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 ( ?? ).
Medicine, Kampo ; Medicine ; Diagnostic ; Classical ; New

We prescribed ninjinto for 3 patients with chronic obstructive pulmonary disease or interstitial pneumonia.Markers for assessing the efficacy of this formulation included dull sensations in the stomach and diarrhea.These markers rapidly improved following the administration of ninjinto. The 3 patients experienced 2 com mon features, including an obstructive and a cold feeling in the pit of the stomach. Moreover, a cessation or significant decrease in cough and sputum was observed following ninjinto administration. Ninjinto is usually used to treat digestive disorders. However, these findings suggest that ninjinto may also be used for the treat ment of respiratory disorders.

We report four patients suffering from dumping syndrome treated effectively with Keishito and its additional prescription. Case1was a 57-year old male who received subtotal gastrectomy 30 years ago. After the operation he felt shaking sensations and eyes flickering after meals for10minutes to 4 hours. These symptoms tended to occur along with hunger. After taking Keishito, these symptoms improved. Case 2 was a 63-year old male who received subtotal gastrectomy 7 years ago. In recent years, he has had noticeable sweat and fatigability 20-30 minutes after meals. After taking Keishito, these dumping syndrome symptoms disappear. Case 3 was a 71-year old female who received subtotal gastrectomy 9 years ago. Thereafter, cold sweats and dizziness came to appear regardless of what she ate. After taking keishikashakuyakuto or shokenchuto the aforementioned symptoms disappeared. Case 4 was a 72-year old female who received subtotal gastrectomy 2 years ago. Sweats and hot flushes began to occur after meals for 30 minutes to 3 hours, from last July. These symptoms were improved simply by licking candy. After taking Keishito, these symptoms also disappeared.
symptoms <1> ; Gastrectomy ; Dumping Syndrome ; Cases ; Hour

Saiko-sokan-to has been traditionally used for the amelioration of symptoms such as anxiety, insomnia, Shigyaku-san-sho (sho = pattern of symptoms determined by Kampo diagnosis) with left hypochondralgia and Shigyaku-san-sho with a feeling of obstruction in the costal region. However, there are still aspects that remain to be elucidated concerning the indications for this formula.
This study involved 7 cases with stiff shoulders, headaches, abdominal distension, meteorism and flushing which responded to Saiko-sokan-to. The experience of these cases suggests that conditions indicating Saiko-sokan-to have the following features: (1) there is resistance or tenderness upon pressure in the subcostal region (traditionally referred to as Kyokyokuman), (2) there is resistance or tenderness upon pressure in the epigastric region (traditionally referred to as Shinkahiko), (3) there are signs of Ki-depression, (4) for severe “blood stagnation” syndrome (traditionally called oketsu), Ikkando Saiko-sokan-to was found to be more effective than Igakutoshi Saiko-sokan-to.

There have been few studies of the relationship between respiratory function, chest x-rays, electrocardiograms, and the abdominal palpation signs of Kampo medicine. This investigation was designed to elucidate the above points with 489 subjects who had undergone a full physical examination. As a result of this study, we make clear the following features:
1. Abdominal tension (traditionally referred to as “fukuryoku”) was related to vital capacity, lateral distance of the thorax, CTR, counter-clockwised axis deviation of QRS, and negatively related to the intra-vertical thoracic distance.
2. Sound of gurgling fluid in the abdomen (“Shinsuion”) was related to intravertical distance of the thorax, clockwise axis deviation of QRS, negatively related to the lateral distance of the thorax, width of the heart and CTR.
3. Tonus of the rectus abdominis muscles was related to vital capacity and intravertical distance of the thorax and negatively related to the lateral distance of the thorax.
4. Palpitation of the abdominal aorta (traditionally called “Shinkaki”, “seijouki”, and “saikaki”) revealed nega tive correlation to the lateral distance of the thorax and width of the heart.
5. Resistance or tenderness upon pressure in the epigastric resion (“shinkahiko”) was negatively related to the intrathoracic distance.
6. Resistance resembling a string of pearls in the midline of the lower abdomen (“seichushin”) was related to intravertical distance of the thorax, clockwise axis deviation of QRS, and negatively related to SV 1 electro cardiogram voltage.

