KAIM
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INTERNATIONAL INSTITUTE OF HEALTH AND HUMAN SERVICES,
BERKELEY
Volume 12, Number 2 ･ Summer 2017

Editorial

Efficacies of Each Single Crude Drug Used in Traditional Japanese Kampo Medicine
Toshiaki Makino

Report from WFAS Tokyo/Tsukuba 2016

Overview of the “Toyo Hari Medical Association” (1)Toyo Hari Medical Association

Integrating Kampo and Evidence-Based Medicine (10)Living along with the Patient until the End of the Life
Hiromichi Yasui

Clinical Report 1 (Acupuncture)

A Case in which an Improvement Was Seen in Facial Nerve Paralysis Owing to Acupuncture and Moxibustion Treatment of the Upperand Lower Legs
Mariko Oikawa and Shuichi Katai

Clinical Report 2 (Kampo Medicine)

A Case of Bad Health Condition from her First Delivery Comprehensively Treated with Kampo Medicine, which Led to the Next
Pregnancy
Mizuho Kobayashi

ISSN:1559-033X

College Logos
We believe it is necessary to create a new way of thinking
for the total understanding of "Life, Survival, and Health".
We decided to coin the world "Lifence" to express this.
Lifence means the combination of life sceince and medicine
as well as other disciplines such as health science, psychology,
ethics, etc.
Our college logos symbolizes the above.
The ripple effect represents the ocean and the birth of life.
The rainbow colored sphere represents a safe environment
and a barrier to protect us from negative influences.
The picture by Leonardo da Vinch represents a balanced
body and health.
Completing our logos is a ring which represents the unity ofspace fulfilling the total meanings of lifence.

―

The Journal of
Kampo, Acupuncture andIntegrative Medicine(KAIM)
Research on Theory, Practice and Integration

Volume 12, Number 2 ･ Summer 2017

EXECUTIVE EDITOR

Shuji Goto
Chairman, GOTO College ofMedical Arts & Sciences

TA B L E O F C O N T E N T S

Tokyo, JapanEDITOR-IN-CHIEF

Donald Lauda, Ph.D.
Dean Emeritus, College of Health &Human Services
California State University-Long Beach

1 Editorial
Efficacies of each single crude drug used in Traditional Japanese Kampo Medicine
Toshiaki Makino

CA, U.S.A.

ASSOCIATE EDITORS
Shuichi Katai
Ibaraki-ken, Japan

Hiromichi Yasui

2 Report from WFAS Tokyo/Tsukuba 2016
Overview over the “Toyo Hari Medical Association” (1)Toyo Hari Medical Association

Tokyo, JapanEDITORIAL STAFF

Akihiro Souma
Hiromi Sasaki
Hiroshi Tsukayama
Hitoshi Yamashita
Junko Okubo
Kazunari Ozaki
Kengo Nakata
Masayuki Kashima
Naoya Ono
Noboru Mitsuhata
Sayaka Toda
Takao Namiki
Toshiaki Makino
Toshihiro Togo

PUBLISHER

Shuji Goto
International Institute of Health andHuman Services, Berkeley

6 Integrating Kampo and Evidence-Based Medicine (10)Living along with the Patient until the End of the Life
Hiromichi Yasui

8 Clinical Report 1 (Acupuncture)
A Case in which an Improvement Was Seen in Facial Nerve Paralysis Owing to
Acupuncture and Moxibustion Treatment of the Upper and Lower Legs
Mariko Oikawa and Shuichi Katai

16 Clinical Report 2 (Kampo Medicine)
A Case of Bad Health Condition from her First Delivery Comprehensively Treated with
Kampo Medicine, which Led to the Next Pregnancy
Mizuho Kobayashi

2550 Shattuck Avenue, Berkeley
California 94704-2724, U.S.A.

MISSIONTo disseminate peer-reviewed information on the use of acupuncture and herbs, and integration with western
medicine, based on research from an international perspective; thereby stimulating further research, applicationof documented therapeutic measures; and facilitating dialogue among health care practitioners worldwide.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)KOTARO PHARMACEUTICAL introduced in 1957 the world's first Kampo extract
preparations on the market. Later, in 1967, six of our preparations could be covered in Japanfor the first time by the health insurance and after 1976 more than 100 of our preparations
were used in hospitals and clinics. Now it is half a century since we put our Kampo extract
preparations on the market and believe, we made a major contribution to this industry.
In the future we intend to continue working in accordance with our company motto: "Still better
Kampo for still more people" and provide pharmaceutical products of still higher quality.

Origin of the company's name
The company was named "KOTARO" by its
founder Taro Ueda with reference to his birthplace. Close to the ancient city of Nara. Kotaro
is the name of an enormous sheer cliff, 700 m
wide and about 200 m high. Mr. Ueda felt anaffection rising to the heavens for this cliff andthus made it the company's name.

KOTARO PHARMACEUTICAL CO., LTD.
5-23 Nakatsu 2-Chome, Kita-ku, Osaka 531-0071, JAPANURL: http://www.kotaro.co.jp

Volume 12, Number 2 | Summer 2017

Editorial
Efficacies of each single crude drug used in Traditional Japanese Kampo Medicine
In Japan, the standards of crude drugs and Kampo formula are defined by two official compendiums fromJapanese government, “the Japanese Pharmacopoeia (the latest one is 17th edition, 2016)” and ”the approval
standards for OTC Kampo products.” The former defines the origin and their botanical, botanical and chemical
properties of approximately 200 kinds of crude drugs and 35 kinds of Kampo extracts, and the letter defines
the components and dosages of crude drugs in Kampo formula, and the efficacies of Kampo formula. By thedescriptions in the latter compendium, the physical properties and efficacies of 148 kinds of ethical Kampo
extract formulation are approved by Japanese government though the components and efficacies are slightly
different among the products produced by each company.
On the other hand, as regards the efficacies of individual crude drugs, although only 30 kinds of crude
drugs have the official efficacies defined in the official compendium “the guideline of approval for the products
using crude drug defined in the Pharmacopoeia”, the most of crude drug do not have the specific efficacies
officially approved. In public health insurance, the official efficacies of individual crude drugs are “for theprescription in Kampo formula”.
In China, the official compendium “Chinese Pharmacopoeia 2015” describes the efficacies of individual
crude drugs in traditional Chinese medicine. However, in Japanese traditional Kampo medicine, it has been
popular to fix and use the formula without considering the efficacies of individual crude drugs. The efficacies
of individual crude drugs are shown in some books described in private textbooks, but consequently, theefficacy descriptions of individual crude drug in textbooks differ much depending on the authors. For thenational examinations for pharmacists and physicians, the efficacies should be standardized to prevent unfair
advantage among students depending textbooks used. However, the descriptions of the efficacies of crude
drugs in traditional medicines are based on not scientific evidences but experiences, and it is very difficult tostandardize them among specialists of cognoscenti.
In order to fix this problem, we made database of the efficacies of individual crude drugs described in
textbooks published from 1887 to 2014, and uploaded at http://metabolomics.jp/wiki/Persist:CrudeDrugList.
Furthermore, we showed the private idea for standard of the efficacies of individual crude drugs on the article(The Japanese Journal of Pharmacology 71, 1–37, 2017)．

