All About Abdominal Palpation / 日本東洋医学雑誌

In Japanese Kampo, we use abdominal palpation as a clinical examination method. Abdominal palpation, a kind of tactile inspection method, which in turn is one of the four mainstays inspection methods (palpation, visual, auditory, and verbal), is the most effective technique giving one information to determine a patient's sho diagnosis. Moreover, abdominal palpation is the only clinical examination method of those traditional techniques passed down to the countries and regions of East Asia, which was developed solely in Japan. Abdominal palpation as it is practiced today stems mainly from the Koho-ha Old School of thought, which traces back to ancient Shokanron (Treatise of Cold Damage Disorders) text medicine, although it also influences the Secchu-ha Compromise School of thought. And although an awareness of abdominal palpation is perfunctory, it does require a certain amount of training and proficiency, as it is a skill. In this paper, we discuss abdominal palpation findings amassed over many long years since ancient times.

All About Abdominal Palpation-The Traditional Diagnosis Method / 日本東洋医学雑誌

In Japanese Kampo, we use abdominal palpation as a clinical examination method. Abdominal palpation, a kind of tactile inspection method, which in turn is one of the four mainstays inspection methods (palpation, visual, auditory, and verbal), is the most effective technique giving one information to determine a patient's sho diagnosis. Moreover, abdominal palpation is the only clinical examination method of those traditional techniques passed down to the countries and regions of East Asia, which was developed solely in Japan. Abdominal palpation as it is practiced today stems mainly from the <I>Koho-ha</I> Old School of thought, which traces back to ancient <I>Shokanron</I> (Treatise of Cold Damage Disorders) text medicine, although it also influences the <I>Secchu-ha</I> Compromise School of thought. And although an awareness of abdominal palpation is perfunctory, it does require a certain amount of training and proficiency, as it is a skill. In this paper, we discuss abdominal palpation findings amassed over many long years since ancient times.

Review of Japanese Traditional Medicine; Kampo / 日本東洋医学雑誌

Japan has created a unique culture, based on the influence and acceptance of Chinese culture since long years ago. This can also be said of medicine.<br>Traditional medicine of Japan, is called “Kampo” medicine, which had been rearranged from Chinese medicine years ago suitable for the topography, climate, and race of the Japanese islands.<br>The rearrangement of Chinese medicine to Japanese medicine started at the latter half of the 16th century. This took place during the Ming era when medical treatment was that of the Chin-Yuan era. In Japan, Li-Chu medicine was accepted among schools in medicine, and resulted in establishing the socalled Gosei-Ho school later.<br>During the 18th century, there arose a movement to search for the origin of its medicine and to follow the original medical treatment. They finally attained the “Chang Han Lun” (“Shokan-Ron” in Japanese), established in the Heu-Han era in China. Many doctors read and studied that textbook and wrote their interpretation in their own books at that time. The medical treatment based on “Shokan-Ron” is called Ko-Ho school. Also the name Kampo, traditional Japanese medicine, may be implicated by the original medical treatment of the Han (Kam in Japanese) era.<br>The unique point of Ko-Ho school in medical treatment of Japanese kampo medicine may be the restoration of the old medical textbook “Shokan-Ron” to apply for clinical practice. The following books have left great influence up to the present time, “Ruiju-ho” written by Tohdo Yoshimasu, “Fukusho-Kiran” (1800) and “Fukusho-Kiran yoku” (1809-1853) which contain the method for abdominal examination by palpitation so-called Fukushin, written by Bunrei Inada and Shukuko Wakuda, respectively.<br>On the contrary, Ko-Ho school established a therapeutic method based on the readjustment of disorders mentioned in “Shokan-Ron” (Shokan namely febrile acute illness), followed by the concepts of Hyo-Ri, Kan-Netsu, and Kyo-Jitsu. Also, the school recalled Fukushin (abdominal sho), the sign of the abdominal wall, written in “Shokan-Ron” following the objective restoration. Based on its original Fukusho, other Fukushos were found and extended its original Fukusho, other Fukushos were found and extended its category to apply for other diseases. This has been handed down to the present era.<br>My presentation on this theme, review of Japanese traditional medicine: Kampo, will be given more concretely.

