Volume 5, Number 2 | Summer 2010

Kampo Formula Developed in Japan (2)Jumihaidokuto
Hiromichi Yasui
Japan Institute of TCM Research

ProfileJumihaidokuto is a modified formula of theoriginal Schizonepeta Antiphlogistic Decoction
described in the chapter of “Yoso (malignant skinboils)” of “Manbyo Kaishun.” Seishu Hanaoka(1976-1835) modified the original prescription 200
years ago for the treatment of pyosis of the skin.
Hanaoka was a competent Japanese surgeon andis well known for the excision of breast cancer
under general anesthesia with a Kampo drug.
Today, jumihaidokuto is applied to a wide variety
of skin disorders including purulent skin lecisons,eczema, dermatitis, and hives (urticaria).
This prescription developed for ethical use
consists of the following:
Platycodi Radix 3 g
Bupleuri Radix 3 g
Cnidii Rhizoma 3 g
Poria 3 g
Saposhnikoviae Radix 1.5 g
Glyzirrhizae Radix 1 g
Schizonepetae Spica 1 g
Zingiber Rhizoma 1 g
Quercus Cortex 3g
Araliae Cordatae Rhizoma 1.5 gm.
Note: For the original formula, Notopterygii
Rhizoma was used instead of “Araliae Cordatae
Rhizoma.” For Quercus Cortex, which is a crude
drug often used in Japan, barks of deciduous
broad leaved trees such as oak are used. Somemakers use Pruni Cortex instead of the Quercus
Bark.
[Efficacy] Dispel wind, relieve toxins, and expel
puss/dispel sores and relieve itching[Indications] External contraction of cold / windmoist-heat toxin[Drug actions] Fineleaf Schizomepeta Herb,
Divaricate Saposhnikovia Root, Double-teeth
Pulbescent Angelica Root, and Ginger work todispel wind and cold of the skin surface by theaction of dispelling wind and releasing the exterior.
Bupleurum Root having the action of releasing theexterior with pungent-cool has the ability ofclearing heat produced by skin pyrosis.
Balloonflower Root and Quercus Bark, which has
the action of releasing toxins and dispelling pus,
are also effective for skin suppuration. Cnidium
Rhizome activates blood and frees the collateral
vessels, by which enhances local circulation isenhanced and pure is promoted. Tuckahoe
eliminates internal moist and deals with lesions
caused by moist in collaboration with the drugs
that have the action of eliminating external moist,such as Divaricate Saposhnikovia Root andDouble-teeth Pulbescent Angelica Root. Licorice
Root has the action of clearing heat and releasing
toxins and concurrently works to harmonize
various drugs.
Wild Cherry Bark and Quercus Bark have been
put to civilian use and said to be effective for
furuncles, hives, dermatitis, and athlete’s foot.
The drug actions of these two drugs are not muchdifferent each other. From the past experiences,
however, it is thought that Wild Cherry Bark has
the action of dispelling pus, whereas Quercus
Bark is good for relieving itching. The medical
properties of these two, however, are not clear. It
is thought, however, that they are used in theformula mainly for the purpose of dispelling pus
as they do not have a strong action of clearing heat.
Indications

Jumihaidokuto has effects of dispelling windand cold, moving qi and harmonizing the bloodand it has also the effects of healing throughexpelling pathogenic factors from the exterior of
the skin. From this point of view, indications of
this formula become as follows:

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First, because of the action of dispelling wind,relieving toxins, and draining pus, it has theindications for pus-related disorders of any kind in
the initial stage. Second, by releasing exterior
pathogens, this formula can remove exteriormoist-heat (eczema, etc.) and water-moist (hives,etc.). However, only few drugs in the formula havethe action to stop itching. Third, because of theaction of dispelling wind, the formula has theindication for common cold in the initial stage.
1. Pyosis of the skinThis formula can be effectively applied from thecondition in which the affected areas turn red andbecome swollen in the early stage of skin disorders
such as folliculitis and furuncle to the condition inwhich inflammation becomes localized andinfiltrations are indurated or hardened. It is often
the case that continued use of the formula
gradually decreases the emergence and over time
the symptoms do not appear.
Moriya Okuma used jumihaidokuto for theprotection of cellulitis observed in lymphatic
edema in a female of 58 years old and reports that
cellulitis that used to appear once a month could
be suppressed1). Ryosaburo Senaga reports that
he used this formula for furunculosis andpyoderma of infant’s heads in the pediatric fieldwith successful results 2).
Case 1: Furuncle
A woman, 36 years old, had furuncles on theface and nape of the neck all through the year.
Soon after one was cured, another one appeared.
Although she used various kinds of antibiotics,
furuncles did not become better. The patient wasof average height and weight. Her complexion
was not very good. No diabetes. Due to the natureof her business, the patient drank alcohol a little
every night.
I used jumihaidokuto for furuncles. After26

about one month of administration, furuncles did
not develop, so the medication was suspended. In
a month, however, they began to appear. The
medication was resumed and continued forfurther about three months and a cure wasachieved.
(Keisetu Ootuka, Shoko ni yoru Kampo Chiryo no
Jissai P499 Nanzando 1963)
2. Eczema/Dermatitis
Kobayashi, et al. report that they administeredjumihaidokuto to17 patients with chronic eczema,with the results of markedly improved in 4
patients, improved in 7, slightly improved in 3,
remained unchanged in 3 with the improving
rates of 64.7% of more than improved and 82.4%
of more than slightly improved. They further
report that the effectiveness levels between theformula and clemastine fumarate used forcomparison were similar with no differences ofstatistical significance. However, the group of
jumihaidokuto showed marginally high levels
with the result of “more than improved3).”
Kimura,etal. report that they usedjumihaidokuto for 18 patients with chroniceczema with the results of markedly effective in 2
patients (11%), effective in 5 (27%), effective in 7(39%) and remained unchanged in 4 (23%). They
also used the formula for four patients withasteatotic eczema with the results of markedly
effective in 1 (25%), effective in 1 (25%), andremained unchanged in 2 (50%)4).
Case 2: Persistent eczema
One day, a well-built plump man in his 40s
who suffered from rashes/eczema visited me for aclinical examination. The size of a lesion was
about the head of a match stick and the eczema
was slightly tinged with red and bumpy. The
areas of hands, legs, and the lower abdomen to
the lower back were severely affected. Tolerating

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Volume 5, Number 2 | Summer 2010

itching brought him a shivering. He was cautious
not to scratch the affected areas during the night
so that he asked his family to tie both hands tothe bed. He received various injections and usedvariousointments
without
results.
No
abnormalities in urination, bowel movements,
and appetite. I previously had used Pueraria
Decoction for this type of a patient and thismedication had exacerbated the condition.
Therefore, I decided to use jumihaidokuto.
This formula was very effective. Itching
rapidly disappeared and a cure was attained
within about two months. After this, wheneverdrinking beer, he had a recurrence indication.
Therefore, the formula was used for 2 to 3 days
after drinking beer to prevent a recurrence. In
the meantime, the formula was not required atall. This patient visited me after a 10 yearinterval and said that rash-like somethingslightly appeared. This could be recovered by thetwo-week use of the formula.
(Keisetu Ootuka, “Kampo Shinryo 30-nen” p166 167 Sogensha 1959)
3. Seborrheic dermatitis
Yamamoto pointing out that adult seborrheic
dermatitis is one of good indications ofjumihaidokuto says5) as follows: “I use
jumihaidokuto for seborrheic dermatitis in adults.
If it is an extract form, the daily dosage is 10g to
20g or more. It is very effective and a cure can beachieved quickly. However, with the use of only
about 7g/day, it takes many days for treatment or
the skin disorders cannot be cured,” and if theextract formula cannot be modifieda, “I combine
orengedokuto if inflammation is intense, such as a
red flare. Skin rashes in the arm pits and theumbilical region become wet from sweat andswelling becomes intense during the summer
season. In that case, I combine shofusan 5). ”