Toshiaki Makino, Ph.D.
Professor, Department of Pharmacognosy
Graduate School of Pharmaceutical Sciences
Nagoya City University, Nagoya, JapanThe Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

1

Volume 12, Number 2 | Summer 2017

Report from WFAS Tokyo/Tsukuba 2016
Overview over the “Toyo Hari Medical Association” (1)Skill teaching using literally a hands-on approach

Toyo Hari Medical Association

persons are visually impaired, they had to devise

The Toyo Hari Medical Association was founded
in 1959 by the five people Kodo Fukushima,
Katsuyuki

Kosato,ToyoyaSatomi,Senryuu

Takahashi and Syuukou Takahashi in its previous
form under the name "Classical Acupuncture
Medical Society". Later, the name was changed to
Toyo Hari Medical Association based on the ideology:"pass on the skills of meridian therapy on from hand
to hand to the farthest corners of the world!" and theassociation continues to hold regular monthly
meetings based on this concept. Shortly it will reachits 60th anniversary.

means that because all of the above mentioned fiveand propose significantly modified procedures forrunning the society. Naturally there has be noprecedent for this approach in Japan, but also notglobally, where the mentor actually takes theaspiring practitioner by the hand, explaining theactual needling techniques like "you form yourpressing and needling hand like this" during theguidance. This facilitated the chances of people withvisual impairment to contribute to society. That is
why also many people with normal vision applied for
admittance to the society and while the number ofmembers with normal vision has now increased, thebasic teaching concept has not changed. The training
style of the Toyo Hari Medical Association favoring
practical training over classroom studies has notmuch changed over the 60-year period from its
establishment until today. In the future too it will
persistently continue to pursue a form of meridian
therapy suiting the bodies of all people.
Characteristics of the techniques of this association
The practice of the Toyo Hari Medical Association
has the following characteristics.
1. Restraining adjustment
When the pulses in both positions within aHari-Kyu Technical Sessions 4

restraining correlation manifests a deficient state
the treatment administered distributed between left
and right is called a restraining adjustment. In thiscontext the modality administered first is called root
treatment, while the later administered treatment iscalled auxiliary treatment.
For example, in case of a restraining correlation
between lung deficiency and liver deficiency the lungdeficiency would be named the root and the liver
deficiency the auxiliary pattern. Or simply put
together as lung-liver restraining correlation.
Again, the selection of the five phase and the fivecommand points follows the rules set out in the

Demonstration2

difficult issue No. 69 or 75 in the Nan Jing.

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

Volume 12, Number 2 | Summer 2017

traditional medical system to perform reinforcement

2. Needling one side
Single-sided needling refers to a technique wherea certain point located both on the left and right sideor reduction as required to bring about healing.
This

is

calledpatternbased

treatment.

is needled only on one side, although these points

Accordingly, in actual clinical practice patients withused to be needled on both sides. Clinically needlingskin diseases visiting our clinics we follow the

only side restored the balance of the pulse, while

traditional theory of the "four diagnostic procedures"

needling both sides on the contrary led to a

to identify the pathology and then determine thedisordered pulse.

"pattern", which is considered to inevitably bring

The side on which the root treatment is performed,

about the healing. However, in today's clinicalis called the adjustment side, whereas the auxiliary

practice there is a demand for speed. For this reason

treatment is performed on the opposite side. In men

an adjunct therapy developed by our association has

the left side and in women the right side are thebeen added as a local and symptomatic treatment inadjustment sides, but if there is disparity of theorder to augment the effects of the root treatment.

symptoms and symptoms are predominate on the

Nobody believes the assertion that acupuncture andleft side in men, then the right side will become themoxibustion is effective for skin diseases, but it

adjustment side.

actually is very effective. Acupuncturists not

Using

the

above

mentioned

restraining

adjustment in case of a lung-liver deficiency and theabsence of any uneven distribution of the symptoms
in men, left-sided points are used for the lungdeficiency pattern and right-sided points for the liver
deficiency pattern.

familiar with meridian therapy probably cannot
understand this.
Below I will describe a few cases from actual
clinical practice.
* Herpes zoster
The condition manifests on the surface of the skin

3. Yin governing yang following principle andand therefore often represents a lung deficiency

preferential reinforcement

pattern, associated with reactions of the large

Treatment principles stipulate that yin channels

intestine channel, but in case of acute herpes zoster

are treated before yang channels and reinforcement

it is important to use the small intestine channel. In

precedescase of a spleen deficiency yang excess a proper

any

reduction.

For

that

reasonreduction of the pathogenic evil in the small

reinforcement of yin channels is performed first.
Also, based on the treatment principle described

intestine and supplementing the center is effective.

in difficult issue No. 69, in case of a lung deficiency,

Occasionally pricking the network vessel at the wellfirst the lung channel and next the spleen channel ispoint of the small intestine may be performed. Also,

reinforced. The same applies to other patterns too.

application of a single, filiform moxa cone on top of
the herpetic lesions has an immediate effect and can

Articles by this association
Let's introduce two articles published by thisassociation.
1) Special lecture abroad about "skin diseases";President Mitsuyoshi Tanaka
As meridian therapist we understand all diseases
in terms of deficiency or excess of meridians and use
mainlyacupunctureandmoxibustionasapromote complete healing of the herpetic lesions
without scarring.
* Urticaria
Recently a correlation between liver diseases andallergic disorders has been pointed out. Urtication
appears in particular after eating and as a result of
the influence of the liver channel. Upon moxibustion
applied to the point "ura naitei" (reverse ST44),

