The purpose of this study was to evaluate the effect of keishibukuryogan (KB) against the cognitive symptoms associated with silent brain infarction in a prospective cohort study. The subjects were 93 patients with silent brain infarcts who visited the Department of Japanese Oriental Medicine, University of Toyama, and its allied hospitals. They consisted of 24 males and 69 females, mean age (± S.E.) 70.0±0.8.Group SK (n=51) consisted of patients who used KB extract for more than6months per year. Group SC (n=42) consisted of patients who did not use Kampo formulas. The NS group (n=44) consisted of elderly subjects who had no silent brain infarction, 21 males and 23 females, with a mean age (± S.E.) of 70.7±0.7 years. Among the three groups, the revised version of Hasegawa's dementia scale, apathy scale and self-rating depression scale were compared between the study start and after three years. In the SK and SC groups, these scores, and the subjective symptom levels (head heaviness, headache, dizziness or vertigo, stiff shoulder) were also studied. The results showed that the self-rating depression scales at study start for the SK and SC groups were significantly higher compared to the NS group. In spite of the scores for the NS group increasing after three years, the SK group scores were significantly decreased compared to the SC and NS groups. KB was effective against head heaviness, which often complicates silent brain infarction. In the above mentioned, KB was effective in treating cognitive disorders and subjective symptoms related to silent brain infarction.

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The adequacy of the Maoto decoction procedure described in the Shokan-ron text was investigated using the inhibitory activity of blended Ephedra herb on amylase enzyme. This enzyme is closely related to stress, and used clinically as an indicator of stress in humans.
α-amylase in isolated mouse plasma was used in the experiment, and the enzymatic activity was measured according to the Caraway method. Two different decoction methods: the general process used today, and that described in the Shokan-ron (Ephedra herb alone is firstly infused, then another 3 crude drugs are added and it is further infused), were compared for yield of the extracts, inhibitory actions of the extracts, their crude polysaccharide fraction (one of the active components), and remaining fractions contained within each extract. The inhibitory activity of the extract was clearly promoted by the latter, ancient decoction method, compared with the former. Hence, the decoction method described in the Shokan-ron is presumed to have the aim of reducing stress to the body caused by Maoto itself, and mitigating the side effects of its component Ephedra herb. This biologically qualitative approach, reflected over the entire decoction process, is different from the simply physicochemically analytical approach which concerns itself merely with particular constituents, such as alkaloids. So, it may be beneficial to scientifically elucidate the significance of this decoction and its ingestion methods, as described by the ancient Shokan-ron and Kinki-yoryaku texts.

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We medicated14atopic dermatitis patients who had erythema of the face with byakkokaninjinto. Before prescribing byakkokaninjinto for each patient, a questionnaire on their subjective symptoms or constitutions was carried out. Moreover, in order to evaluate the effect of byakkokaninjinto and the transition of subjective symptoms, such as a hot flushes and thirst of the throat, condition diaries were prepared, and the grade of each symptom was scored by the patients themselves during treatment.
These results demonstrated that byakkokaninjinto was effective for patients who had severe hot flushes of the face.

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We treated a 38-year-old woman with Traumatic Cervical Syndrome (TCS) due to a traffic accident, with orthopaedic therapy plus acupuncture. She was driving a light vehicle and was rear-ended. She reported finger numbness, and shoulder and back pain on the day following the accident. We treated her with acupoints of the superior and inferior limb and evaluated her pain using a Numerical Rating Scale (NRS). She felt an immediate effect after the treatment, and NRS changed for the better following her progress. Her most severe symptoms gradually improved with a course of 49 treatments over 7 months. These results suggest the effects of acupuncture appear useful in TCS. Patients with intractable TCS are troubled by long-term treatments. Therefore it is necessary to establish more evidence for acupuncture therapy in TCS cases.

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We report four patients suffering from dumping syndrome treated effectively with Keishito and its additional prescription. Case1was a 57-year old male who received subtotal gastrectomy 30 years ago. After the operation he felt shaking sensations and eyes flickering after meals for10minutes to 4 hours. These symptoms tended to occur along with hunger. After taking Keishito, these symptoms improved. Case 2 was a 63-year old male who received subtotal gastrectomy 7 years ago. In recent years, he has had noticeable sweat and fatigability 20-30 minutes after meals. After taking Keishito, these dumping syndrome symptoms disappear. Case 3 was a 71-year old female who received subtotal gastrectomy 9 years ago. Thereafter, cold sweats and dizziness came to appear regardless of what she ate. After taking keishikashakuyakuto or shokenchuto the aforementioned symptoms disappeared. Case 4 was a 72-year old female who received subtotal gastrectomy 2 years ago. Sweats and hot flushes began to occur after meals for 30 minutes to 3 hours, from last July. These symptoms were improved simply by licking candy. After taking Keishito, these symptoms also disappeared.

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Eight family care providers with various disorders showed improvement of their symptoms when treated with yokukansan-based prescriptions. Case1complained of hot flushes, burning sensation and difficulty in concentration; Case 2 of insomnia and back pain; Case 3 of insomnia; Case 4 of irritation and palpitation; Case 5 of anxiety and insomnia; Case 6 of palm eruptions; Case 7 of a painful sensation in the eyes and headache; and Case 8 of neck pain, stiff shoulders, diarrhea, palpitation, insomnia, general fatigue, etc. These diverse symptoms were all considered to be related to “liver” dysfunction of emotions, muscles and eyes, caused by chronic and continuous stress due to their care burden. In Cases 5, 6, 7and 8 the persons whom the care providers were caring for also took the Yokukansan-based prescriptions at the same time as these said care providers did. Instructions for the traditional medicine Yokukansan indicate that “mother and child should take this medicine at the same time”. And since the relationship between a patient and a care provider in the family might be similar to that between child and mother, we applied yokukansan-based prescriptions to these care providers based on traditional instruction.

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This is a report on schools of Traditional Chinese Medicine (TCM) and the state of the traditional education system in Singapore. School texts made in the People's Republic of China were used in Singaporean schools. In 1994, however, the Minister of Health appointed a committee to review TCM practices, and recommended measures to safeguard patients' interests and safety. The committee's report published in 1995 recommended that TCM practices in Singapore should be regulated, and recommended steps to upgrade training standards. In compliance with said committee, TCM schools have added basic western medical science to their curricula. And TCM school requirements in Singapore were revised to 3 years full-time curricula or 6 years part-time curricula. In 2000, the TCM Practitioners Act was passed. Singapore is small country with a population of 4.16 million. However, it promotes traditional medical education projects and studies enterprisingly, receiving WHO support and NCCAM grants.

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I discuss the question of cold/heat in greater yang disease period and the definition of yang/yin pattern as written in the Nyumon Kampo Igaku, which was the first textbook on Kampo medicine published by the Japan Society for Oriental Medicine. The first question is ; “Is the indication for Kampo medicine in greater yang disease period not the heat, but the exterior cold of a patient?” It is considered that a chilly feeling shows not cold illness, but a process trend toward body fever and sweating as a recovery strategy. The second question is ; “Should we adopt Okuda's definition of yang/yin pattern when my definition is obscure?” Okuda's definition was written for acute illnesses based on the treatise Shanghanlun (On Cold Damage). Nevertheless, we can not adopt this definition because our textbook has to be applied for treating patients with chronic illness, and the use of Goseiho and traditional Chinese medicine. The discrimination of quantitative analyses in the21st century, and qualitative approaches to discussing Kampo medicine diagnostic standards are considered important in the21st Century.

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