A Case of Kampo Medicine Treatment for Acute Antebrachial Compartment Syndrome in the Arm Caused with Percutaneous Coronary Intervention Via Radial Artery / 日本東洋医学雑誌

After percutaneous coronary intervention (PCI), the patient developed symptoms of pain, sensory impairment, paralysis, pallor of the skin, and pain during passive extension, and was diagnosed with PCI-induced antebrachial compartment syndrome. Since it was considered to be blood stasis and water stasis in Oriental medicine, we administered jidabokuippo and keishibukuryogan to the patient. Then the subjective and objective symptoms improved promptly, and the symptoms disappeared by the 10th day after the operation. The patient was able to discontinue jidabokuippo 14 days after the operation. It was suggested that the symptomatic treatment with Kampo medicine is effective for compartment syndrome.

The Effect of Mokuboito in the Puerperium Lung Edema / 日本東洋医学雑誌

Mokuboito is a Kampo formulation consisting of four flavors of Sinomeni Caulis Radix (防已), Gypsum Fi­brosum (石膏), Cinnamomi Cortex (桂皮) and Ginseng Radix (人参). From a modern medical interpretation of the source “Kinkiyoryaku” it can be indicated for pulmonary edema, and if administered early in the onset, respiratory management by tracheal intubation can be avoided, which may contribute to improving the pa­tient's QOL. We experienced 10 cases of pulmonary edema that occurred during the postpartum period and were able to avoid tracheal intubation with mokuboito already. All patients complained of dyspnea and moist rales were heard. Their chest X-­rays showed decreased permeability of the lung field and increased pulmonary vascular shadow, increased cardiothoracic ratio (CTR), costophrenic angle (CP angle) blunting, therefore, they were diagnosed as pulmonary edema. After X-­ray confirmation, mokuboito was administered, and in 6 cases,the subjective symptoms decreased from 7 to 4 in NRS (numerical rating scale), the CTR decreased from 60 to 40%, and CP angle, lung field findings, moist rales also improved. In 3 cases, mokuboito+choreito or mokuboito+choreito+choijokito were administered, and the X-­ray findings were similarly improved. Mokuboito was useful for respiratory management of pulmonary edema during puerperium.

A Case of Pseudoaldosteronism Caused by Tokakujokito During Receiving Insulin / 日本東洋医学雑誌

A 51-­year-­old woman with a 10-­year history of diabetes visited our clinic for treatment of stiff shoulder and constipation. She was 156 cm tall and weighed 68 kg. The blood pressure was normal. Physical examination revealed no significant abnormalities. After she took the usual amount of tokakujokito for 3 days, hypertension and facial edema, legs edema, weight gain, and headache were observed. Pseudoaldosteronism inhibits 11 β-­hydroxysteroid dehydrogenase Type 2, which is an active glycyrrhizin (GL) and its metabolites glycyrrhizic acid, 3-­monoglucuronyl-­glycyrrhizic acid metabolize and inactivate cortisol to cortisone. As a result, excessive cortisol acts on the mineralocorticoid receptor and promotes sodium reabsorption and excretion of potassium (K+), resulting in water retention and hypokalemia in the body. Insulin also causes hypokalemia because it also takes K+ at the same time as it takes blood glucose in the cell. As a result of these two different processes, it was thought that pseudoaldosteronism developed in low dose licorice. Glycyrrhizin-­containing preparation should be careful used in patients receiving insulin.

<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>On Ryokyu ARIMA, Tenmin NAMIKAWA's Mentor </b> / 日本東洋医学雑誌

Tenmin NAMIKAWA (並河天民) thought the <i>Shanghanlun</i> (傷寒論) was an important text. He also taught his pupils the importance of prescribing Zhongjing ZHANG's (張仲景) medicines. Ryokyu ARIMA (有馬凉及) was a physician-teacher, who prescribed Chengqitang (承気湯) for the emperor without conferring with other doctors. His chengqitang formulary was derived from medical texts by Zhongjing ZHANG. Kyugo GODA (合田求吾) on the other hand, was a pupil of Ikkannsai MATSUBARA (松原一閑斎), who wrote in the <i>Idokikigaki</i> (医道聞書) : the<i>Koho</i> (古方) school started by Ryokyu ARIMA. He was a hero who was punished by the Goseiin (後西院) emperor. He taught <i>Koho </i>to Tenmin. This therefore reveals that Ryokyu ARIMA was a teacher who taught the importance of the <i>Shanghanlun</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.

The Usefulness of the Kampo for the Improvements of the Athletes Performance \lq\lqA new Management of Athletes by Kampo Medicine\rq\rq / 日本東洋医学雑誌

From a point of stress, the competitive sports are totally different from exercises for the health promotion. It would be even harmful especially for middle-distance or long-distance women runner. It brings them paramenia, defatigation and other orthopedic troubles which makes them unable to exercise further more.We have investigated the possibility of the preventive use of Kampo Medicine for those athletes and found that it is useful. The nine women who belong to the Tohoku-Region women team of long-distance relay road race had received Kampo medical treatment for 7 months. Serum CPK and AST were elevated with training exercise. In the cases whose CPK level was above 500 IU/l, most of them suffered from fatigue, leg pain, low back pain, and lower abdominal pain, which is very important for Kampo diagnosis. Because these symptoms unable athletes to exercise as planned, we understand that for the improvement of physical capacity, it is important to prevent those symptoms. For the treatment and prevention of the symptoms, we prescribed Keishibukuryogan, Rikkunshito, and Shimotsuto. We defined preventive medication period as “Mibyou” and continued to use Kampo medicine for 7 months. During the period, they were free from any troubles that would make them unable to exercise. These medicines enabled them to improve their records drastically. This study shows that preventive use of Kampo Medicine is extremely effective for any athletes to maintain their good conditions.