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

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Volume 12, Number 2 | Summer 2017

located opposite to neiting (ST44) on the sole of thefoot, is felt immediately as hot on the left side,
whereas on the right side the patient has difficultyof feeling the heat, so that the moxibustion isrepeated until the heat is felt. If the heat is not felt
on the right side, this can be interpreted as evil
having invaded the liver, warranting treatment for aspleen deficiency liver excess pattern. If the heat is
not immediately perceived on the left side, a yangchannel is treated in case of spleen deficiency, or else
the treatment is for spleen excess in case of liver
deficiency.
Also, when in doubt about the pattern in cases ofhepatitis, application of moxibustion to reverse ST44
and comparison of both sides, the side with less pain
can be considered the governing side.
This reverse ST44 is not only useful for thetreatment of liver diseases, but also for diagnosis. On
the abdomen reactions are often observed at theright-sided ST19, ST21 and ST24.
* Atopic dermatitis

Treatment is characterized by the following two
essential points.
"Prevent the development of deficiency heat"
Normally, deficiency heat develops often from theliver and spleen of the middle energizer. Thus, we
focus on the middle energizer as the source of the
deficiency heat and attempt to clear that heat. In
meridian therapy we use the command points of theyin channels and adjust their anomalies. In case ofheat clearing therapy usually we use acupuncture toadminister reinforcement of the water points.
"Normalize the function of the interstices"
Next, a treatment to normalize the function of theinterstices is performed. The interstices are an organ
under the control of the lung. Further, deficiency
heat caused by anomalies of the liver lead to someloss of function of the interstices, so that the water
point of the lung channel is reinforced using
acupuncture. For the symptomatic treatment bybring the side of a spoon needle in contact with the

Pathogenic mechanism
In meridian therapy dry atopic dermatitis isconsidered to be a problem to be approached asskin to perform a light scraping massage.
Pathogenic mechanism of exudative atopy"treatment for deficiency heat". Based on the

In meridian therapy exudative atopic dermatitis

characteristics of deficiency heat it has rising andis understood as a problem of "skin and hair as welldivergent properties. Accordingly, the arising fromas the interstices". Skin and hair have lost vigor and"the locations of the yin organs and positions of theare deficient in defensive qi, so that the defensive

various yang organs" the deficiency heat rises

barrier of the interstices is not working sufficiently,

towards more superficial organs. And it thenallowing skin and hair to be damaged by external

stagnates in the most superficial layer of skin andstimuli, leading to the development inflammations

hair. When the interstices of the skin and hair canin the affected areas. For example, sweat contains

function sufficiently and open up to allow the

many stimulatory components strongly irritating

stagnant deficiency heat to dissipate, this deficiency

the skin. Areas likely to sweat easily include theheat can the be treated normally. However, if thearmpits, the pit of the elbows, the neck etc. That isinterstices do not function properly, the deficiency

also why the condition worsens in the summer.

heat continues to stagnate below skin and hair and

To improve the qi deficiency of the lung andsteams it from below. This causes then thereinvigorate strength the earth point of the lungdevelopment of inflammation of skin and hair,channel is reinforced. This represents a root

resulting in dermatitis. Based on meridian therapy

treatment. For the symptomatic treatment the side

concepts this is pathogenic mechanism of dry atopic

of spoon needles are brought into contact with thedermatitis.

skin to perform a light scraping massage in such a

4

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

Volume 12, Number 2 | Summer 2017

way, that the normal skin surrounding the affectedareas is stroked towards to affected area in order togather defensive qi there.
Treatment is characterized by the following two
essential points.
"Improve strength of the lung" "reinforce skin, hairand the interstices"
Pulse patterns are often lung-liver restraining,spleen-liver restraining, lung deficiency liver excess,spleen deficiency liver excess.
* Alopecia
Root treatment aims at harmonizing the body as
a whole, while the symptomatic treatment uses lighttapping with filiform needles of the affected areas.
That is then followed by heat-sensing moxibustion
using filiform moxa cones.
Often the pulse condition shows a kidney
deficiency root pattern.
At the end I would like to add, that from ameridian therapy point of view the description ofcases like those above is important in showing thatthe therapeutic effects of the root treatment,
representing the true nature of meridian therapy,
lead to an obvious improvement of the symptoms.

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

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Volume 12, Number 2 | Summer 2017

Integrating Kampo and Evidence-Based
Medicine (10)Living along with the Patient until the End of the Life
Hiromichi Yasui
Japan Institute of TCM Research

Although this is a narrative essay which may notconvey an objective scientific point of view, I would
really like to tell this story to you. This is a story
based on a memo written by my close friend, Dr.
Hideaki Yamaguchi (working at Tosei General
Hospital, Seto, Japan, at that time). I believe thatthe content of the story is so profound that it will be
helpful to all those who are involved in Kampo
treatment.
A

maledeveloped

idiopathic

interstitial pneumonia at the age of 20 when he wasa second-year student at a university. He had beentreated at a large outside general hospital; however,no improvement was noted, and at the age of 21, he
was referred to and admitted to Department ofRespiratory Medicine and Allergy, Tosei General
Hospital, one of the leading hospitals to treat
diseasesinJapan.

Experimental

treatment along with standard therapy, however, did
not improve his symptoms and his condition
gradually worsened. Because he could not find a newtreatment in the respiratory department, he wasintroduced to my department of Kampo medicine
when he was 23 years old.
I treated him with various decoctions combining
herbal medicine from the viewpoint of Kampo
medicine. His symptoms differed frequently, andeach time, he complained to me of his various
symptoms, and sometimes, he told me of his life. I
answeredvisited me at my hospital. She found a blog entry
that was left in his computer, which was written
three days before his death, and she brought it to me.
There was a written message as follows: "Dr.
Yamaguchi come to me with his sincere eagerness tocure the disease until this very end. I am grateful tomeet you, Dr. Yamaguchi. Thank you." This
statement saved me from helplessness and taught
me another meaning of Kampo Medicine.
As a result, Kampo medicine was hardly effective
for him. All I did was to listen to what he said every
time, and make a subtle change to the prescription
in response to his complaint. When he saw myresponse, he might feel that this doctor was trying to

24-year-old

respiratory

One month after his death, suddenly his mother

one

by

one,

and

devisedKampo

prescriptions. Such a clinical praxis continued for along time and scarce improvement was noted. Abouta year later, he died of respiratory failure due tobacterial pneumonia. I thought that I was doing mybest over the past year; however, the treatment

tackle his illness seriously. In every situation,
Kampo medicine can propose treatment according to
the condition of the patient. Apart from its
effectiveness, Kampo medicine can support the hopeto live until the very end. This may be more
important than what we imagine.
Looking at this memo, I would like add this article
to the serial essays. So far, in this series I havedescribed four medical classifications, and a social
classification which is handled differently from them.
However, the case mentioned here cannot beclassified. Nonetheless, I absolutely wanted to
introduce this story because the characteristics ofKampo medicine are well described in this case. As
written in Dr. Yamaguchi‘s memo, Kampo medicine
can suggest formulae and prescriptions according to
the patients’ symptoms. It is all the same regardlessof what kind of disease; whichever stage it is in.
Perhaps this is not limited to Kampo medicine.
Probably the same thing can be done if you can talkwith a patient, and you can propose treatment
accordingly.

