Complementary and alternative medicine (CAM) is making waves all over the world nowadays. The National Institute of Health started an office of alternative medicine in 1992 and established the National Center for CAM (NCCAM) in 1998. The annual budget has increased to 113.3 million dollars. The NCCAM has founded the Office of International Alternative Medicine (OIHR), to support collaborative work with countries other than USA. In 2003, 10 international planning grants were awarded which included a collaboration with Keio University in Japan.
In most of Asian countries except for Japan, the government supports promotion of its own traditional medicines. When European medicine came from Holland to Japan, in the Edo period, Japanese doctors quickly adopted European ways and mixed them with traditional Kampo medicine. For example, Seishu Hanaoka combined surgery with Kampo, for the benefit of his patients.
Taro Takemi pointed out Kampo drugs should be used in Kampo ways, and not in western medical ways. To globalize Kampo, first of all, Kampo should be more visible both in Japan and in the world. Secondly, the government's support is essential. Thirdly, public enlightenment concerning Kampo is necessary. Many people actually confuse Kampo, with dietary supplements. Fourthly, we need faculty members in universities, who can introduce Kampo as a part of Japan's medical culture. Lastly, Japan should contribute more to the development of traditional medicine in Asia.
Kampo is a definitive model of integrative medicine in our world. We must introduce this traditional heritage and treasure, globally.

It is not a few cases that present with fever and fatigability of an unknown cause. We report a case of fever and fatigability treated effectively with hangeshashinto. The case was 47 year-old woman who had been having fever and fatigability for three years. Sometimes she could not go to work because of this malaise. She was diagnosed with patterns of qi deficiency, upper body heat and lower body cold, qi stagnation and stagnant blood. We carefully considered shinkahiko (epigastric tightness and resistance).
Hangeshashinto was prescribed, and her complaints improved remarkably. Hangeshashinto is a well-known Kampo formulation for treating disorders of digestion. But this suggested that hangeshasinto is effective for a variety of symptoms in patients with digestional disorders, who also have a shinkahiko condition.

It is difficult to treat arthralgia of unknown cause. We report a case of polyarthralgia treated effectively with hochuekkito.
The case was a 48 year-old woman who had polyarthralgia for three months. Her joints were not swollen and reddish. There were no remarkable signs of rheumatoid arthritis or any other immune diseases. She also complained of fatigability. She was diagnosed as patterns of qi deficiency and qi stagnation. After prescribing hochuekkito for fatigability, her arthralgia as well as fatigability substantially decreased. In this case, it is suggested that hochuekkito was effective as a qi-tonifying formulation.

Bofutsushosan has recently become a well-known Kampo formulation for treating metabolic syndrome. It is effective for obesity in people who have mental disorder, but few reports suggest that it is effective for mental disorder itself. We report a case of depressive complaints treated effectively with bofutsushosan. The case was 63 years-old male who had had depression for twenty years. His depressed condition had been stable owing to antidepressant therapies. However, he had could not read books, and so had not been able to enjoy the pleasure of reading since nine months previously. He did not believe that his depression had taken a turn for the worse, but rather that he had the partial androgen decline (or deficiency) of aging males. Therefore he did not consult his psychiatrist, and he wanted to be treated with Kampo formulations. He was diagnosed with a hyperfunctional constitution, heat pattern, and a ki obstruction pattern. Bofutsushosan was prescribed, and his complaints improved remarkably. This suggests that bofutsushosan is effective for treatment of not only obesity but also mental disorder itself.

The World Health Organization plans to incorporate "traditional medicine" into the next revision of its International Classification of Diseases-Version 11 (ICD-11). If traditional medicine is included in ICD-11, it is definitely an epoch-making issue. The expected result is the International Classification of Traditional Medicine, China, Japan and Korea Version (ICTM-CJK). The intention of the ICTM project is not only beneficial for traditional medical components, but also might be beneficial for Western biomedicine. For this shared purpose, China, Japan and Korea must understand the meaning of this project and collaborate to develop it.

We performed a statistical analysis to find characteristic elements or moments which may make old people feel life worth living in rural areas in Japan, using the results of a questionnaire survey we reported in 1996 wiht the title “Aging of the Rural Population and Effective Measures to Respond to the Trend.”
In the analytical procedure, we used a multiple regression analysis with a logistic model. The dependent variable was the question “Is your present life worth your while to live?” As the independent variables, 168 questions were used covering various aspects of everyday life-farm work, activity in the community, environment, health, medication, aging, death, etc.
The number of subjects responded to the survey totaled 1, 373 men and women at age 55 and over living in 7 prefectures in Japan. The purpose of the analysis was to obtain items of questions with statistically significant coefficients in the logistic regression equation for the dependent variable. A total of 28 items of questions of statistic significance were obtained and most of the answers to these questions had a positively directed nature in order. Some of the items are as follows:
“Principles in life, ”“High hopes on agriculture, ”“Family with plural generations, ”“Satisfaction with domestic conditions, ”“Positive (healthy) ADL-markers, ”“Liking for harmony, ”“Participation in neighborhood activity, ”“Medication up to the terminal stage, ”“Willingness to leave one's body to medicine or donate for organ transplantation, ” etc.
Further, we discussed the comparison of items of unique characteristics between prefectures, healthy and unhealthy groups, sexes, age groups, and farmers and non-farmers.

