KAIM
T
Thhee JJoouurrnnaall ooffK
Kaammppoo,, A
Accuuppuunnccttuurree aanndd IInntteeggrraattiivvee M
Meeddiicciinnee
INTERNATIONAL INSTITUTE OF HEALTH AND HUMAN SERVICES,
BERKELEY
Volume 3, Number 1 ･ Spring 2008

Foreword

Evolving System
Hiromichi Yasui

Japanese Acupuncture - Current Research
Shonishin: Japanese Original Acupunture for Children
Etsuko Inoue

Kampo Medicine - Current Research

Best Use of Hochuekkito against MRSA-infectious Diseases
Akihiro Soma

Clinical Report 1 (Japan)

Development of Acupuncture Therapy for Adpiration Pneumonia and Traditional Medicine Outpatient Clinic of Tohoku Univ. Hospital
Takashi Seki

Clinical Report 2 (Japan)
Infant Crying at Night
Zen’ichiro Watanabe

Clinical Report 3 (Japan)

One Case that showed Effects of Jiinkokato in Dry-Type Bronchiectasis
Mitsuyuki Takamura and Hiromichi Yasui

Kampo Dermatology – Clinical Studies
Treatment of Alopecia (Hair Loss) with Kampo (1)Fumino Ninomiya

Medical History in Japan

Origin of Japanese Acupuncture: Waichi Sugiyama and his Text – Sugiyama Shindenryu (1)Jikan Oura

ISSN:1559-033X

Volume 1, Number 1 | Spring 2006

A good motive creates a selfless devotion.
“I just want my customers to feel better, body and soul. Just to see
their faces light up with hope and happiness, I’d do anything,”
remarks Masao Tsuji, President of Ominedo Pharmaceutical Industry
Company. He visits various sites where raw herbs and substances foruse in their Kampo products are picked. And he believes this is the
tradition Ominedo had maintained for over a century now since thecompany was founded in 1900.
The same philosophy is applied in handling the numerous
high-quality formulas created at their labs where highly advanced
scientific and pharmacological researches are conducted. The
company’s state-of-the-art facilities that comply with GMP standards
turn out various extracts to be incorporated into their pride products.
“Every merchandise is the by-product of our sincere devotion todelivering a lineup of products that not only work for the customers’
body, but also bringing peace of mind as well,” Tsuji concludes,“delivering the right product to customers who appreciate ourknowledge and devotion is our ultimate goal.”

Ominedo Pharmaceutical Industry Co., Ltd.
574, Nenarigaki, Yamatotakada-City, Nara 635-0051, Japan
URL: www.ominedo.co.jp
Contact: info@ominedo.co.jp
FAX (81) 745-23-2540

ああThe Journal of
Kampo, Acupuncture andIntegrative Medicine(KAIM)

T
Thhee JJoouurrnnaall ooff
K
Meeddiicciinnee
Kaammppoo,, A
Accuuppuunnccttuurree aanndd IInntteeggrraattiivvee M

Research on Theory, Practice and Integration

Volume 3, Number 1 ･ Spring 2008

EXECUTIVE EDITOR

Shuji Goto
Chairman, GOTO College ofMedical Arts & Sciences
Tokyo, JapanEDITOR-IN-CHIEF

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

TA B L E O F C O N T E N T S
1 Foreword
Evolving System
Hiromichi Yasui

2 Japanese Acupuncture - Current Research
Shonishin: Japanese Original Acupuncture for Children
Etsuko Inoue

ASSOCIATE EDITORS
Shuichi Katai
Ibaraki-ken, Japan

Hiromichi Yasui
Tokyo, Japan

8 Kampo Medicine - Current Research
Best Use of Hochuekkito against MRSA-infectious Diseases
Akihiro Soma

EDITORIAL STAFF

Akira Shimaoka
Hiroshi Tsukayama
Hitoshi Yamashita
Naoya Ono
Noboru Mitsuhata
Yoshiro Sahashi

10 Clinical Report 1 (Japan)
Development of Acupuncture Therapy for Aspiration Pneumonia and Traditional Medicine
Outpatient Clinic of Tohoku University Hospital
Takashi Seki, MD, PhD

EDITORIAL BOARD
Denmei Shuto
Hajime Haimoto
Hideaki Yamaguchi
Hidemi Takahashi
Katsutoshi Terasawa
Kazushi Nishijo
Keigo Nakata
Keishi Yoshikawa
Koji Ebe
Shohachi Tanzawa
Tadashi Yano
Takahisa Ushiroyama
Tomomasa Moriyama
Toshihiko Hanawa
Yoichiro Ebe
Yoshiharu Motoo
Yoshiro Yase

PUBLISHER

Shuji Goto
International Institute of Health andHuman Services, Berkeley

16 Clinical Report 2 (Japan)
Infant Crying at Night
Zen’ichiro Watanabe

18 Clinical Report 3 (Japan)
One Case that showed Effects of Jiinkokato in Dry-Type Bronchiectasis
Mitsuyuki Takamura and Hiromichi Yasui

