We created a new medical interview form which is called chronological analysis for East Asian Traditional Medicine (EATM).
I would like to focus on our medical interview in EATM. Our patient comes to see a doctor with his or her life and medical histories.
When we interview and write them on CHRONOLOGICAL ANALYSIS CHART, we can give them into several groups. Each group is characterized as a chronic health problem (CHP) and named by the traditional major pattern diagnosis and the symptom-to-medicine pattern diagnosis. The former base on TCM (Traditional Chinese Medicine) and the latter Japanese Kampo Medicine.
On this chart the patient's life events are written in the left side and his or her active symptoms are written in right side. We write them to make in the same longitudinal time line. Comparison with light life events and right illnesses makes us understand the structure consisting of several groups. We already saw more than three hundred thousand patients in 30 years. A 52 year-old women came to see us. We interviewed by our chronological analysis. Her history consist of several groups:The 1 st group is Detoxication pattern, the 2 nd is heat in intestine blood, the 3rd is congestion in blood, and the 4 th is Liver "CHI"congestive dysfunction and finally we diagnosed as Toukakujyoukitou decoction for climacteric dysfunction.
The most significance is we could guess that she had a stressful time in the blue colored part.
After observing each patient's chronic health problems, we relate them chronologically to their life events and develop a graphic structure for each patient comprehensively. To see a patient from this kind of this view, we call emphasize them in both modern and traditional medicine. We show a new interview way using chronological chart to understand patients more deeply.
Amid the growing medical needs of an aging society this chronological analysis is significant to understand our patients comprehensively.
Through these medical approach we understand patients and give them traditional healing of mind and body.

We report on a case of ascites with liver cirrhosis due to hepatitis B virus (HBV) that was successfully treated with a combination of inchinkoto and goreisan (inchinkoto-go-goreisan). Our patient, a 58-year-old woman had neglected her chronic B hepatitis and diabetes mellitus, and had not been treated with medication. She was admitted to our hospital because of severe jaundice and the ascites, which were noted when she consulted us for traumatic neck pain. Though we administered human albumin with diuretics, e.g. the combination of furosemide and spironolactone, the ascites did not improve. After administering a combination of inchinkoto and goreisan decoction, however, the ascites decreased rapidly within a month. In this case, we found that an inchinkoto-go-goreisan decoction was more effective than an inchinkoto decoction or a goreisan extract. This suggests that the effects of Gardenia and Rheum they are made from can be significant.

Persistent hiccups impair the quality of life of patients, and are sometimes difficult to treat. In our hospital, we usually use a shiteito decoction to treat hiccups, however, there are no published data about the effect of shiteito on hiccups. We retrospectively investigated patients with hiccups treated with a shiteito decoction as a first-line drug from February 1, 2014 to February 28, 2016. Twenty-seven patients were included (three women), and their ages ranged from 24 to 89 years (mean age : 65.4 ± 15.1 years). The shiteito decoction was completely or partially effective in 66.7% of all patients, and 59.3% of all patients completely recovered. In most cases, the hiccups disappeared within two days, and 88.9% of the patients with complete or partial recovery found the decoction to be effective within four days. Shiteito was an effective hiccup treatment, and since it could be easily administered at bedside, it would be useful regardless of patient pattern.

The treatment by Kampo decoction is partly covered by National Health Insurance in Japan. However, this system is facing bankruptcy crisis because of rising prices of crude drugs in China, their main producer. The board of crude drug materials of the Japan Society for Oriental Medicine (JSOM) distributed questionnaires to 7416 JSOM member doctors, and performed statistical analysis (with JSOM approval) of 1877 answers to visualize the data. Twenty-six percent of respondents said that they had prescribed a decoction, and 29% of respondents said they had not, but wanted to prescribe a crude drug. Eighty-eight percent of doctors who prescribe decoctions offered medical treatment primarily to insured patients. Nine percent offered medical treatment at patients' own expense. The latter group prescribed decoctions more frequently. Many doctors were aware of the financial risk of prescribing crude drugs imposed by the drug price standard and rising crude drug import prices. Four hundred and fifty­-five doctors explained when they were most inclined to prescribe a decoction. Thirty-five percent of these said they used decoctions when they couldn't treat patients with extracts. This result implies a necessity for decoctions. Many doctors said they prescribed decoctions for autoimmune or allergic diseases. Financial constraints were the most frequently cited barrier to treatment with decoctions. This survey made clear the financial difficulties clinics are facing. We therefore calculated the amount of crude drugs used for decoctions to validate the possibility of their domestic production.

The consumption and sales of Kampo products, as well as the crude drugs that make up the products, have been increasing recently. However, the Kampo industry has been exhibiting a long-term decline due to the rise in price of imported crude drugs and reduction in standard prices of crude drugs by the Japanese National Health Insurance scheme. As the production of crude drug in Japan has been decreasing for the past thirty years, efforts have been made to improve the situation. Although the production of Aizu Ginseng decreased from 153 metric tons to 8 metric tons in Fukushima, university research institutes have initiated research on expansion of the farm field for Ginseng and reduction in a cultivation term. In Nara, farmers, pharmaceutical and food manufacturers, and university research institutes, aiming to develop new products using Yamato Angelica root, organized a joint council and have been working together to establish integrated systems from cultivation to sales. The Ministry of Agriculture, Forestry and Fisheries, the Ministry of Health, Labour and Welfare, and Japan Kampo Medicines Manufacturers Association have held local meetings with farmers and pharmaceutical companies in different areas throughout Japan over the past three years from fiscal year 2013. In order to reduce national healthcare costs by Kampo medicine, it is necessary to upgrade the health care system where not only Kampo extract products but also medicinal plants as raw materials including decoctions can be used. Discussions on measures to cover the costs of domestic production of crude drugs should be required.