Volume 1, Special Edition | Current Kampo Medicine 2005

Clinical Applications of Kampo Medicine

Hiromichi Yasui, Committee Chairman
Annual Report Committee of Kampo Medicine

Table of Contents
1. Geriatric Medicine
2. Skin, Hair and Nails
3. Eye4. Ear, Nose and Throat
5. Lung
6. Heart
7. Systemic Hypertension
8. Blood Vessels and Lymphatics
9. Blood
10. Alimentary Tract
11. Liver, Biliary Tract and Pancreas
12. Gynecology
13. Obstetrics
14. Arthritis and Musculoskeletal Disorders
15. Kidney
16. Urology
17. Nervous System
18. Psychiatric Disorders
19. Endocrinology
20. Diabetes Mellitus
21. Lipid Abnomalies
22. Nutrition
23. Infectious Diseases
24. Cancer
25. Pediatrics
Introduction
Legitimate Japanese medicine until about 140
years ago was Kampo Medicine. Naturally, the Dutch
medicine, representing the legitimate European
medicine of the day, was at the time of its introduction
to Japan a non-mainstream medicine. Yet, its contents
gradually became known and thus started to spread,so that in 1804 a mastectomy was performed by Seishu
Hanaoka under general anaesthesia in a patient withbreast cancer. This showed the emergence ofphysicians highly skilled in both forms of medicine andrepresents a successful example of integrative
medicine that occurred 200 years ago. Trends in the
medical world attempting the integration of westernand Kampo forms of medicine in Japan actually were
not modern efforts, but have been an important topic
for several hundred years.
Kampo medicine is widely used in daily medical
practice. This form of medicine originally was atherapeutically oriented medicine with outstanding
characteristics. The excitement during its revival
movement in the 1930s frequently showed it to besuperior to the western medical approach. However,later the developments in western medicine andrelated sciences, greatly expanded therapeutic
possibilities. Correspondingly, the scope of application
14of Kampo medicine has declined in proportion to the
expansion of western medicine. However, currently it
is still frequently applied for the treatment of many
diseases for which western medicine is unable toprovide satisfactory solutions.
In Japan, only a few physicians are specializing
solely in Kampo medicine. Except for such extreme
exceptions (that means almost always) physiciansassume a western medical stance and add Kampo
medical treatment as required. In other words,
integrative medicine is practiced on a private level.
Described below is the generally practiced form of
Kampo medicine in daily clinical routine. The
descriptions are based on the experiences of the author
and refer to the references 1 to 6 (either of which
describes the general treatment of diseases). Citationof references from related research are indicated bynumbers and are introduced in the order of theirappearance.
References:
1. Otsuka K., Yakazu D., Shimizu T.: encyclopedia of Kampo Diagnosis,
Manzando 1963
2. Terasawa K.: KAMPO Japanese-Oriental Medicine Insight from ClinicalCases, Standard Macintyre Tokyo ISBN915719-05-7 C3047
3. Hanawa T.: Lessons of Kampo Diagnosis, Kanehara Publishing 1995
4. Bando S.: Medical Practice with Kampo for Disease, Medical Yukon 2003
5. Otsuka K.: Medical Practice with Kampo for Symptom, Nanzando 1963
6. Matsuda K.: Medical Practice with Kampo for Symptom, Sogensha 1992
7. The Guideline of Medical Insurance for Kampo Medicine, edited by theJapanese Society for Oriental Medicine; revised edition, 1993

1. Geriatric Medicine
Among Japanese medical books, the "Kei Teki
Shu" (1574) by Dosan Manase was the first to separate
geriatric medicine from other clinical disciplines. Thus,
Kampo medicine has a very long tradition of geriatric
medicine, but with the addition of modern medical
approaches in recent years, there are still more newdevelopments. In particular the "Japanese Kampo
Medical Care for the Elderly", edited by Katsutoshi
Terasawa, is a very valuable book describing the
Kampo medical treatment for senile diseases in great
detail1).
Problems of particular importance in the elderly
are aging induced changes in the central nervous
system, the so-called cerebrovascular dementia and
Alzheimer's disease, which are associated withdementia, depressive states, delirium and similar
mental symptoms. Currently these symptoms are thesubjectofmulti-center
cumulative
research.
Particularly, research into the efficacy of Uncaria
Powder for the treatment of cerebrovascular dementia
and Angelica and Peony Powder for Alzheimer's
disease appear promising 2,3,4,5). Recent research into theclinical effects of Liver-Inhibiting Powder on 'Behavioral
and Psychological Symptoms of Dementia (BPSD) has
been performed, and the results were published in "J. Clin.
Psychiatry" and similar organs6).
In Kampo medicine, aging is closely related to thekidneys. Age related changes in bones and joints too

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Volume 1, Special Edition | Current Kampo Medicine 2005

are often related to a weakening of the kidneys. For
low back pain due to osteoarthrosis, gonalgia andsimilar typical diseases of bones and joints in theelderly, the application of kidney tonifying
preparations should be considered. The available datasuggest that Kidney Qi Pill is effective for the treatmentof postmenopausal osteoporosis.
There are several problems pertaining to diet also
requiring careful attention, since aspiration for
example may even be fatal. Certain reports and someresearch indicate that the use of Pinellia and Magnolia
Decoction or Lung-Clearing Decoction for patients
suffering from repeated aspiration pneumonitis
produces favorable results7,8).
Among the diseases of the urinary tract, Kampo
medicines are frequently used for dysuria. Kidney Qi
Pill9) for the treatment of impending incontinence andMiddle-Reinforcing and Qi-Benefiting Decoction or
Pueraria Decoction10,11) for abdominal pressureincontinence have been found to be effective in somestudies. Kampo treatment also appears to be
therapeutically useful during the early stages ofhypertrophy of the prostate12).
In the elderly, even simple infections like colds
should not be taken lightly. The reason for this is thatthey may be complicated by bronchitis, causing loss ofappetite and thus may easily lead to debility. The useof Kampo preparations during the early stages ofinfections in the elderly reportedly can lead to an earlyrecovery at low costs. Akiba treated stationary
patients
suffering
from
upper
respiratory
inflammation or bronchitis and found a shorter
duration of the morbidity and lower treatment costs
than in patients treated only with western
medications13). Moreover, Kampo also appears to be
useful for the treatment of refractory infections likethose caused by MRSA (see section on infections) 14).
1) Terasawa K.: "Japanese Kampo Medical Care for the Elderly", Igaku-Shoin 2005
2) Shimada Y., Terasawa K., Yamamoto T. et al: A well-controlled study ofUncaria Powder and placebo in the treatment of vascular dementia, J. Trad.
Med. 11: 246-255, 1994
3) Terasawa K, Shimada Y, Kita T, et al: Uncaria Powder in the treatmentnt
of vascular dementia a double-blind, placebo controlled study,
Phytomedicine 4: 1522, 1997
4) Inanaga K., Dainoson K., Ninomiya Y. et al.: Multi-center joint research into
the therapeutic effects of Angelica and Peony Powder on cognitive disorders
in the elderly, Prog. Medicine 16: 293-300, 1996
5) Yamamoto T.: Kampo and modern medical treatment of Alzheimer's disease,
Current Medicine 5: 96-102, 1989
6) Arai H., Iwasaki K.: Effects of Liver-Inhibiting Powder on AssociatedSymptoms Cognitive Disorders, Kampo Igaku 29(4): 13-15, 2005
7) Mantani, N. et al: Effect of Lung-Clearing Decoction , a Kampo medicine, in
relapsing aspiration pneumonia an open-label pilot study, Phytomedicine, 9:195-201, 2002
8) Iwasaki, K. et al.: The traditional Chinese medicine banxia houpo tang
improves swallowing reflex. Phytomedicine, 6: 103-106, 1999
9) Yamanaka H., Suzuki T., Tokunaga S. et al.: Kampo Therapy for
Incontinence, Kampo Igaku 21(8): 2-10, 1997
10) Kase H., Akashi M., Satou T.: Effects of Middle-Reinforcing and
Qi-Benefiting Decoction on Pressure Incontinence, Kampo Igaku 29(3):19-21, 200511) Shin S., et al.: Usefulness of Pueraria Decoction for Pressure Incontinence,
Summary collection of the 47th General Academic Conference of the Japan
Society of Oriental Medicine, P126, 1996

12) Harada K.: Japanese & Chinese Pharmacotherapy for Urologic Disorders,Japanese Journal of Clinical Urology 45: 295-300, 1991
13) Akiba T.: Effects and possibility of reducing medical costs by local andsystemic application of Kampo preparations, Progress in Medicine, 21(8):1863-1865, 2001
14) Kitahara M., Ishikawa S., Hara K.: Protective effect of Ten Strong Tonic
Herbs Decoction against infection after acute ischemic stroke in elderly
patients. Biotherapy 17(3): 287-298, 2003

2. Skin, Hair and Nails
Skin diseases used to belong in the realm ofsurgery. That is due to the fact that there were somany infections of the skin that required surgery.
Many preparations have been developed for thetreatment of skin infections, but can also be applied toskin diseases other than infections and currently arein fact widely used. Seishu Hanaoka, who did theworld's first surgery for breast cancer under generalanaesthesia, invented the representative preparations
for the treatment of skin disease Antiphlogictic
Decoction with Ten Herbs and Purple Cloud Ointment.
His experiences are still useful today.
For diseases in this field there are excellent modern
medical treatments, leaving fewer pathologic
conditions that would require the use of Kampo
preparations. There was not a significant reference tothe use of Kampo therapy, but nevertheless a
combination with Kampo medicine frequently provides
additional benefits1). Among these conditions, Kampo
is used most frequently for the treatment of atopic
dermatitis. Regarding this disease, the combination of
appropriate skin care and Kampo medicine is effective.
Experienced dermatologists achieve good results bycombining various preparations2). Here the effects ofMiddle-Reinforcing

andQi-Benefiting

Decoction

during infancy are particularly well known. The
situation changes during childhood, adolescence andadulthood, where Wind Dispersing Powder, For
Eczema Decoction, Coptis Detoxificating Decoction,
Bupleurum Liver-Clearing Decoction, White Tiger plus
Ginseng Decoction, Yue Bi Decoction for Relieving
Edema plus Atractylodes, Warming and Clearing
Decoction, Head-Clearing Divaricate Saposhnikovia
Decoction, Schizonepeta and Forsythia Decoction andsimilar preparations are used. Still other effective
preparations are available as decoctions. A significant
number of physicians prescribe specially modified
decoctions for refractory cases. Using a combination of
topical steroids and Kampo preparations generally
allows the physician to taper the dose of the topicaldrug application. The Kampo formulas are then useduntil patients are capable of managing self medication.
These diseases are characterized clinically by their
psychological aspects and some physicians also seek
the cooperation of clinical psychologists for thetherapy.
1) Morohashi M.: Current Situation and Use of Kampo Medicine in the Field ofDermatology, 27-46, Kampo Report of Dermatology, 1990
2) Ninomiya F.: Treatment of atopic dermatitis with extract preparations, The
Kampo 13(1): 13-17, 1995

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Volume 1, Special Edition | Current Kampo Medicine 2005

Steroid ointments or topical retinoids and similar
western medical preparations are given priority for thetreatment or psoriasis. Kuboki et al. reportedly foundthat a combination therapy with Minor Bupleurum
Decoction, Poria Powder with Five Herbs had significantly
improved effects on pruritus, erythema, scaling,
infiltration, hyperplasia etc3).
Topical steroid ointments alleviate the symptomsof seborrheic dermatitis, but the condition tends to berecurrent throughout life and therefore warrants a
trial with Kampo therapy. Antiphlogictic Decoction
with Ten Herbs or Wind Dispersing Powder are widelyused for this purpose. Tsutsui et al. treated 30 patientswith seborrheic dermatitis with Wind Dispersing
Powder and reportedly found in their study ausefulness of 81.5%4).
It has been recommended that Yue Bi Decoction for
Relieving Edema plus Atractylodes or Gentian
Liver-Purging Decoction are used in conjunction withwestern medical treatment during the acute phase ofherpes zoster. For the treatment of postherpetic
neuralgia as a late effect of this condition, Ephdra,
Aconite and Manchurian Wildginger Decoction, Cassia
Twig Decoction plus Atractylodes and Aconite, Evodia,

Fresh Ginger plus Chinese Angelica Cold Limbs
Decoction and similar preparations are used.
Formulas like Schizonepeta and Forsythia
Decoction, Cassia Twig and Tuckahoe Pill Plus Coix
Seed, Antiphlogictic Decoction with Ten Herbs etc. are

generally used for the treatment of acne. A number ofstudies investigating this condition have also been
performed. Okuma et al. performed a RCT using
Antiphlogictic Decoction with Ten Herbs and Coptis
Detoxificating Decoction in a combination with theusual topical applications and found for Antiphlogictic
Decoction with Ten Herbs an efficacy of more than 75%
and for Coptis Detoxificating Decoction of more than40%5). Hashimoto et al. used in a RCT Schizonepeta
and Forsythia Decoction and tetracycline antibiotics
and found for Schizonepeta and Forsythia Decoction
an equivalent usefulness of 60.6%. A combination ofboth preparations reportedly resulted in a usefulnessof 78.6%6).
Research has also been done on palmoplantar
pustulosis. Hashimoto et al. treated 97 patients withpalmoplantar pustulosis with Warming and Clearing
Decoction extract and reportedly found in the fourthweek a usefulness of 59.8% and by the eighth week
69.8%7). The research of Watanabe et al. using Coptis
Detoxificating Decoction led to similar results8).
Antiphlogictic Decoction with Ten Herbs is also widelyused.
Regarding rosacea, numerous studies haveinvestigated Antiphlogictic Decoction with Ten Herbs.
Nakanishi administered Antiphlogictic Decoction withTen Herbs to 50 patients with rosacea and reportedly
found in 46 of these patients a marked improvement in
the diffuse erythemata9).

163) Kuboki J., Harada S. Fujisawa R., et al.: Investigation of the Effects of
TJ-114 (Minor Bupleurum Decoction, Poria Powder with Five Herbs )Combined with Topical Steroids for the Treatment of Psoriasis, Journal of
Clinical Therapeutics & Medicine 17: 927-937, 1991
4) Tsutsui K., Hirone T., Tanaka T. et al.: Clinical Effects of Wind Dispersing
Powder on Atopic Dermatitis, Seborrheic Dermatitis, Nummular Eczema
and Chronic Eczema, Kampo Igaku, 118: 309-312, 1994
5) Okuma M.: Combination Therapy of Orally Applied Kampo Medicine andTopical Preparations, Journal of Traditional Medicine 10: 131-134, 1993
6) Hashimoto Y., Matsuo S., Iizuka H.: Experiences with Schizonepeta andForsythia Decoction in the Treatment of Acne, Records of the 12th Meetingof the Research Group for Oriental Medicine in Dermatology, 46-53, 1994
7) Hashimoto Y., Matsumoto M.: Experiences with Warming and Clearing
Decoction in the Treatment of Palmoplantar Pustulosis, "Kampo Therapy"
Helpful for Daily Practice, 10: 51-155, 1991
8) Watanabe M., Ohkuma N.: Experiences with Coptis Detoxificating
Decoction in the Treatment of Palmoplantar Pustulosis, Kampo Igaku,
10:21-24, 1986
9) Nakanishi T.: Effects of Antiphlogictic Decoction with Ten Herbs on the
Diffuse Erythemata of Rosacea and a Combination of Atopic Dermatitis andRosacea, Current Situation of Kampo Therapy in Dermatology, 8: 67-83,
1997

Urticaria is occasionally an indication for Kampo
therapy. For acute urticaria, suitable western medical
treatment has been established, so that circumstances
specifically calling for the application of Kampo
therapy are few. Chronic forms of urticaria also include
refractory cases for which attempts at using Kampo
therapy have been made. Yano used a Kampo medicine
combination therapy on 19 patients with refractorychronic urticaria continuing the original treatment
and found a usefulness in 10 of the patients,
ineffectiveness in 7 and aggravation in 2 patients10).
The most frequently used preparation was Bupleurum
Liver-Clearing Decoction, followed by Wind Dispersing
Powder and Minor Bupleurum Decoction, Poria
Powder with Five Herbs in that order. Horiguchi et al.
treated 13 patients with chronic urticaria with

Capillary Wormwood Poria Powder with Five Herbs

and reported finding a slight usefulness in 85% of thecases11).
For warts, there used to be two traditional
treatment forms in Japan. One was the direct
application of moxibustion on the warts, something all
acupuncturists would do. This is extremely effective.
The other is the preparation of a Yokuinin decoction
and drinking this infusion. This latter treatment has
frequently led to very good results, so thatdermatologists now are using the extract. Among the
Kampo formulas, Ephedra, Apricot, Coiw and Licorice
Decoction is widely used.
When the cause of pruritus is determined,
treatment should be directed at the etiology, otherwise
this condition becomes an indication for Kampo therapy.
For the treatment of senile dermal pruritus, Kidney Qi
Pill, Life-preserving Kidney-Qi Pill, Angerica Decoction,
Antipruritus, Coptis Detoxificating Decoction andsimilar preparations are used. RCTs have shown thatthe effects of Kidney Qi Pill or Coptis Detoxificating
Decoction are comparable to antihistaminic drugs,
achieving an improvement of approximately 70% 12,13,14).
The occurrence of dermal pruritus among patients withThe Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 1, Special Edition | Current Kampo Medicine 2005

chronic renal failure requiring dialysis is frequent andAngerica Decoction, Antipruritus has, in some cases,
reportedly proven to be effective 15). Gentian
Liver-Purging Decoction or ”B”Character Decoction
are used for anal or genital pruritus.
10) Yanot T.: Kampo Therapy for Refractory Chronic Urticaria and Atopic
Dermatitis, Kampo Igaku 19(7): 17-20, 1995
11) Horiguchi Y., Furukawa F. Mitani T. et al.: Clinical Experiences with
Antiphlogictic Decoction with Ten Herbs and Capillary Wormwood Poria
Powder with Five Herbs for the Treatment of Chronic and Acute Urticaria,
Proceedings of Dermatology, 82: 365-368, 1987
12) Five Universities Joint Research Group: Experiences with the use of TJ-15,
TJ-107 for the Treatment of Patients with Senile Pruritus, Dermatology inWestern Japan, 53: 1234-1241, 1991
13) Fujita M., Ohno S., Miyaji Y. et al.: Therapeutic Effects of Kidney Qi Pill
(Tsumura) on Refractory Senile Pruritus, Proceedings of Dermatology, 88:
175-179, 1993
14) Hori Y., Saida T., Torii Y. et al.: Clinical Experiences with Angerica
Decoction, Antipruritus (Tsumura) for the Treatment of Senile Pruritus,
Proceedings of Dermatology, 79: 209-214, 1984
15) Sakaizawa I.: One Case in which Angerica Decoction, Antipruritus for theTreatment of Refractory Erythema and Pruritus in a Patient on Dialysis
due to Chronic Renal Failure, Kampo Igaku, 29(3): 38, 2005

Decubitus ulcers are treated following a fixed
protocol, but combination with Kampo preparations
may result in an even better prognosis. Nagasaka useda decoction of Kigi Kenchu To Ka Bushi (that is
Astragalus Middle-Strengthening Decoctoin withadded Toki (Japanese angelica root) and Bushi (aconiteroot)) and observed many favorable outcomes16).
Middle-Reinforcing and Qi-Benefiting Decoction and
Ten Strong Tonic Herbs Decoction are also widely used.
Dermal affections caused by cold include frost bitefor which Evodia, Fresh Ginger plus Chinese Angelica
Cold Limbs Decoction is effective and frequently
administered 17). According to Mori, RCTs have also
been performed. Burns among heat induced affections
is principally treated by western medical therapy, but
occasionally topical Kampo medications like Purple
Cloud Ointment are also applied. There are casereports about the treatment of burn scars in patientsfor whom surgical treatment could not be performed 18).
Nagasaka K. et al.: Therapeutic Experiences with Astragalus
Middle-Strengthening Decoctoin for the Treatment of Decubitus Ulcers,

16)

Kampo Medicine (Jap. Journal of Oriental Medicine), 49: 273-280, 199817) Mori S.: Clinical Experiences with Evodia, Fresh Ginger plus ChineseAngelica Cold Limbs Decoction for the Treatment of Frost Bite, Kampo
Shinryo 3(1): 46-51, 1984
18) Shimizu J.: A Patient with Burn Ulcers Successfully Treated with Shiun K,
Kampo Igaku, 20(4): 122-123 1996

3. EyeTechnical books about ophthalmology existed in
the Tang period in China. In Japan, the first
specialized physicians appeared in the 13th century.
Yet, their experiences were not handed down to us, sothat the treatment in this field was developed only inrecent years. Among the diseases and conditions
Kuroki wanted to treat with Kampo medicine were eyestrain, dry eye, central retinitis, some forms ofpigmentary degeneration of the retina, some forms ofglaucoma, some forms of cataracts, prevention of therecurrence of uveitis, conjunctival injection (cause

unknown), pterygium, ticks, bulbar contusion, bulbar
postsurgical care, neovascularization of the maculaand similar conditions1).
1) Kuroki S.: The Use of Kampo in These Cases - Eye Diseases; The Kampo for
the Practical Physician No.3: 2-7, 1999

Regardless of whether conjunctivitis is of bacterial
or viral origin, western medical treatment has priority.
However, Yamamoto described patients he treated for
keratomycosis or corneal herpes and obtained
excellent results, stating that great expectations may
be placed on Kampo therapy for infections of the eyes2).
Application of steroid or antiallergic eye lotions as wellas orally applied medications for the treatment ofallergic conjunctivitis are standard therapy, but
Kampo medications used for allergic rhinitis appear tobe effective for conjunctivitis as well. Minor Blue
Dragon Decoction, Yue Bi Decoction for Relieving
Edema plus Atractylodes, Ephdra, Aconite andManchurian Wildginger Decoction and similar
preparations are widely used. Dwarf Lilyturf Decoction,
Bupleurum Cassia Twig and Dried Ginger Decoction,
Liver-Inhibiting Powder, Modified Merry Life Powder,
Kidney Qi Pill, Ginseng Decoction and similar
preparations are used for the treatment of dry eye3).
There is also cumulative research into the use ofGinseng Nutrition Decoction. Fukuda et al. divided agroup of 60 patients with dry eye of unknown origin ina group of 30 patients treated with Ginseng Nutrition
Decoction and a placebo for 30 patients. Both groups
used the same eye lotions and were evaluated after 12
weeks. At this point, a slight improvement of thesubjective symptoms was reportedly found in 63.3% of
the patients in the treatment group as compared to 50%
in the placebo group 4).
2) Yamamoto S.: Kampo Therapy in Ophthalmology, Journal of Kampo
Medicine 47(11): 10-18, 2000
3) Yamamoto S.: Kampo Treatment for Sjörgren’s Syndrome, The Journal of
Traditional Sino-Japanese Medicine 14(3): 23-36, 1993
4) Fukuda Y., Narita Y., Miwa M. et al.: Effects of Ginseng Nutrition Decoction
for Dry Eye - New Ophthalmology 12: 1427-1430, 1995

Some forms of glaucoma are indications for Kampo
therapy. Yue Bi Decoction for Relieving Edema plus
Atractylodes, Minor Bupleurum Decoction, Poria
Powder with Five Herbs, Uncaria Powder and similar
preparations are used to lower ocular pressure.
Toshihiko Ueda treated glaucoma patients (22 patientswith primary open angle glaucoma, 5 patients withclosed angle glaucoma, 1 patient with secondary
glaucoma, 1 patient with normal pressure glaucoma
and 2 patients with ocular hypertension), in whom
control with eye lotions alone had been foundinsufficient. Over a period of 24 weeks with Minor
Bupleurum Decoction, Poria Powder with Five Herbs,
he reportedly found a significant reduction in ocularpressure5). Kinugawa et al. analyzed 7 patients
suffering from open angle glaucoma treated with Yue
Bi Decoction for Relieving Edema plus Atractylodes,
which resulted in a reduction in ocular pressure. He

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Volume 1, Special Edition | Current Kampo Medicine 2005

reported that the ocular pressure reducing effects
started to appear at the earliest a few hours following
administration. These effects apparently continued,
and even after a treatment period of 2 years, no side
effects had been observed. Clinically, carbonic
anhydrase inhibitors are the drugs of first choice used
to achieve a reduction in ocular pressure, while Yue Bi
Decoction for Relieving Edema plus Atractylodes may
be administered as a maintenance drug6). There are alarge number of case reports pertaining to this disease.
5) Ueda T.: Effects of Minor Bupleurum Decoction, Poria Powder with Five
Herbs on Glaucoma and Ocular Hypertension, Kampo Medicine (Jap.
Journal of Oriental Medicine), 46(6): 154, 1996
6) Kinugawa K., Sato K.: A Case Where Yue Bi Decoction for Relieving Edema
plus Atractylodes was Effective in Reducing Ocular pressure in Glaucoma,
Kampo Igaku 21(10): 19-21, 1997

Uveitis is treated with steroids, but heat clearing
Kampo preparations like Gentian Liver-Purging
Decoction or Coptis Detoxificating Decoction can also
be used. Yamamoto used Coptis Detoxificating
Decoction (heat clearing formula) and blood stasis
expelling formulas (blood activating and stasis
resolving formulas) in the treatment of 23 patientswith uveitis in whom treatment in university hospitals
or similar institutions had not led to any
improvements. He sought Kampo therapy andobserved a favorable course. This author states thatthe addition of aconite root was occasionally required
for elderly patients. Kuroki et al. modified the Yang
tonifying formula Jio Inshi for the treatment ofpatients with uveitis in whom treatment with heatclearing formulas like Gentian Liver-Purging Decoction
alone did not lead to improvements. He observed an
alleviation of the ocular symptoms in three patients7).
7) Kuroki S., Son K.: There Cases in Which the Application of Yang Tonifying
Preparations was Effective for Uveitis, Kampo Medicine (Jap. Journal of
Oriental Medicine) 54: Separate Volume 248, 2003

Kampo preparations are also used for some formsof cataracts and in some cases have led to an
improvement in visual acuity. Fujihira treated 284
patients (568 eyes) with senile cataracts with Kidney
Qi Pill and reported an improvement in visual acuityin 54.6% of the patients8). Kubota treated both eyes of
6 patients with senile cataracts over a period of 3 years
with Kidney Qi Pill and reported that further progressof the cataract could be prevented 9). Kidney Qi Pill,
Ginseng Decoction and Ten Strong Tonic Herbs
Decoction are also used. However, even if an
improvement in visual acuity is observed, there are nodata that would suggest any changes in theophthamologically observed degeneration of thevitreous body with a few exceptions10).
8) Fujihira K.: Treatment of Senile Cataracts with Kidney Qi Pill, Kampo
Medicine (Jap. Journal of Oriental Medicine), 24(4): 465-479, 1973
9) Kubota Y.: Treatment Results of Senile Cataracts with Kidney Qi Pill Basics and Clinics, 23(6): 2359-2540, 1989
10) Yamamoto S.: Kampo Therapy of Senile Cataracts, Current Kampo
Therapy, Journal of Kampo Medicine & Herb, 198518

For age-related macular degeneration there areexcellent western medical treatments, but occasionallyKampo therapy is also very effective. Shizuka et al.
reported cases in which treatment with Kidney Qi Pill
improved visual acuity11). However, in most cases ofthis disease an efficacy cannot be anticipated unlessdecoctions are used. Kuroki et al. prepared formulas
based on TCM theories and later published two casereports in which improvements in ocular findings wereobserved12). Various studies have been performed
dealing with macular edema (cause: branch retinal
vein occlusion = BRVO, diabetic retinopathy = DR,central serous choroidopathy = CSC etc.). Generally,
diuretic preparations like Yue Bi Decoction for
Relieving Edema plus Atractylodes or Minor

Bupleurum Decoction, Poria Powder with Five Herbs
are used for these conditions. There is cumulative
research into the use of Minor Bupleurum Decoction,
Poria Powder with Five Herbs13,14).
11) Shizuka T., Arai M. Sato H.: One Case with Age-Related Macular
Degeneration in Kidney Qi Pill induced Improvement in Visual Acuity,
Kampo Medicine (Jap. Journal of Oriental Medicine) 56: Separate Volume249, 2005
12) Kuroki S., Son K.: Two Cases of Age-Related Macular Degeneration (AMD),
Kampo Medicine (Jap. Journal of Oriental Medicine) 56: Separate Volume248, 2005
13) Iwashita K., Yamagishi K., Yuge K. et al.: Effects of Minor Bupleurum
Decoction, Poria Powder with Five Herbs on the Macular Edema of BranchRetinal Vein Occlusion, Clinical Ophthalmology, 54: 1247-1251, 2000
14) Isobe Y., Inamura M., Okada K. et al.: Clinical Effects of Minor Bupleurum
Decoction, Poria Powder with Five Herbs on Eye Diseases Associated with
Macular Edema, Pharmacology and Clinics, 3: 165-179, 1993

Retinic pigment degeneration is a hereditarydisease, but early initiation and continuous treatment
with Kampo preparations reportedly allows its
progression to slow down. Yamamoto observed atemporary normalization of the visual field and theappearance of peripheral visual field, but also statedthat the nature of the disease requires an observation
period of 20-30 years15). Fujihira published one highlyinteresting case report where Kampo therapy induced
a marked improvement in visual acuity.
15) Fujihira K.: A Case of Marked Improvement in Retinal Pigmentary
Degeneration, Journal of Traditional Sino-Japanese Medicine, SelectedCase Reports 188-189, Igaku Shuppan Center, 1984

4. Ear, Nose and Throat
Diseases in this field are indications for Kampo
therapy, frequently for chronic inflammatory andallergic diseases, but it is also used for a number ofother diseases that are often difficult to cure withwestern medicine.

