Report on the 9th MHLW ICF Symposium"Looking to a New Stage of ICD-11 and ICF Utilization - Toward a Common Language in Various Fields" / 全日本鍼灸学会雑誌

The International Classification of Functioning, Disability and Health (ICF), adopted by WHO in 2001, is an evolution of the International Classification of Impairments, Disabilities and Handicaps (ICIDH). It is a model that integrates the levels of 1) body function and structures, 2) activity, and 3) participation, and uses a holistic approach by focusing on the health of the entire body with an emphasis on the positive aspects of being able to do things. In May 2019, the WHO General Assembly adopted ICD-11, revised after 30 years, and for the first time introduced the classification of diseases used in traditional medicine. A symposium organized by the Ministry of Health, Labour and Welfare of Japan (MHLW) was held online on February 20, 2021, and is reported here.

Chapter 26 Traditional Medicine Included in ICD-11 has Been Released, Till Now and From Now On! / 日本東洋医学雑誌

According to the World Health Organization (WHO), mortality by age, sex, and cause of death is the foun­dation of public health both globally and domestically. Comparable mortality statistics over time and investi­gations of mortality were used to develop the International Statistical Classification of Diseases and Related Health Problems (ICD). In the ICD, the WHO states that morbidity statistics are also an essential foundation of public health, but they are much less widely applied. The 10th revision of the ICD (ICD-10) is now in use, but further revisions must be made in the development of the 11th revision (ICD-11) to capture advances in health science and medical practice, to make better use of the digital revolution, and to evaluate traditional medicine (TM). Revision of ICD-10 began in 2007, and an ICD-11 version for preparing implementation was released on July 18, 2018. ICD-11 features a new TM chapter on Japanese traditional medicine, known as Kampo medicine, traditional Chinese medicine, and Korean medicine. ICD-11 will be approved at the next World Health Assembly in May 2019 and will come into effect. This means that the WHO does not currently recognize the effects of TM, but that we as well as the WHO will have hard time to prepare and study the effects of TM on morbidity statistics. It is very important to the study of Kampo medicine that we will be able to properly evaluate the terms and classifications contained in ICD-11.

Relationship between the five viscera symptoms and "depression"or "anger" / 全日本鍼灸学会雑誌

[Introduction]Patients express various symptoms that reflect their physical, mental and psychological conditions. Thus, traditional Chinese medicine (TCM) emphasizes the relationship between physical and mental states. In the clinical practice of acupuncture and moxibustion, however, many patients chiefly cite physical complaints, and are often treated without a full discussion of their mental and psychological conditions. In TCM, feelings are divided into five categories:anger, happiness, concern, sadness, and fear. The relationship between these feelings and symptoms of disease of the five viscera is not clearly defined, so we attempted to clarify the correlations. This report describes the results of a survey on the characteristics and nature of anger and depression in terms of the five viscera.<BR>[Methods]After obtaining informed consent, 102 students from a vocational school and our university (60 men and 42 women, average age 25 ± 8) were recruited for this study. Three survey sheets were used:Oriental Medicine Health Questionnaire 57 (OHQ57) for understanding the condition of the five viscera; 24 of the 34 items of the State-Trait Anger Expression Inventory (STAXI) for understanding the state of anger;and Beck Depression Inventory (BDI) for assessing depression. The survey was conducted from June to July in 2012.<BR>[Results]The average scores in OHQ57 were 5.1 ± 3.1 for kan (liver), 4.6 ± 3.2 for shin (heart), 5.2 ± 3.1 for hi (spleen), 3.8 ± 3.3for hai (lung), and 3.9 ± 2.7 for jin (kidney). The average scores in STAXI were 23.0 ± 5.1 for State of Anger, 18.8 ±.1 for Anger-Expression, 20.8 ± 3.8 for Anger-Suppression, and 18.9 ± 3.5 for Anger Control. The average score in BDI was 12.4 ± 8.0. Significant correlations were found between State of Anger and kan:Anger-Expression and han/shin/hai in STAXI, and between depression and shin/hi in BDI.<BR>[Conclusion]The Suwen ("Basic Questions,"the oldest Chinese medical text) and other TCM literatures report that anger and depression are related to kan, and the results of this study confirmed the relationship between anger and kan. Based on factor analyses, scores of Anger State (intensity of anger) revealed that groups suspected of having diseases of kan tended to get angry easily and Anger-Expression (expression of anger) showed that these groups displayed both aggressive behavior and verbal assertion. On the other hand, latent factors of depression, possibly caused by diseases of kan, were not revealed in factor analyses, although depression was significantly correlated with shin and hi.