Japanese Kampo doctors usually understand amenorrhea as caused by oketsu (blood stasis) and kekkyo (blood insufficiency). In recent years, there have been a few case reports which describe patients treated only with prescriptions for junki function (the treatment of kiutsu or ki stasis). Our case was 37 year-old woman with amenorrhea from osteopathy manipulation a half year previously in London. Her usual menstruation had been normal. She had thoracic and sacral pain, joint click, epigastric pain, lower abdominal pain, hematuria and muscle stiffness but her usual daily living was not affected. No abnormality was noted with laboratory or imaging, or endocrinological tests. From a Kampo examination, she was diagnosed with hiesho (coldness) and kiutsu. We chose uyakujunkisan without white silkworm, with aconite root. Her arthralgia and hiesho improved one month later, and her menstruation re-started three months later. Uyakujunkisan is introduced in the Wazaikyokuho, and we believe this classical textbook indicates that this prescription can be used to treat amenorrhea. Ki abnormality is one of the most important complications of secondary amenorrhea and a prescription with junki function is important treatment option. Thus, in assessment of patients with amenorrhea,we feel it is important to focus on ki abnormality.

Physicians usually prescribe specific formulae which are classified as treating blood stasis for dysmenorrhea in Japanese Kampo medicine. Daisaikoto is not classified as the category and rarely used to treat dysmenorrhea. Here, we report 2 cases of dysmenorrhea that were successfully treated with daisaikoto. In case 1, the patient was a 19-year-old student. Menstrual pain worsened and accompanied premenstrual headache and vomiting, disturbing her to go college since she started her college life. Commercial non-steroidal anti-inflammatory drugs were not effective. Her Kampo abdominal findings included abdominal strength excessive, fukuman, kyokyokuman and tenderness in the peri-umbilical region. We diagnosed her as “excessive pattern”, “heat pattern”, “qi stasis”, and “blood stasis”. We prescribed extract of daisaikoto 7.5 g per day. Four weeks later, she reported improvement of premenstrual headache and vomiting. Twenty weeks later, she needed no more analgesics at menstrual period. In case 2, the patient was a 35-year-old mother. After entrance examinations of her son and moving, her menstrual pain, headache and irritability worsened. Her Kampo abdominal findings included abdominal strength slightly excessive, fukuman, kyokyokuman, shinka hiko, and tenderness in the peri-umbilical region. We diagnosed her as the same as case 1 and prescribed the same. Eight weeks later, she reported dissaperance of headache and irritability. Twenty weeks later, menstrual pain improved.

We report 2 cases in which byakkokaninjinto was effective for general malaise in aging males. In 1939, climacterium disorders with general malaise were reported in aging men in America. Later, late-onset hypogo nadism (LOH) was defined, and guidelines for LOH syndrome were made.
We distinguished two cases of climacterium disorder with LOH syndrome in aging males. We used the AMS score (which is a diagnostic criteria for LOH syndrome) at the first medical examination.
Case 1 was a 48-year-old man suffering from serious headaches every day for which he took many analge sics. His AMS score was 27/85 at the first medical examination. Mild LOH syndrome was suspected in this case. Case 2 was a 48-year-old man suffering from frequent daily hot flashes. His AMS score was 42/85 and moderate LOH syndrome was suspected.
General malaise in aging males arises from a decrease in male hormone with aging and is treated with an drogen hormone replacement therapy (androgen HRT), while Kampo treatment is also a consideration. As Kampo treatments, hachimijiougan and kamishouyousan are usually chosen. Byakkokaninjinto was effective these patients who showed thirst and polydipsia.

We report the case of a 17-year-old male who had involuntary movements treated with yokukansankashakuyakukoboku. He had first recognized the involuntary movement 6 years previously. His symptom could not be alleviated with neurological and psychological treatments, and he visited our clinic for treatment with Kampo medicine. His symptom gradually alleviated with yokukansankashakuyakukoboku. The ancient physician Sekki (薛已) created yokukansan in China's Ming Dynasty. Yokukansan and its various add-on combinations were used in the Edo Era of Japan. Keisetsu Ohtsuka then created yokukansankashakuyakukoboku, which is however now rarely used because there is no extract drug in Japan. There are markedly nervous patients however, who can be treated with this formula. Thus, the authors feel that more research needs to be done on the differences between yokukansan and yokukansankashakuyakukoboku.