ABSTRACT
We report a case of a 57-year-old woman with radiation proctitis (RP) treated by shiunko (SK) enema with promising outcomes. The patient underwent interstitial brachytherapy for anterior vaginal vault recurrence of uterine cancer. Nine months after the treatment, she had anal pain and was diagnosed with RP by clinical course and colonoscopy. The rectal ulcer was so severe that a surgeon proposed permanent stoma formation as one option, given eventual risk of rectovaginal fistula. The patient rejected stoma formation and opted for Kampo medicine. Though she took keishibukuryogankayokuinin for blood stasis at first, her anal pain and rectal bleeding gradually worsened. Thereafter, she mainly used SK enema, kyukikyogaito and magnesium oxide. Anal pain and rectal bleeding decreased after applying SK to the rectal wall per rectum. Magnetic resonance imaging (MRI) and colonoscopy findings of the rectal ulcer also improved. SK effectively reduced anal pain and rectal bleeding as well as stimulated tissue repair in our patient, and therefore SK is worth considering in the treatment of RP.
ABSTRACT
When female patients with skin disorders become pregnant, the treatments with the previously used antiallergic oral drugs are preferred to be switched to the treatments with external medicines alone, which often make patients experience unbearable itching and exacerbation of rashes. The use of tokishakuyakusan is known to be safe and improve various symptoms in the pregnancy period. In this report, the treatment of 4 patients with skin disorders were successfully switched to tokishakuyakusan alone from previously used antiallergic internal medicines and other traditional Japanese herbal medicines after pregnancy. Case 1 and 2 were patients with atopic dermatitis who had been treated only with the external medicine during a previous pregnancy but without amelioration. Case 3 was a patient with prurigo gestations who had rashes on the upper body trunk and complained of a strong itching sensation. Case 4 was a patient with acne vulgaris. In all cases, the rashes and itching sensation improved promptly with oral administration of tokishakuyakusan, followed by successful delivery. No side effects of gastrointestinal disorders were observed in any cases. Their skin disorders were speculated to be caused by the blood deficiency and stasis. Qi deficiency and fluid disturbance developed in association with pregnancy, which led to Yin deficiency and abundance of moisture. The positive responses of these conditions indicated that tokishakuyakusan was effective in the cases reported herein.
ABSTRACT
We investigated the decocting time to prepare the formulas containing unprocessed aconite root, such as shigyakuto, tsumyaku shigyakuto, and kankyobushito, which had been registered in “Shanghanlun” edited in Song Dynasty, using the weights and measures in Houhan Dynasty when the original “Shanghanlun” was regarded to have been established. Also the contents of aconitine-type diester alkaloids (ADA) eluted from unprocessed aconite root in the decoction were analyzed in time-dependent manners. As regards the modified formula for the “physically strong patients” in the texts of tsumyakushigyakuto in “Shanghanlun”, adding dried ginger was found to lead the decocting time to be shorter and the sum of ADA content in the decoction of the modified formula to increase about 20%. It was also found that the compositions of diterpene alkaloids derived from aconite root in kankyobushito decoction were highly different from those in shigyakuto decoction, containing less ADA and more aconine and hypaconine, due to the high pH of the decoction, which was the consequence of lacking glycyrrhiza in kankyobushito formula. It is suggested that the doctors in the era of “Shanghanlun” establishment may have carefully adjusted the contents of ADA in the decoctions using unprocessed aconite root by choosing co-decocted crude drugs.
ABSTRACT
Shiunko, topical herbal ointment, has been used in Japan for hemorrhoid and skin wound such as scratch, incision and burn. We report two cases of radiation dermatitis with erosion, which have a good outcome after treatment with shiunko. Case 1 was 72-year-old man with radiation dermatitis of bilateral inguinal region caused by postoperative irradiation for bilateral inguinal lymph node metastases from penile cancer. Re-epithelization was observed in erosion on the 10th day after applying shiunko. It showed earlier recovery from radiation dermatitis than the cases treated with topical external medicine of azulene and/or steroid. Case 2 was 60-year-old man with the perianal radiation dermatitis with pain caused by pelvic radiotherapy for recurrence of advanced rectal cancer after chemotherapy. Shiunko gave rapid relief from anal pain and the patients felt no pain on the day subsequent to applying shiunko. Shiunko hastens analgesic effectiveness and improvement of wound caused by radiotherapy.
ABSTRACT
The decoctions of unprocessed aconite root (uzu) were prepared with the tap water samples collected in Tianjin and Shanghai in China, and the contents of alkaloids in the decoctions were compared to those prepared with purified water or with tap water collected in Niigata, Japan. The contents of aconitine-type diester alkaloids (ADA) in the decoctions prepared with tap water collected in China were significantly lower than those with purified water or tap water in Niigata. It was speculated that this difference appeared by buffering effect of bicarbonic anion in tap water in China to decline pH of the decoction. When uzu was decocted with glycyrrhiza, ginger, or jujube, the contents of ADA in the decoctions exhibited the tendency to have higher levels than those prepared using unprocessed aconite root singly, and also this tendency was observed more remarkably when the decoctions were prepared with tap water collected in China. It was suggested that even the decocting period was fixed, unexpected change of the contents of ADAs might be induced by the differences in the properties of water used for decoction or the crude drugs decocted with aconite root. The physicians in the era when “Songban Shanghanlun” had established may have adjusted the contents of ADA in the decoction by carefully choosing the crude drugs combined to aconite root.
