We examined the effect of Sho-seiryu-to and Bakumondo-to on eosinophil viability and degranulation in vitro. Human eosinophils were cultured at various concentrations of Sho-seiryu-to and Bakumondo-to with or without recombinant human interleukin-5 (rhIL-5, 100pg/ml) at 37°C, 5% CO₂ 95% air and the eosinophil viability was measured on day four. Both Sho-seiryu-to and Bakumondo-to significantly reduced eosinophil viability at a concentration of 1, 000μg/ml (p<0.05, p<0.05, respectively). For degranulation assay, human eosinophils were cultured with various concentrations of Sho-seiryu-to and Bakumondo-to for 15min at 37°C, 5% CO₂ 95% air and then further cultured with ovalbumin (OVA), human immunoglobulin G (hIgG) or human secretory IgA (hsIgA)-coated sepharose 4B for four hours. The culture supernatants were collected and the contents of eosinophil cationic protein (ECP), indicating eosinophil degranulation, were measured by radioimmunoassay. Eosinophil degranulation induced by OVA, hIgG and hsIgA was significantly inhibited by Sho-seiryu-to (40μg/ml, p<0.05; 200μg/ml, p<0.05 and 200μg/ml, p<0.05, respectively). OVA-induced eosinophil degranulation was significantly inhibited by Bakumondo-to (1, 000μg/ml, p<0.05). These results suggest that Sho-seiryu-to and Bakumondo-to, especially the former, may be useful in the treatment of allergy, though further studies are needed.

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For the purpose of establishing a method for evaluation of crude drugs, we demon strated the effect of aqueous extracts from the roots of seven different (types of) Angelicae (“Toki”) and rhizomes of seven different (types of) Atractylodes (lancea) (“Jutsu”) on the binding of immune complexes to macrophages. Among the extracts from “Toki”, extract of Angelica acutiloba Kitagawa (harvested in Nara Prefecture and the Hokuriku district in Japan) had the most potent enhancing activity on the binding. Among the extracts from “Juste”, extract of Atractylodes lancea DC, (An Hui Sheng in China) had the most potent enhancing activity. However, when the extracts were made from the codecoction of Angelica and Atractylodes lancea, the enhancing activities were varied. These results suggest that the combination of crude drugs tays an important role in the appearance of the pharmacological activities.

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Fifty-five infants aged two or less suffering from stridor were treated with Shin'i-seihai-to (Tsumura's extract preparation). The results were very favorable. The formulation was found to be very effective in 26 infants, effective in 16, and ineffective in three. No statistically significant differences were noted in accompanied sinusitis or concomitant use of other drugs. Management of infantile stridor is often difficult, and the effect of Shin'i-seihai-to merits attention.

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We studied a case of bronchial asthma associated with irritable bowel syndrome which responded to Bukuryo-Keishi-Kanzo-taiso-to. The 54-year-old woman was admitted to our hospital due to recurrent abdominal pain and paroxysmal coughing. The abdominal pain was diagnosed as irritable bowel syndrome, and paroxysmal coughing as bronchial asthma. Uzu-Keishi-to, Sekiganyo, Gekyu-shokuso-to were given for abdominal pain, and Ryo-kan-kyo-mi-shin-ge-nin-to and Soshi-koko-to were given for cough. None of these, however, were effective. We consider the condition at the time of attack to be hypochondriasis with palpitation attack, including coughing and abdominal pain, based on the fact that (1) abdominal pain and paroxysmal coughing were accompanied by marked perspiration, (2) the patient felt that something was being pushed upward from the epigastrium into the throat, (3) the patient complained of coldness in the abdomen concomitant with a feeling of warmth in the head, neck, and chest, and (4) subjective palpitations in the upper and lower abdomen were significant. We then used Bukuryo-keishi-kanzo-taiso-to, and both the abdominal pain and the coughing improved using this formulation alone. Although there seem to be two different diseases, they can sometimes be treated as one in kampo medicine.

