ABSTRACT
We investigated the history and indications of Toenho, Kinseiho, and Cho-Sanshaku-Shinteiho, which are different formulae with the same name of seishoekkito. According to the description in “Futsugoyakushitsuhokankuketsu” written by Sohaku Asada, Kinseiho exhibits an immediate effect, while Toenho has preventive effects. However, according to the original text, Kinseiho was formulated such that it could be administered regularly in the summer for prophylaxis. Furthermore, Kinseiho is regarded as a simplified formula with the central structure of Toenho. This implies that Kinseiho is composed of selected crude drugs used in Toenho that are responsible for the main effects of Toenho, such as invigorating spleen energy, clearing fever and generating body fluids. Moreover, there is an instruction to arrange Kinseiho to fit each patient’s condition. In this study, it was found that Cho-Sanshaku-Shinteiho described in “Futsugoyakushitsuhokankuketsu” is a modification of Kinseiho prescribed by Katsuki Gyuzan for patients with fever, consistent with the concept of personalized medicine. The medical extract preparation seishoekkito, which is currently widely used, is Kinseiho. We may use it with heat-clearing formula, fluid-regulating formula or some modifications to make the appropriate formulation based on the patient's symptoms.
ABSTRACT
The Japan Society for Oriental Medicine (JSOM) has made various efforts against coronavirus disease (COVID-19) to build evidence. JSOM has launched an academic society-led clinical research project on COVID-19 based on the concept and characteristics of Kampo medicine, including (1) prevention of disease by activating the immune system to regulate body conditions (pre-symptomatic stage of illness), (2) symptom alleviation in the mild and moderate stage and prevention of aggravation (acute to subacute stage of illness), and (3) early recovery and improvement of prolonged symptoms (late stage of illness). Since the declaration of the pandemic, the special working group has conducted the following activities : enlightening academic members, lobbying other academic societies, preparing research protocols, establishing research groups, conducting ethical reviews, responding to the research disclosure system, preparing protocol papers and review articles as the basis for the research, reporting research progress, soliciting case reports, warning against Chinese medicine use, requesting for research support funding, and revising the JSOM website. We also discuss the interpretation of COVID-19 from the perspective of Kampo medicine and the direction of the selection of Kampo formulas in this report.
ABSTRACT
A commemorative lecture meeting on the inclusion of a new chapter of traditional medicine in ICD-11 was held in Tokyo in February 2020. The head of the Collaborating Centre for WHO-FIC in Japan explained the process of the project, which started in 2006 to increase WHO's data collection from developing countries and expressed gratitude to the concerned persons who made efforts to obtain consensus with China and Korea. WHO promoted integrated coding between traditional medicine and Western medicine. In the field of acupuncture, meridian and collateral patterns proposed by Japan were adopted and research activities have begun. In the field of Kampo medicine, the prescription content is often used in a fixed form as a representative formula pattern in Japan, so clinically high-level research will be possible under this new classification. In the field of medical information, it has been pointed out that there are high hurdles for medical information managers to understand traditional medicine. It is expected that the progress of mutual understanding of both medicines. From now on, activities in research, translation, education and dissemination of this new classification should be promoted.
ABSTRACT
To help medical doctors practicing Kampo medicine suggest appropriate acupuncture treatments for individual patients, a study group made up of 7 acupuncturists and 5 medical doctors developed an acupuncture curriculum. The group provided a learning program based on the curriculum for 16 medical doctors in charge of outpatient Kampo services in a research institute. The learning program consisted of a lecture and practical training, and a total of 4 sessions were held. At the end of each session, a test was conducted to examine the participants' level of understanding. After the completion of the learning program, a questionnaire survey was conducted to confirm the usefulness of the acupuncture curriculum for the practice of Kampo medicine. The mean number of participants per session was 10.8 ± 1.3. The mean test score was 9.3 ± 0.5 (full score : 10). In the questionnaire, 14 out of the 16 (88%) answered that the acupuncture curriculum was useful or relatively useful for the practice of Kampo medicine. On comparing the numbers of new acupuncture patients with a history of outpatient Kampo service use before and after the acupuncture curriculum, there was a 1.8-fold increase after it. The results support the usefulness of the acupuncture curriculum to understand acupuncture and practice Kampo medicine. Further evaluation is necessary.