20 Kampo Dermatology – Clinical Studies
Treatment of Alopecia (Hair Loss) with Kampo (1)Fumino Ninomiya

22 Medical History in Japan
Origin of Japanese Acupuncture: Waichi Sugiyam and his Text – Sugiyama Shindenryu (1)Jikan Oura

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)

Volume 3, Number 1 | Spring 2008

Foreword
Evolving System
Kampo medicine is a unitary system in which diagnosis and courses of treatment are administeredas a single process. The Japanese have built this system based on “Shanghanlun” since nearly 300 years
ago. As a matter of course, in the backdrop there is TCM that has several thousand years of history.
However, Shanghanlun has unique principles different from those of today’s TCM. Yoshimasu
Todo, who was active in the 18th century (1702-1773), did not assimilate the principles of both TCM and“Shanghanlun” into his clinical practice as he could not actually see them practiced before him. Recently
efforts are underway to interpret these principles in a fresh light and thereby research of Kampo medicine
has entered a new stage.
With the Meiji Restoration in 1868, the new government took the policy to have Kampo medicine
step down from the standing as orthodox medicine. However it continued to exist as a private medicine.
In recent years, it has started to draw new attention; medical schools have also started to teach Kampo
medicine, and the general public shows high levels of interest in Kampo medicine.
What primarily caused such popularity of Kampo medicine is the existence of 148 kinds of extract
formulas, instead of decoctions that are trouble-taking in preparation. Such extract formulas were
invented by the Japanese as a result of their research efforts over many years since 1940s. As soon as
extract formulas - initially viewed as being a little strange products - were approved in 1976 for coverageby the National Health Insurance System, they have spread the most rapidly and now are absolutely
necessary in general practices.
Upon introduction of extract formulas into the National Health Insurance System, experts of thosedays launched a new system construction for Kampo medicine that used extract formulas. They havecontinuously performed scores of clinical and basic research, and in recent years, a certain measure ofcompletion has been achieved. Even now, varieties of research results are being reported in a stream.
Japanese Kampo medicine is quite different from Chinese TCM in many aspects. It is particularly
obvious in the aspect of theories as well as their attitude toward formulas. In a word, TCM of China isenthusiastic about creating new formulas, whereas Japanese Kampo medicine is enthusiastic about how
to make good use of a group of formulas for various diseases with the main focus on classical formulas.
As a result, enormous amounts of experiences for a single formula have been accumulated and theynaturally suggest indications for the formula. For instance, Poria Powder with Five Herbs is markedly
effective for migraines under particular conditions and is also specifically effective for acute rotavirus
enteritis. It is also used to relieve brain edema in the acute stage of cerebral infraction. Meanwhile it is also
used as a hangover medicine.
For each formula, indications are being established one by one, and this step-by-step process
configures a system as a whole. Kampo medicine will further substantiate and solidify this systemthrough a great deal of clinical experiences and a lot of basic research.

Hiromichi Yasui
Japan Institute of TCM Research

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

1

Volume 3, Number 1 | Spring 2008

Japanese Acupuncture - Current Research
Shonishin: Japanese Original Acupuncture for Children
Etsuko Inoue
Morinomiya College of Medical Sciences & Arts

Introduction
In Japan, a specialized form of acupuncture that
focuses on stimulation to the skin has beenpracticed on infants and children for the purpose of
their health management. It has been very popularin the Kansai area, particularly in Osaka of Japan.
This approach is referred to as acupuncture forchildren (Shonishin or Shonihari in Japanese.)
While acupuncture for adults involves the insertionof needles, acupuncture for children or pediatricShonishin is a non-insertive form of acupuncture

The

that makes use of a variety of tools to stimulate theShonishinskin.

historyofacupunctureforchildrenor

It is not known when pediatric acupuncture began

It has been reported that regular monthly

to be practiced. There are historical materials

pediatric Shonishin treatments help promote health(1763), recording a pediatric acupuncturist existed

and stable mind-body growth of infants and children.

in Nakamura-village, northern Osaka in thePediatric Shonishin techniques may be applied to

midterm of Edo period (Photo below).1)

the adults who experience acupuncture treatment
for the first time or who are excessively sensitive tostimuli. This report will present a brief overview ofpediatric Shonishin practiced in Japan.

Especially in Osaka, pediatric Shonishin rapidly
increased in popularity during a period from the endof Taisho Era to early Showa Era (1920s) so that
almost all acupuncturists, except for a few, practiced
this new form of acupuncture. There were many
acupuncturists who put up the sign saying“acupuncture for children.” In these days, Shuji
Fujii of Fujii Family in Yotsuhashi distinguished forpediatric Shonishin conducted animal experiments2)
on the Shonishin and acquired a doctoral degree inmedical science. This fact attracted more attention

