In Kampo medicine, sickness is regarded as affecting the whole body even though the symptoms may appear obvious only in the abdomen. This makes abdominal palpation an important means of physical examination, and diagnosis. Because learning abdominal palpation in the Kampo style is very difficult, we attempted to simplify learning by building typical anatomical abdomen models for training. To create six abdominal models : Shinka-hiko, Kyokyo-kuman, Fukuchokukin-renkyu, Shofuku-fujin, Shofuku-koman, and Shinkabu-sinsuion, we employed several materials, including artificial leather for epidermal tissue, pile fabric for subcutaneous tissue, cotton cloth or jersey cloth for membrane tissue, polyurethane or natural rubber for muscle tissue, specialized polyester resin for costae, and cotton for internal organs. We employed a harder polyurethane, for example, in Shinka-hiko to simulate resistance in the region beneath the heart, in Kyokyo-kuman to simulate resistance in the subcostal region, and in Shofuku-koman to simulate horseshoe-shaped resistance in the lower abdominal region. Otherwise, in Shofuku-fujin, a lack of resistance was simulated by a defect in the polyurethane at the center of the lower abdominal region. Shinkabu-sinsuion was modeled using a water dabbling sound via a water-filled balloon that could be gently shaken with the fist in the region above the navel. Fukuchokukin-renkyu was modeled as excessive strain of the rectus abdominis muscles via the use of natural rubber. We tried to represent the tenderness on pressure at the para-umbilical region, cecal region, and sigmoid region in the Shofuku-koman model by making a specialized switch with conducting rubber, and using electric device and battery. We believe these models are useful teaching devices, in that they simplify Kampo abdominal palpitation training.
We have limited evidence as to the clinical indications for Kampo medicines, especially as they relate to gastrointestinal function. Thus, we investigated the efficacy of the Kampo medicine hangekobokuto (HKT) on patients with functional dyspepsia (FD), with special reference to its clinical indications for gastrointestinal function, including gastric emptying and bowel gas volume. Gastric emptying rate (GER) in FD patients was significantly facilitated by HKT. HKT also improved the gastrointestinal symptoms of the patients. Among these, patients who had inchuusharen, or a symptom of globus sensation, and a representative indication for HKT, showed significant improvement of both their GER and gastrointestinal symptoms compared with patients who did not have inchuusharen. As for bowel gas, the bowel gas volume calculated from a plain abdominal radiogram (gas volume score, GVS) in FD patients decreased significantly, after administration of HKT. Patients who had fukuman, or a feeling that one's stomach is full or bloated, and another representative indication for HKT, showed significant decrease of their GVS to normal levels, compared with patients who did not present with fukuman. These results suggest that the presence of clinical indications, such as inchuusharen or fukuman, are strongly related to HKT efficacy in patients with FD, and that these are useful, scientifically validated markers for the efficient use of HKT.
The “Kokon Hoi” was compiled by Koga Tsugen and was the most widely used formulary in the Edo era. Here are the results of this author's examination of various “Kokon Hoi” editions. 1) Koga Tsugen received the source book of “Kokon Hoi” from the publisher Umemura, and compiled “Sanpo Kokon Hoi”. 2) The original edition of “Kokon Hoi” was published by Umemura in around1692. This edition was a lengthwise book and contained 1263 prescriptions, which is the fewest of all the editions examined here. 3) Umemura published an expanded edition of the original “Kokon Hoi” around1696. This was an oblong book, and included almost all of the prescriptions of the original “Kokon Hoi” with an additional 273 prescriptions. 4) At the request of Umemura, Koga Tsugen published “Sanpo Kokon Hoi” with an additional 348 prescriptions in 1733, and subsequently, “Jutei Kokon Hoi” with an additional 43 prescriptions in 1747. “Jutei Kokon Hoi” was then reprinted in the years 1780, 1808 and 1862.
The drug therapies for pregnant woman should consider the safety of the mother, and the embryo. And safety during pregnancy has not been well-established with Kampo therapies. Therefore, it would be best to refrain from administering these medicines except when there is serious disease, or when a pregnant woman's QOL might be degraded. Even so, it would be advantageous if there were still a way to treat pregnant women with no risk. Thus, we treated6pregnant women suffering from allergic conditions such as allergic rhinitis, urticaria or atopic dermatitis, by using herbs which are also used as foods, in an attempt to offer Kampo treatments which were also safe. As a result, efficacy was demonstrated, and no problems were caused. Accordingly, we propose the use of edible Kampo herbs as a safety standard. The safety of each herb used in this report was examined clinically, and in the literature. Other edible herbs not used in this report are tabulated and shown.
