Volume 2, Number 3 | Fall 2007

Kampo Medicine - Current Research
Effects of Saikokeishito on Pediatric Diseases

observed, saikokeishito had been effective in 34 ofthe cases. The age distribution here too ranged from

Hiromichi Yasui
Japan Institute of TCM Research

1 to 12 years and classified by sex the patients
included 17 boys and 17 girls. Regarding diseases
these patients included 19 cases of common cold

Introduction

syndrome, 9 cases of common cold induced gastritis,

The source text for the prescription saikokeishito

3 cases of acute otitis media, 2 cases of pollinosis(Chai-hu-gui-zhi-tang) is the "Shang Han Lun" andand one case of urticaria. The treatment period

this formula is used extremely frequently in Japan.

varied from one day to six weeks. Combination

The reason lies in the fact, that Japanese physicians

therapy with other Kampo prescriptions washave traditionally attached great importance to theadministered in 3 cases of common cold syndrome, 1"Shang

thiscase of acute otitis media and 2 cases of pollinosis.

prescription very frequently. This resulted in theThe other patients were treated with saikokeishito

accumulation of a wealth of experience pertaining toalone.

its use and the achievement of good results obtained

combination therapy with western medications onlybytherapeutic

2 out of the 34 patients with acute otitis media

developments in this field in recent years treatingreceived a combination therapy with antibiotics.

Han

pediatric

Lun"

and

physicians

therefore

duetousedvarious diseases. Miyazaki and Mori have focusedon this aspect and examined pediatric patients inwhom treatment with saikokeishito had beeneffective in the past and studied the kind of diseases
for which this prescription is effective. The results
published in "Journal of Kampo Medicine", Vol. 53
No.2 under the title "Study of pediatric diseases
treated effectively with saikokeishito". Below I will
discuss the application of this prescription while
presenting some of the contents of that treatise.

Amongthepatientswhoreceived

aThere were 37 cases that saikokeishito was effective
against chronic pediatric diseases.
The age distribution ranged from 2 to 12 years
and the patients included 20 boys and 17 girls.
Classified by diseases there were 10 patients withatopic dermatitis (7 moderately severe and 3 mildcases), 7 cases with bronchial asthma (6 cases ofmoderate severity and 1 mild case), 5 cases of
exudative otitis media, 4 patients with a highsusceptibility to catching cold and 3 patients withchronic gastroenteritis. The administration period
for saikokeishito varied from 2 months to 2 years

Research by Miyazaki and Mori
Miyazaki and Mori examined 71 cases (37 boys,and2months.

The20cases

hadrecieved

34 girls; age distribution from 1 to 12 years, average

combination therapies with other Kampo medicines.

age being 7.3±3.6 years) among the pediatricPatients receiving western medical combination

patients in their two clinics treated successfully

therapies included 8 cases of atopic dermatitis and 7with Tsumura's saikokeishito between January andcases of bronchial asthma.

June 2005. These patients were then classified byacute and chronic conditions and the Kampo
findings (excess-deficiency, pulse pattern, tongue
pattern,

abdominal

subsequently

thepattern)diseases,summarized
treatment

andperiods,

combination therapies with Kampo prescriptions orcombination therapies with western medicationsstudied.
Among the acute pediatric diseases these authors
8MiyazakiandMorimadeKampo

medicaldiagnoses of all these patients. They were as follows.
Regarding excess and deficiency 35 of the patients
presented with a pattern intermediate between
excess and deficiency, 29 patients with mild
deficiency pattern and 7 patients with clear
deficiency patterns. Regarding the pulse patterns
intermediate between floating and deep, clearly

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

Volume 2, Number 3 | Fall 2007

floating or deep, slightly floating and wiry as well as

fluctuating and did not yet bring about a cure. In

wiry and somewhat deficient were found in this

this situation the administration of saikokeishito

order. The tongue showed patterns of moist +led to improvements in moderately severe and mild

minimal white fur, slightly dry + minimal white fur,cases of acute otitis media. Regarding the twomoist + white fur as well as moist + no fur in thispatientsorder.
patients

saikokeishito
andotherKampo
medicine(shokenchuto) allowed to achieve a skillful control.

