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).

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Sixty-five patients who complained of various unidentified symptoms (undefined clinical syndrome), including 59 with climacteric syndrome, received Kampo medicine for eight weeks or more according to scores for their body constitution. Saiko-keishi-kankyo-to was given to those with a deficient constitution, Saiko-karyukotsu-borei-to to those with a robust constitution, and Kami-shoyo-san to those with a medium constitution.
A deficient constitution was more common among those aged 40 to 49, while those with a robust constitution increased in patients aged 50 to 59. The pretreatment climacteric index was comparable among the three groups, and most of them were mild to moderate. The faces of those with a robust constitution had more gloss and a tenser texture while those with deficient constitution were paler and had a face with less of a tense texture. Other signs such as a repeated epigastric splashing sound, hypochondriac resistance, dark rings around the eyes, dark purple tongue, and paraumbilical resistance were similar between those with robust and deficient constitutions. These signs were mild and observed in about 90% of patients. They therefore appear to be common signs among patients suffering from undefined clinical syndrome.
The severity of conditions determined by the mean value of the climacteric index was moderate among those with robust to medium constitutions and mild among those with deficient constitutions. The index was reduced to the normal values within two weeks of starting Kampo medicine in those with a deficient constitution, within six weeks in those with a medium constitution, and within eight weeks in those with a robust constitution. The mean values of clinical laboratory test results and hormone levels remained unchanged during treatment (eight weeks).
The overall improvement rating (“markedly improved” plus “improved”) was high (80%) in those with a deficient constitution, and slightly above 60% in those with a medium and a robust constitution. Safety was very high in all Kampo medicine used. The clinical value (“very useful” plus “useful”) was highest with Saiko-keishi-kankyoto given to those with a deficient constitution, followed by Kami-shoyo-san given to those with a medium constitution and Saiko-ka-ryukotsu-borei-to given to those with a robust constitution in that order.

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We examined the clinical effects of the administration of Saiboku-to (TJ-96 7.5g/day) on 14 patients suffering from chronic bronchial asthma. The observation period was from 22 to 52 weeks, and the administration period 26 to 52 weeks. Eight out of 14 cases (57.1%) showed slight improvement or better with respect to asthmatic points and clinical phenomenon. A Steroid-sparing effect was evident in 6 out of 14 cases (42.9%). From urinary excretions following the administration of Saiboku-to, we detected the magnolol component of magnoliae cortex. Effective cases showed increased free magnolol in urine, suggesting the value of combined magnolol as a clinical parameter. We also investigated the function of 11β-hydroxysteroid dehydrogenase (11-HSD) inhibition, one of the mechanisms of the steroid-sparing effect, in healthy subjects using three Saiko-zai. Saiboku-to lowered the activity of 11-HSD and increased the concentration of prednisolone (PSL), while Sairei-to had no influence on the metabolism of PSL. Shosaiko-to, on the other hand, increased the activity of 11-HSD and lowered the concentration of PSL. Thus the three Saiko-zai showed different results.

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If a spectrum of fluctuations in peripheral blood flow is used as an objective index to assess the effect of acupuncture and moxibustion, physiological changes need to be known. We studied the spectra of such fluctuations in healthy subjects under various situations occurring in daily life in association with physiological changes and the symptoms patients complained of. The results are shown as follows.
1) When the autonomic nervous system is well balanced, the fluctuation spectra displayed a pattern where the intensity of the fluctuation frequency components was inversely proportional to the frequency (f), namely a 1/f type.
2) When the sympathetic tone was enhanced or the sympathetic control was not working at the conscious level, the spectrum was close to a pattern where the intensity of fluctuation frequency components was constant and proportional to 1/f⁰ regardless of the frequency.
3) During deep sleep, the spectrum was close to a pattern where a long fluctuation was proportional to 1/f⁰, suggesting that the central conscious level has a great influence on the spectrum.
4) It was suggested that these fluctuations in blood flow take place at the level of arterioles in the corium. Therefore, with a prototype flowmeter produced by the Institute of Applied Electric Science of Hokkaido University, which can measure to a depth of 0.5mm, we were able to measure the spectra of blood flow fluctuations without being limited by the sites of the measurements. However, with a Canon LC-1, which is available on the market, and can only measure to a depth of 0.25mm, we were only able to measure the spectra on the inside of the fingers where the skin is thin.