ABSTRACT
The patient was a 44-year-old man with right facial paralysis as the main complaint. Upon resection of a benign parotid gland tumor (6 cm in diameter), one of the buccal branches of the right facial nerve was severed. Immediately after the surgery, facial nerve paralysis occurred in the areas innervated by the buccal and marginal mandibular branches. Therefore, on the 5th day after the surgery, acupuncture was started. The paralyzed facial site was treated weekly for 15 minutes by inserting a disposable acupuncture needle (40 mm in length and 0.16 mm in thickness) about 5 mm deep into the site. As a result, the discomfort around the right ear was alleviated and the right facial nerve paralysis was gradually improved and cured in 6 months after the onset. Acupuncture may have prevented secondary changes such as tissue scarring and atrophy after the surgery, and promoted healing. The paralysis of the areas innervated by the buccal branches may have been improved through rerooting from the other branches in the periphery region of the neurectomy site. The present case is informative in considering the indications of acupuncture.
ABSTRACT
Few reports currently exist demonstrating that Kampo medicine is effective for dry nose. Here, we describe three cases of dry nose that were successfully treated with hachimijiogan or rokumigan. The chief complaints of the three cases differed. Dry nose was the second or third most troublesome symptom. The three cases had kidney deficiency and its typical symptom of abdominal numbness in common. Upon administration of hachimijiogan or rokumigan, dry nose improved promptly, along with the improvement of kidney deficiency. In addition, it became easier for all three cases to breathe. According to “Pu ji fang”, dry nose is ascribed to wind-heat or kidney deficiency. The kidney is considered to control the reception of qi inhaled by the lungs. Taken together, we speculate that dry nose of the three cases were due to kidney deficiency, because treatment with hachimijiogan or rokumigan improved their dry nose along with the improvement of their kidney deficiency as well as their breathing which suggests the improvement of the reception of qi inhaled by the lungs. Hachimijiogan or rokumigan is shown to be effective for dry nose in the patients with kidney deficiency.
ABSTRACT
We report five female patients (range 33-54 years) with irritable bowel syndrome (IBS) that were successfully treated with ireito-based prescriptions. Showing yin deficiency and weak constitution, they maintained a good state of bowel movement with warming and invigorating prescriptions. However, when it became hot around March to June and these patients encountered stressful conditions, they became thirsty and tended to take a lot of cold food and drink. Then, they developed diarrhea, epigastric and/or abdominal fullness, anxiety and depressive feeling, which are regarded as due to qi stagnation. Stuck sensations in pit of stomach by abdominal examination were reported in all cases. Their symptoms were derived from water retention and qi stagnation, and therefore, we prescribed ireito for one patient, ireito with keishikashakuyakuto or kenchutobased prescriptions (ogikenchuto or shokenchuto) for 3 patients, and ireito with keishibukuryogan for one patient. Ireito is composed of heiisan and goreisan. The Chinese herbs Magnolia Bark and Citrus Unshiu Peel in heiisan not only help the digestive system, but also improve qi stagnation. These results suggest that ireito,containing Peony Root, is effective for patients with IBS, who show stuck sensations in the pit of stomach and suffer from diarrhea with abdominal pain after taking cold food and drink under stressful conditions.
ABSTRACT
In Kampo medicine, general fatigue is categorized as a symptom caused by qi deficiency according to the qi-blood-water criteria. However, in some patients with general fatigue, formulae for qi deficiency are not effective, and this might be because their chronic symptoms are associated with blood stagnation. Recently, we encountered ten patients (M/F 1/9, mean age 46 years, range 23-55 years) with general fatigue that was improved by agents for treating blood stagnation, such as keishibukuryogan and/or tokakujokito. These patients, who were mostly of medium build, complained of neck or shoulder stiffness (9/10), constipation (5/10), and blushing or hot flushes (5/10). They had no problem with appetite, except that 5 patients tended to overeat. Remarkable sublingual collateral vessels (8/10), paraumbilical tenderness (9/10) and periorbital dark circles (5/10) were observed on physical examination. The tongue and abdominal signs improved or had disappeared after treatment for 3 to 8 months. Our results suggest that patients with general fatigue, but who present with symptoms associated with blood stagnation, could be treated with drugs for blood stagnation such as keishibukuryogan and/or tokakujokito.