2

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

Volume 3, Number 1 | Spring 2008of the general public toward pediatric Shonishin. In
Osaka it seems likely that there were families suchas Nakano’s and Okajima’s other than Fujii’s thatgained public notoriety for pediatric Shonishin1);
Nakano who drew in many patients so that the word
“hari” (needle) was given to a part of his village
name Nakano, like Hari-Nakano, and Okajima who
was renowned for the trade name of “Usagi Bari”(rabbit needle.) In the prewar era, Sorei Yanagiya
wrote a book to introduce Fujii Family’s Shonishin
to practitioners in Tokyo. However, it was notadequately familiarized in Tokyo3). After the war,
Hirohisa
Yoneyama
andHidetaroMorico-authored a book titled “Shounishinpou(Shonishin techniques)”1). They travelledaround Japan to give lectures for promoting
pediatric Shonishin. Mori’s efforts extended
to travelling over to California of the U.S.A.,
Brazil, and Argentina in 1990. In recent years,
Kentoku Tanioka is actively promoting it in
the United States and European countries.
A database of integrated literatures inJapanese on acupuncture and moxibustion
since Meiji Era was opened to the public in
2007 (http://acupuncture.jp/).

If the keywords containing Shonishin are input,
three literatures (if prewar literatures are needed)by Shuji Fujii will be retrieved.
The tools of Shonishin
In Shonishin, various tools of different shapes
have been devised to meet the needs of individual
techniques and not to scare infants and children(Photos). Materials are stainless steel, god, andwood. Hands of small animals (mole hands) may be
used to make tools. The Harikyu Museum(http://www.harikyumuseum.com/) has the Hidetaro
Mori collection of Shonishin needles on display(literatures)4). Today, plastic disposable needles for
Shonishin are sold in the market (Photos below).

They are divided into four categories4).
Tools to rub the skin surface, 2) Tools to tap the skin, 3) Tools to cut the skin, and 4) Tools to contact the point.

Spin Needle
Roller Shin

Kaki

Roller Shin

Bari

(pitchfork)
Choto Shin (long(small) 鍼
Bachi-Bari (plectrum) (large)
Taishi Bari
Matsuba Shin
鍼（大）(Pine leaf)
Hoki Shin

鍼 大(broom)Sankaku bari (triangle)鍼Haguruma
Shin (gear)
鍼（大）

大）

Hoki Shin

Bachi
FurikoShin(plectrum)

Shumo (small)）
Shin

Bari
Yoneyama
Icho-Bari(Ginkoleaf)いちょ

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

3

Volume 3, Number 1 | Spring 2008

Tools of category 1) are Haguruma Shin, Roller
Needle, Yoneyama Icho Bari. They are used togently rub the skin making up and down motions on
the shoulder and back, abdomen and arms and legs.
The Tanioka’s Taishi pediatric needle is a blunt
triple edged Sanryoshin (Fig.) used for thistechnique.

Tools of category 2) include those of Bane (spring) type, Furiko (pendulum) type, Shumo Shin (brush), and
Go Shin (filiform needle). They are used to rhythmically tap the skin surface on the head, arms and legs,shoulder and back and chest-abdomen.
Tools of category 3) include Choto (long sword) Shin, Sanryo Shin, Usagi (rabbit) Bari, and Kaki
(pitchfork) Bari. Sanryo Shin is used to prick meridian points and others are used to scratch the skin. The
application areas of these tools are distal arms and legs.
Tools of category 4) include Tei Shin (Photo). The round tip of Tei Shin is used to contact acupuncture
points for several seconds to several minutes. When treatment requires an invasive technique, Go Shin,
which is a thin needle with a diameter of 0.16mm or below, may be inserted only to the depth within 1mm
from the surface of the skin to supplement above three procedures.
4

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

Volume 3, Number 1 | Spring 2008

may focus on stimulating the areas surrounding

Target Children
Shonishin treats infants from about 20 days of

meridians

dependingon

symptoms.

Pediatric

age or above. Many of the children who receive

acupuncture is a form of technique to stimulate theShonishin are from 5-6 months to 5 years of age. Itskin whatever techniques practitioners use.

is effective particularly for mental symptoms
appearing in infants of 5 months to 2 years of age.

Treatment Time, Period, and Frequency

Of course it is also effective for children ofschool-age or above..

Shimizu, et al. conducted a questionnaire surveyof

Shonishin

Acupuncture
Indicated Symptoms

targeting&members

Moxibustion

of

Osaka

Association.

The

results from 203 respondents show that theSymptoms indicated for Shonishin are as follows:

treatment time was 3 to 10 minutes and the

1. Typical neurotic-like symptoms in infants andtreatment frequency was three consecutive days per

children such as insomnia, night crying, tempermonth (Fig.)7).

tantrums, squeaky voice, night terrors, and biting
2.

Respiratory symptoms such as colds, tonsillitis,

7 8%

asthma, rhinitis
3.

Digestive symptoms such as lack of appetite,indigestion, diarrhea, constipation
4.

Allergic symptoms such as atopic dermatitis,

hives, asthma
5.

