After achieving a spectacular economic growth through 60's to 80's of the 20^th Century, Japan seems to have lost its momentum and stays stagnant in the last 10 years of so-called ‘a lost-decade’. What has been wrong? Here, I will discuss the historical background and the social structure of modern time Japan and their relevance to the global changes driven by information and transportation technology which affected political, economical, and social environments of the world or so-called ‘globalization’. In this context, it will become clear that the mechanism that has supported the success of modern time Japan will no longer be workable in this time of ‘globalization’ of 21^st Century and will left alone even in Asia. To avoid such perspective, radical changes in nurturing future leadership is urgently needed.

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All prescriptions containing Dai-kenchu-to (DKT, Da-Jian-Zhong-Tang), one of the most commonly prescribed Kampo medicines (Sino-Japanese traditional herbal medicines) in Japan, that had been issued during a six-month period from September 1999 to February 2000 at Kitasato University Hospital, were analyzed. The DKT used at this hospital was in the form of ethical extract granules (Tsumura, Tokyo), and it was mainly prescribed to patients who were treated in the Departments of Gynecology and Surgery and who had undergone surgery. In order to clarify problems in the administration of DKT granules to post-operative patients, a questionnaire was distributed to nurses working in the wards of eight large hospitals (over 470 beds each). More than 80% of the nurses reported that they had observed problems with the taste and dosage of DKT administered to their patients. Hard granules do not readily dissolve in water, and the nurses observed difficulty in deglutition upon oral administration of DKT, and tube obstruction in patients who were administrated DKT through a gastric tube. These difficulties in the administration of DKT are thought to increase the workload of the care staff, and the development of a new route of administration of DKT, for example, a decocted solution packed into a stick, is expected.

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Kumi-binro-to is a Kampo formulation produced by Sohaku Asada. It has been used for patients with stasis of body fluids presenting beriberi-like symptoms. The cases in this report where Kumi-binro-to was effective had symptoms similar to the cases where it was ineffective, but they had different distributions of tympanic sound in the abdomen.
We investigated the efficacy of four weeks of treatment with Kumi-binro-to in 30 cases having both symptoms of stasis of body fluids and tympanic sound in the abdomen. Kumi-binro-to was effective in 20 of 25 cases that had the tympanic sound in the right iliac, flank and subphrenic regions. However, Kumi-binro-to was not effective in 5 cases where the tympanic sound was restricted to the epigastrium, left iliac, flank and subphrenic regions. Tympanic sound on the right side of the abdomen might be one of the indications for Kumi-binro-to.

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We report on two elderly patients in the extended care unit who were successfully treated with “Furidashi” extract (an extraction method of dipping in hot water) of Astragali Radix, for copious sweat. Case 1 was a 65-year-old male hospitalized for rehabilitation after cerebral hemorrhage. He needed a change of clothes three or four times a day because of copious sweat. After administration of Hochu-ekki-to and “Furidashi” extract of Astragali Radix, his sweat decreased. Case 2 was a 66-year-old female hospitalized for rehabilitation after cerebral contusion. She was dripping-wet with perspiration, and had itchy eczema and skin erosions on her trunk. After administration of the “Furidashi” extract of Astragali Radix, her sweat decreased and the erosions were cured. This strongly suggests that the “Furidashi” extract of Astragali Radix provides a convenient and inexpensive treatment against copious sweat accompanied by skin disorder in the elderly.

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Traditional Chinese acupuncture was used in four cases of intractable tinnitus associated with presbyacusis, showing greater losses at higher frequencies while lower frequencies were only slightly below the normal threshold on a pure tone audiogram. Further audiologic evaluation by means of a speech discrimination test and short-increment sensitivity index (SISI) showed that cases 1 and 2 were the labyrinthine impairment type, case 3 was the mixed type, and case 4 was the retrolabyrinthine type. However, the etiology and pathogenesis of all patients were diagnosed as constitutional deficiency of kidney essence failing to nourish both the ear and brain, the so-called “sea of marrow” based on TCM differentiation. Following the principle of invigorating kidney essence and nourishing “Kidney Qi, ” acupuncture treatment was given around the ear as well as at distal points on the extremities once a week, with 10 sessions constituting one therapeutic course.
In cases 1, 2 and 3, a temporary minor reduction effect of tinnitus lasting half a day to a few days could usually be achieved by each acupuncture session, and long-term effects, with significant improvement of subjective intensity and loudness of tinnitus (which always dropped to 1/2-1/3 of the pretreatment levels) was possibly obtained after 3-4 treatment sessions. Acupuncture was less effective in case 4, in which some fluctuation of tinnitus loudness values was reported within the period of treatment, but there was no remarkable stable improvement, either in terms of loudness or disturbance of the tinnitus after 10 treatment sessions.
The results indicate that traditional Chinese acupuncture is a recommendable therapy in treating age-related tinnitus, especially the labyrinthine type or mixed type rather than the retrolabyrinthine type.

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