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INTERNATIONAL INSTITUTE OF HEALTH AND HUMAN SERVICES,
BERKELEY
Volume 12, Number 4 ･ Winter 2017

Editorial

Kampo Medicine Seen from the Viewpoint of Clinical Reasoning – Part 2
Mitsuyuki Takamura

Report from WFAS Tokyo/Tsukuba 2016

Hokushinkai Style Acupuncture and Moxibustion Treatment
General Incorporated Association HokushinkaiType 2 Case of Yasui Classification

Two Cases of Acute or Subacute Polyarthralgia Successfully Treated with Boiogito Extract
Hiroshi Kakuto

Clinical Report (Acupuncture)
Kidney Deficiency Low Back Pain
Masanori Takashi and Makoto Arai

ISSN:1559-033X

College Logos
We believe it is necessary to create a new way of thinking
for the total understanding of "Life, Survival, and Health".
We decided to coin the world "Lifence" to express this.
Lifence means the combination of life sceince and medicine
as well as other disciplines such as health science, psychology,
ethics, etc.
Our college logos symbolizes the above.
The ripple effect represents the ocean and the birth of life.
The rainbow colored sphere represents a safe environment
and a barrier to protect us from negative influences.
The picture by Leonardo da Vinch represents a balanced
body and health.
Completing our logos is a ring which represents the unity ofspace fulfilling the total meanings of lifence.

―

The Journal of
Kampo, Acupuncture andIntegrative Medicine(KAIM)
Research on Theory, Practice and Integration

Volume 12, Number 4 ･ Winter 2017

EXECUTIVE EDITOR

Shuji Goto
Chairman, GOTO College ofMedical Arts & Sciences

TA B L E O F C O N T E N T S

Tokyo, JapanEDITOR-IN-CHIEF

Donald Lauda, Ph.D.
Dean Emeritus, College of Health &Human Services
California State University-Long Beach

1 Editorial
Kampo Medicine Seen from the Viewpoint of Clinical Reasoning – Part 2
Mitsuyuki Takamura

CA, U.S.A.

ASSOCIATE EDITORS
Shuichi Katai

2 Report from WFAS Tokyo/Tsukuba 2016
Hokushinkai Style Acupuncture and Moxibustion Treatment

Ibaraki-ken, Japan

General Incorporated Association Hokushinkai

Hiromichi Yasui
Tokyo, JapanEDITORIAL STAFF

Akihiro Souma
Hiromi Sasaki
Hiroshi Tsukayama
Hitoshi Yamashita
Junko Okubo
Kazunari Ozaki
Kengo Nakata
Masayuki Kashima
Naoya Ono
Noboru Mitsuhata
Sayaka Toda
Takao Namiki
Toshiaki Makino
Toshihiro Togo

14 Type 2 Case of Yasui Classification
Two Cases of Acute or Subacute Polyarthralgia Successfully Treated with Boiogito Extract
Hiroshi Kakuto

17 Clinical Report (Acupuncture)
Kidney Deficiency Low Back Pain
Masanori Takashi and Makoto Arai

PUBLISHER

Shuji Goto
International Institute of Health andHuman Services, Berkeley
2550 Shattuck Avenue, Berkeley
California 94704-2724, U.S.A.

MISSIONTo disseminate peer-reviewed information on the use of acupuncture and herbs, and integration with western
medicine, based on research from an international perspective; thereby stimulating further research, applicationof documented therapeutic measures; and facilitating dialogue among health care practitioners worldwide.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)KOTARO PHARMACEUTICAL introduced in 1957 the world's first Kampo extract
preparations on the market. Later, in 1967, six of our preparations could be covered in Japanfor the first time by the health insurance and after 1976 more than 100 of our preparations
were used in hospitals and clinics. Now it is half a century since we put our Kampo extract
preparations on the market and believe, we made a major contribution to this industry.
In the future we intend to continue working in accordance with our company motto: "Still better
Kampo for still more people" and provide pharmaceutical products of still higher quality.

Origin of the company's name
The company was named "KOTARO" by its
founder Taro Ueda with reference to his birthplace. Close to the ancient city of Nara. Kotaro
is the name of an enormous sheer cliff, 700 m
wide and about 200 m high. Mr. Ueda felt anaffection rising to the heavens for this cliff andthus made it the company's name.

KOTARO PHARMACEUTICAL CO., LTD.
5-23 Nakatsu 2-Chome, Kita-ku, Osaka 531-0071, JAPANURL: http://www.kotaro.co.jp

Volume 12, Number 4 | Winter 2017

Editorial
Kampo Medicine Seen from the Viewpoint of Clinical Reasoning – Part 2
In the Editorial of the previous issue, I mentioned the application of Clinical Reasoning System 1 to
Kampo medicine. In this traditional medicine, the decision of making a correct prescription is important,numerous clinical pearls and evidence data such as from randomized control trials are extremely
fundamental for intuitive reasoning, and Japanese Kampo doctors are skillful in this point.
Then, what is the application of System 2 to Kampo medicine? It is to understand the logicallyconstructed structure which this traditional medicine originally possesses and to diagnose Kampo
pathological conditions by utilizing them to derive the optimal prescription. Several methods have been
proposed for this approach.
The most common method is modern Traditional Chinese medicine (modern TCM) that originates inancient China. This diagnostic and therapeutic method reaches the final decision of prescription byrepeating hypothesis formation and hypothesis verification from the patient's symptoms. This is a typical
System 2 model.
A different method is advocated by the Japan Society for Oriental Medicine which is the mostcommon approach in Japan. It aims to assist prescription selection by making full use of concepts suchas: yin/yang; exterior/interior; cold/heat; excess/deficiency; qi, blood and fluid; Six stage pattern. This issimilar to modern TCM, whereas TCM performs “analysis” of disease states, the Japanese approach is“category classification” of disease.
Recently, another theory which deserves attention has emerged in Japan. Yoichiro Ebe invented“Keiho Theory” based on the content of Kampo classics; "Shang Hang Lun" and "Jin Gui Yao Lue", especially
focusing on the movement of qi (ki). It describes physiology / pathology / therapeutics in the time ofcreation of these classics. He also describes the principles of Kampo medicine. It can be expected that thisfield will be further researched in future.
In any case, System 2 in Kampo medicine requires a high-load of thought work and takes time toreach the final objective, but it can be verbalized and conveyed to other people hence verifying the thoughtprocess.
In this way, it can be said that more accurate prescription decisions are made by using both Systems
in Kampo medicine rather than by using only one of the Systems.

