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.

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

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.

A 64-year-old female who had suffered from rheumatoid arthritis (RA) for many years was admitted to our hospital because of acute abdominal pain and diarrhea. She was diagnosed with RA, Sjögren syndrome and protein-losing enteropathy (PLE) with GI tract amyloidosis. She was treated with total parenteral nutrition, prednisolone, tranexamic acid and a variety of Kampo medicines, for example: kanzo-syashin-to, keishi-kashakuyaku-shoukyou-ninjin-to, and bushi-kobei-to. However, diarrhea continued and paralytic ileus occurred. Then she was treated with Ubai-en, which is known as an anti-ascarid drug or anti-diarrheic drug. Ubai-en was effective on her diarrhea in 2 weeks. This suggests that Ubai-en may be an effective treatment for PLE.

We report a case of an 84-year-old septic patient who was treated with Ogi-kenchu-to (Huang-qj-jian-zhong-tang). The patient had remained positive for Klebsiella pneumoniae. The focus of infection had not been detected, but bacterial translocation from the digestive tract was suspected from the clinical course. After two weeks of antibiotic therapy, he still had a high fever and positive blood culture. In addition, multiple cultures showed the destruction of normal flora and an increase of antibiotics-resistant bacteria.
Antibiotics were then suspended, and he was treated with Ogi-kenchu-to alone. His fever and inflammatory signs gradually disappeared, and his blood cultures became negative without restarting antibiotic treatment. He recovered completely. Ogi-kenchu-to is indicated for treating “generally weakened” patients or patients with intestinal problems. However, we could not find any reports of its application to septic patients. Although we still need to determine the mechanism for its efficacy, we consider that this case adds further evidence that Ogi-kenchu-to may be helpful for those suffering from severe infection, especially in elder patients and immuno-suppressed patients.

We gave Borei-takusya-san to six patients with intractable edema under the waist. This treatment cured three of the six. Two of the cured patients had Ki-deficiency or Yang-Ki-deficiency in the kidneys. In these cases, we first intensified Ki in the kidneys and improved their conditions to Yin-disease, first stage. We noticed improvement of their subjective symptoms and objective signs after we gave them Borei-takusya-san in combination with their prescriptions. All of the ineffective cases presented some conditions of hypo-tonus or hypo-reactivity.
With reference to many ancient medical books and our own experience we studied the use of Borei-takusyasan. It applies to patients (1) with oliguria, (2) with edema under the waist, (3) without Ki deficiency and Yang-Ki-deficiency in the kidneys and with (4) more reactive stage than Yang-disease, second stage and Ki between excess and deficiency. (5) If they had Ki-deficiency or Yang-Ki-deficiency in the kidneys, we should first replenish with Ki sufficiently, and make out prescriptions for the patients.
We consider that Borei-takusya-san is capable of wide application to the patients with edema under the waist, following our indications.

A 44-year-old male with cyclic neutropenia who had suffered from repeated general fatigue and severe abdominal pain over twenty-six years was admitted to our hospital. Various active treatments such as steroid, granulocyte colony-stimulating factor and immunosuppressive regimen had been attempted, but a lasting cure could not obtained. In addition, the cycle of neutropenia had gradually been disturbed and abdominal pain occurred even at the period of normal neutrocyte. The patient fell into severe asthenia and cold syndrome judging from Japanese traditional Kampo medicine. Tsumyaku-shigyaku-to and Dai-kenchu-to combined with Busi-koubei-to were administered alternately, and then abdominal pain was reduced, accompanied by improvement of his cold and strengthening of his constitution. Furthermore, several Kampo formulas such as modifications of Chu-kenchu-to were administered on the basis of abdominal symptom and the cycle of neutropenia was regularized. This suggests that the genus Kenchu-to may be an effective treatment for cyclic neutropenia.

We administered Seki-gan-ryo to 24 patients with severe asthenia and cold syndrome as judging by Japanese traditional Kampo medicine. The patients were separated into responder, and non-responder groups. There were 12 patients in the non-responding group. We investigated the clinical indicators of Seki-gan-ryo with special reference to the type of cold and pulse diagnosis. The type of cold wass divided into three groups; heat in the upper and cold in the lower, and limbs type. Pulses superficialis-profundus and excess-efficiency were graded from the diagram.
Seven of the 11 patients in the non-responder group appeared to have a general type of cold. There was, however, no statistical difference between the responders and the non-responders, in their type of cold. All patients in the responder group presented with relatively strong pulses (excess: 1, relative excess: 4, and balance: 5). On the other hand, the strength of pulses in the non-responder group appeared to vary.
If patients with severe asthenia and cold syndrome present with a relatively strong pulse, Seki-gan-ryo may be thought of as discriminating formula.