1.Development of a Quick High-Yield Method for the Preparation of Decoctions, Inspired by the “Zhu san Fa” of the Song Period (Part 2)
Tsukasa FUEKI ; Toshiaki MAKINO ; Takanori MATSUOKA ; Masashi BEPPU ; Takao SUNAGA ; Koichiro TANAKA ; Takao NAMIKI
Kampo Medicine 2016;67(2):114-122
The IPCD (Immersing Powdered Crude Drugs) method, inspired by the “zhu san fa” which was widely used in the Song period of China, has been developed to prepare Kampo decoctions quickly and easily, with highyield extract from crude drugs. One trouble with the IPCD method occurs when separating the decoction from the muddy residue of the crude drug powder. When powdered ephedra herb is packed in a nonwoven fabric bag and immersed in hot water, yield of the marker compounds is much lower than that obtained when ephedra herb powder is dispersed freely in hot water without a nonwoven fabric bag. Thus the use of a nonwoven fabric bag was shown to be unsuitable with the IPCD method. In investigating an easy and more efficient separation method, we tried decanting with a commercially available wine carafe to separate the decoction and residue. With IPCD followed by decantation using the wine carafe, yields of about 80% decoction volume were obtained as compared with those when cut crude drugs are decocted and filtered using a tea strainer, in 6 of the 7 formulas tried. We find that decantation using a wine carafe is a more practical way of separation in the IPCD method.
2.Differences in Water Hardness when preparing Ephedrae Herba Decoctions : Special Focus on a Comparison of Tap Water in Japan and China
Tsukasa FUEKI ; Takanori MATSUOKA ; Masashi BEPPU ; Hidetoshi YAMAGUCHI ; Hideyuki NAKATA ; Kenshu RAI ; Yumi SAKAI ; Kazuhiko NAGASAKA ; Toshiaki MAKINO ; Takao NAMIKI ; Kenkichi OKADA ; Yusen IWAI ; Kazuhiro MAKIZUMI
Kampo Medicine 2012;63(5):313-321
Decoctions of Ephedrae Herba were prepared using tap water sampled in Changping District, Beijing City(China), tap water sampled in Niigata City (Japan) and some mineral water samples sold in markets. Various dissimilarities were found between drug extracts prepared using tap water in Japan and China, and the extraction efficiency of the alkaloids with Beijing tap water was approximately 80% of that with Niigata tap water. It is suggested that these dissimilarities result from concentrations of temporally hard components, such as calcium and magnesium bicarbonate salts, in the water. In addition, when Zizyphi Fructus and Ephedrae Herba were decocted together in hard water, the state of the decoction, ephedra-alkaloid content included, was found to come close to that of single Ephedrae Herba decoctions prepared using soft water. It was suggested that Ziziphi Fructus might possibly play roles as a softening agent in decoctions prepared using hard water.
3.On Ryokyu ARIMA, Tenmin NAMIKAWA's Mentor
Takanori MATSUOKA ; Hideki KURIBAYASHI ; Masashi BEPPU ; Hidetoshi YAMAGUCHI ; Hideyuki NAKATA ; Tamie ANAN ; Tsukasa FUEKI ; Kenju RAI ; Hidetoshi ITAKURA ; Koichiro TANAKA ; Yoshinari KONO ; Mikumo UEMATSU ; Kazuhiko NARA ; Keiko SERIZAWA ; Kenkichi OKADA ; Yusen IWAI ; Kazuhiro MAKIZUMI ; Oto MIURA ; Takao NAMIKI ; Tetsuo AKIBA
Kampo Medicine 2012;63(6):417-427
Tenmin NAMIKAWA (並河天民) thought the Shanghanlun (傷寒論) was an important text. He also taught his pupils the importance of prescribing Zhongjing ZHANG's (張仲景) medicines. Ryokyu ARIMA (有馬凉及) was a physician-teacher, who prescribed Chengqitang (承気湯) for the emperor without conferring with other doctors. His chengqitang formulary was derived from medical texts by Zhongjing ZHANG. Kyugo GODA (合田求吾) on the other hand, was a pupil of Ikkannsai MATSUBARA (松原一閑斎), who wrote in the Idokikigaki (医道聞書) : theKoho (古方) school started by Ryokyu ARIMA. He was a hero who was punished by the Goseiin (後西院) emperor. He taught Koho to Tenmin. This therefore reveals that Ryokyu ARIMA was a teacher who taught the importance of the Shanghanlun.