intermediate, somewhat soft in 36 patients andIn these patients the pollinosis was triggered byclearly soft in 5 patients. The incidence of the"common cold", so that it can be considered to be a

individual abdominal patterns was in 59.2% of theform of cold and thus the Kampo medicines werecases tension, 52.1% presented with fullness,

administered

tenderness or discomfort of the hypochondrium,

manifestations, while the use of the medication

28.2% with increased resistance and tenderness ofduringthe epigastric region and 25.4% with a hard glomus

unnecessary, so that this treatment plan allowed to

below the heart epigastrium in that order.

obtain sufficient therapeutic results by treating only

Abdominal

strengthwasin30

withpollinosis

aaccording

asymptomaticcombination

totheperiods

wasofrelevant
considered

the acute symptoms.
Research results

Below follows a breakdown of chronic diseases for

Below follows a breakdown of acute diseases forwhich saikokeishito had been effective.

which saikokeishito had been effective.
The authors classified many atopic dermatoses

This prescription is used in many cases ofaccording to either treatment of the root or local andcommon cold syndrome when a few days after thesymptomatic treatment, where treatment of the root

onset of the condition in addition to a lack ofappetite, bitter taste in the mouth and similar
symptoms of a half exterior half interior pattern
headache, chills and similar symptoms of an

represents

acausaltherapy

andlocalandsymptomatic treatment a conservative therapy.

saikokeishito has a harmonizing action on theexterior pattern are still remaining. Yet, two cases

nutrient

have also be reported, in which the administration

conditioning for the constitution, so that it is used

for early symptoms like headache, chills andas a prescription for the treatment of the root.

generalized malaise brought about a cure in just one

Ephedra preparations for example eppikajutsuto etc.

day. This indicates the efficacy of saikokeishito forcan be used for local and symptomatic treatment,

acute pediatric diseases from an early stage on. The
authors have in the past already recommended theearlyadministrationofKampo

medicineforcommon cold and now would like to emphasize, thatand

defensesystems

andworks

Scutellaria and Coptis prescriptions for example

orengedokuto etc. or byakkokaninjinto etc. are usedasprescriptionsforlocalandsymptomaticthe prescription saikokeishito should be added totreatment. The 7 patients with bronchial asthma

the selection of applicable formulas.

were classified as moderately severe or mild cases

Reportedly administration of this prescription to
the9patients

withcommoncold

during the chronic stage. Since 6 out of the 7

inducedpatients simultaneously presented with patterns

gastroenteritis produced quick improvements. The

representing indications of other Kampo medicines,

three patients with acute otitis media were alreadyunder treatment by otolaryngologists using mainly
antibiotics, but the therapeutic progress was

saikokeishito was used in conjunction with thoseother prescriptions (mainly Ephedra prescriptions,enriching and moistening prescriptions as well as Qi

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

9Volume 2, Number 3 | Fall 2007

Regulating prescriptions. This decision has its

sweating,

foundation in the dragover disease theory of theirdiscomfort of the hypochondrium (Kyokyo kuman),teacher Fujihira. In particular a combination of thestuck feeling in pit of stomach, excessive strain ofhere discussed prescription and the qi normalizing

abdominal muscles, so that with a treatment usingprescription

hangekobokuto

often

producesfavorable therapeutic results.
Regarding pediatric exudative otitis media mostcases represent a transitional condition from a notyet fully healed acute otitis media in a state, where
there is an accumulation of exudate in the middle
ear. Those authors considered this disease to belocated in the lesser yang region, because the lesion
is at the side of the head. Moreover, based on theaccumulation of the exudate, they considered it to
be a form of water stagnation. Again, by becoming
chronic the condition is considered to deteriorate
into a deficiency pattern, so that mainly Bupleurum
preparations, diuretic prescriptions or kenchuto areused. The reported five cases presented with anindication for Bupleurum preparations and a mildly
deficient pattern, which was associated withspontaneous

sweatinganddizziness,sothatsaikokeishito was used. Three out of these patients
presented with a spleen and stomach deficiency (qideficiency), so that they reportedly combined theformerprescriptionwithshokenchuto.