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Case 1 was a 70-year-old female patient who visited our Department mainly due to palpitations which had persisted for the previous four years. From about one year ago, paroxysmal palpitations have occurred frequently. The 24-hour Holter ECG monitoring and echocardiography indicated supraventricular arrhythmia, but there was no temporal association between the arrhythmia and the palpitations. She was very nervous and irritable. She felt fullness of the upper abdomen and palpitations in the lower abdomen. She was given Chugoho-honton-to-ka-bukuryo-byakujutsu. One week later, the palpitations became less frequent, and two weeks later they all but disappeared.
Case 2 was a 41-year-old male company employee. He visited our Department complaining of general malaise, abnormal perspiration of the upper body, and pain in the fingers. Six years previously, he had developed erythema both in the palms and in the soles of the feet and also pain in the fingers of both hands. Four years ago, swelling occurred in the tips of his fingers and toes, which then aggravated. He was diagnosed as having acromegaly accompanied by pituitary adenoma and subsequently underwent resection of the pituitary tumor. After the operation, he developed general malaise and abnormal perspiration in the upper body, which obliged him to take time off work. Based on marked feelings of heat in the upper body and cold in the lower body and also abnormal sweating attacks, he was considered to be suffering from hypochondriasis with palpitation attack. One week after he was started on Chugoho-honton-to-ka-bukuryo-byakujutsu, his legs no longer felt cold. Symptoms of the joints and abnormal sweating subsequently improved, which enabled him to return to work.
Case 3 was a 32-year-old housewife who visited our Department complaining of headache and pain in the right shoulder. She had had contusion in the scapula ten years previously and had been suffering from dull pain ever since. Seven years ago, when she had a baby, she developed severe pain in the paraspinal muscle facing the right scapula. This severe pain radiated along the dorsal muscle and was accompanied by headache. Because she felt hot in the upper body and cold in the lower body, subjective palpations in the upper abdomen, and a mass in the hypochondria and umbilical region, Chugoho-honton-to-ka-bukuryo-byakujutsu was given. This produced excellent results.
Based on the experience of these three cases together with what can be found in the literature, we believe that conditions where Chugoho-honton-to-ka-bukuryo-byakujutsu are indicated have the following features. (1) The conditions are often triggered by fright, fear, depression etc. (2) There exist paroxysmal palpitations, headache, and the sensation of hot flushes. (3) A feeling of anxiety ascends from the abdomen. (4) The disease is in the initial stage of the three Yin diseases. (5) There are signs and symptoms of a deficiency in Qi. (6) There are subjective palpitations in the upper abdomen and in the epigastrium. (7) There is fullness of the upper abdomen and epigastrium, often accompanied by a mass in the hypochondria or umbilical region.

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Nineteen children with mycoplasmic pneumonia who were treated with western medicine until CRP values became negative and who had coughing and dry mouth were treated with the Makyo-kanseki-to extract in a daily dose of 2-3g in addition to Western medicine (Kampo combination group). They visited my clinic in 1992 and 1993. Sixteen children with mild mycoplasmic pneumonia were treated with western medicine alone at the Department of Pediatrics, Chiba Municipal Kaihin Hospital (Western medicine group). Antibacterial agents included oral ricamycin or minomycin. Diagnosis was made when the mycoplasma antibody titer (CF, HA) in the paired serum was four-fold or more. Coughing disappeared in all patients in the Kampo combination group after Makyo-kanseki-to was added for a period of two to four days. The mean duration of administration of the antibacterial agent was 7. 1±1.3 days and the mean duration required to eliminate coughing was 10.2±1.2 days. Both figures were lower than those in the Western medicine group, namely 10.8±2.0 days and 12.3±4.7 days respectively (P₁<0.0001, P₂=0.06). It occurred to me that coughing and dry mouth, which are noted during the recovery stage of mycoplasmic pneumonia in children, are primary symptoms for which Makyo-kanseki-to is indicated. This formulation indeed improved these symptoms. The results suggest that Makyo-kanseki-to may be useful for coughing in mycoplasmic pneumonia.