Case 3: Seborrheic dermatitis[Patient] Male of 60 years[Initial visit] April 28, 1983
[Past medical history] Present condition andcourseHe had an itchy scalp with a lot of dandruff. In
recent days, from 5mm-1cm of the hairline of theforehead towards the hair of the head there were
erythemas with a clear boundary line where, inparticular, there were pityroid scales.
Under the both arm pits, there were also
erythemas having a relatively clear boundary
and there were pityroid scales in the boundaryarea.
And there were keratotic papules (raisedrashes) and erythemas on the dorsal surface.
Diagnosis was seborrheic dermatitis and Extract
Powder of jumihaidokuto 10g/day divided into
equal 3 portions was administered. After one week,rashes on the trunk area disappeared and thoseon the head and armpits also improved. However,the central parts in the armpit areas were difficult
to cure and tended to become exacerbated. So thevolume of Extract Powder of jumihaidokuto wasincreased to 15g/day from May 26. Because a flareup in the central part was intense and it was noteasy to cure, Extract Powder of orengedokuto
5g/day was concomitantly used from June 9. On
June 30, a cure was mostly achieved.
The reason of selecting the prescription is asfollows:
Diagnosis was seborrheic dermatitis. As thepatient’s condition was relatively mild, theextract preparation of jumihaidokuto was used.
From my experiences, seborrheic dermatitis in
adults can be cured with modified jumihaidokuto
regardless of age, sex, being fat or thin, pulsation,
and abdominal conditions.
As the patient’s condition was comparatively
mild, the extract preparation was used. In somecases, 6-7 gm per day yields effects. But with thisdose amount, treatment often becomes prolonged,

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recurrent, or intractable.
In the case of this patient, the starting dosage
was 10g/day, which was increased as necessary
according to the progress of the condition todetermine the effective dosage. The dosage ofabout 20g/day as a standard would markedly
improve the effectiveness.
(Iwao Yamamoto, Clinical Lecture of Departmentof Dermatology THE KANPO Vol.4, No.2 P13 14 1986)
4. Atopic dermatitis
jumihaidokuto is sometimes applied to atopic
dermatitis but its application is limited to a very
narrow range. Ninomiya says that “the formula isgood for suppurative eruptions in the individuals
having a moderate degree of physical strength.6)”
Kinuko Kobayashi, et al. report that theyadministered jumihaidokuto to18 patients withatopic dermatitis and the results showedmarkedly improved in 2 patients, improved in 7,
slightly improved in 7, and remained unchangedin 2 with the overall improvement rates of 50% of
more than improved and 88.9% of slightly
improved. They further reports that the formula
had similar levels of effectiveness to those of
clemastine fumarate used for comparison4).
Case 4: Atopic dermatitis[Patient] Male of 19 years
The patient had a moderate degree of atopic
dermatitis. There were erythemas and papules
mostly all over the body with mild lichenification,desquamation, and rupture scars. According to
the enveloped method, clemastine fumarate wasgiven orally from August 1992. Eight weeks later,
effectiveness was assessed as mildly improved.
Although the internal administration was
continued for a while, I thought the symptoms of
the patient seemed to be the “sho” ofjumihaidokuto because he tended to become
constipated and has a muscular build. In
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December of 1992, Tsumura jumihaidokuto wasstarted. After two weeks of administration,itching and skin rashes improved significantly.
After a few months, the skin disorder was nearlyrecovered. Then, the skin condition is wellmanaged only with the internal use of TJ-6.
(Kinuko Kobayashi, et al. , Treatment Effect of
jumihaidokuto for Chronic Eczema and Atopic
Dermatitis, 12th Hifu-ka Toyo Igaku Kenkyu
Kai Kiroku p29-30, 1994)
5. Prurigo
Case 5: Modified jumihaidokuto for urticaria
perstans[Patient] 26 years old, female, company employee[Initial visit] May, 1985
[Past Medical history] Summer rashes developed
when she was a kindergarten child.
[Current medical history] Last summer, thepatient had mosquito bites on both upper
extremities, which became indurated like warts
and felt itchy. That is, urticaria perstans. Bowel
movements were twice a day and normal. No
abnormalities in menstruation.
[Present condition] Height 158cm, weight 54kg.
White furs on the tongue. No special mention
from the abdominal diagnosis..
[Course] jumihaidokuto 6.0g divided into equal
2 portions and Rei Rhizoma powder 0.1g wereadministered.
June 1985, itching was eased.
August of the year, the condition was mostly
good, but there were new traces of mosquito bites.
The overall skin, however, was becoming clear.
By October of the year, the same medications
continued.
In November of the year, the patient claimed
that the number of wort-like indurations
increased. jumihaidokuto 6.g with an addition of
Coix Seed Extract 3.0, both divided into equal

