Volume 7, Number 2 | Summer 2012

EditorialTransition of Indications for Kampo Medicine in Japan
Before Western medicine was introduced to Japan, any diseases were indicative of Kampo
medicine. In 1869, following the Meiji Restoration, the new Japanese government adopted
German medicine as well as the medical education and the system as a standard. Thoughremarkable progression had been made in some basic medicines such as pathology andbacteriology and development in public health, western therapeutic science around that time wasstill developing; a definitive way to treat diseases was not established. On the other hand, Kampo
medicine had shown many therapeutic effects with application of appropriate prescription use
for many diseases in its long history.
Japanese traditional medicine once declined was reviewed in the 1930's for its prominent
therapeutic effects and for many literatures that a few excellent Kampo doctors left with favorable
results of their treatment. These became a foundation of today's Kampo medicine. "Practice ofClinical Kampo medicine"(1941) was a representative book that these doctors wrote, which
attracted an attention from medical community of the day. It was later revised upon request ofthe times and was published in 1969 under the name of "Norm of Kampo Medicine". This book
was translated into English by Hong-yen Hsu from Taiwan and published in the United States in1982 under the name "Natural Healing with Chinese Herbs".

Norm of Kampo medicine

Natural Healing with Chinese Herbs

Meanwhile, western medicine has developed significantly in the last half century andtreatment methods have also advanced. With the development of modern Western medicine, anumber of clinical indications of Kampo medicine have been steadily decreasing, and completelychanged from 50 years ago.

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

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Volume 7, Number 2 | Summer 2012

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include attenuation of physical function and reduction in muscular strength. This indicates that sarcopenia
reduced,but instead, therapeutic areas indicative of Kampo medicine have clearly been
is closely associated with frailty. The presence of sarcopenia is associated with dizziness, fall/fracture, andhighlighted. It is a new therapeutic field in which Western and Kampo medicines are integrated.
frailty in elderly individuals, and correlates closely with physical dysfunction and conditions requiring
In the future, Kampo medicine
will acquire new indications in the new world.
assistance with daily living (1).
2. The term “asthenic” was seemingly used in the early 20th century.
Hiromichi
Yasui
Concepts such as frailty, locomotive syndrome, and sarcopenia, which correspondto the Japanesetermthcentury
Western“Kyojaku” or “weak constitution” were already in use at the beginningthe 20 ofJapan ofInstituteTCM inResearchcountries. In 1908, a publication in the journal Lancet used the term “asthenic constitution” to indicate thegroup of diseases causing “atonic habit of body” in the broader sense of the term. These conditions
included floating kidney, gastroptosis, enteroptosis, nervous dyspepsia, and neurasthenia (1). The term“asthenic” seems to have been a word that was prevalent in those days. This term was also used in thefamous paper on body build and physical constitution typing by Kretschmer. Kretschmer described three
types of body build: pyknic (stocky and rounded), athletic (with strong development of muscles andbones), and asthenic or leptosomatic (lean and narrow) (1).
3. What is the traditional medicine term corresponding to frailty, locomotive syndrome, and sarcopenia?
Before discussing Kampo medicine terms corresponding to frailty, locomotive syndrome, and sarcopenia,
we will focus only on the physical aspects of frailty without considering the mental/psychological andsocial aspects mentioned in its definition to simplify the discussion. We will thus treat locomotive
syndrome and frailty as the same concept and explore Kampo medicine terms corresponding to thisconcept.
The Kampo medicine or traditional Chinese medicine terms corresponding to locomotive syndrome andfrailty seem to be “leg weakening/adynamia” and “weakening/adynamia,” which were used in“Dokkatsukiseito, or Pubescent Angelica and Taxillus Decoction (Du Huo Ji Sheng Tang, 獨活寄生湯)” in themonograph “Important Formulas Worth a Thousand Gold Pieces (Bei Ji Qian Jin Yao Fang, 備急千金要方)”(1). “Pubescent Angelica and Taxillus Decoction” is an Eight-Treasure Decoction (Ba Zhen Tang, 八珍湯)
made of a Four-Substance Decoction (Si Wu Tang, 四君子湯) with blood-replenishing activity and a FourGentlemen Decoction (Si Jun Zi Tang) with Qi-replenishing (補気) activity. This herbal mix has been usedto treat (1) conditions characterized by physical senescence (kidney deficiency according to traditional
Chinese medicine); and (2) those condition involving shortages of Qi and blood accompanied by cold
sensation and pain in the lower back and knees due to moisture or water retention, and by fear of coldness,pleasure with warmness, weak/powerless legs, and paralysis/neuralgia/swelling attributable to external
factors (invasion by disturbing factors, such as wind, coldness, and moisture). In Japan, Pubescent Angelicaand Taxillus Decoction is often replaced with an herbal extract called “Relax the Channels and Invigorate
the Blood Decoction (Hu Jing Huo Xue Tang, 疎経活血湯),” which is covered by the national healthinsurance system.

2The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)