<b>A Consideration of </b><b><i>Shukuben </i></b><b>(Feces Stagnation in the Digestive Tract) </b> / 日本東洋医学雑誌

It has been thought that the term “<i>shukuben</i>” does not mean a simple constipation but rather that a substance is stagnating in the digestive tract despite ordinary defecation. However, there has been no concrete evidence for this <i>shukuben </i>definition.<br>The authors have obtained evidence for what may be one type of <i>shukuben</i>, by means of X-ray photography after an upper digestive tract examination using a barium sulfate contrast medium, in a patient with irritable bowel syndrome. The X-rays showed the contrast medium adhering to the colon wall three days post-examination despite subsequent diarrhea, suggesting one type of <i>shukuben</i>. In this paper, the authors also reported the result of a historical search for the term <i>shukuben </i>in the past medical textbooks, which revealed that the first description of this term is found in <i>hougizashi </i>and was described by Yodo Odai. We also considered that this term is a derivation of <i>shukushoku </i>meaning a stagnation of digestive tract contents.

Cases Report of Colic Pain of Lithiasis Successfully Treated with Contact Needle Therapy / 日本東洋医学雑誌

Since ancient times, acupuncture and moxibustion have been widely administrated for any emergency case. In this country, they have been endeavored at establishing the harmony between Kampo and Modern medicine. Based on such background, we report two cases of colic pain attack of lithiasis successfully treated with contact needle therapy established by Bunkei Ono.In case one, ureterolithiasis brought colic back pain. Symptoms were improved with satisfaction for one session and the stone discharged via following Kampo-medication.In case two, the patient suffered from colic epigastralgia of choledocholithiasis complicated by severe appetite loss. Although one session successfully extinguished the symptoms, blood chemistry revealed implying signs of cholangitis. A laparotomy with T-tube drainage was performed eventually.These cases pronounced the efficacy of contact needle therapy in the treatment of colic pain and invited deliberate estimation with Modern medicine. The harmony between Kampo and Modern medicine was considered as a prerequisite for clinical practice.

Cluster Analysis of First-visit Patients' Answers for Japanese-Oriental Kampo Questionnaire Supporting the Empirical Decision of Sho-syndrome / 日本東洋医学雑誌

Sho-syndrome was analyzed by cluster analysis of answers to a set of questionnaire presented to first-visit patients at a hospital of Japanese-Oriental (<i>Kampo</i>) medicine. The answers from 270 new patients were classified into 3 groups by hierarchical cluster analysis, with a total of 202 non-female related items. We looked at which Sho-syndromes of metabolic (Mb: “<i>Kan</i>-” _??_-), gastrointestinal (Gi: “<i>Hi</i>” _??_-), respiratory (Rp: “<i>Hai</i>-” _??_-), or water and mineral-balance (Wm: “<i>Zin</i>-” _??_-) deficiency (“<i>Kyo</i>” _??_) disorders were included, in one of the groups at high frequencies. Water and mineral-balance deficiency disorders were in Group II and III, while metabolic deficiency disorders were in Group III. We conclude that the results of this analysis support the rationale for the empirical determination of <i>Sho</i>-syndrome, in addition to pulse diagnosis by <i>Kampo</i>-clinicians who examine patients.

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.

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.

The Correlation Between Signs of Kampo Medicine and Visceral Fat Obesity / 日本東洋医学雑誌

Visceral fat obesity is closely associated with lifestyle-related diseases that include symptoms such as hypertension, diabetes mellitus, hyperlipidemia, etc. To examine the correlation between pulse, appearance of tongue, and abdominal palpation-diagnostic indicators according to Kampo medicine-and visceral fat obesity, we investigated 209 subjects who received health screenings, and obtained the following results. 1) The simply obese subjects, as determined by body mass index, showed symptoms of excess state, Kidepression, and stasis of body fluids according to the diagnostic techniques of Kampo medicine. 2) The visceral fat-rich subjects were diagnosed by means of abdominal ultrasonography and showed symptoms of pulsus maximum and Oketsu (blood stasis) state.

