This shows my clinical experiences with Japanese traditional (Kampo) treatments on acute phases of illness, mainly some case reports.Shanghanlun, which is one of the most famous textbooks about ancient Chinese medicine, must be the oldest textbook of EBM. In the book, clinical courses and variations of acute febrile diseases are stated with the suitable prescription respectively based on clinical experiences. Regarding the Kampo practice, especially at the acute phase, it is very important to judge the yin-and-yan and the six stages of disease. Only the excess-deficiency theory is inadequate. Heat-cold which is an aspect of yin-and-yan is also important. Besides, particularly at acute febrile disease, we should find changes in the clinical condition like the six stages of disease caused in the clinical process. Sometimes the Kampo diagnosis can be two or three stages at same time, or be one but look like multiple stages.Kampo medicine effects change so quickly that trying therapeutic diagnosis for the appropriate prescription called shihuku is very useful especially for acute diseases. During a Kampo examination, checking the pulse condition and abdominal signs including cold and warm sensation are effective. On the prescription, Keishinieppiichito is often potent and should be used more frequently to treat patients in acute febrile disease. For treatment of serious cases, I believe that we need more medical institutions which can hospitalize using natural Kampo formulas, containing raw aconite i.e.

A 72-year-old female who had been experiencing chest pain after slight exertion for over one month was admitted to our hospital. An electrocardiogram after exercise revealed a myocardial ischemic change. We diagnosed Ketsu-kyo on the basis of symptoms such as extreme tenderness in the epigastric region (Shinka-hiko) and also tenderness in the anterior chest wall. After prescribing Dai-kankyo-to, which was made by boiling with Daio, Bosyo and Kantsui, the expected diarrhea did not occur. We then made Dai-kankyo-to according to the original method of Sho-kan-ron and administered it. The chest pain disappeared and severe diarrhea occurred. A coronary angiogram did not reveal a stenotic lesion and the patient was diagnosed with microvascular angina pectoris. This suggests that Dai-kankyo-to may be an effective treatment of microvascular angina in its acute stage.

Apart from development of medical technology, how we prevent disease has been an important issue.
Moreover, it has become clear that the diseases, such as cancer, diabetes, myocardial infarction, cerebral infarction and cerebral hemorrhage, which lead to the cause of death for a great portion of Japanese, are often caused by lifestyle factors and the outbreak of such diseases could possibly be prevented by changing lifestyle.
At this seminar, the lecturers discuss developments in lifestyle especially paying attention to food.
First a lecture was given from a viewpoint of caloric restriction and balance in relevance to healthy eating habits, next the effects of acupuncture and moxibustion on nutrition absorption, and finally oriental holistic foods concepts and the relationship between diet and disease.
We held a discussion based on this lecture. and we reviewed the relation between diet and disease, the affect of acupuncture and moxibustion on nutrition absorption, and the view of the holistic meal as part of oriental medicine. Finally a useful possibility for combining diet with acupuncture and moxibustion therapy was suggested.

We sought a connection between the half-exterior half-interior symptoms (hanpyo hanri sho), mentioned in the classic Chinese Shang han lun text and used in Kampo medicine, and embryology. An agreement between these shao yang (lesser yang) symptoms, and embryonic brachial arch domains was found. A part of the brachial arches strongly agrees with the ruling domain from the trigeminal nerve to the vagal nerve, and a connection was also seen to the vestibulocochlear nerve and partly to the accessory nerve. Thus we believe that half-exterior half-interior symptoms are a condition which relate back to part of the brachial arches, and are a result of so-called Heat reaction. Shang han lun Chinese medicine and embryology are two completely different fields. However, we consider an embryological view of nerve pathways to be helpful in understanding half-exterior half-interior symptoms, at least to a certain degree.
symptoms <1> ; CONSIDERATION ; Chinese People ; Nerve ; Medicine

The prognosis of rheumatoid arthritis (RA) worsens significantly when accompanied by renal disorders due to amyloidosis. Recently, satisfactory results have been obtained by the administration of Daibofu-to to a patient suffering from amyloidosis and renal failure with RA. The patient was a 64-year-old female, whose chief complaint was a polyarthralgia. Ten years ago she was diagnosed as having RA. Both gold compound and glucocorticoid had been administered. Renal dysfuntcion was discovered in February, 1993, and she was admitted to the Aso-Iizuka Hospital in **********. On admission she was evaluated as class II and stage IV. Deposits of amyloid was found in the mucosa of the stomach, duodenum, and the glomerular tissues of the kidney. Administration of Daibofu-to brought about a reduction in the Lansbury's index from 64% to 39% during a two week period.
After four weeks, the serum creatinine level fell from 1.7mg/dl to 1.5mg/dl, and the daily amount of urinary protein excreted dropped from 4g/day to 2.5g/day. At present, one year after discharge, the RA with amyloidosis and renal failure is being successfully controlled with Daibofu-to.