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Volume 5, Number 2 | Summer 2010

two portions, was administered.
February 1986, a cure was achieved and the
medication was discontinued.
[Comment] Uurticaria perstans is quitepersistent but jumihaidokuto is often effective forthe disorder. It takes time for the treatment. In
the case of this patient, it took nine months.
(Kunio Matsuda, Shorei ni yoru Kampo Chiryo no
Jissai, P331, Sogensha 1992)
6. Urticaria
Nakai, et al. report that they administered
Extract of jumihaidokuto to 26 patients withchronic urticaria and obtained an effective rate of
65% including “slightly effective”7). Maeda, Morita,etal.
reportthat
theyadministeredjumihaidokuto to nine patients with urticaria
from their experience of using Kampo
preparations in the field of dermatology and theresults showed complete cure in 3 patients andrelieved in 3, and no effects in 3 with aneffectiveness rate of 66% (6/9 patients)8). Koga
administered Tsumura jumihaidokuto to 30
patients of over 15 years old with the diagnosis ofchronic urticaria in the departments ofdermatology in eight university hospitals in theregions of Kyushu and Okinawa with the resultsof markedly improved in 6 patients (20%), morethan useful in 19 (63.3%), and slightly more thanuseful in 28 (93%)9). Yamaguchi, et al. used Kampo
preparations for ethical use for various
dermatological diseases. And they report that in
the patients for whom jumihaidokuto was usedaccording to the sho, 42.9% of the group of chronic
urticaria (with an addition of Rhubarb tablets)
showed more than effective and 85.7% of the groupof eczema and dermatitis showed more thaneffective10). Horiguchi, et al. used jumihaidokuto
for 11 patients with urticaria persistent for morethan one month with the results of 91% of slightly
more than effective11).

Case 6 Chronic urticaria
The patient was a female of 19 years old.
According to the patient, in her childhood, she had
repeatedly
hadautotoxication
andherconstitution was fragile. However, over the years,
she was gradually becoming fat. She had ruddy
cheeks and obese. Appetite and bowel movements
are normal, but mouth dryness was intense. Her
main complaint was urticaria, which had been
persistent for about a year since last summer. The
abdomen distended with almost no bloated feelingin the chest and hypochondriac regions.
Menstruation was normal. I administeredjumihaidokuto with an addition of Gypsum
Fibrosum for these symptoms and a cure wasachieved with three weeks administration.
However, in end June of this year, urticaria began
to develop again and the same medication wasgiven. About one month later, full recovery wasachieved.
(Otsuka, Keisetsu, “Kampo Shinryou 30-nen”
P166 Sogensha 1959)
7. AcneJumihaidokuto cannot be used for acne very
extensively. It can, however, be applied if acne has
a strong tendency of becoming prulent.
Makoto Tanaka reports that he administered
this formula together with Minomycin (100mg/day) the subjects of 35 patients with acneand had the result of effectiveness in 23 patients(66%). Subsequently, he added 135 subjects,
making a total of 170, who were assigned to thegroup of jumihaidokuto alone, the group ofminomycin alone, the group of Lurid alone, thegroup of jumihaidokuto + minomycin, and thegroup of shosaikoto + Lurid and obtained theresult that the group of jumihaidokuto +minomycin showed the most excellent result12).
Moriya Okuma performed the treatment of 128
patients with acne vulgaris who were assigned to