Minor Bupleurum Decoction, Poria Powder with
Five Herbs is frequently used for the treatment ofstasis of the auditory tube or exudative otitis media
among the forms of otitis media and there are many
cumulative studies1,2,3). Minor Blue Dragon Decoction
and Yue Bi Decoction for Relieving Edema plus
Atractylodes are reportedly effective for the treatment

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

Volume 1, Special Edition | Current Kampo Medicine 2005of adult diseases4). When an edema of the external
meatus of the auditory tube develops due to a common
cold, Pueraria Decoction or Minor Bupleurum
Decoction plus Cyperus and Perilla Leaf Powder canbe employed. Specialized treatment for both the acuteas well as chronic phase of purulent otitis media
should be given priority, but if required, a Kampo
combination therapy can also be used. In particular, inchronic cases that prove to be almost refractory to theordinary therapies, the application of Kampo medicine
should beattempted. Here Pueraria Decoction, Minor
Bupleurum Decoction, Major Bupleurum Decoction,
Schizonepeta and Forsythia Decoction, Cassia Twig
plus Astrgalus Decoction and similar preparations areused.
1) Nakajima T., Yanagida N., Niwa H., et al.: Therapeutic Effects of Minor
Bupleurum Decoction, Poria Powder with Five Herbs for Exudative Otitis
Media; Clinical Otorhinopharyngology 82(7): 1025-1030, 1989
2) Ito S., Hayashi N.: Clinical Experiences with Minor Bupleurum Decoction,
Poria Powder with Five Herbs for The Treatment of Exudative Otitis
Media; Prog. Med. 11: 3087-3091, 1991
3) Tanaka H.: Usefulness of Minor Bupleurum Decoction, Poria Powder with
Five Herbs for Exudative Otitis Media; Prog. Med. 15: 1451-1452, 1995
4) Inoue H.: Immediate Effectiveness of a Combination Therapy with Minor
Blue Dragon Decoction and Yue Bi Decoction for Relieving Edema plus
Atractylodes in Adult Patients With Acute Exudative Otitis Media; ClinicalOtorhinology 47(5): 361-366, 2001

Vertigo is a comparatively frequent indication for
Kampo medicines among the diseases of the inner ear.
This symptom may be the subject of a Kampo therapy
whether the symptom is central or peripheral, andpreparations are chosen depending on which of thesymptoms are to be treated. For the treatment of
Ménière's syndrome Pinellia, Largehead Atractylodes
and Tall Gastordia Decoction, Bupleurum plus
Dragon’s Bone and Oyster Shell Decoction, Tuckahoe,

Cassia Twig, Largehead Atractylodes and Licorice
Decoction and similar preparations are used.
Otherwise Uncaria Powder is used for vertigo due toinsufficient cerebral circulation; Tuckahoe, Cassia
Twig, Largehead Atractylodes and Licorice Decoction

for the treatment of orthostatic syncopes. For dizzinessin the elderly during walking North Water God
Decoction finds frequent application. There iscumulative research into the effects of Pinellia,
Largehead Atractylodes and Tall Gastordia Decoction5).
In cases of tinnitus, depending on its cause, there aremany refractory forms rendering treatment difficult.
For chronic forms of tinnitus there are cumulative
studies regarding Life-preserving Kidney-Qi Pill,
Bupleurum and Cassia Twig Decoction, Uncaria
Powder, Bupleurum plus Dragon’s Bone and Oyster
Shell Decoction and similar preparations6,7,8,9,10).
5) Kimura T., Yamanaka N., Kuki K.: Clinical Effects of Pinellia, Largehead
Atractylodes and Tall Gastordia Decoction for the Treatment of Tinnitus,
Clinics of Ear and Nose 45 (5) 443-449, 1999
6) Onishi S., Sawaki S., Tsuchiya K. et al.: Multi-center Joint Clinical Trial
Regarding the Effects of Tsumura Life-preserving Kidney-Qi Pill on
Tinnitus, Developments in Otorhinopharyngology 37(3): 371-379, 1994

7) Kida K., Ito Y., Akita S. et al.: Effects of Bupleurum and Cassia Twig
Decoction on Chronic Tinnitus, Clin ics of Otorh inopharyngology,
Supplement 98: 31-34, 2001
8) Iwasaki N., Sakamoto M.: Clinical Evaluation of Uncaria Powder in theTreatment of Tinnitus, Medical Journal of the National Noborito Hospital
12: 20-23, 2001
9) Saito A.: Evaluation of the Effects of Uncaria Powder on Tinnitus Using
Headache and Hypertension as Indices, Clinics of Otorhinopharyngology,
Supplement 98: 20-30, 1998
10) Takei S., Masuno H., Ando M. et al.: 9th Kanto Conference on Kampo
Research in Otorhinolaryngology, clinical reports; clinical effects of
Bupleurum plus Dragon’s Bone and Oyster Shell Decoction on hypertension
associated with tinnitus, Prog. Med. 16(9): 2242-2245, 1996

Application of Kampo medicine appears to be ofparticular importance for viral rhinitis (common cold)
among the diseases of the nasal cavity and accessory
nasal sini. In Japan, preparations listed in the "Shang
han lun" are most frequently used. For further detailplease refer to the section on infections. The treatmentof acute inflammation of the paranasal sini follows theguidelines for the treatment of common cold. Yet,
Kampo medicine is used more often for the treatmentof chronic inflammation of the paranasal sini. Herepreparations like Pueraria Decoction, Pueraria

Decoction plus Szeshwan Lovage and Magnolia Flower,
Magnolia Flower, Lung-Clearing Decoction findapplication11,12), but when the underlying pathology
has been identified as phlegm-fluid retention,

Pinellia, Largehead Atractylodes and Tall Gastordia
Decoction or Two Vintage Herbs Decoction are also
administered.
11) Shibuya K.: Experiences with Magnolia and Lung-Clearing Decoction for
the Treatment of Refractory Chronic Inflammation of the Paranasal Sini inChildren, Prog. Med. 15: 1479-1481, 1995
12) Ito H.: Kampo Treatment of Chronic Inflammation of the Paranasal Sini.
Clinical effects of long-term administration of Pueraria Decoction plus
Szeshwan Lovage and Magnolia Flower for the treatment of chronic
inflammation of the paranasal sini in children, Prog. Med. 12: 2578-2585,
1992

Allergic rhinitis is widely treated with Minor Blue
Dragon Decoction or Ephdra, Aconite and Manchurian
Wildginger Decoction either alone or else incombination with antiallergic drugs. For year-roundtreatment of allergic rhinitis with Minor Blue Dragon
Decoction, double-blinded randomized controlled
studies (DB-RCT) showed significantly better effects
than in the control groups. Examination of the general
improvement shows a marked improvement in 12.0%of the cases, an intermediate degree of improvement in
32.6% and mild improvements in 39.1% and thus withoverall favorable results. The usefulness has received
an acceptable rating of 46.2% 13). Regarding Ephdra,
Aconite and Manchurian Wildginger Decoction there issome cumulative research14). Besides the above mentioned
drugs Pueraria Decoction, Pueraria Decoction plus
Szeshwan Lovage and Magnolia Flower, Yue Bi Decoction
for Relieving Edema plus Atractylodes, Tea-Blended
Szechwan Lovage Powder, Bupleurum Cassia Twig andDried Ginger Decoction, Tuckahoe, Licorice, Dried ginger,

Magnoliavine, Manchurian wildginger herb, Pinellia
rhizoma and Apicot kernel Decoction and similar

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

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Volume 1, Special Edition | Current Kampo Medicine 2005

preparations are also used.
Seasonal allergic rhinitis is also treated inapproximately the same manner, but during
asymptomatic periods it is recommended to administera combination of Middle-Reinforcing and Qi-Benefiting
Decoction and Angelica and Peony Powder as apreventive medication.
13) Baba J., Takasaka T., Inamura N. et al.: Effects of Year-around Treatment
with Minor Blue Dragon Decoction on Allergic Rhinitis, single anddouble-blinded comparative studies, Clinical Otorhinopharyngology 88(3):389-405, 1995
14) Ito H., Baba J., Tkagi I. et al.: Evaluation of the Pharmacologic Effects of
Ephdra, Aconite and Manchurian Wildginger Decoction on Allergic Rhinitis
Clinical effects on nasal obstruction, Clinical Otorhinopharyngology 52:
107-118, 1991

Pharyngitis and tonsillitis are usually considered
to be caused by the intrusion of wind heat, so thatduring the early stages, Shinryo Kaihyo (xin liang jie
biao = releasing the exterior with pungent-cool)treatment principle is applied. Since most of these
diseases are bacterial infections, they are indications
for antibacterial therapy, but Kampo medicine is also
useful. For further detail please refer to the section on
infections. Regarding pharyngitis there are case series
studied using Balloon Flower Root Decoction15).
15) Tsujihisa S., Maeda S.: Experiences with the Use of Tsumura Balloon
Flower Root Decoction extract for the Treatment of Patients with Acute
Upper Respiratory Infections Complaining About Pharyngitis, Basics andClinics, 19(5): 481-485, 1985

Anomalies of the pharyngolarynx are considered to
be a form of psychosomatic disease treated in western
medicine with tranquilizers, but in refractory cases,

Combind Minor Bupleurum Decoction and Pinellia andMagnolia Decoction, Cyperus and Perilla Leaf Powder,
Pinellia and Magnolia Decoction and similar
preparations may also be used 16,17). For dryness of themouth Dwarf Lilyturf Decoction, Ginseng Nutrition
Decoction, White Tiger and Ginseng Decoction etc areused18,19). These preparations are also effective forptyalolithiasis.
16) Tanino T., Takeda Y., Harada K. et al.: Experiences with Tsumura

Combind Minor Bupleurum Decoction and Pinellia and Magnolia Decoctionin Treating Abnormal Feelings of the Pharyngolarynx (from a multi-center
joint study), Prog. Med. 11: 3111-3114, 199117) Motoo Y., Taga H.: Effects of Cyperus and Perilla Leaf Powder on
Abnormal Sensations in the Pharyngolarynx Associated with Depressive
Moods, Kampo and Modern Therapy 7(3): 249-251, 1998
18) Okawa S., Shindoi N., Akagawa Y.: Clinical Effects of Ginseng Nutrition
Decoction in Patients with Dry Mouth, Prog. Med. 21: 1037-1039, 2001
19) Umino M., Nagao M., Muroga S.: Effects of White Tiger plus Ginseng
Decoction in Elderly with Dry Mouth - Analysis of the correlation between
improvement in subjective symptoms and the diagnostic pattern, Kampo
Medicine (Jap. Journal of Oriental Medicine) 45: 107-113, 1994

5. Lung
Many diseases of the respiratory tract are in daily
practice treated with Kampo medicine. The use of
Kampo medicines for the treatment of the chronic
phase of bronchial asthma has so far achieved quite
remarkable results. Since the spread of steroid
inhalants has fundamentally changed the basic
western medical therapy of asthma, Kampo
20

preparations are now used less frequently than in thepast. Still, since problems frequently develop in people
continuously using bronchodilators or steroids, there is
still a strong demand for Kampo preparations.
Currently, the question of how Kampo therapy ofpatients otherwise treated with the most advanced
modern western medical therapies should be employedis the subject of actively pursued research1,2).
Among the extract preparations, Minor Blue Dragon
Decoction, Ephedra, Apricot, Licorice and Gypsum
Decoction, Five Tiger Decoction, Combind Minor

Bupleurum Decoction and Pinellia and Magnolia
Decoction, Mistery Decoction, Dwarf Lilyturf Decoction
etc., are used for spleen deficiencies; Middle-Reinforcing
and Qi-Benefiting Decoction, Four Gentelmen Decoction
etc., for the elderly with kidney deficiency Kidney Qi
Pill, Ophiopogon, Schizandra and Rehmannia Pill
(Eight-immortal Pill for Longevity , which can besubstituted with a combination of the extract
preparations Dwarf Lilyturf Decoction + Six
Ingredient Pill with Rhemannia) are used. Refer to thesection on pediatric disease regarding pediatricasthma.
Cumulative research includes RCTs using

Combind Minor Bupleurum Decoction and Pinellia
and Magnolia Decoction and multi-center case series

studies3,4), both of which have achieved favorable
results. Moreover, results of multi-center case series
studies about Minor Blue Dragon Decoction showed abetter than intermediate improvement in more than
52.2% of the cases5). Also, treatment of adults sufferingfrom bronchial asthma associated with dry coughusing Dwarf Lilyturf Decoction revealed an antitussive
effect in 69.4% of the cases6).
1) Ito T.: The Role of Kampo Therapy in the Age of Steroid Inhalants, Kampo
Medicine (Jap. Journal of Oriental Medicine) 55(4): 447-453, 2004
2) Terasawa K.: Allergy and Kampo Therapy, Allergy 47 (1), 1998
3) Nakajima S., Takagi H., Tsutani Y. et al.: Examination of the Usefulness of

Combind Minor Bupleurum Decoction and Pinellia and Magnolia Decoction
Extract Fine Granules for the Treatment of Bronchial Asthma, Prog. Med.
9: 3138-3151, 1989
4) Egashira Y. and Nagano H.: A multicenter clinical trial of Combind Minor
Bupleurum Decoction and Pinellia and Magnolia Decoction in patients withsteroid-dependent bronchial asthma. Ann. NY Acad. Sci. 685: 580-583, 1993
5) Egashira Y., Yoshida M., Nagano J.: Clinical Effects of Minor Blue Dragon
Decoction on Bronchial Asthma - evaluation of a multi-facility open trial,
Kampo Medicine (Jap. Journal of Oriental Medicine). 45(4): 859-876, 1995
6) Tamaki T., Nizuma T.: Clinical Effects of Dwarf Lilyturf Decoction andAnalysis of Excretatory Components in the Urine - Antitussive effects ofDwarf Lilyturf Decoction on bronchial asthma and active principles.
Journal of the Tokyo College of Medicine and Dentistry 57(1): 23-30, 1999

There are several approaches to the treatment ofchronic obstructive pulmonary disease (COPD).
Clinicaltrialsusing
Middle-Reinforcing and
Qi-Benefiting Decoction extract have been performed,
but did not necessarily result in marked
improvements7). This disease is difficult to treat withextract preparations. Using decoctions, Haimoto on
the other hand, reported outstanding results8). A
number of studies deal also with pulmonary
emphysema9).

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

Volume 1, Special Edition | Current Kampo Medicine 2005
7)

Sugiyama

Y.,

Kitamura

S.:

Effects

of

the

Kampo

Medication

Middle-Reinforcing and Qi-Benefiting Decoction in the Treatment of
COPD, Japanese Thoracic Clinics 56: 105-109, 1997
8) Haimoto H.: Treatment of Chronic Obstructive Pulmonary Disease - A
compromise between Chinese and western medical therapies, The Kampo
15(2): 46-1, 1997
9) Shimoda T., Taniguchi T. Yasuoka A.: Clinical Effects of Combind Minor
Bupleurum Decoction and Pinellia and Magnolia Decoction in theTreatment of Chronic Pulmonary Emphysema and its Influence on
Bronchial Hypersensitivity, J. Trad. Med. 8: 426-427, 1991

Bronchitis is also a good indication for Kampo.
Depending on the conditions of the cough andproperties of the sputum, many different preparations
are used. Cumulative research showed that forpatients presenting either watery sputum, wheezing or
cough, observation of the effects of Minor Blue Dragon
Decoction during DB-RCT, revealed that the observed
general improvement and improvement of individual
symptoms were both significantly better than in theplacebo groups10). Treatment of this disease requires
identification of the etiologic agent, and based on thesefindings, administration of appropriate antibacterial
drugs, but Kampo preparations are often used in
combination with those antibacterial drugs. Somestudies are emerging that focus on the observation ofvariations in pulmonary function during combination
therapy with Combind Minor Bupleurum Decoction
and Pinellia and Magnolia Decoction and macrolide
antibiotics 11).
There are case series studies indicating that theuse of Pueraria Decoction Plus Szeshwan Lovage andMagnolia is effective for the treatment of thesinobronchial
syndrome12,13).
This
diseaseischaracterized mainly by the symptoms of bronchitis,
but treatment of inflammation of the paranasal sini
responsible for the condition, allows consequentpursuit of improvements.
10) Miyamoto S., Inoue H., Kitamura S.: Minor Blue Dragon Decoction for theTreatment of Bronchitis - Placebo controlled double-blinded comparative
study, Clinical Pharmacology 17(8): 1189-1214, 2001
11) Tanno Y.: Kampo Therapy for Respiratory Diseases (round-tablediscussion) - Variations in pulmonary functions before and after a
combination therapy with Combind Minor Bupleurum Decoction andPinellia and Magnolia Decoction and macrolides, Kampo Medicine (Jap.
Journal of Oriental Medicine) Vol. 21, Nol 10: 6-7, 199712) Egashira Y., Ushijima M.: Effects of a Combination Treatment of theSinobronchial Syndrome (SBS), in Particular Erosive Panbronchiolitis with
Pueraria Decoction Plus Szeshwan Lovage and Magnolia , Kampo andAllergy 4: 33-41, 1990
13) Kato S., Kishiro I., Onuma N. et al.: Long-term Combination Therapy
Using Erythromycin and Pueraria Decoction Plus Szeshwan Lovage andMagnolia for the Treatment of Sinobronchial Syndrome, Breathing 17(8):919-926, 1998

Bronchiectasis, during acute exacerbations,requires modern western medical treatment, mainly
using antibiotics, but during the chronic phase it is acomparatively good indication for Kampo therapy.
Lung-Clearing Decoction, Yin Nourishing Realtreasure Decoction, Tuckahoe, Licorice, Dried giner,

Magnoliavine, Manchurian wildginger herb, Pinellia
rhizoma and Apicot kernel Decoction have been used
for the treatment.
Among the pulmonary infections, community-acquired

pneumonia is currently treated primarily with modern
western medicine. However, Kampo therapy has beenused so frequently, that it has actually controlled thesurvival prognosis. Accordingly, there have been manystudies and combination therapies are still employed
today. Thus, administration of antibacterial agents still
represents the basics and Kampo medicine should not
be the treatment of first choice.
Hospital acquired pneumonia develops based on amultitude of different factors and while it is generally
not possible to provide a specific therapy, the condition
is usually marked by a decrease in immune function
associated with a high likelihood of infections. Under
these circumstances either only Qi tonifying or else
both Qi and Blood tonifying preparations like
Middle-Reinforcing and Qi-Benefiting Decoction or
Ginseng Nutrition Decoction are used. In cases of
MRSA infections, or infections with non-specificacidophilic bacteria, effectiveness of antibacterial
agents may hardly be expected and the same holds true
for chronic infections of the lungs.
Ideopathic fibrotic interstitial pneumonia is a groupof several disease entities. Except in a small number of
exceptions, all of these forms are exceedingly difficult totreat. While that is so, there are a number of casereports dealing with Kampo medicine. Ito reported thatmild cases of interstitial pneumonia can be treated with
Kampo14). Preparations used so far in published cases
include representative items like Minor Bupleurum
Decoction, Cassia Twig Decoction plus Atractylodes andAconite, Bupleurum Cassia Twig and Dried Ginger
Decoction, Kidney Qi Pill, Tuckahoe, Apricot Seed andLicorica Decoction etc. Several valuable case reports
have been published by Honma and also have been
described in the introduction15).
14) Ito T.: Kampo Therapy for Respiratory Diseases, Kampo Medicine (Jap.
Journal of Oriental Medicine) 54: 29-46, 2003
15) Honma Y.: Kampo Medical Treatment under Health Insurance,
Respiratory Division (26), Ideopathy Interstitial Pneumonia (IIP) 29:
562-563, 1993

Note:
It is known that several Kampo preparations may
induce drug interstitial pneumonia. Since 1992 several
cases of drug interstitial pneumonia due to Minor
Bupuleurum Dragon Decoction have been reported.
Statistically the condition occurs in about 4 out of
10,000 people. Considering that the incidence ofinterstitial pneumonia caused by the use of interferon inpatients with chronic hepatitis is 25 times higher, thisrate does not seem to be so high. Being completely
different in nature from the interstitial pneumonia
described in the main body of this text, this condition
can be diagnosed early based on subjective symptoms
and chest x-rays and discontinuing the offending drugat that time will lead to recovery. In severe cases
treatment with steroids may be required, but thedisease will basically run a benign course.

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Volume 1, Special Edition | Current Kampo Medicine 2005

6. Heart
In traditional Kampo medicine there is no concept
for blood pressure. Congestive heart failure is viewed
as a form of edema, while coronary artery diseases aredescribed as Kyohi (xiong bi = chest qi-blockage) andclassified and treated under different entities. Only
recently these symptoms have been summarized as
circulatory diseases. Following the progress in modern
medicine therapies, Kampo medicine is also
developing.
The incidence of coronary artery diseases, thatused to be rather low in Japan, is continuously
increasing in association with the westernization ofdiet and life style.
Some forms of angina pectoris are an indication for
Kampo medicine. The prognosis of patients withangina pectoris in Japan, compared to the prognosis of
the same disease in America, is comparatively goodand patients accordingly can be managed mostly on
ordinary pharmacotherapy. Yet, often there are also
indications for percutaneous transluminal coronary
angioplasty (PTCA) or coronary artery bypass grafts(CABG). The frequency of both of these procedures isrising. The use of Kampo medicine is restricted topatients managed by pharmacotherapy. In particular,
the use of Kampo preparations for effort angina
requires a sufficiently thorough diagnosis. Conversely,
Kampo medicine for atypical angina caused by
vascular spasms is often rather effective and therefore
warrants a try more than in patients with effort
angina1). However, in these cases treatment withextracts proves to be difficult, so that decoctions areused. There are a number of case reports2). Japanesepeople often present the indications for phlegm
dispelling preparations like Trichosanthes Fruit,
Chinese Chive and Pinellia Decoction, while blood
activating and stasis resolving preparations are notrequired as much as in China. Otherwise, Bupleurum
plus Dragon’s Bone and Oyster Shell Decoction, Coptis
Detoxificating Decoction, Bupleurum Cassia Twig andDried Ginger Decoction, Angelica Decoction andsimilar preparations are also used. During the acutephase of a myocardial infarct, Kampo therapy iscontraindicated.
After
initiating
rehabilitation
following the acute phase, however, Kampo therapy is
employed in order to improve the general conditionand prevent recurrences3).
1) Haimoto H.: Traditional Chinese Medical Therapeutic Effects on Angina
Pectoris and Coronary Angiographic Findings - from a standpoint offunctional and structural diseases, The Kampo 15(1): 7-16, 1997
2) Kimura H., Furuta K., Mitsuma T.: Major Sinking Into the Chest Decoction
for the Treatment of Microvascular Angina Pectoris - Clinical experiences,
Kampo Medicine (Jap. Journal of Oriental Medicine) 54(5): 945-950, 2003
3) Sato Y.: Ischemic Heart Diseases and Rehabilitation: Kampo and Advanced
Therapies 4(4): 361-365, 1995

Disorders of the pulse rate are classified as rhythm
disorders, i.e., some forms of arrhythmia are
indications for Kampo therapy. The medication varies

22

depending on the pathology. The classification into
Kampo types and the names of western medical
diagnoses do not necessarily match, but generally
Pinellia and Magnolia Decoction, Cassia Twig plus
Dragon’s Bone and Oyster Shell Decoction, Roasted
Licorice Decoction, Bupleurum plus Dragon’s Bone andOyster Shell Decoction, Bupleurum Cassia Twig andDried Ginger Decoction and similar preparations areoften used for paroxysmal supraventricular tachycardia
and Roasted Licorice Decoction for the treatment ofventricular extrasystoles. There are cumulative studies
regarding the use of Bupleurum plus Dragon’s Bone andOyster Shell Decoction4).
4) Konnai K., Munakata M., Sato A.: Clinical Effects of Bupleurum plus
Dragon’s Bone and Oyster Shell Decoction on Tachycardia Developing
during Administration of Ritodrine Hydrochloride, Obstetrics andGynecology 65(12): 1767-1770, 1997

Among the forms of heart failure, the acute phase ofcongestive heart failure is principally an indication fortreatment with modern medicine using diuretics andcardiotonic agents. Among the case reports where Kampo
medicine had been used, there are occasional examples,
where its use caused a remarkable improvement.
Extracts are indicated for the chronic phases, causing
improvement of mild congestive heart failure.
Preparations used include Fourstaman Stephania
Decoction, Roasted Licorice Decoction, Kidney Qi Pill,
North Water God Decoction5,6,7).
Congestive heart failure5) Yakubo S., Kinoshita Y. et al.: Clinical evaluation of Fourstaman Stephania
Decoction(Mu-fang-Yi-Tang): A Japanese and Chinese traditional
medicine for heart failure, J. Trad. Med. 19: 159-163, 2002
6) Ebe Y..: Treatment of Senile Heart Failure with Modifications of North
Water God Decoction - 30th Japan Oriental Medicine Conference,
Chu-Shikoku Branch General Assembly at the Tottori Conference 2001
(presentation)7) Katayose H., Shirato K.: Experiences with North Water God Decoction for
the Treatment of Patients with Severe Heart Failure Associated with
Marked Atrial Blocks - 52nd General Assembly of the Japan Society for
Oriental Medicine 2001 (presentation)

7. Systemic Hypertension
The first choice of treatment for hypertension is
life
style
guidanceandadministrationofantihypertensive drugs. In Japan there is no notion oftrying to control high blood pressure by Kampo
medicine alone. Although many case reports show thata successful reduction in blood pressure had beenachieved with the administration of Kampo
preparations alone, Kampo medicines are notconsidered to have a more reliable effect than diuretics,
ACE inhibitors, ARB, calcium antagonists, -blockers,
-blockers and similar preparations. Two cumulative
studies deal with Uncaria Powder1,2). Both systolic anddiastolic effects were observed. In actual clinicalpractice Uncaria Powder is widely used and attempts
have been made to increase the antihypertensive effectby adding Uncaria Powder to this extract
preparation3).
This preparation acts by pacifying the liver andsubduing yang in conditions marked by ascendant