43%

43%

3 minutes or less
3 to 5 minutes
5 to 10 minutes
10 minutes or more

Other symptoms such as nocturnal enuresis,

Chic, and torticollis

Adjustment of the Amount of Stimulation
According to the results of the questionnaire

Body Locations for Shonishin Treatment andsurvey by Shimizu, et al. (153 respondents), many ofTechniques

the respondents use, as a measure of the amount of

Shonishin is usually performed through rubbing

stimulation, various factors such as the levels ofor tapping depending on what is require on almost

reddening of the skin, sweating, and relaxation of

all parts of the body of arms-legs-chest, abdomen,

the body surface tension (Fig. 3)6).

neck region, shoulders, lower back, and head (Fig. 1).
In performing treatment on infants and children,
the acupuncturist who takes account of their age inmonth, constitution, and skin properties (softness)
adjusts the amount of stimulation based on theirfacial expression or the levels of reddening on theskin. In performing Shonishin, it is said better tomove or manipulate the pediatric tools along themeridian flow.
It is also better to gently contact the chirike,hyakue, and jikan points with Tei Shin. Someacupuncturists administer needle insertion into the

その他
体表
眼の色
11%
の温
4%
度
泣き声
2%
5%
脈
7%
発汗
8%
表情
10%

発赤
39%

体表の
緊張14%

kokou sankan meridian point even if patients are
small children7). Pediatric Shonishin acupuncturist

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

5

Volume 3, Number 1 | Spring 2008

Mechanism of ShonishinforYuko Sato mentions about the effects of skin

theirchildren

and

bring

them

acupuncture-moxibustion

clinics

stimulation on the body as follows8). The effects ofdecreased.

ofstimulation on development of immature babies are

moxibustionof significance as the study by Schanberg, et al.

established “Oyako Skin Touch Association” in 2002

(1997) reported that repeated daily skin stimulation

as a part of the “Shonishin Dissemination Project”

to immature babies promoted weight increase

for the purpose of re-disseminating Shonishin. The

compared to non-stimulated ones. Although it ispractitioners instructed parents on skin stimulation

known that acupuncture stimulation induces orin homes using a spoon. This activity was wellmodifies various reflex responses through the motor

received by parents in communities as a support toneurons, autonomic nerves, and endocrine system,

nurture children and has spread nationwide. The

Sato, et al. conducted a systematic experiment using

Association continues to do the activity as the Japan

anesthetized

Skin Touch Kyogikai (http://s-touch.net/).

animalsonreflexes

that

skin

Practitioners
in

have

to

sharplyacupuncture

Tokushima-prefecture

and
have

stimulation induce through the mediation of the

Nippon Shonihari Gakkai (Japan Shonishinautonomic nervous system (1997), and elucidated

Academic Society) was established in April 2007

that these reflexes have two types of spinal reflexes(http://shounihari.com/), and it holds a yearlyspecific to body parts and supraspinal reflexes

conference.

occurring by stimulation to any part of the body9).

delivered

They also showed that skin stimulation was not

Conference in 2009 on Shonishin practiced inonly transmitted to the brain via the afferent nerves

Germany (application of Taishi Shonishin by

but also conducted antidromically via afferent fibers

Tanioka, L.Ac.) 10). His speech indicated Shonishin

to cause reactions such as vascular dilation.

has begun to be familiarized in Europe.

ThomasalectureWernickefromGermanyat

Third

Academicthe

Mitsuhiro Denda recently delivered a lecture,saying that in the skin cells there are receptors

Conclusion

similar to the ones in the hippocampus and that
when

the

skin

is

stimulated,it

Shonishin has actively been practiced in Japan,

secretes

particularly in the Osaka region for the healthyneurotransmitters – this means that similar to thedevelopment of infants and children since 1700s. In

brain, the skin is doing positive activities10).

Shonishin, a variety of tools with different shapes

It is natural to think that even light skinstimulation

by

such

as

Shonishincanbehave been designed and developed to meet the needsofthespecific

methods

ofmanipulationortransmitted to the brain and recorded there totechniques.

influence affectivities.

alleviating or dispersing and eliminating various

Shonishiniseffective

inquickly

Although the effective mechanism of Shonishin

symptoms commonly observed in the development

techniques has not been elucidated sufficiently, theprocess of infants and children. Shonishin is also

effects of skin stimulation can be expected as

effective

indicated in the results of above studies.

development. I expect that Shonishin will becomeinpromotingtheirmentally

stablewidespread globally and further improve as an
Dissemination of Shonishin

effective means of helping the healthy development

In today’s Japan where the trend of nuclear
familiesisincreasing

with

fewer

of children.

childrencontinuing to develop, parents who desire Shonishin

6

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

Volume 3, Number 1 | Spring 2008

References
1.
2.

3.

4.

5.

Hirohisa Yoneyama, Hidetaro Mori: Pediatric

Captions for Figures

Acupuncture, 1964: Ido-no Nippon-sha

1. Horeki Year 13 (1763), Map of Sesshu Hirano,

Shuji Fujii: Shonihari ni kansuru chiken hoi

Description of “a Shonihari acupuncturist in(Experimental study on the effects on blood

Nakano-village”

pressure, respiration, body temperature, kidney2.

and capability of pigment excretion). Journal of(reprinted from the Harikyu Musecum Vol.2)

Osaka Igakukai, 1929; 28: 2911 - 2920

3. Disposable pediatric Shonishin needles (products

Hitoshiof Seirin)

Nagano:Shoniharinokeisei-shi.

