<b>Two Cases of Abdominal Aortic Aneurysm Diagnosed with Abdominal </b><b>Palpation</b> / 日本東洋医学雑誌

<p>In Kampo medicine, abdominal palpation is essential procedure to make the diagnosis of Sho. We experienced two cases of abdominal aortic aneurysm which are diagnosed by means of abdominal palpation. The coexistence of aneurysm and the sign of abdominal palpitation is extremely rare, but every clinician should pay attention to this fact.</p>

<b>On the Mechanism of Palpitation Above the U</b><b>mbilicus</b> / 日本東洋医学雑誌

<p>A sign of palpitation above the umbilicus is an important piece of information which means a disorder of Ki circulation in the Kampo medicine. This study revealed that the amplitude of this palpitation observed in the abdominal wall was about 4 mm. The author has been speculated for a long time that this sign should accompany significant change of the diameter of abdominal aorta. But this speculation was denied by MRA study, which showed at most 1.5 mm change of the diameter of abdominal aorta. The ultrasonic studies of abdominal aorta showed that the amplitude of diameter of the aorta changed about 1.5 mm. The discrepancy between the amplitude of abdominal wall (4 mm) and that of ultrasonic image (1.5 mm) could be explained by assuming the impulse force toward the abdominal aorta wall. Concerning the generated powerful impulse, the author considered three factors including increased pulse velocity, reaction force by the spine and the sound pressure generated in the heart.</p>

The Effect of the Kampo-Formula without Shakuyaku on the Palpitation at Rest Due to Imbalance of Ki-distribution / 日本東洋医学雑誌

We treated five patients with palpitation at rest due to imbalance of Ki-distribution, a concept of traditional Chinese medicine in which there is abnormal upward flowing of “Ki, ” who showed rapid improvement after Shakuyaku was excluded from their original regimen or after initiation of treatment with Shakuyaku-free regimens. All these patients shared in common two findings before the initiation of the Shakuyaku-free treatment: first, the absence of strain of the rectus abdominas muscle in the whole abdomen between the hypochondrium and the upper margin of the pubic bones, and secondly, the presence of abdominal pulsation diagnosed as pericardiac, infra-umbilical or sub-umbilical pulsation. We also treated patients who developed palpitation at rest only after Shakuyaku-free regimens were replaced with regimens including Shakuyaku. These findings suggest that there may be many patients in whom Shakuyaku-free regimens may improve palpitation when they have an imbalance of Ki-distribution as an underlying condition.