Kampo formulae are selected according to a patient's symptoms. In certain cases the decoctions are modified with additional herbs to provide a suitable treatment. Knowledge of herbs and formulae used clinically in Kampo medicine is essential; however there is a lack of knowledge on how extensively certain herbs are applied. We have analyzed our Kampo outpatient clinic prescriptions for September 2004. The 20 most frequently applied formulae accounted for 60% of all prescriptions. Also, we analyzed our patients' medical backgrounds in relation to the most frequently used 20 prescriptions in September 2004, and the distribution of our patients for each prescription. The distribution of patients for each prescription differed significantly from the distribution of all patients. As a last point, we looked at which herbs were most frequently added to prescriptions. The most frequently added herb was Astragali Radix, followed by Coicis Semen and Aconiti Tuber. We consider this to be significant information for Kampo physicians and pharmacists.

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[Purpose] In Kampo medicine, blood deficiency is considered to cause systemic symptoms such as insomnia and dizziness, in addition to skin-related symptoms such as xeroderma. Diagnosis of blood deficiency does not appear to be definitive since it is based on subjective judgment. To resolve this problem, we have attempted to establish an objective method for diagnosing blood deficiency by measuring skin moisture.
[Methods] Using a skin moisture meter, we measured the skin moisture (at the neck, forearm, and abdomen) of 80 women during their first examination at our clinic. The patients were also classified according to their blood deficiency scores.
[Results] A statistically significant difference was observed between patients with blood deficiency and those without blood deficiency with regard to the skin moisture at the neck and forearm. The coefficient of correlation between the skin moisture of the neck and the blood deficiency score was -0.41.The results of statistical analysis performed using a type1quantification method revealed high values even for some conditions not associated with the skin, such as hypomenorrhea and excessive strain of the abdominal muscles, in addition to high values for skin-associated conditions. And in pre-post-treatment comparisons, improvements in blood deficiency scores generally matched transitions in keratinous moisture.
[Discussion] Due to the absence of a high correlation between skin moisture and the blood deficiency score, it is unlikely that skin moisture can be used instead of the blood deficiency score as a parameter for the accurate diagnosis of blood deficiency.
[Conclusion] Although skin moisture levels may be an indicator of blood deficiency, further studies are required before this parameter can be applied in clinical diagnosis.

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We report a case of a 65-year old man who suffered from hyperhydrosis for 15 years and was treated with the combined formulation of hangekobokuto and ryokeijutsukanto as determined by Kampo diagnosis according to traditional logic. Not only excessive sweating but also complications such as a feeling of obstruction in the throat, palpitation at rest, panting at times of light work, and a feeling of residual urine were diagnosed. We conclude that these symptoms were induced by a dysfunction of the qi (vital energy) and jin (nourishing fluids) circulation between the upper and the middle aspect of the body caused by the existence of wet phlegm, which were ameliorated by the effects of eliminating phlegm, and regulating stagnated or regurgitated qi with this combined formulation.

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We report two cases of nephrotic syndrome successfully treated with saireito. The first patient developed massive proteinuria of 5.2 g/day, was diagnosed with minimal-change nephrotic syndrome upon renal biopsy, and rapidly improved with saireito treatment for 2 months to the reduced urinary protein level of 0.3 g/day. Urinary protein increased to 2.0 g/day just after discharge, then again decreased and was brought to remission soon thereafter. The second patient with biopsy-proven idiopathic membranous nephropathy maintained nephrotic syndrome remission for 8 years with the treatment of small-dose prednisolone, an immunosuppressant, and an angiotensin II receptor blocker, then relapsed with 4.4 g/day proteinuria. In this patient, proteinuria was reduced after 4 weeks with the above combination therapy plus saireito to 1.3 g/day, then remitted again soon thereafter. The former patient presented with mild discomfort and opposition when the subcostal region was pressed ; the latter patient presented with apparent discomfort and opposition together with moderate leg edema. Because rapid remission of massive urinary protein with saireito treatment was observed in these patients, we report here and discuss possible mechanisms.