Collectionofpediatric

Shonishinneedles

Journal of Nippon Shonihari Gakkai, 2009;

4. Various pediatric Shonihari needles

2:13-19

5. Taishi-ryu pediatric Shonihari needles

Hidetaro Mori, Hitoshi Nagano: The Harikyu

6 – 8 Pediatric Shonishin needles for frequent use

Museum Vol.2 Japanese Traditional Medicine

9. Shonishin treatment time (Shimizu, et al., 2001)

and Culture. 2003; Morinomiya Iryou Gakuen

10. Judging measure of the amount of stimulation

Shuppan-bu(Shimizu et al., 2001)

Isao Okuda: Shonihari no kiso to rinshou(Basics and Clinical Practice of Shonishin).
Journal of Shin-Kyu OSAKA 1986; 2 (1): 20-23

6.

Yasuji Nonoi: Shonihari of Yasuji Nonoi-sensei.
Journal of Nippon Shonihari Gakkai, 2008;
Abstracts: 8

7.

Naomichi Shimizu: Shonihari ni kansuru chosato Shimizu-ryu Shonishin no jissai (Research of
Shonishin
Shimizu-styleandActualSituationon

Shonishin),

2001;

51(3)

Abstracts: 335-336
8.

Yuko Sato: Hifushigeki ga shintaini oyobosu
eikyou (Somatic effects of stimulation of skin)
Journal of Shin-Kyu OSAKA, 1998; 14(1): 27-33

9.

Sato A, Sato Y, Schmidt R F: The impact ofsomatosensory input on autonomic functions.
Rev Physiol Biochem Pharmacol, 1997; 130:
1-328

10. Mituhiro Denda: Kanji kangae kataru hifu,
Sekai to inochi no kyoukai (The Skin that feels,
think, and speak, The boundary between the
world

and

life)

The

Japan

Societyof

Acupuncture and Moxibustion (JSAM), 2008;
58 (3) Abstracts: 324-325
11. T Wernicke: Reality of Pediatric Shonihari in
Germany. Journal of Nippon Shonihari Gakkai,
2009, Abstracts: 10-12

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

7

Volume 3, Number 1 | Spring 2008

Kampo Medicine - Current Research
Best Use of Hochuekkito against MRSA-infectious
Diseases

whether surgically treated or not. Thus, MRSA canoften be detected in such patients. Prompted by thefact that MRSA disappeared in patients who

Akihiro Soma
KAIM Editorial Member

received hochuekkito, he administered this formula
to all consciousness-disturbed inpatients with
MRSA. The result showed that MRSA dissipated in

MRSA (methicillin-resistant Staphylococcusaureus) is Staphylococcus aureus that is highly
resistant to penicillin type β-Lactam antibiotics,

all patients in the dosing period of one to threemonths.
Thereafter, having realized the treatment effects

typically methicillin. In Japan, a series of cases ofof hochuekkito, Dr. Kitahara uses this formula for

MRSA

all inpatients from an early disease stage in

infected

inpatients(hospital-acquired

infection) began to be reported in 1980’s and medical

anticipation of the formula’s effects on infection

institutions were working to find means to prevent

prevention.

and control MRSA. In the meantime Vancomycin
and other antibiotics effective for MRSA were used;

Effects of hochuekkito against MRSA

the number of newly infected people peaked in

The survey during 1991 to 2005 by Dr. Kitahara

1990s, and MRSA infections became a social

showed that 56 out of 61 patients having MRSA

problem.

detected in their sputa turned negative (91.8%) andAt such times, a clinical report was publisheddescribing “MRSA turned out negative by theadministration of Kampo medicine.” This report

the median time to turn to MRSA negative was 8.4
weeks.

Hochuekkito

wasadministered

to

196

created an event that not only gave a tremendous

consciousness-disturbed patients within a week

shock to medical personnel but also helped tofromprovide people wide recognition of clinical efficacy of

prevention. And then MRSA was detected in the

Kampo medicines.

sputa of 16 out of 196 patients, representing atheonset,

inanticipationofinfection

detection rate of 8.2%. During the time that
Coincidental occurrence of MRSA dissipation andhochuekkito and other Kampo formulas were notcure of pressure ulcer

being used, infections were confirmed in 98 out ofThis was reported by the neurosurgeon Dr.

234 patients, representing an infection rate of 34.5%.

Masakazu Kitahara. Dr. Kitahara, having difficulty

The data indicates that the use of hochuekkito

to treat pressure ulcer in his patient with MRSA,

greatly inhibited infections.

commenced the administration of hochuekkito
which

had

reportedlybeeneffectiveforDr. Kitahara says that he realizes the use ofthehochuekkito from the early stage of admission totreatment of pressure ulcer. The ulcer improved day

hospital is beneficial to managing the whole body ofby day and was completely cured within about 45

patients as well as controlling hospital-acquired

days. Moreover, sputum examination showed non

infections.

presence of MRSA. This result caused a twofold
greater shock.