4.The Weights in Ben Cao Jing Ji Zhu (Dun Huang Version) and the Volume of a Fang Cun Bi (One Cun Square Spoon) : Weights and Measures in the Period when the Shan Han Lun was Written
Tsukasa FUEKI ; Takanori MATSUOKA ; Toshiaki MAKINO ; Takao NAMIKI ; Masashi BEPPU ; Hidetoshi YAMAGUCHI ; Hideyuki NAKATA ; Kenshu RAI ; Keisuke HAGIHARA ; Koichiro TANAKA ; Kazuhiko NAGASAKA ; Takao SUNAGA ; I-JUNG LEE ; Kenkichi OKADA ; Yusen IWAI ; Kazuhiro MAKIZUMI
Kampo Medicine 2014;65(1):38-45
For the purpose of investigating weights in the era when the Shan Han Lun was set forth, the weight and measures described in the Ben Cao Jing Ji Zhu, written in the period slightly after the Shan Han Lun, were studied. Some descriptions of the metrological standards are confusing in the Ben Cao Jing Ji Zhu. We focused on the measuring container, whose volume is equal to that of the one cun square spoon (fang cun bi), shown in the dun huang version of the Ben Cao Jing Ji Zhu. The volume of this measuring container was calculated on the assumption that the measures in this text follow those of the Han Shu Li Li Shi, and a result of 5.07 cm3 was obtained. The result was confirmed by using the actual measured values of the crude drugs. The result was also considered to support measurements of the volume in the Ben Cao Jing Ji Zhu as following the Han Shu Li Li Shi. With those results, descriptions of the density of honey and lard were examined, and the weight in the Ben Cao Jing Ji Zhu was clarified to follow that in the Han Shu Li Li Shi.
5.The Investigation of Metrological Standard in “Songban Shanghanlun” :Focus on the Absorbed Liquid in the Decoction Residues and the Extraction Efficiency of Ephedra-alkal
Tsukasa FUEKI ; Takanori MATSUOKA ; Toshiaki MAKINO ; Takao NAMIKI ; Masashi BEPPU ; Hidetoshi YAMAGUCHI ; Hideyuki NAKATA ; Kenshu RAI ; Keisuke HAGIHARA ; Koichiro TANAKA ; Takao SUNAGA ; Kazuhiko NAGASAKA ; Kenkichi OKADA ; Yusen IWAI ; Kazuhiro MAKIZUMI
Kampo Medicine 2014;65(2):61-72
The dosage of crude drugs described in the Shanghanlun has long been discussed, and a conversion ratio for 1 liang in the Songban Shanghanlun into modern grams has not been established yet. Ekisai Kariya, a bibliologist in Edo period Japan, claimed that the formulas in the Songban Shanghanlun could not be decocted when weighed with the “Han shu (lu li zhi)” scale (1 liang = 14 g, “regular scale”), and the weight scale in the text should be “Scale of Shen nong” (1/10 scale of the regular scale). This claim leads to the standards for Kampo prescription dosages. We inspected this matter by focusing on the amount of liquid absorbed by decoction residues, and demonstrated that the formulas in Songban Shanghanlun could actually be decocted when weighed with the “regular scale”. In addition, we calculated the quantities of Ephedra-alkaloids in the one-time dose of “Ma huang tang” of the several books written in the Song period, and the Songban Shanghanlun text, with results showing that Chinese doctors in the Song period recognized 1 liang in the Songban Shanghanlun as 14 grams in modern terms, and that the “regular scale” could be applied clinically. This strongly suggests that the metrological standard in the Songban Shanghanlun should be the “regular scale”.