<b>Japanese Literature Survey of Tongue Findings for the Purpose of Creating a Unified Multicenter Description of Clinical Tongue Diagnoses</b> / 日本東洋医学雑誌

In Kampo medicine, a tongue examination, whereby the shape and color of the tongue is observed, is thought to reveal the constitution and condition of the patient. In Japan, numerous books on this tongue examination have been published. However, tongue findings are expressed differently in these books, and a standard description for such findings has yet to be established. A standard description would be useful when examining the tongue, and when educating students of Kampo medicine. We therefore compared how tongue colors and shapes were expressed in the Japanese literature on tongue examinations (12 publications).<br>Using these results, we have arrived at a standardized description for tongue findings in accordance with Kampo specialists of tongue diagnoses at many facilities. In the process, we focused on easily recognizable findings that can be noted with short clinical examination times, and that can also be understood by beginners.

Review of Literature on Morning Diarrhea: “_??_” / 全日本鍼灸学会雑誌

[Objective] “Morning diarrhea” is chronic diarrhea that appears only during the hours of “fifth watch of the night (_??_)” or the hours of the Tiger and the Rabbit (the period from 3 a.m. to 5 a.m. and from 5 a.m. to 7 a.m.), There is, however, neither a unified definition for parthologenesis or defined concept of time relating to morning diarrhea. Accordingly, to make these clear, philological research with classic medical was performed.<br>[Methods] First, we made a computer search for Encyclopedias of Traditional Chinese Medicine about “morning diarrhea (_??_ and _??_)” and “kidney diarrhea (_??_ and _??_)”. Second, we examined the concept of time, pathogenesis, data of symptoms, onset time, the name for “morning diarrhea”, and Modern Western medicine.<br>[Results] As a result of the search there were 31 books and 37 hits for “morning diarrhea (_??_)”, 12 books and 14 hits for “morning diarrhea (_??_)”, 91 books and 216 hits for “kidney diarrhea (_??_) and 38 books and 74 hits for “kidney diarrhea (_??_)”. “Morning diarrhea” had its origin in “kidney diarrhea”, a type of kidney illness that was recognized in the mid twelfth century. Later, the pathogenesis became known, and the onset time was extended to the hour of the Rat (the period of time from 11 p.m. to 1 a.m.). The pathogenesis is a kidney yang (positive deficiency) deficiency, alcoholic hepatitis, cold accumulation, food dyspepsia, liver subjugating spleen, and yang and qi (life force) deficiency, and blood stagnation.<br>[Conclusion] “Morning diarrhea” and “kidney diarrhea” have many points in common, however explain its difference of mainly pathological mechanism, “Morning diarrhea” results from superabundance of liver and shaoyang, fire generating during the hours of the Tiger and the Rabbit. And “kidney diarrhea” results from superabundance of kidney-yin on the hours of the Mouse (the period of the day from 11 p.m. to 1 a.m.), so occur during the hours of the Mouse to the Rabbit. But there is some doubt about the relationship between the onset and pathogenesis. On the other hand in the latter half sixteenth century, emphasize the time of “fifth watch of the night”, but after that appearing time of “kidney diarrhea” had included the hours of the Boar to the Rabbit, So there is some possibility of not being main name.