Recently, eastern medicine is reconsidered favorably. For example, most of Kampo-drugs are covered by health insurance and the essence of the eastern medicine is now included in the curriculum of medical education program. However, eastern medicine can not yet get rid of “placebo” effects, and should be re-evaluated through randomized double blind controlled studies. It is absolutely important to know merits and demerits of Western and Eastern medicine and to apply to the patients integrative medicine.

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Oriental medicine explains that Kikyo (deficiency of Qi) is an exhausted state of the human body's energy. Hence a lack of energy state could be equal to a state of low metabolism. It would affect any blood test. Kikyo-scores were evaluated in 333 new patients who had visited our clinic within a 13-month period, and their blood samples were collected on the same days. A chi-square test was done with the Kikyo cases, indicating points of 30 and above of Kikyo-score, and patients who indicated lower than standard levels in their blood tests. A relationship between Kikyo, and points lower than normal chemical screening test values was proved (p<0.0001). Forty-nine percent of Kikyo-patients were under normal limits, but the positive predictive ratio was85%. We have to recognize it is an exhaustive Qi state we see, when chemical screening data values are low.

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Objectives : The objective of this study is to develop a Japanese version of the Constitution in Chinese Medicine Questionnaire (CCMQ) in Chinese, which is comprised of 60 items with 9 sub-scales, and evaluate its reliability and validity. Methods : We conducted a survey of 130 participants in the Toyama area of Japan from Dec. 2005, to Feb. 2006. A test-retest method was used. Feasibility was evaluated by the response times to the questionnaire, and the response rates of the CCMQ items. Internal consistency within the sub-scales was assessed by Cronbach's α coefficient. Reproducibility was confirmed between the first and second occasions using weighted kappa and Spearman correlation. Lastly, criterion validity was evaluated by correlation between CCMQ and SF-36 sub-scales. Results : Response time was 8 minutes on average and its rate was nearly 100%. Internal consistency was achieved for each of the 9 sub-scales with a 0.65 to 0.79 α coefficient. Reproducibility ranged from 0.41 to 0.81 for the items, and from 0.79 to 0.88 for the sub-scales. Regarding the criterion validity, the “Gentleness type” sub-scale was positively correlated with SF-36 (0.46, P<0.001), while other 8 pathological constitutional types of the CCMQ were negatively correlated with SF-36 (-0.35 to -0.50, P<0.001) as expected. Conclusions : We developed a Japanese version of the CCMQ and found acceptable levels of reliability and validity using a survey of 130 subjects in Japan. This suggests that the CCMQ could be a useful tool in comparing the constitution profiles between Chinese and Japanese.

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The literary source of seishitsuketanto, which has been used for intercostal neuralgia, and similar pain in the chest and back, is the text Shou shi bao yuan. We prescribed seishitsuketanto to 5 patients suffering from coldness and/or pain of the thorax. As a result, seishitsuketanto was effective for 4 patients, and not effective for 1 patient. An investigation of the effective cases, an invalid case and references suggest that findings indicating seishitsuketanto have the following features; migratory coldness of the thorax, significant symptoms of disorder in body fluid metabolism, sphygmopalpation without floating pulse, and thoracic pain due to inflammation based on pulmonary insufficiency.

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As mental stress has a great impact on the symptoms of atopic dermatitis, we administered Qi-related prescriptions to 6 patients with atopic dermatitis. Not only were mental and autonomic imbalances, but also skin conditions were improved in all six. We examined changes in palmoplantar sweating and a self-rating depression scale to evaluate the effectiveness of the Qi-related prescriptions. The Qi-related prescriptions were used in combination with standard treatments as follows : keishikaryukotsuboreito in Case 1, shigyakusan in Cases 2 and 3, yokukansankachimpihange and keishikaryukotsuboreito in Case 4, shigyakusan and keishikaryukotsuboreito in Case 5, and saikokeisikankyoto in Case 6. It appears to be important to treat Qi-disorders, along with skin disorders, in patients with atopic dermatitis.

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In order to evaluate the effect of shuchi-bushi, a powder form of the aconite tuber, we examined changes in finger temperature (FT) and tissue blood flow (TBF). No significant differences were observed in FT between pre-administration and 90 min post-administration, however, FT at 72 min was significantly higher than that at the pre-administration (p=0.0736and p=0.0219, respectively). The FT at 72 h was also significantly higher than that at 90 min (p=0.0253). No significant differences were observed in TBF between pre-administration and 90 min, nor between the 90 min and 72 h. However, the TBF at 72 h was significantly higher than that at pre-administration (p=0.0219). A significant correlation was observed between the FT and TBF (p=0.0052). Our results suggest that shuchi-bushi may play a role in warming and increasing tissue blood flow in human.

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We sought a connection between the half-exterior half-interior symptoms (hanpyo hanri sho), mentioned in the classic Chinese Shang han lun text and used in Kampo medicine, and embryology. An agreement between these shao yang (lesser yang) symptoms, and embryonic brachial arch domains was found. A part of the brachial arches strongly agrees with the ruling domain from the trigeminal nerve to the vagal nerve, and a connection was also seen to the vestibulocochlear nerve and partly to the accessory nerve. Thus we believe that half-exterior half-interior symptoms are a condition which relate back to part of the brachial arches, and are a result of so-called Heat reaction. Shang han lun Chinese medicine and embryology are two completely different fields. However, we consider an embryological view of nerve pathways to be helpful in understanding half-exterior half-interior symptoms, at least to a certain degree.

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An Oriental medicine awareness survey was performed with the doctors having graduated from Nara Medical University. The questionnaire was mailed to the doctors having trained there 3, 4 and 5 years after their graduation. The collection rate was 24.1%. The percentage of doctors with an interest in Oriental medicine was 83.0%. These doctors believed that Oriental medicine exerts a different efficacy from western medicine. In contrast, the doctors (17%) with no interest in Oriental medicine answered that they had little or no Oriental medicine knowledge and experience. Most doctors (89.8%) supposed that Oriental medicine will play a more important role in the future, and that Oriental medicine lectures and seminars are essential. It seems important, therefore, to give doctors more Oriental medicine instruction, to learn the basic theories, prescriptions, and diagnoses. Those doctors (93.2%) who answered in the affirmative said that they would make use of Oriental medicine in the future, presumably due to social trend.

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