A Case of Recurrent Nausea with Vomiting for Past Sixteen Years Successfully Treated with a Kampo Formulation Shimbuto / 日本東洋医学雑誌

We herein report a 36-year-old male patient, who complained of persistent and recurrent nausea with vomiting for 16 years in spite of various standard treatments, was successfully treated with Kampo formulation Shimbuto, which selected based on the left para-navel tender point. We speculated that the clinical disorder in this case was related to suitai i.e. water imbalance syndrome in Kampo medicine. However, there has never been such a case report in the field of Kampo, and no related papers have been found in the standard database Medline. We believe this report is valuable from the viewpoint of therapeutics in both Western and Kampo medicine.

Three Cases of Febrile Diseases Successfully Treated with a Kampo Formulation Shimbuto / 日本東洋医学雑誌

We herein report three patients who complained atypical febrile diseases associated with painful whole body (Case 1), general fatigue (Case 2), and a sense of general discomfort (Case 3). All cases were not accompanied by dizziness and a shaky feeling which are commonly associated in shimbuto-sho i.e. indication of shimbuto, but presented severe tenderness at the left paraumbilical region which was suggested as indicative point of shimbuto by Yoshiko Takagi. We made a diagnosis in these three cases as shimbuto-sho based on the Takagi's tender point. Through these clinical experiences we propose that a new type of shimbuto-sho, which are completely different from the fixed idea of inherited knowledge. This new type of shimbuto-sho consists of following signs ; fever with chill, floating and feeble pulse, no sweating, general fatigue or body pain, and severe pain at Takagi's tender point.

A Case of Delayed Recovery of Navel Wound Healing after Laparoscopic Surgery for Cholecystectomy Successfully Treated with a Kampo Formulation Senkinnaitakusan / 日本東洋医学雑誌

We herein report a patient who complained persistent exudate at navel in spite of adequate antibiotics therapy after laparoscopic cholecystectomy was successfully treated with Kampo therapy. The pharmacological effect of this Kampo formulation i.e. senkinnaitakusan is still unknown, but this formulation has been used for persistent infectious diseases. According to the description in the classic textbook, this formulation is suggested to encourage metabolic function and exhibit anti-inflammatory function. There have been no reports of Kampo therapy for the superficial incisional site infection associated with laparoscopic surgery. The authors propose that Kampo medicine is another promising option in the management of surgical site infection (SSI).

Two Cases of Abdominal Distension Successfully Treated with Tokishigyakukagoshuyushokyoto / 日本東洋医学雑誌

Abdominal distension is one of the common symptoms and can cause abdominal pain and anorexia, which may raise adverse effect on general well-being and quality of life. In Western medicine, there are specialized treatments for structural lesions associated with abdominal distension, but functional abdominal distension is often difficult to treat. There have been some reports of Kampo medicine for treatment of abdominal distension, but no case reports on tokishigyakukagoshuyushokyoto. We experienced two cases of abdominal distension successfully treated with tokishigyakukagoshuyushokyoto. Case 1 was 86-year-old woman who developed abdominal distension with frequent belching. Case 2 was 59-year-old man who developed abdominal distension associated with opioid. Regulating qi medicine was not effective for abdominal distension in both cases. Both cases had reversal coldness of the extremities, tympanic sounds of abdomen, coldness of abdomen, and inguinal tenderness and resistance. Therefore, we diagnosed them as tokishigyakukagoshuyushokyoto sho. After administration of tokishigyakukagoshuyushokyoto, in Case 1, the frequency of belching decreased and the appetite increased with the improvement of abdominal distension. In Case 2, increasing the dose of goshuyu in tokishigyakukagoshuyushokyoto relieved abdominal distension. Tokishigyakukagoshuyushokyoto can be effective for abdominal distension with interior cold pattern.

A Case of Pleural Effusion Due to Bacterial Pleurisy Markedly Reduced by Treatment with Saikanto / 日本東洋医学雑誌

Although saikanto has often been used for infectious pleuritis, there are few reports on the usefulness of it in recent years. We experienced a patient successfully treated with saikanto, who was suffering from bacterial pleuritis with residual pleural effusion, which was difficult to drain and treat with antibacterial drugs. Kampo treatment including saikanto should be used for pleuritis that is not sufficiently improved by Western medical treatment alone.

Two Cases Report of Trigeminal Neuralgia Successfully Treated with a Kampo Formulation Tokishigyakukagoshuyushokyoto / 日本東洋医学雑誌

The authors experienced two cases of trigeminal neuralgia successfully treated by a Kampo formulation tokishigyakukagoshuyushokyoto (TSG). Case 1 is 70-year-old woman who complained of severe pain on the right side of her face. She was administered carbamazepine. It was effective for the facial pain but she could not take it continuously because of side effect, namely ataxia. Therefore, we tried to administer TSG. This Kampo formulation proved effective, and her pain was controlled without carbamazepine. Case 2 is 69-year-old woman who complained of localized pain on the right side of her face. In this case TSG alone was effective.