Mitsuyuki Takamura, M.D., PhD.
Kampo Medicine Outpatient Clinic,
Mie University Hospital

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 12, Number 4 | Winter 2017

Report from WFAS Tokyo/Tsukuba 2016
Hokushinkai Style Acupuncture and Moxibustion
Treatment

Main body of the text
1. What is Hokushinkai?

General Incorporated Association Hokushinkai

Hokushinkai was established as an academic
association by Renpu Fujimoto and his associates inIntroduction:

1979. The philosophy of Hokushinkai is as follows:

Hokushinkai style treatment, with a small number“Oriental medicine is a true medicine that can cureof acupoints (one acupoint, in most cases) has been

body, mind, and soul. Based on this premise, we aim

successfullyThe

to help patients from the standpoint of oriental

Hokushinkai style, a school of traditional Japanese

medicine. To achieve this, we pursue both scientificacupuncture and moxibustion, is based on theknowledge and artistic skills.” In 2009, Hokushinkai

appliedtomanydiseases.

(patternbecame a general incorporated association. We haveandheld regular meetings and workshops that aim totreatment) and uses the terminology of traditional

enhance the knowledge and skills of practitioners.

Chinese medicine as a common language. This paper,

Currently, many practitioners in acupuncture andconsisting of two parts, describes the theoreticalmoxibustion, as well as physicians, participate in our

characteristics of the Hokushinkai style.

program.

principleof

identification/syndrome

benshoronchi
differentiation

2. Current traditional Chinese medicine in perspective
The basic theory of Hokushinkai has been developed
under the influence of traditional Chinese medicine
from the very beginning. We have held conferencesand education programs based on traditional
Chinesemedicine.

Concurrently,

we

have

emphasized that there are limitations in the direct
application of current traditional Chinese medicine
to clinical practice. The following are some of the
Hokushinkai views on current traditional Chinese
medicine.
1) Advantages of traditional Chinese medicine
a. Logicality:
Consistency regarding examination, diagnosis, andtreatment is essential in medicine. The clinicalpractice of current traditional Chinese medicine isfounded on the principle of benshoronchi, correlatingof all four examinations. We apply these procedures
intheclinicalpracticeofacupunctureandmoxibustion for disease identification, by which we
can determine the appropriate treatment withrespect to the basic disease mechanism and pattern
identification in the fields of traditional Chinese
medicine. In addition, the traditional Chinese

2

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017

medicine examination methods can provide more

2) Limitation

information than zuisho therapy which is based only

According to current traditional Chinese medicine,on inquiry or pulse diagnosis. Employment of the“all substances in nature are composed of qi withexamination system is, therefore, useful whenvarious levels of density, and qi is the most

holding conferences and providing education.

fundamental substance.”* However, if qi is regardedb. History of the medicine

as a substance with quantity (using the term inSince publication of “Huangdj’s Internal Classic”,

physics), this notion leads to materialism, which isthere have been considerable advances in oriental

inconsistent with the view of qi monism since

medicine (traditional Chinese medicine) in terms of“Huangdj’s Internal Classic,” where emphasis isdiagnostic and therapeutic methods. Because ofplaced on function, rather than substance.

these advancements, we can utilize the accumulated* As presented in “Basic Traditional Chinese

knowledge regarding basic disease mechanisms andMedicine”

pattern identification for treatment of each disease,

Traditional Chinese Medicine Study Group.

according to traditional Chinese medicine. We canthoroughly learn the historical developments andtheoretical issues that are essential in each school ofcurrent traditional Chinese medicine. In addition,
the findings are suggestive in the context of theheritance and progress of traditional Japanese
medicine.
Oriental medicine (traditional Chinese medicine)originates in China. It has progressed independently
from the original style, mainly in the Korean
Peninsula and Japan, based on treatment inaccordance with three causes (seasonal and local
as

well

as

patient

individuality).

Nonetheless, all oriental medicine is based on thecommon principles that have developed since thepublication

of

1995)

by

Kobe

3. Multifaceted observation of body surface
Hokushinkai

styleemploysthebodysurfaceobservation techniques of old Japanese schools forpracticing

benshoronchi;

observation

techniques

these
have

body

surfacecontributed

toimproved diagnostic accuracy. Here, we outline someof the techniques.

c. Globalization

conditions,(Ryogen-shoten,“Huangdj’s

Internal

Classic.”

Therefore, we believe that the World HealthOrganization international standard terminology
regarding traditional Chinese medicine is useful for1) Mubun school abdominal examination
Based on the monograph regarding Mubun school
dashin (needle tapping), titled “Shindo Hiketsushu,”
we have continued our efforts to apply thesetechniques in clinical practice. Location of tension in
the abdominal wall is evaluated by palpation. By
confirming the areas of the viscera and bowels
corresponding to the tension, practitioners candiscern the disease location in the viscera and bowels,
as well as any uneven distributions of qi and bloodin the body.

our communication, although additional explanatory
notes may be needed in some cases. Through thisstandardized communication, we can convey theuniqueness and advantages of Japanese traditional
acupuncture and moxibustion to practitioners inmany countries.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 12, Number 4 | Winter 2017

Figure 3: Abdominal examination in practice.
2) Back examination
In the Hokushinkai style examination, the two sidesof the spinous process on the governor vessel arerecognized as the first line points, the lines 1.5-sun(approximately 4.5 cm) outside the governor vessel
points are recognized as the second line points(traditional

firstline),

and

the

lines

3-sun

(approximately 9 cm) outside the first line points arerecognized as the third line points (traditional secondline). By evaluating the responses of the backtransport points through palpation, using theconcepts of deficiency/excess and cold/heat, theconditions of the viscera and bowels, as well as otherbody

regions,canbeassessed

in

terms

of

deficiency/excess/yin/yang. The back-transport points
were originally described in “Miraculous Pivot” (in thesection regarding back meridian points) and “Plain

Questions” (in the section regarding heat patterns). In
Japan, examination of the back-transport points wasintroduced as “Shihai” (seeing the back) in “Ippondo
Figures 1 and 2: Two figures depicting abdominal
examination.

koyo igen,” written by a physician, Shuan Kagawa, in
the Edo period. In the early stages following the
introduction of “Shihai,” tenderness was used as theprimary index. Since then, various efforts have been
made

to

improvethetechnique.

