<b>Proposal of New Method for Abdominal Diagnosis in a Standing Position</b> / 日本東洋医学雑誌

The abdominal diagnosis plays an essential role in Japanese Kampo medicine. Moreover, this diagnostic method is a characteristic practice in Kampo medicine. The conventional method of abdominal diagnosis is performed with the patient in a supine position. However, the author has found that several patients have presented with tenderness of the epigastrium or hypochondrium in a standing position, which was not detected in a conventional supine position. This paper is intended to announce the significance of a new method of abdominal diagnosis named “Ritsuishin”. In this paper, the author describes the utility of this method via a case of saikokeishikankyoto and of hontonto (Chugoho).

<b>Standardization of Kampo Medical Findings in a Specialized Kampo Medical Service Facility </b> / 日本東洋医学雑誌

Standardizing Kampo medical findings is a significant challenge in Kampo medical circles. These findings are fundamental to Kampo diagnosis. This paper introduces our attempt to standardize these findings in a specialized Kampo medical service facility.<br>We started our project with verbal standardization. Nine medical doctors, all of whom were Kampo advisors or Kampo specialists, discussed issues such as subjective and objective findings, including those of the tongue, pulse, and abdomen, as well as the selection of target items, criteria for judgments on each item, and associated issues. When discussing the above issues, descriptions in prominent traditional Kampo texts were given most importance, and the wisdom of famous Kampo doctors since the Showa period was also given weight. In addition, we focused attention on clarifying the criteria for making judgments.<br>One hundred and twenty items were selected as subjective Kampo findings. We selected 12, 6 and 10 items as objective Kampo findings in the tongue, pulse, and abdomen, respectively, and provided criteria for judgments with each.<br>Our next challenge is to spread these standardizations in Kampo medical circles.

Evaluation of a simulator for teaching clinicians abdominal palpation in the kampo style / 医学教育

In kampo medicine, an illness is considered to affect the entire body, even if the symptoms appear only in the abdomen. Abdominal palpation is considered an important diagnostic physical examination in kampo medicine. Because learning the kampo style of abdominal palpation is difficult, we attempted to simplify the process by developing typical models of 6 important kampo abdominal diagnoses (shinka-hiko, kyokyo-kuman, fukuchokukin-renkyu, shofuku-fujin, shofuku-koman, and shinkabu-shinsuion).1) When we discussed abdominal palpation in lectures on kampo medicine for clinicians we also assessed the opinions and impressions of participants about the abdominal palpation simulators. 2) We administered an anonymous questionnaire survey about interest in kampo medicine, the understanding of abdominal palpation in the kampo style, and an evaluation of the abdominal palpation simulators. We obtained 149 replies from participants of the 11 lectures. 3) Of the participating physicians, 85.2% were interested in kampo medicine. However, 23.5% of physicians were not familiar with abdominal palpation in the kampo style. 4) Furthermore, 58.4% of physicians thought that kampo-style abdominal palpation was explained well or very well in the lecture with the abdominal palpation simulators. The abdominal palpation simulators were judged to be useful or very useful by 72.2% of the physicians. 5) In conclusion, the abdominal palpation simulators were considered to be useful for learning abdominal palpation in the kampo style, even though these simulators have some shortcomings. These models may be useful for simplifying the learning of abdominal palpation by students of kampo medicine.

Improvement of A Simulator Production Project for Abdominal Palpation in Kampo Medical Training / 日本東洋医学雑誌

In Kampo medicine, sickness is regarded as affecting the whole body even though the symptoms may appear obvious only in the abdomen. This makes abdominal palpation an important means of physical examination, and diagnosis. Because learning abdominal palpation in the Kampo style is very difficult, we attempted to simplify learning by building typical anatomical abdomen models for training. To create six abdominal models : Shinka-hiko, Kyokyo-kuman, Fukuchokukin-renkyu, Shofuku-fujin, Shofuku-koman, and Shinkabu-sinsuion, we employed several materials, including artificial leather for epidermal tissue, pile fabric for subcutaneous tissue, cotton cloth or jersey cloth for membrane tissue, polyurethane or natural rubber for muscle tissue, specialized polyester resin for costae, and cotton for internal organs. We employed a harder polyurethane, for example, in Shinka-hiko to simulate resistance in the region beneath the heart, in Kyokyo-kuman to simulate resistance in the subcostal region, and in Shofuku-koman to simulate horseshoe-shaped resistance in the lower abdominal region. Otherwise, in Shofuku-fujin, a lack of resistance was simulated by a defect in the polyurethane at the center of the lower abdominal region. Shinkabu-sinsuion was modeled using a water dabbling sound via a water-filled balloon that could be gently shaken with the fist in the region above the navel. Fukuchokukin-renkyu was modeled as excessive strain of the rectus abdominis muscles via the use of natural rubber. We tried to represent the tenderness on pressure at the para-umbilical region, cecal region, and sigmoid region in the Shofuku-koman model by making a specialized switch with conducting rubber, and using electric device and battery. We believe these models are useful teaching devices, in that they simplify Kampo abdominal palpitation training.

Changes in Abdominal Diagnosis of Normal Newborn Infants and Babies / 日本東洋医学雑誌

Changes of abdominal diagnosis were examined in 28 cases of normal healthy children who received abdominal examinations three or more times within one year after birth. Abdominal diagnosis was done within a week after birth, and thereafter during infants' regular physical examinations. There were 19 cases of Kyoukyoukuman (fullness, tenderness or discomfort of the hypochondrium): neither resistance of the upper abdomen nor Seijouki were evident. There were 17 cases of strain in the rectus abdominas muscle recognized in all age groups (0-12 months of age). Softness of the lower abdomen was identified in 15 cases in all age groups, but the positive coefficient dropped along with age. Only one of the 15 cases occurred in infants in the 7-10 month age range. As a result of softness of the lower abdomen and Seichushin, it appears that Jin (kidney) develops rapidly by one year after birth. In all 21 cases, the abdominal strength was 2.5-3/5 for all ages.

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.