The Tradition and Genealogy of the Kampo Medicine / 日本東洋医学雑誌

Since 1883 (15th year of Meiji), the number of students desiring to study Kampo medicine gradually began to decline due to the fact that the Meiji government passed a series of new reforms requiring all practicing doctors to obtain an education in Western medicine. As a result, practitioners of Japanese traditional Kampo medicine could not get medical licenses, all but forcing them out of practice. These reforms followed the model set by the Japanese government in which a saturation in Western culture was encouraged at the expense of Japanese tradition. This tendency can be seen even to this day.<br>However, in his book “Kisso Shoei”, with the exception of surgery, Sohaku Asada notes many instances in internal medicine where better results were obtained with Kampo medicine than with Western medicine. In 1910 (Meiji 43), Keijuro Wada wrote a book entitled “Ikai no Tetsui”, which stressed the importance of Kampo medicine. This book revived interest in Kampo medicine. Dr. Kyushin Yumoto, after graduating from Kanazawa Medical School was so impressed by this book that he became a student of Dr. Wada, spending his entire life in the study and practice of Kampo medicine. In 1927 (Showa 2), after several years of research, he wrote the “Kokan Igaku” in three volumes. This was the first Kampo book in which a mixture of Western medical findings were used to interpret the “Shokanron” and “Kinkiyoryaku” using language familiar to current-day readers. Dr. Yumoto's “Kokan-Igaku” influenced not only the reconstruction of Kampo medicine in our country, but also assisted in the preservation of traditional Chinese medicine.<br>Although Kampo traditions were upheld by only a few traditional Kampo practitioners and doctors during the first part of the Showa age (1926-1930's), a mood favorable to the return of Kampo was gradually nurtured through various revival movements. By 1936 (Showa 11), new researchers in the Kampo field held the “Kaiko Gakuen Seminar” to promote Kampo, known as the “Takushoku University Kampo Seminar” the following year. This seminar was held eight times until 1944 (Showa 19) at three to four month intervals. In 1949 (Showa 24, after World War II), the 9th seminar was held for 15 days under the title of the “Koryo University Kampo Seminar”. In total more than 700 people were in attendance over the nine seminar period, including several people who would become key figures in the Kampo medical field. (The author, a medical student at the time, was also in attendance at this 9th seminar after the war.)<br>In 1941 (Showa 16; pre-war), ‘Kampo Shinryo no Jissai’ was published by Nanzando Publishing Company. This book listed the prescriptions of well-known Kampo formulas that were in current use for various disorders by the disease name. It was a step forward in that up until this point the “Sho” or “manifestation-type” the patient exhibited was traditionally used as the primary diagnostic basis for treatment. This was an outstanding commentary for its time. In 1954 (Showa 29) the revised addition was published, and in 1969 (Showa 44), the new edition, “Kampo Shinryo Iten” published by Nanzando was a completely revised version of “Kampo Shinryo no Jissai”. These books, by updating the descriptions of diseases to include the Western medical disease names, enabled physicians to apply these traditional formulas, thereby greatly expanding the modernday usage of Kampo extracts. They also exerted a considerable influence on present-day Kampo medicine.<br>The first edition of “Kampo shinryo no Jissai” was cowritten by Drs. Keisetsu Otsuka, Domei Yakazu, Chokyu Kimura and Totaro Shimizu. They were truly the core of the Takushoku University Seminar, and as instructors, were directly responsible for the revival of Kampo.<br>Dr. Chokyu Otsuka became the successor

Analysis of Polypharmacy-Structure of Chinese Medical Prescription (IV) / 日本東洋医学雑誌

Eight Chinese medical presriptions for bronchial asthma, listed in the official documents from the Japanese Ministry of Health & Welfare and 23 prescriptions for bronchial asthma, listed in Japanese “Kanpo” books, are analised using multidimentional scaling analysis and cluster analysis.<BR>As for the 8 officially listed prescriptions, a good configration was obtained with quadratic form. But their constructions were considered to be biased slightly to the attack period of bronchial ashtma.<BR>And the 23 other prescriptions were roughly classified to 6 groups. From the practical view of the padents who visit Chinese medical clinics, these 23 Prescriptions also have reasons for exlstence.<BR>The indications mentioned in the official publication should be reconsidered.