Currently,

practitioners can accurately assess the deficiency andexcess of acupoints, while remaining aware of defense
qi, using a very soft touch (feather touch).

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The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017

For example, the points of the governor vessel andthe first, second, and third line points are assessed
as a unit, such as the set consisting of GV6, BL20
along the first line (right and left sides of the 11th
thoracic vertebra spinous process), BL20, and BL49.
In general, the governor vessel and first line are
more reactive in the acute stage; when the condition
becomes chronic, the second and third lines often
become reactive.

Figure 6-1: Back examination of the upper back:feather touch.

Figure 4-1: The left half depicts the variety of
responses from acupoints for deficiency. The righthalf depicts the variety of responses from acupoints
for excess.

Figure 6-2: Deep touch on the acupoint BL15 of
the upper backFigure 4-2: A schematic diagram showing thedefense qi in acupoints for deficiency and excess.

Figure 5: Positional relationships of back transport
points.

Figure 7-1: Back examination of the lower back:feather touch.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 12, Number 4 | Winter 2017

Figure 7-2: Deep touch on the acupoint BL20 of thelower back.
Figure 8: Examination of source point SP3: feather
touch.

3) Examination of source points
Abnormalities in the viscera and bowels, meridiansand collaterals, and meridians sinew can beevaluated through the examination of source points(e.g., deficiency, excess, cold, and heat) based on“Miraculous Pivot” and “Classic of Difficult Issues.”
All of the back-transport points are located in the
bladder meridian (the foot-taiyang). By contrast, thesource points are located in the 12 meridians andcollaterals;

therefore,

modulation

of

the

12

meridians, as well as the collaterals and meridianssinew, is easy to detect. The palpation method is inaccordance with the method of back examination,although a more delicate procedure is needed,compared with back examination, because theanatomical structures vary across points and thesizes of the source points are smaller than those of

Figure 9-1: Examination of source point LI4: feather

the back-transport points.

touch.

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The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017

Figure 9-2: Examination of source point LI4: deep

Figure 11: Examination of well point of the foot.

touch.

5) Pulse diagnosis

4) Examination of well points

The lung meridians of the hand-taiyin originate from

Well points are points where tenderness appears as
a reaction to acute disease. The imbalances in thethe middle energizer and run to the cun section of
the wrist (the place where the pulse can be felt).

viscera, bowels, meridians, and collaterals can be

Therefore, the rise and fall of stomach qi related todetectedregardingthe middle energizer (acquired qi) is reflected in thetenderness of the governor vessel points and firststate of pulse at cun. In Hokushinkai style, pulse

line points. In practice, areas of great tenderness are

examination at cun is adopted as a method todetected by soft palpation of the neighboring areas

evaluate the state of stomach qi. In addition, cun cannear PIP or DIP joint, rather than by palpation of thebe also interpreted as a representation of the whole-well points themselves.

body condition. Examination of the rise and fall ofbycollatinginformation

stomach qi is extremely important; it is essential forthe assessment of clinical course of disease,treatment efficacy, and exploration of optimaltreatment strategies. Patients are asked to clasp
their hands in prayer near the point below the navel.
This contributes to the mental relaxation of thepatient. In addition, this hand position is suitable for
ensuring that patients make the same wrist angles
every time, by which practitioners can accurately
evaluate the change in pulse before and after therapy.

Figure 10: Examination of well point of the hand.
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 12, Number 4 | Winter 2017

Figure 13: Pictures of tongue and magnetic

Figure 12: Pulse diagnosis of stomach qi.

resonance image, cited from “Tongue inspection and6) Tongue diagnosis
This

is

a

very

importantexaminationforunderstanding of the eight principles (especially forheat/cold/yin/yang). In Japanese acupuncture andmoxibustion, tongue diagnosis was not incorporated
into

clinical

Hokushinkai.

practice
In

until

its

Hokushinkai

adoptionstyle,

bytonguediagnosis has been applied from the very beginning

imaging diagnosis,” Oriental Medicine Journal of
Acupuncture & Moxibustion vol. 1.
7) Other body surface observations
Other

examination

methods,

such

as

cubit

examination (elbow-to-wrist skin examination) andspatial examination, are described in the text, “Bodysurface observation” (Renpu Fujimoto, Midori-shobo).

for the treatment of acute feverish diseases,

In the next portion of the paper, theory, diagnostic

miscellaneous diseases, and intractable diseases.

methods, and needling methods, all of which are

Renpu Fujimoto has extensive experience regarding

important in Hokushinkai style clinical practice, aretongue diagnosis. Importantly, he reported that

described.

there was a tendency for coincidence between thelocations of cysts in the ventral surface of tongue and

4. Important theory and diagnostic methods inthe topography of trunk lesions.

Hokushinkai style
1) Taiji Yin Yang theory
Qi is the source of the universe. Our examinationand treatment are primarily based on the theory ofqi monism. Practitioners can be inspired by the Taiji
Yin Yang theory and various principles, based on the
dualistic monism of yin and yang. The details aredescribed in “Universe of oriental medicine” (Renpu
Fujimoto, Midori-shobo).
2) Theory of the viscera and bowels and meridiansand collaterals

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The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017

In current traditional Chinese medicine, there has5) Spatial theory, spatial examination, and spatial

been a tendency that the viscera and bowels arepattern identification

described separately from meridians and collaterals,

When multiple symptoms are unevenly distributed on

as seen in the titles of textbooks such as “Visceral andone side (left, right, upper, or lower), treatment based

bowel theory,” “Visceral and bowel pattern
identification,” “Meridian and collateral theory,” and“Meridian and collateral pattern identification.”onspatial theory and the diagnosis and treatment

However, “viscera and bowels” and “meridians andmethods to correct the uneven distribution of qi werecollaterals (meridian, meridian divergence, meridian

developed by Renpu Fujimoto, based on his clinicalsinew, and fifteen collaterals)” are inseparably linked

experience of acupuncture and moxibustion. The

with each other in clinical practice. Therefore, weconcept of spatial theory originates from pulse

address them together, using the framework “theory

examination in the three positions and nineof viscera and bowels and meridians and collaterals”

indicators in “Plain Questions.” The details arefor treatment. If the framework is compared to a tree,

described in “Vertical, Horizontal and Anteroposterior“roots” represent the viscera and bowels, whereas

Rules” (Renpu Fujimoto, Medical Yukon).