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

Volume 1, Special Edition | Current Kampo Medicine 2005

hyperactivity of liver yang, which is a condition inmodern hypertensives. Several reports describe theuse of preparations for other pathologic conditions
such as the use of Pinellia, Largehead Atractylodes andTall Gastordia Decoction for congestions and excess ofphlegm-dampness,andBarbary
Wolfberry,
Chrysanthemum and Rehmannia Pill or Kidney Qi
Pill for liver and kidney deficiency4,5,6,7,8,9).
Generally,
Kampo
medicinesarenotantihypertensives per se, but can be used for andappear to be useful for, associated symptoms.
Frequently used extract preparations include among
others, Major Bupleurum Decoction, Coptis Detoxificating
Decoction, Three Huang Heart-Clearing Decoction withThree yellow color Herbs, Bupleurum plus Dragon’s Boneand Oyster Shell Decoction, Divaricate Saposhnikovia
Miraculous Powder, Seven Herbs Decoction for
Hypertension and similar preparations.
1) Nagata K., Hara K., Kinoshita T. et al.: QOL in Hypertension and the
Effects of Uncaria Powder, J. Trad. Med. 8: 252-253, 1991
2) Nagata K., Okamoto A., Kamano Y. et al.: Treatment of Hypertension with
Uncaria Powder and QOL, J. Trad. Med. 6: 426-427, 1989
3) Bando S.: Practice of Kampo Therapy Based on Disease Names, Medical
Yukon, 2004
4) Ogawa I.: Effectiveness of Bupleurum plus Dragon’s Bone and Oyster Shell
Decoction for the Treatment of Hypertension, Kampo Therapy 12, 1993
5) Sasaki A., Matsunaga A., Kusuda M. et al.: Effects of Major Bupleurum
Decoction and Uncaria Powder on Essential Hypertension, Clinics andResearch 70: 269-279, 1995
6) Ishikawa T., Umemura S.: Special: Strategies of Hypertension Therapies Oriental medial therapies for hypertension, Therapy 82(4): 1367-1372, 2000
7) Arakawa K., Saruta T., Abe K. et al.: Double-Blinded Controlled Study of
the Effects of Coptis Detoxificating Decoction on Accessory Symptoms ofHypertension, Clinics and Research 80(2): 354-372, 2003
8) Horino M.: Effects of Three Huang Heart-Clearing Decoction with Threeyellow color Herbs on Hypertension, Kampo Medicine (Jap. Journal of
Oriental Medicine) 53(1-2): 41-46, 2002
9) Katayose H.: Experiences with Bupleurum plus Dragon’s Bone and Oyster
Shell Decoction in the Cardiovascular in Ambulatory Practice, Kampo
Medicine (Jap. Journal of Oriental Medicine) 52(1): 25-38, 2001

8. Blood Vessels and Lymphatics
Most of obstructive arterial diseases are caused byatherosclerotic changes, but there is almost no clinicalresearch pertaining to the mechanism of action of
Kampo medicine on this etiologic factor. Yet, a
substantial amount of basic research has been
performed. For example, treatment of rabbits withexperimental models of atherosclerosis using

Bupleurum plus Dragon’s Bone and Oyster Shell
Decoction, showed that the treatment was reportedly

able to prevent disturbances of vascularization andsome other effects1).
1) Hasegawa M.: Antiatherosclerotic Modes of Action of Kampo Preparations
and their Effects, Prog. Med., 15: 131-140, 1995

Regarding obstructive arterial diseases of the lower
extremities, there is considerable experience pertaining
to the treatment of intermittent claudication in patientswith arteriosclerosis obliterans. Currently, mainly blood
activating and stasis resolving preparations areadministered, but kidney deficiency due to aging or

rheum turbidity, heat toxins also occur, so that it isoften not possible to treat these conditions simply
using the blood activation and stasis resolving
principle. Widely used extract preparations include

Evodia, Fresh Ginger plus Chinese Angelica Cold Limbs
Decoction,
Cassia Twig and Tuckahoe Pill,
Channels-Dredging and Blood-Activating Decoction,
Szechwan Lovage andAngelica Decoction forRegulating Blood Flow, Kidney Qi Pill etc.2,3,4,5). The
pathology of Buerger's disease may be different, but
treatment principles are similar6). Evodia, Fresh
Ginger plus Chinese Angelica Cold Limbs Decoction isoften used for Raynaud's disease and there are
relevant case series studies7).
2) Takahashi K., Sugano M., Totsuka O. et al.: Patients Treated with
Channels-Dredging and Blood-Activating Decoction Plus Coix Seed forArteriosclerosis Obliterans, Kanto Koshin Etsu Branch of the Japan Societyof Oriental Medicine, 1999 Sectional Meeting in Gunma Prefecture(presentation)3) OikawaO., Fujiki N., Matsumoto A. et al.: Attempts at Treating
Arteriosclerosis Obliterans (ASO) Induced Chronic Pain of the Lower
Extremities with Combination Therapy - Autogenic Training and Kampo(Peony and Licorice Decoction and Cassia Twig Decoction plus Atractylodes
and Aconite) - 35th General Conference of the Japan Society of Oriental
Psychosomatic Medicine in 1999 (presentation)4) Ide Y., Sekiyama H., Kitamura M. et al.: Three Patients withArteriosclerosis Obliterans Successfully Treated with Kampo Medicine,
Journal of the Japanese Pain Clinic Society 5(3): 327, 1998
5) Kaneki M.: Practical Application of Japanese Kampo Medicine for theTreatment of Arteriosclerosis Obliterans, Three cases, Kampo Medicine(Jap. Journal of Oriental Medicine) 47(6): 150, 1997
6) Kubo T.: Case Report of a Patient Following Quadruple Amputations due to
Buerger's disease with Refractory Pain Treated with Life-preserving
Kidney-Qi Pill, Hokkaido Study Group for Kampo Treatment of Elderly
Patients, 7th Conference 1998 (presentation)7) Kaneuchi H.: Comparison of Raynaud's Phenomenon in Patients with
Connective Tissue Diseases and Thermographically Observed Skin
Temperature - Pharmacologic Evaluation of Evodia, Fresh Ginger plus
Chinese Angelica Cold Limbs Decoction , Summaries from the Public
Toyooka Hospital 11: 69-76, 1999

Orthostatic hypotension is a good indication for
Kampo therapy. Here Tuckahoe, Cassia Twig,
Largehead Atractylodes and Licorice Decoction, Poria
Powder with Five Herbs and similar preparations areused8,9). Controlled clinical trials regarding thetreatment of diabetics with orthostatic hypotension
using Poria Powder with Five Herbs have beenreported and demonstrated good results10). Moreover,
North Water God Decoction, Pinellia, Largehead
Atractylodes and Tall Gastordia Decoction and similar
preparations have also been used for the treatment ofhypotension.
8) Shiotani Y., Shintani T., Fujinaga H. et al.: Discussion of the Modes of
Action of Tuckahoe, Cassia Twig, Largehead Atractylodes and Licorice
Decoction and its Clinical Application, Kampo Medicine (Jap. Journal of
Oriental Medicine) 50(1): 21-28, 1999
9) Shibahara N., Goto H., Kita T. et al.: Two Cases of Orthostatic Hypotension
Where the Use of Tuckahoe, Cassia Twig, Largehead Atractylodes andLicorice Decoction was Effective - a discussion, Kampo Medicine (Jap.
Journal of Oriental Medicine) 53(6): 244
10) Nakamura H., Nakamura T., Nakagawa T. et al.: Effects of Poria Powder
with Five Herbs on Orthostatic Hypotension in Diabetics, Diabetes Frontier
11: 561-563, 2000

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9. Blood
In TCM there are such concepts as blood deficiency
and blood stasis. Although they do somewhat resemble
hematologic diseases like anemia or congestion as they
are understood in modern medicine, they are inpractice different concepts. Accordingly, when treating
diseases of the blood with Kampo medicine, anintegration of these traditional and modern medical
concepts has to be achieved.
For the treatment of diseases that can be treatedwith current medical methods, there is little use of
Kampo medicine, but in cases where standard
therapeutic methods cannot be established, they may
have their practical application. Aplastic anemia or
idiopathic thrombocytopenic purpura (ITP) are
examples.
Anemia may have many causes and therapy
depends on the relevant cause. Iron deficiency anemia
is treated using preparations with added iron powder,but currently iron can also be administered orally or
intravenously, so that former methods have now
become redundant. Thus, with the progress of modern
medicine, Kampo medicine in this field is used only
under special circumstances.
For example, if substantial blood loss isanticipated during major surgeries, autologous blood issometimes collected prior to surgery and thus
artificially induces anemia. Under these circumstances
attempts have been made to achieve an early recovery
through treatment with Kampo medicine 1,2).
Regarding leukemia and other myeloproliferative
disorders, modern medical therapies are given priority.
There is only a limited number of reports about
treating these disorders with Kampo medicine. The
same applies to lymphomas.
Idiopathic thrombocytopenic purpura (ITP) is nottreated easily with Kampo medicine, but there areexamples where Back to the Spleen Decoction,
Modified Back to the Spleen Decoction, Bupleurumand Cassia Twig Decoction have led to favorable
changes3). This applies also to aplastic anemia or theosteomyelodysplastic syndrome for which there aresome cumulative studies4,5).
1) Aoe H., Matsuo T., Ebisutani M. et al.: Effects of Ten Strong Tonic Herbs
Decoction on Presurgical Autologous Blood Pooling in Cancer Patients,
Progress in Obstetrics and Gynecology 17: 67-71, 2000
2) Aoe H., Sumida Y., Takada K. et al.: Effects of a Combination Therapy with
Erythropoetin Preparations and Ginseng Nutrition Decoction on
Presurgical Autologous Blood Pooling, Progress in Obstetrics andGynecology 15: 67-71, 1998
3) Sakuragawa N., Yasunaga K., Nomura T. et al.: Multi-center Clinical
Evaluation of TJ-137 ( Modified Back to the Spleen Decoction ) for theTreatment of Idiopathic Thrombocytopenic Purpura (ITP), Clinics andResearch 70(11): 3711-3718, 1993
4) Miyazaki T., Uchino H., Kimura I. et al.: Clinical Usefulness of EK108,
Ginseng Nutrition Decoction , for the Treatment of Aplastic Anemia,
Clinical Medicine and Pharmacology 10(11): 2591-2603, 1994
5) Miyazaki T., Uchino H., Kimura I. et al.: Clinical Usefulness of Ginseng
Nutrition Decoction for the Treatment of Osteomyelodysplastic Syndrome,
Clinical Medicine and Pharmacology 10(11): 2575-2590, 199424

10. Alimentary Tract
Diseases in this field are extremely common indaily life and an enormous variety of Kampo medicines
are provided for their treatment. An abundance of
preparations are used that allow minute responses.
Among the forms of dyspepsia, functional
indigestion is a good indication for Kampo therapy. For
symptoms like pain or discomfort mainly in the upper
abdominal region (upper abdominal distention,
burning sensation, tympanism, yawning, nausea,
retching, vomiting) the use of Kampo medicines should
be considered, because they may be more useful thanfor other symptoms. Frequently used preparations
include Pinellia Heart-Purging Decoction, Coptis
Decoction, Bupleurum and Cassia Twig Decoction,
Stomach-Calming Powder, Stomach-Calming Powder,
Middle-Soothing Powder , Tuckahoe Decoction,
Ginseng Decoction etc. Many reports deal with NUD
and there are relevant cumulative studies1). Available
data suggest that the preparation Six Gentlemen
Decoction facilitates the excretory function of thestomach and a number of studies revealed theeffectiveness of this preparation2,3,4,5). Not restricted tothese preparations, there are also a number of otherformulas for indefinite complaints of the upper
abdomen. In particular, Stomach-Calming Powder
suits the physical disposition of the Japanese, who areeasily affected by dampness, and for people who areexposed to cold, Middle-Soothing Powder is afrequently used formula. For the above describedreasons these two formulas are widely used as OTC
preparations.
1) Muraki T., Sugiyama M.: Kampo Therapy of NUD (Non-Ulcer Dyspepsia) Discourse on Kampo preparations - New Drugs and Clinics 46(4): 433-437, 1997
2) Harasawa S., Miyoshi A., Miwa T. et al.: Postmarketing Multi-Facility Joint
Clinical Trial on the Effects of Six Gentlemen Decoction on Dysmotility
Type Indefinite Complaints of the Upper Abdomen - intergroup comparisonin double-blinded groups, Progress in Medicine 187(3): 207-229, 1998
3) Miyoshi A., Yachi A., Masamune O. et al.: Clinical Effects of Six Gentlemen
Decoction on Indefinite Gastrointestinal Symptoms like Chronic Gastritis Multi-Facility Comparative Trial Using Cisapride as Control, Prog. Med.
11: 1605-1631, 1991
4) Hamamoto T., Kadohara M., Yoshimura T. et al.: Multi-Facility Clinical
Evaluation of Six Gentlemen Decoction for Indefinite Complaints of theUpper Abdomen, Clinics and Research 71(7): 1888-1894, 1994
5) Sato J., Shima H., Asaki S. et al.: Multi-Facility Clinical Evaluation of Six
Gentlemen Decoction for Chronic Gastritis Associated with Indefinite
Complaints of the Upper Abdomen, Prog. Med. 11: 1633-1645, 1991

While Kampo medicine provides a variety of
formulas for the treatment of constipation, it attempts
to regulate intestinal function without using laxatives
to improve bowel movements. For conditions requiring
the use of laxatives, Formula include Rhubarb, inparticular Rhubarb and Licorice Decoction, isfrequently used 6). This is a very simple preparation
combining only the crude drugs Daio (rhubarb root)and Kanzo (licorice root) that is mild and regularly
used by many people in whom constipation is not
associated with abdominal pain. For scybalum Hemp
Seed Pill with its "moistening the intestines to loosen

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Volume 1, Special Edition | Current Kampo Medicine 2005

the bowel" action is used, a condition particularly frequentin the elderly with an accordingly high demand 7).
Conversely, Minor Middle-Strengthening Decoction or
Major
Middle-Strengthening
Decoctionarepreparations lacking any laxatives and therefore serve
to regulate intestinal function.

11) Namiki M., Yachi A., Yoshida Y. et al.: Investigation into the Usefulness ofThree Huang Heart-Clearing Decoction with Three yellow color Herbs andCoptis Detoxificating Decoction for the Treatment of Gastritis or Peptic
Ulcer, Clinics and Research 71: 1585-1597, 1994
12) Watanabe H.: Examination of Maintenance Therapy for Peptic Ulcer Using a
Combination with Kampo Medicine, Kampo Igaku, Vol. 19, No.1: 6-7, 1994
13) Haimoto H.: Isolated Kampo Therapy for the Acute Phase of
Gastroduodenal Ulcer 3(1): 4-6, 2001

6) Miyoshi A., Masamune O., Fukutomi H. et al.: Clinical Effects of Rhubarb
and Licorice Decoction According to New Evaluation Criteria, Alimentary
System 22: 314-328, 1996
7) Sato H.: Elderly and Kampo (constipation, diarrhea, loss of appetite, gastricdistention), Kampo and advanced therapies for disorders of the alimentarytract 2(1): 15-18, 1993

Irritable bowel syndrome in Japan is exceedingly
frequent, found in about 35% of outpatients visiting
departments of gastrointestinal diseases. This disease,
being a sort of psychosomatic disease, may not be easily
resolved by using Kampo medicine, but is generally
considered to be a good indication for frequently usedpreparations like Pinellia Heart-Purging Decoction or
Cassia Twig Decoction plus Peony. Classified by types
Ginseng Decoction, North Water God Decoction,
Ginseng, Poria and Atractylodes Macrocephala Powder ,Open the Spleen Decoction and similar preparations
are used for the treatment of the diarrhetic type, while
for the constipation type Modified Merry Life Powder,
Rhubarb and Licorice Decoction, Hemp Seed Pill,
Cassia Twig Decoction plus Piony and Rhubarb areused. For a form characterized by alternating
constipation and diarrhea Cassia Twig Decoction plus
Peony, Cold Limbs Powder, Important Formula for
Painful Diarrhea and the like are used, but for the gas
type associated with abdominal pain Areca Seed
Decoction with Nine Herbs or Cyperus and Perilla Leaf
Powder is used. There is an extremely large number ofcase reports, and for Cassia Twig Decoction plus Peony,
Stomach-Calming Powder and Cyperus and Perilla
Leaf Powder also cumulative studies14,15,16,17).

Among the forms of diarrhea, acute diarrhea isprincipally an indication for western medical
treatment. Poria Powder with Five Herbs is very
effective for the treatment of rota virus induced acutegastroenteritis, so that this is an often selected
preparation8). This applies also to Norwalk virus
induced conditions. Most of the chronic forms ofdiarrhea are non-inflammatory and among these asubstantial portion is considered to be due to irritablebowel syndrome (IBS). The treatment of IBS conforms
to that of diarrhea. Crohn's disease and ulcerative
colitis will be discussed later.
8) Hashimoto H.: Comparative Study of Applications of Poria Powder with
Five Herbs and Minor Bupleurum Decoction, Poria Powder with Five Herbs
Applied as Enemas as Treatment for Pediatric Viral Gastroenteritis
Associated with Vomiting, Kampo Igaku 25: 73-75, 2001

Among the diseases of the stomach and duodenum,
H. pylori induced gastritis can now be relieved due tothe advances in antibacterial therapies, so that therole of Kampo medicine has declined in this field. Yet,
Kampo preparations are still used as a first choicetreatment for this disease. The prescriptions match
those described above for indigestion. For Pinellia
Heart-Purging Decoction there are some cumulative
studies9). Six Gentlemen Decoction is used forendoscopically confirmed erosive gastritis and hasreportedly been associated with a 92.9% ratio of better
than mild improvement 10).
9) MiyoshiA., Murohisa B., Kitagawa M. et al.: Examination of the Usefulnessof Kanebo's Pinellia Heart-Purging Decoction for the Treatment of Gastritis(Acute Gastritis, Acute Exacerbations of Chronic Gastritis), Prog. Med. 13:
1627-1632, 199310) Makino S., Yasutake K., Irie K. et al.: Effects of Six Gentlemen Decoction
on Verrucose Gastritis, Kampo Igaku Vol. 20, No. 6: 17-21, 1996

Currently H2-blocker and proton pump inhibitors
are available for the treatment of gastroduodenal
ulcers, so that Kampo medicine is used only in a
supplementary function. Regarding the use of Three

Huang Heart-Clearing Decoction with Three yellow
color Herbs and Coptis Detoxificating Decoction there

are cumulative studies11). Moreover, Kampo medicine
is also administered in patients in whom peptic ulcers
have healed, in order to prevent their recurrence andreportedly have been proven to be useful12). Also, anumber of case reports showed that Kampo therapy
was effective, when modern medications could not be
used for one reason or other13).

14) Sasaki D., Uehara A., Hiwatashi N. et al.: Clinical Effects of Cassia Twig
Decoction plus Peony on Imitable Bowel Syndrome, Clinics and Research
75: 1136-1152, 199815) Mizuno S., Nagata K., Yoshida K. et al.: Therapeutic Effects of Cassia Twig
Decoction plus Peony on Imitable Bowel Syndrome, Diagnosis and Therapy
73: 1143-1152, 1985
16) Tokutomi K.: Results of Using Stomach-Calming Powder for Imitable
Bowel Syndrome, Kampo and Clinics 43: 1187-1194, 199617) Shiramine K., Hisamura M., Akita K. et al.: Effects of Cyperus and Perilla
Leaf Powder on Gas Type Irritable Bowel Syndrome, Kampo Igaku Vol. 23,
No. 2, 1999

Crohn's disease is an intractable condition forwhich there is a small number of valuable casereports18). Treatment is not aimed directly at thisdisease, but rather at the symptoms of ileus that may
be caused by it and the available cumulative research
revealed its usefulness19).
18) Kogure T., Shimada Y., Tosa H. et al.: A Patient with Recurrent Crohn's
Disease in whom Treatment with Japanese Kampo Medicine Proved to beHighly Effective, Kampo Medicine (Jap. Journal of Oriental Medicine)19) Takazoe M., Yamauchi H.: Attempt at Medical Treatment of Symptoms ofIleus in Crohn's Disease: Usefulness of Major Middle-Strengthening
Decoction , Research Team for the Investigation of Refractory Inflammatory
Intestinal Disorders, 1997 Research Report: 137-141, 1998

Ulcerative colitis responds well to treatment with
Kampo medicine and numerous studies have been

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Volume 1, Special Edition | Current Kampo Medicine 2005

performed 20,21). In mild cases Kampo may be used
independently, but in intermediately to severe cases
Kampo is administered in the form of a combination
therapy with salazopirine or steroids. Used extracts
include Cassia Twig Decoction plus Peony , Cassia Twig
Decoction plus Piony and Rhubarb, Minor Bupleurum
Decoction, Poria Powder with Five Herbs, Bupleurumand Cassia Twig Decoction, Scutellaria Decoction,

pain associated with spasms of the internal sphincter
muscle of the anus, Peony and Licorice Decoction isadministered and, according to a number of studies,
produced favorable results30). Moreover, for thetreatment of incarceration of hemorrhoids Ephedra,
Apricot, Licorice and Gypsum Decoction is used andoccasionally has produced dramatic results, but thisusage is peculiar to Japan.

preparations; but for serious therapy, decoctions are
required. There is cumulative research regarding28) Yoshio T., Ynagida K., Sumiyama Y. et al.: Clinical Effects of ”B”Character
Decoction on Internal Hemorrhoids, New Drugs and Clinics 40: 2087-2096
29) Honda T. et al.: Women and Hemorrhoidal Diseases, No. 4 - Effects of
Kampo ( ”B” Character Decoction ) - Maternal Hygiene Vol. 31, No. 1, 1990
30) Endo T.: Clinical Results of the Application of Peony and Licorice Decoction
for Pain Associated with Spasms of the Internal Sphincter Muscle of Anus
Due to Anal Laceration, New Drugs and Clinics 49: 712-719, 2000

Szechwan Lovage Rhizoma, Angelica Root, Ass-hide
Glue and Argy Womwwod Leaf Decoction and similar
Minor Bupleurum Decoction, Poria Powder with Five
Herbs22,23).

20) Matsuike T., Suzuki Y., Nozawa H. et al.: Significance of Kampo Therapy
for the Treatment of Ulcerative Colitis, Prog. Med. 19(4): 879-885, 199921) Takahashi T.: Kampo Therapy for Inflammatory Bowel Diseases(Ulcerative Colitis, Crohn's Disease), Kampo and Advanced Therapies 5(3):225-229, 199622) Suzuki Y., Matsuike T., Nozawa H. et al.: Indications for and Limitations of
Minor Bupleurum Decoction, Poria Powder with Five Herbs in theTreatment of Ulcerative Colitis, Current Medicine 11: 132-136, 199623) Okubo A., Masuda H., Hayashi N. et al.: Experiences with the Use of
Kampo Therapy ( Minor Bupleurum Decoction, Poria Powder with Five
Herbs ) for Ulcerative Colitis, Medical Journal of Nippon University 55:
286-289, 1996

Kampo medicines are also useful in the field of
abdominal surgery. There is cumulative research
regarding the use of Major Middle-Strengthening
Decoction for the treatment of Ileus caused byabdominal surgery24,25,26,27). Moreover, in a departmentof abdominal surgery, Major Middle-Strengthening
Decoction was administered to facilitate the recovery
of intestinal peristaltic, which resulted in a shorteningof the hospital stay by several days. Consequently, thisis useful in improving cost efficiency.
Kubo N., Uchida Y., Akiyoshi T. et al.: Effects of Major
Middle-Strengthening Decoction on Ileus - Multi-facility study, Prog. Med.

24)

15 (9): 1962-1967, 1995
25) Yokota H., Kobayashi H., Kasamaki S. et al.: Research into the Preventionof Postsurgical Adhesive Ileus, Japan Medical News 3986: 16-18, 2000
26) Sugiyama M.: Investigation of the Usefulness of Major
Middle-Strengthening Decoction for Postsurgical Adhesive Ileus, Prog. Med.
12: 1668-1372, 1992
27) Furukawa Y., Kawasaki N., Hanyu N.: Effects of Major
Middle-Strengthening Decoction on Ileus Following Surgery of Alimentary
Tract - Basics and Clinics - Kampo and Advanced Therapies 12(3): 235-241,
2003

Among the diseases of the anus, hemorrhoids andhemorrhoidal bleeding are indications for Kampo
therapy. For hemorrhoids, the preparation ”B”
Character Decoction, developed in the 19th century bya Japanese physician, is widely used and there are
relevant cumulative studies28). Clinically, dependingon the pathologic condition, this is frequently
combined with 'activating blood and resolving stasis’,‘'clearing heat and removing toxins’, ‘Qi tonifying’ and‘upraising’ preparations. In puerperal women,
attention has to be paid to hemorrhoids that do not
improve within one month following delivery. Some
cumulative studies show the results of the applicationof this preparation in such patients29). Conversely, for26

11. Liver, Biliary Tract and Pancreas
Among the lesions of the liver, those associatedwith icterus used to be major indications for thistherapy for diseases like acute hepatitis A and the
below described lesions of the gallbladder. Beside these
conditions, the final stage of hepatocytic damage livercirrhosis and a number of complicating conditions
were the subject of initial therapeutic attempts. Since
therapeutic interventions during the early stages ofchronic hepatitis recently became possible, and in
conjunction with the progressive clarification of the"state of disease" even for other forms of liver diseases,
Kampo therapies using Kampo preparations have beendeveloped. Kampo medicine is frequently used forchronic viral hepatitis, regardless of whether this is
hepatitis B or C. Some DB-RCT studies examined theuse of Minor Bupleurum Decoction for the treatment of
hepatitis B and reportedly achieved significantly
better results than in the control groups1). Yet, many
physicians do not consider Minor Bupleurum
Decoction to be the ideal preparation and administer it
rather as a decoction that can be freely modified 2,3,4,5,6).
The other comparatively frequently used extracts
include Modified Merry Life Powder, Minor

Bupleurum Decoction plus Cassia Twig and Tuckahoe
Pill, Bupleurum and Cassia Twig Decoction,
Bupleurum Cassia Twig and Dried Ginger Decoction

and similar preparations. A number of physicians havepointed out that histologically the morphology ofhepatitis C differs from that of hepatitis B, and viewed
from the standpoint of Kampo medicine, deficiency
patterns are more frequent; so that prescriptions varyfrom those applied for hepatitis B. Middle-Reinforcing
and Qi-Benefiting Decoction, Summer Heat-Clearing
and Qi-Benefiting Decoction, Six Gentlemen Decoction
and similar spleen and stomach tonifying preparations
are used 7,8,9). Recently, combination therapies using
PEG-interferon and ribavirin have become thestandard therapy, but available data indicate that afurther combination with Kampo medicines achieves
better results. There are cumulative studies dealing
with interferon combination therapies. Moreover,regarding transition from hepatitis C to liver cirrhosis
following an interferon therapy, a number of excellent

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Volume 1, Special Edition | Current Kampo Medicine 2005

studies show significantly better effects than forordinary liver protective drugs10).
1) Mizuta M., Murata K., Morimoto T. et al.: Evaluation of Minor Bupleurum
Decoction for the Treatment of Chronic Hepatitis - Investigation Using
Single and Double Blinded Studies - Liver, Gallbladder, Pancreas 12(1):155-168, 1986
2) Fujiwara K., Mochida S.: Kampo Therapy for Diseases of the Liver,
Gallbladder and Pancreas - Kampo therapy for viral hepatitis - Kampo andAdvanced Therapy 5(3): 240-246, 1996
3) Itoh T.: Effect of Kampo Treatment on chronic viral hepatitis on the basis of
traditional diagnosis, Journal of Traditional Medicines 16（1）: 7-14, 1999
4) Nakada K., Furue M., Takakuwa H. et al.: Kampo Therapy for Chronic
Liver Disorders, Japanese Oriental Medical Journal 33(3): 25, 1983
5) Baba H.: Effects of Modified Merry Life Powder in the Treatment of Chronic
Hepatitis, Kampo Medicine (Jap. Journal of Oriental Medicine) 33(4): 29-34,
1983
6) Haimoto H.: New Traditional Chinese Medical Therapies for Chronic Active
Hepatitis - Pilot study dealing with detoxification/resolving phlegm/
activating blood - Clin. J. Trad. Chin. Med. 16(2): 146-150, 1995
7) Ito T., Nagasaka K., Kita T. et al.: Clinical Effects of Middle-Reinforcing and
Qi-Benefiting Decoction in the Treatment of Patients with Chronic
Hepatitis C - Correlation between the presence of Qi deficiency pathology
and effectiveness - Kampo Medicine (Jap. Journal of Oriental Medicine)50(2): 215-223, 1999
8) Shimizu H.: Hepatitis C - Concepts and Therapies - Clin. J. Trad. Chin. Med.
15(4): 370-374, 1994
9) Kumada H.: Effects of Minor Bupleurum Decoction for the Treatment of
Hepatitis C Non-responsive to Interferon, Clinics of Adult Diseases 24(8):1103-1109, 1994
10) Nakajima O., Sone Y., Onishi H. et al.: Inhibitive Effects of Minor
Bupleurum Decoction on the Progression from Hepatitis C to Liver
Cirrhosis, Clinics and Research 76(5): 1008-1015, 1999

Regardingautoimmune
hepatitis,
reports
indicated that in individual cases certain ingenuous
modifications of the prescriptions led to a relief of thesymptoms, while the standard therapy with steroids
was used more in the sense of a complementary
therapy and thus allowed a gradual dose reduction oreven interruption of the steroid therapy. Certain
cumulative studies document the latter case using

Minor Bupleurum Decoction, Poria Powder with Five
Herbs11).