Four Cases Report of Intractable Pressure Ulcers Effectively Treated with Kigi-kenchu-to-ka-bushi / 日本東洋医学雑誌

Four intractable decubitus ulcer patients who had not responded to any Western medicine were treated effectively with Kigi-kenchu-to-ka-bushi. Case 1 was a 82-year-old female patient who had been admitted due to multiple-cerebral infarction. She had been bedridden and suffered repeatedly from pressure ulcers. Her bed sores were controlled successfully with Kigi-kenchu-to-ka-bushi. After treatment by Kigi-kenchu to-ka-bushi, any decubitus ulcer was not recurrence. Case 2 was a 85-year-old female patient. The pressure ulcer was 2cm in diameter and extent of soft tissue fissure underlying it was about 10cm in diameter. Skin color around pressure sore changed to purple. After administration of Kigi-kenchu-to-ka-bushi, skin color returned to normal and decubitus ulcer recovered. Case 3 was a 59-year-old male patient who had undergone operation on an intractable decubitus ulcer with fistula, but he did not get well. Two weeks later, after treatment with Kigi-kenchu-to-ka-bushi, he felt pain when we sterilized his ulcer. It was thought to be a sign of improvement of the wound. Physical status became better as the ulcer healed. Case 4 was a 64-year-old female patient with brain death because of acute myocardial infarction. Her pressure ulcer was treated effectively with Kigi-kenchu-to-ka-bushi, too.

The Correlation Between Pulse, Tongue and Abdominal Palpation Signs as Measured by Kampo Medicine Diagnostic Techniques / 日本東洋医学雑誌

To clarify the correlation between pulse, appearance of the tongue and abdominal palpation signs as measured by Kampo medicine diagnostic techniques, we investigated 488 cases who received health screening. In addition we investigated the effects of smoking and drinking alcohol on pulse, tongue and abdominal palpation signs, and also the correlation between the findings of blood biochemical tests, and the pulse and appearance of the tongue, and obtained the following results.<br>1) In normal pulse the abdominal power and the tension of lower abdominal wall elevate, and the subjective palpitations of the upper umbilicus and the fluid sound in the stomach upon palpation were faint.<br>2) In elevated pulse abdominal power increased and the subjective palpitations of the lower umbilicus were faint.<br>3) As the oppressive pain on bilateral area near the umbilicus increased, the petechia often occurred.<br>4) The epigastric throbbing pulsation over epigastric region showed the positive correlation with transverse dehiscence.<br>5) Positive correlation was shown between the oppressive pain on the left area near the umbilicus and the purple tongue coating.<br>6) Smokers are apt to have red or purple tongue and tend to show yellow, thick, or ? residue-like (_??__??_) tongue coating. During abdominal palpation the positive correlation was shown between the frequency of smoking and the tonus of the left rectus abdominis muscle.<br>7) The amount of drinking alcohol and the abdominal power show positive correlation, and negative correlation with the subjective palpitations of the upper umbilicus.<br>8) The value of hemoglobin and hematocrit were often increased when a red tongue coating, purple tongue coating, petechia or a thick tongue coating were shown, and were decreased in ? emaciation (_??__??_).<br>9) The value of amylase showed a negative correlation with the red, thick, ??_??__??_, ? residue-like (_??__??_) tongue coating.

Case Report of Bukuryo-shigyaku-to / 日本東洋医学雑誌

Literature on Bukuryo-shigyaku-to describes it as “those who perspire, have diarrhea, do not recover from disease and are afflicted by restlessness.” In this study we examined 4 cases where the administration of Bukuryo-shigyaku-to had an effect, where complaints which accompanied autonomic disorder and psychoneurosis brought about by automobile accidents were diagnosed as restlessness. With the experience of these cases and consideration of the literature, we consider the following to be appropriate states of illness for the administration of Bukuryo-shigyaku-to in psychoneural sicknesses.<br>1) states of illness where conditions of psychological introversion caused by such things as fear, heart palpitations, and depression exist, and it is necessary to lift spirits.<br>2) states of illness where such Ki-depressions as whole body weariness and lack of appetite exist.3) states of illness where such stasis of body fluids as dull headache and dizziness exist.<br>4) where epigastric region tenderness and abdominal palpitations exist.

The Correlation Between Abdominal Palpation Signs of Kampo Medicine and Laboratory Data / 日本東洋医学雑誌

There have been few studies on the relationship between the body mass index (BMI), complete blood cell count, blood chemistry, fatty liver evidence and Kampo abdominal palpation signs. This study was designed to clarify the above points. It involved 484 subjects who had undergone full physical examinations. The results of this study, can be summarized as follows:<br>1. Abdominal tension (traditionally referred to as “fukuryoku”) was related to BMI (males and females), TG, TCh/HDL, GPT, RBC, Hb and evidence of fatty liver (males) and corresponded negatively with HDL (males).<br>2. Tonus of the rectus abdominis muscle (“fukuhikokyu”) was negatively related to BMI (males).<br>3. The sound of gurgling liquid in the stomach (“shinsuion”) was negatively related to BMI (males and females).<br>4. Palpitations of the abdominal aorta in the upper abdomen (“shinkaki”) was related toHDL (males) and negatively related to BMI (males and females).<br>5. Palpitation of the abdominal aorta below the navel (“saikaki”) was negatively related to BMI (males).

