Draft Standardization for Crude Drug Efficacies Prescribed in Ethical Kampo Formulation / 日本東洋医学雑誌

The usage of Kampo medicine has been expanding in hospitals and pharmacies, and the systematic education on Kampo medicines and their components is urgently needed. Although the efficacies of Kampo formulations are approved at the national level, those of the composing crude drugs are not approved individually except for some cases. Consequently, the efficacy description of individual crude drug in textbooks differs much depending on the authors. To clarify this situation, we suggested the standardized description of the efficacy of crude drugs used in ethical Kampo formulation using terms of modern Western medicine in the previous study. In this study, we reviewed the descriptions of efficacies using the terms of Kampo medicine in the books published in Japan from the 17 century to the present to explore the possibility of standardizing the crude drug efficacies using the terms of Kampo medicine. The proposal for standardized description of the efficacy of crude drugs was based on the high frequency of appearance of the terms in successive books.

Japanese Kampo Medicines for Pandemic/Epidemic Prone-acute Respiratory Viral Infections Represented by Influenza Before Modern Times—The Quality of Ephedra Herb and Its Impact on Clinical Efficacy / 日本東洋医学雑誌

Japanese traditional (Kampo) medicine saved many lives during the Spanish influenza pandemic of 1918-­20. In Japan, acute viral respiratory infections represented by influenza have been called shokan (cold damage), and so on since ancient times. These infections were treated by prescriptions that were adopted from Chinese classical texts including “Shanghan lun (Treatise on Cold Damage Diseases),” “Xiaopin fāng (Prescriptions of Sketch),” “Tai ping hui min he jì ju fang (Formulary of the Bureau of Taiping People's Welfare Pharmacy),” and “Wan bing hui chun (Restoration of Health from Myriad Diseases).” Additional materials include (but are not limited to) “Ishimpo (Prescriptions of Medical Sprit),” “Ton-­i-­sho (Abstract of Medical Enlightenment),” and the diaries of some Muromachi aristocrats. In the Edo period (1603-1868), treatment with Kampo medi­cines developed uniquely in Japan, but due to medical and economic disparities, many patients could not be treated by Kampo experts. Ephedra herb, a key drug for treating shokan (cold damage), has shown major problems in terms of quality, because it has been confused with plants of the genus horsetail since at least the 8 th century ; its medicinal effects may therefore have been underestimated. The effectiveness of Kampo medicine against the novel influenza/coronavirus pandemic is anticipated, however, in order to fully exploit its potential, it is important that physicians with sufficient knowledge of Kampo should use Kampo medications properly.

The Development for the Classification of Formula Based on the Main Crude Drug and Its Background ; Consideration for the Relationship Between the Classification of Formula Based on the Main Crude Drug in Japan and Formulae on Shang Han Za Bing Lun / 日本東洋医学雑誌

The Koho school has a high regard for formulation corresponding to sho uniquely developed as a conspicuous feature of Kampo medicine, and Ruihobunrui (the classification of formulae based on the main crude drug : CF) has played an important role in structuring the foundation of this development in the Koho school. CF is a classification method used to express the adaptation and characteristics of formulae in the Koho school, and is useful for research on drug compositions. Therefore, CF can be used effectively in both clinical practice and education. CF has shown little development in China after the appearance of Xu Ling Tai ; however, in Japan the development of CF centered on such influential figures as Todo Yoshimasu of the Koho school, and Naohiro Kitamura of the Kosho school. Kenzo Okuda and Keisetsu Otsuka used CF for clinical practice and education during the revival stage of Kampo medicine in the Showa era ; moreover, CF had a large effect on structuring the foundation of clinical application by formulating Kampo extracts for prescriptions. Thus, CF has played an important role in Kampo medicine. However, the research has been stopped in the present circumstances of Japan. We focus here on CF of the Koho school in Edo and Showa eras, and carried out considerations of CF to establish one of the characteristics of Kampo medicine that places importance on Shang Han Za Bing Lun.

