I will illustrate our research, which elucidate the efficacy of Kampo medicines for “Ki”.In order to compare hangekobokuto with kososan, we assessed them by binocular infrared video pupillography. The results revealed that sympathetic nerve activity was inhibited by taking hangekobokuto in the patients belonging to sympathetic dominant group, while it was stimulated by taking kososan in the patients belonging to parasympathetic dominant group.Administration of hangekobokuto has decreased the value of brachial-ankle pulse wave velocity. This result suggests that hangekobokuto ameliorates the elasticity of vascular wall, which is closely related to autonomic nervous system.The gastric emptying rate, which was evaluated by ultrasonographic method in FD patients, showed its significant increase after administration of hangekobokuto.Global gene expression analysis using a DNA chip has shown the pharmacological actions of kososan.In the animal study using depression-like model mice, we have found that kososan decreased the suppression of neurogenesis.
Medicine, Kampo ; experience (practice) ; Clinical Research ; Cancer patients and suicide and depression ; Psychological suppression

On one hand a matchless Kampo clinician, on the other a dedicated collector of antique books, Otsuka Yoshinori (1900-1980) left for posterity his immense personal library: The Shukindo bunko. We at the Medical History Department (Kitasato Research Institute) have organized and catalogued Otsuka's library. In addition to our announcement of the completion of the catalogue, we wish to introduce a summary of his life and his collection.
I. Brief biography/achievements/the person
1) the origins of the Shukindo, 2) medical specialization in Kumamoto, 3) opening a clinic in Kochi, 4) to the capital to study Kampo, 5) clinical research and educational pursuits, 6) the dispersal of the library during the war and the post-war Nishi Ogikubo years.
II. Shukindo bunko
1) the order of things, 2) the special nature of the collection, 3) the prominence of the ‘Shang Han Lun’ and ‘Jin Kui Yao Lue’ texts, 4)the substantiality of the Koho-school, 5)the Gosei-school; the Kosho-school; acupuncture and moxibustion texts.

Background and objective : Diet has been recognized as an important part of Kampo medicine, and various plants with which we often cook are included as components of many Kampo formulations. Accordingly, nutritional science is closely related to Kampo medicine. So there is a need for national registered dietitian and nutritional science students to learn Kampo medicine. Despite this, no survey has reported on the awareness of nutritional science students toward Kampo medicine in Japan. We conducted for the first time a survey on this awareness amongst nutritional science students about Kampo medicine.Methods : A 13-item anonymous questionnaire was distributed to the third-year students in a national registered dietitian training program in Japan.Results : We obtained answers from 509 students in 9 institutions. Of the respondents, 59.3% answered that they were interested in Kampo medicine, and 86.4% of the students who were not interested in Kampo medicine answered that the reason was they had no chance to learn it. However, 81.3% of the students answered that they would attend lectures on Kampo medicine if it was adopted as part of their curriculum.Conclusions : These results suggest that Kampo medicine should be included in educational programs for nutritional science students.

Case 1 was a 40-year-old woman who used a facial treatment machine and felt burning facial pain at night.She then felt unpleasantness in her facial skin all day long and was too uncomfortable to leave her home. We prescribed kamikihito. Ten days later, she felt the positive effects of treatment. Forty-five days later, she did not feel the unpleasantness on her facial skin, and she was able to go out again. Case 2 was a 36-year-old woman who had intense inflammation of her face, because she had stopped treatment with a steroid ointment.After 6 months, her face still felt hot and strange, which decreased her quality of life. We prescribed yokukan sankachinpihange. Four weeks later, she felt the positive effects of the treatment, and 14 weeks later, she was able to restart her part-time job. Because both of these cases had received various types of conventional medi cal therapy in the beginning that were not effective, their Kampo therapy was begun a long after the start of their abnormal facial sensation symptoms. Kampo therapy demonstrated a positive effect after approximately one month in both of these refractory cases. Thus we recommend Kampo medicines for the treatment of abnor mal facial sensations.

We experienced 2 cases in which Kampo (Chinese medicine) treatment was effective for septic osteoarthritis. Case 1 : a 34-year-old female. Septic coxarthritis developed with no left hip joint abnormality being noted, while DIC (disseminated intravascular coagulation) from MRSA pneumonia was treated. Surgeries were carried out five times, but there was no wound closure, and exudate discharge continued. At first, she was treated with Hochuekkito, did not run a fever, and good granulation tissue was formed in the wound. After a change to Senkinnaitakusan, exudate quantity decreased. Moreover, after an external fixation operation and being treated with Juzentaihoto, epithelization progressed, and the wound eventually closed. Case 2 : a 79-year-old female. One year and 6 months after osteosynthesis with compression hip screw was carried out for a femoral neck fracture, operation scar complications and large quantities of exudate were seen, so we diagnosed her with late onset septic osteomyelitis. She gained weight with Juzentaihoto treatment, while a decrease in exudates and fistula closure with Astragali Radix and Ginseng Radix were confirmed by MRI, and her nutritional state improved. Generally speaking, septic arthritis and osteomyelitis are difficult to treat, but Kampo medicines were curatively effective for these diseases, particularly when increasing Astragali Radix and Ginseng Radix quantity.