11) Masuda A., Kajii N., Omura R. et al.: Therapeutic Effects of Minor
Bupleurum Decoction, Poria Powder with Five Herbs on Autoimmune
Hepatitis Regarding Steroid Dose Reduction and Relief of Side Effects Diagnosis and Therapy 81(4): 911-915, 1993

Fatty liver (both alcoholic and non-alcoholic fatty
liver diseases) is caused mainly by alcohol
consumption,
obesity,diabetes
mellitus,
hypertriglyceridemia etc. To improve these factors, inparticular the fatty liver due to overfeeding, Major
Bupleurum Decoction was administered and found in
cumulative studies to be useful12).
12) Ishioka T., Miura H., Shinoi T. et al.: Clinical Research into the Effects ofMajor Bupleurum Decoction on Fatty Liver due to Overfeeding, Basics andClinics: 4425-4431, 1992

Regarding liver cirrhosis, the state of disease in
Kampo terms differs for the compensated anddecompensated phases, so that the type of preparation
varies.
During the compensated phase, the therapy
follows the therapy for chronic hepatitis, but fibrosis ishere viewed as a manifestation of blood stasis, so that
often activating blood and resolving stasis medicinals

are added. The decompensated phase calls mainly forskillful management of water metabolism, requiring
foremost combinations of diuretics13). In extremelyrare cases, administration of large doses of Poria
Powder with Five Herbs reportedly resulted in theovernight disappearance of large amounts of ascites14).
Moreover, the use of Poria Powder with Five Herbs inpatients with decompensated liver cirrhosis associatedwith ascites non-responsive to diuretics, hadreportedly been effective in 40% of the patients15). The
above described studies used extracts, but generally
decoctions are prescribed for decompensated livercirrhosis. Middle-Reinforcing and Qi-Benefiting
Decoction, Qi-Reinforcing and Middle-Being Healthy
Decoction, Separate and Reduce Decoction, Areca Seed
Decoction with Nine Herbs, Bolster the Spleen
Decoction, North Water God Decoction, Augmented
Five-Ingredient Powder with Poria and similar
formulas arebasic preparations. Conversely,
cumulative studies showed that treatment with
GinsengNutrition
Decoction
improved
thethrombocytopenia associated with liver cirrhosis. 16).
13) Okubo H., Amaki S., Fujita S. et al.: Kampo Therapy for Liver Cirrhosis,
Kampo and Advanced Therapies 5(3): 247-252, 1996
14) Imadaya A. et al.: Elimination of Refractory Ascites Through Sweating - A
case treated with large amounts of Poria Powder with Five Herbs extracts Kampo Medicine (Jap. Journal of Oriental Medicine) 32(4): 37-42, 1981
15) Takamori S., Furuki T., MiyazakiT. et al.: Investigation of the Usefulness
of Poria Powder with Five Herbs for the Treatment of Compensated Liver
Cirrhosis, Kampo Igaku 13(10): 300-305, 1989
16) Iwata K., Kamimura S., Shijo S. et al.: Administration of Ginseng
Nutrition Decoction for the Treatment of Liver Cirrhosis - In particularregarding the effects on thrombocytopenia, Clinics and Research 72(3):746-750, 1995

Some research has been done on the inhibition of
the progression from liver cirrhosis to liver cancer
through administration of Kampo medicines. Thesestudies
clearly
showedthatthroughtheadministration of Minor Bupleurum Decoction or Ten
Strong Tonic Herbs Decoction the incidence of livercancer decreased significantly 17,18). Recent publishedstudies indicated this as a possible mechanism for thefunctioning of Minor Bupleurum Decoction as a radical
scavenger.
17) Oka H., Yamamoto S., Kuroki T. et al.: Prospective Study of
Chemoprevention of Hepatocellular Carcinoma with Minor Bupleurum
Decoction （Tj-9）, Cancer 76(6): 743-749, 1995
18) Higuchi K., Watanabe A.: Investigation of the Inhibition of the Progression
from Liver Cirrhosis to Liver Cancer Through Administration of Ten Strong
Tonic Herbs Decoction Methods in Kampo Pharmacology 5: 29-33, 2000

Gallstones, excluding asymptomatic cases, arecurrently removed by endoscopic cholecystectomy.
While today the surgical removal constitutes thegeneral form of treatment, this condition used to be agood indication for Kampo medicine. Even today
Kampo medicines are used in some selected cases.
Major Bupleurum Decoction is a representative
preparation and there are 2 cumulative studies
dealing with it19,20). The removal of stones with Chinese
medicine is not performed in Japan. Regarding

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27

Volume 1, Special Edition | Current Kampo Medicine 2005

cholecystitis or choledocholithiasis there are some casereports, but generally these conditions are notconsidered to be indications for Kampo therapy.
19) Shoda J., Matsuzaki, Y., Tanaka N. et al: The inhibitory effects of
dai-chai-hu-tang (dai-saiko-tou) extract on supersaturated bile formation incholesterol gallstone disease. Am. J. Gastroenterol 91(4): 828-30, 1996
20) Fujita K.: Effects of Major Bupleurum Decoction for Cholelithiasis Attacks,
Kampo Medicine (Jap. Journal of Oriental Medicine) 45(2): 411-421, 1994

Among diseases of the pancreas, mild forms ofacute pancreatitis are an indication for Kampo
medicine, but usually are treated with western
medicine, so that there are only few case reports andno cumulative studies. During the intermittent phasesof compensated chronic pancreatitis, this condition isfrequently treated with Kampo medicine. Yet, there
are only a few published studies. Tanaka et al.
reported on Kampo therapy used with 62 patients
presenting hyperamylasemia, who were suspected tosuffer from chronic pancreatitis. Combined efficiency
was 38.8%, and among the preparations, Bupleurumand Cassia Twig Decoction was used in 15 patients,
Liver-Soothing Decoction in 16, Pinellia Heart-Purging
Decoction in 9, Life-Prolonging Pinellia Decoction in 6,
Middle-Soothing Powder plus Tuckahoe in 4, Nourish

the Stomach Decoction with Aucklandia and Amomumin 5 and Galanga and Bitter orange Decoction in 3
patients21). The efficacy in this trial was notparticularly high, but the trial included mostly
patients that had already consulted multiple western
medical facilities and for whom Kampo therapy
eventually became the final resort. When taking thissituation into consideration, the standard results
would probably be evaluated higher.
21) Nakada K., Hosono Y., Hosono H. et al.: Kampo Therapy of Chronic
Pancreatitis, Kampo Medicine (Jap. Journal of Oriental Medicine) 36(4):25-44, 1986

12. Gynecology
Since women have menstruations and give birth,the necessity to comprehend pathologic conditions thatdiffer from those in men has been recognized sinceancient times. Traditionally, the Jin gui yao lue,compiled by the end of the second century establisheda specialty of treating women. Later in the "Qian jinfang" (compiled by the middle of the seventh century),
the section on gynecology was put at the top of thisscript. In Japan, this field was separated from otherfields since the 15th century and in the first half of the
18th century Genetsu Kagawa (1700-1777) discovered
approximately at the same time as the British William
Smellie, that the fetus assumes an inverted position
within the uterus and developed a large number ofinnovative techniques and preparations. Current
gynecologists and obstetricians still inherit thistradition, skillfully using a small number of Kampo
medicines for the relevant therapies. Many of thediseases in this field are indications for Kampo
28

therapy based on experience.
Regarding abnormal bleeding prior to menopause,
Kampo medicines are frequently used for both
hypermenorrhea and dysfunctional uterine bleeding.
Generally hormone therapy is performed, but specialists
also use Kampo therapy either as an adjunctive or
independent therapy. There are cumulative studies
regarding Szechwan Lovage Rhizoma, Angelica Root,
Ass-hide Glue and Argy Womwwod Leaf Decoction1,2,3).
Naturally, in the presence of organic disease, modern
medical treatment is given priority.
1) Iwabuchi S.: Hemostatic Effects of Szechwan Lovage Rhizoma, Angelica
Root, Ass-hide Glue and Argy Womwwod Leaf Decoction on Dysfunctional
Uterine Bleeding, Kampo Medicine (Jap. Journal of Oriental Medicine) 50:
883-890, 2000
2) Hatano K., Terawaki S., Tomonari S.: Hemostatic Effects of Szechwan

Lovage Rhizoma, Angelica Root, Ass-hide Glue and Argy Womwwod Leaf
Decoction , Medical Journal of the Oita Prefectural Hospital 14: 95-103,
1985
3) Inaba Y., Hori S., Hosoi N. et al.: Treatment of Dysfunctional Uterine
Bleeding with Szechwan Lovage Rhizoma, Angelica Root, Ass-hide Glueand Argy Womwwod Leaf Decoction Extract, Obstetrics and Gynecology 8:
825-836, 1983

Premenstrual tension syndrome (PMS) is a good
indication for Kampo therapy. Presenting as a typical
pattern of Qi stagnation and blood stasis, treatment
with Kampo medicine has already developed into astandard 4). The representative preparation Modified
Merry Life Powder is frequently used, while Angelica
and Peony Powder, Cassia Twig and Tuckahoe Pill,
Warm the Menses Decoction and Goddess Powder are
also widely used.
4) Ushiroyama T.: Kampo Therapy for Dysmenorrhagia and Prementrual
Syndrome, Kampo Therapeutic Manual for Physicians Specializing in
Gynecology (Nagai Publications): 56-59, 2003

Dysmenorrhagia is almost always associated with
Oketsu (blood stasis) so that blood activating andstasis resolving medicinals are used in relevantprescriptions. Cassia Twig and Tuckahoe Pill is afrequently used preparation and besides this, Peach
Kernel Purgative Decoction, Negotiation Decoction,
Modified Merry Life Powder and similar preparations
are also widely used. When channel warming and cold
dispelling (Onkei Sankan) is required, Evodia, Fresh
Ginger plus Chinese Angelica Cold Limbs Decoction or
Middle-Soothing Powder may be considered.
Middle-Soothing Powder is reportedly very effective
for menorrhalgia associated with marked stomach cold
affecting the entire body. In cases of blood deficiency,
Angelica and Peony Powder, or for spleen deficiency
Minor Middle-Strengthening Decoction or else
Angelica
Middle-Strengthening
Decoctionarecommonly used. As a special use, the short-term
administration of Cassia Twig and Tuckahoe Pill
during menstruation has been recommended andproduced favorable results5). Moreover, research
conducted in recent years clearly showed that Peonyand Licorice Decoction inhibits the prostaglandin

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Volume 1, Special Edition | Current Kampo Medicine 2005

production, so that attempts have been made toadminister this preparation in synchronization withthe menstrual cycle6). Secondary dysmenorrheal, due
to endometriosis or submucosal myomata, is also agood indication for Kampo therapy, but often thewestern medical treatment receives priority.
5) Ota H., Tanaka T., Kushima T.: Short-term Administration of Cassia Twig
and Tuckahoe Pill During Menstruation for the Treatment of
Dysmenorrhea, Progress of Kampo Research in Gynecology and Obstetrics
17: 48-50, 2000
6) Imai A, Ito M., Tamaya T.: Mechanisms of the Inhibition of Prostaglandin
Production by Peony and Licorice Decoction , Kampo Igaku 20: 218-221, 1996

Regarding irregular menstruation Cassia Twig
and Tuckahoe Pill, Peach Kernel Purgative Decoction
and similar blood acitivating and stasis resolving
preparations are widely used. In addition, Modified
Merry Life Powder and like Qi stagnation blood stasis
formulas, blood tonifying preparations like Four Herbs
Decoction, Evodia, Fresh Ginger plus Chinese Angelica
Cold Limbs Decoction, Aconite and Ginseng Decoction
and the like Yang tonifying and cold dispellingprescriptions, Qi mobilizing drugs like Pinellia andMagnolia Decoction, Cyperus and Perilla Leaf Powder
or else heat clearing preparations like Coptis
Detoxificating
Decoction
or
Three
Huang

Heart-Clearing Decoction with Three yellow color
Herbs also find, their application depending on the14) Tanaka T.: Effectiveness of Cassia Twig and Tuckahoe Pill Extract Tablets
Administered with the Purpose of Avoiding Surgery in Endometriosis like
Diseases, WE No. 4: 7-8, 2003

Several clinical reports deal with ovarian
insufficiency. Studies in which Angelica and Peony
Powder was administered to all patients with ovarian
insufficiency showed a tendency towards increasing
concentrations of estrogen and progesterone during
the luteal phase15). Patients with various ovarian
disorders were treated either with clomiphene alone(52 patients) or a combination therapy of clomipheneand Angelica and Peony Powder (41 patients) and led
to the publication of highly interesting results16).
Moreover, when 34 patients with polycystic ovarian
syndrome (PCOS) presenting hypertestosteronemia
were treated with Angelica and Peony Powder, a
reduction in testosterone levels was reported for 30(91%) of these patients17).
15) Koyama T, Ohara M, Ichimura M. et al.: Effect of Japanese Kampo
medicine on hypothalamic-pituitary-ovarium function in women withovarian insufficiency, Am J Chin Med, 16: 47-55, 1988
16) Yasui T., Kahara M., Aono T. et al.: Investigation of the Efficacy of a
Combination Therapy of Clomiphene and Angelica and Peony Powder inPatients Without Ovarian Disorders, Journal of the Japan Society ofInfertility 40: 83-91, 1995
17) Takahashi K., Kitao M.: Polycystic Ovarian Syndrome (PCOS) and Kampo,
Gynecology and Obstetrics 42: 201-208, 1990

Smooth muscle myoma uteri is the most frequently
observed benign tumor of the female genitalia andthere are many reports about its treatment with
Kampo medicine9,10,11). The question whether the
myoma can be reduced in size using Kampo medicine
is very important and there have been several related
studies. Inoue et al. used Cassia Twig and Tuckahoe
Pill and measured the size of the myoma withultrasound. A number of studies reported the relevant
ratios of size reduction12,13).

Patients non-responsive to western medical
therapies for infertility are treated with Kampo
medicines, which often successfully lead to pregnancies.
Generally, Angelica and Peony Powder, Cassia Twig
and Tuckahoe Pill, Peach Kernel Purgative Decoction,
Warm the Menses Decoction, Modified Merry Life
Powder, Minor Middle-Strengthening Decoction, Ten
Strong Tonic Herbs Decoction and similar preparations
are used. Infertility in patients with hypertestosteronemia
or hyperprolactinemia is treated with Peony andLicorice Decoction, which reportedly leads to asignificant reduction in the concentration of both
hormones18,19). Moreover, in patients with antibodies
against sperm, treatment with Minor Bupleurum
Decoction, Poria Powder with Five Herbs has beenreported 20). Please refer to the section on urogenital
diseases regarding male infertility.

9) Sakagami S.: Myoma Uteri, Gynecology and Obstetrics 42: 79-91, 1990
10) Aiba S.: Is Kampo Effective? Gynecology and Obstetrics 45: 1192-1193, 1991
11) Dozono H.: Kampo Therapy of Myoma Uteri, Gynecology and Obstetrics
71: 669-672, 1995
12) Inoue S., Nakada M., Kataoka Y. et al.: Investigation of the Myoma Uteri
Size Reducing Effect of Cassia Twig and Tuckahoe Pill Measured with
Ultrasound, Progress of Kampo Research in Gynecology and Obstetrics 14:
59-62, 1997
13) Inoue S., Nakada M, Kataoka Y. et al.: Investigation of the Myoma Uteri
Size Reducing Effect of Cassia Twig and Tuckahoe Pill Measured with
Ultrasound (second report), Progress of Kampo Research in Gynecology and
Obstetrics 15: 57-62, 1997

18) Yanaginuma T., Okamura T., Takeuchi T. et al.: Blood Androgen
Concentration Lowering Effects of Peony and Licorice Decoction in Women
with Hypertestosteronemia, Ovulation inducing effects and safety multi-facility joint study, Journal of the Japan Society of Infertility 33:
606-616, 1988
19) Ito N., Omi Y., Inazawa N. et al.: Experiences with Peony and Licorice
Decoction in Women with Latent Hyperprolactinemia, Practice ofGynecology and Obstetrics 49: 1161-1164, 2000
20) Kano T., Furudo M., Okuyama K. et al.: Causes of Infertility in our Clinic
and Analysis of Treatment Results Obtained Mainly with Minor Bupleurum
Decoction, Poria Powder with Five Herbs , Japan Infertility Journal 38:
671-679, 1993

Endometriosis is frequently identified as the cause
for abnormal bleeding or secondary dysmenorrhea andKampo therapy is often attempted. The administrationof Cassia Twig and Tuckahoe Pill for the purpose of
avoiding surgery has been reported 14).

Generally, menopausal syndrome is treated withhormone therapy, but many physicians also consider
Kampo medicine to be a treatment of first choice.
According to an investigation by Margaret Lock, there

presenting pattern. In this area Kampo medicines areprescribed as a standard therapy 7,8).
7) Kawakami S., Umeki M., Ikuta Y. et al.: Kampo Therapy in our Clinic andits Effects on Irregular Menstruations, Progress of Kampo Therapy in
Gynecology and Obstetrics 21: 52-56, 2004
8) Ushiroyama T.: Kampo Knowledge for Gynecologists and Obstetricians, 6.
Kampo Therapy and relief from irregular menstruation (General Remarks)

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Volume 1, Special Edition | Current Kampo Medicine 2005

are major differences between symptoms reported byAmericans and Europeans on the one hand andJapanese women on the other. Japanese womenallegedly suffer from a greater variety and more severe
symptoms21). This is an appropriate view and in Japan
there is abundant experience with the application of
Kampo medicines that are used for very minutely
tuned treatments22). For hot flashes, Modified Merry
Life Powder, Coptis Detoxificating Decoction, Bupleurum
plus Dragon’s Bone and Oyster Shell Decoction,
Bupleurum Cassia Twig and Dried Ginger Decoction,
Warm the Menses Decoction and similar preparations,as well as for numerous indefinite complaints otherthan the above listed formulas. Drugs like Pinellia andMagnolia Decoction, Cyperus and Perilla Leaf Powder,

Tangerine Peel, Pinellia Rhizoma plus Liver-Inhibiting
Powder, Cold Limbs Powder, Goddess
Powder,Modified Back to the Spleen Decoction, Uncaria
Powder etc. are also selected depending on thepresenting pattern. There are also a number ofclinical studies23,24,25,26,27,28,29,30). The osteoporosis
associated with menopause is basically considered to
be a kidney deficiency and thus treated using Kidney
Qi Pill, Six Ingredient Pill with Rhemannia andsimilar preparations31). One report states that Kidney
Qi Pill is effective for the treatment of senile
vaginitis32).
21) Lock M.: Mythologies of Menopause in Japan and North America 1993
22) Ushiroyama T.: Kampo Therapy for Climacteric Disorders, Kampo
Therapeutic Manual for Physicians Specializing in Gynecology (Nagai
Publications): 50-55, 200323) Maruo T., Katayama K., Mochizuki M. et al.: Kampo Therapy for
Climacteric Disorders - in particular examination of the usefulness ofCassia Twig and Tuckahoe Pill, Gynecology and Obstetrics 45: 167-176,
199324) Morioka N., Wakatsuki A., Sagara Y. et al.: Effects of Modified Merry Life
Powder on Climacteric Disorders, Progress of Kampo Research in
Gynecology and Obstetrics 12: 79-85, 1993
25) Koyama T., Aso T.: Kampo Therapy for Women in Effulgant Fire Age,
Evaluation using simplified climacteric indices, Progress of Kampo
Research in Gynecology and Obstetrics 9: 30-34, 1992
26) Tamaya T., Ito M., Ito T.: Unidentified Clinical Syndrome, in Particular
Investigation of the Usefulness of Kampo Preparations for Climacteric
Disorders ( Bupleurum Cassia Twig and Dried Ginger Decoction , Modified
Merry Life Powder, Bupleurum plus Dragon’s Bone and Oyster Shell
Decoction), Kampo Medicine (Jap. Journal of Oriental Medicine) 44: 71-81,
199427) Nishimura K., Umekawa T., Kanazawa K. et al.: Experiences with Uncaria
Powder for the Treatment of Climacteric Disorders, Progress of Kampo
Research in Gynecology and Obstetrics 17: 125-127, 2000
28) Chimura T., Nakahara K., Miyata R. et al.: Clinical Effects of Modified
Merry Life Powder on Indefinite Complaints During Climacteric Disorders,
Medical Care and New Drugs 27(11): 18-24, 1990
29) Chimura T., Koseki K., Sanjo N. et al.: Clinical Effects of Modified Merry
Life Powder on Indefinite Complaints During Climacteric Disorders (II),Medical Care and New Drugs 29(3): 145-151, 1992
30) Sagara Y., Morioka N., Wakatsuki A.: Experiences with Modified Merry
Life Powder for the Treatment of Climacteric Disorders - In particularregarding evaluation methods of combinations of subjective and objective
symptoms - Gynecology and Obstetrics 60(2): 290-296, 1993
31) Ushiroyama T.: Kampo Therapy of Elderly Women - Urinary incontinence,arteriosclerosis, osteoporosis - Kampo Therapeutic Manual for PhysiciansSpecializing in Gynecology (Nagai Publications): 89-94, 2003
32) Inoue S., Ueno T., Kusanishi H. et al.: Therapeutic Effects of Six
Gentlemen Decoction on Senile Vaginitis, Progress of Kampo Research in
Gynecology and Obstetrics 17: 140-145, 2000

30

13. Obstetrics
Medical questions related to pregnancy andchildbirth have since ancient times been discussed
separate from other issues. In medical schools
established in the 8th century, women specialists weretrained in this field. Since the 15th century, obstetrics
was separated from the other medical specialities andrelevant specialists engaged in comparatively highlevels of medical practice. Marked progress wasachieved after the emergence of the aforementioned
Kanetsu Kagawa in the 18th century.
Pregnancy is associated with various disordersthat are treated with Kampo medicines1). For example,
for the treatment of the common cold during pregnancy,
Cyperus and Perilla Leaf Powder or Cassia Twig
Decoction are used instead of modern prescriptions.
Minor Pinellia Decoction plus Tuckahoe or Pinellia
and Magnolia Decoction have been used for morning
sickness. Cough during pregnancy has been treatedwith Dwarf Lilyturf Decoction. Angelica and Peony
Powder is administered by Japanese physicians toensure an uneventful pregnancy and Nakata et al.
reported "its administration during pregnancy
resulted in a 100% safe delivery ratio" 2). They also
reported that for "patients visiting our clinic because of
their inability to conceive or the occurrence of
spontaneous abortions early after conception, e.g.,patients with so-called "habitual abortion", Angelica
and Peony Powder is extremely effective, so that 4 outof 5 patients were safely able to conceive and deliver achild". Also, due to its inhibition of uterine
contractions, this preparation is expected to beeffective for the treatment of threatened abortion3).
Therapeutic attempts have been made with
Kampo medicine for Preeclampsia. The results ofobservations of the effect of Angelica and Peony
Powder in 5,000 pregnant women reported by Noguchi
et al. showed that in the treatment group the incidenceof preeclampsia decreased significantly 4). Kampo
medicines, including mainly diuretic preparations, will
be helpful for the prevention of this condition.