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I studied three cases of acute infectious disease which responded to Sho-saiko-kyo-hange-ka-karokon-to. One had acute pneumonia and AGML, one had septicemia complicated with cholangitis, and the other had hydronephrosis complicated with acute nephropyelitis. All these cases presented signs for which Sho-saiko-to is indicated, but the patients had severe thirst. I also used antibiotics and fluid therapy, but I believe the main effects were achieved by this herbal formulation, which was prepared by removing pinellia tuber from sho-saiko-to, increasing Ginseng radix 1.5 fold, and adding trichosanthes root. In a text on Sho-saiko-to, I studied early researchers' views on this formulation. I also studied the differences between Sho-saiko-kyo-hange-ka-karokon-to and Saiko-kyo-hange-ka-karo-to in the Jin kui yao lue and found that there are some differences in features of the disease.

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We have previously reported that Bukuryo-shigyaku-to (BSG) has the effect of improving the asthmatic state of steroid dependent patients. Nevertheless, the standard indication for this drug in Kampo medicine was not established in these patients. In this paper, we report three such patients who improved by its administration. A 66 y. o. male diagnosed as having as asthma with pulmonary emphysema was treated daily with 30mg of oral prednisolone. A 45 y. o. female diagnosed as having asthma with autonomic disorder was treated daily with 7.5-15mg of oral prednisolone. A 61 y. o. female diagnosed as suffering from asthma with diabetes mellitus was treated daily with 10mg of oral prednisolone. The reason for the use of BSG was that their asthmatic state remained unchanged by other Kampo drugs which were indicated by the usual Kampo diagnosis, and in the second and third cases the duration until feeling heat from the applied electrical warm acupuncture apparatus was overly long. Weakness of radial pulse and cold in the extremities, the usual indications for the use of BSG by Kampo diagnosis, were absent in these three cases, but nevertheless its administration improved their asthmatic states. This apparent contradiction with Kampo diagnosis might be related to the effect of the steroid drugs used.

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A 41-year-old man had been suffering from loss of appetite and abdominal distension since November, 1990 and was diagnosed as suffering from chronic gastritis with intestinal metaplasia and mild depression as a result of examinations. His symptoms were not cured by various kinds of western drugs and he was admitted to our hospital on June 19, 1992. We diagnosed his symptoms as caused by chronic gastritis with intestinal metaplasia and regurgitated bile juice based on his general examinations (Kyoukyoukuman) and findings of gastrointestinal fiberscopy (GIF) . He made favorable progress on Saikokeishi-To within one week and his weight increased from 55 kilograms to 58 kilograms five months. 5 months after treatment with Saikokeishi-To, GIF findings were considered to have shown improvement but histological findings of gastritis with intestinal metaplasia were considered to have been aggravated. Saikokeishi-To cured his symptoms and increased his body weight, but failed to improve histological findings in the gastric mucosa. Therefore Saikokeishi-To may have a good psychological effect and improve gastrointestinal motility.

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Total or diffuse alopecia areata is difficult to treat and often recurs. Many different hypotheses have been proposed concerning its etiology and therapy, but no agreed view has been established. There is no therapy available to guarantee a cure. Two girls with very similar conditions who did not respond to the most advanced western medicine have been treated orally with Saiko-keishi-to-ka-ryukotsu-borei. They have shown considerable improvement. In my report, I outline the etiology and therapy for alopecia areata based on the literature, discuss the two cases mentioned above, and describe the value of this prescription.

