In order to have a more “universal understanding” of Kampo medicine, it helps to explain the “fundamental concepts” and the “theoretical framework” of Kampo medicine, in latest life science knowledge with a key word “context.”Ki, Ketsu and Sui are the three elements which compose the cellular environment (context), and shoulder the maintenance of life's activities, which are dependent on metabolic changes and information flow. The function and structure of the living body are normally led by Ki, Ketsu and Sui.The five parenchymatous viscera (lungs, heart, liver, spleen, kidneys) are not only organs which maintain the cellular environment, they also act as higher control systems which control organ activities. These five viscera as higher control systems create conditions (context) throughout the body and control the life activities of each organ in an integrated manner.In a sick person, these organ life activities take on a kind of “fighting style” which can change from moment to moment, with natural disease progression and/or treatment intervention. The classic text Shokanron describes these changes in fighting style as the “six stages of disease”, and indicates formulation choices based on variations in the body's fighting style.From the viewpoint of a connection with Western medicine and a dialog with traditional Chinese medicine, explaining Kampo medicine in ways which anyone can understand by creating a universal understanding of its fundamental concepts and theoretical framework, is our mission for the 21st Century.
Medicine, Kampo ; Medicine ; seconds ; Comprehension ; Fighting

In this paper, we report four patients with chronic respiratory diseases who improved by administration of Bukuryo-kyonin-kanzo-to.
A 66-year-old female diagnosed as bronchial asthma could increase the peak flow rate and stopped western medicines by its administration. A 63-year-old female suspected to have cough variant asthma and an 08-year-old female diagnosed as having bronchiectasia with cough and dyspnea on exertion improved gradually after a few months of treatment. A 62-year-old female diagnosed as having interstitial pneumonia with systemic sclerosis showed improvement of cough and dyspnea. The erythrocyte sedimentaion rate and serum lactate dehydrogenase decreased and arterial oxygen pressure increased by its administration. This report and past reports seem to indicate that a patient profile which can be expected to be responsive to this formula is: elderly female, cough worse at night, chest dyspnea, and epigastric tenderness and muscle guarding. This drug was considered to have wider applications for chronic respiratory disease.

Atopic dermatitis in adolescents and adults has severe erythema and desquamation, particularly on the face and the neck, and is often resistant for various treatments. We previously reported the case of intractable erythematous dry-type atopic dermatitis where Kagen-ichiin-sen-ka-kiban-kyo was effect. Kagenichiin-sen-ka-kiban-kyo has an effect for nourishing Yin and Blood. Although its antiinflammatory effect is weak, we expected it would improve the deteriorated barrier function of the skin by moistening dry skin, and treat the atopic dermatitis more fundamentally. This time aiming broad application for the lesion of exudative eczema, we treated atopic dermatitis by using sekko-added Kagen-ichiin-sen-ka-kiban-kyo (Kagen-ichiin-sen-ka-kiban-kyo-sekko). The moisture content of the forehead and the extensor surface of forearm sequentially increased. And IgE-KIST and LDH, the markers of the state of a disease, were significantlly reduced. Good results were given; 68.8% of efficacy in men and 77.8% in women.
This Kampo formulation is assumed one of the effective formulations for the treatment of atopic dermatitis.

Medicine, Kampo ; Names ; Disease ; Diagnosis

A patient with systemic lupus erythematosus (SLE), complicated by severe thrombocytopenia was successfully treated with Juzen-taiho-to. The patient was a 38-year-old woman presenting thrombocytopenia in 1974. She was diagnosed as having SLE with the appearance of renal failure in 1975. In 1984, she began blood dialysis due to deterioration of renal function. In addition, she repeatedly suffered from severe bleeding episodes due to thrombocytopenia. In 1989, she visited our clinic to undergo Kampo therapy, with no significant results obtained with any of the formulas tried.
In September 1992, she suffered from duodenal ulcer bleeding and stopped Kampo therapy for some time. However, since she began taking Juzen-taiho-to in June 1993, her thrombocytopenia improved and her platelet count stabilized at 10-15×10⁴/mm³. This made it possible to taper the dosage of the steroids being administered. Since July 1994, the prednisolone (PSL) dosage has been 5mg on alternate days. Since July 1995, the anti-DNA antibody was negative. The platelet count has been maintained at 15-20×10⁴/mm³ (as of December, 1996).

We report a case of sciatica showing improvement by treatment with Gorei-san-ryo. The patient, a 66-year-old woman with right gonarthrosis, had been receiving treatment at the orthopaedic surgery department since May 19, 2000. She felt left hip pain and left leg numbness on May 10, 2002. She was diagnosed with left-side sciatica on May 15, 2002. She was treated with loxoprofen, eperisone, and epidural steroids at the orthopaedic surgery, but her symptoms hardly improved. She visited our department on August 7, and treatment wiht Busi-to was begun. After four weeks, her symptoms had not improved. Busi-to was stopped and Gorei-san-ryo was begun on September 4. After two weeks, her hip pain had improved. Keishi-bukuryo-gan was administered in addition to Gorei-san-ryo on September 18. On December 25, her sciatica as evaluated by visual analogue scale, had decreased from 100 to 35 since first visiting our department. Based on this experience, it is suggested that Gorei-san-ryo be considered in the treatment of sciatica.

The administration of Bukuryo-shigyaku-to has been effective in five cases of chronic headache. All five patients visited our department because of unsatisfactory results using Western medicine. They suffered from severe migraines with restlessness, and they were treated effectively with Bukuryo-shigyaku-to. In four of all cases (cases 1-4), symptoms and signs related to coldness were obvious, and especially cases 1 and 3 complained about undesirable coldness on their backs. It is suggested that Bukuryo-shigyaku-to can be useful against severe migraine with restlessness caused by exposure to strong coldness. Case 5 was initially thought to have a status of heat and excess, but the effect of Bukuryo-shigyaku-to revealed the existence of cold and deficiency. Case 5 emphasizes the importance of being aware of the possibility of hidden coldness and deficiency, and that Bukuryo-shigyaku-to can be useful in such a case.

We treated one rheumatoid arthritis (RA) patient with Toki-shakuyaku-san-ka-bushi. A 51-year-old woman was diagnosed as RA in another hospital and was treated with salazosulfapyridine (SASP) and methotrexate (MTX). She was living a restricted daily life while taking MTX. She had to lie down for almost 48 hours after taking MTX once a week because of general fatigue. She was also suffering from depression. After the administration of Toki-shakuyaku-san-ka-bushi, her malaise after taking MTX and her depressive-mood disappeared. Her quality of life improved measurably.

To investigate the difficulties of taking Japanese traditional (Kampo) medicines, questionnaires were filled out by patients under 19 years old or their families.Forty-six questionnaires were valid for analysis. The mean age of the patients was 9.7 &qlusmn; 5.3 years old (2 to 19 years old) and the percentage of male patients was high (65%). They took extract granules (n = 40) or decoction (n = 6) and most of the patients (n = 38, 83%) took medicines twice a day. Though 69% of patients under 5 years old needed direct assistance from their family to take medicines, none of over 6 years of age needed any help except to dissolve medicines in hot water, while notably 77% of the patients over 13 years old took their medicines un-aided. It was found that patients' families gave them the concrete explanations on the necessity of their medicines regardless of patients' age, so it is important for pharmacist to guide not only families but also patients themselves. Furthermore, pharmacists should understand the taste and the constituent crude drugs of Kampo medicines to improve patients' adherence in taking medicines.