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three groups; the group of jumihaidokuto alone,
the group of jumihaidokuto + external medication,and the group of external medication alone. As aresult, the group of jumihaidokuto alone had acomplete disappearance of skin rashes withmarkedly effective in 22 patients, effective in 13,
slightlyeffectivein6
andremained
unchanged/exacerbated in 5. He further says thatjumihaidokuto is adequately effective without theuse of other external medicines (steroids, sulfur
compounds, Clindamycin)13).
Case 7: Modified jumihaidokuto for pimples[Patient] 23 years old female
Initial visit: December 12, 1978.
[Present medical history] Around February 1978,
a large number of pimples developed and weretreated by a dermatologist for three months andrecovered at the time. In around September ofthe year, pimples recurred and treated by thesame dermatologist. However, they were not
cured and rather became reddened, swollen, andmap-like rashes. The patient’s face looked pitful.
She was recommended extract tablets ofshosaikoto and keishibukuryogan by a Kampo
pharmacist and took them with no effect.
[Present condition] The physical frame andnourishment were moderate. The whole bodyseems to contain excessive water. The patient
was fatigable, irritable, and easily became angry.
The face had many rashes that were map-likeand swollen. Other conditions were ringing in theears, congested nose, stiff shoulders, stuffy
stomach, sweater (face), cold hands and legs,
constipation, irregular menstruation (delayed),
good appetite, can eat anything, and eat muchraw vegetable.
The tongue was covered with white furs, moist
and there was an accumulation of saliva in themouth. The pulse was sunken and weak. The
abdomen was soft in general and there was a
bloated feeling in the chest and hypochondrium on

30

both sides. Right and left rectus muscles were
hardened.
[Treatment and course]
When jumihaidokuto plus Forsythiae Fructus,
Coicis Semen and Rei Rhizoma was administered
for about seven days, pimples worsened andbegan to discharge pus.
The patient was told to continue themedication with a sense of security as “this is thesign that the prescription was working.” When
about 40 days passed, pimples mostly
disappeared.
Then, the medication was continued for 90
days, by the time the purulent tendency
completely disappeared. However, as there werescars/spots after pimples treated by the previous
dermatologist, the patient was continuously on
the medication. As of end January, 1980, her faceregained a clear complexion.
(Genpo Ogata, Kampo Chiryo Shorei Senshu I P289290 Gendai Shuppan Planning Co., Ltd. 1988)
8. Rosacea
Nakanishi

reports that he administeredjumihaidokuto to 50 patients with diffuse
erythema (redness) of rosacea and had the resultsof markedly improved in 46 patients (92%),
moderately improved in 1 (2%), slightly improvedin 1 (2%), and no effect in 2 (4%). As for the 42
patients (91%) out of 46 who had marked
improvements, the effects appeared within 7 days
after the start of the administration14). He further
reports that there was no big difference in therates of marked improvement between the
combination group of jumihaidokuto anddoxycycline, which was combined due to thepresence of rosacea-like papules, and the group of
no combination. In the meantime the rate ofmarked improvement in atopic dermatitis with acomplication of rosacea was 90%, a similar rate tothat of the group without the complication15).

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9. Palmoplanter pustulosis
Kaneuchi reports that he administeredjumihaidokuto to 38 patients with Palmoplanter
pustulosis and the overall results of the formulafor skin lesions were markedly improved in 3
individuals (7.9%), effective in 7 (18.4%), slightly
effective in 9 (23.7%), remained unchanged in 13(34.2%), and exacerbated in 6 (15.8%), whereas,
relating to subjective symptoms, markedly
improved was in 4 (10.5%), effective in 12 (31.6%),
slightly effective in 12 (31.6%), remained
unchanged in 7 (18.4%), and worsened in 3
(7.9%)16).
Case 11: Jumihaidokuto for palmoplanter
pustulosis
Male, 50 years old. A rash began to develop on thepalms and soles 1.5 years ago. Nails became dirty
colored. It was Palmoplanter pustulosis.
He had a medium build. Abdominal strength
was slightly weak or intermediate. Under theright hypochondrium, weak resistance andoppression when compressed were felt, which wasconsidered as a light bloated feeling (fullness) inthe chest and hypochondriac region.
jumihaidokuto was administered and about one
month later, effects appeared and three months
later, a rash mostly disappeared. So the patient
stopped the medication but a rash recurred after
1.5 months. He hastily visited the clinic andreceived the same medication for four weeks. He
has not visited the clinic since then. He might
possibly have had a cure.
I think that there are a substantial number ofpatients who will have similar effects ofjumihaidokuto as this patient did.
(Koin Yamada, Katsu Vo. 22, No. 12, 1981)
References
1) Okuma M: Limpashu ni Mirareru Hokashikien
no Yobo ni Yakudatu Jumihaidokuto, Takikan
Shogai no Kampo Chiryo