Boiogito, which has been used for obesity, edema and arthritis by using flabby constitution as a clinical indication, is mentioned in Jin Kui Yao Lue (Synopsis of the Golden Chamber). We experienced five cases of wind-wetness syndrome or edema caused by the pathogen Wind successfully treated with boiogito. There were common findings in these cases, i.e., heavy sweating or perspiration while sleeping, chilly feelings and worsening of the evening subjective symptoms and pulse diagnoses, such as floating, string-like and congested pulse in objective findings. On the basis of these cases, we investigated the efficacy of boiogito extract in 10 patients having the all of common findings mentioned above. As a result, boiogito improved symptoms in 8 patients. This suggests that medical examination by interview and distinctive pulsation are important in deciding the Kampo diagnosis for boiogito.
Case1was a 91-year old man diagnosed with multiple cerebral infarctions. He had undergone percutaneous endoscopic gastrostomy in the same year. One year later, we initiated acupuncture treatment because of recurrent respiratory tract infections. The acupuncture points selected were LU 5, Chize and KI 13, Taixi. Before acupuncture, the frequencies of antibiotics-use and feverish days were 6.3 days and 2.7 days per month on average. During acupuncture therapy, these frequencies were reduced to 1.2 days and 0.6 days per month, respectively. Case 2 was an 81-year old man diagnosed with right thalamic hemorrhage. He underwent percutaneous endoscopic gastrostomy in the same year. After 6 months, we began acupuncture treatment, also because of recurrent respiratory tract infections. The acupuncture points were the same as in Case 1.Prior to acupuncture, antibiotics-use and feverish days were 8 days and 4.5 days per month, which were then reduced to1and 0.6 days per month, respectively. Case 3 was a 93-year old man diagnosed with dementia. He was being fed via nasoenteric tubes. After 3 months, again because of recurrent respiratory tract infections, acupuncture treatment was begun. The acupuncture points were the same as in Cases 1 and 2.His use of antibiotics and feverish condition were 9 days and 10 days per month on average before acupuncture, but with acupuncture therapy these were improved to 2 days and 1.3 days per month. Based on this experience, it is suggested that acupuncture be considered for the treatment of recurrent respiratory tract infections in elderly, tube-fed patients.
We present a patient with short bowel syndrome (SBS), successfully treated with the Kampo medicine, shigyakuto-kagen. The patient was a 74 year old female complaining of severe diarrhea, abdominal distention, and abdominal pain. She was diagnosed as having tuberculous peritonitis when she 23 years of age. A partial resection of the small bowel and colon was performed for ileus, secondary to her tuberculous peritonitis, eventually causing her short bowel syndrome (SBS). Severe abdominal distention and pain had persisted even after the resection surgery. She consulted our clinic at 60 years of age in order to receive Kampo therapy. Bukuryoshigyakuto was prescribed, and her condition markedly improved. Zanthoxylum piperitum was added to bukuryoshigyakuto, and the regimen had the reactivity of daikenchuto. She regained her pre-operation body weight. It is significant that this case was followed for 14 years with therapy based on Kampo diagnosis, without remarkable complications, although patients with SBS often tend to have poor prognosis.
We experienced a case of infantile hydrocele with operation indication successfully treated with therapy based on Kampo diagnosis. The case was 4 years-old boy who was advised about an operation with the diagnosis of left hydrocele. At first, goreisan extract was administered, which resulted in a reduction of his hydrocele. However, the condition had worsened after his entrance into preschool. So, we changed the formulation to shokenchuto extract, which resulted in the disappearance of the hydrocele. Up to now, there has been no recurrence. We suggest that it is worthwhile to treat infantile hydrocele patients with Kampo medicine for a certain period of time, if their family gives consent. Moreover, shokenchuto or similar formulations might be practicable for such hydrocele, in addition to formulae which regulate body fluids.
Acupuncture and moxibustion were introduced to Japan from China in the 6 th Century. Since then our ancestors adapted these unique techniques and knowledge to our climate and ethnicity, and eventually developed the Japanese system of acupuncture and moxibustion. Whether acupuncture and moxibustion therapy is successful or not depends on the knowledge and skill of the individual acupuncturist. However, in recent years, the role of medical doctors, nurses, physical therapist and other medical professionals working as a team has become particularly important, with some acupuncturist starting to work in university hospitals as part of these teams, and contributing to patient well-being. In this paper, to elucidate the roles of acupuncture and moxibustion in modern medicine, we show how acupuncture and moxibustion are applied in university hospitals, and how acupuncturists evaluate the effectiveness of their acupuncture and moxibustion.