A Case Report of Severe Headache after Decompression Craniotomy by Cerebellar Infarction Successfully Treated with a Kampo Formulation Goreisan / 日本東洋医学雑誌

We report a case of severe headache associated with cerebellar infarction was successfully treated with Kampo therapy. The patient complained of severe headache and vertigo in spite of standard therapy after the decompression craniectomy. However, his symptoms were relieved immediately by administration of goreisan. The pharmacological effect of Kampo formulation i.e. goreisan is still unknown, but this formulation has been used for headache with edema, vertigo and vomiting. According to the classic textbook, this formulation has a potential to improve water imbalance in the body, including brain edema. This Kampo medicine is seemed to be an alternative to manage such patients.

Two Cases of Hiccups Successfully Treated with Keishininjinto / 日本東洋医学雑誌

Persistent or intractable hiccups worsen the activity of daily life and the quality of life of patients, but are sometimes difficult to treat. There are no recommended therapies in Western medicine for hiccups, and Kampo medicine can often be used. However, there have been no case reports on keishininjinto for hiccups. We experienced two cases of hiccups successfully treated with keishininjinto. Case 1 was a 68-year-old man who continued intractable hiccups for 3 years. Case 2 was an 81-year-old man who developed persistent hiccups during mechanical ventilation. Both cases had spontaneous sweat, tendency of diarrhea, epigastric discomfort and resistance, and cold of epigastrium, so we diagnosed them as keishininjinto-sho. It took 6 months to improve hiccups after administration of keishininjinto in case 1 and 1 week in case 2. Keishininjinto can be effective for hiccups with interior and cold pattern.

Two Cases of Hypertension Successfully Treated with Keishininjinto / 日本東洋医学雑誌

Keishininjinto has been used for those who have both interior cold pattern of ninjinto and exterior pattern, but there were no reports on improvement of hypertension. We experienced two cases that treatment with keishininjinto was effective for hypertension. The complaint of one case was dizziness, and the other was diarrhea. Both cases had epigastric discomfort and resistance, cold of epigastrium, and upper heat and lower cold. Treatment with keishininjinto was effective not only for the complaints but also for improvement of hypertension. Hypertension can be managed by Kampo therapy with keishininjinto in accordance with traditional sho indications. We consider that there were interesting clinical cases treated with Kampo medicine based on the theory whereby sho correlates with a formulation.

Five Cases of Frequent Hypertensive Urgency Successfully Treated with Shichimotsukokato / 日本東洋医学雑誌

Hypertensive urgency is sometimes repeated and difficult to treat with anti-hypertensive agents or anxiolytics. There were few reports on treatment of hypertensive urgency with Kampo medicine. We experienced five cases of frequent hypertensive urgency, successfully treated with shichimotsukokato only. All cases had deficiency pattern and symptoms of blood deficiency. It took relatively short term to stabilize blood pressure after taking shichimotsukokato, and the efficacy of this drug had been continued. Shichimotsukokato can attribute to rapid and continuous stabilization of blood pressure for frequent hypertensive urgency of those who have deficiency pattern and blood deficiency.

A New Historical Material on the Visitation to Lord Nambu by Dr Yoshimasu Todo / 日本東洋医学雑誌

According to the biography of Dr Todo Yoshimasu, he visited to Lord Nambu in 1752. However, this biography does not describe the detail of his therapeutic process. Recently we found out the historical materials, i.e. Zassho which is a diary written by a chief counselor of Morioka-­Nambu feudal domain. This diary describes the detail of Dr Todo Yoshimasu's medical activity to the Lord Nambu. This report intends to introduce the description of this diary and discuss concrete activities of Dr Todo Yoshimas. This report is a new significant excavation since when publication Todo­zenshu in 1917.

On the Naming of the Classic“難経(Nangyo, Nanjing)” / 日本東洋医学雑誌

It has been recognized that meaning of “難経(Nangyo, Nanjing)” is a scripture of difficult issues, or of the questionnaire for the term “難(nan)”. The author would like to propose that the real meaning of “難(nan)” in this scripture is not difficulty but immutability. “The Classic of Changes (易経)” deals with changes in the uni­verse, on the other hand Nangyo describe definitive and/or immutable evidences in the field of acupuncture. The author proposed that this epoch making scripture described in the purpose of make clear the concrete evi­dences of pulse diagnosis or manipulation of acupuncture, and relationship between the meridian routes with the five viscera and six entrails.

A Dispose of Yoshimasu Todo's Disciples in Morioka-Nambu Feudal Domain / 日本東洋医学雑誌

The authors previously reported on a Dr. Todo Yoshimasu's visit to a feudal lord of Nambu domain in 1752. This paper describes the outcomes of our investigation on what happened after the visit based on the diary “Zassyo” written by a chief retainer of the domain. Despite Yoshimasu's treatment, the load was not cured and ended up passing away. At that time, there were three of Yoshimasu's pupils who were from Nambu and serving as medical doctors for the domain. A record in the diary indicates that, after the lord's death, all of them were either discharged or penalized with pay cut. It indicates that Yoshimasu's revolutionary medical philosophy and methodology were not fully understood nor appreciated back then.

