In order to have a more “universal understanding” of Kampo medicine, it helps to explain the “fundamental concepts” and the “theoretical framework” of Kampo medicine, in latest life science knowledge with a key word “context.”Ki, Ketsu and Sui are the three elements which compose the cellular environment (context), and shoulder the maintenance of life's activities, which are dependent on metabolic changes and information flow. The function and structure of the living body are normally led by Ki, Ketsu and Sui.The five parenchymatous viscera (lungs, heart, liver, spleen, kidneys) are not only organs which maintain the cellular environment, they also act as higher control systems which control organ activities. These five viscera as higher control systems create conditions (context) throughout the body and control the life activities of each organ in an integrated manner.In a sick person, these organ life activities take on a kind of “fighting style” which can change from moment to moment, with natural disease progression and/or treatment intervention. The classic text Shokanron describes these changes in fighting style as the “six stages of disease”, and indicates formulation choices based on variations in the body's fighting style.From the viewpoint of a connection with Western medicine and a dialog with traditional Chinese medicine, explaining Kampo medicine in ways which anyone can understand by creating a universal understanding of its fundamental concepts and theoretical framework, is our mission for the 21st Century.
Medicine, Kampo ; Medicine ; seconds ; Comprehension ; Fighting

In this paper, we report four patients with chronic respiratory diseases who improved by administration of Bukuryo-kyonin-kanzo-to.
A 66-year-old female diagnosed as bronchial asthma could increase the peak flow rate and stopped western medicines by its administration. A 63-year-old female suspected to have cough variant asthma and an 08-year-old female diagnosed as having bronchiectasia with cough and dyspnea on exertion improved gradually after a few months of treatment. A 62-year-old female diagnosed as having interstitial pneumonia with systemic sclerosis showed improvement of cough and dyspnea. The erythrocyte sedimentaion rate and serum lactate dehydrogenase decreased and arterial oxygen pressure increased by its administration. This report and past reports seem to indicate that a patient profile which can be expected to be responsive to this formula is: elderly female, cough worse at night, chest dyspnea, and epigastric tenderness and muscle guarding. This drug was considered to have wider applications for chronic respiratory disease.

Atopic dermatitis in adolescents and adults has severe erythema and desquamation, particularly on the face and the neck, and is often resistant for various treatments. We previously reported the case of intractable erythematous dry-type atopic dermatitis where Kagen-ichiin-sen-ka-kiban-kyo was effect. Kagenichiin-sen-ka-kiban-kyo has an effect for nourishing Yin and Blood. Although its antiinflammatory effect is weak, we expected it would improve the deteriorated barrier function of the skin by moistening dry skin, and treat the atopic dermatitis more fundamentally. This time aiming broad application for the lesion of exudative eczema, we treated atopic dermatitis by using sekko-added Kagen-ichiin-sen-ka-kiban-kyo (Kagen-ichiin-sen-ka-kiban-kyo-sekko). The moisture content of the forehead and the extensor surface of forearm sequentially increased. And IgE-KIST and LDH, the markers of the state of a disease, were significantlly reduced. Good results were given; 68.8% of efficacy in men and 77.8% in women.
This Kampo formulation is assumed one of the effective formulations for the treatment of atopic dermatitis.

Medicine, Kampo ; Names ; Disease ; Diagnosis

A patient with systemic lupus erythematosus (SLE), complicated by severe thrombocytopenia was successfully treated with Juzen-taiho-to. The patient was a 38-year-old woman presenting thrombocytopenia in 1974. She was diagnosed as having SLE with the appearance of renal failure in 1975. In 1984, she began blood dialysis due to deterioration of renal function. In addition, she repeatedly suffered from severe bleeding episodes due to thrombocytopenia. In 1989, she visited our clinic to undergo Kampo therapy, with no significant results obtained with any of the formulas tried.
In September 1992, she suffered from duodenal ulcer bleeding and stopped Kampo therapy for some time. However, since she began taking Juzen-taiho-to in June 1993, her thrombocytopenia improved and her platelet count stabilized at 10-15×10⁴/mm³. This made it possible to taper the dosage of the steroids being administered. Since July 1994, the prednisolone (PSL) dosage has been 5mg on alternate days. Since July 1995, the anti-DNA antibody was negative. The platelet count has been maintained at 15-20×10⁴/mm³ (as of December, 1996).