There have been few studies on the relationship between the body mass index (BMI), complete blood cell count, blood chemistry, fatty liver evidence and Kampo abdominal palpation signs. This study was designed to clarify the above points. It involved 484 subjects who had undergone full physical examinations. The results of this study, can be summarized as follows:
1. Abdominal tension (traditionally referred to as “fukuryoku”) was related to BMI (males and females), TG, TCh/HDL, GPT, RBC, Hb and evidence of fatty liver (males) and corresponded negatively with HDL (males).
2. Tonus of the rectus abdominis muscle (“fukuhikokyu”) was negatively related to BMI (males).
3. The sound of gurgling liquid in the stomach (“shinsuion”) was negatively related to BMI (males and females).
4. Palpitations of the abdominal aorta in the upper abdomen (“shinkaki”) was related toHDL (males) and negatively related to BMI (males and females).
5. Palpitation of the abdominal aorta below the navel (“saikaki”) was negatively related to BMI (males).

Four intractable decubitus ulcer patients who had not responded to any Western medicine were treated effectively with Kigi-kenchu-to-ka-bushi. Case 1 was a 82-year-old female patient who had been admitted due to multiple-cerebral infarction. She had been bedridden and suffered repeatedly from pressure ulcers. Her bed sores were controlled successfully with Kigi-kenchu-to-ka-bushi. After treatment by Kigi-kenchu to-ka-bushi, any decubitus ulcer was not recurrence. Case 2 was a 85-year-old female patient. The pressure ulcer was 2cm in diameter and extent of soft tissue fissure underlying it was about 10cm in diameter. Skin color around pressure sore changed to purple. After administration of Kigi-kenchu-to-ka-bushi, skin color returned to normal and decubitus ulcer recovered. Case 3 was a 59-year-old male patient who had undergone operation on an intractable decubitus ulcer with fistula, but he did not get well. Two weeks later, after treatment with Kigi-kenchu-to-ka-bushi, he felt pain when we sterilized his ulcer. It was thought to be a sign of improvement of the wound. Physical status became better as the ulcer healed. Case 4 was a 64-year-old female patient with brain death because of acute myocardial infarction. Her pressure ulcer was treated effectively with Kigi-kenchu-to-ka-bushi, too.

Visceral fat obesity is closely associated with lifestyle-related diseases that include symptoms such as hypertension, diabetes mellitus, hyperlipidemia, etc. To examine the correlation between pulse, appearance of tongue, and abdominal palpation-diagnostic indicators according to Kampo medicine-and visceral fat obesity, we investigated 209 subjects who received health screenings, and obtained the following results. 1) The simply obese subjects, as determined by body mass index, showed symptoms of excess state, Kidepression, and stasis of body fluids according to the diagnostic techniques of Kampo medicine. 2) The visceral fat-rich subjects were diagnosed by means of abdominal ultrasonography and showed symptoms of pulsus maximum and Oketsu (blood stasis) state.

In all but a few cases, the treatment for elderly patients must be conservative owing to the unavoidably poor general condition of the patients.
We report on three cases of long-term bedridden patients with acute cholecystitis or cholangitis who were effectively treated with Kampo prescriptions. An 86-year-old male with choledecholithiasis and acute cholangitis responded to Inchin-ko-to. When he repeatedly relapsed after the discontinuance of Kampo treatment, Inchin-ko-to was effective, and Inchin-shingyaku-to successfully improved his general condition. In an 89-year-old male with acute cholecystitis, Dai-saiko-to extracts and Bukuryo-shigyaku-to were effective. An 88-year-old female with cholecystolithiasis and acute cholecystitis responded to Dai-saiko-to and Bukuryo-shigyaku-to.
Most elderly patients are Inkyo-sho (Yin-deficient). But, when they are suffering from acute sickness, it is important to treat them according to the principle of “Senkyukokan (treating acute symptoms before treating chronic internal symptoms).” The severe sickness is treated first, and then the mild phase of the disease is treated.

A Kampo formulation, Senkinho-Karo-to, is considered to be effective for chest pain or discomfort. However, there have been few case reports concerning this formulation. Here, we report four cases of patients suffering from chest pain or discomfort that were successfully treated with Senkinho-Karo-to. We compared the clinical features of these four cases where Senkinho-Karo-to was effective with those of four other cases where Senkinho-Karo-to was ineffective. The cases where Senkinho-Karo-to was effective had the following features: Deficiency, feeling of spasmodic uprising heat, shoulder stiffness, deficient pulse, impressions of teeth on the rim, palpitation of the abdominal aorta in the supra-umbilical region, reduced tension in the lower abdomen, tenderness in the para-umbilical region, and Ki-depression.