ABSTRACT
PURPOSE: Gastric adenocarcinoma of the fundic gland type (chief cell predominant type) (GA-FG-CCP) was first reported as a rare adenocarcinoma found in the normal fundic mucosa. Recent studies have proposed the possibility that GA-FG-CCPs were also generated in the atrophic mucosa after Helicobacter pylori (HP) eradication therapy. However, little is known on the endoscopic findings of GA-FG-CCP generated in the atrophic mucosa due to its extreme rarity. MATERIALS AND METHODS: A total of 8 patients who underwent endoscopic submucosal resection and were diagnosed with GA-FG-CCP generated in the HP-uninfected mucosa (4 cases, HP-uninfected group) or HP-eradicated atrophic mucosa (4 cases, HP-eradicated group) were retrospectively analyzed, and their endoscopic findings, including magnifying endoscopy with narrow band imaging (M-NBI), and pathological features were compared. RESULTS: While GA-FG-CCPs in the 2 groups displayed similar macroscopic appearance, M-NBI demonstrated that characteristic microvessels (tapered microvessels like withered branches) were specifically identified in the HP-eradicated group. Pathological investigation revealed that a decreasing number of fundic glands and thinned foveolar epithelium covering tumor ducts were thought to lower the thickness of the covering layer over tumor ducts in the HP-eradicated group. Moreover, dilation of vessels just under the surface of the lesions contributed to the visualization of microvessels by M-NBI. CONCLUSIONS: The change in background mucosa due to HP infection influenced the thickness of the covering layer over the tumor ducts and M-NBI finding of GA-FG-CCP.
Subject(s)
Humans , Adenocarcinoma , Endoscopy , Epithelium , Helicobacter pylori , Helicobacter , Microvessels , Mucous Membrane , Narrow Band Imaging , Retrospective Studies , Stomach NeoplasmsABSTRACT
Gastroesophageal reflux disease (GERD) can cause not only esophageal symptoms, but also extraesophageal symptoms such as globus pharyngis. Here, we describe a case of globus pharyngis in GERD successfully treated with seinetsuhoketsuto. A 72-year-old female began to have tingling in her pharyngolarynx in February 20XX. Otolaryngologist did not point out abnormal findings. However, reflux esophagitis was detected by upper gastrointestinal endoscopy. Although treatment with rabeprazole relieved the tingling, she experienced a relapse in September 20XX and visited our clinic in November. We prescribed seinetsuhoketsuto because she exhibited numerous blood deficiency-related symptoms including dryness of the skin and eyes, shallow sleep, coldness in the feet, etc. The tingling then decreased rapidly and disappeared in two months. In addition, dryness of the skin and eyes and her sleep also improved markedly. Seinetsuhoketsuto has been regarded as a medication for inflammation in the mouth such as oral ulcers and erosions. However, this case indicated that seinetsuhoketsuto could also be utilized to treat symptoms in the pharyngolarynx due to GERD.
ABSTRACT
In female patients with migraine, the triggering or exacerbating factors for migraine including stress, menstruation and fatigue, should be treated intensively in addition to treatment for headache. Patients with coldness and weak constitution become a state of qi and blood deficiency in terms of Kampo medicine under the circumstances of severe fatigue, lack of sleep and menopausal symptoms. They tend to suffer from migraine at around the 4th or 5th day of menstrual period after rather heavy menstrual bleeding on the 2nd or 3rd day. We experienced 4 patients with headache during the late period of menstruation whose symptoms were successfully treated by juzentaihoto known to improve qi and blood. In Case 1, daily prescription was changed from unkeito to juzentaihoto. In Case 2, during the 7 days of menstrual period, juzentaihoto was added to tokishigyakukagoshuyushokyoto, while juzentaihoto was substituted for tokishakuyakusan in Case 3 and Case 4. In 9 cases of headache, including these 4 cases, juzentaihoto was efficacious against migraine headache during the late period of menstruation with coldness (9/9 cases), fatigability (9/9 cases) and dryness symptoms (7/ 9 cases). These results indicate that juzentaihoto is effective for migraine during the late period of menstruation, especially in patients with fatigue after menstrual bleeding. The administration period of juzentaihoto should be individualized for each patient depending on the severity of qi and blood deficiency.
ABSTRACT
We describe three cases of insomnia due to a feeling of heat in parts of the body, successfully treated with saikokeishito. Case 1 was a 50-year-old man who felt hot in his trunk and extremities at night. Case 2 was a 57-year-old women with osteoarthritis in the fingers who felt hot in her back at night. Their heat/pain was regarded as shisetsuhanto, or vexing pain in the extremities as described in “Shang Han Lun.” Case 3 was another 57-year-old woman who reported hot flushes both day and night. She did not have vexing pain in her extremities, but developed a rash. Although three patients felt hot, they all felt chill when they took off a blanket. Their heat vexation and intolerance of cold were considered as zokansonetsu, as seen in saikokeishito syndrome. They had kyokyokuman, or objective tenderness in the hypochondrium. However, they differed in shinkashiketsu, or tightness below the heart, another characteristic physical findings of saikokeishito : case 1 had stuffiness and rigidity below the heart and abdominal muscle contracture, case 2 had hardness and stiffness in zhong wan (middle segment of the stomach), and case 3 had mild stuffiness and rigidity below the heart, in terms of signs classically reported by Japanese doctors in the Edo period. These findings may suggest that saikokeishito has a wide range of indications. The three cases shared several characteristics, such as during menopause, without cold limbs, moderate or hypofunctional body energy, and alternating heat and chills. Saikokeishito could be a good medicine to treat patients suffering from insomnia with such symptoms, especially during menopause.