A

combination with shokenchuto is often used in casesof refractory chronic pediatric diseases, probably
based on the experiences of those authors.
A high susceptibility to catching cold and chronicdizziness,fullness,

tendernessormainly saikokeishito good results were reportedlyachieved.
There was one patient with pseudomyopia. This
was a 7-year old boy. Visual acuity upon firstexamination was 0.4 on the right and 0.5 on the left.
Miyazaki and Mori observed a mild deficiency
pattern, bitter taste in the mouth, glomus below theheart, mild degree of fullness, tenderness or
discomfort of the hypochondrium on the right side
and excessive strain of abdominal muscles. Basedon these findings they administered saikokeishito.
Seven months later visual acuity had improved on
both sides to 0.8 and after 1 year of treatment visualacuity had improved on the right to 1.0 and on theleft to 0.9.
Habitual headache, orthostatic dysregulation,
bed wetting etc. are interpreted as a form ofpediatric autonomic dystonia and these authors
reported, that saikokeishito provides an effectivetreatment. Saburo Aimi published in his work
"Application of saikokeishito to the treatment ofautonomic dysregulation syndromes" numerous
cases of effective treatment2). Those authors too had
success with the application of this prescription
based on this concept.

Conclusion

gastroenteritis represent what is generally regarded

Miyazaki and Mori investigated cases in which

as a pediatric weak constitution. There are asaikokeishito had been effective and their report

number of reports describing the effectiveness ofshows that this prescription is indicated for a wide

saikokeishito in treating these children. Bupleurumrange of pediatric diseases, both acute and chronic,

preparations are in general frequently used to treat

and has been found to be an effective formula.

mainly chronic nose diseases like allergic rhinitis,

Actually, in the field of pediatrics in Japan thischronic rhinitis, chronic parasinusitis and similarprescription is one of the most frequently usedconditions that are associated with heat syndrome

formulas. For example, when used for children

or water stagnation. The 4 cases described here

suffering from repeated upper respiratory tract

presented with mild deficiency pattern, spontaneousinfections the frequency of infections gradually
decreases and through long-term treatment the10The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 2, Number 3 | Fall 2007

children have reportedly slowly become healthy3,4).

saikokeishito

Otherwise Saburo Aimi reported the application ofJapanese Journal of Pediatrics, 45 (9), 1964,

this prescription for the treatment of epilepsy5),

1992

Hiroseits

headache6)

applicationincases

andetal.

Moriofforfor

orthostatic

dysregulation:

habitualorthostaticdysregulation7), which shows, that there is a
substantial amount of study regarding the use of
thisprescription

in children.

The reportbyMiyazaki and Mori verify the results of past reports
and at the same time newly proposed its use during
the early stage of common cold. Reading this reportmakes it clear, that the skillful use of saikokeishito
in pediatric care is very important.

References
1) Miyazaki M, Mori K: Examination of pediatricdiseases effectively treated with saikokeishito,
Journal of Kampo Medicine Vol. 53, No.2,265-277, 2006
2) Aimi S: Application of saikokeishito to thetreatment of autonomic dysregulation syndromes,
Japanese Journal of Oriental Medicine, 160,41-46, 1965
3) Akiba

T,

ArakiY,

NakajimaA,

etal.:

Improvement of easy susceptibility to infections
through long-term treatment with saikokeishito,
Japanese Journal of Oriental Medicine 41:
149-155, 1991
4) MineM:

Experiences

withtheuseofsaikokeishito in nursery school children withfrequently repeated infections, Third General
Conference of Japan Ambulant Pediatrics, 1993
5) Aimi S: Treatment of epilepsy with saikokeishito,
Results and discussion as well as the influenceon encephalographic findings, Japanese Journalof Oriental Medicine 27, 99-116, 1977
6) Hirose S: Pediatric habitual headache andsaikokeishito,

Journalof

Traditional

Sino-Japanese Medicine (extra edition), ModernKampo Medical Case Report Collection No. 3,150-151, 1987
7) MoriM,etal.:

Clinicalapplicationof

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