“branches and leaves” represent the meridians andcollaterals; thus, the condition of the roots (visceraand bowels) can be assessed by observation of thespatialexamination

andspatialpattern

identification is often significantly effective. This

6) Pattern identification of healthy and pathogenic qi
Deficiency indicates weakened qi, whereas excess

branches and leaves (meridians and collaterals).

indicates an excess of pathogenic qi. Discrimination

3) Pathogenesis and pathology

identification for deficiency and excess in the eight

In the practice of benshoronchi, treatment principles
are determined based on the identification of a“pattern.” However, the “pattern” itself only reflects
the pathologic condition of the patient at the time of
examination. Having an accurate understanding of
the pathogenesis and pathology underlying thepattern is important for prognostic prediction andtreatment of disease, including disease in thepresymptomatic state. This notion leads to theperspective of narrative-based medicine that has
recently received attention.

between deficiency and excess is made by pattern
principles. In clinical practice, there are cases where
the signs of deficiency and excess are mixed. In suchcases, knowing which is dominant, or whether bothare equivalent or not, is important for thedetermination of treatment strategies. Based on theassessment of dominance of deficiency and excess(healthy and pathogenic), optimal treatment isselected. Appropriate supplementation and draining
canbeperformed

accordingtothepattern

identification of healthy and pathogenic qi.
7) Shinshu theory (mind and pain theory)
Awareness of pain is governed by the mind. Based on4) Qi stagnation theory
As described in “Miraculous Pivot,” acupuncture andmoxibustion therapy aims to restore the health ofpatients by removing the blockage of meridian flow.
In Japan, Mubunsai and Gonzan Goto proposed the“qi stagnation pathology theory,” which stipulated
that “all diseases are caused and exacerbated bystagnation of qi.” This theory has an important rolein Hokushinkai style clinical practice.

the premise that a peaceful mind leads to the
reduction of pain, therapy is targeted at acupoints
that are related to relaxation of the mind.
5. Utilization of a specially designed chart
The specially designed chart for Hokushinkai styleincludes approximately 300 inquiry items. There arecharts specialized for women (including items
regarding menstruation and delivery) and men

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

9Volume 12, Number 4 | Winter 2017

(including items related to pathologies in men). A

naturally,

utilizingthebalancebetweenthechart for adults has seven pages. Sample charts areelasticity of the skin at the acupoint and that of theshown in the appendix of “Acupuncture clinical

tip and saddle of the needle. (Figure 14)(Figure 15)competency–Hokushinkai style: Theory edition.”
6. Unique techniques of acupuncture and moxibustion
In Hokushinkai style, one acupoint (or up to three
acupoints) is selected as the therapeutic target, inorder to dramatically improve the flow of qi andblood and to restore the imbalances of yin and yang.
This allows practitioners to evaluate the treatment
effect more clearly and to correct the treatment
strategies, if needed. We developed a needling
method that is suitable for people in Japan today.
This method exerts an optimal effect, without
disturbing defense qi and putting stress on the body.
It is called the “Renpu needling method.”
1) Filiform needle therapy (flexural needle insertion)
a. Regarding the small number of needles

Figure 14: Types of filiform needles.

After proper pattern identification and decision
regarding treatment strategies, one (or up to three)acupoint is selected. Healing of the body byacupuncture (moxibustion) treatment is considered
to occur through the accumulation of healthy qi andreduction of pathogenic qi at the treatment point.
When the number of treatment points increases, thegathering of healthy qi becomes difficult, leading toa lessened treatment effect. For this reason, the mosteffective acupoint is selected after assessment of
dominance of deficiency and excess. Small number
needling allows us to evaluate treatment effects
accurately, as well as to correct treatment strategy if
the treatment proves ineffective.
b. Flexural needle insertion
Traditionally, a needling method involving a guide

Figure 15: Procedure of needle insertion.

tube has been widely used in Japan. We propose ac. Needle placement after selection of acupoints,

flexural needle insertion because it is more quickly

based on the left-right difference.

adaptable to the conditions of the acupoints and body,

In examination of source points and the back,based on body surface observations. Practitioners

different responses between left and right points areshould be aware that defense qi is also present in theconsidered to indicate problems. It is assumed thatparts distant from the examined body surface, andmalfunction of the weakened viscera and bowels

that the defense qi will start to react when the needle

causes left and right imbalances in acupoints along

approaches the body. The needle should be inserted

the meridians and collaterals. A draining method is

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The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017used during needle placement on the excess side,

wall, both of which contribute to the restoration ofwhile a supplementation method is used on theimbalances of yin and yang. In accordance with thedeficiency side; thus, the imbalances are consideredprinciples of the Mubun school, acupuncture therapy

to be restored, based on the balancing principle inis performed only on the abdominal region, andthe Taiji Yin Yang theory. We use needle placement

diseases can be cured by adjusting all the meridians,ascollaterals,

the

basic

techniquebecausecomplicatedviscera,andbowels,

as

well

as

procedures hinder quantification of healthcaremaldistribution (left/right/upper/lower) of the qi andresource use. (Figure 16)

blood. This method is especially effective for patientswith seriously weakened qi in whom filiform needle
is not applicable, those with hypersensitivity, andchildren. (Figure 17)

Figure 16: A picture of needle placement.
2) Dashin (tapping round-tip needle with a mallet)
Dashin, in Hokushinkai style, derives from the
Mubunschooldashindescribed

inFigure 17: Tools of dashin in “Shinkyu Chohoki.”“Shindohiketsushu.” This method was further developed by
Renpu Fujimoto in his attempt to develop an
acupuncture method suitable to the Japanese peopleof today. In the early phase of development, Mubun
school dashin (needle insertion by tapping with amallet) was adopted without modification; however,it was then abandoned because it caused pain andstress on the body. Then, a round-tip needle, similar
to spoon needle and round-pointed needle, wasdeveloped using metals such as gold, silver, andstainless steel. The use of this new needle was
effective and did not cause stress on the body. Thisnew technique involves a comfortable beating soundwith a mallet, along with vibration of the abdominal

Figure 18: Tools of dashin currently in use.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 12, Number 4 | Winter 2017

