[Primary meaning and pathology of the "Jue": significance of the clinical case of the Guo prince treated by Bianque].

The "Jue" refers to a disease appearing frequently in the ancient book of Traditional Chinese Medicine. The definition of "Jue" is ambiguous because of various cognitions of this illness today. We studied the primary meaning of "Jue" in Suwen, Lingshe and the chapter of Bianqueyun in Shiji and revealed the following results. In general, it is believed that the "Jue" will be caused by an imbalance between internal "Yin" and "Yang." The "Qi" of the external world, which varies according to each season or day and night, additionally seems to influence the inner body. In the pathology of "Jue", when the external "Qi" cannot reach the deep part of the body, at first, the internal "Qi" deviates from the natural course and cannot work in the body. The spirit in the deep part, subsequently, cannot work freely and paroxysmally changes location to the upper and surface parts of the body. The Guo prince's disease noted in the chapter of Bianqueyun in Shiij seems to have been a case of "Jue". In the case of the Guo prince, the method of treatment with "Sanyangwushu" by Bianque was based on the theory of "Sanbujiuhouzhen" which is a classic diagnosis in Suwen.

[Reexaminations of dosages in Shanghanlun: comparison of the dosages among decoctions, pills and powder formulations].

This paper reveals the dosages of decoctions in Shanghanlun in relation of pills and powder formulations, and obtains following results. At the first examination of the system of weight, while Taohongjing shows three kinds of system of weight; [(1)1liang is equivalent to 14 g. (2) 1liang = 7 g (3) 1liang = 1.4 g], he describes the necessity of the corrective system of weight among the decoctions, the pills and the powder formulations. After Song dynasty, Zhusanfa, which is the method of preparing the decoction by placing powder ingredients of prescriptions in water and simmer, have been mainly adopted. In the term of Zhusanfa, although the whole quantities of prescriptions are written with the ancient weight unit, the notation of the dosage is indicated by the current weight unit, Qian. In Shanghanlun, since the dosage form seems to have been changed from the pills or the powders into the decoction, some of decoctions contain impractical dose for decoction.

[Significance of Sijiseiki disease and Henseibyo disease on the Shanghanli chapter in the Shanghanlun].

It seemed that the chapter "Shanghanli" in Shanghaulun had been incorporated into the text of the Shanghanlun by "Wang shuhe". Therefore, the "Shanghanli" wasn't studied as adequately as the original Shanghanlun written by "Zhang Zhongjing. We focused on the significance of "Sijiseiki" disease and "Henseibyo" disease in the chapter "Shanghanli" and revealed their relation to the ideas on pathology in the Shanghanlun. In the theory of "Sijiki", the four seasons each had their own "Qi", called "Sijiki"; the cold belonging to winter, the warm to spring, the hot to summer and the cool to autumn. The influence of "Sijiki" in each season caused the disease of "Sijiseiki". Since "Sijiki" was related to the normal "Qi" for each season, "Sijiseiki" disease was expected to be recovered from in order. When "Sijiseiki" disease had not been cured in each season, it caused a complex disease according to the influence of other seasonal "Sijiki"; "Henseibyo" disease.

[Primitive treatment of the Shanghan by Huatuo in the chapter "Shanghanmen" of Qianjinfang].

This report considers the primitive treatment of the "Shanghan" in the chapter "Shanghanmen" of the Qianjinfang. In the primitive etiology of"Shanghan", there were three stages of the recognition of disease pathogenesis, which were first the existence in fear and awe, second the poison, and the last the cold and fever. The etiology seemed to develop into that of the Shanghanlun. Furthermore, from the standpoint of therapeutics, the target for the diseases changed from influences of the external world to the body, as well. Although "Huatuo" used pills and powder formulations which have the effects of a diaphoretic, an emetic and a laxative to reject the outside diseases, he adopted the decoctions for complicated symptoms of diseases. In conclusion, the etiology and therapeutics discussed in the chapter "Shanghanmen" of the Qianjinfang are related to the formation of the Shanghanlun.

[Significance of the term "huku-yaku" (taking medicines)].

The term "Huku or Fu" in "Huku-yaku or Fu-yao", which means taking medicines, does not mean " to wear" , but means "to obey certain rituals or duties." Therefore "Huku-yaku (Fu-yao)" means " to obey the nature of a drug." From the viewpoint of "ShenXian" thought, the term used when referring to taking medicine depends on whether the purpose is to cure diseases or strengthen pneuma. The term "Huku (Fu)" is adopted for the latter. When the purpose is to strengthen pneuma, the drug does not only effect the inner body, but also works on the external world. Hence the "ShenXian" thought aims to conform to the rules of nature and obtain youth and longevity through taking medicines.

[Questions relating to Manase Gensaku's medical writings. Did Manase Gensaku write "Sankyoshiyo Bassui" and "Saiminki"?].

This study investigated the texts attributed to Manase Gensaku (1549-1631, the second Mamase Dosan), successor to the first Manase Dosan (1507-1594). The investigation yielded the following results:(1) "Saiminki," "Sankyoshiyo Bassui" and "Iden Fukyuroku," said to have been authored by Manase Gensaku, constitute the first Manase Dosan's works. Manase Gensaku is thought to have revised "Saiminki," recompiled "Sankyoshiyo Bassui," and published "Iden Fukyuroku."(2) Manase Gensaku's medical writings, "Denshin Hoho," "Keitokuho" and "Jozanho," have the same contents.(3) Late in his life, Manase Gensaku wrote the pharmaceutical volumes, "Kyushin Zappo," "Iho Joboku" and "Iho Kenko." These books described pharmaceuticals that were described by Manase Dosan, as well as pharmaceuticals that were being developed at that time.(4) "Iho Meikan," the most important work of Manase Gensaku, contains descriptions of almost all of the pharmaceuticals described by the first Manase Dosan.(5) The principal aim of Manase Gensaku was the production of straightforward, compact and convenient medical texts that could be used by clinicians. This was because most of Manase Dosan's medical texts were too extensive to be useful for practicing clinicians of the time.(6) In addition to working on aspects of internal medicine investigated by Manase Dosan, Manase Gensaku made radical improvements in disciplines such as materia medica, regimens, acupuncture and moxibustion.