The ‘Kenjuroku’ is a book of 54 case reports written by Yoshimasu Todo in 1763. The cases studies of four Buddhist monks (Gyokutan, Soboku, the director of Seikoji temple, and the son of the director of Shorakuji temple) from Toyama prefecture are described. Through an investigation of the biographies of these men, the authors attempted to determine the disease condition and symptoms present at the time of their meeting with Todo and inclusion in his book. These four cases were unique in that they appeared to have actively accepted Todo's new medical theories. This led to a discussion of the analogous aspects between his theories and the doctrine of Jodo-shinshu.

Two cases of hyperthyroidism were treated with Kampo therapy alone, without the use of antithyroid drugs. The first case was a 47-year-old female who had been experiencing palpitations, weight loss, nervousness, tinnitus and vertigo for two years. She was diagnosed as having Graves'disease because of serum thyroid stimulating hormone (TSH) and increases in free T3 (fT3), free T4 (fT4), TSH binding inhibiting immunoglobulin (TBII), and 24-hour thyroid radioactive iodine uptake (24-h RAIU). Shakanzo-to was given for palpitations and other symptoms. Saiko-ka-ryukotsu-borei-to was later added in accordance with the Kampo diagnosis. After about one year and ten months, serum levels of TSH and fT3, fT4, and TBII are normalized.
The second case was a 40-year-old female, in whom palpitations had appeared about 3 years previously. Three months ago she was diagnosed as having hyperthyroidism. Thiamazole had been administered for two months. Serum TSH was decreased and fT3, fT4, TBII were increased when she first came to our clinic. Shakanzo-to was given for palpitations and other symptoms. After three weeks she refused to take thiamazole of her own accord. Saiko-ka-ryukotsu-borei-to was given concomitantly in accordance with the Kampo diagnosis. The serum levels of fT3 and fT4 increased gradually, but the palpitations were reduced. After about 10 months, the fT3 and fT4 levels were observed to decrease. This suggests that some of the hyperthyroidism can be imprgved by Kampo therapy without antitnyroid drugs.

Satisfactory results were obtained when Daiou-kanzui-to was administered to a patient suffering from osteoarthritis with Graves' disease.
The patient was a 61-year-old female, whose chief complaint was bilateral knee joint pain and leg edema. She was admitted to our clinic in May, 1995. She was diagnosed with Graves' disease and thiamazole was administered for six months. After discharge, the knee joint pain and edema worsened and she was readmitted to our clinic **********. Abdominal examination revealed fullness and lenderness of the lower abdomen. After administration. of Daiou-kanzui-to, the knee joint pain and leg edema improved remarkably, and she was discharged on **********. Although hyperthyroidism was discovered during the second admission, it improved without anti-thyroid drugs after five months of treatment with Daiou-kanzui-to.
Despite the fact that Daiou-kanzui-to is a strong purgative, no side effects were observed even with longterm administration. There are only two reports on the use of Daiou-kanzui-to since the Meiji era. The authors investigated old texts concerning abdominal symptoms, such lower abdominal fullness, which characterizes Daiou-kanzui-to, to establish indications for its application.

Recently we observed three cases in which symptom-producing doses of Kampo medicine with aconiti tuber dramatically ameliorated primary diseases. The symptoms were similar to intoxication caused by aconiti tuber. Case 1 had been suffering from rheumatoid arthritis. After the daily dose of Keishi-ni-eppi-itto-ka-ryojutsubu, a Chinese herbal medicine containing aconiti tuber, was increased from 6g/day to 7g/day, the patient briefly experienced palpitation and nausea. At the same time, polyarthralgia and laboratory data dramatically improved. Case 2 suffered from lumbago due to osteoarthritis. Numbness around the lips and in the limbs and gait disturbance occurred in this patient after the basal prescription was changed from Shakuyaku-kanzo-bushi-to to Hachimijio-gan-ryo with the 4g/day dose of aconiti tuber remaining the same. The patient's lumbago disappeared almost completely. Case 3 had osteoarthritis and began taking Hachimijio-gan-ryo, containing aconiti tuber (8g/day), in early June. Numbness around the lips and limbs occurred after administration of Hachimijio-gan-ryo containing aconiti tuber (4g/day) in late July. After that, her gonalgia was recovered. Based on our experience above, we had the impression as follows: 1) Symptoms similar to intoxication due to aconiti tuber may be caused not only by increasing the daily dose of aconiti tuber, but also by changes of basal description or climate variations such as a rise in temperature. 2) In order to use aconiti tuber effectively, it is sometimes necessary to increase the daily dose to the level where it provides treatment, in spite of the risk of intoxication.