About hochuekkito

In the area of neurosurgery, a large percentage of

It has been reported that hochuekkito has thepatients are in conscious state with a weakened

activation of cell-mediated immunity1) and theability to defend against infection regardless ofability to modulate the activity of NK cells by

8

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

Volume 3, Number 1 | Spring 2008changing the level of the activity – when the activity

References

value is low, the activity is raised; and when the

1) Chiharu

Kubo,

YuzuruInagaki,

Harukoactivity value is high, the activity is reduced. 2)And,

Kawaguchi, et al.: Meneki kinouni oyobosu

it has also been reported that the findings from thehochuekkito no kouka (Effects of hochuekkito on

use of this formula in the experiment with micemadeleucopenic

indicatedpreventionofpseudomonal infection, improvement of the ability
to proliferate bone-barrow hematopoietic precursor

immune function)
Kampo and Immuno-allergy 1: 50-57, 1988
2) Shuji Ohno: Effects of a traditional Chinese

cells, and improvement of hematopoietic cytokine

Medicine “Hochueki-To” on Natural-Killer

production.3)

Activity. Allergy, 37: 107-114, 1998

It is known that exposures to physical and

3) Masahiro

mental stresses reduce body resistance. On therecoveryother hand, it is suggested that hochuekkito

leucopenia in mice administered a Japanese

improves the body resistance ability weakened bystresses. The administration of this formula to miceexperimentally

infectedwith

Listeria

reducedbacterial counts and significantly restored IFN-γ
production

compared

to

that

of

the

ethicalKaneko,
from

et

al.:

Accelerated

cyclophosphamide-induced

herbaldrug,

Hochuekkito.

Immunopharmacology, 44，223-231，1999
4) Yasutoshi Yamaoka, Takuya Kawakita: Kikuo
Momoto, Protective effect of a traditional

non-administration group. In Listeria infected mice,

Japanese

depressed accumulation of macrophages in infected(Japanese name: Hochuekkito), on the restraint

sites

stress-induced susceptibility against Listeria

made

a

significant

recoverybytheadministration of the formula. 4)

Hochuekkito is composed of 10 kinds of crude
drugs, which, it has been confirmed, containarginine.

5)Arginine

is an amino acid, which

supplementation is needed for pressure ulcer,
wounds, or transmitted diseases.

medicine,

Bu-zhong-yi-qi-tang

monocytogenes. Immunopharmacology, 48 ，35-42，2000
5) Kazuo Uebaba, et al.: Basic Amino Acid in
Crude Drugs: Arginine. Journal of Traditional
Medicines, 1 (1) 96-97, 1984

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

9Volume 3, Number 1 | Spring 2008

Clinical Report 1 (Japan)
Development of Acupuncture Therapy for Aspiration
Pneumonia and Traditional Medicine Outpatient Clinic of
Tohoku Univeristy Hospital
Takashi Seki, MD, PhD
Center for Asian Traditional Medicine
Tohoku University Graduate School of Medicine

be noticed (inapparent aspiration), allowing saliva
or intraoral bacteria to enter the lungs.
Evaluation

of

the

deglutitional

measurement of the deglutition reflex latency
For the assessment of the deglutitional function
videofluorographic studies are

The Super-aging Society Japan and Aspiration
Pneumonitis
Based on an announcement made bey the cabinet
the ratio of elderly in Japan (the portion of the
population older than 65 years) has increased
steadily every year since investigations have been
started (in 1968) and in 2007 the ratio exceeded 21%,
resulting in a super-aging society, and by October
2008 this ratio has reached 22.1%. By the year 2055
the ratio will reach 40.5%, so that is has been
estimated, that one in every 2.5 people will be anelderly. (2008, Current situation of the elderly
population and the state of implementation ofcountermeasures for the aging society.)
Pneumonitis is the fourth frequent cause of deathin Japan. More than 90% of the deceased are elderly
over the age of 65. A characteristic form ofpneumonitis

inelderlypeopleisaspiration

pneumonitis. The deglutition and cough reflex are
defense mechanisms protecting the lungs fromaspiration. A major cause of pneumonitis in theelderly are diminished deglutition and coughfunction:

employed, but theirperformance is restricted to facilities capable ofperforming them and definitely are not easy. For
this study we used the latency time of theswallowing

reflex:LTSRdeveloped

at

Department of Geriatrics of the Tohoku University
as a measuring method for the deglutitional
function and as an assessment technique. Thismethodhas

theadvantage

that

it

suggests a correlation with aspiration pneumonitis.
Multipurpose 8f tubes and syringes (1 ml, 10 ml)
are attached to a three-way stopcock, the tip of the
tube inserted to a depth of about 12 cm and left
dwelling the pharynx of the examinee, then 1 ml ofdistilled water in injected (Figure 1) and the LTSR
defined as the period from the begin of the injectionof the distilled water to the begin of the pharyngeal
elevation. It is common knowledge that there is arisk of aspiration, when this LTSR exceeds 5
seconds.
Figure 1: Kit for the measurement of the deglutitionreflex latency

cerebral basal ganglia (Nakagawa T, et al. Arch
Intern Med 1997; 157:321-324). Vascular disorders
in the basal ganglia lower the amount of dopamine
produced in the nigrostriatal body. In this way theamount of substance P (SP) released from thesyringessensory branch of the vagal nerve to the pharyngeal
and tracheal mucosa decreases. Since the SP

syringes

represents an important trigger stimulus for theamount of SP also decreases those reflexes (Yamaya

three-way
stopcockM, et al. JAGS. 2001; 49:85-90). In cases with adiminished deglutition reflex the aspiration may not