ABSTRACT
We report three cases of depression, which were effectively treated with oriental medicine. All three patients were employees at the same workplace, which had a total of 17 employees. Case 1 was a 46-year-old, who had worked at the company for 20 years and complained of depression and insomnia. Case 2 was a 28-year-old woman, who had worked at the company for 9 years and complained of nausea and mood disturbance. Case 3 was a 41-year-old man, who had worked at the company for 15 years and complained of restlessness, insomnia, and depression. The three patients were treated with yokukansan and yokukansankachimpihange, which are Kampo formulations, and subsequently showed improvements in symptoms. In choosing prescriptions for these patients, we considered the fact that all three patients worked in the same workplace. Yokukansan is traditionally co-administered to mother and her child. Furthermore, Hoffman (1984) proposed the system of sharing emotional contagion in the field of neuropsychiatry. When considered holistically, medication shared by mother and child is an empirical treatment taking into account emotional contagion. This treatment is also considered applicable within a single community, such as the one in the same workplace. Shared medication that takes into account emotional contagion within the same workplace, could be useful as it was for our patients.
ABSTRACT
Our institute performs retained acupuncture for cold-related symptoms using planar electric heaters. After placing retained acupuncture needles at 8 points on the lower back, the site is covered with a planar electric heater and heated for 20 minutes, with the 6-channel dial of the device set at 5, the second highest temperature. Using this method, we treat and examine patients with cold-related symptoms. If patients feel discomfort during the heating process, the procedure is continued when heat is used for treatment and immediately terminated in the case of examination. On examining related adverse events in 75 cases (224 sessions) within the 8-month period between March and October 2016, there was soreness/irritation of the skin surface in 5 (2.2%), itching in 3 (1.3%), and physical deconditioning in 1 (0.4%). However, all of these events were mild and temporary, supporting the safety of the method. As a future challenge, it may be necessary to expand this study to clinical research on traditional Chinese medicine and acupuncture/moxibustion.
ABSTRACT
Soshikokito has long been used to treat cough in frail patients with cold sensation in their feet, based on the Japanese traditional Kampo textbook “Iryo-Shuhou-Kiku”. In many old documents including “Wazai-Kyokuho,” where soshikokito was first described, it is suggested that airways obstructed by a large quantity of watery expectoration should be the proper indication for the use of this formula. However, in the five cases that we successfully treated, the quantity of sputum was relatively small. To determine the practical indications for this, we examined their abdominal strength and the presence or absence of “cold feet” sensation. In addition, we investigated the nature of sputum in the past clinical reports in which successful treatment using soshikokito was described. It has become clear that we can prescribe soshikokito as an antitussive regardless of the patients' physical fitness as deduced from the abdominal strength. The “cold feet” sensation was not an essential symptom and was regarded as one of the symptoms of qi counterflow. Regarding the properties of sputum, it was viscous and small in quantity. In the cases where soshikokito was effective, it was speculated that viscous sputum would result in airway obstruction, coughing, and wheezing. These conditions will be ameliorated by the antitussive and expectorant effect of this formula, which improves qi counterflow and mildly tonifies water. In the treatment of cough with respiratory distress, “sputum with high viscosity and hard to discharge” is considered to be the targeted symptom in the practical usage of soshikokito.
ABSTRACT
Allergic rhinitis is an allergic disease affecting the nasal mucous membrane, and is aggravated by many kinds of factors. Here we describe 4 cases of allergic rhinitis successfully treated with tokishakuyakusan. Case 1 was a 31-year-old woman who suffered from coldness and irregular menstruation. We administered tokishakuyakusan, and her allergic rhinitis improved. When she stopped taking tokishakuyakusan, her allergic rhinitis recurred. Case 2 was a 40-year-old woman who suffered from seasonal pollenosis every year. Her pollenosis did not respond to keishibukuryogankayokuinin, administered for uterine myoma, but when we switched to tokishakuyakusan, her pollenosis improved. Case 3 was a 49-year-old woman who suffered from allergic rhinitis. She had not responded to many herbal medicines, but when we administered tokishakuyakusan, her allergic rhinitis rapidly improved. Case 4 was a 65-year-old woman who suffered from allergic rhinitis. She did not respond to kakkontokasenkyushin'i, but when tokishakuyakusan was added, her allergic rhinitis improved. Efficacy of tokishakuyakusan for rhinitis is not described in the classic literature. Our results suggest that tokishakuyakusan could be a suitable herbal medicine for asthenic, cold constitution of patients with allergic rhinitis caused by blood stagnation and blood deficiency as well as water disturbance.