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It is believed that the restoration of the original indications of meridian points in acupuncture and moxibustion equals to the restoration of the formulations and Kampo diagnoses of Koho-ha school. The restoration has hardly ever deen attempted since the Tang age, mostly due to the loss of Ming tang lei cheng of the ancient style.
In 19c, a part of Ming tang lei cheng of the ancient style was found in Ninnaji Temple, which has initiated study in this area. Also, the project of reprinting classical texts in 1980's accelerated this activity. Our study lies along this line of activity.
Our study is characterized by the fact that we use a method which analyses not only the order of letters in the texts, but also the view itself of the author of Ishimpo. Through this study, we attempted to sort out the original indications and define the original principle.

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The analysis of research activities is becoming important, and there has been an increase of interest in bibliometrics as a useful technique to determine research activities quantitatively. The purpose of this bibliometric survey is to study the present state of the scientitic papers in the field of traditional medicine. Using MEDLINE from 1966 to 1991, 9839 papers were selected as this research materials. The papers in the field of traditional medicine were divided to some subject areas that were acupuncture, therapeutic cults, osteopathic medicine, and chiropractic. The size of papers and the distribution of papers by country were analyzed. Based on the 81 papers from Japan in the 1987 through 1991 period, the ranking of the number of papers by organization was shown. In order to analysis the research activities in traditinal medicine, more bibliometric survey can be expected in the fufure.

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In order to relieve the pain accompanying colonoscopy, we gave patients “Tsumura Shakuyaku-kanzo-to extract” 5.0g 30 minutes before their examination, and investigated its effect.
We were unable to find a statistical difference in the increase in systolic blood pressure and heart rate during the examination between the group prescribed Shakuyaku-kanzo-to (n=18) and the control group (n=20). However, the mean for visual pain score, by which we estimated the pain, was 4.89±0.42 in the group prescribed Shakuyaku-kanzo-to and 6.20±0.34 in the control group. This difference was statistically significant.
These results suggest that Shakuyaku-kanzo-to is effective as a premedication for relieving the pain accompanying colonoscopy. From the literature, we assume that this is caused mainly by the sedative effect resulting from suppression of the nerve center.

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A 34-year-old internist had been suffering from recurring atopic dermatitis for five years and had been unable to withdraw from oral and topical corticosteroids for four years. Oral doses increased one year ago and he visited the clinic for a prescription of decoction. He had dry skin, mainly over the face, shoulders, and flexions of the extremities, and the skin was partly lichened. The serum IgE level was 9, 302IU/ml, and the RAST score showed a strong reaction to mites. He was of medium weight and had fullness, tenderness or discomfort of the hypochondria. He also had irritable bowel syndrome (chronic diarrhetic type).
Pruritus was reduced four day after he started receiving a modified prescription of Shofu-san plus Oren-gedoku-to. One month later when flare was reduced, the treatment was changed to a modified prescription of Shofusan plus Unsei-in. This treatment made the skin non-dry. Furthermore, addition of sesame resulted in a marked reduction of the oral corticosteroid five months after he started receiving the decoction.

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With an increasing number of patients suffering from chronic renal failure, the question of how to prolong the period before starting hemodialysis therapy has been attracting great attention. Kremezin^® and Daio-Kanzo-To, which have been reported to produce good clinical results, were administered to two patients with chronic renal failure in the preservation phase. When the treatment started, renal function tended to deteriorate, and hemodialysis had to be introduced in both patients. We investigated possible causes of this deterioration, and the effect of the combined use of Kremezin^® and Daio-kanzo-To the renal function could not be denied. This combination therapy needs to be studied very carefully.

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In order to establish signs in healthy subjects of pulses, tongue, and abdominal palpation determined by diagnostic techniques used in Kampo Medicine, we performed such diagnostic techniques in 71 subjects who had undergone a full physical examination and shown no abnormal signs from the viewpoint of western medicine. Pulses in men were often of medium depth, of medium speed, slightly large and substantive. There seemed to be at least two types of pulse in women, one was similar to the pulse signs found in men while the other was pulses of medium depth, of medium speed, small, and slightly deficient.
The tongue was pale pink, slightly damp, and slightly enlarged. The coating of the tongues was white or slightly white. Abdominal palpation often detected fullness, tenderness or discomfort of the hypochondrium (males and females), right paraumbilical tenderness (females), palpitation above the umbilicus (females), and softness below the umbilicus (males). A statistically significant difference between male and female subjects was noted in softness below the umbilicus which was more common in males, and in paraumbilical tenderness and palpitation above the umbilicus, which was more common in females. There was a significant correlation among signs of abdominal palpation.