ABSTRACT
Crude drugs that feature the name “gui” have appeared in classical medicinal textbooks with different names,and the correspondence between their names and origins remains the subject of research and discussion. In the present study, we investigated these correspondences using the descriptions in the annotations of the Bencaojingjizhu and through our previous study that revealed the standards of weights and measures in this book. Based on this investigation, we strongly speculate that “gui” in the Bencaojingjizhu was the branch skin of Cinnamomum cassia (C. cassia) (corresponding to cinnamon sticks in the market), which fits with the descriptions about the length and weight of “gui” -related crude drugs in this book. We measured the contents of cinnamic aldehyde and coumarin in the branch skin of C. cassia, and compared these to contents in other crude drugs related to “gui” that can be obtained on the market. The contents of these two compounds in the branch skin of C. cassia were similar to those in the bark of C. cassia from Vietnam that meets the standards for cinnamon bark in the Japanese Pharmacopoeia and is regarded as high-grade in the market. These results support our speculation, and it might be possible that the branch skin of C. cassia can be used as medicine instead of cinnamon bark.
ABSTRACT
<p>The treatment of tinnitus is difficult with modern medicine. We encountered three cases of tinnitus for which press tack needle was effective.<br>The first case was a 65-year-old woman. She suffered from sudden deafness, and bilateral tinnitus continued for 5 years, at which point she consulted us. Her Tinnitus Handicap Inventory (THI) score was 66 points. We administered press tack needle on the bilateral Yifeng (TE 17) points. Her THI score fell to 14 points after 1 month and zero points after 2 months, at which time treatment was completed. The second case was a 69-year-old man. Forty years before his initial visit, a gun was fired near his left ear, and tinnitus developed. The tinnitus repeatedly improved and aggravated. The tinnitus continued for 8 years before his initial visit. His THI score was 18. Press tack needle was administered to his Yifeng points. The THI score lowered to 2 points after 3 months. The third case was a 31-year-old woman. Her bilateral tinnitus started 15 days before her initial visit. Her THI score was 34 points. Press tack needle was administered to the bilateral Yifeng points. Her THI score dropped to 8 points after 4 months.<br>Press tack needle to the Yifeng points is simple and straightforward. This suggested that it is a valuable method to consider.</p>
ABSTRACT
The IPCD (Immersing Powdered Crude Drugs) method, inspired by the “zhu san fa” which was widely used in the Song period of China, has been developed to prepare Kampo decoctions quickly and easily, with highyield extract from crude drugs. One trouble with the IPCD method occurs when separating the decoction from the muddy residue of the crude drug powder. When powdered ephedra herb is packed in a nonwoven fabric bag and immersed in hot water, yield of the marker compounds is much lower than that obtained when ephedra herb powder is dispersed freely in hot water without a nonwoven fabric bag. Thus the use of a nonwoven fabric bag was shown to be unsuitable with the IPCD method. In investigating an easy and more efficient separation method, we tried decanting with a commercially available wine carafe to separate the decoction and residue. With IPCD followed by decantation using the wine carafe, yields of about 80% decoction volume were obtained as compared with those when cut crude drugs are decocted and filtered using a tea strainer, in 6 of the 7 formulas tried. We find that decantation using a wine carafe is a more practical way of separation in the IPCD method.
ABSTRACT
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”.
ABSTRACT
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 cm<sup>3 </sup>was 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>.
ABSTRACT
About half of Japanese women have feelings of coldness, but there is no drug for their treatment in modern medicine. Here, we report 3 cases of dizziness with feelings of coldness effectively treated with tokishigyakukagoshuyushokyoto. The first case was a 35-year-old female with benign paroxysmal positional vertigo,the second case was a 29-year-old female with dizziness of unknown cause, and the third case was an 80-year-old female with benign paroxysmal positional vertigo. All cases were physically thin and had feelings of coldness. On Kampo medical examination, their diagnosis was <i>Rikan-kyosho </i>and <i>Kekkyo</i>. To improve feelings of coldness, we administered tokishigyakukagoshuyushokyoto to all three cases, and it was very effective. Thus, being aware of patients' coldness and using tokoshigyakukagoshuyushokyoto may be advisable when doing Kampo examinations.
ABSTRACT
As interesting results were obtained upon testing the responses in healthy adult males (age 20-54) of cutaneous touch, pain and heat sensitive points due to pressure stimulation and acupuncture stimulation at LI-4, and cutaneous touch and pain point reactions to acupumcure stimulation at St-36, we present the following report.<br>Previously it was discovered that pressure at LI-4 results in 1 decrease in the touch and pain point populations on the upper extremities on the stimulated side with the numbers returning to normal when stimulation ceased. With acupuncture stimulation, during stimulation the numbert of sensory points on the arm, thoracic and shoulder of stimulated side showed a remarkable decrease in the number of pain points. Very little change occured in thenumber of touch points however. Similar results were also reported on the abdominal area of the stimulated side with stimulation at ST-36. As for acupuncture stimulation and the cutaneous sensory point populations on the opposite side, cases of demhease in the number of sensory points and cases of no change were reported. Also it was reported that during acupuncture stimulation at LI-4 the number of heat points decreased and in 1 case returned to former levels when stimulation ceased.<br>For this study we increased the number of subjects and studied changes in the touch and pain sensitive point populations on the opposite side using acupuncture stimulation. We also examined changes in the number of heat sensitive points during acukuncture stimulation.<br>Stimulation on the opposite side produced nearly the same decrease in pain point population as did stimulation on the same side, with little change observed in the touch sensitive point numbers. The change in the number of heat sensitive points during acupuncture stimulation indicated a remakable tendency for decrease, similar to results observed with pain sensitive points. These results were obtained by studests during lab sessions.<br>We would like to find some clinical meaning in the administration of treatment on the opposite side.