms with a dryer. After boiling Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu with sake, she was able to sleep well.<br>Case 2 was a 65-year-old male patient who had been suffering from polyarthralgia, low back pain and feelings of coldness. After taking Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu boiled with sake, he felt numbness around the lips and limbs, although the amount of aconiti tuber was not changed.<br>It is believed that SAKE heats and enhances Yang-Ki in Kampo formulas. These characteristics are the same as those produced by aconiti tuber. At first, we suspected that aconiti tuber and alcohol combined synergistically and could therefore give rise to occurrences of aconiti poisoning. But ethanol, in amounts comparable to the alcohol content in sake, did not create this effect. The effect was dependent on the sake itself rather than the alcohol.

The Influence of Kampo Medicine on the Disease Activity in Forty-three Patients with Rheumatoid Arthritis / 日本東洋医学雑誌

During a four-year period from 1994 to 1998, we treated 46 cases of rheumatoid arthritis (RA) with Kampo medicine. Clinical disease activity of RA was assessed using the Lansbury activity index (L. I.). After a year of treatment with Kampo medicine, 20 patients showed over 75% improvement by L. I Eleven cases were considered to be non-responders. Twenty-six cases out of 37 who had been treated with Western medicine were able to discontinue using, or reduce reliance upon, analgesic drugs and steroid hormones following Kampo treatment. Steinbrocker's functional classification of RA was improved from 2.3 to 1.8.<br>We used Aconiti Tuber for 40 patients, and 13 cases showed aconiti poisoning. Two cases represented adverse reactions to Astragali Radix.<br>In this study, Boi-ogi-to-ka-bushi was the most effective for RA, and Keishi-ka-ryo jutsubu-to was the second most effective. Efficacy of Boi-ogi-to was enhanced with large quantities of Sinomeni Caulis et Rhizoma and Astragali Radix. We mixed Boi-ogi-to with Keishi-ka-ryo jutsubu-to when Keishi-ka-ryo-jutsubu-to did not work well. RA is one of the representative diseases that respond to Kampo medicine.

Case Reports of Senkinho-Karo-to / 日本東洋医学雑誌

A Kampo formulation, Senkinho-Karo-to, is considered to be effective for chest pain or discomfort. However, there have been few case reports concerning this formulation. Here, we report four cases of patients suffering from chest pain or discomfort that were successfully treated with Senkinho-Karo-to. We compared the clinical features of these four cases where Senkinho-Karo-to was effective with those of four other cases where Senkinho-Karo-to was ineffective. The cases where Senkinho-Karo-to was effective had the following features: Deficiency, feeling of spasmodic uprising heat, shoulder stiffness, deficient pulse, impressions of teeth on the rim, palpitation of the abdominal aorta in the supra-umbilical region, reduced tension in the lower abdomen, tenderness in the para-umbilical region, and Ki-depression.

Case Reports of Kampo Treatment on Acute Cholecystitis or Cholangitis in the Long-term Bedridden Patients / 日本東洋医学雑誌

In all but a few cases, the treatment for elderly patients must be conservative owing to the unavoidably poor general condition of the patients.<br>We report on three cases of long-term bedridden patients with acute cholecystitis or cholangitis who were effectively treated with Kampo prescriptions. An 86-year-old male with choledecholithiasis and acute cholangitis responded to Inchin-ko-to. When he repeatedly relapsed after the discontinuance of Kampo treatment, Inchin-ko-to was effective, and Inchin-shingyaku-to successfully improved his general condition. In an 89-year-old male with acute cholecystitis, Dai-saiko-to extracts and Bukuryo-shigyaku-to were effective. An 88-year-old female with cholecystolithiasis and acute cholecystitis responded to Dai-saiko-to and Bukuryo-shigyaku-to.<br>Most elderly patients are Inkyo-sho (Yin-deficient). But, when they are suffering from acute sickness, it is important to treat them according to the principle of “Senkyukokan (treating acute symptoms before treating chronic internal symptoms).” The severe sickness is treated first, and then the mild phase of the disease is treated.