Figure 21: Kodaishin currently in use.
In the early phase of development, needles made of gold

Figure 19: Dashin in practice.

or silver, similar to those discovered in China, wereused;3) Kodaishin
In 1968, ancient needles from 2100 years ago werediscovered in a tomb in the Western Han Dynasty of
China (the tomb of Liu Sheng). Subsequently, we
produced replicas of the ancient needles and began
to use them in clinical practice. As a result, we foundthat the procedure of needling without insertion(just touching) was sufficiently effective. Since then,the practitioners of Hokushinkai style have used theancient needles in clinical practice, under the nameof Kodaishin. (Figure 20 / Figure 21)

different

needles

werecold/heat/supplementation/draining.

used

for

However,

werecently found that stainless Kodaishin is useful for any
symptoms related to cold/heat/supplementation/draining;
moreover, it produces significant effects simply byholding aloft the acupoint, without touching. The
indications of Kodaishin are almost the same as those ofdashin. Since therapy with Kodaishin does not require
extended time, it is often used for patients who cannot
lie on the back or for children who are restless.
(Figure22)

Figure 20: Replicas of Kodaishin.
Figure 22: Kodaishin therapy in practice.

12

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 20174) Others

1)

Renpu Fujimoto has studied with the nine needles
and their needling written in “Miraculous Pivot”
since the beginning of his practice. Currently, he2)occasionally uses round-sharp needle and shear
needle, but most frequently uses the needles
described

above.

moxibustion

for

In

addition,patients

he

may

a

significant

with

use

deficiency cold pattern, as well as for those requiring
treatment with Sinshu theory.
Conclusion
The medical philosophy of Hokushinkai style is

3)

4)

5)

based on qi monism and the Taiji Yin Yang theory,
following the philosophy of oriental medicine since
the publication of “Huangdj’s Internal Classic.” Thus,

6)

it originates from a standpoint that is different fromthe materialisms seen in current traditional Chinese
medicine.

Hokushinkai

styleemphasizes

theimportance of clinical practice in accordance with
control of the three causes (seasonal and local
conditions as well as patient individuality), while
using

the

terminologyof traditional

Chinesemedicine and adopting the science of traditional
Japanese acupuncture and moxibustion. We havebeen

makingcontinuous

effortstodevelopacupuncture and moxibustion medicine in the spiritof “from practice to theory.” We have established aseries of treatment systems in acupuncture andmoxibustion, including in-depth benshoronchi, withdetailed inquiries and with multifaceted bodysurface observation, small number needling therapy,
dashin, and Kodaishin. We continue our efforts todevelop traditional acupuncture and moxibustion.
Hokushinkai style is an active school attempting tocure a wide range of diseases, including intractablediseases. We hope that Hokushinkai style will be
spread far and wide. Lastly, a list of textbooks of
Hokushinkai style and related literature arepresented below.

7)

Renpu Fujimoto (ed.). Acupuncture clinicalcompetency–Hokushinkaistyle:
Theoryedition. Midori-shobo, 2016.
Renpu Fujimoto (ed.). Acupuncture clinicalcompetency–Hokushinkai style: Practiceedition. Midori-shobo, 2018.
Renpu Fujimoto. Body surface observation:
wisdom of Japanese acupuncture andmoxibustion. Midori-shobo, 2012.
Renpu Fujimoto. From practice to theory inacupuncture and moxibustion part 1.
Taniguchi-shoten, 1990.
Renpu Fujimoto. From practice to theory inacupuncture and moxibustion part 2.
Taniguchi-shoten, 1993.
Renpu Fujimoto. Collection of Essential Skillsof Acupuncture. Sizen-sya, 1978. Second
edition, Midori-shobo, 2000.
Renpu Fujimoto. Pulse examination of

stomach qi: illustration of pulse examinationin acupuncture and moxibustion. Morinomiya
Iryo Gakuen Shuppan, 2004.
8) Renpu Fujimoto, et al. Atlas of tongue
examination in acupuncture and moxibustion.
Midori-shobo, 1983.
9) Renpu Fujimoto. Universe of oriental
medicine. Midori-shobo, 2010.
10) Renpu Fujimoto, Yuichi Okumura, Tadashi
Yutani. Theory of viscera and bowels andmeridians and collaterals. Morinomiya Iryo
Gakuen Shuppan, 2003.
Acupunctureand11) Renpu
Fujimoto.
moxibustion:
Vertical,Horizontal
andAnteroposterior Rules. Medical Yukon, 2008.
Acupunctureand12) Renpu
Fujimoto.

moxibustion method by Renpu Fujimoto 3:
practice of Kodaishin. Oriental Medicine
Journal of Acupuncture & Moxibustion 24: 3136, Midori-shobo, 2012.
13) Renpu Fujimoto, Kazu

Murai. Tongue
diagnosis and imaging diagnosis. Oriental

Medicine Journal of Acupuncture
Moxibustion 1: 41-47, Midori-shobo, 2008.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)&

13

Volume 12, Number 4 | Winter 2017

Type 2 Case of Yasui Classification
Two Cases of Acute or Subacute Polyarthralgia
Successfully Treated with Boiogito Extract

Hiroshi Kakuto

Department of East Asian Traditional Medicine
Ehime Prefectural Central Hospital, JAPANBecause of elevation of WBC (15,490/µL) and CRP(7.94mg/dL), moreover, limited effect of Celecoxib for
his arthralgias made another local doctor introduced
us on May 26, 20XX.
[Physical findings]
His body temperature hovered around 37 degrees(Celsius).

Background
Many patients with polyarthralgias see doctors

He had limitations on range of motion of bilateralevery day all over the world. We must exclude many

shoulders, elbows, and knees.

differential diagnoses such as collagen diseases,

His legs were slightly edematous.

especially rheumatoid arthritis; however, it is

He had no tenderness of upper extremities, no nailsometimes difficult to identify the causes. In thechanges, no rushes.

cases of acute or subacute stage in particular, it is[Urinalysis] protein (-) , sugar (-)

assumed that some sort of viruses cause these[CBC] WBC 13,840/µL, RBC 512×104/μL, HBG

symptoms. Nevertheless, we sometimes prescribe

15.1g/dL, PLT 45.0×104/μL

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)[Biochemistry] ESR 46mm/h, AST 15U/L, ALT10U/L,

only because it is difficult to identify the causes,

LDH 157U/L, γGTP 31U/L, ALB 3.6g/dL, CK <24U/L,

moreover, most of antiviral drugs are ineffective for

BUN 18.3mg/dL, CREA 0.85mg/dL, Na 139mEq/L, K

these viruses. We experienced two cases of acute or

4.1mEq/L, Fe 28µg/dL, CRP 5.64mg/dL, HbA1c 5.8%,

subacute polyarthralgia successfully treated with

TSH 1.249µIU/mL, Ferritin 209ng/mL

boiogito extract. It is suggested that boiogito extract[Antibody] Parvovirus B19 IgM (-), RF (-), CCP (-)

is useful for nonspecific polyarthralgia.