2)

Senaga R: Shonika Ryoiki ni okeru
Kansensho, Arerugi Shikkan ni taisuru
Kampo-Yueki Chiryo Proc. Symp. WAKANYAKU. 11: 36,1978
3) Ninomiya F: Atopi-sei Hifuen no Shinryo
Manyuaru, Gendai Shuppan Planning P*-*
19964) Kobayashi K, et al.: Mansei Shisshin, Atopi-sei
Hifuen ni taisuru Jumihaidokuto no Chiryo
Koka, 12th Hifuka Toyo Igaku Kenkyu-kai
Kiroku p25-34
5) Kimura T, et al.: Kakushu Shisshin ni taisuru
Jumihaidokuto no Chiryo Koka, Juntendo
Medical Journal Vol. 31-4, p584-587
6) Yamamoto I: Hifu-ka Rinsho Koza THE
KANPO Vol.4, No.2 p13-14, 1986
7) Nakia T, et al.: Jinmashin ni taisuru
Jumihaidokuto no Chiryo Koka, Rinsho toKenkyu Vol.59 No.7 p123-125, 1995
8) Maeda M, Shunji MORI: Hifu-ka Ryoiki ni okeru
Kampo Seizai no Shiyo Keiken, Journal of New
Remedies & Clinics Vol.29 p2115-2125, 1980
9) Koga T: Mansei Jinmashin ni taisuru
TSUMURA jumihaidokuto no Koka, JAMA
(Japanese version) Vol.16 No.11 p40-41, 1995
10) Yamaguchi Z, et al.: Kakushu Hifuka Shikkan
ni taisuru Iryou-yo Kampo Seizai no Shiyo
Keiken,JournalofMedicineandPharmaceutical Science Vol.10 No.1 p299-313,
198311) Horiguchi Y, et al.: Mansei oyobi Kyusei
Jinmashin ni taisuru jumihaidokuto toinchingoreisan no Shiyo Keiken, Hifuka Kiyo
Vol.82 No.3 p365-368, 1987
12) Tanaka
M:
Jinjyoseizaso/TSUMURA
jumihaidokuto, shosaikoto to Koseibusshitu
Heiyo no Koka, Hifuka no Kampo Chiryo –Saikin no Wadai p75-80
13) Okuma M: Jinjyosei Zaso ni taisuru
jumihaidokuto (naifuku) Gaiyo-eki Heiyo
Ryoho, Journal of Medical and PharmaceuticalSociety for WAKAN YAKU 5, p346-347, 1988

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Volume 5, Number 2 | Summer 201014) Nakanishi T: Shusa no Biman-sei Kohan ni
taisuru jumihaidokuto no Koka oyobi Atopi-sei
Hifuen to Shusa no Gappei ni tsuite, Hifuka
no Kampo Chiryo p67-88
15) Nakanishi T: Shusa no Chiryo ni okeru
jumihaidokuto no Yuyosei, Kampo Shinryo
Vol.14 No.5 p30-33, 199516) Kaneuchi H: Jinjyosei Kansen to ShosekiNoho-sho ni taisuru unseiin to jumihaidokuto
no Yuyosei, Kampo & Newest Therapy Vol.5
No.1 p69-74, 1996

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