However,

medicineisoutstandingly superior to other treatments in thisrespect. I am delighted to dare to understand thereasons posted here as out of Classifications. I thankDr. Yamaguchi for this memo.

resulted in failure, and I suffered from helplessness.

6

Kampo

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

Volume 12, Number 2 | Summer 2017

Postscript: When I sent this essay to Dr. Yamaguchi,
the following reply came.
“Sometimes he got questions about life (such as“what is the meaning of life?”). I answered as muchas I could, but if I did not came up with treatment
plan, it might have been difficult to face this patient.
I think that both of us may have shared a little hope”.

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

7

Volume 12, Number 2 | Summer 2017

Clinical Report 1 (Acupuncture)
A Case in which an Improvement Was Seen in Facial Nerve
Paralysis Owing to Acupuncture and Moxibustion
Treatment of the Upper and Lower Legs
Mariko Oikawa1) and Shuichi Katai2)
1) Center for Integrative medicine, Faculty of Health
Sciences, Tsukuba Univercity of Technology2) Department of Health, Faculty of Health Sciences,
Tsukuba University of Technology

by conservative treatment, facial nerve decompression
is chosen.
In Eastern medicine, peripheral facial nerve
paralysis is mainly treated by acupuncture andmoxibustion

treatment.

The

WHO

identifies

neuroparalysis as a disease that is susceptible totreatment by acupuncture and moxibustion, andperipheral facial nerve paralysis also falls under thisscope. Clinical reports to date mainly discuss theapplication of needle retention therapy and electro-[Introduction]
Facial nerve paralysis is a disease where thenerves that control the facial muscles are damaged
for some reason, and causes the face to be paralyzed1).
It is roughly classified into central paralysis andperipheral paralysis, depending on the where thedamage occurs, but most cases of facial nerve
paralysis seen in the otorhinolaryngology field are
peripheral facial nerve paralysis. Peripheral facial
nerve paralysis can be divided into intracranial,intercranial, and extracranial facial nerve paralysis,
dependingonthelocationofthedamage.

Intercranial facial nerve paralysis accounts forapproximately 80% of all cases of facial nerve
paralysis. It is most frequently caused as a result of
Bell’s palsy, Ramsay Hunt syndrome, temporal bone
fracture caused by head trauma, tympanitis, middle
ear surgery, and congenital disorder6).
The cardinal signs of peripheral facial nerve
paralysis mostly appear in the form of facial

acupuncture therapy to the face.
This

paper

reports

on

a

case

where

an

improvement was seen in the symptoms of facial
nerve paralysis as result of performing acupuncture
and moxibustion treatment by mainly applying
stimulations to distant regions of the body, namely
the upper and lower legs, instead of to the affected
region.
[Case]
67-year-old male. Height 175cm, weight 58kg.
Unemployed. Family history: Dementia in mother.
Medical history: Amnesic attack after a traffic
accident (at age 40), asthma (at age 45), lung cancer(at age 67).
The patient’s first visit was on Oct. 23, 20XX. His
chief complaint was paralysis of the right side of his
face (Bell’s palsy).
[History of present illness]

movement disorders caused by paralysis of facial

On Oct. 12, 20XX, the patient felt a strangenessmuscles, but also frequently accompany suchon the right side of his face while jogging to the park.

associated symptoms as abnormal watering of the

He stopped jogging and went home. The strangenesseyes, hyperacusis, dysgeusia, hearing loss, vertigo,

persisted thereafter, so he made an emergency visit

post-auricular pain, and oppressive facial pain2).

to T Hospital in the late afternoon of the same day.

Generally, the cure rate of peripheral facial nerve

An MRI of the head and X-P were performed, but noparalysis treatment is 70% to 80% or more, andproblem was found. The patient was given an IV

relatively high. However, the remaining 30% at theinfusion and sent home. On the following day, themost are said to be left with some form of aftereffects

patient received another IV infusion at the same

due to poor prognosis3). In Western medicine,

hospital, and on the day after that, he was diagnosed

peripheral facial nerve paralysis is mainly treated bywith nerve paralysis on the right side of this facedrug therapy and stellate ganglion block therapy(Bell’s palsy) by an anesthesiologist at the hospital.

today. When sufficient improvement cannot be seen

According to the Yanagihara facial nerve grading

8

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

Volume 12, Number 2 | Summer 2017

system (a score of 36 and above indicates normal

LI10, LI10, LI4, LI11, KI2, SP4, HT3, SP3 and KI4

movement), the patient’s facial movement scored 8

on both sides. The needles were left inserted for 12

out of 40. He was told his facial paralysis is severe,minutes. Moxa sticks were placed between the KI7

and that it would take from one to three months toand KI3 on both sides for 5 to 6 minutes. In prone

cure. The patient went to T Hospital every day the

position, a stainless steel needle (Seirin Corporation)

following week, and received an IV infusion and

40m long and 0.16mm thick was inserted to a depth

stellate ganglion block therapy. On the eleventh dayof 3 to 4mm in the LI10 point on the right hand.

of developing the disease, the patient visited ourStainless steel needles (Seirin Corporation) 50mm

hospital on recommendation of the anesthesiologist

long and 0.18mm thick were inserted to a depth of 3

at T Hospital.

to 4mm in the BL10, the BL9, the longissimusState of illness at first visit: Blood pressuremuscle, splenius muscle, and semispinal muscle on

131/72mmHg, pulse 83/min (regular). Yanagihara

both sides. The needles were left inserted for 7

facial nerve grading system: 8. No facial pain,

minutes. Immediately after the treatment, thetenderness. Sagging of the eye and mouth on the sidepatient himself noticed that he could slightly moveof the paralysis. Tension in the longissimus muscle,

his nostril on the paralyzed side. The same

splenius

acupuncture treatment was applied on the patient’s

muscle,semispinal

muscleofneck,rhomboideus muscle, erector muscle of spine, andbrachioradial muscle, on the right side. In a NET
test, nasolabial fold was 4.7mA, and ENoG value was
71.8% on the affected side. In our hospital, doctors
determined that there was a difference in the NET
test and ENoG value between the right and left sides,
and surface EMG indicated minor synkinesis. In
terms of ADL, the paralyzed side of the face wasdifficult to move, foods spilled from the mouth wheneating or drinking, the eye frequently watered on theparalyzed side (especially in the wind), the nosewatered on the paralyzed side, but no loss of hearing,tinnitus, vertigo or dysgeusia were observed.

second visit and thereafter.
[Evaluation method]
The acupuncture treatment for peripheral facial
nerve paralysis was evaluated by the Yanagihara
facial nerve grading system, a paralysis criteria
recommended by the Japan Society of Facial Nerve
Research, and also by palpation for responses of thesurface of the face, neck, shoulder, back and upperand lower legs.
The Yanagihara facial nerve grading system is aregional evaluation system that evaluates major
facial functions by dividing the face into a number ofunits and evaluating each unit individually. It
assesses the degree of paralysis by total score.

