Dr. Sakaguchi, who has succeeded to the “Asada-style” of Dr. Hosono's Kampo Medicine, has been long studied the dietary theories of Sakurazawa, acupuncture, moxibustion, and homeopathy based on Hosono Kampo Medicine.
Dr. Sakaguchi has made great contributions, along with Dr. Shiro Hosono, the reconstruction of Showa Era (1926-1989) Kampo medicine through pharmacological studies of Kampo formulae, and development of their extracts. One remarkable characteristic of Dr. Sakaguchi, as a clinician, is that he attaches importance to “the treatment of minus one-year-olds”, i. e. the treatment by Kampo medicine for a pregnant woman.

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For the dispensing of Kampo formulas, only an adult dose is described by conventional formulary. Therefore a child's dose is often prescribed by reducing instructions for the fraction-times of an adult dose. However, it is necessary to study whether the content of Kampo-extract pharmaceutical preparations at a child's dose, are similar to decoctions prepared by reducing the dose of crude drugs, and reducing the quantity of water by fraction-times. Therefore it was compared whether the constituents of a decoction liquid at an adult dose, were equal to those of a child's dose. In the decoction method of our clinic, adult doses are decocted with an initial 600mL quantity of water to half volume, as per the normal decoction method, whereas children's doses are reduced to 2/3 or 1/3 times that of adult dose, and decocted to half of the early-stage quantity of water that they are with adults. In the present study, three Kampo formulas which have been used frequently in our clinic and have different prescription weights i.e., Oren-gedoku-to (9g), Keishi-bukuryo-gan-ryo (20g), and Juzen-taiho-to (33g) were studied. When child and adult doses were compared, a difference was noted in pH, extraction rate and extracted constituents. Extraction rates for a child's dose of Oren-gedoku-to and Juzen-taiho-to were lower than that of an adult dose. Extraction rates of component gradients? ferulic acid in Oren-gedoku-to, pae-oniflorin in Keishi-bukuryo-gan-ryo, and paeoniflorin and liquiritin in Juzen-taiho-to? for a child's dose were lower than those of an adult dose. However, extraction rates of component gradients? albiflorin in Keishi-bukuryo-gan-ryo and albiflorin and trans-cinnamic acid in Juzen-taiho-to ? for a child's dose (quantity of 1/3 times) were higher than those of an adult dose. These results suggest that the content of a decoction, which was prepared by reducing an adult dose to the fraction-time of a child's dose, is not the same as reducing the amount of Kampo-extract pharmaceutical preparation to the fraction-time of a child's dose.

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[Purposes] Evidence-based medicine (EBM) is now the established standard for selecting appropriate treatment, the basic ideas of which cannot be ignored even in the field of Kampo medicines. With this in mind, we conducted a meta-analysis (MA) for those Kampo medicines which had been administered in randomized clinical trials, as a method of establishing the evidence for Kampo medicines, and then examined the resulting data obtained for the present study. Here, we focused on the assessing the usefulness in postpartum control, using Kyukichoketsuin (KCI), with methylergometrine maleate (MME) as control.
[Methods] We searched and collected articles published before September 2004 in Igaku Chuo Zasshi (Japana Centra Revuno Medicina) and Medline using keywords such as “Kyukichoketsuin”, etc. First we selected target articles for analysis in accordance with our inclusion criteria and examined the quality of those articles using a score system adopted by Chalmers, in 1981. Then we extracted target data from the articles in accordance with meta-analytic methods, integrated the resulting data using the DerSimonian-Laird method, and implemented sensitivity analysis to them.
[Results and Discussion] We selected four articles for our target analysis. All four were of similar quality. When we set post-labor pains as an assessment item, and integrated three of the four articles, KCI showed that it more significantly decreased those pains compared to MME, with an integrated odds ratio of 0.32 (95%CI, 0.17-0.60). The one remaining independent article, however, in which KCI exerted statistically significant effect in height of day-five uterine fundus, indicated no higher significance through integration with the first three articles. Also, even integrating the height of the uterine fundus shown in the articles, on day four as well as the height before integration, had no significance. These results indicate that the effect of KCI for the involution of the uterus may be the same as that of MME. Regarding the volume of breast-milk lactation on day four in comparison between two test drugs, some articles showed more volume in both the KCI and MME. groups, despite reaching no significant decreases in volume, with an integrated odds ratio of -8.20 (95%CI, -16.17--0.23). However, contrary to this, results for the integration of day-five breast-milk lactation volume showed an increase in the KCI group, although without reaching significant difference. Therefore, the effectiveness of KCI for breast-milk lactation could not be generally categorized as less than that of MME.
[Conclusion] MA demonstrated that KCI was more effective in decreasing post-labor pains than was MME. We could not implement the comparable study in safety at this time. Therefore, further analysis on KCI including safety may be required to argue total effectiveness on postpartum control.

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We present a case of megacolon successfully treated with Kampo medicine. A 65-year-old male diagnosed with megacolon in 1999, came to our department in July 2003 complaining of severe abdominal distention. We successively used different Kampo formulae, in accordance with the diagnostic standard known as “SHO” which were: Daikenchu-to, Koboku-sanmotsu-to, Chukenchu-to, and Koboku-sanmotsu-to again. Daikenchu-to was only partly effective. Koboku-sanmotsu-to made the abdominal distention worse, forcing a change of drug. Chukenchu-to relieved the symptoms for some time, but the patient had to be hospitalized because of pseudoaldosteronism caused by the drug. Koboku-sanmotsu-to, however, worked smoothly on the second occasion and the symptoms disappeared. The efficacy of Koboku-sanmotsu-to was completely different on the two occasions it was used. This suggests that the pathological conditions were in a state of change, and these changes were identical to changes of SHO. This case reinforces the importance of detecting changes of the SHO accurately.

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