Szechwan Lovage and Angelica Decoction forRegulating Blood Flow is used to regulate the physicalcondition following delivery. This preparation, with its
blood activating and stasis resolving properties, wasdeveloped by a famous physician in China of the Ming
period to treat various postpartum symptoms. Later
this concept was inherited in Japan and thus led to its
present use. There are a number of case reports5).
1) Ushiroyama T.: Pregnancy and Kampo, Kampo Therapeutic Manual for
Physicians Specializing in Gynecology (Nagai Publications) P50-55, 2003
2) Nakata K., Yamaoka K., Konishi E. et al.: Clinics of Angelica and Peony
Powder, Kampo Medicine (Jap. Journal of Oriental Medicine) 28(3):101-107, 1978

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Volume 1, Special Edition | Current Kampo Medicine 2005
3) Chimura T. et al.: Effects of Treatment with Angelica and Peony Powder for
Threatened Abortion, Gynecology and Obstetrics 41(8): 722-731, 1989
4) Noguchi K.: Investigation of Patients with Preeclampsia Over the Past 10
Years in our Clinic, in particular regarding the administration of Kampo
medicine and maternal classes, Jap J Prim Care 8: 131-133, 1985
5) Kiuchi C.: Case Report: Szechwan Lovage and Angelica Decoction forRegulating Blood Flow: The Kampo for the Practical Physician, No. 6: 11-13, 2000

14. Arthritis and Musculoskeletal Disorders
Many of these disorders are associated with pain.
Amongpatients consulting
medical facilities
specializing in Kampo therapy, the most frequent
complaint is pain associated with the locomotor system.
The cervical syndrome, periarthritis humeroscapularis(frozen shoulder), low back pain, sciatica, gonarthrosis
and similar disorders are all good indications for
acupuncture therapy and equally good indications for
Kampo therapy.
Osteoarthropathy (osteoarthritis) is in daily life acommonly observed disorder. Among the patientsseeking Kampo therapy, gonarthrosis is the mostfrequent disorder and represents, unless the deformity
has reached a rather extreme degree, a good indication
for Kampo therapy1,2). The nature of this disorder in
the initial phase is mainly a dysregulation of water
metabolism, so that treatment results withpreparations suitable for the presenting pattern, even
if it is associated with the development ofhydrarthrosis, are comparatively good. Cassia Twig
plus Yu Bi Decoction and Stephania and Astragalus
Decoction are widely used preparations and often
rather effective. A number of cumulative studies
dealing with Stephania and Astragalus Decoction
show that the addition of Hobushi (prepared aconite
tuber) powder apparently improved the efficacy 3).
Cumulative studies about Yue Bi Decoction for
Relieving Edema plus Atractylodes showed significant
improvements in clinical findings and results ofsynovial fluid examinations of patients presenting
with local heat sensation, swelling and tenderness ofthe joints4). When these diseases run a somewhat
protracted course, blood stasis develops and thus
makes blood activating and stasis resolving
preparations like Cassia Twig and Tuckahoe Pill,

Szechwan Lovage andAngelica Decoction forRegulating Blood Flow necessary5). In case of severe
pain, aconite tuber is added.
When the disease has been present for a certain
period and is associated with severe deformations,acupuncture treatment or blood letting is usedconcomitantly. Naturally, inclusion of these treatment
forms is recommended right from the beginning.
1) Nagao K.: Comprehensive Oriental Medical Therapy of Gonarthrosis,
Kampo and Most Advanced Therapies 5(4): 343-348, 2000
2) Nishizawa Y., Nishizawa K., Amenomori Y. et al.: Analgesic Effects ofAnti-inflammatory drugs and Kampo Preparations for Bilateral
Gonarthrosis - Comparison of the capability for continuous locomotor
function and improvement of the quality of life, Pain and Kampo Medicine
8: 17-32, 1998

3) Otani T., Matsumoto H., Kawakubo M. et al.: Clinical Effects of Stephania
and Astragalus Decoction on Gonarthrosis, Journal of the Tokyo Knee
Society, The Tokyo Journal of Knee Joint 18: 31-33, 1998
4) Sugiyama S.: Effects of Yue Bi Decoction for Relieving Edema plus
Atractylodes for Gonarthrosis, Kampo Medicine (Jap. Journal of Oriental
Medicine) 48(3): 319-325, 1997
5) Matsumoto K.: Explanation of Kampo Preparations, Szechwan Lovage andAngelica Decoction for Regulating Blood Flow - First modification - On
Blood Stasis, Oriental Medicine 8(6)The use of Stephania and Astragalus Decoction inpatients in whom hydrarthrosis developed following
surgical removal of the lateral meniscus underorthoscopic observation reportedly led to favorable
results6).
6) Otsuka K.: Effects of Stephania and Astragalus Decoction in Patients After
Knee Surgery, Kampo Igaku 25(1): 15-17, 2005

Among the crystal arthropathy forms, gout is thedisease that is most frequently observed. Kampo
therapy is somewhat effective for acute attacks. The
pathology is viewed as damp heat and the preparations

Yue Bi Decoction for Relieving Edema plus
Atractylodes and Gentian Liver-Purging Decoction are
widely used for this condition. In case of severe pain
the treatment is combined with western medical
measures, but the independent use of Kampo is quite
effective and it remains useful even after the most
severe pain has subsided. Continuous use of the
preparation therefore, provides comparatively quick
relief of both swelling and pain. Currently, no
preparations have been reported, that would be able todefinitively decrease the hyperuricacidemia. Yet, there
are some theoretical hypotheses and a few case reports.
Neck pain is a frequently observed condition
among the pain syndromes. In Japan, this is often
called the cervical syndrome. Chronic neck pain inmost cases is caused by osteoarthropathy and isgenerally subject to conservative therapy. Yet, this is agood indication for acupuncture therapy. With thistreatment modality, pain is frequently relieved after
short treatment periods.
Kampo therapy appears to be extremely useful.
The muscles of the neck and shoulder are associatedwith the greater and brighter yang areas, so that
Pueraria Decoction by itself may be used to improve
pathologic conditions in these regions. Modifications
obtained by addition of Sojutsu or Bushi are alsofrequently used. Nishina administered Pueraria
Decoction to a total of 78 patients, including 41
patients with cervical spondylosis, 31 patients withcervical syndrome, 3 trauma patients and 3 patientswith other conditions and reported, that undersuitable conditions the treatment was effective in two
thirds of the patients7). Beside from Pueraria
Decoction, Cassia Twig Decoction plus Atractylodes
and Aconite, Channels-Dredging and Blood-Activating
Decoction, Swordlike Atractylodes and Largehead

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Volume 1, Special Edition | Current Kampo Medicine 2005

Atractylodes Decoction, Coix Seed Decoction andsimilar preparations are also used.
7) Nishina F.: Pueraria Decoction and the Pulse in Orthopedic Diseases,
Kampo Therapy Vol. 4, No. 3: 48-50, 1985

Reference

Although almost unnoticed in America and Europe, "stiffshoulders" is an extremely important symptom in Japan. An often
asked question is, whether the concept of "shoulder stiffness" isprevalent in Japan. Numerous works deal with this symptom andresearchers like Kuriyama have discussed this from a historicalpoint of view, which is of great interst from the perspective of
current Kampo medicine8) . In modern Japan this symptom
frequently observed in daily practice is not a disease, but still
disturbs daily life. Many researchers also view this condition as thepreliminary stage for the development of other diseases. For
example, the associated symptom of hypertension, one of thesymptoms preceding stroke (when the muscles of the neck stiffen,
this may interfere with the blood flow from the neck and thus leadto congestion of cerebral venous system and thus eventually tovessel rupture). Treatment of shoulder stiffness associated withcervical syndrome may help to improve the aforementioned
conditions, so that this is a very important symptom. Naturally,
acupuncture treatment and blood letting can provide instant relief,
but Kampo medicine can be very effective too. The most commonlyused preparation is Pueraria Decoction. A number of studies havethermographically investigated the effect of this formula onshoulder stiffness9).
8) Kuriyama S.: Reflections on Shoulder Stiffness, edited by Yamada,Kuriyama: Disease and Medicine in History, 37-62, Shibunkaku
Publications 1997
9) Yakubo S., Komaki K., Yagi H. et al.: Improvement of Shoulder Stiffness
Using Pueraria Decoction and Thermographic Investigations, Kampo
Medicine (Jap. Journal of Oriental Medicine). 47(5): 795-802, 1997

Whiplash injuries are a relatively common traumaof the neck. If the initial treatment is not successful, it
may result in a protracted course of the condition
which consists of a mixture of psychosomatic
symptoms that may prove to be difficult to heal. There
are a number of good Kampo preparations for thiscondition. During the acute phase, the conditions are
considered to be characterized by blood stasis. In order
to expel the formed blood stasis from the body,
preparations also including cathartics like For
Contusion Decoction or Dreging and Dissipating
Powder, are used. The chronic phase is considered to
be characterized by Qi stagnation and blood stasis andthus Modified Merry Life Powder is used. Whendampness accumulates within the muscles of the neck,preparations like Pueraria Decoction, Cassia Twig
Decoction plus Atractylodes and Aconite or Swordlike

Atractylodes and Largehead Atractylodes Decoction

are used.
Scapulohumeral periarthritis (frozen shoulder) is afairly common condition among Japanese and most areprobably due to disorders of the rotator cuff. It occurs
comparatively frequently in both men and women over
the age of 40. Based on the age of onset, the conditionis popularly called "50-year-old Shoulder" (pain in theshoulders around the age of 50). This too is a good
indication for acupuncture treatment and can
32

effectively be supplemented by Kampo medicine 10). For
neck pain preparations like Pueraria Decoction plus
Atractylodes and Aconite, Cassia Twig Decoction plus
Atractylodes and Aconite, Swordlike Atractylodes andLargehead Atractylodes Decoction or Coix Seed
Decoction are used. For cases of long standing, thepresence of blood stasis is considered, so that the
aforementioned drugs are used in combination withblood activating and stasis resolving preparations like
Cassia Twig and Tuckahoe Pill.
10) Ogawa H.: Scapulohumeral Periarthritis and Cervical Spondylosis, Kampo
and Most Advanced Therapies, 9(3): 229-234, 2000

For low back pain, acupuncture is the treatment of
first choice and supplemented by Kampo medicine; but
the latter is also very effective by itself. Yet, both
effectiveness and the choice of preparations varydepending on the etiology 11,12). Even in cases ofherniation of a lumbar intervertebral disk associatedwith radicular pain, treatment with Kampo medicine
may help to alleviate the symptoms. Among extract
preparations, Cassia Twig and Tuckahoe Pill, Evodia,

Fresh Ginger plus Chinese Angelica Cold Limbs
Decoction, Kidney Qi Pill, Channels-Dredging andBlood-Activating Decoction, Powder for Five Kinds ofStagnations etc. and among the decoctions
Yin-Tonifying Decoction, Angelica Pubescens andSanjisheng Decoction and similar preparations areused. In cases of severe pain, the addition of aconite
tuber may be required.
11) Fukuda Y.: Kampo Therapy for Low Back Pain and Lumbar Spondylosis,
Kampo and Most Advanced Therapies 5(4): 359-362, 1996
12) Shirafuji T.: Kampo Therapy for Neuralgia (including herpes zoster),Modern Oriental Medicine 14(2): 35-39, 1993

For the treatment of low back pain due to lumbar
spinal canal stenosis, Kidney Qi Pill has been used andcumulative studies showed an efficacy of 68%, while
similar cumulative studies with Life-preserving
Kidney-Qi Pill showed an efficacy of 55%, thus a highefficacy for either of these formulas13,14).
13) Hayashi Y., Saito E., Takahashi O.: Usefulness of Kidney Qi Pill for theTreatment of Lumbar Spinal Canal Stenosis Geriatr. Med. 32(5): 585-591,
199414) Yamagami H., Hashizume K., Sakamoto T. et al.: Effects of Life-preserving
Kidney-Qi Pill in the Treatment of Lumbar Radicular Pain - with particularfocus on variations in subjective and objective symptoms, Pain and Kampo
7: 25-28, 1997

The concept of autoimmune disease did not exist in
TCM. Yet, for articular rheumatism, a representative
disease of this group, many therapies have beendevised. The other forms of connective tissue diseases
were almost not recognized and probably only
individual symptoms were dealt with. Currently,
better therapies for these diseases are available than
before.
Rheumatoid arthritis (RA) is a disease for which
Kampo offers hope. This disease includes various types,
stages and grades. Based on these, the prognosischanges, Kampo therapy is particularly effective

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Volume 1, Special Edition | Current Kampo Medicine 2005

during the initial stages of RA. Early diagnostic
criteria for ARA showed that the probability for people
who were suspected of having RA, the number ofpatients in a Kampo treatment group (in whom thediagnosis of RA was definitely established) after
several years, reportedly appeared to be lower than ina group of patients not treated with Kampo 15). Besides
this report, there is an abundance of other reports that
also provide similar suggestions16,17,18).
Traditionally, the symptoms of RA are considered
to be due to the intrusion of the three evils wind, coldand dampness in the body. Clinically, these symptoms
also include a feeling of heat in the joints, so that thesymptoms are also often viewed as heat symptoms.
Choice of the prescription has to be modified
depending on the degree of pain, heat sensation andthe general condition. For the therapy, basic
preparations like Cassia Twig Decoction plus
Atractylodes and Aconite, Cassia Twig Peony, andAnemarrhena Decoction, Two-parts Cinnamon Twig

Decoction and One-part Maidservant from Yue
Decoction, Stephania and Astragalus Decoction,
Disband Painful Obstruction Decoction are used andthenmodified
dependingontherelevant
considerations of cold and heat factors. Usually thisdisease can not be properly treated with extracts, sothat many physicians use the corresponding decoctions.
In particular, the skillful application of Wild Aconite
Tuber constitutes a key point of the therapy andspecialized physicians conduct the therapy by exactly
controlling the amount of alkaloids like aconitine andmesaconitine. Some RA case reports have described
dramatic improvements by using formulas containing
comparatively large amounts of Wild Aconite Tuber19).
There are some cumulative studies dealing with Minor

Bupleurum Decoction, Poria Powder with Five Herbs
or Stephania and Astragalus Decoction20,21,22).

15) Ebe K.: New Cases of Chronic Rheumatoid Arthritis, Investigation of 10
cases, Φυτο 1(4): 4-12, 200116) Haimoto H.: Recent Situation Regarding Chronic Rheumatoid Arthritis,
Clin. J. Trad. Chin. Med. 18(4): 370-381, 1997
17) Fukuda Y.: 54th Academic Conference of the Japan Society of Oriental
Medicine, Academic Symposium: Kampo Therapy for Rheumatoid Arthritis,
1. Probing the possibilities of Kampo preparations, Kampo Medicine (Jap.
Journal of Oriental Medicine) 54(6): 1064-1067, 2003
18) Nagasaka K., Hikiami H., Tatsumi T. et al.: Examination of 43 Patientswith Chronic Rheumatoid Arthritis, Kampo Medicine (Jap. Journal of
Oriental Medicine) 51(2): 241-246, 2000
19) Furuta K., Mitsuma T., Shintani T. et al.: Three Cases of Dramatic
Improvements Associated with Poisoning Symptoms Using Uzu Containing
Preparations, Kampo Medicine (Jap. Journal of Oriental Medicine) 50(2):247-255, 199920) Matsuura M.: Effects of Minor Bupleurum Decoction, Poria Powder with
Five Herbs in the Treatment of Chronic Rheumatoid Arthritis (RA),Recordings of the 10th Clinical Wakan Yaku Research Group Modern
Physician, 14: 403-408, 199421) Borijini, M. J. et al: TJ-114( Minor Bupleurum Decoction, Poria Powder
with Five Herbs ), an herbal medicine in rheumatoid arthritis. A
preliminary “go-no go” clinical trial. J. Clin.Rheumatol 2: 309-316, 199622) Tanaka M., Ono S., Suzuki T. et al.: Usefulness of Stephania andAstragalus Decoction for the Treatment of Chronic Rheumatoid Arthritis,
Journal of the Japan Society of Oriental Medicine 40: 73-77, 1989

Regarding other connective tissue diseases like
SLE, PSS or SSc, Kampo therapy is added to therespective western medical therapies, but so far there
are only a few reports23,24,25).
23) Ono S.: Kampo Therapy for Systemic Lupus Erythematodes, Kampo andMost Advanced Therapies 2(4): 333-339, 199324) Imadaya A.: Withdrawal from Steroid Therapy Facilitated by Kampo
Therapy, a case of Long-term Remission in a Patient with Systemic Lupus
Erythematodes, The Journal of Traditional Sino-Japanese Medicine 104,198925) Matsuda K.: Therapeutic Guidelines for Kampo Health Care Services,
Progressive Systemic Scleroderma (PSS), revised edition (Organization:
Japan Society of Oriental Medicine): 199-202, 1993

Behcet's disease, with its aphthous ulcers of theoral mucosa, genital ulcers and skin symptoms, can be
sufficiently treated with Kampo medicine and is thus acomparatively good indication for this treatment
modality. Generally, Warming and Clearing Decoction,
Ten Strong Tonic Herbs Decoction, Modified Merry Life
Powder and similar preparations are used. For the oral
lesions, Coptis Detoxificating Decoction or Licorice
Decoction are taken into the mouth, in such a way thatthe drugs come in contact with the affected sites before
swallowing. For Warming and Clearing Decoction
there are placebo controlled clinical trials and caseseries studies26,27).
26) Kaneko F.: Warming and Clearing Decoction for the Treatment of Behcet's
Disease, Prog. Med. 6: 384-386, 198627) Hashimoto T., Takeuchi A., Mori S. et al.: Clinical Effects of Warming andClearing Decoction for the Treatment of Behcet's Disease, Therapy and
New Drugs 20(10): 2283-2285, 1983

Kampo therapy has also been tried for thetreatment of Sjögren’s syndrome, for dryness of theoral cavity and the eyes. Basically, dryness is
considered to be due to a lack of fluids and therefore
Yin tonifying formulas are administered. Dwarf
Lilyturf Decoction, Ginseng Nutrition Decoction,

Bupleurum Cassia Twig and Dried Ginger Decoction

and similar preparations are comparatively well used.
There are comparative trials and case series studies
using Dwarf Lilyturf Decoction, as well as multi-center
case series studies using Ginseng Nutrition
Decoction28,29,30).
28) Ono S., Suzuki T., Doi Y.: Effects of Dwarf Lilyturf Decoction on Disordersof Saliva Secretion in Sjögren Syndrome, Rheumatism 30: 10-16, 1990
29) Tonotsuka N., Abe M., Tahara K. et al.: Effects of Dwarf Lilyturf Decoction
on Dryness of the Eyes in Sjögren’s Syndrome, Journal of the Society for
Wakan Yaku 6: 436-437, 1989
30) Yokohari R., Kishimoto S., Tanimoto K. et al.: Clinical Effects of Ginseng
Nutrition Decoction (EK-108) on Dryness of the Eyes and the Oral Cavity in
Sjögren’s Syndrome, Clinical Medicine and Pharmacology 9: 1959-1968,
1993

15. Kidney
Kidney diseases are often associated with edema.
Yet, examination of literature older than 100 years,
makes the distinction of whether the edema mentioned
in the relevant works is due to cardiac or renal
diseases difficult. Naturally, at that time, thehistologic identification of the lesions had not yet beenpossible so that application of records of those days to

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Volume 1, Special Edition | Current Kampo Medicine 2005

current clinical practice, with a few exceptions, isdifficult. On the other hand, there is a growing trend
in recent years to apply the data of hematologic
examinations and histopathologic findings to Kampo
clinical practice.
Chronic renal diseases remain difficult to treat
with western medicine and in the end have to rely on
dialysis. Kidney transplantations are performed inJapan, but the number of cases is small. A variety ofdifferent approaches to these diseases using Kampo
therapy have been attempted, and among these, someepoch-making forms have received considerable publicattention. Yet, for these attempts, no extracts wereused. Rather large amounts of crude drugs wereselectively administered in special treatment forms.
First, it has been proven that creatinine levels
decrease in response to treatment with large amountsof astragalus(milk-vetch) root. Haimoto discovered
during the treatment of several patients with chronic
renal insufficiency that among numerous crude drugs,
astragalus root is independently capable of decreasing
the creatinine level1). Moreover, treatment results
indicated that efficacy improves even further byadding red peony root. Conversely, Ebe devised, basedon his own original theory and again centering on
astragalus root formulations, a mixture made up ofdifferent crude drugs (red peony root, rhubarb rhizoma,
trichosanthes seeds, pinellia tuber) with similar effects
and has already used this formula for several dozens ofpatients2,3). Among these there is a substantial numberof patients in whom the start of the dialysis treatment
could be significantly delayed or else the frequency of
the required dialysis sessions decreased.
The findings obtained from these studies indicatedthat rhubarb apparently decreased BUN andcreatinine4,5,6,7). According to relevant clinical andexperimental research, these effects have been verified.
Traditionally, Poria Powder with Five Herbs, Separate
and Reduce Decoction, Bolster the Spleen Decoction,
Middle-Reinforcing and Dampness-Removing Decoction,and similar preparations have been used as diuretics.
With a few exceptions, sufficient efficacy was observed
only in rare cases. In recent years, based on Chineseexperiences, the combination of Houttuynia herb,
astragalus radix and imperatae rhizoma has proven tobe effective. Recent follow-up studies from Japan
yielded similar results. This drug mixture too is used
as a decoction and appears to be effective 8).
Kampo medicine can be used for various conditions
in dialysis patients. For example, Warming andClearing Decoction is administered for dermal pruritus
developing in patients undergoing dialysis and its
efficacy has been shown in case studies9). Peony andLicorice Decoction is administered for muscle cramps
and case studies10) have shown an efficacy of 88.5%.
Case studies regarding the use of Minor Bupleurum
Decoction plus Poria Powder with Five Herbs for34

osteoarthritis related to dialysis11,12) have shown anefficacy of 61%. In any case, the usefulness of Kampo
medicines was very good.
1) Haimoto H.: Efficacy of Astragalus Root in Decreasing Serum Creatinine
Levels in Chronic Renal Failure, Φυτο 7(1): 4-9, 2005
2) Hashimoto M., Ebe Y.: Kampo Therapy for Chronic Renal Failure (1)Clinical Journal of Traditional Chinese Medicine 25(4): 482-487, 2004
3) Hashimoto M., Ebe Y.: Kampo Therapy for Chronic Renal Failure (1)Clinical Journal of Traditional Chinese Medicine 26(1): 88-94, 2005
4) Oura H., Yokozawa T.: Pharmacologic Action and Effects of Rhubarb The
Journal of Traditional Sino-Japanese Medicine 12(2): 87-92, 1991
5) Tarasawa K., Shibahara N.: the Role of Kampo Therapy in the Treatment ofRenal Diseases - Opinions by Kampo Experts, Kampo & the Newest
Therapy 8(2): 101-105, 1999
6) Oura H., Yokozawa T.: Efficacy of Japanese and Chinese Medicine (Wakan
Yaku) in the Treatment of Experimental Renal Failure - Kidney and
Dialysis (Extra Edition) 26: 38-42, 1989
7) Mitsuma T. et al.: Research into Rhubarb and Rhubarb Containing Kampo
Preparations for the Treatment of Chronic Renal Failure (Second Report),
The Japanese Journal of Nephrogy 29: 195-207, 1987
8) Haimoto H. et al.: Traditional Chinese Treatment of Chronic Nephritis andNephrotic Syndrome, The Kampo 14(3): 62-68, 1996
9) Arisaka M., Kusano E., Asano Y. et al.: Clinical Experiences with the Use of
Onsei In for the Treatment of Pruritus in Dialysis Patients, Kidney and
Dialysis 35: 565-569, 1993
10) Kumakura M., Hyodo T., Tomimitsu E. et al.: Fast-acting Properties ofPeony and Licorice Decoction for Muscle Cramps in Dialysis Patients,
Dialysis Care 6: 75-79, 2000
11) Oka Y., Miyazaki M., Takatsu S. et al.: Importance of Early Discovery of
Osteoarthritis in Dialysis Patients - Study of the Usefulness of Minor
Bupleurum Decoction, Poria Powder with Five Herbs , Journal of the Japan
Dialysis Society 33: 1371-1376, 2000
12) Takasu S., Hatamura T., Sasahara K.: Clinical Effects of Minor Bupleurum
Decoction, Poria Powder with Five Herbs on Osteoarthritis in Dialysis
Patients, Kampo Shinryo 15: 18-21, 1996

The concept of glomerular nephritis wasestablished in recent years. Moreover, this disease wasonly treated when it was associated with such
macroscopically visible anomalies of the body likeedema. Today, in addition to the aforementioned sign,abnormal biochemical data, proteinuria or hematuria(including microscopic hematuria) have become
treatment indications and the range of treatment
indications for Kampo medicine has also beenbroadened.
Acute postinfectious glomerular nephritis used to
be a frequently observed disease, but today its
incidence has decreased due to the wide spread use ofantibiotics, so that the chances to treat the condition
with Kampo have diminished. Some forms of IgA
nephropathies respond well to Kampo therapy andthere are RCTs verifying this finding 13). Nephrotic
syndrome is a disease for which Kampo medicine has
been used widely and even today continues to be underused, although under fairly restricted conditions.
Histopathologic examination shows that disorders ofthe minimal change group and membranous
nephropathy respond well to Kampo medicine. There
are relevant data regarding the use of Minor

Bupleurum Decoction, Poria Powder with Five
Herbs14,15,16,17). Moreover, a combination of the above
mentioned Houttuynia cordata, astragalus radix andimperata rhizoma is effective for the treatment of
edema and proteinuria, characteristics of this disease.

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13) Yoshikawa N., Ito T., Sakai T. et al.: Prospective Controlled Study Using
Minor Bupleurum Decoction, Poria Powder with Five Herbs for theTreatment of Pediatric IgA Nephropathy with Focal, Minimal Mesangial
Proliferation, The Japanese Journal of Nephrogy 39: 503-556, 1997
14) Tojo S., Yoshitoshi Y., Nagasawa T. et al.: Ethical Kampo Preparations for
Chronic Glomerular Nephritis and Nephritic Syndrome: Clinical Effects ofMinor Bupleurum Decoction, Poria Powder with Five Herbs (First Report),
Multi-facility Open Trial, Kidney and Dialysis 31(3): 613-625, 199415) Ito K., Okada T., Kitagawa T. et al.: Ethical Kampo Preparations for
Pediatric Chronic Glomerular Nephritis and Nephritic Syndrome: ClinicalEffects of Minor Bupleurum Decoction, Poria Powder with Five Herbs ,Multi-facility Open Trial, Kidney and Dialysis 36: 1237-1246, 1994
16) Yoshikawa T., Ito T., Takekoshi Y. et al.: Pediatric Steroid Reactive
Nephritic Syndrome, Initial Steroid Treatment Period and Recurrence inPatients Treated with a Minor Bupleurum Decoction, Poria Powder with
Five Herbs Combination Therapy - Prospective Controlled Study, The
Japanese Journal of Nephrogy 40: 587-590, 1998
17) Yasaki T., Hirose S.: Clinical Effects of Minor Bupleurum Decoction, Poria
Powder with Five Herbs on Pediatric Nephritic Syndrome, Journal of
Traditional Medicine 4: 203-206, 1987

16. Urology
Regarding urologic diseases, ancient textbooks
refer to the "Five Lin" (five stranguries): stone, Qi,
unctuous, consumptive and bloody Lin. These are
general terms for conditions currently designated as
cystitis, urinary stones, hematuria, syphilis anddysuria etc. Today, specific therapies have been
proposed for these individual conditions and not thetraditional concept of "Lin" 1).
1) Ishibashi A.: Kampo Therapy of Urologic Diseases (Continued), for Practical
Physicians, The Kampo No.3: 2-7, 1999

Among the urogenital infections Kampo medicine
is effective for acute cystitis, but the condition isusually treated with antibiotics. In ordinary clinicalpractice it is, however, not possible to provide a
preventive therapy with antibiotics, so that Kampo
therapy is given to those patients for whom thecondition has progressed to the chronic stage.
Umbellate Fungus Decoction, Combind Umbellate
Fungus Decoction and Four Herbs Decoction, Gentian
Liver-Purging Decoction, Powder for Five Kinds ofStranguria, Heart-Clearing Lotus Seed Decoction,
Kidney Qi Pill are frequently used preparations. Thereare case series studies dealing with the use of Combind

Umbellate Fungus Decoction and Four Herbs
Decoction for the treatment of ureter syndrome2).

