Amidst field of Alternative Medicine, this is the report on Kampo practice in Japan in the past and the present. Kampo was transmitted to Japan from China in the 6th century. The Western Medicine became popular practice after Meiji Restoration, but around 1928 and after, Kampo began to regain its momentum again. By 1976, the Kampo preparation was accepted by the health insurance, which enabled many doctors to utilize the Kampo preparations.
Currently, 147 kinds of Kampo extract is adapted by health insurance, and it is particular to Japan that doctor is allowed to prescribe Kampo preparation with Western medicine. There is a need to make the most of this opportunity so that Kampo is used more effectively in the treatment.
Japan is rapidly aging, and medical expense is significantly increasing accordingly. Immunity deteriorates in aged people, and numerous diseases that they experience are due to the deterioration of internal organs, and treatment of such requires prescription of large quantity of medication, since separate medicine is prescribed for each disease with Western Medicine.
On the other hand, Kampo Medicine would increase the immunity of the patient and one type of medication would improve many diseases at the same time, which means that it will avoid excessive use of medication. Adapting Kampo would, therefore, contribute to cutting down the medicine expense, which constitutes medical treatment expense. From this point of view, economical aspect of Kampo in aging society is valued highly as well.

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I compared the efficacy of conventional therapies with Kampo therapies for atopic dermatitis, one of the typical chronic dermatoses. Causes and factors of deterioration of atopic dermatitis are divided into constitutional allergies and non allergic that in external stimuli invasion due to abnormality of epidermal defensive function against outside.
Acute dermatitis arises from activation of Th 2 cells followed by production of cytokines IL 4, IL 5, IL 13 involving IgE anitibody and Eosinophile in type I allergic reaction. Chronic dermatitis arises from activation of Th 1 cells followed by production of IL 2, IFNγ in type IV allergic reaction.
In constitutional allergy, dehydration due to epidermal shortage of ceramide and humidity make abnormalities of epidermal defensive function (against outside) leading to vulnaerability to external stimulus followed by prompt aggravation of dermatitis.
As, pathogenic dampness and heat exist under epidermis and in dermis in dermatitis, We use herbs diuretic or draining dampness and dispelling heat to remove pathogenic dampness and heat. Sometimes with further combination of herbs tonifying Yin.

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In the previous paper, the authors have investigated a Chinese crude drug Ge-gen, the root of Pueraria species of the family Leguminosae, and concluded that it should be collected in the early summer for medical use. This is a report of the differences in the content of the constituents between Ge-gen harvested in the summer and in the winter. Yields of water extract of winter Ge-gens were generally higher, while no significant difference was recognized in the content of starch and flavonoids, such as puerarin and daidzin. Starch content varies widely with the stock, and that of the same stock did not show significant difference between the summer root and the winter one.

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Dai-kankyo-gan has traditionally been used for great resistance for tenderness upon pressure in the epigastric region (Shinkahiko) and rigidity of nape (Kohai-kyo). We treated two cases with Dai-kankyo-gan for years.
Case 1 was a 75-year-old male patient. He had been experiencing shortness of breath after slight exertion since 1986, and had been treated with theophyline, bronchodilator, and expectorants, as well as prednisolone for emphysema and pneumoconiosis. After receiving Dai-kankyo-gan, the patients Kohai-kyo and dyspnea improved and he was able to stop taking prednisolone. It is well known that Dai-kankyo-gan makes Shinkahiko and Kohai-kyo better. In this case, it improved throat discomfort as well.
Case 2 was a 56-year-old female patient who had been suffering from stiff shoulders and headaches. After receiving Dai-kankyo-gan, Kohai-kyo improved and the thick coating on the tongue was normalized.
Shinkahiko, which depends on stasis of body fluid, is usually normalized with the improvement of subjective symptoms. But in these cases, it was not cured.