[Treatment]
We diagnosed non-specific polyarthralgia by viral

Case report

infection. There was a possibility of reactive arthritis

Case1: 39 year-old maleas a differential diagnosis, however, symptomatic[Main complaint]

treatments were recommended anyway. We added

Polyarthralgia, fever

7.5g/day[Past history]

extract to 200mg/day of Celecoxib on his first visit.

Operated on testicular torsion when in junior highHis symptoms gradually improved within two weeks.

schoolHe continued that medications for a months.

ofboiogito(Fang-Yi-Huang-Qi-Tang)[Medicine(/day)]Celecoxib (100mg) 2T, Famotidine (20mg) 1T

Case 2: 55 year-old female[Life history][Main complaint]

Non-smoker, social drinker, doesn’t have any pets,

Polyarthralgia

no overseas travelling.

[Past history]

Job: a nurse of mental hospital

Type[Present illness]

hyperlipidemia, hypertension

He felt arthralgias on his wrists and knees from a2

diabetes

mellitus,

hyperthyroidism,(these were well-controlled)

few weeks ago. He supposed they were due to the[Medicine(/day)]training at fitness club at first; however, his legs got

Thiamazole(5mg)

3T,

Alogliptin(25mg)

1T,

swollen from knees to feet. A local orthopedist said

Pioglitazone(15mg)

0.5T,

Glimepiride(1mg)

1T,

to him that his

Pitavastatin(1mg)

1T,

Amlodipine(5mg)

1T,

14

X-ray examination had no problems.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017

Irbesartan(100mg)

1T,

Azosemide(30mg)

0.5T,[Antibody] U1RNP (-) , Sm (-) , SS-A (-) , SS-B(-) , Scl-

Metformin(500mg)

2T,

Loxoprofen(60mg)

3T,

70 (-) , MPO-ANCA (-) , PR3-ANCA (-) , CCP (-) , RF

Troxipide(100mg) 3T(-) , ANA 40times (SPECKLED)[Life history][Treatment]

Non-smoker, non-drinker, doesn’t have any pets.

We diagnosed non-specific polyarthralgia by viral

Job: a stuff of a welfare office

infection, not collagen diseases such as rheumatoid[Present illness]arthritis. We prescribed 7.5g/day of boiogito (Fang-

She felt both coxalgia a few years ago but didn’t

Yi-Huang-Qi-Tang) extract on her first visit. Her

have any medication because a rheumatologist she

polyarthralgia disappeared immediately in a few

consulted excluded rheumatoid arthritis.

days. We completed this medication within two

Thereafter she had pain of both knees and ankles

months.

from one year ago, which sometimes disabled her towalk only 50 meters. Furthermore, both coxalgia andDiscussion

shoulder pains occurred but other rheumatologist in

When examining the patients with arthralgias, it

the city hospital she consulted diagnosed as nois necessary to distinguish severe or emergency

problems. Non-steroidal anti-inflammatory drugs

diseases such as pyogenic arthritis, gouty arthritis,(NSAIDs) that her home doctor prescribed was notor pseudogout. And then we survey autoimmune

effective, moreover, she presented finger pains. Her

diseases;home doctor referred her to us.

systemic lupus erythematosus, psoriatic arthritis[Physical findings]

and Reiter syndrome among other things. Moreover,

Her blood pressure was 130/80 mmHg, pulse

inparticularrheumatoid

arthritis,

viral infections also cause polyarthralgias. The

87/min, body temperature 36.5 degrees (Celsius).

following kinds of viruses are common as the causes;

She had no morning stiffness, perspired a lot, andhepatitis B/C virus, rubella virus, parvo virus B19,

was not constipated.

dengue virus, mumps virus, coxsackie virus, herpes

She had spontaneous pains of her shoulders, hips,
knees, and ankles without tenderness, swelling nor
heat.

simplexvirus,

varicellazostervirus

andchikungunya virus.
Viralarthritis

commonly

has

symmetrical

Tongue signs: Pale red, scalloped, thin white coating,arthritis like rheumatoid arthritis but no destroying

overswelling of veins.

thePulse signs: Strong, slippery

lengthening of the symptoms nor recurrences except

Abdominal pattern: Soft, fat

for rubella virus, parvo virus B19, chikungunya

Skin: Edematous

virus and alpha virus. It is difficult to identify the[Urinalysis] protein (-) , sugar (-)

virus causing polyarthralgia unless patients have[CBC] WBC 7380/µL, RBC 466×104/μL, HBG

rashes or other distinctive symptoms. Medical

14.3g/dL, PLT 27.6×104/μL

treatments for viral polyarthraligas are usually only

[Biochemistry] ESR 16mm/h, AST 20U/L, ALT

symptomatic therapies, for which NSAIDs are used

31U/L, LDH 183U/L, γGTP 33U/L, CREA 0.67mg/dL,

as standard medicines. We have to pay attention to

Na 141mEq/L, K 4.1mEq/L, Fe 93µg/dL, CRP

adverse effect of NSAIDs, for example gastric ulcer

0.07mg/dL, HbA1c 7.9%, TSH 7.480µIU/mL, Ferritin

and renal injury if patients take for a long time

86ng/mL

period. Furthermore, effect of NSAIDs alone isjoints.

Itusually

doesn’thaveneithersometimes insufficient. Combination therapy of

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

15

Volume 12, Number 4 | Winter 2017

NSAIDs and kampo medicine is expected to be safe

Referencesand effective.

1) Nishizawa Y et al. Pharma Medica 25 (10): 15 -21.