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Heat-treated and detoxified Aconite tuber has many useful properties such as analgesic, diuretic, and cardiotonic effects. Two hundred forty-seven patients were treated with Aconite Tuber powder (1.5 - 8.0g/day) added to Kampo extract granules. The Visual Analog Scale (VAS) was used for the assessment of its pain-relieving effect. One hundred two patients improved dramatically (the pre/post administration VAS ratio was less than 50%), 84 improved (between 51 to 75%), and61did not improved (more than 76%). Three patients(1.2%) showed adverse reactions, such as tongue numbness, squeezing sensation of the bladder, anasarca. These reactions were not serious. This study suggests that Aconite tuber powder can be used more widely, especially for arthralgia and somatic pain with coldness in elderly patients.

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Shoyogan is a Kampo prescription described in the Jinkuiyaolue text, but there have been no case reports regarding this medicine. We report a patient with terminal stage lung cancer, whose appetite and general well-being was maintained following oral administration of this medicine.
A 62-year old woman had her main tumor in the left pulmonary lobe, which invaded to the bilateral peritoneum and the mediastinum. Metastasis was recognized in the left femoral bone which had been broken, the ilium, chest and lumbar vertebral bones, and the liver. Her general condition was very poor in spite of the administration of corticosteroids and narcotic medicines, when she began to take shoyogan 5 months after the onset of her symptoms. Cytological examination of her pleural effusion revealed adenocarcinoma. Following the administration of shoyogan, her appetite recovered, nutrition improved, and she was able to survive while maintaining her quality of life for another 2 months.
In this paper we discuss the efficacy of shoyogan in improving the general well-being of patients having the above-mentioned conditions, or jueyinbing in Kampo parlance. Although preparing shoyogan is laborious, we believe this medicine should be used more frequently.

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Kakkonkokato is a special formula used for the treatment of rosacea-like dermatitis lesions in the nasal region, but very few cases treated with this formulation have been reported so far. Here, we report three patients with refractory facial eruptions of rosacea-like dermatitis treated successfully with kakkonkokato. Case1was a 39-year-old man who presented with a 15-year history of rosacea-like dermatitis lesions in the nasal region. After 3 weeks' treatment with kakkonkokato, a marked improvement of his lesions was seen, with disappearance of the redness of his face. Case 2 was a 56-year-old woman who presented with a prolonged history of itchy eruptions around her mouth and nasal region. After 8 weeks' treatment with kakkonkokato, an almost complete disappearance of her eruptions was observed. Case 3 was a 26-year-old woman who presented with atopic dermatitis and intractable erythema under her nose, which was refractory to treatment with steroid ointments and antiallergic agents. After 2 months' treatment with kakkonkokato, her erythema completely resolved, along with improvement of the systemic lesions of atopic dermatitis. The observations in these three cases suggest that kakkonkokato may be a useful formula for the treatment of not only rosacea-like dermatitis in the nasal region, but also of refractory facial eruptions of other causes.

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The world has now rediscovered the value of traditional medicine. Much traditional medicine in South-East Asian countries originated from the medicines of ancient China, and developed independently within those individual countries. As a measure toward information exchange and communication among these countries, the World Health Organization's Western Pacific Regional Office (WHO-WPRO) has published its International Standard Terminologies (IST) for use globally. While domestically in Japan, Kampo is now taught as a regular subject in all medical schools. In this light, there is significant meaning to holding conference with the purpose of understanding the current status of Japanese Kampo around the world, and considering the best ways to disseminate Kampo information globally. The International Conference of Kampo Medicine (provisional title) has been held thus far a total of three times, to address the current status of Japanese Kampo, Japanese Kampo issues from global point of view, as well as the current status of traditional medicine in China and Korea also originating from the ancient Chinese medicine. The conference was entitled &lsquoWhy Kampo? Why Now? Why Me?—The reason why foreign medical doctors worldwide choose Japanese Kampo, and the situation or development of Kampo medicine in their own countries”, in which foreign doctors in Japan, medical students, and leading Kampo medical practitioners were invited to give lectures, which were followed by free discussions by all participants.

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