Improvement of A Simulator Production Project for Abdominal Palpation in Kampo Medical Training

Abstract

In Kampo medicine, sickness is regarded as affecting the whole body even though the symptoms may appear obvious only in the abdomen. This makes abdominal palpation an important means of physical examination, and diagnosis. Because learning abdominal palpation in the Kampo style is very difficult, we attempted to simplify learning by building typical anatomical abdomen models for training. To create six abdominal models : Shinka-hiko, Kyokyo-kuman, Fukuchokukin-renkyu, Shofuku-fujin, Shofuku-koman, and Shinkabu-sinsuion, we employed several materials, including artificial leather for epidermal tissue, pile fabric for subcutaneous tissue, cotton cloth or jersey cloth for membrane tissue, polyurethane or natural rubber for muscle tissue, specialized polyester resin for costae, and cotton for internal organs. We employed a harder polyurethane, for example, in Shinka-hiko to simulate resistance in the region beneath the heart, in Kyokyo-kuman to simulate resistance in the subcostal region, and in Shofuku-koman to simulate horseshoe-shaped resistance in the lower abdominal region. Otherwise, in Shofuku-fujin, a lack of resistance was simulated by a defect in the polyurethane at the center of the lower abdominal region. Shinkabu-sinsuion was modeled using a water dabbling sound via a water-filled balloon that could be gently shaken with the fist in the region above the navel. Fukuchokukin-renkyu was modeled as excessive strain of the rectus abdominis muscles via the use of natural rubber. We tried to represent the tenderness on pressure at the para-umbilical region, cecal region, and sigmoid region in the Shofuku-koman model by making a specialized switch with conducting rubber, and using electric device and battery. We believe these models are useful teaching devices, in that they simplify Kampo abdominal palpitation training.