The Correlation Between Abdominal Palpation Signs of Kampo Medicine and Anatomical and Physiological Findings of the Cardio-respiratory System / 日本東洋医学雑誌

There have been few studies of the relationship between respiratory function, chest x-rays, electrocardiograms, and the abdominal palpation signs of Kampo medicine. This investigation was designed to elucidate the above points with 489 subjects who had undergone a full physical examination. As a result of this study, we make clear the following features:<br>1. Abdominal tension (traditionally referred to as “fukuryoku”) was related to vital capacity, lateral distance of the thorax, CTR, counter-clockwised axis deviation of QRS, and negatively related to the intra-vertical thoracic distance.<br>2. Sound of gurgling fluid in the abdomen (“Shinsuion”) was related to intravertical distance of the thorax, clockwise axis deviation of QRS, negatively related to the lateral distance of the thorax, width of the heart and CTR.<br>3. Tonus of the rectus abdominis muscles was related to vital capacity and intravertical distance of the thorax and negatively related to the lateral distance of the thorax.<br>4. Palpitation of the abdominal aorta (traditionally called “Shinkaki”, “seijouki”, and “saikaki”) revealed nega tive correlation to the lateral distance of the thorax and width of the heart.<br>5. Resistance or tenderness upon pressure in the epigastric resion (“shinkahiko”) was negatively related to the intrathoracic distance.<br>6. Resistance resembling a string of pearls in the midline of the lower abdomen (“seichushin”) was related to intravertical distance of the thorax, clockwise axis deviation of QRS, and negatively related to SV 1 electro cardiogram voltage.

A Study of the Differences in the Clinical Use of Atractylodes Japonica and Atractylodes lancea in Kampo Formulas / 日本東洋医学雑誌

In the classical Oriental medical texts the “Shang Han Lun” and the “Jin Kui Yao Lue”, no clear distinction is made between Atractylodes japonica and Atractylodes lancea. Even today, no sharp critical distinction is made between the usage of these crude drugs in Kampo formulas. The authors have attempted to elucidate the differences in their clinical effect by investigating the way patients reacted when the two crude drugs were interchanged in Kampo formulas the patients were taking.<br>It was found that Atractylodes lancea was more effective than Atractylodes japonica for patients with arthralgia. Of the effective cases, 60% reported that the formula had a pleasant taste, while 9% reported it tasted bad. This suggested that taste may play a significant role in patient's responses to Kampo formulas.

Two Cases of Report of Bedridden Aged Patients Effectively Treated with a Kampo Prescription Ogi-kenchu-to / 日本東洋医学雑誌

Two cases of bedridden patients effectively treated with the Kampo formula Ogikenchu-to are reported. The first case was a 76-year-old female. She had been admitted to a hospital for about five months due to subarachnoid hemorrhage and had been bedridden because of a lack of volition. She was transferred to Riverside Hospital for rehabilitation. At the time of her admittance, her legs were paralyzed with disuse atrophy and her activity of daily living was very restricted. The authors prescribed Ogikenchu-to for her. Her activity of daily living (ADL) showed improvement day by day, and she was finally able to walk with the help of a walking supporter.<br>The second case involved an 86-year-old female who was hospitalized in a clinic with a compression fracture of the lumbar spine. She had been bedridden for about two years. After being transferred to Riverside Hospital for rehabilitation. Ogikenchu-to was administered. Her willingness to participate in rehabilitation gradually improved. She regained the ability to sit up straight, and could walk with a cane. She now enjoys her life with her family.<br>These clinical case studies suggest that Ogikenchu-to may be useful in the treatment of aged bedridden patients.