[Name of disease]
Nerve paralysis on the right side of face (Bell’sThis case is presented here with the patient’s

palsy) (M Hospital)consent.

[Treatment plan][Progress of treatment]

Improvement of blood flow around the face,

Second visit (Oct. 29)

neurological

For a whole day after the first treatment, thefunctions, mitigation of tension in neck and shoulder

patient’s watery eye and runny nose on the

promotingtheimprovementofparalyzed side stopped. This allowed the patient to[Treatment method]
In supine position, stainless steel needles (Seirin
Corporation) 40mm long and 0.16 thick wereinserted to a depth of 3 to 4 mm in the TE8, TE5,

spend the day with a measure of comfort. However,
the watery eye and runny nose gradually returned
from the following day (although to a lesser degree
than the first visit). Additionally, he had found it

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

9Volume 12, Number 2 | Summer 2017difficult to see with his right eye, on the paralyzed

that he became able to put some strength into hisside, but became able to see with his right eye again.

eyelid on his paralyzed side when intentionally

The skin of his cheek had felt a layer thicker, but it

closing his eye.

felt as though it became slightly thinner. He became

Fourth visit (Nov. 2)

able to move his mouth on the paralyzed side. He

The watery eye and runny nose on the patient’s

found it easier to eat and drink, compared to before

paralyzed side stopped. However, he still felt like his

receiving treatment. On October 28, he visited Teyes would water up. When looking in the mirror, aHospital, and was told that his symptoms have

nasolabial fold gradually appeared on the paralyzed

improved. From this day, he was instructed to lightly

side. When eating, food would sometimes still collectmassage his face, and he commenced doing as he wasin his mouth, but he was becoming able to eat

instructed. He also began self-care at home.

without spilling, as he did before he developed the

Yanagihara facial nerve grading system: 16 points.

disease. He would sometimes spill water from his

The tension in his brachioradial muscle, longissimus

mouth when gargling, but he was getting better at it,

muscle, semispinal muscle, and splenius muscle

little by little. He still felt as though his mouth was

decreased compared to before.

shifted toward the unaffected side.

The same treatment was performed as in the firstYanagihara facial nerve grading system: 30 points.

visit. The patient noticed that he had a clear double

The tension in the brachioradial muscle, longissimus

eyelid on the paralyzed side after treatment.

muscle, semispinal muscle, and splenius muscle

Third visit (Oct. 30)

decreased compared to before.

From after the treatment on his second visit, theThe pain from lumbago on the right side of thepatient’s watery eye and runny nose stopped on thepatient’s body was improving compared to before theparalyzed side. However, the watery eye and runny

previous treatment. However, he felt a stretchingnose gradually returned from the following day,sensation and strangeness when he bent forward or

although to a much lesser degree compared to before.

flexed the right side of his body.

When eating, food tended to collect in his mouth, but

The same treatment was performed as on Octoberit had gradually become easier to eat and drink.

30. Immediately thereafter, the patient became able

There was still some strangeness and difficulty into open his mouth slightly on the paralyzed side, andmoving his mouth, eye, and nose, in this order. He

the difference with the left side decreased. His facial

felt as though his mouth was shifted toward themuscles improved compared to before treatment, but

unaffected side.

he still felt some strangeness when moving the

40-point grading system: 20 points. The tension inmuscles in his face.

the brachioradial muscle, longissimus muscle,

Fifth visit (Nov. 6)

semispinal muscle, and splenius muscle decreased

Food no longer collected in the patient’s mouthcompared to before.

when eating. He also spilled food less often. When

There was a complaint from the patient that he felt

talking for a long time, he felt his voice becamea slight pain from his lower back to the outer side ofmuffled, but he was gradually improving since

his buttock when walking or lying on the sofa, frombeginning treatment. There was still a slight feelingbefore. Thus, treatment for lumbago was added tothat his mouth was shifted to the unaffected side.

his treatment regimen from this day.
The KI9 and GB34 were added to the patient’s

Yanagihara facial nerve grading system: 32
points. The tension in the brachioradial muscle,

initial treatment regimen, for lumbago treatment.

longissimus

Immediately after treatment, the patient noticed

splenius muscle decreased compared to before. There10

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

semispinal

muscle,andVolume 12, Number 2 | Summer 2017

was tension in the sternocleidomastoid and posterior

The same treatment was performed as onscalene muscle. There was a deficiency response

November 6. Immediately after the treatment, the(less suppleness compared to the unaffected side,patient found it easier to close his eye and mouth on

and depression when palpated) in the lower part ofthe paralyzed side, and became able to put somethe ST4 and ST3 on the face, and an excess responsestrength into these parts.

(tension when palpated) in the SI18. There was also

Seventh visit (Nov. 13)

a deficiency response (depressed when palpated) in

The patient went to T Hospital on November 11
and was told that his condition was favorable, andthe SP3.
The lumbago on the right side of the bodythat treatment at T Hospital has been completed.
Subjectively, the patient hardly felt any difference

disappeared.
The application of moxa sticks to the LR4 point,

between the left and right sides of this face, and no

SP5 point, the lower part of the ST4 point, ST3, SI18,

strangeness in his paralyzed side. Foods no longer

and SP3 on the right side was added to the treatmentcollected in his mouth when eating. He still felt agiven on October 30. Immediately after theslight sense of his voice muffling when talking for atreatment, the patient became able to move hislong time, but that feeling was mostly negligible.

mouth on the paralyzed side. (Compared to before

Yanagihara facial nerve grading system: 40 points.

treatment, the tension in the muscles of the neck,

Tension in the brachioradial muscle, longissimus

shoulderthemuscle, semispinal muscle, and splenius muscle.