6.Four Cases of Patients with Skin Disorders (Atopic Dermatitis, Prurigo Gestationis, Acne Vulgaris) During Pregnancy Responded well to Tokishakuyakusan
Hiroko MOROHASHI ; Toru YANASE ; Tsukasa FUEKI ; Ichiro YAMAZAKI ; Takao SUNAGA
Kampo Medicine 2020;71(2):115-120
When female patients with skin disorders become pregnant, the treatments with the previously used antiallergic oral drugs are preferred to be switched to the treatments with external medicines alone, which often make patients experience unbearable itching and exacerbation of rashes. The use of tokishakuyakusan is known to be safe and improve various symptoms in the pregnancy period. In this report, the treatment of 4 patients with skin disorders were successfully switched to tokishakuyakusan alone from previously used antiallergic internal medicines and other traditional Japanese herbal medicines after pregnancy. Case 1 and 2 were patients with atopic dermatitis who had been treated only with the external medicine during a previous pregnancy but without amelioration. Case 3 was a patient with prurigo gestations who had rashes on the upper body trunk and complained of a strong itching sensation. Case 4 was a patient with acne vulgaris. In all cases, the rashes and itching sensation improved promptly with oral administration of tokishakuyakusan, followed by successful delivery. No side effects of gastrointestinal disorders were observed in any cases. Their skin disorders were speculated to be caused by the blood deficiency and stasis. Qi deficiency and fluid disturbance developed in association with pregnancy, which led to Yin deficiency and abundance of moisture. The positive responses of these conditions indicated that tokishakuyakusan was effective in the cases reported herein.
7.A Case of Chi-no-michi-sho that was Successfully Treated with Traditional Japanese Herbal Medicine for Seven Years
Ichiro YAMAZAKI ; Hiroko MOROHASHI ; Tsukasa FUEKI ; Kenya INUKAI ; Toru YANASE
Kampo Medicine 2020;71(4):344-351
Chi-no-michi-sho involves neuropsychiatric and physical symptoms that appear with hormonal changes, such as those during pregnancy and menopause. Until now, there were many case reports, which were within 2 years from the start of treatment. We present a case of chi-no-michi-sho that was successfully treated with Kampo formulations for 7 years. A 43-year-old woman had complaints of candida eczema in the vulva, palpitations, and headache. Tokishakuyakusan and shakanzoto were then administered for kekkyo (blood deficiency), oketsu (blood stasis), and suidoku (fluid retention), and a topical antifungal agent was administered for candida eczema. The headache and palpitations were reduced. Subsequently, tokishigyakukagoshuyuto and keishibukuryogan were administered because of skin rash and deterioration of sensitivity to cold. However, various symptoms, such as weight loss amenorrhea due to self-determination, eczema, feeling heavy in the head, and edema, remained. We prescribed tokishakuyakusan again in addition to Western medical treatment. Her menstruation then resumed ; her eczema, palpitations, and headache also improved. However, she developed hyperthyroidism. While paying attention to organic diseases such as thyroid dysfunction, prescription of tokishakuyakusan may be effective when chi-no-michi-sho is long-lasting and there are blood deficiency and stasis with fluid retention.
