Dang Gui Liu Huang Tang (in the Lan Shi Mi Cang written by Li Dong-yuan) is a common medicine for treating night sweats. We describe its historical development and therapeutic uses. The use of Huan qi (Radix Astragali sen Hedysari) is based on the Han-Sui dynasty medical principle that night sweats are mainly caused by Deficiency of Yang. Herbs to enrich the lood and Yin, Dang gui (Radix Angelicae Sinesis), Seng di huang (Radix Remannia), Shu di huang Radix Rehmannia preparata) were later added because Son dynasty physicians mentioned that Yin deficiency caused night sweats. The addition of heat-reducing herbs, such as Huang lian (Rhizoma Coptidis), was based on the Song dynasty theory that night sweats are caused by pathologic heat in the body, which forces body fluid out of the skin. In the same period, the herbal medicine called Da Jin Hua Wan created by Liu Wansu, and this greatly influenced the principles for treating night sweats. The clearest explanation can be found in the medical treaties Huang Di Nei Jing Su Wen, and Xuan Ming Lun. This medical combination was based on medical theories from a number of historical periods, which may explain its effectiveness. Dang Gui Liu Huang Tang is not effective against types of weak heat (Dan xin xin fa), severe vital Qi Deficiency (Zhang shi yang), or serious deficiency of Yin (Yi xue xin wu). It sometimes hurts Pi and Wei (digestive system). It is useful in the treatment of spontaneous perspiration (Yi xue zheng zhuang, Jin xue quan shu). In summary, this medicine is most effective when the seriousness of heat and Yin deficiency are almost equal and a slight Qi Deficiency exists, or in cases of spontaneous perspiration.

We re-examined Qi, a concept unique to oriental medicine, mainly from late century Chinese medical texts. Qi forms the basis of everything, and the phenomena of life arises from Qi. The integrated / holistic views characteristic of oriental medicine have their basis in this concept of Qi. Biological function is called Qi, and that which gives the body form, Ketsu (Xue). Ketsu is said to be sustenance, formed by Qi, and thus Ketsu and Qi can be regarded as two sides of the same coin. Through the concepts of Qi and Ketsu, is born an awareness that a whole body grasp of malady, the importance of synergistic relationships between organs as well as function and (bodily) substance cannot be separated. Qi is formed from the digestive tract and lungs (acquired Qi), and that which one is born with (innate Qi). It is theorized that “the heart” is expressed by Qi, and through the concept of Qi comes the association, and integration of “the heart” and body. Qi disorders can be classified into (1) those in which Qi function is lowered (Qi deficiency and Yang deficiency), or (2) those in which Qi circulation is impaired (Qi stagnation / Qi regurgitation). These conditions together, bring an overall feeling of fatigue and weakened physical condition. Qi is both a practical and useful view of physiological disease unique to oriental medicine.

We re-examined Qi, a concept unique to oriental medicine, mainly from late century Chinese medical texts. Qi forms the basis of everything, and the phenomena of life arises from Qi. The integrated / holistic views characteristic of oriental medicine have their basis in this concept of Qi. Biological function is called Qi, and that which gives the body form, Ketsu (Xue). Ketsu is said to be sustenance, formed by Qi, and thus Ketsu and Qi can be regarded as two sides of the same coin. Through the concepts of Qi and Ketsu, is born an awareness that a whole body grasp of malady, the importance of synergistic relationships between organs as well as function and (bodily) substance cannot be separated. Qi is formed from the digestive tract and lungs (acquired Qi), and that which one is born with (innate Qi). It is theorized that “the heart” is expressed by Qi, and through the concept of Qi comes the association, and integration of “the heart” and body. Qi disorders can be classified into (1) those in which Qi function is lowered (Qi deficiency and Yang deficiency), or (2) those in which Qi circulation is impaired (Qi stagnation / Qi regurgitation). These conditions together, bring an overall feeling of fatigue and weakened physical condition. Qi is both a practical and useful view of physiological disease unique to oriental medicine.

In order to study epidemiological characteristics of patients with “Oketsu” (blood stagnation), we compared patients suffering from “Oketsu” with those who visited our departments of internal medicine for the first time (including those with “Oketsu”). In order to eliminate ambiguity, we defined patients with “Oketsu” as those who responded to drugs designed to overcome “Oketsu”. “Oketsu” was more common among slightly fat, middle-aged females and less common among young slender patients. “Oketsu” was noted more in patients who had a history of surgery (especially gynecological surgery), induced abortion, and abnormal delivery and in patients with chronic disease and gynecological disorders. In young patients, “Oketsu” was associated with obesity and gynecological disorders. In middle-aged patients, it was associated with a history of disease, and in older patients, it was associated with current disease. In slender patients, “Oketsu” was associated with a history of induced abortion, and in those with normal weight it was associated with a history of disease. Other factors were comparable to those of controls. Middle age, a tendency to obesity, and a history of disease are all independently related to “Oketsu, ” and “Oketsu” often seems to be related to only one of these factors. Those with “Oketsu” could be categorized into two groups, namely group (1) with a history of a high incidence of disease (those of middle age and with normal weight) and group (2) with comparable incidence of a history of disease. Group (2) comprises those with a tendency of obesity (young and old patients) and non-obese patients (middle-aged ones).