<b>Various Descriptions of Abdominal Examinations among Traditional Kampo Medical Books Beyond the Showa Era</b> / 日本東洋医学雑誌

The practical use of abdominal examination is a major characteristic of Kampo medicine. Although most Kampo medical texts describe an abdominal examination for a Kampo formula, comparative studies between texts have not contributed to any standardized descriptions for such examinations. We investigated descriptions of 147 prescription Kampo extract formulations in Kampo texts written after the Showa Era, and obtained the following results. Abdominal examinations were described differently by authors, even for the same prescription. Additionally, we examined the descriptions for anchusan (安中散) and kososan (香蘇散), which are called the <i>Gosei </i>school formulae (後世方). Descriptions of abdominal examinations for these drugs were not quoted from an original Chinese medical text, but were empirically constituted in Japan. As knowledge was accumulated, these various descriptions were created through limited personal connections, and/or the opinions of particular authorities. We suggest that a consensus on abdominal examinations would further studies on the viability of traditional medicines, and better characterize Kampo medicine.

Study on Juniritsuho: Todo Yoshimasu's Pills and Powder Formulations / 日本東洋医学雑誌

The author reveals that Todo Yoshimasu prescribed patients both decoctions from the <I>Shanhanglun</I> and the <I>Jinguiyaolue</I> in pill and powder formulations. The establishment of combined uses for his decoctions and pills and powders was the fruit of his many years of experience as a clinician. In his formularies are the “Juniritsuho ” which are his original twelve classes of pills and powders. In addition, his “Juniritsuho” terms originated from ancient “Juniritsu ” twelve-tones terms. Todo Yoshimasu proposed removing poison, or “Doku ” through his “Juniritsuho”, because, in his “Manbyoichidoku ” medical theory, he recognized all diseases as the action of one fundamental poison on various organs of the body. Additionally, he stated such poison results from the congestion of indigestible foods or drinks. With his clinical principles, Todo Yoshimasu insisted on the availability of abdominal palpation for the diagnosis of poison, and gave the pills and powders to take away that root of illness. Thus he applied a correspondence between the abdominal palpation of poison and “Juniritsuho” prescriptions. At the same time, he regarded “Sho ” in the <I>Shanghanlun</I> as the appearance of symptoms, and prescribed <I>Shanghanlun</I> decoctions corresponding to their “Sho”.

<b>Original Meaning of Concurrent Exogenous and Endogenous </b><b>Factor Disease Pathology in Oriental Medicine </b> / 日本東洋医学雑誌

In oriental medicine, when an exopathogen enters the body, the inner spirits (内精) and the exopathogen conflict with each other. Disease occurs in this deficient condition of inner spirits. In most classical formulary, such as the <i>Shanghanlun</i> (傷寒論), the cause of disease is regarded as the external circumstance, such as the cold, the wind or warmth. Here, the authors surveyed the significance of exopathogens and endogenous factors in medical books such as the <i>Shanghanlun</i>, as well as the <i>Jinkuiyaolue</i> (金匱要略), the <i>Suwen</i> (素問), the <i>Lingsue</i> (霊枢) and the others, to obtain the results herein. In the original pathology of a disease concurrent with both an exogenous and an endogenous factor, there is conflict between well-regulated seasonal <i>Qi</i> (四時正気) and unregulated inner spirits. Previous to the development of internal mechanisms for disease causes,this concurrent pathology thinking is concerned significantly with the external world and <i>Shenxien</i> (神仙) thought. Furthermore ambiguities arise from various relationships between exogenous factors and endogenous factors.

Study on the School of Traditional Japanese Medicine in the Dose and the Usage Directions of Medication / 日本東洋医学雑誌

The authors studied the doses and usage directions for some of the first Traditional Japanese Medicines (TJM) and reached the following conclusions. Since Dosan Manase, who had strong influence on TJM, adopted a method of selecting drugs one by one and refused to use fixed prescriptions, it has been hard to comprehend how much of any drug he administered. As criterion, he showed a half common system of weights. Ekiken Kaibara defined an extremely small dose as 1 ∼ 2 <i>qian</i>. Todo Yoshimasu set around 3 <i>qian</i> as the quantity for one dose, although he calculated that 1 <i>liang</i> was equivalent to about 2 <i>qian</i> (7.5g). Additionally, the Koshogaku school proposed that 1 <i>liang</i> was equivalent to 1.4g.