2) Sugaya K., Nishizawa O., Noto H. et al.: Effects of Umbellate Fungus
Decoction and Combind Umbellate Fungus Decoction and Four Herbs
Decoction for the Treatment of Ureter Syndrome, Urology Bulletin 38:
731-735, 1992

Among the forms of bacterial prostatitis, acuteinfections are an indication for antibiotics. Chronic
bacterial prostatitis, nonbacterial prostatitis or thechronic prostatitis syndrome cause similar symptoms
for which western medical treatment is not sufficiently
effective. For these conditions Kampo therapy is oftenvery effective. Gentian Liver-Purging Decoction isfrequently used3). Combination with Kidney Qi Pill may
in some cases give better results. Beside these formulas,
there are studies dealing with Life-preserving

Kidney-Qi Pill and Cassia Twig and Tuckahoe Pill.
Cumulative studies have been performed for Cassia
Twig and Tuckahoe Pill among the above mentioned
preparations and showed effectiveness in 12% andslight effectiveness in 66.4% of the treated patients4).
3) Takashi M., Haimoto H.: Experiences with Kampo Therapy for Patientswith Chronic Prostatitis presenting with a Greasy Tongue Coating,Φυτο 1(2): 16-18, 2001
4) Harada K.: Usefulness of Blood Stasis Expelling Drugs for the Treatment ofChronic Prostatitis - Using Mainly Cassia Twig and Tuckahoe Pill, WE
No.7: 9-10, 2004

In most cases of urinary tract stones causing
colicky pain, Kampo medicine alone cannot provide
relief, but there have been many attempts at using it.
Peony and Licorice Decoction, Umbellate Fungus
Decoction and Peony and Licorice Decoction, Major
Middle-Strengthening
Decoctionandsimilarpreparations have been prescribed. A new indication inthis field is the excretion of the stone fragments
following
ESWL (extracorporeal
shock
wave
lithotripsy). For this purpose, the combination of large
amounts of fluid replacement with the administrationof Umbellate Fungus Decoction has been proposed andtested in comparative clinical trials5).
5) Takada M., Yano H., Kambara N. et al.: Effects of Umbellate Fungus
Decoction on Post-ESWL stone excretion, Acta Urologica Japonica
43:311-314 1997

Erectile dysfunction in men is not due to a single
cause and the indications for Kampo therapy are
limited, but it is used for psychogenic or age dependentcases. Kidney Qi Pill, Middle-Reinforcing and
Qi-Benefiting Decoction, Bupleurum plus Dragon’s
Bone and Oyster Shell Decoction, Cassia Twig plus
Dragon’s Bone and Oyster Shell Decoction have been
selectedandused6).
Middle-Reinforcing
andQi-Benefiting Decoction is frequently used for thetreatment of oligospermia or insufficient motility ofsperm found in cases of male infertility. Several hours
after the administration of Middle-Reinforcing and
Qi-Benefiting Decoction the number of sperm andsperm motility have been confirmed to markedly
increase7,8). Preparations like Kidney Qi Pill or
Life-preserving Kidney-Qi Pill have similar modes ofaction and the latter preparation has been shown incase series studies to increase the number of sperm incase of oligospermia and very efficiently improve
motility in asthenospermia9).
6) Ikeuchi T.: EBM in Kampo Therapy - Current Situation - 3. Overview overthe current situation of EBM in various fields, 7) EBM and Renal and
Urologic Diseases, Prog. Med. 22(9): 53-56, 2002
7) Li Ping, Takase K., Mukobayashi M. et al.: Clinical Effects ofMiddle-Reinforcing and Qi-Benefiting Decoction in the Treatment of Male
Infertility, Progress in Obstetrics and Gynecology 48(4): 406-410, 1996
8) Akiyama M., Oeda T., Akiyama H. et al.: Clinical Experiences with
Middle-Reinforcing and Qi-Benefiting Decoction in the Treatment of Male
Infertility, Chapter of Urology in Western Japan 59(5): 442-446, 1997
9) Ohashi M., Ishikawa H., Yauchihara H. et al.: Efficacy of Life-preserving
Kidney-Qi Pill in the Treatment of Male Infertility - Seminal Fluid Findings
Obtained with an Automatic Seminal Fluid Analyzer, Journal of theJapanese Society of Fertility and Sterility 39(2): 79-83, 1994

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The initial stages of prostate hypertrophy are an
indication for Kampo therapy. Kidney Qi Pill is afrequently used preparation and there are case series
studies dealing with its application10,11). When treatment
with Kidney Qi Pill alone is insufficiently effective, thehypertrophy of the prostate gland can be viewed as amanifestation of blood stasis. Some studies demonstrated
that treatment with blood activating and stasis resolving
preparations like Cassia Twig and Tuckahoe Pill or
Rhubarb and Moutan Bark Decoction (in case of adecoction Choryu To) appears to be beneficial12).
10) Harada K.: Treatment of Urological Diseases with Japanese and Chinese
Medicine; 4. Diseases of the Prostate and Micturation Disorders, Clinical
Urology 45: 295-300, 1991
11) Yoshida K., Nakagawa Y., Tani Y. et al.: Clinical Effects of Kidney Qi Pill
for Prostrate Hypertrophy, The Clinical Report 9: 2861-2870, 1991
12) Yamamoto I.: Outline of Kampo Therapy for Diseases of the Lower Urinary
Tract; Miscellaneous Records of Oriental Medicine 3, (“Essays of eastern
medicine” Vol.3): 637-648, 1983

Urinary incontinence is frequently observed inelderly patients, particularly in women. It is likelythat patients do not report this symptom because ofembarrassment. For the treatment of pressureincontinence, the preparation Middle-Reinforcing and
Qi-Benefiting Decoction with its "upraising"properties is widely used 13). Kase et al. administered
Middle-Reinforcing and Qi-Benefiting Decoction toseven patients who did not wish to undergo surgicaltreatment of pressure incontinence, and evaluatedthe results with the questionnaire proposed by theInternational Consultation on Incontinence (ICI).
They found that the average incontinence score
reportedly dropped from 10.4±3.7 points to 6.3±5.0
points 14). Moreover, in recent years it has been noticed
that Pueraria Decoction also has incontinence
inhibiting actions. The discovery of this effect wasmade by Prof. Shin, who found that treatment offemale outpatients in an obstetrics and gynecology
clinic suffering from common cold with Pueraria
Decoction resulted in an alleviation of the incontinence
occurring simultaneously with the cure of the cold.
Prof. Shin conjectured that this effect is probably due
to a contraction of the internal cystic sphincter inducedby the ephedrine contained in Pueraria Decoction,
while the component paeoniflorin of peony root seems
to induce relaxation of the smooth muscles of the
bladder15). Impending incontinence is considered to be
one pathologic form of kidney deficiency, so that here
kidney tonifying preparations like Kidney Qi Pill andLife-preserving Kidney-Qi Pill are widely used16).
13) Murakami Y.: Effects of Middle-Reinforcing and Qi-Benefiting Decoction
on Mobile Kidneys and Pressure Incontinence, Acta Urologica Japonica 34:
1841-1843, 1988
14) Kase H., Akashi M., Sato T.: Effects of Middle-Reinforcing and Qi-Benefiting
Decoction on Pressure Incontinence, Kampo Igaku 29(3): 19-21, 200515) Shin S. et al.: Usefulness of Pueraria Decoction on Pressure Incontinence;
47th Conference of The Japan Society for Oriental Medicine, Summary
Collection P126, 1996
16) Yamanaka H., Suzuki T., Tokunaga S. et al.: Kampo Therapy for
Micturation Disorders, Kampo Igaku 21(8): 2-10, 1977

36

17. Nervous System
Many diseases in this field are indications for
acupuncture therapy, but a combination therapy with
Kampo medicine is more effective. Traditionally there
has been a lot of experience with stroke and headache.
For various forms of degenerative cerebral diseases,
Kampo therapy has been effective to a certain extent
and today numerous therapeutic trials are performed.
Regarding headache, both tension headache andmigraine are both good indications for Kampo therapy.
Widely used preparations include Evodia Decoction,
Poria Powder with Five Herbs, Pueraria Decoction,

Pinellia, Largehead Atractylodes and Tall Gastordia
Decoction, Tea-Blended Szechwan Lovage Powder ,Cassia Twig plus Ginseng Decoction, Coptis
Detoxificating Decoction and similar formulas. Eachof these preparations are used for corresponding
disease states, but the TCM classification may notnecessarily always be the same, so that prescriptions
may differ. Among these, Poria Powder with Five
Herbs is a characteristic Japanese formula not foundin Chinese textbooks. Haimoto found through skillful
application of clinical epidemiologic methods anefficacy of over 90% when the preparation was used forthe treatment of headache associated with a drop in
atmospheric pressure. The odds ratio of the correlation
between headache and the drop in atmosphericpressure was reportedly 16.21). In Japan, Evodia
Decoction has traditionally been used for thetreatment of this condition and there are a substantial
number of related studies. A case series study showed
better than simple improvements in 77 out of 147
patients2). The data of another case series study
examining 30 patients with tension headache showedthat the treatment was effective in 23 patients (that is
an efficacy of 76.3%)3). Yet, in actual clinical practicethe efficacy does not seem to be that high. Moreover,treatment with this preparation reportedly results inimprovements of vascular headache, but statisticaldifferences were not observed. However, sometimes
there are cases with dramatic improvement. Case
series studies examining the use of Pueraria Decoction
for the treatment of tension headache showed at the
fourth treatment week an efficacy of 66.3% 4). Somecase series studies deal with the treatment of tension
headache using Uncaria Powder, or else chronicheadache in patients with cerebrovascular disorders andreported effectiveness for both conditions5,6). Treatmentof trigeminal neuralgia follows the therapeutic
guidelines for headache.
1) Haimoto H.: Discussion of Clinical Epidemiologic Research into Chronic
Headache and the Correlation with Shifting Atmospheric Depressions,Φυτο 1(3): 8-15, 1999
2) Maeda K., Miyagi A., Sugawara T. et al.: Effects of Evodia Decoction on
Chronic Headache, Kampo Igaku 22: 55-57, 1998
3) Akamine M., Hyoudo Y., Ashihara M. et al.: Usefulness of Evodia Decoction
for Tension Headache, Japan Oriental Psychosomatic Medical Research 15:
36-38, 2000

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4) Yamamoto M.: Clinical Effects of Pueraria Decoction on Chronic Tension
Headache Caused by Stiffness of Shoulders and Neck, The Japanese
Journal of Clinical and Experimental Medicine 72: 1299-1303, 1995
5) Kimura K., Sasao S.: Clinical Effects of Tsumura's Uncaria Powder for
Chronic Headache in Patients with Cerebrovascular Disorders, Geriat. Med.
27: 445-449, 1989
6) Takada O.: Usefulness of Uncaria Powder for Chronic Tension Headache,
Kampo Igaku 22: 121-124, 1998

Throughout a lengthy history, a number ofdifferent therapies have been administered for epilepsy.
During the 18th century in Japan, apart from theordinary treatment, "vomitting" (intentional inductionof emesis) was performed occasionally as part of thetherapy, but did not produce sufficient results.
Currently, various adapted forms of Kampo therapy
are used in conjunction with modern western medical
treatment, but independently cannot be expected to beeffective. For the treatment of refractory pediatricepilepsy there are reports about using Minor

Bupleurum Decoction plus Cassia Twig Decoction plus
Peony, Minor Bupleurum Decoction plus Minor
Middle-Strengthening Decoction, Bupleurum andCassia Twig Decoction and similar preparations,where the data indicate an efficacy of 30-70%. For
details please refer to the section on pediatrics.
Cerebrovascular disorders have for a long time
been recognized as an extremely frequent conditionand constituted the number one cause of death in theJapan 50 years ago. Today, in conjunction with theprogress in modern medicine, fatal cases have becomemuch rarer, but the incidence of small infarcts andbleedings are still frequent. Additionally, these
conditions as a sequela of surgical intervention haveemerged as a new pathology. During the acute phase of
these diseases, western medical treatment is given
priority. Kampo therapy is performed during the acutephase only under special conditions or else during thechronic phase (late effect period). In recent studies,
Kimoto administered Poria Powder with Five Herbs inorder to alleviate cerebral edema immediately
following a stroke (including lacunar stroke) andreported achieving a better prognosis than with theordinary therapy alone7). For the treatment of sequelaeof this disease (hemiplegia, articulation disorders andthe like) acupuncture is very well suited and Kampo
therapy
is
used
more
supportively.
Coptis
Detoxificating Decoction, Major Bupleurum Decoction,

Bupleurum plus Dragon’s Bone and Oyster Shell
Decoction, Uncaria Powder, Liver-Inhibiting Powder,Angelica and Peony Powder, Cassia Twig andTuckahoe Pill, Cassia Twig Decoction plus
Atractylodes and Aconite, Kidney Qi Pill and similar

preparations are used. In this field many case series
studies and randomized controlled trials have been
performed8,9,10,11,12,13,14,15,16).
Regarding treatment with decoctions, further
modifications of the therapy have been applied.

7) Kimoto H.: Application of Kampo medicine to acute cerebral infarction:
Summary of 14 cases and comparison of their clinical prognosis with theresult of Japan Standard Stroke Registry Study (JSSRS) J. Trad. Med.
20(2): 68-73, 2003
8) Ushikubo Y., Sakurai T., Yokouchi T. et al.: Effects of Coptis Detoxificating
Decoction on Cerebrovascular Disorders and Quantitative Evaluation of
Blood Flow, Journal of New Remedies & Clinics 47: 176-183, 1998
9) Ito E., Takahashi A., Kuzuya F.: Clinical Effects of Coptis Detoxificating
Decoction on Stroke, Geriat. Med. 29: 303-313, 1991
10) Otomo E., Togi H., Kogure K. et al.: Usefulness of Coptis Detoxificating
Decoction for the Treatment of Cerebrovascular Disorders - Controlled
study with Ca Hopantenate as the Control Using the Envelope Method,
Geriat. Med 29: 121-151, 1991
11) Araki G.: Effects of Coptis Detoxificating Decoction on the Sequelae of
Cerebrovascular Disorders - Particularly discussing improvements in
cerebral circulation (vertigo, dizziness), Geriat. Med 29: 1587-1599, 199112) Ito E., Uchida M., Sakakibara T. et al.: Effects of North Water God
Decoction on the Sequelae of Cerebrovascular Disorders, The Japanese
Journal of Clinical and Experimental Medicine 71: 562-568, 199413) Matsushita S., Ueda S., Ouchi Y. et al.: Usefulness of Uncaria Powder for
the Treatment of Accessory Symptoms of Cerebrovascular Disorders,
Chronic Cerebral Circulatory Insufficiency and Hypertension, Geriat. Med
33: 1333-1341, 1995
14) Ito K., Yamamoto H., Nishihara T. et al.: Investigation of the Usefulness ofKidney Qi Pill for the Treatment of Various Symptoms in Patients with
Hypertension or Cerebrovascular Disorders (excluding the acute phase) Multi-facility crosover double-blinded trial, Diagnosis and Treatment 76(4):1096-1114, 1988
15) Fukushima T., Tomonaga M., Tanaka A. et al.: Clinical Effects of Angelica
and Peony Powder on the Sequelae of Cerebrovascular Disorders, The
Japanese Journal of Clinical and Experimental Medicine 71: 1065-1070,
199416) Goto H., Shimada Y., Mitsuma T. et al.: Effect of Cassia Twig and Tuckahoe
Pill on asymptomatic cerebral infarction for short term, J. Trad. Med 19:
46-50, 2002

Regarding cerebrovascular dementia, research
about Uncaria Powder and similar preparations is
progressing. Please refer for further details to thesection on mental diseases.
Several preparations have been tried in form of
combination therapies with western medical
treatment during the initial phase of Parkinsonism. So
far, Liver-Inhibiting Powder and Tangerine Peel,
Pinellia Rhizoma plus Liver-Inhibiting Powder are
representative formulas17). In recent years case series
studies with Coptis Detoxificating Decoction,
Tea-Blended Szechwan Lovage Powder , Six Gentlemen
Decoction and similar formulas have also been
performed 18,19,20).
17) Ogawa S.: Purpose and Application of Liver-Inhibiting Powder andTangerine Peel, Pinellia Rhizoma plus Liver-Inhibiting Powder, Kampo
Medicine (Jap. Journal of Oriental Medicine) 49(3): 330-334, 199818) Ito M.: Clinical Experiences with Coptis Detoxificating Decoction for theTreatment of Parkinson's Disease, The Clinical Report 26: 1519-1524, 1992
19) Shizuma N., Muramatsu S., Ikeguchi K. et al.: Effects of Tea-Blended
Szechwan Lovage Powder on the Dyskinesia of Parkinson's Disease, Kampo
Medicine (Jap. Journal of Oriental Medicine) 51: 1087-1091, 200120) Hiyama Y., Tosa H., Terasawa K. et al.: The effects of Six Gentlemen
Decoction on Parkinsonian patients with unstable effect oflevodopa/carbidopa, J. Med. Pharm. Soc. WAKAN-YAKU 8: 83-88, 1991

Since approximately 60% of the patients with
Bell's palsy recover spontaneously without any
treatment, many patients do not necessarily require
therapy. This condition is a good indication for
acupuncture therapy and improvement immediately

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37

Volume 1, Special Edition | Current Kampo Medicine 2005

after the treatment is not uncommon. Therefore theuse of Kampo medicine is not required. Several RCTs
have been reported that compare this medication witha steroid group 21,22). According to these studies, there
were not any major differences between the twogroups.
21) Horiguchi I., Otake T.: Comparison of the Therapeutic Effects of Steroids
and Minor Bupleurum Decoction, Poria Powder with Five Herbs on
Peripheral Facial Palsy (Bell's Palsy), Kampo & the Newest Therapy 7(4):363-368, 199922) Obata H., Otake T., Ishikura H.: Usefulness of Minor Bupleurum
Decoction, Poria Powder with Five Herbs for the Treatment of Facial Palsy A comparison with steroids, Pain Clinic, Pain Clinic 16(１): 49-52, 1995

Occasionally the use of Kampo medicine in thetreatment of myasthenia gravis makes a dose reduction
in anticholinesterase agents possible. Several casereports indicated the use Middle-Reinforcing and
Qi-Benefiting Decoction or Pueraria Decoction andthere is research on the use of Six Gentlemen
Decoction23).
23) Oikawa O.: Application of Six Gentlemen Decoction in the Field of
Neurology, Prog. Med. 23(8): 2163-2169, 2003

18. Psychiatric Disorders
A multitude of mental diseases have been recorded
from ancient to modern times. In TCM, various
preparations have been devised depending on the stateof the relevant disorders. Since there had been noclassification of diseases like those used today (forexample the DSM classification), it remains difficult todetermine what modern disease the disorders
described in those days correspond to. The disorders inthis field were viewed as anomalies of the Zhang-Fu,
the viscera and organs, revealing most often problemsof heart, liver, spleen and gallbladder. In the course of
the pattern, identification anomalies of these visceraand bowels were found causing the problem. In Japan,
the "Shang han lun" or “Jin gui yao lue” offers adiversity of preparations for the treatment of these
conditions. Active research into relevant formulas
has been conducted since the Tang dynasty and led tosuitable applications.
Among common psychiatric disorders, Kampo
therapy is used as an integral part of behavior therapy,social therapy, psychotherapy and medical treatmentof stress & adjustment disorders (situational disorders).
Regarding anxiety disorders, the components of theanxiety may be either psychogenic or somatic. Kampo
medicines include preparations capable of reducing theanxiety in itself and are used as a matter of course. Itis frequently observed that through improvement of
the physical symptoms, the related anxiety isalleviated. For this reason, it is necessary to base theprescription not on disease names, but follow the
Kampo medical pattern identification. The mostfrequently observed general anxiety disorders areoften treated with preparations like Pinellia andMagnolia Decoction, Tangerine Peel, Pinellia Rhizoma
38

plus Liver-Inhibiting Powder, Bupleurum and Cassia
Twig Decoction, Bupleurum plus Dragon’s Bone andOyster Shell Decoction, Middle-Reinforcing and
Qi-Benefiting Decoction, Back to the Spleen Decoction,
Modified Merry Life Powder, Cyperus and Perilla Leaf
Powder, Warm the Gallbladder Decoction, Goddess
Powder, and Coptis Detoxificating Decoction. These
formulas are also employed for panic disorders andobsessive-compulsive disorders (OCD) and suitabledrugs are administered based on the SHO (symptoms
and signs). There are a number of case series studies
regarding this topic1,2,3,4,5).
1) Kudo Y., Mori A., Asai M. et al.: Clinical Effects of Modified Merry Life
Powder for Various Forms of Necrosis, Journal of Clinical Therapeutics &Medicine 8(12): 2989-3007 1992
2) Okamoto K., Hasama T., Okamoto R. et al.: Effects of Pinellia and Magnolia
Decoction on Neurosis, The Journal of Traditional Sino-Japanese Medicine
15(4): 571-576, 1994
3) Ohara K., Fukazawa H., Suzuki Y. et al.: Clinical Effects of Bupleurum plus
Dragon’s Bone and Oyster Shell Decoction and Pinellia and Magnolia
Decoction on Neurosis, Journal of New Remedies & Clinics 34(1): 131-141,
19854) Shinozaki T.: Effects of Tangerine Peel, Pinellia Rhizoma plus
Liver-Inhibiting Powder in 30 Neurosis Patients with Irritation as Their
Chief Complaint, Kampo Shinryo 18(2): 42-44, 1999
5) Shinozaki T.: Effects of Bupleurum plus Dragon’s Bone and Oyster Shell
Decoction in 15 Neurosis Patients with Irritation as Their Chief Complaint,
Kampo Igaku 24(3): 122-124, 2000

Somatoform disorders (abnormal illness behavior)
are a group of disorders that are very difficult toconceptualize. Yet, Kampo therapy occasionallyappears to be useful. These conditions are notapproached directly from their mental aspects, but byrelieving physical problems with Kampo therapy therelevant mental conflicts are sometimes relieved.
Many Kampo preparations act by improving physicaldysfunction and are administered in order to improve
the physical disposition of the patients. For chronic
pain disorders, Kampo therapy does not appear to bevery effective. However, it can in rare cases, beeffective when the pathology is properly identified
according to Kampo medical concepts.
To date no systematic studies on the application of
Kampo therapy for schizophrenic disorders have been
performed. Yet, there are a number of accessory
approaches. One of these was the administration of
Coptis Detoxificating Decoction to 10 patients in whom
symptoms had been stabilized through treatment with
antipsychotic drugs, where subsequently during theobservation period an improvement in the total scoreof the brief psychiatric rating scale (BPRS) was noted.
This took the form of significant improvement indepressive moods, delusions of guilt, delusions ofpersecution and agitation6). Another approach was thetreatment of 12 patients complaining of mild tomoderate restlessness with Kidney Qi Pill extract. The
observation of the four parameters: loss of motivation,
anxiety, restlessness and depressive moods, showedsignificant improvement 7).

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Volume 1, Special Edition | Current Kampo Medicine 2005
6) Yamada K., Kamba S., Onishi M. et al.: Clinical Effects of Coptis
Detoxificating Decoction During Convalescence From the Active Phase of
Schizophrenia, Kampo Medicine (Jap. Journal of Oriental Medicine) 47(4):603-607, 19977) Ozaki S., Morita H., Shimomura Y.: Clinical Effects of Kidney Qi Pill andNeedling of the Back on Schizophrenia (inhibition of auditory
hallucinations through kidney tonification), Oriental Medicine 21(3): 69-75,
1993

Among mood disorders (depression & mania),
history shows a comparatively large number ofattempts at using Kampo therapy for depression which
led to the selection of several effective preparations.
Clinically, these are effective when used in the form of
combination therapies with western medications.
Middle-Reinforcing and Qi-Benefiting Decoction,
Modified Back to the Spleen Decoction, Pinellia andMagnolia Decoction, Cyperus and Perilla Leaf Powder,
Six Gentlemen Decoction, Minor Middle-Strengthening
Decoction, Ginseng Nutrition Decoction, Bupleurum
plus Dragon’s Bone and Oyster Shell Decoction andsimilar preparations are used. There are also caseseries studies for these formulas8,9,10,11).
8) Ohara K., Nishimoto M., Miyasato K. et al.: Effects of Middle-Reinforcing
and Qi-Benefiting Decoction on the Loss of Appetite Associated with
Depression, Prog. Med. 14(6): 1705-1712, 1994
9) Kudo Y., Mori A., Asai M. et al.: Clinical Evaluation of Kami Kihi in theTreatment of Various Neurotic Disorders, Journal of Clinical Therapeutics& Medicine 8(12): 2989-3007, 1992
10) Ohara K., Fukazawa H., Suzuki Y. et al.: Clinical Effects of Bupleurum
plus Dragon’s Bone and Oyster Shell Decoction and Pinellia and Magnolia
Decoction in the Treatment of NeurosisJournal of New Remedies & Clinics
34(1): 131-141, 1985
11) Tsutsui S., Igarashi M., Takekoshi I. et al.: Experiences with Pinellia andMagnolia Decoction in the Treatment of Depression and Depressive Moods,
Journal of New Remedies & Clinics 42(9): 1913-1920 1993

Insomnia is treated among the sleep disorders
with psychotherapy, life style guidance andpharmacotherapy in that order; but in reality,
hypnotics are applied rather lightheartedly. Kampo
medicines do not act like western soporific medications,but are more adjusted in a way to suit the various
disease states. From a Kampo medical point of view,
sleep disorders are considered to be caused byanomalies of organs like the heart, liver, or gallbladderand prescriptions are administered according to therelevant pathologies. Wild Jujube Seed Decoction,
Coptis Detoxificating Decoction, Modified Merry Life
Powder, Pinellia and Magnolia Decoction, Back to theSpleen Decoction, Warm the Gallbladder Decoction,
Liver-Inhibiting Powder and similar preparations are
selected. By treating patients who developed atriazolam dependency, with Wild Jujube Seed
Decoction, Ozaki et al. succeeded in gradually
decreasing the frequency of the triazolam use.
Reportedly, many patients were finally able to sleep
relying only on Wild Jujube Seed Decoction12).
Moreover, when Ozaki et al. used a combination
therapy of zopiclone and Wild Jujube Seed Decoction,
the sleep duration increased in spite of a facilitatedelimination of zopiclone from the blood and the QOL
on the following day reportedly improved 13).
12) Ozaki T.: Description of Patients who were Able to Completely Withdraw
from Hypnotics by Using Tsumura's Wild Jujube Seed Decoction , Japan
Society of Ryodoraku Medicine 42(7): 4-15, 199713) Ozaki T., Ohara S., Saito K.: Combined Effect of Zopiclone and Wild Jujube
Seed Decoction in the Treatment of Insomnia, Kampo Igaku 22(5): 22-23,
1998

Dementia is a disease difficult to treat. It isfrequent among the elderly and currently there are no
therapeutic measures available for the treatment of
the three forms of cortical dementia. Research into theuse of Kampo medicine for this condition has justbegun, but some interesting results have already been
published. First, DB-RCTs using Uncaria Powder havereceived much attention. Terasawa et al. administeredin several facilities either Uncaria Powder or a placebo
to 139 patients with cerebrovascular dementia andreported for the former a signficantly better
improvement than that obtained with the latter 14). The
studies conducted by Shimada et al. could also beinterpreted in a similar way (placebo and RCTs) 15).
Based on these studies the improvement inspontaneous conversations, poor facial expressions,decreased calculation abilities, night delirium, sleep
disorders, hallucinations and delirium was in the
Uncaria Powder group significantly better than in theplacebo group. There are also multi-facility case series
studies using Coptis Detoxificating Decoction thatshow significant improvements16,17). Uncaria Powder is
not effective for cerebrovascular dementia, but is for
Alzheimers disease18). Regarding this disease, there
are a number of excellent studies using Angelica andPeony Powder19). Hagino et al. focused on theneuroendocrine action of this drug and found inexperiments using rats that it causes an increase in
the number of nicotinic acetylcholine receptors and theconcentration of catecholamines in the cerebral cortex
and hippocampus, thereby determining that this has
an inhibitive effect on the dementia20). Results ofresearch in this area look very promising.
14) Terasawa K., Shimada Y., Kita T. et al: Uncaria Powder in thetreatmentnt of vascular dementia a double-blind, placebo controlled study,
Phytomedicine 4: 1522, 199715) Shimada Y., Terasawa K., Yamamoto T. et al: A well-controlled study ofUncaria Powder and placebo in the treatment of vascular dementia, J. Trad.
Med. 11: 246-255, 199416) Araki G.: Investigation of the Effects of Coptis Detoxificating Decoction on
Dementia, Journal of Senile Dementia 4: 110-117, 1990
17) Araki G.: Effects of Coptis Detoxificating Decoction on Senile Dementia,
Therapeutic Research 15: 986-994, 1994
18) Yamamto T.: Kampo Therapy of Alzheimer's Disease, Current Medicine 5:
96-102, 1989
19) Inanaga K., Dainoson K., Ninomiya Y. et al.: Therapeutical of Angelica andPeony Powder on Senile Cognitive Disorders, Multi-facility Joint Research,
Prog. Med. 16: 293-300, 199620) Hagino N., Koyama T.: Stimulation of nicotine acetylcholine receptor
synthesis in the brain by Angelica and Peony Powder(TJ-23).Recent
Advances in the Pharmacology of Kampo (Japanese herbal) Medicines
144-149, Excerpta Medica, Tokyo, 1988

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Volume 1, Special Edition | Current Kampo Medicine 2005

19. Endocrinology
The growing knowledge about various hormones inthe body and the organs that secrete them has inrecent years clarified many questions. Regarding
diseases in this area, hyperthyroidism is marked byvisible characteristics and specific clinical symptoms.
This condition has been recognized since ancient times,
but most other diseases in this field were not clearly
defined. This is only natural because there had been
no concept of endocrine function. Even though thenature of these diseases has gradually been clarified inrecent years, there are almost no studies showing theefficacy of Kampo therapy. The only condition forwhich there are many reports is hyperthyroidism.
Regarding this disease, a modern biomedical therapy
has been established and Kampo therapy is used only
ancillarily. Roasted Licorice Decoction, Bupleurum
Cassia Twig and Dried Ginger Decoction, Bupleurum
plus Dragon’s Bone and Oyster Shell Decoction andsimilar preparations are frequently used. Several
reports also deal with combinations of thyroid drugs
and Kampo medicines1). Tachino described three cases
in which good control was achieved using thyroid
drugs and Roasted Licorice Decoction. Moreover, hereported a comparative study treating 35 patients
divided in two groups Group A treated with thyroid
drugs and Roasted Licorice Decoction and group B
treated with thyroid drugs and propranololhydrochloride. The improvements in tachycardia andsubjective symptoms were reportedly much better ingroup A2).
1) Yukimura Y.: Combination Therapies with Kampo Preparations forHyperthyroidism - Kampo Medicine (Jap. Journal of Oriental Medicine)35(2): 47-54, 1984
2) Tatsuno I.: Three Cases of Hyperthyroidism, Modern Kampo Therapy:
280-283 Toyo Gakujutsu Shuppansha, 1985

20. Diabetes Mellitus
Diabetes mellitus has been known since ancient
times in both western Europe and China as a disease
where sweet urine is passed. Yet, during antiquity or
the middle ages, it was not known that this disease
was due to an insufficient secretion of insulin and theresulting hyperglycemia. Likewise it was not known
that leaving the condition unattended anduncontrolled
will
eventually
resultinthemanifestation of microvascular lesions. In TCM,
symptoms like intensely dry mouth, voracious appetiteand the passing of large amounts of urine wereclassified as being related to the upper, middle or lower
portion of the body and thus appropriate therapies
were devised. Although this is a useful classification
indicating suitable therapies and preparations, thebasis of diabetes therapy remains diet and exercise.
Diet, caloric intake in particular, in relation tocarbohydrates, poses problems for which Yoichiro Ebe
40

has proposed an epoch-making diet (since this is notdirectly related to Kampo medicine its description will
be omitted here). Naturally, Kampo medicine is helpful
for the therapy on any level of the disease. White Tiger
Phis Ginseng Decoction, Major Bupleurum Decoction,
Kidney Qi Pill, Heart-Clearing Lotus Seed Decoction,
Poria Powder with Five Herbs and similar
preparations are prescribed depending on thesymptoms. Wagazuma et al. performed a randomized
controlled study treating 18 patients with type II
diabetes with Heart-Clearing Lotus Seed Decoction
and compared these with the patients in a control
group. The researchers observed a significant
difference between the two groups, where combined'improvement' and'slight
improvement' wasreportedly 58.38% 1). Moreover, Wagazuma et al. also
described obtaining favorable results with long-term
treatment of diabetics with Poria Powder with Five
Herbs2).
The focus of interest in Kampo therapy regarding
diabetes is its effects on the manifestation of
peripheral neuropathies associated with this disease.
Some case series studies have described the effects ofKidney Qi Pill and Life-preserving Kidney-Qi Pill3,4,5,6).
Also, some reports state that Life-preserving
Kidney-Qi Pill appears to be effective for the treatment
of diabetic corneal disorders7).
1) Azuma M., Motomiya M., Toyoda T.: Results of Clinical Trials Using
Heart-Clearing Lotus Seed Decoction for the Treatment of Diabetes, Kampo
Medicine (Jap. Journal of Oriental Medicine) 45: 339-344, 1994
2) Azuma M., Sato G., Fukuzawa M.: Long-term Course of Diabetes Therapy
Using Poria Powder with Five Herbs , Journal of Traditional Medicine 19(S):56, 2002
3) Mikura R., Suzuki S., Iino S.: Therapeutic Effects of Kidney Qi Pill and Six
Ingredient Pill with Rhemannia on Diabetic Neuropathies, Bell Medico,
7(6): 21-22, 1992
4) Sakamoto N., Sato Y., Goto Y. et al.: Oriental Medical Treatment of Diabetic
Neuropathies - Comparative Trial with Life-preserving Kidney-Qi Pill andCobalamine, The Journal of the Japan Diabetes Society 30(8): 729-737, 1987
5) Tawata M., Kurihara A., Nitta K. et al: The effects of Goshajinnkigan, aherbal medicine, on subjective symptoms and vibratory threshold inpatients with diabetic neuropathy. Diabet.Res.Clin.Pract 26: 121-128, 1994
6) Taniuchi K., Kashimura H., Fujiwara K. et al.:Clinical Effects of a 1-Year
Administration of Life-preserving Kidney-Qi Pill for Diabetic Neuropathies,
Journal of New Remedies & Clinics 36(4): 636-646, 1987
7) Nagaki Y., Hayasaka S., Hayasaka Y. et al: Effects of Life-preserving
Kidney-Qi Pill on corneal sensitivity supedcial punctate keratopathy andtear secretion in patients with insulin-dependent diabetes mellitus AM, J.
Chin. Med. 31: 103-109, 2003

21. Lipid Abnomalies
Almost none of the metabolic diseases had beenrecognized in the past as a disease. The concept of lipid
anomalies was first established when the technologies
to measure lipid concentrations in blood became
available and the relevant knowledge regarding
metabolism had developed. Accordingly, new Kampo
concepts were needed and corresponding therapies
sought.