deficiency/excess reaction in the face improved, andThere was a deficiency response (less strength

palpation found the patient’s condition to be moving

compared to the unaffected side, and depression) in

toward the unaffected state.)the lower part of the ST4 and ST3 on the face, andSixth visit (Nov. 9)

an excess response (tension) in the SI18. There wasandforearm

hadlightened,

Foods hardly collected in the patient’s mouth any

also a deficiency response (depressed) in the SP3, butmore when eating. He no longer spilled foods when

the tension in the muscles of the neck, shoulder andeating or drinking. The feeling that his mouth was

forearm had lightened compared to before, theshifted to the unaffected side began to wane.

deficiency/excess reaction in the face improved, andGradual improvements were observed, but thepalpation found the patient’s condition to be moving

patient still slightly felt that his voice became

toward the unaffected state.
The same treatment was performed as on

muffled when talking for a long time.
40-point grading system: 36 points. Tension in theNovember 6. Immediately after the treatment, thebrachioradial

patient said he felt better compare to before themuscle,longissimus

muscle,semispinal muscle, and splenius muscle. There wastreatment, and more comfortable.

a deficiency response (less strength compared to theEighth visit (Nov. 13) – Eleventh visit (Dec. 25)

unaffected side, and depression) in the lower part ofSince the seventh visit, there seemed to be

the ST4 and ST3 on the face, and an excess response

nothing wrong with the patient’s facial symptoms.

(tension) in the SI18. There was also a deficiency

However, the patient worried about a possible

response (depressed when palpated) in the SP3, but

recurrence, and a palpation found a difference

the tension in the muscles of the neck, shoulder andbetween the left and right corners of the mouth

forearm had lightened compared to before, the(the affected side did not display appropriate

deficiency/excess reaction in the face improved, andelasticity), so treatment was continued until there

palpation found the patient’s condition to be moving

was no difference between the left and right sides.

toward the unaffected state.

On the eleventh visit (Dec. 25), moderate elasticity

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

11

Volume 12, Number 2 | Summer 2017

was confirmed in the right corner of the mouth

below 10 out of 40 indicate incomplete paralysis, andthrough palpation, and there was no longer any

scores below 8 indicate complete paralysis. It also

difference between the affected and unaffected

deems scores above 20 as mild cases, scores from 18

sides of the face, so treatment was agreed to be

to 10 as intermediate cases, and scores below 8 as

terminated.

severe cases. Recovery is mostly achieved with ascore of 36 or above and an absence of any medium-[Observations]
A patient who developed peripheral facial nerve
paralysis (Bell’s palsy) was treated 11 days later by
acupuncture and moxibustion mainly to distantregions in the upper and lower legs, a total of eleventimes over a period of two months, with the result
that

his

symptoms

improved

andeventuallydisappeared.
Bell’s palsy accounts for 60% of all cases of facial
nerve paralysis, and has the highest frequency ofoccurrence. The annual incidence rate is 20 to 30
people per 100,000 people in Western countries. In
Japan, a survey conducted in 1985 found as many as
30 to 40 cases nationwide. There is no genderdifference in its frequency of occurrence. There is nodifference in which side of the face is affected, but
simultaneous

bilateral

paralysis

occursinapproximately 1% of cases, and recurs on one side at
a rate of 4.9%. The age of onset ranges from infants
to the elderly, but most frequently occurs to people in
the thirties to sixties age range, at an average age of
44. There is no distinct period or seasonality ofoccurrence. Patients have diabetes at a rate of 9%and high blood pressure at a rate of 16%, and develop
the disease mostly from having a stiff shoulder,
physical fatigue, and emotional fatigue. Complete
recovery is seen in most cases, and particularly
where the conductivity of facial nerves is maintainedby electroneuronography (ENoG), complete recovery
is achieved at a rate of 90%6).
In the case presented here, the patient wasdiagnosed with peripheral facial nerve paralysis of
the right side of the face, and rated a score of 8 outof 40 in a facial movement grading system. He had
severe symptoms of incomplete paralysis, andimprovement was expected to take time. In the
Yanagihara facial nerve grading system, scores
12

degree pathological associated movements5).
In Eastern medicine, facial nerve paralysis iscalled “deviation of the eye and mouth.” Facial nerve
paralysis is classified into a number of patterns, but
the case presented in this report was thought to berelated to the Interior Wind meridian. The concept of
the Interior Wind meridian (salivation due to cold) isthat when the meridian becomes empty, exteriorwind enters the empty meridian, attacks the middle
yang of the hands and feet and causes causing poor
meridian flow, making it difficult to close the mouth,
and thus causing salivation4). In the said case, thepatient had just begun to exercise after undergoingan operation for lung cancer in March andrecognizing a decline in physical strength. He
developed facial nerve paralysis around the time
when temperatures were gradually falling during
the turn of the season. A cold wind had been blowing
on that day.
The patient had also been caring for his motheraround this time, and was probably exhausted inboth mind and body. Thus, irregular emotion could
also have been a cause of his paralysis. Paralysis
caused by irregular emotion means that a feeling ofanger has been aggravated by “five emotions inexcess”4). Furthermore, yin deficiency could cause“water failing to nourish wood,” and when irregularemotion is added to this and liver yang is aggravated,
an aggravation of anger may also be induced. Thiscondition activates wind and fire so that qi and blood
rise and cause “deviation of the eye and mouth.” In
the said case, treatment was applied based on thisthinking.
Treatment focused mainly on acupuncture points
in the upper and lower legs, and not the affected
region. Treatment of the upper and lower legs was

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

Volume 12, Number 2 | Summer 2017

also performed to relieve the tension that waspoor

observed in the neck and shoulder of the affected side.

treatment was applied to the affected region in theAtpatient

fifth treatment. As a result, movement at the corner

experienced a runny nose and excessive watering ofof the mouth improved, and the patient subjectively

the eye on the affected side of his face, but thesefelt a change in his symptoms immediately after

symptoms disappeared immediately after treatment,

treatment. By applying moxibustion to the affectedalbeit for a short period time, and disappeared forregion in addition to the treatment applied to distantlonger periods of time with each treatment. The

regions, the difference between the left and rightLarge Intestine meridian and Triple Energizer

corners of the mouth improved. This is thought tomeridian were used to treat the runny nose andhave promoted better circulation around the facewatery eye symptoms. These are meridians that flow

and accelerated the improvement of the symptoms.

around the eyes and mouth. It is thought that

There have hardly been any reports on moxibustion

treatment of these points stimulated the sensory

treatment for facial nerve paralysis2) in the past, butorgans on the side of the face that developed nerve

since the corner of the mouth moved better

paralysis due to some type of damage. From theimmediately after moxibustion treatment in thisperspective of Western medicine, it is thought thatcase, moxibustion treatment could be expected to befacialeffective for facial nerve paralysis.

thebeginning

nerve

of

paralysistreatment,(Bell’sthepalsy)

isanmovement

there.