A total of 147 subjects presenting with common colds were discussed in the context of traditional Japanese medicine. Using diagnoses and treatment based on traditional Japanese medicine, the subjects were divided into three groups, including wind-cold and wind-heat, and were prescribed herbal medicines. The subjects were compared in terms of time-of-onset, complaints, subjective and objective symptoms, and constitution.1) Wind-cold was observed in 42.9% of their cases, mostly treated with kakkonto/keishito. This type of common cold occurred frequently during winter but was less common in summer. Many patients were found to have a weak stomach and/or an excessive sensitivity to cold. Typical symptoms were chills (often the chief complaint) and cold sensations in the limbs, both of which are external cold symptoms. There were no objective symptoms other than a floating pulse. 2) The percentage of wind-heat colds was 46.3%. Gingyosan was frequently used. This type of common cold occurred more frequently in spring, but was also seen in autumn. Slightly more subjects were sensitive to heat and/or had a healthy constitution. Symptoms were extensive, including external/internal heat symptoms, such as pharyngeal pain (often the chief complaint), redness of the pharynx, hot sensation, feverishness, dry mouth favoring cold water, and dryness symptoms and, less often, cold state symptoms. 3) The remaining subjects, accounting for 10.9%, were regarded as a complex of cold and heat states, and were treated with kufugedokuto.

Oketsu-night sweat was first mentioned in the “Yi lin gai cuo” by Wang Qing ren and the “Xue zheng lun” by? Tang Rong chuan, but there are few explanations of its disease condition. Thus we made pathological studies in Oriental medicine based on three cases (women), where Oketsu-sho was alleviated with Keppu-chikuo-to modification, and Teitou-gan and Tokaku-joki-to (Tao he cheng qi tang) modification. Common disease conditions were Netsu-sho or heat syndrome (summer incidences, redness, flushing during night sweat), and lower Oketsu symptoms (lower abdominal distention, distention and cramping of the lower abdomen, and increased urinary frequency). The theory of these disease conditions is as follows: During sleep, Wei-energy enters the blood. Because of this, Wei-energy of the body surface becomes asthenia making it easier to break out in sweat. The Wei-energy in the blood is depressed by Oketsu, and heat of Oketsu becomes stronger during the night. This fever heats and evaporates bodily fluids, and as a result fluids are pushed outward and cause night sweat. Therefore heat syndrome appears to be a pre-condition of Oketsu-night sweat. If the lower aspect of the body is taken to mean the liver, one would hypothesize that Oketsu-night sweat is more likely to emerge because blood accumulates in the lower area because it returns to the liver at night. Thus, it is thought to be necessary to consider Oketsu as one of the causes of night sweat.

This paper reports the results of clinical research on spring pollen disease based upon the Oriental medical diagnoses. Sixty-nine patients (twenty-four males and forty-five females) who were afflicted with the spring pollen disease were categorized into groups according to the types of Oriental herbal medicine that they responded to. Then, the authors compared the respective periods when the disease first developed in the patients of each group. A comparison was also made based on the differences between their objective signs and subjective symptoms.
As a result of the research, the types of spring pollen disease observed have been classified into the following three groups, with one exceptional type (see Example 4). The first is a group for which “a treatment for superficies-syndrome” (Kai-hyo) was effective using “the drugs of acrid taste and warm nature” (Shin-on) (see Example 23). The patients of this type first manifested their symptoms in the period between the end of January and mid-February. It was found that most of them exhibited a predisposition to a “hypofunctioning condition” (Kyo-sho), and were diagnosed as having pollen disease with the “wind-cold symptom” (Fu-kan-sho). The second is a group for which “a treatment for superficies-syndrome” was effective using “acrid and coldnatured drugs” (Sin-ryo) (see Example 22). Most of the patients of this type first manifested their symptoms after mid-February. It was found that they exhibited the symptom of “cold in the superficies” (Gai-kan) and “the pathogenic factor blending wind-evil and heat-evil” (Fu-netsu), and that most of them manifested “a hyper-functioning condition” (Jitsu-sho). They were diagnosed as having pollen disease with the “wind-warm symptom” (Fu-on-sho) of a “warm disease” (On-byo) with a strong “wind-evil” (Fu-ja) and weak “warm-evil” (On-ja). The third is a group with the mixture of “the treatment for superficies-syndrome” with “the drugs of acrid taste and warm nature” and those of “acrid and cold nature” (see Example 20). It was found that the patients of this group carried little predisposition to “a hypofunctioning condition, ” and that they exhibited a mixed condition of coldness and heat, carrying both characteristics of the first and second groups. They were diagnosed as having the pollen disease with “auxiliary symptoms” (Ken-sho), “the wind-warm symptom” of “a warm disease” combined with “cold-evil” (Kan ja).