Sex and Age, As the Influential Factors in the Process of Selecting a Chinese Medical Prescription (KANPO-Medicine) / 日本東洋医学雑誌

In order to testify the hypothesis that sex and age of a patient should be influential factors in the process of selecting the KANPO medicine (Chinese medicine), we statistically analyzed the KANPO prescriptions (4, 848 times in total) which had been given to the outpatients (3, 156 in total number) on the lst visit at the Japanese KANPO Medicine Research center's Shibuya Clinic from the lst of Dec. 1981 through the 30th of Nov. 1982.<BR>The ranking of the medicines, from the most frequently used, was as follows: (1) Males; (1) Shoseiryu-to, (2) Hachimi-gan, (3) Saikokeishi-to, (4) Shosaiko-to, (5) Saikokaryukotsuborei-to, (2) Fermales; (1) Kamishoyo-san, (2) Tokishakuyaku-san, (3) Keishibukuryo-gan, (4) Shoseiryu-to, (5) Keishikajutsubu-to. The difference by sex is apparent.<BR>The distribution of age of the patients were not even in number. So, after correcting this unevenness by a certain calculation, it was studied about each medicine (above mentioned), if there might be some relationship between age and the number of how many times the medicine was prescribed for the patients of corresponding age. As the result, the frequencies of using a certain medicine seemed to be changed in relation to age. Every medicine seemed to have its own pattern in this point of view.<BR>For example, Shoseiryu-to was most often used among the younger patients of both males and females. To the contrary, Hachimi-gan was most often used among the older male. Kamishoyo-san had its peak of usage among 40s' and 50s' female.<BR>These facts seem to justify our hypohesis. We also discussed this problem from the historial view.

Profile of the Patients Consulting A KANPO / 日本東洋医学雑誌

Only a few years have passed by since the national health insurance began to be applied to the KANPO treatments. In order to grasp the patients profile of KANPO treatments, 3, 156 patients who consulted Shibuya Clinic from the lst of December in 1981 through the 30th of November in 1982, were analyzed. As the result; (1) in the respect of sex-age distribution in number, middle-aged female were most frequent. (2) the classification of chief complaints associated with the sex-age distribution seemed to suggest that the symptoms might change by aging from those of the upper respiratory tract or the skin lesion to arthralgia or lumbago, from the surface to the deep, or from the upper to the lower part of the body. we also tried to compare the result with this kind of reports of the others.

A Case of Primary Hyperthyroidism Improved by Herbal Medicine (Shakanzo-To) / 日本東洋医学雑誌

This is a case report of primary hyperthyroidism, treated by Shakanzo-To (a herbal medicine) alone, without any other medical intervention. Effects of Shakanzo-To was proved by the measurement of serum thyroid hormone levels.<BR>The patient was 32 y. o. female. Struma and exophthalmus were apparent. Weight loss was also noticable (-10kg/2 years). Serum thyroid hormone levels were abnormally high (T<SUB>3</SUB>=421ng/dl, T<SUB>4</SUB>=36.0μg/dl, TSH=1.0μU/ml). Thyroid scintigram showed diffuse uptake. <SUP>131</SUP>I uptake ratio was 71.5%/24 hours. She was diagnosed as primary hyperthyroidism. According to the “Sho” (the diagnostic approach of oriental medicine, KANPO), Shakanzo-To (water-boiled) was prescribed. Six weeks afterwards, the hormone levels decreased (T<SUB>3</SUB>=291, T<SUB>4</SUB>=17.3). From that time, we used the same “Shakanzo-To” medicine, but in the form of chemically-extractedgranules. After four weeks, the hormone levels increased again (T<SUB>3</SUB>=291, T<SUB>4</SUB>=24.7). So, we used again the former Shakanzo-To (water-boiled). Then the hormone levels decreased once again six weeks later (T<SUB>3</SUB>=210, T<SUB>4</SUB>=17.3). TSH levels remained less than 1.25μU/ml.<BR>We believe it important that effects of Shakanzo-To seem to be demonstrated by the improvement of the thyroid hormone levels.