Therefore,

moxibustion

exacerbation mechanism of paralysis that occurs

In this case of facial nerve paralysis, treatment

when latent HSV-1 infection in the geniculate

was applied not only to the affected region, but also

ganglionandto acupuncture points at the periphery of meridians

stimulation as fatigue, coldness, tooth extraction,that mainly flow through the face. As the patientand pregnancy, causing paralysis through viral

recovered in two months, the result suggests thatneuritis, and the neuritis causing edema, which thenacupuncture and moxibustion treatment to distantbrings about a vicious circle of osseous compression

regions is effective. However, in this case, ENoG

in the neural canal, constriction and ischemia6).

value was 71.8% in an electrophysiologic study. Thisisreactivated

by

such

stressIn acupuncture and moxibustion treatment, it ishigh ENoG value and minimum neurologicalthought that a somatic-visceral reflex occurred as adisorder may have contributed to the patient’s early

result of acupuncture stimulation and acted on therecovery after treatment. Stellate ganglion blockautonomic nerves in some way to stop the patient’s

shots were applied every day for a week after therunny nose and watery eye. Additionally, it isonset

thought that an improvement was observed in themoxibustion treatment was applied thereafter. The

patient’s symptoms by improving the blood flow

combination of these treatments may have also led

around the face, promoting the improvement ofto the patient’s early recovery.

of

the

disease,andacupunctureandneurological functions, and mitigating the tension in

Acupuncture and moxibustion treatment wasneck and shoulder that occurred accompanying theperformed 11 times in this case. The patient hadother symptoms. In the latter half of the treatment,

never experienced acupuncture treatment before, so

inconveniences in the patient’s ADL gradually

he had some feelings of worry and fear about

improved, and he became able to live more

receivingcomfortably. However, some paralysis remained in

acupuncture and moxibustion treatment to distantthe corner of the mouth. He scored low in theregions in the upper and lower legs mitigated the

Yanagihara facial nerve grading system for thepatient’s burden (worry and fear) compared tocorner of the mouth, and palpation also confirmed

applying treatment directly to the affected region,thetreatment.

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

It

isthoughtthat13Volume 12, Number 2 | Summer 2017and led to his positive attitude to receiving

medicine to treat peripheral facial nerve paralysis

treatment. In the criteria for facial nerve paralysis,

also contributed to the patient’s early recovery.

a score of 36 or higher in a 40-point system and theabsence of pathologicalassociated movements

References

constitute recovery5). Since the patient scored 40 out

1) Shimoji, Koki; Yoneyama, Kimihiro: Facial nerveof 40 in the seventh treatment, the doctor could haveparalysis, Information Center for Standard

judged the patient as having recovered andMedical Treatments, 2014.

completed the treatment. However, because the2) Yamaguchi, Tomo: Illustrated technical guide topatient was worried about a possible recurrence ofacupuncture and moxibustion therapy II, Part 6

the symptoms, and also because a palpation of the

Otological and ophthalmic disorders-2, Facial

face found a weakness (deficiency) around the corner

nerve paralysis, 930-939, 2012.

of the mouth on the affected side compared to theunaffected side, treatment was continued with the3) Tsuji,

Sadatoshi

et

al.:

Standard

nerve

treatment: Bell’s palsy, 171-185, 2008.

patient’s consent until there was no difference4) Hyodo, Akira (translation supervisor) + Gotobetween the left and right sides. This case showed

College Traditional Chinese Medicine Institutethat rather than making a judgment based only on(trans.), Acupuncture and Moxibustion Series

an objective evaluation method, it is important totetralogy, Acupuncture and Moxibustion Series 2,

listen to the patient’s feelings of concern and reach a

Tianjinmutual agreement regarding treatment, including

Medicine + Goto College Traditional Chinese

the prevention of recurrence, between the patient

Medicine Institute (ed.), 278-285, 460-465, 1993.

UniversityofTraditional

Chinese5) Nishida, Takeshi: Qualitative evaluation based

and physician.

on the 40-point facial nerve paralysis grading
system using principal component analysis.
6) Nomura, Yasuya et al. (total ed.): CLIENT21—[Summary]
Acupuncture and moxibustion treatment wasapplied to distant regions in the upper and lower legs

21stcentury

clinicalpracticeintheotolaryngology field—.

eleven days after a patient developed peripheral

7) Furuya, Yoshiro: Guidebook on facial nerve

facial nerve paralysis (Bell’s palsy), with the result

paralysis treatment—Bell’s palsy and Huntthat

syndrome—1-year edition, Kanehara & Co., Ltd.

thepatient’s

symptoms

improved

andeventually disappeared. The treatment had aparticular effect in improving the excessive wateringof the eyes and runny nose. In clinical reports to date,treatment had been mostly applied directly to theaffected region. However, this case suggested theeffectiveness of treatment to distant regions in theupper and lower legs. Acupuncture and moxibustion
treatment to the distance regions in the upper andlower legs allowed treatment to be performed while
mitigating the patient’s burden (worry and fear)
compared to direct treatment of the affected region.
The combined use of Western medicine and Eastern

14

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

Volume 12, Number 2 | Summer 2017

FigureChange over time according to Yanagihara facial nerve grading system

40(Normal)

40

40

40

36
32

30

30
20

20
10

(Complete paralysis)

8

8
0

16
Acupuncture
treatment

Drug therapy
10月12日
10月23日Oct. 12Oct. 23
発症of disease
Onset(day of treatment)
10月29日Oct. 29

10月30日Oct. 30

11月2日
Nov. 2

11月6日
Nov. 6

11月9日
Nov.
9

11月13日Nov. 13
発症から一ヵmonthafter onset
月

12月25日
Dec.
25
(診療日)
最終日
final
treatment

The above figure shows the evaluation of thepatient’s condition according to the Yanagihara
facial nerve grading system in the said case, by dayof treatment.
Total score: 40 points
8 points or lower: Complete paralysis
36 points or higher: Normal

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

15

Volume 12, Number 2 | Summer 2017

Clinical Report 2 (Kampo Medicine)
A Case of Bad Health Condition from her First Delivery
Comprehensively Treated with Kampo Medicine, which Led
to the Next Pregnancy