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Regarding hyperlipemia, there are no preparations
that definitely lower total cholesterol and neutralize
fat concentrations, but Major Bupleurum Decoction or

Bupleurum plus Dragon’s Bone and Oyster Shell
Decoction reportedly did lower these values to acertain extent1,2,3,4,5). Research into effects of Kampo
preparations influencing the lipid metabolism onarteriosclerosis has begun. Itakura concentrated his
experiments on the LDL cholesterol in rabbits andassumed that Major Bupleurum Decoction inhibits
oxidation of LDL cholesterol, phagocytosis bymacrophages and prevented the adhesion of lipid tothe vessel wall6). Hasegawa treated patients for 4
years with Bupleurum plus Dragon’s Bone and Oyster
Shell Decoction and then examined vascular function
by measuring the aortic pulse wave velocity and the
carotid arterial system using ultrasonic transduction.
Reportedly, antiarteriosclerotic activity was observedin either case7). For these studies, extract preparations
were used. By proper adjustments of decoctions evenslightly better results are expected and currently are
the subject of investigation.
1) Murakami T., Oku J., Kimura Y. et al.: Treatment for Hyperlipidemia by
Kampo-drugs, J. Trad. Sino-Japanese Med. 11(1): 35-40, 1990
2) Sasaki A., Matsunaga A., Handa K. et al: Effects of Major Bupleurum
Decoction on Hyperlipemia - Comparison with Clinofibrate, The Japanese
Journal of Clinical and Experimental Medicine 68: 3861-3871, 1991
3) Yamano S., Sawai F., Hashimoto T. et al.: Effects of Major Bupleurum
Decoction on Serum Lipids and Brain Circulation - Comparison withelastase, Kampo & the Newest Therapy 4: 309-313, 1995
4) Miki S., Yashijima A., Wada M. et al.: Effects of Major Bupleurum Decoction
on Serum Lipids and Examinations of the Coagulation System in Diabetics,
Journal of Traditional Medicine 7(2): 120-124, 1990
5) Onuma, T. et al: Effects of Bupleurum plus Dragon’s Bone and Oyster Shell
Decoction (Kampo medicine) on abnormal plasma lipoprotein and glucose
metabolism in diabetic Patients, A comparison to Dai-saiko-to, J. Trad. Med.
12: 124-128, 1995
6) Itakura H.: Kampo Medicine and Arteriosclerosis (interview), Kampo Igaku
20(4): 11-13, 1996
7) Hasegawa M.: Anti-arteriosclerotic Actions of Bupleurum plus Dragon’s Boneand Oyster Shell Decoction (interview), Kampo Igaku 21(5): 11-13, 1997

22. Nutrition
Establishment of sound knowledge pertaining tonutrition is a rather recent event. Comprehension of
the necessary amounts of nutrition and an evaluationof the nutritional status in Kampo medicine has beenvague in the past making the overall image obscure
until the establishment of modern nutrition science.
Among the nutrition disorders, the one being
viewed as particularly problematic for modern man is
obesity. The basic situation in obesity is a problem
with caloric intake (in particular carbohydrates) andcaloric consumption. Thus, the condition does not callfor an active use of Kampo medicine. However, theuse of Kampo medicine can occasionally lead toweight reduction of a few kilograms. One aspect of
this weight loss is a Kampo medicine stimulated

excretion of surplus body water, for which, forexample, Stephania and Astragalus Decoction can beused1). When this preparation is administered during
the treatment of gonarthrosis, it induces analleviation of articular symptoms and at the sametime may often result in a weight reduction of about
2-3 kg. Yoshida et al. administered Stephania andAstragalus Decoction to 19 patients with diabetes ofthe viceral obesity type for whom exercise is difficult
because of the underlying disease and reportedly
observed a significant decrease in viceral fat as well
as a decrease in cholesterol levels2). Another suitablepreparation is Divaricate Saposhnikovia Miraculous
Powder. This preparation has traditionally beenclassified as an exterior-interior releasing formula,but because it contains Rhubarb and Mirabilite, it
improves bowel movements and thus facilitates theexcretion of surplus materials through the feces.
Several studies have dealt with this topic 3). Akiyama
et al. administered Divaricate Saposhnikovia
Miraculous Powder to obese patients with mutationsof the 3-adrenergic receptor gene, finding a marked
reduction in the waist/hip ratio and reportedly also
observed an improvement in insulin resistance 4).
1) Sento S., Tanaka N.: Effects of Stephania and Astragalus Decoction on
Physical Symptoms due to Anomalies in Water Metabolism and Obesity,
Therapic Research 20(6): 2021-2028, 1996
2) Yoshida M., Takamatsu J., Yoshida S. et al.: Effects of Stephania andAstragalus Decoction in Diabetics with Viceral Type Obesity, Kampo
Medicine (Jap. Journal of Oriental Medicine) 49(2): 249-256, 1998
3) Sekine N.: Investigation of the Clinical Usefulness of Divaricate
Saposhnikovia Miraculous Powder for Hypertension and Obesity, Prog. Med.
24(11): 2803-2806, 2004
4) Akiyama T., Yoshikawa H., Tanaka H. et al.: β３adrenergic receptor Effectsof Divaricate Saposhnikovia Miraculous Powder in Obese Patients with
Gene Mutations, Digestion and Absorption 21(2): 159-162, 1998

Several reports indicated that treatment with
Kampo medicine is beneficial for the eating disorderanorexia nervosa5). The use of Minor Bupleurum
Decoction, Liver-Inhibiting and Spleen-Assisting
Decoction has been recommended, but the ratio of
successful treatments is not very high. Regarding
bulimia nervosa, there are no reports. Disorders ofvitamin metabolism are not considered to be anindication for Kampo medicines.
5) Otsuka K.: Five Case Reports About Anorexic Disorders (Psychogenic Lackof Appetite), Jap. J. Orient. Med. 7: 21-22, 1956

23. Infectious Diseases
The development of TCM is closely related to
infectious diseases. One important Chinese classic text,
the “Shang han lun", is widely known for its
descriptions of the treatment of so-called cold induced
disease. Even for infectious diseases that appeared
later, it provided the basis for the development oftherapies based on entirely new concepts for the age.
The episodes surrounding Li Dong-Yuen's creation of

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Volume 1, Special Edition | Current Kampo Medicine 2005

the formula Middle-Reinforcing and Qi-Benefiting
Decoction in the 12th century are famous. Following
epidemics of new diseases from the 16th to the 17th
century, the concept of "heat induced disease" wasestablished, later providing major contributions to thetreatment of infectious diseases, so that it came to belisted as an important item in most textbooks.
Historically, since the “Shang han lun" was taken
very seriously in Japan, the prescriptions listed in thisclassic text have been applied widely for this kind of
disease. For infectious diseases of the warm type,prescriptions developed later have been used for the
relevant conditions.
Today, progress in public health and hygiene aswell as improvements in comprehensive patientmanagement due to the appearance of antibiotics orantibacterial
agents,variousvaccines,
fluid
replacements etc. led to a significant reduction in
potentially fatal infections. For this reason theapplication of Kampo medicine to the treatment of
infectious diseases in modern Japan is now quite
limited. Yet, there are still many diseases treatedeither solely with Kampo preparations or else incombination with modern medical therapies.
For the common cold and the common cold
syndrome, Kampo medicine is used as the treatment of
first choice and there are numerous dissertations
documenting its use. The symptoms of the common
cold are similar to those appearing during upper
respiratory infections or diseases of the upper
alimentary tract and often develop later into specificdiseases. In Japan there is the proverb "The cold is theorigin of all diseases". Not only during the initialstages of the common cold, but also with a whole groupof similar conditions attempts have been made to curethe emerging symptoms with Kampo medicine.
Regarding Kampo medicine, great importance was
assigned to the "Shang han lun" since the middle of the
18th century and medical care performed based on its
medical concepts. It offers preparations suitable forthe treatment from the onset of acute febrile diseases
and through their various stages. The methodology
outlined in this book enables practical application of
Kampo to the treatment of common cold and thetreatment carried out along its guidelines. Japanesephysicians actually practicing Kampo medicine
consider the "Shang han lun" as the therapeutic
foundation regarding infectious diseases and thetreatment of the common cold meticulously
implements the contents of this book. Many physicians
specialized in Kampo medicine consider the treatmentof the common cold to be the basics of Kampo therapy
and a large number of dissertations deal with this
topic1,2).

42

The most frequently used formula is Pueraria
Decoction. Because this formula suits the Japanesephysique very well, it is generally used during theearly phase of the common cold and apart from that
may also be useful as a preventive medication during
epidemics3,4,5). Basic studies show that it inhibits therelease of PGE2 etc. and have clarified a number ofother actions as well6,7). Generally, many prescriptions
can be used for the wind and cold induced common cold.
During the early phase, other formulas beside
Pueraria Decoction, like Ephedra Decoction, Cassia
Twig Decoction, Cassia Twig and Ephedra half andhalf Mixture Decoction, Bupleurum and Cassia Twig

Decoction, Ephdra, Aconite and Manchurian
Wildginger Decoction, Cyperus and Perilla Leaf
Powder, Ginseng and Perilla Decoction are used.
Following the passage of a few days, Minor Bupleurum
Decoction and its modifications or Bamboo Shavings
Gallbladder-Warming Decoction are used. In case of a
protracted
course,Middle-Reinforcing
andQi-Benefiting Decoction and other tonifying formulas
come into use. Kampo preparations permit generaltreatment even when patients are allergic to western
medicines8).
In Japan there are a few prescriptions forwind-heat conditions. This is due to the fact that theconcept of heat induced disease was not adequately
introduced in Japan from China. Until the middle ofthe 19th century there were relatively few epidemics ofheat induced disease. While the representative
extracts Honey Suckle and Forsythia Powder or
Mulberry and Chrisanthemum Flower Decoction are
not available, this concept has now found wide
acceptance and both preparations are used as
decoctions. OTC prescriptions are employed, or elsethese preparations are substituted with Head-Clearing
Divaricate Saposhnikovia Decoction or Schizonepeta
and Forsythia Decoction.
Cumulative research indicates that in RCT using
both Ephdra, Aconite and Manchurian Wildginger
Decoction and generic cold medicines Ephdra, Aconite
and Manchurian Wildginger Decoction apparently led
to a significantly better improvement in the symptom
complex during the early phase of the disease9). Again,
DB-RCT studies showed that after more than 5 days
following onset, patients with common cold(corresponding to the lesser yang disease state) treatedwith Minor Bupleurum Decoction fared significantly
better than the placebo group 10). The efficacies ofDwarf Lilyturf Decoction and dextromethorphanhydrobromide were examined in a comparative
study11) for the treatment of cough as the soleremaining symptom, after the other cold symptoms
had subsided.

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1) Ito T.: Treatment of the common cold syndrome in Kampo medicine, ClinicalAll-round 49(10): 2697-2698, 2000
2) Homma Y.: Usefulness of Kampo medicine for the treatment of patientswith febrile syndromes, Kampo Medicine (Jap. Journal of Oriental
Medicine). 46(2): 285-291, 1995
3) Yanagi K. et al: Usefulness of a single dose of Pueraria Decoction during theearly phase of common cold, in: Summaries of the lectures held at the 52ndGeneral Conference of The Japan Society for Oriental Medicine, P243, 2001
4) Kaji M., Kashiwagi S., Hayashi J. et al: Clinical effects of Pueraria
Decoction for the common cold, Jpn. J. Clin. Exp. Med. 70: 3266-3272, 1993
5) Nishimoto T., Higasa K., Matsumoto K.: Clinical effects of Pueraria
Decoction drinks for the common cold (Medical Care and New Drugs) 28:
1433-1440, 1991
6) Nakahata N., Ishimoto H., Ohizumi Y. et al: Effects of Pueraria Decoction ,Minor Bupleurum Decoction and Ephedra Decoction on prostaglandin
production and hydrolysis of inositol phospholipids in cultured rabbit
astrocytes, Kampo Igaku 17: 200-217, 1993
7) Kurokawa M., Imakita M., Kumeda C. A. et al.: Pueraria Decoction
suppressed interleukin-1α production responsive to interferon andalleviated infkuenza infection in mice, J. Trad. Med. 13(3): 201-209, 1996
8) Yamaguchi H.: Common cold in patients with drug induced hepatitis;
Lecture seminar on Kampo medicine for medical students, 19979) Homma Y., Takaoka K., Yozawa H.: Comparative study using the envelop
method to determine the usefulness of Ephdra, Aconite and Manchurian
Wildginger Decoction for the common cold syndrome, Kampo Medicine (Jap.
Journal of Oriental Medicine) 47(2): 245-252, 1996
10) Kaji M., Kashiwagi S., Yamakido M.: Double-blinded comparative study
using Minor Bupleurum Decoction and a placebo for the treatment of thecommon cold, Jap. J. Clin. Exp. Med., 78(12): 2252-2268, 2001
11) Fujimori K., Suzuki E., Shimojo F.: Comparison of the efficacy of Dwarf
Lilyturf Decoction ; Ophiopogon Decoction to and dextromethorphanhydrobromide for residual cough following improvement of the common cold
syndrome (pilot study), Kampo Medicine (Jap. Journal of Oriental
Medicine), 51(4): 725-732, 2001

In daily clinical practice, antiviral agents like
Tamiflu, Relenza or Symmetrel, are used for thetreatment of influenza. Kampo preparations whenemployed skillfully, are also quite effective12,13,14).
Many of the formulas given in the “Shang han lun" areused for the treatment of this kind of disease in Japan.
This particular classic lists an abundance ofprescriptions designed for the treatment of pathologic
conditions caused by the invasion of wind cold evil.
Among extracts, Ephedra Decoction is frequently used,
but a combination of Cassia Twig Decoction andEphedra, Apricot, Licorice and Gypsum Decoction toprepare Major Blue Dragon Decoction, also finds
application15). During influenza epidemics Pueraria
Decoction has been used for prevention and reportedly
was found to be effective16).
12) Iwasaki K.: Special: New strategies for the treatment of cold andinfluenza; Cold and cold remedies as viewed in Kampo medicine, Current
Therapy 20(10): 1049-1053, 2002
13) Koizumi K.: Special: Management of the common cold syndrome andinfluenza for the primary care physician; An approach to the common cold
with Kampo medicine, Journal of Therapy 85(12): 3205-3210, 2003
14) Kimoto H., Kuroki H.: Significance of Kampo medicine during influenza
epidemics, Journal of Traditional Medicine 20(S): 146, 2003
15) Mitani K.: Case studies of patients with high fever treated the extract
preparation Major Blue Dragon Decoction , phil KAMPO 4: 15-16
16) Yakazu D.: Prevention of influenza, Sokai December issue 1975: 93-94

Most of the other infectious diseases require
western medical treatment. Yet, some infectious

diseases, difficult to treat with western medicine, arestill treated with Kampo preparations. For example,
Middle-Reinforcing and Qi-Benefiting Decoction, Ten
Strong Tonic Herbs Decoction or Ginseng Nutrition
Decoction are used for the treatment of chronic MRSA
infections17,18).
17) Kitahara M., Ishikawa S., Hara K.: Protective effect of Ten Strong Tonic
Herbs Decoction against infection after acute ischemic stroke in elderly
patients, Biotherapy 17(3): 287-298, 2003
18) Kitahara M.: The Effect of Supplementing Formulas for the Treatment of
MRSA infections in Neurosurgery, Evolving Kampo 2005, 1(1): 14-15

Regarding HIV infections, research has juststarted, but future results are anticipated with great
expectations. Please refer to the section on pediatricdiseases regarding measles, epidemic parotiditis,
roseola infantum, rota virus infections, Kawasaki
syndrome and similar pediatric diseases.
24. Cancer
In this field there are no Kampo prescriptions thatare definitely effective. However, Kampo medicine isused as adjunctive therapy following surgery forvarious malignant tumors, or else in combination withchemotherapy or radiation therapy and here plays asignificant role1). Frequently used preparations
includeMiddle-Reinforcing
andQi-Benefiting
Decoction, Ten Strong Tonic Herbs Decoction, Ginseng
Nutrition Decoction etc. and there is an extensive bodyof research pertaining to these drugs2,3,4,5,6). The
purpose of the Kampo therapy is to provide relief forthe suffering of the patients, prevent or alleviate theside effects of western medical therapies, improve
immune function, prolong survival and improve the
QOL. Each of the above mentioned preparations
improve immune function and influences NK cell
activity. In this field there is an abundance of basic
research and the drugs are topics in the relevant
academic societies7,8,9). Many basic studies have been
performed on those topics and their results support theclinics. Saiboku has investigated the inhibitive actionsof the aforementioned three preparations on thedevelopment of metastases and it is now becoming
clear that there are differences in their respectivemode of action. He states that the manifestation of theeffects of Kampo preparations may possibly be related
to physical disposition or else organ selectivity10).
In actual therapy, a number of cases that can betreated with extracts are rather limited, so that theuse of decoctions is required. Here the experiences
gathered in China prove to be useful and a significant
number of physicians put them to practical use. Those
physicians determine the Kampo medical pattern(SHO) according to the location of the malignant tumor
and its type and then prepare and administer suitable
formulas (which contain crude drugs with antitumor
activity)11). Shimizu selects the crude drugs

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Volume 1, Special Edition | Current Kampo Medicine 2005

corresponding to the malignant tumors of theindividual’s bowels and viscera and has proposed
preparations to be administered following surgery,radio- or chemotherapy respectively12).
1) Okamoto T., Sairenji M.: Significance of Kampo in the Treatment of Cancer,
Kampo and Most Advanced Therapies 4（2）: 123-128, 1995
2) Kuroda T., Imai J., Tamakuma S.: Prevention of Anticancer Drug Side
Effects by Ten Strong Tonic Herbs Decoction and Clinical Immunologic
Investigations Biotherapy 3（4）: 789-795, 1989
3) Fujiwara M., Kohmoto Y.: Usefulness of Ten Strong Tonic Herbs Decoctionin the Treatment of Myelostasis due to Chemotherapy for Gynecologic
Cancers, Journal of the Gynecology and Obstetrics in Chugoku andShikoku Region 47(2): 153-157, 1999
4) Abe K.: Effects on Side Effects due to Chemotherapy Following Cancer
Surgery, Prog. Med. 9: 2916-2922, 1989
5) Hasegawa K., Fukunishi H., Kiyoshige T. et al.: Journal of Traditional
Medicine 11, 181-187 1994: Clinical Effects of a Combination Therapy with
Kampo preparations ( Ginseng Nutrition Decoction , Ten Strong Tonic Herbs
Decoction ) to Alleviate the Side Effects of Carcinostatic Agents6) Sugimachi K.: Research into the Usefulness of Ginseng Nutrition Decoction
as an Adjuvant Chemotherapy After Surgery for Gastric Cancer, Clinics
and Research 72(2): 182-186, 1998
7) Kawakita T., Nomoto K.: Immunopharmacologic Actions of Ginseng Nutrition
Decoction and its Clinical Application, Prog. Med. 19: 2113-2121, 1999
8) Kawakita T., Nomoto K.: Immunopharmacologic Actions ofMiddle-Reinforcing and Qi-Benefiting Decoction and its ClinicalApplication, Prog. Med. 18: 801-807, 1998
9) Nakawa H., Sai B., Tsuno N. et al.: Effects of Ten Strong Tonic Herbs
Decoction and Middle-Reinforcing and Qi-Benefiting Decoction on Cells
with Induced Cancer Genes, Kampo and Most Advanced Therapies 4(2):129-132, 1995
10) Saiki I.: Cancer Metastases and Kampo Preparations, Science 75(7):842-845, 2005
11) Kotaka S.: Regarding Therapies for Malignant Tumors - Discussion, TCM
Clinics 17(2): 2-5, 1996
12) Shimizu H.: New Medical Revolution, Shuei Publications: 139-145, 2004

25. Pediatrics
The field of pediatrics, even when viewed
historically, has been from a comparatively early
period divided into subspecialities leading to theemergence of specialists, so that there is an abundant
body of experience with various diseases. In particular,
the ancient experiences with infectious diseases are
currently very helpful. Yet, the progress of modern
medicine in recent years resulted in a comparative
narrowing of the range of indications for Kampo
therapy. Simultaneously, new indications have arisenor have been developed, opening a new field.
Regarding acute infections, applications have been
attempted, in particular for the early phase of theso-called viral common disease. For the treatment of
epidemic parotitis (mumps) the use of Minor
Bupleurum Decoction1), for measles Cimicifuga andPueraria Decoction1) and White Tiger plus Ginseng
Decoction2), for roseola infantum White Tiger plus
Ginseng Decoction3) has been reported.
Due to the low age of onset, the treatment ofinfluenza with antiviral preparations is limited andtherefore often calls for the administration of Kampo
medicine. Ephedra Decoction, Pueraria Decoction and44

similar preparations are widely used. Abe conducted acomparative trial observing 783 patients divided into agroup treated with Kampo medicine and a control
group treated with western medications. According tothis study, progression to severe stages occurred in the
Kampo treatment group only infrequently 4).
1) Abe K.: Clinical Effects of Minor Bupleurum Decoction for the Treatment of
Mumps and Cimicifuga and Pueraria Decoction for the Treatment ofMeasles, Journal of the Japan Pediatric Oriental Medicine Society 13(1):14-20, 1997
2) Mizutani K.: Experiences with the Use of White Tiger plus Ginseng
Decoction (TJ-34) for the Treatment of Pediatric Febrile Diseases - Inparticular regarding measles, Pediatric Clinic 43(6): 1361-1364, 1990
3) Abe K. Tanaka K.: Effects of White Tiger plus Ginseng Decoction on Roseola
Infantum, Kampo Medicine (Jap. Journal of Oriental Medicine) 47(6): 118, 1997
4) Abe K.: Comparison of Therapeutic Results of Treating Type A Hongkong
Influenza with Kampo Medicine, Western Medicine or Amantadine
Hydrochloride, 63rd Yamakage Pediatric Conference, 1999

The common cold is a good indication for Kampo
medicine. During the early stages, Pueraria Decoction,
Ephedra Decoction, Bupleurum and Cassia Twig
Decoction, Ephdra, Aconite and Manchurian
Wildginger Decoction and similar preparations areused. There are a number of case series studies, but
their description will be omitted here. Clinicallyproblematic is interference with ordinary daily life inchildren due to recurrent upper respiratory tract
infections. These children are highly susceptible to thecommon cold, and once they are affected, the disease
tends to run a protracted course. They may only beable to consume small amounts of food, suffer fromrecurrent diarrhea and become exhausted with lightphysical exercise. This type of child in Japan is said tohave a "weak constitution". Long-term application of
Minor Bupleurum Decoction or Bupleurum and Cassia
Twig Decoction to these children has often been
observed to reduce their susceptibility to infections
and builds physical strength5). Akiba et al.
administered Bupleurum and Cassia Twig Decoction
for a long period to 14 children suffering fromrecurrent infections (catching cold easily) and reported
an efficacy of 78% 6). There are also other case series
studies dealing with the use of Bupleurum and Cassia
Twig Decoction in similar cases, where Koga et al.
found an efficacy of 88% (total number of patients 16) 7),
Mine found 90% (total number of patients 10) 8). Somecase series studies also investigated Minor Bupleurum
Decoction9). Iwama et al. treated 12 children withrecurrent tonsillitis with Bupleurum Liver-Clearing
Decoction and reported an efficacy of 80% 10).
5) Hirose S.: Children With Weak Constitution, 3(3): 253-257, 1994
6) Akiba T., Araki Y., Nakajima A. et al.: Improvements Caused by Long-term
Application of Bupleurum and Cassia Twig Decoction in Children
Susceptible to Common Cold, Kampo Medicine (Jap. Journal of Oriental
Medicine) 41: 149-155, 1991
7) Kouga M.: Easy Susceptibility to Infection (recurrent airway infections) and
Saiko Preparations, Journal of the Research of Japan Kampo Medicine for
Pediatrics 13(1): 71-75, 1997

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Volume 1, Special Edition | Current Kampo Medicine 2005
8) Mine M.: Practical Experiences with Bupleurum and Cassia Twig Decoctionin the Treatment of Nursery School Children Suffering from Frequent
Recurrent Infections, General Meeting at the Third Conference of The
Society of Ambulatory and General Pediatrics of Japan, 1993
9) Iwama M., Iriyama E.: Effects of Minor Bupleurum Decoction on Recurrent
Febrile Airway Infections, Kampo Igaku 25: 115-117, 2001
10) Iwama M.: Bupleurum Liver-Clearing Decoction for the Treatment ofRecurrent Tonsillitis, Journal of the Japan Society of Pediatrics, 1995