Dang Gui Liu Huang Tang (in the Lan Shi Mi Cang written by Li Dong-yuan) is a common medicine for treating night sweats. We describe its historical development and therapeutic uses. The use of Huan qi (Radix Astragali sen Hedysari) is based on the Han-Sui dynasty medical principle that night sweats are mainly caused by Deficiency of Yang. Herbs to enrich the lood and Yin, Dang gui (Radix Angelicae Sinesis), Seng di huang (Radix Remannia), Shu di huang Radix Rehmannia preparata) were later added because Son dynasty physicians mentioned that Yin deficiency caused night sweats. The addition of heat-reducing herbs, such as Huang lian (Rhizoma Coptidis), was based on the Song dynasty theory that night sweats are caused by pathologic heat in the body, which forces body fluid out of the skin. In the same period, the herbal medicine called Da Jin Hua Wan created by Liu Wansu, and this greatly influenced the principles for treating night sweats. The clearest explanation can be found in the medical treaties Huang Di Nei Jing Su Wen, and Xuan Ming Lun. This medical combination was based on medical theories from a number of historical periods, which may explain its effectiveness. Dang Gui Liu Huang Tang is not effective against types of weak heat (Dan xin xin fa), severe vital Qi Deficiency (Zhang shi yang), or serious deficiency of Yin (Yi xue xin wu). It sometimes hurts Pi and Wei (digestive system). It is useful in the treatment of spontaneous perspiration (Yi xue zheng zhuang, Jin xue quan shu). In summary, this medicine is most effective when the seriousness of heat and Yin deficiency are almost equal and a slight Qi Deficiency exists, or in cases of spontaneous perspiration.

Until the Sui Dynasty in China, night sweat and spontaneous perspiration had been thought to be caused by same pathophysiology, that is, lowered superficial resistance by deficiency of Qi.In the Tang Dynasty, these were considered to have different pathophysiologies and a new principle indicated that pathogenic heat caused night sweat.In the Song and Jing Dynasties, deficiency of blood and pathogenic heat by deficiency of Yin was also considered to cause night sweat.In the Jing Dynasty, exogenous pathogens, such as Cold were considered to cause night sweat, which indicated the principle that not only the deficiency syndrome but also the excess syndrome caused night sweat.In the beginning of the Yuan and Ming Dynasties, it was concluded that the deficiency of Yin caused night sweat and the deficiency of Yang caused spontaneous perspiration.In the middle of the Ming Dynasty, another new theory indicated that deficiency of Yang also possibly caused night sweat; therefore we should diagnose abnormal sweat depending on the pathophysiology in each case.In the Qing Dynasty, new theories were established stating that not only exogenous pathogens but also Damp-heat, undigested food and stagnation of blood, all of which are included in excess syndrome, cause night sweat, and that based on which part of the body sweats occurred we might understand pathophysiology of night sweat. The night sweat by Warm-heat, which is different from the one by Wind-cold, was considered to be caused with deficiency of Yin.Thus we conclude that the theories of night sweat developed over time, based on Chinese medical classics.

Academic dissertations on Kampo medicine have a certain peculiarity about them, when they are drawn up by the rules of western medical writing. Compared to western medicine, oriental medicine tends to employ more subjective terms, because of its many humanistic elements.Study objectives, methods, results and discussions however, need to be stated objectively in a way that makes a paper easy to understand for both referees and readers. Although it would be ideal to use designated terms when making objective statements, there are in fact many terms that have multiple meanings, which need to be clarified in a paper. And when presenting new evidence, one must declare how far any problems have been resolved, as clearly as possible.We have explained the recent changes to our regulations for contributors, regarding Kampo formulae naming conventions, abstract word counts, and contributions by mail. Here we discuss how our editing work proceeds, and our thoughts on how papers are re-reviewed or rejected.
Medicine, Kampo ; Medicine ; Academic Dissertations [Publication Type] ; counts ; Review [Publication Type]