We report a case of chronic heart failure successfully treated with bukuryokyoninkanzotokaboiogi. The case was an 87-year-old woman whose chief complaint was chest oppression at rest. She had been diagnosed with chronic heart failure and treated at a university hospital for 6 years, including several episodes of hospitalization. The patient's chest oppression was so strong that she felt depressed. Therefore, she consulted our institute to receive a Kampo treatment in addition to the western medications she was taking. At the patient's first visit to our institute, her serum brain natriuretic peptide (BNP) value was 545pg/ml, and her cardiothoracic rate (CTR) on chest radiogram was 64.1. The severity of the patient's chest oppression was class IV, according to the classification system of the New York Heart Association (NYHA). After we prescribed bukuryokyoninkanzotokaboiogi, her chest oppression and depressive mood gradually improved. Approximately one year later, the patient's BNP value had lowered to 104pg/ml, and CTR was reduced to 57.5. Eventually, her chest oppression and depressive mood disappeared completely. At that time, the chest oppression was categorized as class I in NYHA classification. Treatment with western medicines was not changed over the total clinical course of this case. These results suggest that bukuryokyoninkanzotokaboiogi could be a useful formulation for the treatment of chronic heart failure.

Neuralgia due to tabes dorsalis is refractory to treatment. We report a case which responded to Kagawa-gedoku-zai-kamiho. A 55-year-old female patients started having persistent systemic pain, particularly frequently in both of her lower extremities. It did not improve, and the diagnosis was made as tabes dorsalis at Fukushima Medical College Hospital. After antisyphilitic therapy, she underwent acupuncture and treatment with various drugs for systemic pain. However, the analgesic effect of this treatment gradually diminished, and she was referred to our institute (Department of Kampo Medicine). Based on her medical history and systemic conditions, we prescribed the above formulation. The analgesic effect of a nonsteroidal anti-inflammatory drug (suppositories) gradually increased. When pain in the legs later became more severe, Bushi and Daio were given in increased doses, which relieved the pain completely and enabled the patient to stop the suppositories. In January, 1993, pain developed again in the arm. The doses of Bushi and Daio were increased, which gradually reduced the pain. Kampo medicine seems to offer promising treatment for syphilis after antisyphilitic therapy.

28 years-old male patient has felt dysesthesia as swelling of forehead, numbness of cheeks and pain of eyes. Dysesthesia has developed gradually.
“Fuku-myaku” means the pulse difficult to be palpable. This characteristic pulse and Oketsu symptoms suggested the indications of Tokaku-joki-to and Tokaku-joki-to-go-Daio-botampi-to. As we had found “Fuku-myaku” and oketsu syndrome in this patient, we treated with these kampo medicine according to “Sho” diagnosed by Kampo. The dysesthesia in the patient has been gradually disappeared. At the same time, attacks of asthma which had appeared after discontinuation of Saiboku-to administration have been also disappeared. It is easy to make a mistake that “Fuku-myaku” is for pulse of hypo-functioning condition. But we understand that “Fuku-myaku” is not always for pulse of hypo-functioning condition, but for hyper-functioning condition.

We report a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) in whom saikanto was effective against pleural effusion induced by dasatinib, which is a second-generation tyrosine kinase inhibitor. The patient was a 43-year-old female. After she was diagnosed with Ph+ALL, she received imatinib and other chemotherapy. One year later, she started to receive dasatinib because of imatinib intolerance (vomiting and diarrhea). After about seven months of taking dasatinib, she experienced chest/back pain and a cough; at that time her chest x-ray showed right-sided pleural effusion. She consulted our clinic three months later, for treatment of the hydrothorax that frequently recurred. We prescribed saikanto because she presented with epigastric tenderness diagnosed as shokekkyo, and the pleural effusion and clinical symptoms improved remarkably. Because of the good clinical course in this case, we consider that the decrease of pleural effusion was caused mainly by the immunoregulatory and anti-inflammatory activities of saikanto in addition to its activities to alleviate fluid retention.

Orthopedic symptoms are not rare in palmoplantar pustulosis, but standardized treatments have not yet been established.Here we report a case of palmoplantar pustulosis followed by joint pain that was successfully treated with the Kampo formulation saikokeishito. The patient was a 44-year-old Japanese man. He was suffering from pustules on the soles of his feet due to palmoplantar pustulosis, and joint pain of the sternoclavicular area, hip and lumbo-sacral area, which had not been controlled with diclofenac sodium suppositories. We prescribed saikokeishito for 1 month, and he felt less joint pain and experienced less pustulosis. After that, he suffered from an upper respiratory tract infection, and he again developed plantar pustulosis. We added kikyo (Platycodon grandiflorum root) to treat the sore throat, and his symptoms almost disappeared following this treatment. No author has reported a patient with palmoplantar pustulosis accompanied by joint pain who was treated with saikokeishito. The results experienced in this case suggest that saikokeishito could be a useful formulation for the treatment of palmoplantar pustulosis accompanied by joint pain.