The ‘Kenjuroku’: Clinical Case Reports by Yoshimas Todo / 日本東洋医学雑誌

The ‘Kenjuroku’ is a book of 54 case reports written by Yoshimasu Todo in 1763. The cases studies of four Buddhist monks (Gyokutan, Soboku, the director of Seikoji temple, and the son of the director of Shorakuji temple) from Toyama prefecture are described. Through an investigation of the biographies of these men, the authors attempted to determine the disease condition and symptoms present at the time of their meeting with Todo and inclusion in his book. These four cases were unique in that they appeared to have actively accepted Todo's new medical theories. This led to a discussion of the analogous aspects between his theories and the doctrine of Jodo-shinshu.

A Trial of Kampo Therapy for Primary Biliary Cirrhosis / 日本東洋医学雑誌

The results of a trial treatment of primary biliary cirrhosis using combined Kampo and conventional drug therapy are reported.<br>A 79-year-old female with a chief complaint of pruritis was diagnosed as having primary biliary cirrhosis because of elevations in serum alkaline phosphatase, serum bilirubin, serum IgM, and positive tests for antimitochondrial antibodies and anti-M2.<br>In accordance with the Kampo diagnosis, she was first treated with Shinbu-to, which, however, did not cause any clinical alleviaton of the itching. Shishihakuhi-to was then given concomitantly, which resulted in the disappearance of the pruritis on the second day. Ursodeoxycholic acid was also added to her treatment from the 2nd month on. The serum level of bilirubin was observed to decrease gradually thereafter.<br>This case suggests that Kampo therapy, combined with the Western medical drug ursodeoxycholic acid, may be effective in the treatment of primary biliary cirrhosis.

A Study on the Relationship between Thickness of Tongue Coating and Pancreas Exocrine Function by Pancreatic Function Diagnostant / 日本東洋医学雑誌

The relationship between tongue coating and Pancreas exocrine function was investigated in 45 cases by pancreatic function diagnostant. These cases were classified into three groups, “slight, ” “moderate” and “marked” according to the degree of thickness of tongue coating. Among the three groups, the mean rate of PABA excretion in urine tended to decrease as the degree of thickness of the tongue coating increased. That in the marked group was lower than in the slight group with statistical significance. The results suggest that thickness of tongue coating is partially related to pancreas exocrine function.

A Case of Reccurent Crohn's Disease Effectively Treated with Kampo Medicine / 日本東洋医学雑誌

In 1989, a 17-year-old male patient had fever and was admitted to a hospital in his neighborhood. He was then diagnosed as having Crohn's disease of the colon and ileum. His condition improved when treated with parenteral hyperalimentation via the central vein, an elemental diet, and salazosulfapyridine. Every time a normal diet was introduced, it recurred, which required a second hospitalization. At the third recurrence in July 1992, he expressed the desire to have Kampo medicine and subsequently visited our department. The inflammatory reactions were severe, and he had fever and was losing weight. He was fasted and given parenteral hyperali-mentation via the central vein. He received Kyuki-kyogai-to and Hange-shasin-to concomitantly which were prescribed according to his kampo diagnosis. One month later, CRP was negative and an elemental diet was started. Two months later, he was able to take both elemental and normal diets. Remission is still being maintainned even after he started the normal diet again.<br>Kampo medicine achieved a prolonged remission in this case where Crohn's disease kept recurring when hyperalimentation therapy was given, This suggests that a combination of an elemental diet and Kampo medicine may play an important role in maintenance therapy for this disease.

A Study of Pulse, Tongue, and Abdominal Palpation Signs as Measured by Kampo Medicine Diagnostic Techniques on Subjects who Received a Full Physical Examination / 日本東洋医学雑誌

In order to establish signs in healthy subjects of pulses, tongue, and abdominal palpation determined by diagnostic techniques used in Kampo Medicine, we performed such diagnostic techniques in 71 subjects who had undergone a full physical examination and shown no abnormal signs from the viewpoint of western medicine. Pulses in men were often of medium depth, of medium speed, slightly large and substantive. There seemed to be at least two types of pulse in women, one was similar to the pulse signs found in men while the other was pulses of medium depth, of medium speed, small, and slightly deficient.<br>The tongue was pale pink, slightly damp, and slightly enlarged. The coating of the tongues was white or slightly white. Abdominal palpation often detected fullness, tenderness or discomfort of the hypochondrium (males and females), right paraumbilical tenderness (females), palpitation above the umbilicus (females), and softness below the umbilicus (males). A statistically significant difference between male and female subjects was noted in softness below the umbilicus which was more common in males, and in paraumbilical tenderness and palpitation above the umbilicus, which was more common in females. There was a significant correlation among signs of abdominal palpation.