Volume 5, Number 3 | Fall 2010

Kampo Formula Developed in Japan (3)Fructus work to clear heat and expell toxins inSaikoseikanto
Hiromichi Yasui
Japan Institute of TCM Research
ProfileThe currently used saikoseikanto is a modified
formula of the original saikoseikanto (Bupleuri
Radix,

Scutellariae

Ginseng Radix,
Gardeniae
Fructus,
Platycodi
Radix,Radix,Cnidium
Rhizoma,Forsythiae
Fructus,
Glycyrrhizae Radix) described in the “Wàikē

shūyào Pivot of External Medicine”. The formulamodifiedbyDohakuMori(1867-1931)

ischaracterized by exercising his ingenuity inadding “shimotsuto” and “orengedokuto” to theoriginal prescription.
The current constituents are as follows:

Bupleuri Radix 2 gScutellariae Radix 1.5 g
Phellodendri Cortex 1.5g
Coptidis Rhizoma 1.5g
Trichosanthis Radix 1.5 g
Glycyrrhizae Radix 1.5 g
Platycodi Radix 1.5 g
Arctii Fructus 1.5 g
Gardeniae Fructus 1.5 g
Rehmanniae Radix 1.5 g
Paeoniae Radix 1.5 g
Cnidii Rhizoma 1.5 g
Angelicae Acutilobae Radix 1.5 g
Menthae Herba 1.5 g
Forsythiae Fructus 1.5 g[Efficacy] Heat-clearing and relieving
toxins/soothing liver and blood activation[Indications] Heat toxin/liver depression/bloodstasis[Drug actions] Coptidis Rhizoma, Scutellariae
Radix,

Phellodendri Cortex, and Gardeniae

orengedokuto, while Angelicae Acutilobae Radix,
Paeoniae
Radix,Cnidii
Rhizoma,andRehmanniae Radix work to nourish and cool theblood and activate blood in shimotsuto. Bupleuri
Radix, Arctii Fructus, Forsythia Capsule,
Platycodi Radix, Trichosanthis Radix, Menthae
Herba, and Glycyrrhizae Radix work to dispel
wind and heat, expell toxins and dispel pus.
Especially Arctii Fructus and Platycodi Radix
repress throat inflammation.
Clinical application
Mori devised this prescription for improving
the scrofulous constitution of children. Scrofulous
is a syndrome caused by allergic reactions
relating to a tuberculosis infection. Scrofulous
was often seen in childhood in those days. The
symptoms include swollen lymph glands of theneck and other places, which were accompaniedbyeczema,

keratoconjunctivitis,

blepharitis,

rhinitis or cheilitis, presenting a peculiar sickly
visage. With the decreasing of tuberculosis, suchpatients decreased and are not seen today. Today,with the benefits of the past experience, theprescription

isusedforrespiratory

tract

infections, atopic dermatitis, other skin disorders,and neurotic diseases that are recurring inchildren. Of course, this formula has indications
for adults.
1.

Recurrent upper respiratory inflammation inchildren (especially tonsillitis)
This formula is often used for tonsillitis andsinusitis that recur in childhood. A long termadministration (more than six months) is needed
for these diseases.
Iwama, et al. have released a document on theirstudy in which saikoseikanto was administered toThe Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

27

Volume 5, Number 3 | Fall 201012 child patients (age 2-8, 5 males, 7 females)effectiveness and many patients of the groups ofhaving tonsillitis recurrently, a half of themoderate and serious severity had no effect or

patients had tonsils assessed as grade II ofbecame worsened) 3).

Mackenzie’s classification with white furs on theMikawa, et al. report that they prescribed

cryptae. These patients received the formulasaikoseikanto for children with atopic dermatitis(0.1g/kg/day) for about one year when the disease(15 male and 10 female) who had not obtained

stagestage.

sufficient effects even though the causes of theAlthough eight patients developed a fever after

disease were eliminated or by the use of topicalone month of oral administration, a fever onset

ointments to assess the effects of itching. From

did not appear after two months. Ten patients

one week administration, they obtained theused to suffer from a fever every day during 2-5

impression

months prior to the start of the administration.

improved” in 80% of the children4).

marginallypassed

theacuteof“slightlyimproved”

to“veryThe onset of fever, however, decreased to only
three times a year. Two patients were not

Ito administered saikoseikanto for 12 weeks to

responsive to the treatment, one of which had a

25 children aged 2-15 with atopic dermatitis who

tonsillectomy1). There is other report published on

had not had adequate effects by the application ofthis formula by Fujii2).

topical creams. The results showed that after 2
weeks and onwards, improvements were observed

This formula containing 15 kinds of crude

withsignificancedifferences

anddrugs is complex in its constitution and has been

more-than-improved were shown in 80% of all

created with the concept different from that ofpatients5).

“Shāng hán lùn.” This suggests that children’s
susceptibility to infections has a variety of aspects,

3. Neurosis

Saikoseikanto contains Bupleuri Radix, which

which elucidation remains to be seen.

is a typical drug for soothing the liver, Wild Mint,
2.

Atopic dermatitis

which has both actions of soothing the liver andAtopic dermatitis is a refractory skin disorderdispersing pathogenic factors, shimotsuto, which

and it is increasing in recent years. Saikoseikanto is

nourishes the liver, and many heat clearing drugs,often used for this disorder occurring in childhood.

which cure the pathological conditions ofdepressed liver qi transforming into fire.

Horiguchi,

etal.

reportthat

when

thisTherefore, this formula is used for neurosis and itprescription was used together with topical

is often used especially for neurosis in young

steroids to 34 patients in total in the groups ofchildren.

atopic dermatitis with mild to serious severity,
the combination use was effective in 84% of allpatients and it was also effective in each group,
whereas when petroleum jelly was combined
instead of steroids, this combination use waseffective in 64% (this case, many of the patients inthe group of mild severity showed marked
28

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

Volume 5, Number 3 | Fall 2010

References
1) Masafumi IWAMA: Hanpukusei Hentoen ni

Saikoseikanto. Journal of Nippon Shonikai
Kaiho, No. 10 98-99, 1995
2) Kazuyoshi FUJII, Hiroshi SATO, Hirosato
MIYAKE: Clinical Effects of Saikoseikanto onHabitual Angia (1st report), The Society ofPractical Otolaryngology , 1986, 79, 1343
3) Yuji

HORIGUCHI,

Hiroyuki

NorikoOKAMOTO,HORIGUCHI,Motoi

OGUCHI,

Motoaki OZAKI: Atopiisei Hifuen ni taisuru

Saikoseikanto no Chiryo Koka, Hifuka Kiyo
78: 145-150, 1983.
4) Haruki

MIKAWA,Setsuko

ITO:

Shoni

Atopiisei Hifuen ni taisuru Saikoseikanto.
Kampo & Meneki/Allergy 6: 80-86, 1992.
5) Setsuko ITO: Atopiisei Hifuen ni okeru

Saikoseikanto Extract Granule no Shiyo
Keiken, Modern Oriental Medicine 10 Extra
Edition, Nanbyo, Nansho no Kampo Chiryo
No. 2, 202-203, 1989

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

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