Boiogito (Fang-Yi-Huang-Qi-Tang) extract is from
“Jin Gui Yao Lue”, which says that boiogito treats
the patient with wind-dampness, floating pulse,
heavy sensation of body, sweating, aversion to wind.
In general, Japanese criteria of choosing boiogito aresoft and wet skin, edematous skin, excessive
sweating, heavy sensation of body, and getting worse
when bad weather. It improve Bi syndrome thatmeans arthralgia, numbness and dyskinesia in
traditional Chinese medicine’s theory to tonify qi,

2007 (In Japanese)
2) Majima T et al. Therapy & Technology 4: 1-6. 2012
(In Japanese)
3) Nishizawa Y et al. Pain and Kampo Medicine 8:
17-32. 1998 (In Japanese)4) Ono S. Orthopaedics 28 (5):101-105. 2015 (InJapanese)5) Tanaka K et al. Pain and Kampo Medicine 17:1115. 2007 (In Japanese)
6) Yasui.H. KAIM 10:1:2-7. 2015

promote diuresis, dispel wind.
There are some randomized controlled trials(RCTs) of boiogito about the effects for polyarthralgia.
1)-3)Moreover, other RCTs suggest that boiogito

suppresses

productionofinterleukin

6 or

8

dramatically in synovial membrane cells.4)-5) On the
one hand there are no studies of boiogito about theeffects for acute arthralgias or viral arthritis.
In this case report, we diagnosed both cases aspolyarthralgias caused by viral infection because we
couldn’t find any evidence of other differential
diagnosis. Both were treated insufficiently with
NSAIDs alone, and then improved by combining
with boiogito. These cases suit Type 2 “The effects ofstandard Western medical treatment and Kampo
treatment are both strengthened when the two areused in combination” that Dr. Yasui propounds.6)
Kampo is very safe and useful therapy if it can suit
critera to symptoms.
Conclusion

Boiogito can be the first line drug for acute or
subacute polyarthralgias caused by viral infection or
unkown pathophysiology.

16

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017

Clinical Report (Acupuncture)
Kidney Deficiency Low Back Pain

Past history: He was diagnosed with tinnitus in
Otolaryngology.

Masanori Takashi and Makoto Arai

Present status: Height: 175cm; Weight 77kg BMI 25.1;

Tokai University School of Medicine

Low back pain Vas 67mm, SLR negative, ATR normal.
There is a reaction to KI3 太渓 and BL26 関元 Pulse:

Introduction: Low back pain is the most frequent

string-like, Tongue: dark pale tongue, tongue fur: Few.

complaint among Japanese people according to theTCM diagnosis: Kidney deficiency

Basic survey of national life1) . The prevalence of low

Therapeutic principle: Tonifying the Kidney

back pain was 38% in 2016, which means one in

Adjust Acupuncture Point: BL23 腎兪・BL18 肝兪・three Japanese had low back pain2). Among them,KI3 太渓・RN4 関元・ST36 足三里・SP6 三陰交

nonspecific low back pain accounted for 80% to 90%3).

(Figure 2)

Sixty% of patients who visited clinic of acupuncture
and moxibustion complain low back pain the mostfrequently.4)
This paper describes a patient with “non-specific low
back pain” treated from the TCM.
Case: 29-year-old male, blasting technician
Chief complaint: Low back pain
Present illness: He had discomfort in his waist three
years ago, and coped with it by acupuncture andmassage. He felt strong low back pain when hechanged his position. and He felt tinnitus one year
ago. He visited an orthopedic surgery of the General
Hospital. However, he remained undiagnosed evenafter he had a detailed examination. (Figure 1)

Figure 2

Figure 1
His pain was deteriorated in sitting position twomonths ago. That pain didn’t let him work. He finallycame to my office.
Systemic

symptoms:

Tinnitus.

Theurinary

Figure 2

frequency was 10 times a day and once a night.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

17

Volume 12, Number 4 | Winter 2017

Explanation: BL23 腎兪・BL18 肝兪・KI3 太渓・ST36

Treated

with

the

same

acupuncture

Points,

足三里・SP6 三陰交 were subjected to the Tonification

expression of the low back pain on the VAS waswith twirling. RN4 関 元 were subjected to the

53mm immediately after the second session.

purgation with lifting and thrusting. BL23 腎兪 andThird session:

KI3 太 渓 were contemplated to the tonifying theExpression of the low back pain on the VAS was

Kidney. I also added RN 4 関元 and performed both65mm. After the treatment, he told that thethe yin and yang of the kidney. Also added BL18 肝

treatment eased dull pain of his low back. Actually,兪 for Homogeny of Liver and kidney. And tried toexpression of the low back pain on the VAS wasstrengthen yin of the kidney. St36 足三里 and SP6 三50mm. However, the symptom relapsed on the next

陰交 combined to boost qi and blood production.

day of the third session. The same treatment with

The needle used: Seirin-made sterilized acupuncture

acupuncture Points was given.

needle, length1cun6fen, No. 1

Forth session:

Treatment progress: Treatments were administered

Expression of the low back pain on the VAS before

once a week.

the forth session was 63mm. After the treatment,

Course: (Figure 4)

expression of the low back pain on the VAS wasFirst session: KI3 太 渓 made a slow stimulus in

50mm. The effect had lasted for three days. The

Tonification with twirling. Rn4 関元 also warmed up

effect had lasted for three days. The patientElectronic moxibustion device. Immediately after

complained of a dull pain in his low back three days

the treatment, expression of the low back pain on theafter the forth session. Expression of the low back

VAS was 55mm.

pain on the VAS was 54mm at that time.
Fifth session:

VAS
㎜ 100
80

Expression

CoursePresbycusis VAS
Low back pain VAS

thelow back pain on the
VAS before the fifthsession was 50mm.

50

67

53

After the treatment,

45

65

63
55

60

63
50

expression of the low

50 50
42 40

40

36

25

40

36

35
20

20

20

30
19

20

back pain on the
VAS was 42mm. He

27
15

told me that he had

10
0

0

befor after beforafter beforafter befor after befor after befor after befor after beforafter beforafter befor after befor after befor afterFirst

SecondThird

Fourth

Fifth

Sixth

SeventhEighthTenthsessionthirteenth fifteenth twentieth

Low back pain
treatment

symptoms

oftinnitusandpresbycusis for one
month. I asked him

Presbycusis treatment

detailed

Figure 4questionsabout his symptoms
again.