8.Difference of the Definitions of “Ginger” and “Processed Ginger” Between the Edo Era and the Present in Kampo
Hiroshi KOIKE ; Takanori MATSUOKA ; Tsukasa FUEKI ; Toshiaki MAKINO
Kampo Medicine 2020;71(4):406-417
Kampo physicians in the Showa era, such as ARAKI Seiji and OTSUKA Keisetsu, had called raw ginger as the herbal medicament “ginger”, and processed or unprocessed dried ginger as the medicament “processed ginger”. However, many Kampo physicians in the present Japan call unprocessed dried ginger as the medicament “ginger”, and processed dried ginger as the medicament “processed ginger”. The aim of this study is to investigate the background of the process of this change from the Showa era to the present. We searched the definitions of the medicaments “ginger” and “processed ginger” in successive Japanese Pharmacopoeia editions and other related books describing these definitions. In Japanese Kampo medicine before the Showa era, the herbal medicament “ginger” had referred to raw ginger, and the medicament “processed ginger” had referred to processed or unprocessed dried ginger. However, after the Heisei era, the medicaments “ginger” and “processed ginger” have referred to unprocessed dried ginger and processed dried ginger, respectively. And the raw ginger has been called as “preserved ginger”.
9.The Decocting Time and the Contents of the Aconitine-type Diester Alkaloids in the Decoctions of the Formula Containing Unprocessed Aconite Root in “Songban Shanghanlun”
Tsukasa FUEKI ; Yohei TANIMURA ; Koichiro TANAKA ; Koki CHIBA ; Takanori MATSUOKA ; Takao NAMIKI ; Kosuke FUJITA ; Takao SUNAGA ; Masashi BEPPU ; Toshiaki MAKINO
Kampo Medicine 2019;70(4):313-323
We investigated the decocting time to prepare the formulas containing unprocessed aconite root, such as shigyakuto, tsumyaku shigyakuto, and kankyobushito, which had been registered in “Shanghanlun” edited in Song Dynasty, using the weights and measures in Houhan Dynasty when the original “Shanghanlun” was regarded to have been established. Also the contents of aconitine-type diester alkaloids (ADA) eluted from unprocessed aconite root in the decoction were analyzed in time-dependent manners. As regards the modified formula for the “physically strong patients” in the texts of tsumyakushigyakuto in “Shanghanlun”, adding dried ginger was found to lead the decocting time to be shorter and the sum of ADA content in the decoction of the modified formula to increase about 20%. It was also found that the compositions of diterpene alkaloids derived from aconite root in kankyobushito decoction were highly different from those in shigyakuto decoction, containing less ADA and more aconine and hypaconine, due to the high pH of the decoction, which was the consequence of lacking glycyrrhiza in kankyobushito formula. It is suggested that the doctors in the era of “Shanghanlun” establishment may have carefully adjusted the contents of ADA in the decoctions using unprocessed aconite root by choosing co-decocted crude drugs.
10.Implications of the Origin of “Gui” in the “Bencaojingjizhu”
Tsukasa FUEKI ; Koichiro TANAKA ; Toshiaki MAKINO ; Takanori MATSUOKA ; Tadaaki SATOU ; Kazuo KOIKE ; Kenshu LAI ; Takao NAMIKI ; Koki CHIBA ; Masashi BEPPU ; Takao SUNAGA ; Kenkichi OKADA ; Kazuhiro MAKIZUMI
Kampo Medicine 2017;68(3):281-290
Crude drugs that feature the name “gui” have appeared in classical medicinal textbooks with different names,and the correspondence between their names and origins remains the subject of research and discussion. In the present study, we investigated these correspondences using the descriptions in the annotations of the Bencaojingjizhu and through our previous study that revealed the standards of weights and measures in this book. Based on this investigation, we strongly speculate that “gui” in the Bencaojingjizhu was the branch skin of Cinnamomum cassia (C. cassia) (corresponding to cinnamon sticks in the market), which fits with the descriptions about the length and weight of “gui” -related crude drugs in this book. We measured the contents of cinnamic aldehyde and coumarin in the branch skin of C. cassia, and compared these to contents in other crude drugs related to “gui” that can be obtained on the market. The contents of these two compounds in the branch skin of C. cassia were similar to those in the bark of C. cassia from Vietnam that meets the standards for cinnamon bark in the Japanese Pharmacopoeia and is regarded as high-grade in the market. These results support our speculation, and it might be possible that the branch skin of C. cassia can be used as medicine instead of cinnamon bark.
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