10allowsmeasurement everywhere and available evidence

reflexes due to cerebrovascular disorders of thedeglutition or cough reflex, a reduction in thethe

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

insert to nose

Volume 3, Number 1 | Spring 2008

Necessity of acupuncture treatment

Materials and methods

During the treatment of patients with dysphagia

The study included 41 patients with sequelae oforal application of the required drugs may not

cerebrovascular disorders (average age ± standard

possible precisely because there are difficulties indeviation 76±2 years), all of whom presented with aswallowing. For this reason new treatment forms

history of deglutition disorders. The primary lesion

are required that improve the deglutition reflexof the cerebrovascular disorder was located in most

without relying on oral drug application.

patients in the basal ganglia and the adjoining deep

Development of an acupuncture treatment for
improving the deglutition reflex
Aspiration is considered to be due to a lack ofproper control of deglutition and inhalation and in
traditional Chinese medicine one of the causes is
attributed, based on the visceral manifestation
theory, to the weakened functions "harmonizing
array" of the stomach and "qi absorption" of thekidneys.

white matter. Patients with infarct sites in the brain
stem were excluded.
The LTSR was defined as the time from the begin
of injecting 1 ml of distilled water through atransnasal catheter into the pharynx until the beginof the swallowing movement. The measurement was
performed 5 times and the measurement value
defined as the mean value excluding maximal andminimal values.

Further, since patients with cerebrovascular

The Ashi Sanri and Taikei were needled. Seirin

disorders may not be able to use their extremities at

disposable stainless steel needles (diameter, 0.16

will, an approach using acupuncture therapy can

mm; length 40 mm) were inserted at the acupoints

easily be conceived. Moreover, as a treatment formon the left and right to a depth of 1 cm. The needles

using stimulation of safe sites it is effective in thewere neither manipulated manually nor used forclinical setting. Under these circumstances we choseelectrical stimulation. After retaining the needles

to use the sea point of the brighter yang stomach

for 15 minutes the needles were removed. Breathing

meridian and the source point of the lesser yin

based tonification or sedation was not used either.

kidney meridian as stimulation sites.

The LTSR was performed immediately before theBelow the results of two trials are described.

needling and 30 minutes after removing theneedles.

Research 1:
Deglutition reflex and acupuncture treatment forpatients with cerebrovascular disorders
Seki T, Kurusu M, Tanji H, Arai H, Sasaki H,
Acupuncture and swallowing reflex in poststroke
patients. J Am Geriatr Soc. 51(5) 726-727, 2003.

Saliva and blood samples were also obtained
immediately before the needling and 30 minutes
after removing the needles. The sampled saliva andblood was stored as -80ºC and subsequently theirsubstance P content measured. For this purpose weused a radioimmune assay and followed the
instructions of the manufacturer for quantitative

Background and purpose
Therapies requiring the oral application of drugs

measurements.

TheamountofsubstanceP

are limited in patients who have problems eating.

immediately before the needling and after theThus,needle stimulation were compared.

nonpharmacologic

methods

promotingrecovery of the swallowing function have to be

In seven of the examinees the LTSR wasdeveloped. In this study we examined the effects ofmeasured daily from the day after the needle

needle stimulation at Ashi Sanri (ST36) and Taikei

stimulation for one week.

(KI3) on decreased swallowing reflexes.

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

11

Volume 3, Number 1 | Spring 2008

are related to spontaneous swallowing (Zald DH, et

Results
Figure 2 shows that the LTSR significantly

al. Ann Neurol 1999) and since acupuncture is

improved after a single needle stimulation (average

known to regulate the subcortical grey matter, itvalue before needle stimulation: 10.2 ± 1.4 seconds,

may be inferred that acupuncture treatment causes

average value after needle stimulation: 4.5 ± 0.6

local activation of the brain.

seconds). After adjusting for age, sex and activities
of daily living and primary disease (cerebral infarct,
cerebral hemorrhage) a logistic regression analysis
was performed and showed that the longer the
LTSR was before the needle stimulation, the better
were the therapeutic effects (P=.002).
Moreover, the effects of needle stimulation on the
LTSR continued for 7 days. The average LTSR
before and after needling as well as 1, 2, 3, 4 and 7
days later were 12.8±4.5, 3.2±0.7, 6.2±2.5, 6.7±2.8,
5.6±2.1, 3.6±1.4 and 2.2±0.2 seconds respectively.

