Modern Kampo medicine is mainly based on a restoration of ancient Chinese medicine which occurred in the Edo period in Japan. This historical event rose under the influence of a Confucian renaissance, resulting the exclusion of metaphysics. This report intends to clarify the correlation between these two new cultural movements, and to outline the characteristics of Kampo medicine from a historical perspective.

Keijyuro Wada's Ikaino-tettsui (The Iron Hammer of the Medical World) was first published in 1910, just a hundred years ago. This book admonishes against the influence of modern Western medicine, which is based on the theory of element reductionism. Wada insisted that a reevaluation of Kampo medicine was essential to create a holistic medical system. Immediately after the book was published, Dr. Ryuken Hirade proposed a bitter criticism of it in a medical journal. Dr. Hirade, at that time, was leader of a well-respected medical society in Nagoya. His bitter criticism is very meaningful for us who engaged in Kampo medicine today. There is a conflict between the two different paradigms of Western and Eastern medicine. This lecture intends to discuss our challenges facing Kampo medicine based on Ryuken Hirade's opinions.

Kampo had been the mainstream of medicine in Japan until the Meiji Restoration discarded it in 1875. In 1910, Dr. Keijuro Wada published a book titled “Ikai-no-Tettsui," which proposed to rightly recognize Kampo in harmony with the modern Western medicine. This book inspired Dr. Kyushin Yumoto to engage in the Kampo revival movement. And Dr. Keisetsu Ohtsuka inherited Yumoto's spirit. From the historical point of view, this book has played a great role in reviving Kampo. Just now, it has been one century since “Ikai-no Tettsui" was published. This paper is intended to reveal the historical background of the book, and review the movements in the field of Kampo over the past one hundred years.

Over the past few years, a significant problem has been raised in the field of traditional East-Asian medicines, i. e. the ISO/TC 249 action, which is intended to unify traditional East-Asian medicines with traditional Chinese medicine (TCM).
There is historical evidence that the Korea and Japan imported ancient Chinese medicine in the past, however, either country has greatly its reformed Chinese medicine resulting vast differences from the current TCM.This paper intends to reveal the differences between Kampo and TCM from the viewpoint of disease recognition methods. Kampo recognizes a disease via structuralism, whereas TCM depends on element reduction theory, i. e. The Five Elements and so on. Kampo is based the theory whereby a sho (sign / symptom / indication for) correlates with a formulation. The character of each formulation can be acquired through tactile knowledge with clinical experience mainly based on abdominal findings.
To expand, a Sho represents the name of its most proper formulation, such as with kakkonto-sho. Inother words, a disease entity is expressed in the name of its treatment. This means that Kampo does not lend itself to Chinese element reduction theory, but rather, is used restrictively as a matter of explanation for a selected formulation. Thus there are fundamental philosophical difference between the current TCM and Kampo, so that we cannot agree with the Chinese government's ISO proposal by which both modalities would be brought under the same Chinese heading.

Japan is now faced with the highest population of aged persons it has ever experienced in its history. This has brought about a financial crisis in the National Health Insurance program. It has become impossible to discuss health maintenance, medicine and welfare without bringing in national policy and economic issues. The present confused status of the medical system in Japan means that the Classical era has ended for this system, and a new phase has begun.
In this paper, the author attempted to review the past history of Kampo medicine, especially around the Meiji era when Kampo medicine was eliminated from the medical education system. The author then analyzed the present situation and problems, and discussed the future of Kampo medicine.