ABSTRACT
The consumption and sales of Kampo products, as well as the crude drugs that make up the products, have been increasing recently. However, the Kampo industry has been exhibiting a long-term decline due to the rise in price of imported crude drugs and reduction in standard prices of crude drugs by the Japanese National Health Insurance scheme. As the production of crude drug in Japan has been decreasing for the past thirty years, efforts have been made to improve the situation. Although the production of Aizu Ginseng decreased from 153 metric tons to 8 metric tons in Fukushima, university research institutes have initiated research on expansion of the farm field for Ginseng and reduction in a cultivation term. In Nara, farmers, pharmaceutical and food manufacturers, and university research institutes, aiming to develop new products using Yamato Angelica root, organized a joint council and have been working together to establish integrated systems from cultivation to sales. The Ministry of Agriculture, Forestry and Fisheries, the Ministry of Health, Labour and Welfare, and Japan Kampo Medicines Manufacturers Association have held local meetings with farmers and pharmaceutical companies in different areas throughout Japan over the past three years from fiscal year 2013. In order to reduce national healthcare costs by Kampo medicine, it is necessary to upgrade the health care system where not only Kampo extract products but also medicinal plants as raw materials including decoctions can be used. Discussions on measures to cover the costs of domestic production of crude drugs should be required.
ABSTRACT
We treated dry eyes and eyestrains successfully with electrothermo-acupuncture and Kampo medicine. The case was a 41-year-old woman who was treated with a few eye drops. She came to our hospital to receive Kampo medicine because her photophobia and eye pain got worse. After taking shimbuto, her complaint got better with improving physical fatigue. Electrothermo-acupuncture was effective for photophobia and eye pain promptly and remarkably. After we added kihito to her, she did not need to use eye drops with improving bloody urine and sleeplessness. Photophobia and eye-ache are thought to be related to the trigeminal nerve system. In this case, we consider that the point of application of electrothermo-acupuncture is the trigeminal nerve system. At the same time, “rikan” and “hikyo” might be involved in this case with the general malaise of eye.
ABSTRACT
<p>We describe two cases of cardiac failure in elderly patients successfully treated with shimbuto. Case 1 was that of an 84-year-old man with severe aortic stenosis and liver cancer. His cardiac failure led to repeated hospitalization. After taking shimbuto, his pleural effusion decreased and cardio thoracic ratio improved. Case 2 was that of an 84-year-old man who was hospitalized because of cardiac failure and aspiration pneumonia after undergoing an operation for lung cancer. After taking shimbuto, his urine volume increased and cardiac failure improved. No notable adverse events were observed in any of the abovementioned cases. It is important that kanzo is not included in shimbuto to demonstrate <i>risui </i>action, hence the use of other “ho” formulations should be avoided. These cases suggest that shimbuto is indicated for elderly patients with cardiac failure under terminal care.</p>
ABSTRACT
<p>Constipation is one of the most common symptoms seen in elderly people, and is sometimes difficult to treat. Daikenchuto is a well-known Kampo formulation for treating ileus. Here, we report a case in which daikenchuto was not effective and constipation was effectively treated with kobokushokyohangeninjinkanzoto. The patient was an 81-year-old woman who had been hospitalized for treatment of a thighbone fracture. She was originally constipated, and her constipation had worsened over the course of hospitalization. Colonoscopy examination and abdominal computerized tomography showed no structural lesions. Her constipation improved after the administration of daikenchuto, but the improvement was transient. Since the constipation and abdominal distension worsened after she began eating again, we administered kobokushokyohangeninjinkanzoto. Subsequently, her condition improved remarkably. Eight days later, we changed the initial kobokushokyohangeninjinkanzoto to ninjinto and hangekobokuto. Her complaint did not recur, and she was discharged 17 days later. In case of deficiency pattern ileus, kobokushokyohangeninjinkanzoto may be considered as an alternative to daikenchuto. Furthermore, we believe that the combination of ninjinto and hangekobokuto is an effective alternative to kobokushokyohangeninjinkanzoto.</p>