Volume 9, Number 1 | Spring 2014

Editorial
The Difference between TCM and Kampo Medicine
Do you know the difference between TCM and Japanese Kampo medicine? Both are traditional medicine ofEastern Asia originating in ancient Chinese medicine, they use practically the same drugs, and they utilize
prescriptions that have the same names. However, their difference lies in the process from diagnosis to therapy.
TCM is a combination of physiology, anatomy, etiology, pathology, and their therapeutics, based mainly on
the Theory of Yin-Yang and the Five Elements and other ancient Chinese philosophical theories. The therapeutics
is performed by applying pharmacognosy and prescriptionology that stem from the same theories.
Over time, this system developed with the influence of medicine from the West, as well as of Buddhism andTaoism. By the end of the 16th century, it formed a large region of medical culture that included the Korean
Peninsula, Japan and Vietnam.
This situation continued for about a century, when a change occurred—in Japan only. The change wastriggered by the strong influence that the boom in Shang han lun studies in 17th-century China had on Japan.
Furthermore, at around the same time, a movement occurred that claimed that Japan’s world of thought whichmainly centered on Neo-Confucianism should embrace a revival to Confucianism. In response to this movement,a school of medicine emerged, which claimed that medicine should also attach foremost importance on the greatclassic of ancient Chinese medicine, Shang han lun. Yoshimasu Todo, who belonged to this school, invented asystem for using prescriptions written in the Shang han lun according to their written descriptions. The system
did not place weight on assessing pathological patterns (referred to as “patternsTM1” in ICD-11) in TCM, but
aimed solely to determine the best prescription to administer to each patient.
After Yoshimasu announced his system, the medical community in Japan fell largely into confusion, and ahuge debate erupted between pro- and anti-Yoshimasu groups. Ultimately, the supporters won the debate, andother schools were left to merely pass down their lineage. One reason for Yoshimasu’s success was that he focusedon utilizing the basic prescriptions of Shang han lun. Another reason was because the system could directly
determine which prescription was needed by each patient by assessing their signs and symptoms, without
applying TCM theories to therapy.
However, there were many problems in applying the descriptions of the classic work to patients as they are.
New physicians needed to study under a distinguished mentor for a certain duration and, above all, they needed
to gain first-hand experience. Thus, physicians of succeeding generations established categorical classifications
within the system’s structure that directly linked symptoms to prescriptions, and devised an expedient thatwould facilitate the selection of the best prescription for each patient. Today, the Japanese Society of Oriental
Medicine recommends this variation. It uses the three basic elements of qi-blood-fluid, yin/yang,exterior/interior, cold/heat, deficiency/excess, and the six stage patterns as auxiliary classifications for theselection of the best prescription, and does not analyze them for the purpose of analysis.

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

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Volume 9, Number 1 | Spring 2014

The advantage of this Japanese system lies in being able to utilize the accumulation of knowhow for
administering the excellent prescriptions of the Shang han lun by incorporating them into the system.
Furthermore, it is worthy of special mention that it facilitates clinical studies by utilizing extract preparations byprescription units. The standards of extract preparations by pharmaceutical companies in Japan are basically thesame, so the same effect can be obtained from the product of any company.
The greatest reason why integrated medicine that includes Kampo medicine has succeeded without problem
in Japan despite the focus placed on Western medicine practices within a unified health care system, is because
Japan has a system of Kampo medicine that differs from TCM.
This is not a matter of determining whether TCM or Kampo medicine is better than the other. I simply wantto say that integrated medicine can be made even better by using the two systems of traditional medicine (havingthe same origin) and Western medicine effectively.

Hiromichi Yasui
Japan Institute of TCM Research

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