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We examined the clinical usefulness of Hachimi-jio-gan and other Kampo drugs for the senile patient suffering from gonarthrosis. Kampo drugs were administered referring not only to “Sho”but also roentgenograph of the knee joint. Hachimi-jio-gan was effective for the senile patients with gonarthrosis, while application of the “Seinetu-Risuizai”, drugs which clear away heat-evil and promote diuresis, were required in cases accompanied by excessive pathogenic dampness-heat combination, swelling and deformity of the Knee joint. Kampo drugs for senile patients are extremely useful because they have few side effects and provide high quality healing.

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In order to find a point of contact between eastern and western medicine, the so called _??__??__??__??_ (carriers of every function of the body) were claasified into seven functional systems, such as the respiratory system etc., and assigned to seven corresponding anatomical “organs and tissues”, such as the heart etc. However, the meaning of _??__??_ in traditional eastern medicine does not equate with “organs and tissues” of the “Anatomy”. In this report, in order to find a correspondence of pathological changes and fuctional alterations, all the accessory changes among a total of 92 autopsy cases, who had diseases of the brain, were classified into seven systems, and an assessment of each frequency was performed by the statistical X² method. The resets we obtained point to the accuracy of the insight of ancient Chinese traditional medicine, _??__??__??__??_.

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We measured the concentrations of electrolytes (Na, K, and Cl) contained in Kampo preparations which are frequently used in our hospital and discuss possible clinical problems. The Kampo preparations studied were Kakkon-to, Hachimi-jio-gan, Dai-saiko-to, Sho-saiko-to, Saiko-ka-ryukotsu-borei-to, Hange-syashin-to, Sho-seiryu-to, Sho-hange-ka-bukuryo-to, Toki-shakuyaku-san, Kami-shoyo-san, Keishi-bukuryo-gan, Bakumondo-to, Juzen-taiho-to, Saiboku-to, Unkei-to, Gosha-jinki-gan, and Sairei-to. The electrolytes in these preparations were measured by an autoanalyzer after they were dissolved in distilled water. Potasssium (K) concentrations were 0.18-0.83mEq/L. Relatively lower K concentrations were noted in Sho-hange-ka-bukuryo-to (0.18), Keishi-bukuryo-gan (0.24), and Bakumondo-to (0.34). Relatively high concentrations were observed in Sho-seiryu-to (0.83), Hange-syashin-to (0.79), Gosha-jinki-gan (0.76), and Juzen-taiho-to (0.76). The Kampo preparations we studied do not appear to pose a problem even in patients with renal dysfunction, considering the balance of the formulations with other food and Kampo therapy with decreased doses.

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A drug such as Kakkon-to, which has an acrid taste and warm nature, is used in the treatment of superficies-syndrome. When it is used orally, it is considered important empirically to administer it hot or ‘Onpuku’. However, there have been no reports to compare taking it hot and taking it cold. The effect of drinking hot or cold water and ingesting hot meals on the body temperature has not been studied either. In order to elucidate the significance of Onpuku, the temperature of the ear drum was measured in ten adults after they drank 180ml of 60°C water and 180ml of 10°C water. The temperature of the ear drum was also measured after they had eaten a bowl of noodles with Tempura, which contained 400ml of soup at 70°C.
When the warm water (60°C) was given, perspiration was observed in eight without any clear tendency for the ear drum temperature to change. When the noodles were ingested, the temperature rose by 0.73°C. When cold water (10°C) was given, the temperature dropped by 0.52°C. No change in temperature was noted when Kakkon-to was given orally.

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In this report, we describe a case of rheumatoid arthritis (RA) which responded to Ohi-chu-zai, a new Chinese OTC antirheumatic remedy. A 53-year-old man developed RA in 1989. Various antirheumatic agents were ineffective, and RA remained highly active. A corticosteroid, immunosuppresant, nonsteroidal anti-inflammatory drug, and heat-processed aconite tuber were used, but failed to exhibit sufficient effect. When ohi-chu-zai was added, the activity of RA was reduced markedly, accompanied by a gradual improvement in anemia. The man's appetite increased, his general conditions improved and he could eventually go back to work. Preparations with ephedra herd and aconite tuber have been widely used in Japan, and their effects have been reported. However, there has been no report on Ohi-chu-zai, a new Chinese OTC antirheumatic medicine. This report is the first one in Japan which describes the effect of this preparation as an antirheumatic agent.

