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.

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

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.

Norovirus infection is a common cause of epidemic winter vomiting and diarrhea. The symptoms that present, such as vomiting, diarrhea, fever and abdominal pain, normally disappear within 1 to 3 days, although some fatal cases are reported in the elderly.During the two months from December 1, 2005 to January 31, 2006, we prescribed ogonto to twenty patients who presented with vomiting or diarrhea in a nursing home, and examined prescription times and illness durations, other drugs used, and whether there were any transfusion or complications.The number of ogonto doses given was from 1 to 12. Fifteen cases (75%) were dosed 3 times or less, and four cases were only dosed once. In terms of illness duration: eleven cases were cured in less than 24 hours; six cases were cured from 24 hours to less than 48 hours; two cases were cured from 48 hours to less than 72 hours; and one case was cured from 72 hours to less than 96 hours. Overall, seventeen cases (85%) were cured in less than 48 hours.Regarding the other treatment and complications: domperidone was used in four cases; and a transfusion was given in six cases. Aspiration pneumonia occurred in one case, but no patient required hospital treatment. Norovirus infection is usually treated only with symptomatic therapy, so we think Kampo therapy should be available because when started at an early stage, it can prevent this disease from becoming severe.

We report a case of recrudescent cholangitis successfully treated with Kampo medicine. The patient was a 31-year-old female. She was diagnosed with congenital biliary dilatation, and underwent an operation for partial resection of the liver, and a choledocho-jejunostomy. However, the cholangitis returned two years ago, when she was 29 years old. She had repeated abdominal pain and fever, and at that time received treatment with antibiotics. She desired pregnancy, and was hoping that Kampo treatment would enable her to decrease the amount of antibiotic she was taking. We prescribed inchinkoto as a base treatment and added to daisaikoto or shosaikoto. We changed the prescription according to her symptoms. As a result, her antibiotic quantity was reduced markedly, she safely conceived, and kept taking Kampo medicine while she was pregnant. She remained in good condition throughout her pregnancy. Thus, we consider that Kampo medicine may be useful for treating recrudescent cholangitis after an operation for reconstruction of the biliary tract.

We report a situation involving Kampo therapies on an isolated island and three cases treated with Kampo medicine on the island. The first author received outpatient training at the department of Japanese Oriental Medicine in Iizuka Hospital and provided medical care on the island for 3 years, using Kampo therapies.
About one quarter of patients (total, 134) were prescribed Kampo therapies in April 2009, and we surveyed the number of patients who had taken each Kampo medicine for 2 years from April of 2008 to March of 2010. As to prescriptions of less than 4 weeks, Kampo medicines used for a cold ranked high. As to prescriptions exceeding 4 weeks, hachimijiogan, daiokanzoto and keishibukuryogan were the most prescribed medications, in descending order.
We consider Kampo therapies to have been effective on this isolated island where there are many elderly people, and patients who must be treated comprehensively while giving consideration to their familial states. We also presume the environment of an isolated island to cause certain clinical conditions, water imbalances included, such that Kampo medicines for water imbalances tended to be prescribed frequently.
Finally, learning Kampo therapies has highly motivated the first author to practice community medicine.