To investigate the difficulties of taking Japanese traditional (Kampo) medicines, questionnaires were filled out by patients under 19 years old or their families.Forty-six questionnaires were valid for analysis. The mean age of the patients was 9.7 &qlusmn; 5.3 years old (2 to 19 years old) and the percentage of male patients was high (65%). They took extract granules (n = 40) or decoction (n = 6) and most of the patients (n = 38, 83%) took medicines twice a day. Though 69% of patients under 5 years old needed direct assistance from their family to take medicines, none of over 6 years of age needed any help except to dissolve medicines in hot water, while notably 77% of the patients over 13 years old took their medicines un-aided. It was found that patients' families gave them the concrete explanations on the necessity of their medicines regardless of patients' age, so it is important for pharmacist to guide not only families but also patients themselves. Furthermore, pharmacists should understand the taste and the constituent crude drugs of Kampo medicines to improve patients' adherence in taking medicines.

Four cases of atopic dermatitis successfully treated with the Kampo formula Tokaku-joki-to are reported. Case 1 was a 25-year-old woman who had been suffering from atopic dermatitis since she was in lower elementary school. She came to our clinic in July of 1992. She complained of intense itching of the neck and area around the mouth. Her abdominal tension was moderate, and there was para-umbilical and caecal tenderness. The patient complained of constipation and dysmenorrhea. After four weeks of Tokaku-joki-to administration, the dermatitis improved markedly. After two years of treatment with this formula, she is progressing favorably.
Case 2 was a 14-year-old girl, who had suffered from atopic dermatitis since she was 3 months old. She first came to our clinic in January of 1993. The dermatitis was located in the upper extremities, face and neck. She also had experienced flushing, para-umbilical tenderness and constipation. After two weeks of administration of Tokaku-joki-to, her dermatitis improved remarkably, although she still experienced flushing. Ryokei-mikan-to was added to the formula for the flushing.
Case 3 was a 28-year-old woman who had suffered from atopic dermatitis since she was 3 years old. She consulted our clinic in October, 1993. The dermatitis was located on her face and elbow. She had tenderness around the paraumbilical, caecal and sigmoid regions. The patient is progressing favorably with Tokaku-joki-to administration.
Case 4 was a 26-year-old woman. She had had atopic dermatitis since she was young, and came to our clinic in October of 1993. The dermatitis was on the upper extremities, face and back. At first we prescribed Toki-inshi, but this formula was not effective. The formula was changed to Tokaku-joki-to and the dermatitis improved remarkably after about three months of treatment.
This is the first report of administering Tokaku-joki-to for atopic dermatitis. Based on the clinical study involving the four cases described above, we propose the following indications for use of Tokaku-joki-to for atopic dermatitis: 1) the dermatitis is located on the upper part of the body, 2) there is flushing, with a feeling of coldness in the lower extremities, 3) there is tenderness around the para-umbilical, caecal and sigmoid regions, and 4) there is a tendency towards constipation.

In Kampo therapy for rheumatoid arthritis (RA), Keishi-ka-ryojutsubu-to, Keishini-eppi-itto and Keishi-shakuyaku-chimo-to are considered to be the primary formulas. However, it is often difficult to control arthritis with the primary formula alone. In this study, we administered 7.5g/day of Ji-daboku-ippo to 12 patients with RA, who had not responded sufficiently to the primary formula alone. Administration of the primary formula and other anti-rheumatoid drugs was also continued.
After three months of this supplemental administration of Ji-daboku-ippo, the mean±SE of the Lansbury's index significantly decreased from 45.3±5.8% to 33.3±3.8% (p<0. 01). After treatment for one year, a decrement in the Lensbury's index (of more than 20%) was seen in the four patients. These results suggest that supplemental administration of Ji-daboku-ippo is effective for patients who fail to respond sufficiently to the primary Kampo formulas used for RA.

In this paper, the authors report four case studies of patients with chronic asthma who improved with the administration of Hachimijio-gan (in pill form). The patients involved were three women aged 63, 57 and 41, and one man, aged 42.
In all of the cases, asthma attacks began in adulthood and occurred perennially. They were classified into three grades of severity: patient 1-mild; patient 2-moderate; patients 3 and 4-severe. The standard indications for usage (Sho) in Kampo medicine were confirmed in all four cases. The asthmatic state of patient 1 improved with administration of Hachimi-jio-gan M (Uchida Wakanyaku Inc.), but produced no response in the other three patients. However, when Hachimi-jio-gan pills that were made by hand using the steamed root of Rehmaniae Radix were administered, improvement was seen in the asthmatic state of the other three patients as well. With improvement in the asthmatic state of all patients involved, attack scores decreased, treatment scores decreased and peak expiratory flow rates in the early morning increased. Patient 3 was able to discontinue use of oral corticosteroid drugs, and patient 4 was able to decrease the dosage.
The results suggest that Hachimi-jio-gan improves the respiratory function in patients with chronic asthma, and that the clinical effect was increased when the steamed root of Rehmaniae Radix is used in place of the dry root.