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In order to find a point of contact between eastern and western medicine, the socalled _??_ _??_(five carriers of all the functions of the body) were divided into seven functional systems, such as the respiratory system, the digestive system, etc., together with the additional nervous system and the supporting, locomotive and/or immune system, and arranged them into seven corresponding anatomical “organs and tissues”, such as the lung and digestive canal etc., with two additional corresponding anatommical organs and tissues, with the above mentioned functions. The idea of this new arrangement was prompted by the similarity between the ancient wetern medicine of Hippocrates and Chinese medicine of _??_ _??_ (yellow emperor), as both have a humoral pathology, other than the idea of (a kind of invisible energy) of the latter. This new trial is planned to set np a common medical base for both eastern and western medicine, that may contribute to a reasonable comparison of eastern and western medicine, and may be useful to the physician of western medicine in making a reasonable approach to eastern medicine.

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In Japan formulas are often chosen on the basis of a disease or symptom, not on the basis of “SHO” or conformation, according to which formulas were originally chosen in Chinese traditional medicine.
From a consideration of properties of drugs constituting formulas, the possibility of therapy based on the name of a disease or symptom corresponding to therapy based on “SHO” or conformation was investigated. In this paper, 12 cases were selected, in which formulas were often chosen according to the name of a disease or symptom, and percentages of cases of indication were examined.
“Kakkon-to”, a surface-treating, warming purgative (perspiring) formula, is to be used in the early stages of the common cold, only in chill-strong conformation, not in fever-strong or chill-weak (easily perspirable) conformation, so the indication is 50% or less. “Saiboku-to”, a half-surface and half-interior-treating, cooling, half-purgative and half-tonic, descending (sedative) formula, is effective in about 80% of remissions in bronchial asthma, regardless of conformation (“SHO”).
In the case of single-dose use or only symptomatic use, it is usually possible to choose formulas not on the basis of “SHO” or conformation, for example “Daio-kanzo-to” (purgative) and “Shakuyaku-kanzo-to” (anodyne).

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Asada's Saikatsugekito, which is a mixture of ginseng-and jujube-free, but gypsumadded Shosaikoto-Kakkonto mixture, is thought to be used for the Heibyo of Taiyobyo and Ritekisyoyosho according to its composition and the contents of the description in its source. On the other hand, in the treatment of Heibyo, Senhyogori may be the therapeutical principle for such a pathological condition according to that for Taiyobyo and Yomeibyo, but the present treatment is thought to be exceptionally beneficial due to the effect of Hyorisokai. The present case of cold syndrome, which initially was supposed to be Maotosho, was diagnosed, on the day after its first examination, as transferred to Ritekisyoyosho, i. e. Heibyo of Taiyosho and Ritekisyoyosho. The present treatment caused its symptomatic remission in a short period of time. This may be indicative of the significance of the present treatment for such a state of Heibyo of Taiyobyo and Ritekisyoyosho. From the viewpoint of Heibyo treatment, we should bear in mind that some exceptional use, such as in the present treatment, may be practical in consideration of the therapeutical principle.

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For those who study oriental herbal medicine, it is very important to know the plants and parts thereof used as herbal drug ingredients. Generally speaking, this is done by looking at either dried plant specimens or herbal drug ingredients. In order to keep dried specimens in good condition, it is necessary to spray the plants with insecticides and to repair any broken parts of the specimens. Repairing and spraying takes a lot of time and labor. Therefore, it is actually difficult to look at specimens. To overcome these disadvantages, specimens are dried and laminated. Sealing specimens also keeps them completely dry and safe from insects. Using this new preservation method, you can easily show many specimens to your students and colleagues.

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