He

had

suffered from tinnitus and presbycusis for three

Second session:
Expression of the low back pain on the VAS was
63mm on the following day of the first session.

18ofyears. However, he did not visit a clinic because hethought it would be due to his work environment
where great noises always pealed out. It was two

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 12, Number 4 | Winter 2017

years ago that he finally visited a hospital. He had aexpression of the low back pain on the VAS wasdetailed examination, however, the cause of these

20mm. His symptoms were

symptoms were still unknown. He had visited theEighth session:

hospital for six months, however, his symptoms were

The dull pain in the low back became strong last

not improved. His symptoms of tinnitus had

week. Expression of the low back pain on the VAS

deteriorated for one month. The patient was referred

before the fifth session was 35mm. After theto Otolaryngology. He had a detailed examination

treatment, expression of the low back pain on theagain, however, the cause of these symptoms were

VAS was 20mm. Expression of the tinnitus andstill unknown. (Figure3)

presbycusis on the VAS was 50mm. The induration

improved tendency.

of KI3 decreased by 40%. The same treatment withAcupuncture Points was given.
Tenth session:
Expression of the low back pain on the VAS before
the fifth session was 36mm. After the treatment,
expression of the low back pain on the VAS was
19mm. Expression of the tinnitus and presbycusis on
the VAS was 50mm. The same treatment withAcupuncture Points was given.
Thirteenth session:
Expression of the low back pain on the VAS before
the fifth session was 35mm. After the treatment,
expression of the low back pain on the VAS was

Figure 320mm. Expression of the tinnitus and presbycusis on

He aspired to be given acupuncture and moxibustion.
Expression of the tinnitus and presbycusis on the
VAS was 50mm. Tinnitus and presbycusis wereconsidered kidney essence insufficiency pattern/
syndrome. The treatment was added to the SI19 聴宮 and GB2 聴 会 .Adjust Acupuncture Point was
BL23 腎兪・BL18 肝兪・KI3 太渓・RN4 関元・ST36
足三里・SP6 三陰交・SI19 聴宮・GB2 聴会.
Sixth session:
There was no abnormality in the examination of thehearing loss. Expression of the tinnitus andpresbycusis on the VAS was 50mm. Expression of the
low back pain on the VAS before the fifth session was
40mm. After the treatment, expression of the lowback pain on the VAS was 36mm.
Seventh session:
Expression of the low back pain on the VAS before

the VAS was 45mm. The same treatment withAcupuncture Points was given.
Fifteenth session:
Expression of the low back pain on the VAS before
the fifth session was 27mm. After the treatment,
expression of the low back pain on the VAS was
15mm. Expression of the tinnitus and presbycusis on
the VAS was 40mm. The same treatment withAcupuncture Points was given.
Twentieth session:
Expression of the low back pain on the VAS before
the fifth session was 10mm. After the treatment,
expression of the low back pain on the VAS was 0mm.
Expression of the tinnitus and presbycusis on the
VAS was 25mm.
Because of the work transfer therefore treatment
was ended.

the fifth session was 40mm. After the treatment,

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

19

Volume 12, Number 4 | Winter 2017

Discussion:

Reference

It is said that nonspecific low back pain repeats the1) https://www.mhlw.go.jp/toukei/saikin/hw/k-deterioration and improvement over a long period oftime once it emerges. Nonspecific low back pain isstrongly involved in psychosocial elements. It has

tyosa/k-tyosa16/dl/04.pdf
2) Yoshimura N, et al.: Prevalence of knee pain.
humbar pain and its …

been reported that those patients may have3) masatoshi TERAGUCHI et.al.: Epidemiology ofsymptom of depression.5) In this case, we planned an

Low Back Pain from The Wakayama Spine Study,

Oriental Medicine(TCM) treatment because theClinical orthopedic surgery, 52(12), 1125-1131,

patient

2017

has

few

psychologicalandorganic

4) TAKANO Michiyo et al.:A Cross-sectional Sarvey

observations.
According to 『 Suwen 』 Chapter 17, there is theofrelationship between the waist and the kidney.

Treatment in Japan, Zen Nihon Shinkyu Gakkai

lumbar area is the residence of the kidney. If it can

Zasshi, 52(5), 2002,

not be turning, the kidney energy has been

Patient

Safisfacfion

after

Acupuncture5) HARA Yoshihiro: 原 慶 宏 : Discrimination fromexhausted.6)

diagnosis of low back pain, Diagnosis andHearing loss and tinnitus are described in 『Lingshu』

treatment 98(6): 1023-1027, 2010

Chapter 37 in which the relationship between the6) Yellow Emperor’s Canon of Internal Medicine

kidney and the ear.7) As for the function of the ear, it(Huang di nei ching Suwen 黄 帝 内 経 素 問 )is described that the enhancement of renal care is

Chapter 17 The Essentials and Fandamentals of

involved in the auditory function of the ear in

Diagnostic Palpation 脈要精微論 (in Chinese)『Lingshu』Chapter 17.8) These symptoms may be7) Yellow

Emperor’s

Canon

of

Internal

attributed to his work environment in which he had

Medicine(Huangdi Neijing Lingshu 黄帝内経霊been continuing to hear the large sound. Frequent枢) Chapter 37 Determining the Conditions ofurination and nocturia are lack of harmony of

the five viscera by Examining the Five Sense"opening and closing" of bladder due to a decrease of

Organs 五閲五使篇第三十七 (in Chinese)

activities of kidney-Qi. "opening" is to excrete extra

8) Yellow

Emperor’s

Canon

of

Internal

water and waste products. "closing" means keeping

Medicine(Huangdi Neijing Lingshu 黄帝内経霊the water in the body constant and recycling. Due to枢) Chapter 17 The Length of Channels 脈度篇第abnormality of activities of kidney-Qi, the symptoms

十七 (in Chinese)such as edema, urinary incontinence, frequenturination appear.
As we did the treatment to him, the difference
between the VAS before the treatment and after
became bigger. This result may suggest that it isimportant for patients with low back pain thetreatment like this case to get treatments several
times.
*This case report is a result of slight modification towhat was published in "The Journal of Kampo
Medicine" (Japanese edition)" Vol.59 No 10

20

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We sincerely hope to continue in the future with our contribution tomodern medicine through "Kampo".

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