The Term of Sansho Described in the“Shokanron”and“Kinkiyoryaku”—A Proposal of Three Division of Sansho by the Abdominal Arteries / 日本東洋医学雑誌

The term sansho is an element of six entrails in the Kampo medicine. From anatomical knowledge, Kazuo Ohtomo determined that sansho corresponds to visceral peritoneum and mesentery in the human body. Kazuo Ohtomo's doctrine was derived from the description of “Koteidaikei”. This report aims to reveal the concept of sansho by means of description of ancient textbook “Shokanron” and “Kinkiyoryaku”, and further intend to propose the three division of sansho are able to separate by modern anatomy especially abdominal arteries.

Polypharmacy Caused by Kampo Prescriptions / 日本東洋医学雑誌

As the elderly society grows, polypharmacy becomes a problem in clinical practice. Until now, some Kampo treatments have been reported to be useful for polypharmacy caused by western-­style medicines. But this report shows that Kampo medicines in themselves could be the cause of polypharmacy. In fact, multiple Kampo prescriptions from several medical agencies are given to one patient in Japan. From the view point of proper use of Kampo prescriptions, medical experts and entire business fields related to Kampo medicine should take measures rapidly for so­-called “Kampo polypharmacy” after analyzing the actual situation.

A Case Report of Severe Fatiguability Successfully Treated with a Kampo Formulation Bukuryoshigyakuto after Surgical Pituitary Tumor Extraction / 日本東洋医学雑誌

We experienced a patient, who complained severe fatigue in spite of adequate hormonal supplement after pituitary tumor removal, was successfully treated with Kampo therapy. The pharmacological effect of this Kampo formulation i.e. bukuryoshigyakuto is still unknown, but this formulation has been used for pre-shock conditions in the terminal stage of infectious diseases. According to the description in the classic textbook, this formulation is suggested to encourage metabolic function and maintain core temperature of the human body. The authors propose that Kampo medicine is a hopeful alternative way in the management of such patients.

Counterarguments Against the Articles Advocating Carcinogenicity and Reproductive Toxicity of Kampo Medicine / 日本東洋医学雑誌

Berberine-containing goldenseal root has been classified into Group 2B (possibly carcinogenic to humans) by International Agency for Research on Cancer based on evidence of carcinogenicity in experimental animals. It was also confirmed that ultrahigh concentration berberine can induce DNA damage in cultured cells. Thus, two articles in Journal of Japan Medical Association advocated carcinogenicity and reproductive toxicity of oren, obaku, and daio considering that ingredients of daio and berberine contained in oren and obaku can cause DNA damage. However, many fallacies and arbitrary descriptions are observed in the two articles. The concentration of berberine that caused toxicity in the experiments is extremely higher than the possible concentration in humans taking Kampo medicine. Although no studies have shown carcinogenicity and reproductive toxicity of oren or obaku, the advocates in the articles were played up by a weekly magazine causing unreasonable anxiety to patients. Here, we present scientific counterarguments against the fallacies of the articles.

On the Mind-Body Unity in the Oketsu Syndrome / 日本東洋医学雑誌

The mind-body unity is a fundamental doctrine in Kampo medicine. In this report, the author tried to consider oketsu syndrome as a concrete object because this syndrome consists of both emotional and physical disorders. The oketsu syndrome has been recognized as blood stagnation in the microcirculatory vessels. On the other hand, the emotional aspect of this syndrome correlates with anger or aggressive affection. It is well known that emotional disorders are brought by very complicated neural circuit in the cerebral limbic system, so that this report referenced suitable articles among numerous scientific evidences, and discussed about mindbody unity.

The Pertinence of Kazuo Otomoʼs Doctrine on the Term “Sansho” / 日本東洋医学雑誌

The term “sansho” is an element of six entrails in Kampo medicine. The correspondence of “sansho” with any organ in human body was described in “Seikenshu” written by Narikiyo Yamada at first, and Kazuo Otomo declared that “sansho” corresponds to visceral peritoneum and mesentery. Recently, “The Lancet” published a review on the mesentery in which mesentery should be recognized as an organ. This report aims to discuss the accuracy of Otomo's doctrine, which was published in 1980, from the view point of the new anatomical knowledge.

On the Term Mind-Body Unity, an Etymological Review / 日本東洋医学雑誌

The concept of mind-body unity is a fundamental doctrine in the Kampo medicine which differs from modern scientific medicine. The history of science started on the basis of separation of spirit and human body, as a matter of course which brought in the medical practice a dualistic theory of recognition of diseases. However, a human being is living as a mind-body unity. The author made clear that this term is described in the Buddhism text book, “Shobogenzo” written by Dogen in the Kamakura period. And the author also found out the first person in modern times who used the term “Shinshin'ichinyo” (i.e. mind-body unity) is Yujiro Ikemi, an authority of psychosomatic medicine in Japan.