It is well known that an abdominal sign of painful groin indicates an appropriate condition for choosing the Kampo formulation tokishigyakukagoshuyushokyoto (TSG). This evidence was found by Keisetsu Otsuka in 1963. He thought that this sign is correlated with the liver meridian.
However, the pathophysiological background for this sign has been unknown. Recently, the author made clear that this sign disappears by acupunctural procedure at the Hikon (ExB4) meridian point. According to this clinical evidence, the author proposes a new hypothesis for this abdominal sign in that it closely relates to a homeostatic mechanism. In the cold environment, sympathetic drive to the femoral arteries occurs in order to guard from radiation heat loss in the lower extremities. This drive also causes a reduction of blood supply to the pelvic viscera. The acupunctural procedure at the Hikon (ExB4) meridian point may release both the induration of the iliocostal muscle and the contraction of IOM simultaneously. TGS disconnects the vicious cycle which exist between the pelvic viscera and sympathetic ganglion, and improves various signs that correlates with ischemia of the pelvic viscera.

It is well known that a painful lump around para-naval, ileo-cecal and sigmoid regions are correlated with oketsu syndrome, although, the physiological mechanism for these signs is still unknown. Recently, the author made clear that these signs disappear by acupunctural procedure at the meridian points Hikon (ExB4), Kekkai (SP10) and/or the lump itself. And also the author found out that these abdominal lumps are located in the most peripheral position of the superior or inferior epigastric artery. This evidence may indicate that abdominal lumps are brought by diminished blood flow of the superior or inferior epigastric artery, and acupunctural input from a meridian point or lump itself inhibits not only the excited gamma and alpha motor-neuron in the thoracic 11 and 12 segment of spinal cord but also excites sympathetic neurons. The author speculates that the initial noxious stimuli occur with stagnation of the pelvic vein associated with homeostatic inflammation.

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.

Chilblains is one indication for the use of an ethical Kampo formulation, i.e. tokishigyakukagoshuyushokyoto. This disease is a very common disorder which occurs in cold circumstances. It has been noted that this disorder correlates with diminished peripheral blood flow. However, the inflammatory mechanism associated with this disorder are still unknown. The author's intention is to speculate on the mechanism behind this disorder from the view point of homeostatic inflammation, as proposed by recent immunology. To wit, chilblains may occur via cytokines which are released from ischemic vessels of the microcirculation and/or cells associated with micro-coagulation in the post-capillary venula.

The outline of COE program at University of Toyama entitled “Advanced Approach to Personalized Medicine Based on Oriental Philosophy” was presented. This program consists of two parts, i.e., basic research group and clinical research group. On the basic researches, we performed field work for natural resources of medicinal plants both in Mongolia and China. And we revealed the differences of the chemical ingredients in rhubarb family. Furthermore, we developped a new DNA microarray to detect the panax ginseng family. In this paper, we also reported that the chemical ingredients of medicinal herbs convert new substances by the action of intestinal bacterias. In the clinical research group, we revealed that the characteristic protein pattern of “blood stagnant (Oketsu) syndrome” in Kampo medicine by means of protein chip array system. We showed the result of the midway evaluation by Japan Society for the Promotion of Science.
Universities ; basic research ; seconds ; Chemical compound, NOS ; Proteins

Modern Kampo medicine is mainly based on a restoration of ancient Chinese medicine which occurred in the Edo period in Japan. This historical event rose under the influence of a Confucian renaissance, resulting the exclusion of metaphysics. This report intends to clarify the correlation between these two new cultural movements, and to outline the characteristics of Kampo medicine from a historical perspective.

Keijyuro Wada's Ikaino-tettsui (The Iron Hammer of the Medical World) was first published in 1910, just a hundred years ago. This book admonishes against the influence of modern Western medicine, which is based on the theory of element reductionism. Wada insisted that a reevaluation of Kampo medicine was essential to create a holistic medical system. Immediately after the book was published, Dr. Ryuken Hirade proposed a bitter criticism of it in a medical journal. Dr. Hirade, at that time, was leader of a well-respected medical society in Nagoya. His bitter criticism is very meaningful for us who engaged in Kampo medicine today. There is a conflict between the two different paradigms of Western and Eastern medicine. This lecture intends to discuss our challenges facing Kampo medicine based on Ryuken Hirade's opinions.

Kampo had been the mainstream of medicine in Japan until the Meiji Restoration discarded it in 1875. In 1910, Dr. Keijuro Wada published a book titled “Ikai-no-Tettsui," which proposed to rightly recognize Kampo in harmony with the modern Western medicine. This book inspired Dr. Kyushin Yumoto to engage in the Kampo revival movement. And Dr. Keisetsu Ohtsuka inherited Yumoto's spirit. From the historical point of view, this book has played a great role in reviving Kampo. Just now, it has been one century since “Ikai-no Tettsui" was published. This paper is intended to reveal the historical background of the book, and review the movements in the field of Kampo over the past one hundred years.

Over the past few years, a significant problem has been raised in the field of traditional East-Asian medicines, i. e. the ISO/TC 249 action, which is intended to unify traditional East-Asian medicines with traditional Chinese medicine (TCM).
There is historical evidence that the Korea and Japan imported ancient Chinese medicine in the past, however, either country has greatly its reformed Chinese medicine resulting vast differences from the current TCM.This paper intends to reveal the differences between Kampo and TCM from the viewpoint of disease recognition methods. Kampo recognizes a disease via structuralism, whereas TCM depends on element reduction theory, i. e. The Five Elements and so on. Kampo is based the theory whereby a sho (sign / symptom / indication for) correlates with a formulation. The character of each formulation can be acquired through tactile knowledge with clinical experience mainly based on abdominal findings.
To expand, a Sho represents the name of its most proper formulation, such as with kakkonto-sho. Inother words, a disease entity is expressed in the name of its treatment. This means that Kampo does not lend itself to Chinese element reduction theory, but rather, is used restrictively as a matter of explanation for a selected formulation. Thus there are fundamental philosophical difference between the current TCM and Kampo, so that we cannot agree with the Chinese government's ISO proposal by which both modalities would be brought under the same Chinese heading.

The abdominal diagnosis plays an essential role in Japanese Kampo medicine. Moreover, this diagnostic method is a characteristic practice in Kampo medicine. The conventional method of abdominal diagnosis is performed with the patient in a supine position. However, the author has found that several patients have presented with tenderness of the epigastrium or hypochondrium in a standing position, which was not detected in a conventional supine position. This paper is intended to announce the significance of a new method of abdominal diagnosis named “Ritsuishin”. In this paper, the author describes the utility of this method via a case of saikokeishikankyoto and of hontonto (Chugoho).