Some thirty years ago, the popularity of Kampo medicines began to increase, as they began to be recognized as ethical drugs. Three decades on, however, many doctors still do not appreciate oriental medicine methodology. Some medical professionals, in fact, have no knowledge of oriental medicines at all. And many clinicians today are not offered the opportunity to learn more about the worth of these treatments.Kampo treatments are an important pillar of oriental medicine, and should be appreciated as such. Presently, however, there is much demand to integrate them with western medicine. It is important for clinicians to know historically how the present situation came about, to give them a better appreciation of the worth in employing Kampo medicines.
Medicine, Kampo ; Asians ; Medicine ; Clinicians ; Recent

In order to investigate the effect of traditional medicine on unclassified connective tissue disease (UCTD), we made a comparison of the 2-year outcome of patients with UCTD between in a ‘traditional medicine treatment’ group and in a ‘non-treatment’ group. In the traditional medicine group, only one case out of 30 developed CREST syndrome. In the non-treatment group, 6 cases out of 30 developed connective tissue disease (2 cases with systemic sclerosis, 2 cases with CREST syndrome, one case with MCTD, and one case with Sjögren's syndrome). These results suggest that traditional medicine can be effective in improving the prognosis of UCTD.

To investigate how lectures about Japanese traditional medicine have influenced students, we used a questionnaire to survey their attitudes to it in our medical college. Students who were educated about or who had been treated with Japanese traditional medicine had greater interest and more positive attitudes than other students. The higher-grade students have greater interest in Japanese traditional medicine. These results suggest that lectures and inclusion in standard textbooks are needed in the future to raise medical-college students' awareness of Japanese traditional medicine.

A 62-year-old woman showed signs of liver dysfunction of unknown etiology in 1994. She was admitted to our hospital in July 1996 because the liver dysfunction, as well as general fatigue, worsened. Anti-mitochondrial antibodies were present, and a liver biopsy was performed. Pathological findings were compatible with primary biliary cirrhosis. Treatment with ursodeoxycholic acid (600mg/day) was initiated in August 1996, and liver dysfunction improved. However, ESR and IgM did not improve, and general fatigue persisted. In December 1996, Sairei-to was combined with ursodeoxycholic acid. One month later, ESR, IgM, and general fatigue improved. In May 1997, Sairei-to was replaced by Keishibukuryo-gan because of her symptoms (Hie-sho and varix pain), and liver dysfunction and general fatigue reappeared. Keishibukuryo-gan was later discontinued because of suspected drug-induced hepatitis. Two months later, liver dysfunction remained unimproved. Sairei-to was administered again and liver dysfunction and other symptoms disappeared. These results suggest that combined therapy with Sairei-to and ursodeoxycholic acid is effective in the treatment of primary biliary cirrhosis.

The authors report a case of secondary renal amyloidosis associated with rheumatoid arthritis, which responded well to Kampo therapy. A 68-year-old woman was diagnosed as having rheumatoid arthritis in April 1992. Her disease activity was not controlled well with any anti-rheumatic drugs. In September 1996, proteinuria and hematuria were found, and a renal biopsy showed secondary amyloidosis. Proteinuria and hematuria were progressive. The patient was treated with Sairei-to, and by April 1998, proteinuria and hematuria nearly disappeared. This clinical course suggests that Sairei-to is an effective treatment for secondary renal amyloidosis.

A 28-year-old woman presented with persistent diarrhea, lower abdominal pain, low-grade fever and general fatigue in 1994. She was admitted to a hospital with suspected inflammatory colitis. Aphthoid mucosal changes were founded on colonoscopy, but the etiology was unknown. Salazosulfapyridine was administered for 3 months, but it was not effective for the abdominal symptoms. In November 1995, pyrexia, lymph node swelling and polyarthralgia appeared, and the patient was admitted to our hospital. Malar rash, photosensitivity, leukopenia, antinuclear antibody and anti-DNA antibody were found. She was diagnosed as having systemic lupus erythematosus and lupus colitis. Prednisolone (30mg/day) was administered, and pyrexia, polyarthralgia and leukopenia were improved, but the abdominal symptoms persisted for 5 weeks. Keisi-ka-syakuyaku-to was administered, and it was markedly effective for relieving persistent diarrhea and abdominal pain. Keisi-ka-syakuyaku-to was continued until February 1999 and the patient's clinical course was satisfactory.

Twenty-two patients with chronic glomerulonephritis were treated with Sairei-to (7.5g/day), either alone or in combination with camostat mesilate (600mg/day), to determine the efficacy and adverse effects of these regimens. Although there was significant improvement in proteinuria (p<0.05) after 8 weeks of treatment with Sairei-to alone, this was not longlasting. Combination therapy resulted in sustained significant improvement (p<0.03; there were two dropouts). No adverse effects were seen with either regimen. The results suggest that combination therapy using Sairei-to and camostat mesilate may be a safe and efficacious method of treatment for patients with chronic glomerulonephritis.