The Formation of Decoctions from Pills and Powder Formulations in Shanhanlun / 日本東洋医学雑誌

This paper reveals the formation of the decoctions in the Shanhanlun by comparisons of its pills, powders formulations and decoctions. In the early medicine found in the Huatuofang, pills and powder formulations, which have intense diaphoretic, emetic and laxative effects, were adopted. Although the Shanhanlun steers away from these extreme medicines, in the chapter Kebukepian there are two medical indications for such pills and powder formulations for basic treatment, and for such decoctions for relatively complicated symptoms of diseases. Focusing on the decoction preparations:the doses of the decoctions are related to those of the pills and the powder formulations. In addition, some of the decoction ingredients come from soup or gruel to take with a pill or a powder formulation. These mean that dosage forms are changed from pills and powders, to decoctions in stages. We therefore conclude that the decoctions in the Shanhanlun are derived from pills and powder formulations.

Aim of Editing of Kokon Hoi / 日本東洋医学雑誌

The <I>Kokon Hoi</I> was the most widely used formulary in the Edo era.Here the author examines tendencies in the ways various <I>Kokon Hoi</I> editions were quoted, how Koga Tsugen approached his re-compilations, and how this influenced later, traditional Japanese medicine.<br>1. Editions of the <I>Kokon Hoi</I> compiled before Koga Tsugen are mainly quotations from newer works such as the <I>Wanbinghuichun</I>, the other of Gong Tingxian's works and the <I>Yixuerumen</I>.<br>2. Koga Tsugen re-compiled the <I>Kokon Hoi</I> twice as the (essential) <I>Sanpo Kokon Hoi</I>, and the (revised) <I>Jutei Kokon Hoi</I>.In the Jutei <I>Kokon Hoi</I>, the most popular edition of <I>Kokon Hoi</I> today, there are numerous quotes from the <I>Wanbinghuichun</I>, the <I>Yixuerumen</I> and Xue Ji's medical treatises.<br>3. In the re-compiling the <I>Kokon Hoi</I>, Koga Tsugen not only added the new prescriptions, he revised the list of references, and corrected prescription names, as well as the component drugs and doses of prescriptions.<br>4. The original <I>Kokon Hoi</I> was compiled to collect newly introduced prescriptions. Afterward Koga Tsugen aimed to adopt experiential prescriptions by editing the <I>Kokon Hoi</I>.The <I>Kokon Hoi</I> is one of the first formularies in traditional Japanese Kampo to enumerate prescriptions in which experiential effectiveness is regarded as important.<br>5. The <I>Shuhokiku</I> on the other hand, is based on a medical system of ”basic and modified prescriptions”.But the <I>Shuhokiku</I> gradually had become nearer a system of numerous enumerated experiential prescriptions like the <I>Kokon Hoi</I>.

Comparative Studies on Various Editions of \lq\lq\it{Kokon Hoi}\rq\rq / 日本東洋医学雑誌

The “Kokon Hoi” was compiled by Koga Tsugen and was the most widely used formulary in the Edo era. Here are the results of this author's examination of various “Kokon Hoi” editions.1) Koga Tsugen received the source book of “Kokon Hoi” from the publisher Umemura, and compiled “Sanpo Kokon Hoi”.2) The original edition of “Kokon Hoi” was published by Umemura in around1692. This edition was a lengthwise book and contained 1263 prescriptions, which is the fewest of all the editions examined here.3) Umemura published an expanded edition of the original “Kokon Hoi” around1696. This was an oblong book, and included almost all of the prescriptions of the original “Kokon Hoi” with an additional 273 prescriptions.4) At the request of Umemura, Koga Tsugen published “Sanpo Kokon Hoi” with an additional 348 prescriptions in 1733, and subsequently, “Jutei Kokon Hoi” with an additional 43 prescriptions in 1747. “Jutei Kokon Hoi” was then reprinted in the years 1780, 1808 and 1862.