There is no abnormalities.
Oriental medical Observation
Pulses; profoundly palpable,
Tongue; faint red covered with mild white furring

Mizuho Kobayashi

Abdomen; moderate abdominal tension (3/5) There

Division of Kampo, Machida City Hospitalare mild tenderness in both subcostal region(KYOKYOKUMAN) and mild tenderness in bilateral

Abstract
I report I treated a case who got bad condition
after her first delivery comprehensively with Kampo
medicines. Subsequently she got pregnant with
Kampo medicine contains Rhubarb (Rhei Rhizoma)

lower para-umbilical region (the tender point of
OKETSU)
Clinical course
I prescribed shoseiryuto (Tsumura & Co., Ltd.,

which is generally avoided for woman who intend to

Tokyo,

be pregnant because of its purgative effect. Restoring

pharmaceutical Co., Ltd.) 6g and kamishoyosan

her condition was most important for the pregnancy(Tsumura & Co., Ltd., Tokyo, Japan) 5g twice a dayeven with Rhubarb. Interestingly, once she got

Japan)

5gwithkikyosekko(Kotaroseparately for four weeks. Her rhinitis has improved

pregnant, she couldn’t take the medicines because of

but premenstrual syndrome remained. I changed thediarrhea, which means the pregnancy made aprescription to shosaikoto (Tsumura & Co., Ltd.,

dynamic change in her body and her bodyTokyo, Japan) 5g and keishibukuryogan (Tsumura &demonstrated she didn’t need them any more.

Co., Ltd., Tokyo, Japan) 5g twice a day. These
relieved

Introduction
Pregnancy, delivery and taking care of baby bringabout not a few damages of woman’s body. Especiallyin the late childbearing women often get extremely
tired not only physically but mentally, which may
induce various bad conditions later. But it is often
settled just a fatigue or not serious matter or not“disease”.

In the Kampo therapy “disease” is not

the only target to treat. The coordination of the bodyas a whole by Kampo medicines cure bad conditionsand “disease” as well. Therefore Kampo therapy is
the optimum treatment for women’s problems
connected with menstruation and pregnancy.

headacheanddizzinessbeforethemenstruation. She caught a cold regularly once amonth and I noticed it happened during herovulatory phase. Her susceptibility to infection has
disappeared with shosaikoto (Tsumura & Co., Ltd.,Tokyo, Japan) 5g and unkeito (Tsumura & Co., Ltd.,Tokyo,

Japan)

5g,

which

gave

her

regularmenstruations without any trouble. Accordingly she
had expectation of her second pregnancy a few times
in a year. After one year and three months she
started feeling irritable or depressed before themenstruation because of not getting pregnant
contrary to her expectation. There were theresistance with tenderness in her lower bilateral

Case History

umbilical regions. And she had strain in defecation.

38-year-old woman visited to my clinic suffering

I prescribed saikokaryukotsuboreito (Tsumura & Co.,

from the premenstrual syndrome and the allergicLtd., Tokyo, Japan) 5g and tokakujokito (Tsumura &rhinitis that both became much worse after theCo., Ltd., Tokyo, Japan) 5g twice a day. Her irritabledelivery of her first child one and half years ago. She

or depressed mood before the menstruation wasoften has headache and dizziness for one week before

relieved. After two months with these medicines,

the menstruation which has restarted recently.

finally she got pregnant. She said she stopped taking

Physical examination) 161cm 52kg

these because of a sudden diarrhea as soon as she got

Bp106/68 p74

pregnant.

16

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

Volume 12, Number 2 | Summer 2017second pregnancy. This indicates her unbalanced

Discussion
There are great differences between Kampo

condition was corrected by these two medicines. But

medicine and Western one. In the Kampo therapy,

after a while she started feeling irritable or

the assessment of the patient’s physical and mental

depressed before the menstruation because of

condition as a whole human body is essential for thedisappointed hopes of second pregnancy. This time

diagnosis and the determination of the medicine.

the stagnation and confusion or disorder of Ki madeSymptoms which patients complain are consideredanother unbalanced condition with bad circulation ofas just the expressive form of their condition as a

blood, which I speculated from the tenderness in her

result of losing the balance of the constituent

lower bilateral umbilical regions and her lightelements of the body, such as Yin and Yang or Ki

constipation.

(kind of the spiritual energy), blood and bodily fluids.

ThereforeIchangedthemedicines

to

Therefore one or a few Kampo medicine can curesaikokaryukotsuboreito and tokakujokito to drive

many symptoms of the patient by correcting theand assist the circulation of Ki and blood. Finally she

unbalanced condition.

got pregnant after two months taking with theseDuring the pregnancy, delivery and feeding

medicines. tokakujokito contains rhubarb which isbabies on mother’s milk, there are drastic changes ofgenerally avoided for woman who intend to be

the women’s body of not only bodyweight but

pregnant because of its purgative effect. Moreover

circulation or hormones. Indeed these changes aretokakujokito itself is often denied to woman who

not pathological, but can easily disturb the balance

intend to be pregnant, because its strong efficacy ofof the constituent elements of the body anddriving of blood circulation could prevent theconsequently bring some bad conditions especiallyimplantation.

for the women who gave birth of the first child later.

As a result restoring her condition was mostKamishoyosan is often used for the premenstrual

important for the pregnancy even with tokakujokito.

syndrome which is considered to be mainly caused

Interestingly, once she got pregnant, she couldn’t

by the stagnation of Ki and blood. But this casetake the Kampo medicines because of sudden

didn’t respond it. To strengthen the force to drive thediarrhea, which means the pregnancy made acirculation of Ki and blood I changed the medicine to

dynamic change in her body and her body

shosaikoto and keishibukuryogan. With these she

demonstrated she didn’t need them anymore. In thewas relieved of the headache and dizziness before

Kampo therapy, it is indispensable to assess thethe menstruation. According to the text of “Shang-patient’s physical and mental state as a wholehan-lun”, shosaikoto applies to infection just before

human body, and more important, the physical andor during the menstruation, but she was still

mental state changes in a short period even by thevulnerable to infection before the menstruation. I

therapy.

considered this was because her body struggled toprepare the menstruation and couldn’t spare from
infection.
Then I changed keishibukuryogan to unkeito
which is originally applied for the women on thebrink of menopause to support their body, chiefly
reproductive parts. Shosaikoto and unkeito hasbrought her regular menstruations without any
trouble for a year, since when she expected her

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

17

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