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We treated 200 cases with Spondylosis deformans using acupuncture and Qigong and achieved reasonably good effect.
Results: Clinical cure were 144 cases (72%), while 52 cases (26%) were rated effective. Four cases (2%) were invalid. The total rate of effectiveness was 98%. Twenty seven cases were cured in two courses of treatment, 110 in four courses and 7 in six courses.
Discussion: This disease belongs to the category krown as “Bi zheng” (arthralgiasyndrome) in tradional Chinese medicine. The disease results from “damage to the Governor Vessel” and “stagnancy of Qi and Blood”. The patients practised Shadow Qigong and Huanghai Qigong during the acupuncture treatment. The patients felt “De qi” (needling sensation by acupuncture) and “Qi gan” (Qi sensation of Qigong). The function of Qigong is to improve the circulation of Qi and Blood and to promote health.

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We occasionally experience cases of perioperative misswallowing even when there is no evidence of damage to the recurrent laryngeal nerve. Treatment of such cases has proved to be very difficult. We report a male patient aged 76 who had dyspnea accompanied by aspiration pneumonia after the patient had been operated on for lung cancer. Pneumonia subsequently subsided while misswallowing persisted. Although there was no paralysis of the recurrent laryngeal nerve, marked deficiency of both Qi (vital energy) and blood as well as frequent defecation and diarrhea were noted. A formulation of Ninjin-yoei extract was given in a dose of 9.0g/day through the gastric fistula. Frequent defecation and diarrhea improved one week later, and he started having around 30% of nutrition orally without swallowing in the wrong way. His general conditions improved steadily, and he was released from the hospital. These results indicate that Ninjin-yoei-to is also effective in cases of aspiration pneumonia with deficiency of both Qi and blood.

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Acute autonomic neuropathy is a syndrome where the peripheral nervous system is damaged acutely, primarily, and diffusely. For refractory orthostatic hypotension, which persists in cases where the disorder has not been cured completely, hypertensors or mineralocorticoids are generally administered. We observed that patients who did not respond to such agents did, however, respond to Ryokei-jutsukan-to, although no one has reported previously on the use of this Kampo formulation for acute autonomic neuropathy. In order to define the mechanisms of action of this formulation, we conducted orthostatic tests and drug loading tests and also studied endocrinology and hemodynamics. Blood pressure rose with the treatment of Ryokei-jutsukan-to, and this proved to be due to an increase in peripheral vascular resistance. Furthermore, cardiac output was decreased, and the renin-angiotensin-aldosterone system, which had been slightly activated, was corrected. The increase in peripheral vascular resistance appears to be a result of direct action on the vascular wall, since the formulation inhibited the sympathetic activity and improved the denervation hypersensitivity of peripheral vascular receptors.

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Shiun-ko has proved to be effcctive in burns and hemorrhoids. However, it is not frequently used in children because it has a disagreeable smell, stains clothes, and is indicated only for dry lesions. This formulation, however, has several advantages including its bactericidal activity and its inhibition of cicatrization without forming keloids. We therefore used Shiun-ko in children with vulvar hemangioma or burns. Although the lesions were wet, they dried quickly and healed without keloid for-mation. This formulation appears to be applicable even to wet wounds if it is kneaded and stretched when applied.

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In 1989, a 17-year-old male patient had fever and was admitted to a hospital in his neighborhood. He was then diagnosed as having Crohn's disease of the colon and ileum. His condition improved when treated with parenteral hyperalimentation via the central vein, an elemental diet, and salazosulfapyridine. Every time a normal diet was introduced, it recurred, which required a second hospitalization. At the third recurrence in July 1992, he expressed the desire to have Kampo medicine and subsequently visited our department. The inflammatory reactions were severe, and he had fever and was losing weight. He was fasted and given parenteral hyperali-mentation via the central vein. He received Kyuki-kyogai-to and Hange-shasin-to concomitantly which were prescribed according to his kampo diagnosis. One month later, CRP was negative and an elemental diet was started. Two months later, he was able to take both elemental and normal diets. Remission is still being maintainned even after he started the normal diet again.
Kampo medicine achieved a prolonged remission in this case where Crohn's disease kept recurring when hyperalimentation therapy was given, This suggests that a combination of an elemental diet and Kampo medicine may play an important role in maintenance therapy for this disease.

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The relationship between tongue coating and Pancreas exocrine function was investigated in 45 cases by pancreatic function diagnostant. These cases were classified into three groups, “slight, ” “moderate” and “marked” according to the degree of thickness of tongue coating. Among the three groups, the mean rate of PABA excretion in urine tended to decrease as the degree of thickness of the tongue coating increased. That in the marked group was lower than in the slight group with statistical significance. The results suggest that thickness of tongue coating is partially related to pancreas exocrine function.

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