[Japanese nonprescription drugs (1) "Pediatric Formulas" for five kinds of "Gan"].

The genealogy of children's sedatives such as Kio-gan and Kyumei-gan, which remain in use even today for pediatric conditions including convulsions and nocturnal crying, was traced and the significance of these formulas was investigated. In the Edo Era, pediatric formulas for five kinds of gan (infantile malnutrition) combined four prescriptions to treat individual symptoms of "re (heat) gan," "leng (cool) gan," "hui (helminth parasite) gan," and "ji (spinal) gan" into one prescription. In contrast, during and after the Meiji Era, pediatric formulas for these five kinds of gan have used only one prescription to treat "re (heat) gan". Moreover, these formulas have tended to use a greater proportion of components that are used to treat "re gan". From this information, it readily became apparent that : 1) Edo Era pediatric formulas for the five kinds of gan were intended to improve the physical condition of the children prone to the illness; and, 2) modern (Meiji Era) prescriptions were intended to alleviate the acute symptoms of gan.

[Examination of the Tanyin chapter of the "Heji Jufang"].

An examination of the tanyin chapter of the "Heji Jufang", the world's first national pharmacopoeia and the major pharmacopoeia of the Northern Sung era, yielded the following findings:(1) In the tanyin chapter, we identified many examples of discussions based on the theory of "lung and stomach disorders". Since this theoryis not found in medical books before the Tang era, and since many examples can be found in the "Heji Jufang" and other medical books of the same period, we believe this is a view of pathology peculiar to the Northern Sung era.(2) A comparison of the components of prescriptions used in the "Waitai Miyaofang" and the tanyin chapter of the "Heji Jufang" revealed that the former contains many strong diuretics, purgatives, and crude drugs of a hot nature, while the later contains few of these but many diuretics that have a mild antitussive effect. We believe the use of medicines in the latter is related to the treatment of "avoiding diuretics and purgatives which could adversely affect pi qi."(3) We pointed out that the er chen tang in the tanyin chapter of the "Heji Jufang" is merely one prescription of a group of prescriptions to treat a morbid condition caused by the disorders of the stagnant tanyin. We revealed in the "Yijianfang" and "Wangbing Huichun" the process by which, with the passage of time, that er chen tang came to be widely interpreted as the basic prescription for tanyin, including chronic cases.

[Characteristics of pharmaceuticals in "Heji Jufang"].

Dosage forms, methods of preparation, and methods of taking drugs for formulas described in "Heji Jufang" were investigated and the following results were obtained.1) Powders and pills (processed medicines), which are dosage forms seldom used in conventional traditional Chinese medicine, are often seen in "Heji Jufang". On the other hand, the fact that decoction (non-processed medicines), which is the principal dosage form in traditional Chinese medicine, seldom appears became apparent. In addition, a method of taking the drug by boiling down the powder was frequently seen.2) When decoction formulas are described in "Heji Jufang", the herbal medicines are often classified into two sections, a preceding section and latter one. The herbal medicines as prepared at a pharmacy are listed in the preceding section, while "standard household items" to add during home preparation are assumed to be described in the latter section.3) In "Heji Jufang", there is a rare method of taking drugs where boiling water is poured on powder consisting of aromatic herbal medicine before use. Many of these formulas are found in "Yinshan Zhengyao", which contains food and drink of the Arab region.4) "Heji Jufang" contains confections prepared with honey and powders of crude drugs. This dosage form is often seen in Indian and Arab medicine and was rarely seen in medical books before "Heji Jufang" in China.5) Thus, results 1-4 suggest that "Heji Jufang" was published in accordance with the development of processed medicines. It is believed that Arab medicine influenced the development of processed medicines in China.

[Studies on "Ishin shoden" Edited by Dosan Manase (1507-1594): the introduction of Satsusho Benchi and the process of its establishment].

Sanki Tashiro and Dosan Manase are known for their role as founders of the Gosei-ha school in Japan. Observing that Japanese medicine had not been based on a clear theory, they introduced into Japan the satsusho benchi practiced in Chinese medicine during the Jin and Yuan dynasties. The basis of this system was to examine the patient's condition, then determine the treatment accordingly. Dosan Manase in particular employed the satsusho benchi, writing out a new prescription each time treatment was required, without reference to existing prescriptions. In this study, we carried out an investigation into the "Ishin shoden"edited by Dosan Manase, which reveals the process by which Dosan established the new satusho benchi system of medicine within the framework of traditional Japanese medicine. In the early stages of the process, Dosan prepared prescriptions based on existing iou-tou prescriptions, modifying these by adding or removing medicines. Then, in the middle period, he prepared prescriptions based on toso-tou prescriptions, designed on the basis of the kun shin sa shi or Junchen Zuoshi theory, again modifying these by adding or removing medicines. In the final stage of the process, Dosan ceased this practice of adding or removing medicines from a basic prescription, adopting instead the satusho benchi system of writing out a new prescription for every treatment. In addition, we consider the reasons why the satusho benchi system was not employed by Dosan's successors, and discuss the effects of this.