Regarding infections of the gastrointestinal tract,
vomiting associated with the early phase of acute viralgastroenteritis and treatment with Poria Powder with
Five Herbs has received much attention. In particular,
for the treatment of vomiting associated with rota
virus induced gastroenteritis, this medication applied
as suppository or enema has frequently been reported
as being extremely effective11,12,13,14). This formula has
traditionally been applied orally like other Kampo
formulas, but in cases of vomiting, the administration
may prove difficult. If a rapid onset of the effect isrequired, pediatricians sometimes prepare andadminister suppositories or enemas themselves.
Regarding this use, section 74 of the "Shang han lun"lists the "water reversal pattern" and describes thepractical application of Poria Powder with Five Herbs
for its treatment. Moreover, in developing countries,
where modern medical equipment like intravenous
drip infusions are not available, this preparation could
play an important role in lowering mortality.
11) Hashimoto H.: The Effects of Poria Powder with Five Herbs on Vomiting
Associated with Common Cold Induced Gastroenteritis - Ideas offacilitating oral application, Kampo Igaku 25: 178-180, 2001
12) Fukutomi O., Matsuo N., Teramoto T. et al.: Examination of Poria Powder
with Five Herbs Enemas for the Treatment of Vomiting Associated with
Acute Pediatric Gastroenteritis, Japanese Journal of Pediatric 53: 967-970,
200013) Hashimot H.: Comparative Study of Poria Powder with Five Herbs andMinor Bupleurum Decoction, Poria Powder with Five Herbs Enemas for theTreatment of Vomiting Associated with Pediatric Viral Gastroenteritis,
Kampo Igaku 25: 73-75, 2001
14) Yoshida M.: Effects of Poria Powder with Five Herbs Suppositories for theTreatment of Vomiting in Infants and Children, Oriental Medicine 28(3):36-38, 2000

Acute bronchitis, asthmatic bronchitis etc. areamong those respiratory diseases for which Kampo
medicines are frequently used. Ephedra, Apricot,
Licorice and Gypsum Decoction, Minor Blue Dragon
Decoction, Minor Bupleurum Decoction, Combind

Minor Bupleurum Decoction and Pinellia andMagnolia Decoction, Dwarf Lilyturf Decoction andsimilar preparations are frequently used, but sincethese are very ordinary diseases, no case series studies
are available. Mycoplasmal pneumonia does notparticularly require treatment with Kampo medicine,but during the acute phase, a combination of theantibacterial medication with Minor Bupleurum

Decoction and Lophatherus and Gypsum Decoction
was able to shorten the required treatment period withthe antibacterial agents and also decreased theduration of the morbidity in the treatment group 15).
Moreover, some studies showed that in a group treatedwith Ephedra, Apricot, Licorice and Gypsum Decoction
during the chronic phase, it shortened the duration of
coughing and led to an earlier normalization of the
CRP values16).
15) Miyazaki Z., Mori K.: Acute Mycoplasmal Pneumonitis, Minor Bupleurum
Decoction and Lophatherus and Gypsum Decoction , 200116) Miyazaki Z., Mori K.: Convalescence Period of Mycoplasmal Pneumonitis,
Ephedra, Apricot, Licorice and Gypsum Decoction , 1994

Among the diseases of the cardiovascular system,
Kampo therapy is often applied to orthostatic
hypotension. Mori et al. treated 74 patients meetingthe diagnostic criteria for orthostatic dysregulation
with Bupleurum and Cassia Twig Decoction andobserved improvement for all symptoms. The severityof all symptoms after 4 weeks of treatment wassignificantly lower than that before treatment.
Regarding the chief complaint, a more than mild
improvement was reported for 64.7% of the cases 17).
There are also reports about the use of Pinellia,
Largehead Atractylodes and Tall Gastordia Decoction,
Middle-Reinforcing and Qi-Benefiting Decoction,
Minor Middle-Strengthening Decoction and similar
preparations18,19), either of which showed favorable
results. Arrhythmia too is an indication. Otsuka et al.
treated 31 children with extrasystoles with Roasted
Licorice Decoction extract and found an improvementin supraventricular extrasystoles of approximately
70%, for ventricular extrasystoles a rate of 62%, andreported the resolution of the comparatively dangerous
ventricular tachycardia in 4 out of 5 patients20).
17) Mori M., Yamada K., Saka M. et al.: Clinical Application of Bupleurum andCassia Twig Decoction for Orthostatic Dysregulation, Japanese Journal of
Pediatrics 45: 1964-1974, 1992
18) Tsuru N.: Clinical Experiences with of Pinellia, Largehead Atractylodes
and Tall Gastordia Decoction and Minor Middle-Strengthening Decoction in
the Treatment of Orthostatic Dysregulation, Japanese Journal of Pediatric
48: 585-591, 1995
19) Tomita H., Chiba S., Kadowaki J. et al.: Clinical Effects of Middle-Reinforcing
and Qi-Benefiting Decoction for Orthostatic Dysregulation in Children, The
Journal of Pediatric Practice 60: 162-167, 199720) Otsuka Y.: Extrasystoles (Arrhythmias), The Journal of Pediatric Practice67: 1481-1481, 1988

Kampo medicine is also used for the treatment ofconstipation in children. Muramatsu et al. treated 72
constipated children without any organic disease withMajor Middle-Strengthening Decoction extract andreported improvement in 69.4% of the cases after one
week and 79.2% after two weeks21). Aoki et al. treatedrefractory constipation in severely handicappedchildren with Hemp Seed Pill and Rhubarb andLicorice Decoction
and observed a significantly
increased frequency of spontaneous bowel movements
and also a significantly decreased frequency of enema
administrations and thus stated that bothpreparations are useful22).

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The range of application of Kampo therapy in
pediatrics
has
recently
widened.
Major
Middle-Strengthening Decoction is used to treat
early transport disorders or the development ofadhesive ileus following gastrointestinal surgery
and in many reports, has been described as very
useful 23, 24). When western medical treatment ofpediatric hemorrhoids or perianal abscesses provesdifficult, the application of Middle-Reinforcing and
Qi-Benefiting Decoction reportedly led to good results.
Muramatsu et al. treated 65 patients (all children
were male and age ranged from 22 days to 5 years)
with perianal abscesses or hemorrhoids with Ten
Strong Tonic Herbs Decoction, observing the course incomparison to a 28-patient control group in which only
incisions and pus drainage were performed. In thetreatment group (3 patients dropped out, because they
were unable to use the medication) 13 required an
incision and 1 patient required surgery, but theremaining 48 patients (77.4%) reportedly healed.
There is a report describing that short-term
therapeutic results were best in the Ten Strong Tonic
Herbs Decoction treatment group 25).
21) Muramatsu T., Kawamura K., Kuriyama Y. et al.: Usefulness of Treatment
with Middle-Reinforcing and Qi-Benefiting Decoction for Chronic PediatricConstipation - Evaluation with a constipation score, Japanese Journal of
Pediatric Surgery 32: 285-290, 2000
22) Aoki H., Nishikura T., Ono S. et al.: Kampo Therapy for Constipation in
Severely Handicapped Children - Comparison of Hemp Seed Pill andRhubarb and Licorice Decoction , Kampo Igaku 21(28): 21-24, 1997
23) Fukushige T., Takamatsu H., Noguchi H. et al.: Clinical Experiences withMajor Middle-Strengthening Decoction for Insufficient Postsurgical
Peristalsis, Ileus, Prog. Med. 17(9): 2554-2558, 199724) Kawase K., Satomi A., Yoshida H. et al.: Clinical Experiences in Our
Department with Major Middle-Strengthening Decoction , Prog.Med. 17(9):2550-2553, 199725) Muramatsu T., Fuseya S.: Clinical Experiences with Ten Strong Tonic
Herbs Decoction for the Treatment of Perianal Abscesses in Infants,
Japanese Journal of Pediatric Surgery 32: 1322-1325, 2000

In most cases, idiopathic thrombocytopenic
purpura (ITP) develops as an acute form and isresolved spontaneously after a few months, but forpatients with chronic forms not responsive totreatment, Kampo therapy is also performed. Takeda
et al. administered Modified Back to the Spleen
Decoction to 7 children with ITP resistance to western
medical treatment and achieved an efficacy of 33% 26).
Occasionally there are also individual case reports
about this disease.
26) Takeda T., Nagatate N., Hatae Y. et al.: Clinical Experiences with Tsumura
Modified Back to the Spleen Decoction for the Treatment of Chronic
Thrombocytopenic Purpura, Iryo 46(12): 1016-1019, 1992

Kampo therapy is used for patients with
Henoch-Schönlein purpura resistant to western
medical treatment. Single case reports have been
published 27).
27) Tsuji Y., Abe Y., Hisano M. et al.: Cases of Allergic Purpura Effectively
Treated with Kampo, Kampo Igaku 27: 169-172, 2003

46

The application of Kampo therapy during the earlystages of Kawasaki disease is reportedly associatedwith a favorable prognosis. Hirota et al. divided 19
patients in the acute phase of Kawasaki disease into
two groups and treated both groups with the required
western medical therapy. Group 1 (including 11
patients) received Coptis Detoxificating Decoction andwas then compared with a placebo group (8 patients).
The results revealed that a combination therapy ofvitamin E and Coptis Detoxificating Decoction for
Kawasaki disease improves the anti-inflammatory
effects and lipid metabolism, also improving the
prognosis for the vascular changes and has therefore
been described as an excellent therapy 28).
28) Hirota A., Senaga R., Kawashima S.: Examination of the Effects of Coptis
Detoxificating Decoction on Kawasaki Disease Using a Double-Blind Study,
Japanese Journal of Pediatrics 38: 2329-2335, 1985

The therapy for pediatric bronchial asthma inrecent years has made enormous progress, so that theopportunities for using Kampo medicine are now lessfrequent than before. Yet, a wealth of experiences withthe application of Kampo therapy for this disease has
accumulated and is now used widely. Numerous
preparations are used, but the most widely usedpreparation is Combind Minor Bupleurum Decoction
and Pinellia and Magnolia Decoction and several caseseries studies have investigated its application. Ito etal. conducted a randomized controlled trial (RCT)examining 43 pediatric patients with bronchial asthma
divided into a Combind Minor Bupleurum Decoction
and Pinellia and Magnolia Decoction treatment group
including 23 patients and a tranilast treatment groupof 21 patients. Twelve weeks after the treatment,
general improvement and better than mild
improvement was observed in 95% of the patients in
the Combind Minor Bupleurum Decoction and Pinellia
and Magnolia Decoction group, whereas the same ratio
was reportedly 73.7% in the tranilast group 29).
Watanabe et al. treated 22 patients with atopic asthma
over a period of three months with Combind Minor

Bupleurum Decoction and Pinellia and Magnolia
Decoction extract and found improvements in 16 of thepatients (72.8%) and better than mild improvements
in 22 patients (100%) 30). Minor Blue Dragon Decoctionis also frequently used. Inoue et al. treated 9 patients
about to develop an attack that started with runnynose, sneezing and then developed into cough andphlegm with Minor Blue Dragon Decoction extracts.
This reduced the number of attacks significantly. In sixof these patients, improvements were observed 31).
When the treatment with extract preparations
remains ineffective, the application of decoctions is
worth a try and has been reported to produce goodresults32).

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

Volume 1, Special Edition | Current Kampo Medicine 200529) Ito S., Mikawa H.: Effects of Combind Minor Bupleurum Decoction andPinellia and Magnolia Decoction in the Treatment of Pediatric Bronchial
Asthma - Multi-facility joint research And Comparative Trial with Tranilast,
The Clinical Report 26: 3993-3998, 1992
30) Watanabe H.: Long-term Administration of Combind Minor Bupleurum
Decoction and Pinellia and Magnolia Decoction for Exercise Induced
Asthma and Airway Hypersensitivity in Bronchial Asthma, Kampo
Medicine (Jap. Journal of Oriental Medicine) 41: 233-239, 199131) Inoue K.: Clinical Effects and Limitations of Kampo Therapy for Bronchial
Asthma, Pediatrics of Japan 31: 531-540, 1990
32) Yamaguchi H.: Experience with the Use of Decoctions for the Treatment ofPediatric Bronchial Asthma Where Western Medical Treatment Has
Become Difficult, Φυτο 1(4): 14-17, 2001

Regardingatopicdermatitis,
Bupleurum
Liver-Clearing Decoction, Wind Dispersing Powder,
Coptis Detoxificating Decoction, Middle-Reinforcing
and Qi-Benefiting Decoction, Warming and Clearing
Decoction, For Eczema Decoction, White Tiger plus
Ginseng Decoction, and similar preparations areprescribed and there are many related studies.
Temporarily, high hopes have been placed on Kampo
therapy for this disease in Japan due to an aversion tosteroids. Yet, except for a very small number of cases,
it has been shown that with proper skin care thetreatment of this condition is not that difficult Today
Kampo medicines are not used as frequently as in thepast and independent treatment with Kampo medicine
is not performed. Still, Kampo therapy does have acertain beneficial effect on this disease. Among thecase series studies, particular attention has been paid
to the effects of Middle-Reinforcing and Qi-Benefiting
Decoction for the treatment of infants (which differsfrom that in adults). Tsuji et al. administered
Middle-Reinforcing and Qi-Benefiting Decoction to 187
patients aged between 3 and 6 years with atopic
dermatitis. Observing these patients for a period of 24
weeks, workers found improvements for all the items:
pruritus, erubescence, papules, vesicles, erosion,
hyperplasia, lichenification and scratch marks. In the
24th week, the number of patients that could be
evaluated was 71. Marked improvement was found in
23.9%, intermediate improvement in 62.0% and better
than mild improvement in 85.9%. Further, the use of
topical steroids could significantly be decreased 33).
When Ito et al. treated 25 children with atopic
dermatitis in whom topic medications had not been
sufficiently effective over a period of 12 weeks, theyobserved significant differences in the improvement
following the second week and thus reportedly
achieved a better than mild improvement in generalcondition in about 80% of the patients34).
33) Tsuji Y., Tsujimoto Y., Iikura Y. et al.: Investigation of the ClinicalUsefulness of Middle-Reinforcing and Qi-Benefiting Decoction for theTreatment of Pediatric Atopic Dermatitis, The Japanese Journal of Clinicaland Experimental Medicine 70: 290-299, 199334) Ito S.: Clinical Experiences with the Use of Bupleurum Liver-Clearing
Decoction Granules for the Treatment of Atopic Dermatitis, The Journal of
Traditional Sino-Japanese Medicine, Vol. 10 No.1, Supple. Kampo Therapy
for Intractable Diseases or Conditions, second volume: 202-203, 1989

Regarding renal and urinary diseases, several
studies have dealt with the use of Kampo medications
for chronic glomerular nephritis, nephrotic syndrome
and IgA nephropathy. Minor Bupleurum Decoction,
Poria Powder with Five Herbs extract wasadministered over a period of 1 year to 101 patientswith chronic glomerular nephritis (including 32
patients with IgA nephropathy) and 129 patients withnephrotic syndrome in a multi-facility case series study.
Improvements were achieved in 63.8% of the patientswith chronic glomerular nephritis and 61.5% of thepatients with nephrotic syndrome. Regarding thetissue forms, this patient population included 46
patients with proliferative changes of whom 62.5%
showed better than mild improvements with 36.4% of
the 11 patients with focal sclerosis showing mild
improvement In 28 patients with IgA nephropathy,
Better than mild improvements were observed in
67.9% of the cases, and in 94 patients with nephrotic
syndrome presenting minimal changes, better thanminor improvements were reportedly observed in
61.7% of the cases35). Yazaki et al. treated 80 pediatricpatients with nephrotic syndrome over an average
period of one year with Minor Bupleurum Decoction,
Poria Powder with Five Herbs and thus could
reportedly observed some degree of prevention ofrecurrences and a dose reduction in steroids36). Ito et al.
used Minor Bupleurum Decoction, Poria Powder with
Five Herbs extract for 221 patients with nephrotic
syndrome in combination with steroid medications andobserved a reduction in the frequency of recurrences 37).
Yoshikawa et al. used Minor Bupleurum Decoction,
Poria Powder with Five Herbs for 101 patients withIgA nephropathy showing mesangial proliferation in a
RCT and found after 2 years normalization of theurinary findings in 46% of these patients, which was asignificantly higher ratio than in the control group 38).
Based on these facts, Ito et al. concluded that Minor

Bupleurum Decoction, Poria Powder with Five Herbs

alone in the treatment of IgA nephropathies duringchildhood, characterized histologically by minimalchanges or else focal mesangial proliferation, iscapable of significantly inhibiting proteinuria andhematuria39). Although few in number, some reports
also describe purpuric nephritis40).
Since aggravation of IgA nephropathy may betriggered by infections, it has become clear that
tonsillectomy in conjunction with steroids leads to an
improvement in the hematuria. In other words, if no
infections occur, there will also be no aggravation in
the renal lesions. As stated above, since treatment
with Kampo medicine decreases the susceptibility toinfection, formulas like Bupleurum and Cassia Twig
Decoction or Minor Bupleurum Decoction (theseformulas are included in the preparation Minor
Bupleurum Decoction, Poria Powder with Five Herbs)
etc. are used in order to decrease the chances for
infection in attempts at improving the prognosis of thisdisease.

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47

Volume 1, Special Edition | Current Kampo Medicine 2005
35) Yoshikawa N., Ito T., Takekoshi Y. et al.: Combination Therapy with Minor
Bupleurum Decoction, Poria Powder with Five Herbs for Patients with
Steroid-reactive Pediatric Nephrotic Syndrome During the Early Treatment
Phase with Steroids and Recurrences - Prospective controlled study Journal of The Japanese Society of Nephrology 40: 587-590, 1998
36) Yasaki T., Hirose S.: Clinical Effects of Minor Bupleurum Decoction, Poria
Powder with Five Herbs for Pediatric Nephrotic Syndrome, Journal of
Traditional Medicine 4: 203-206, 198737) Ito K., Okada T., Kitagawa T. et al.: Ethical Kampo Medicines for Pediatric
Chronic Glomerular Nephritis and Pediatric Nephrotic Syndrome: ClinicalEffects of Minor Bupleurum Decoction, Poria Powder with Five Herbs Multi-facility open trial - Kidney and Dialysis 36: 1237-1246, 1994
38) Yoshikawa N., Ito T., Sakai T. et al.: Prospective Controlled Trial Using
Minor Bupleurum Decoction, Poria Powder with Five Herbs for theTreatment of Pediatric IgA Nephropathy Showing Focal and Minimal
Mesangial Proliferative Lesions, The Japanese Journal of Nephrogy 39:
503-556, 199739) Ito K., Miyagawa S.: Chronic Nephritis, IgA Nephropathy, Purpuric
Nephritis, The Journal of Pediatric Practice 67: 1462-1466, 2004
40) Tsuru N., Tokieda K., Niimi K.: Clinical Effects of Tsumura Minor
Bupleurum Decoction, Poria Powder with Five Herbs in the Treatment ofPediatric IgA Nephropathy and Purpuric Nephritis, The Japanese Journalof Clinical and Experimental Medicine 67(9): 236-242, 1990

Among the neurological diseases Kampo medicine
is frequently applied for epilepsy. Several reports
describe the use of Bupleurum and Cassia Twig
Decoction, Minor Bupleurum Decoction and Cassia
Twig Decoction plus Peony , Bupleurum plus Dragon’s
Boneand
OysterShell
Decoction,
Minor
Middle-Strengthening
Decoctionandsimilarpreparations for the treatment of refractory epilepsy
difficult to control by western medical treatment. Okabe
administered Kampo medicine to 26 patients withrefractory epilepsy and reportedly observed marked
effectiveness in one patient (disappearance of attacks)
and an effectiveness in 12 patients41). Sugimoto et al.
administered in addition to the ongoing treatment,
anticonvulsants Tsumura Minor Bupleurum Decoction
extract
granulesandTsumura
Minor
Middle-Strengthening Decoction extract granules to 30
patients (24 patients with mental retardation, 8
patients with cerebral paralysis) with refractory
epilepsy, particularly patients presenting complex
partial seizures. They observed 2.5 years after
initiation of the combination therapy, a marked
effectiveness in 5 patients, effectiveness in 6,
temporary effectiveness in 5, no effects in 10 andaggravation in one patient, resulting in an overall
efficacy of 40% 42). Seki too administered Minor

Bupleurum Decoction and Cassia Twig Decoction plus
Peony to 24 patients with refractory epilepsy andreportedly observed marked effectiveness in 4 patientsand effectiveness in 3, resulting in an overall efficacy
of 29%43).
41) Okabe T.: Kampo Therapy of Neurologic Diseases in Children, The Journalof Traditional Sino-Japanese Medicine 12: 29-37, 199142) Sugimoto T., Yasuhara A., Nishida N. et al.: Kampo Combination Therapy
for Refractory Epilepsy - Treatment with Minor Bupleurum Decoction andMinor Middle-Strengthening Decoction , Japanese Journal of Pediatrics
45(12): 2875-2880, 1992

48

43) Seki T.: Effects of Kampo Medicine (Combined Application of Minor
Bupleurum Decoction , Cassia Twig Decoction plus Peony ) on Refractory
Epilepsy, Oriental Medicine19: 16-22, 1995

In the field of Kampo therapy many attempts at
improving the various problems or disturbances
occurring during the developmental phase of children
have been made. Kin et al. used Licorice, Wheat andChinese Date Decoction for 8 pediatric patients withbreath holding spells and intractable epilepsy to theantiepileptic agents, and reported clear findings ofclinical efficacy with four complete responses and four
effective responses44). Itakura et al. used Licorice,
Wheat and Chinese Date Decoction for 24 patientswith night terrors and reported finding an efficacy of
87%45). The formula Liver-Inhibiting Powder is also
used for this disease. Several attempts have also been
made for patients with autism or ADHD, in whom
pharmacotherapy is difficult. Ida administered Major
Bupleurum
Decoction,
Cold
Limbs
Powder,Liver-Inhibiting Powder and similar preparations to 30
autistic patients (including adults), in whom treatment
had been initiated under the age of 13 years anddescribed an overall improvement ratio including 100%
improvement in sleep disorders, 88.9% improvement in
hyperactivity, 71.4% improvement of temper tantrums,
78.3% improvement of panic attacks, 87.5%
improvement for self-mutilation, 90.0% improvement of
sudden outbursts of violence, 77.8% improvement ofcompulsive
retention,
68.8%
improvementincompulsive behavior, 80.0% improvement of ritual
behavior, 83.3% improvement of unreasonability and80.8% improvement in communication skills46).
Okashima et al. used various different Kampo
medicines in the treatment of severely handicappedchildren presenting night terrors, displaying violent
behavior and similar symptoms and described favorable
results obtained through this treatment. The formulas
used included Licorice, Wheat and Chinese Date
Decoction extract, Liver-Inhibiting Powder extract,
Modified Merry Life Powder extract and similar
preparations47). Takeuchi et al. treated various problems
in children with developmental disorders (Asperger
disorder, higher function autism, ADHD, extensive
developmental disorders, mental retardation with
autistic tendencies) with Kampo medicine and described
9 cases in which an improvement had been achieved48).
Liver-Inhibiting Powder is a formula frequently used
for diseases in this field. This formula was listed by the
famous physician Xue Kai in his own textbook ofpediatrics in the 16th century. It is particularly
noteworthy that he added a statement that "bothmother and child should take the drugs". As an
excellent pediatrician he was well aware of themother's influence on the child's diseases and thus

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

Volume 1, Special Edition | Current Kampo Medicine 2005

explained the importance of treating the mother aswell when children are sick. A number of reports havedescribed
thepractical
applicationof
thisconcept49,50,51,52,53).
Egawa treated 97 patients with the Kampo medical
pattern (SHO) of the Liver-Inhibiting Powder with

Tangerine Peel, Pinellia Rhizoma and Liver-Inhibiting
Powder and reported an efficacy of 55%. Although he isa pediatrician, he included mothers, aged 30-50, in his
study. They were also treatred with this formula. The
author explains that treating the mother facilitates
follow-up observations of the children54). Nishimura etal. explained that the simultaneous treatment ofmother and child based on historical views and thecurrent variety of clinical applications can besubstantiated citing multiple cases55).
In the treatment of adult psychosomatic orders,Kampo medicine may not have any effect on the mental
aspects. However, in children it is extremely effective
for hyperactivity, tension, sleep disorders, tantrum andsimilar neuropsychologic symptoms. The situation hereis markedly different from that in adults.
44) Kin M., Murata R., Matsuoka O. et al.: Effects of Licorice, Wheat and Date
Decoction for Breath Holding Spells and Epileptic Children, The Journal of
Pediatric Practice 47(2): 268-272, 1988
45) Itakura T., Yamaoka K., Konishi H..: Effects of Licorice, Wheat andChinese Date Decoction for Night Crying, Sleep Drunkenness, Kampo
Shinryo 11(12): 44-45, 1992
46) Iida M.: Autism The Journal of Pediatric Practice 67: 1489-1492, 2004
47) Okajima Y., Yamada T.: Usefulness of Kampo Extract Preparations for theTreatment of Night Crying, Excitation, Violence and the Like in Children
with Severe Developmental Disorders, Iryo 43(6): 700-703, 198948) Takeuchi N., Ishizaki A.: Children with Developmental Disorders andTheir Treatment with Oriental Medicine, Jpn. J. Pediatr. Surg. 37(3):348-351, 200549) Egawa M.: Family Therapy Examples for School Refusal, Kampo Formula
Manual, Tangerine Peel, Pinellia Rhizoma plus Liver-Inhibiting Powder,
Shibunkaku Publications: 348-349, 1991
50) Egawa M.: Anorexia Nervosa, Kampo Formula Manual, Tangerine Peel,
Pinellia Rhizoma plus Liver-Inhibiting Powder, Shibunkaku Publications:348-349, 1991

51) Matsuda K.: Treatment of Mother and Child with Yokkan San Ka
Shakuyaku in Cases of School Refusal, Practical Kampo Therapy Based on
Cases, Sogensha: 169-170, 199252) Miyazaki Z.: Effectiveness of Simultaneous Treatment of Mother and Child
with Tangerine Peel, Pinellia Rhizoma plus Liver-Inhibiting Powder,
Journal of Kampo Medicine 42: 333-336, 1995
53) Kobayashi T., Nagasawa K.: One Case of Myospasia Impulsiva Where
Simultaneous Treatment of Mother and Child with Liver-Inhibiting Powder
was Markedly Effective, Kampo Igaku 27: 75, 2003
54) Egawa M., Matsuda K., Otsuka Y.: Clinical Trials for Liver-Inhibiting
Powder, Tangerine Peel, Pinellia Rhizoma plus Liver-Inhibiting Powder,
Kampo Medicine (Jap. Journal of Oriental Medicine) 38(4): 13-17, 1988
55) Nishimura K., Watanabe K.: Simultaneous Treatment of Mother and Child,
The Journal of Pediatric Practice 67: 1514-1518, 2004

Yamaguchi, employed at a large hospital in Aichi
prefecture, treats almost all conditions ranging fromthose encountered in a pediatric emergency room tomany chronic diseases. While training many interns,
and being the head of the pediatric department, he hasat the same time a profound knowledge of Kampo
medicine. He treated 89 patients with Kampo medicine(decoctions) for whom standard western medical
treatment proved difficult and published the results.
The overall improvement ratio of 64% was very positive.
This work certainly verifies that Kampo medicine willplay in the future a very important role in this field 56).
56) Yamaguchi H.: Kampo Therapy for Patients Difficult to Treat with
Western Pharmacotherapy - Experience with Kampo decoction in pediatrics- The Journal of Pediatric Practice67: 1542-1546, 2004

Conclusions
Current Kampo therapy for a number ofrepresentative diseases has been described. Kampo
medicine is a system with an extremely broad range ofapplications of which only a portion has been described
here. Due to the lack of space, descriptions of thetheoretical aspects of Kampo medicine have been kept
to a minimum. A comprehensive list of thesedescriptions is found in cited references.

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49