Sho, the Diagnostic Basis of Kampo Medicine ---Classical Concept vs. New Concept--- / 日本東洋医学雑誌

ABSTRACT

The practice of Chinese medicine has continued for more than 2,000 years, based on its long record of effectiveness. In this regard, Kampo medicine has also been used successfully for these many years, and it is still equally effective today, reflecting the fact that humans have changed little during that duration. In fact, it is said that humans have not undergone much evolutionary change in the last four million years. In contrast to this, however, are the ongoing changes in our environment and surroundings, which are giving rise to a host of new diseases, including many that are allergy-related.In the Japanese system of Kampo medicine, the pathophysiological diagnosis (Sho) and treatment are decided on the basis of two venerable texts, Shokanron and Kinkiyoryaku. There is, as a matter of fact, a prevailing, and possibly too extreme, opinion among Kampo practitioners that Kampo methods and medications not found in these two manuals are not to be applied. However, it is thought that changes had already been made to these texts in 1065-1066 by Rinoku et al., and possibly also by others earlier during the Song Dynasty (960-1279). Furthermore, two other texts, Ishimpo and Taiheiseikeiho, present many points that differ from those found in Shokanron. Thus, it is highly likely that Sho is also based on other revisions possibly carried out on these texts (originally authored by Cho Chukei) before Rinoku et al., if not on their own revised versions. From this, it must be realized that revision itself is not a bad process, and rather that the changes for which Rinoku et al. were responsible are quite in harmony with the present age.We must not be afraid to break with an old style. From the early days of Kampo medicine, Sho was assessed on the basis of the four available examination methods (visual examination, examination according to hearing and smell, questions and answers, and palpation). The field of medicine has since undergone some remarkable transitions, and its current state is one of tremendous development. As part of these newly acquired abilities, elevated levels of leucocytes and CRP as reflecting the state of the disease, for example, can be incorporated into the assessment of Sho. In this sense, Kampo practitioners should adopt and apply useful methods also originating from Western medicine. As a matter of fact, this is in line with the preface of Shokanron, which states that useful medications and methods should be gathered as broadly as possible ( ?? ).