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We report a case of an 84-year-old septic patient who was treated with Ogi-kenchu-to (Huang-qj-jian-zhong-tang). The patient had remained positive for Klebsiella pneumoniae. The focus of infection had not been detected, but bacterial translocation from the digestive tract was suspected from the clinical course. After two weeks of antibiotic therapy, he still had a high fever and positive blood culture. In addition, multiple cultures showed the destruction of normal flora and an increase of antibiotics-resistant bacteria.
Antibiotics were then suspended, and he was treated with Ogi-kenchu-to alone. His fever and inflammatory signs gradually disappeared, and his blood cultures became negative without restarting antibiotic treatment. He recovered completely. Ogi-kenchu-to is indicated for treating “generally weakened” patients or patients with intestinal problems. However, we could not find any reports of its application to septic patients. Although we still need to determine the mechanism for its efficacy, we consider that this case adds further evidence that Ogi-kenchu-to may be helpful for those suffering from severe infection, especially in elder patients and immuno-suppressed patients.

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Repeated relapses of vomiting were treated with Bukuryo-takusha-to in a patient with resistant gastric ulcer. A 77-year-old woman, who had been admitted to our hospital due to manic disorder, presented tarry stool in February 1997. Gastrointestinal endscopy revealed an active gastric ulcer. The ulcer remained at the healing stage even after three years of treatment with H₂ receptor antagonist or proton pump inhibitor. She developed vomiting attacks in February 1998; thereafter, these vomiting episodes recurred repeatedly. During one three-day episode, she vomited the contents of breakfast every evening. Therefore, we regarded this attack as “ihon” from the view of Kampo diagnosis. After the administration of Bukuryo-takusha-to, the vomiting attacks disappeared within a day. The gastric ulcer then reached the scarring stage. In this patient, Bukuryo-takusha-to might have been effective in treating the resistant gastric ulcer as well as the recurring vomiting attacks.

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We gave Borei-takusya-san to six patients with intractable edema under the waist. This treatment cured three of the six. Two of the cured patients had Ki-deficiency or Yang-Ki-deficiency in the kidneys. In these cases, we first intensified Ki in the kidneys and improved their conditions to Yin-disease, first stage. We noticed improvement of their subjective symptoms and objective signs after we gave them Borei-takusya-san in combination with their prescriptions. All of the ineffective cases presented some conditions of hypo-tonus or hypo-reactivity.
With reference to many ancient medical books and our own experience we studied the use of Borei-takusyasan. It applies to patients (1) with oliguria, (2) with edema under the waist, (3) without Ki deficiency and Yang-Ki-deficiency in the kidneys and with (4) more reactive stage than Yang-disease, second stage and Ki between excess and deficiency. (5) If they had Ki-deficiency or Yang-Ki-deficiency in the kidneys, we should first replenish with Ki sufficiently, and make out prescriptions for the patients.
We consider that Borei-takusya-san is capable of wide application to the patients with edema under the waist, following our indications.

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In the hormonal treatment of uterine myomas, which are estrogen dependent, GnRH agonist (GnRHa) therapy has become widespread. However, GnRHa therapy causes uncomfortable or harmful side effects such as climacteric symptoms. The aim of this study is to evaluate the effect of Kampo (herbal) medicine to diminish climacteric symptoms induced by the GnRHa. Twenty-six patients with symptomatic uterine myoma were recruited, and informed consent was obtained from all subjects. Leuprolide acetate depot 3.75mg (LA) as GnRHa was given with subcutaneous injection every four weeks for six months. After LA therapy was initiated, Toki-shakuyaku-san, Kami-shoyo-san, or Keishi-bukuryo-gan was given from the second month of treatment. Climacteric symptoms were evaluated with Simplified Menopausal Index, which was improved for Japanese women. In the present study, we found all three Kampo medicines were useful. In particular, Kami-shoyo-san was useful for climacteric symptoms induced by LA. Also, LA therapy combined with Keishi-bukuryo-gan had beneficial effects in uterine myomas. However, the precise mechanism by which results were achieved remains unclear. Therefore, further research may be necessary to evaluate the ability of Kampo medicines to diminish climacteric symptoms induced by GnRHa.

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