Three questions were provoked by the case of a young female with acute leukemia who died in spite of allogenic stem cell transplantation : 1)What is responsible for the widespread belief that bodies are like machines that can be repaired scientifically? 2)Is there a perspective enabling us to view humans and disease holistically? 3)How can clinicians deal with the question “Why do I have such a disease?” Descartes's mind-body dualism and reductionism is the origin of the biomedical model regarding the human body as a machine. Though the biopsychosocial model advocated by Engel supplanted the biomedical model, this article proposes a more holistic medical model based on the body-mind-spirit trichotomy and four relationships : “self and others,” “self and the natural environment,” “self and oneself,” and “self and transcender.” These four relationships are modeled here in a “trichotomy-triangular pyramidal model.” We postulate that the true cause of disease may be discordance among these relationships. This model is capable of describing all varieties of healthcare professions, and suggests a future form of a team approach that includes chaplains and complementary/alternative medicine specialists, and may give clinicians a guide to healing the grief of patients who ask, “why me?”

A 19-year-old man was referred to our clinic for frequent nausea and vomiting. At age 16, he started to have periodic bouts of nausea and vomiting. During an attack, he would experience vomiting more than ten times a day and was unable to eat, which resulted in hospitalization for a week. Inpatient investigations did not reveal any abnormalities except dehydration. Between attacks, he was asymptomatic. Initially, he had attacks a few times a year. However, beginning at age 19, the attacks occurred almost every month. At our clinic, routine physical examination and laboratory tests were unremarkable. On Kampo medical examination, he had qi stagnation and qi counter-flow. He was diagnosed with cyclic vomiting syndrome. Hangekobokuto was administered with improvement of his symptoms. Hangekobokuto may be effective for cyclic vomiting syndrome with qi stagnation and qi counter-flow as diagnosed with Kampo medicine. This suggests the effectiveness of Kampo medicine in functional gastrointestinal disorders.