Research 2:
Deglutition reflex and acupuncture treatment forpatients with cerebrovascular disorders:
videofluorographic studies
Seki T, Iwasaki K, Arai H, Sasaki H, Hayashi H,
Yamada S, Toba K.
Acupuncture for Dysphagia in poststroke patients: avideofluoroscopic study. J Am Geriatr Soc.
53(6):1083-4. 2005.
Background and purpose

The concentration of substance P in plasma

We reported that needle stimulation of Ashi

(average of 25.9±3.0 vs 26.6±3.0 pg/mL) and saliva

Sanri and Taikei improved the swallowing reflex.

(average of 15.2±2.9 vs 17.7±3.4 pg/mL) showed no

Here we used videofluorography to investigate

significant variation before and after the needle

whether needle stimulation improved swallowing

stimulation.

disorders or the swallowing in patients with

Health disturbances like local infections etc. were
not observed.
Figure 2 (below)

Discussion
A network of cholinergic, histaminergic anddopaminergic nerves is involved in the control of theswallowing reflex (Jia YX, et al. Geriatr Gerontol
Int 2001). The activities of several sites in the brain

12

cerebrovascular disorders.
Materials and methods
The study included 32 patients living a healthcare center for the elderly in Sendai city (average
age ± standard deviation; 84±4 years; 20 women, 12men) in whom cerebrovascular disorders had been
diagnosed using MRI. A written informed consent
was obtained from these patients. The examinees
were randomly divided into two groups. The
patients in the needle stimulation group (average
age ± standard deviation; 77±9 years; 10 women, 8men) received acupuncture treatments 3 times aweek over a period of 4 weeks. The needle
stimulation was the same as the one used inresearch 1. The control group included 14 persons(average age ± standard deviation; 79±5 years; 10
women, 4 men) and received only the ordinary carewithout needle stimulation.
The videofluorography was performed in theneedle stimulation group before and after the firstneedle stimulation and in the fourth week before
and after the last treatment. In the control group it

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

Volume 3, Number 1 | Spring 2008

was performed before observation begin andfollowing completion of the observation after fourweeks. For a single videofluorographic examination
the patients were asked to swallow 5 ml of waterover a period of 5 minutes, 5 ml of liquid diet andsolid food (cookies corresponding to 5 ml) inarbitrary order. The water and food was mixed withbarium (Enemastar Enema Powder, FUSHIMI
Pharmaceutical, Marugame, Japan). For theimaging during the videofluorography the patientswere asked to assume either a sitting position or lie
on their side. For the imaging a DVD/HDD recorder(RD-XS30, Toshiba, Tokyo, Japan) was used,connecting it to an imaging device (Prestige, GE
Medical Systems, Tokyo, Japan). Thirty frames per
second were taken and the measurements
performed using an image processing software(Premier 6.0, Adobe Systems, Tokyo, Japan) by aradiological technician, who was not informed about
the group to which the examinee belonged. If afterswallowing water or food boli were still observed in
the epiglottal groove or the piriform recess, this was
defined as pharyngeal retention. If water or foodboli reached the trachea below the height of the
vocal cord folds, this was defined as aspiration. The
patients were observed from the moment theswallowing instruction was issued to the examinees
until the water and food boli had reached theesophagus.
Body temperature of the examinees wasmeasured daily at 2 o'clock in the afternoon. The
number of days when the body temperature
exceeded 37.8°C during the 4-week period wererecorded.

stimulation group 1.1±0.3 sec (p< .05), liquid diet
5.0±4.8 sec (p< .05) and for solid food 11.8±9.3
seconds. In the control group the times were forwater 2.1±0.9, liquid diet 5.4±5.4 and for solid food10.1±6.9 seconds. In the needle stimulation groupthe swallowing time for water and liquid diet wascompared to the pretest value after four weeks
significantly shortened.
Figure 3 shows the percentage of pharyngeal
retention and aspiration in the two groups of
examinees. The degree of pharyngeal retention had
significantly decreased in the needle stimulationgroup, but in the control group no significant change
was observed. Aspiration before test begin was in
the needle stimulation group 40% for water, 8% forliquid diet and 25% for solid food, but after fourweeks aspiration was no longer observed for any of
the food forms.
In the control group no significant change in theratio of aspiration was observed between the pretest
condition and the condition after 4 weeks. The
number of days body temperature exceeded 37.8°C
was in the needle stimulation group 4 out of 356 days,
whereas it was in the control group 28 out of 394,
showing that it was significantly higher in the control
group than in the needle stimulation group (P <.01).
Figure 3 (below)

Results
In the needle stimulation group the time required
the swallowing before test begin until the swallowedmaterial reaches the esophagus was for water on the
average (±SD) 1.7±1.0, for liquid diet 8.7±13.2 and forsolid food 10.4±7.0 seconds. In the control group therespective times were for water 1.9±0.6, liquid diet
4.5±3.7 and for solid food 9.7±7.6 seconds.
Four weeks later these values were in the needle

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

13

Volume 3, Number 1 | Spring 2008

Discussion
Needle stimulation of Ashi Sanri and Taikei
improves the incidence of pharyngeal retention andaspirationinpatients

withcerebrovasculardisorders repeatedly suffering from aspiration.
Conclusions
These results indicated the possibility thatneedle stimulation of Ashi Sanri and Taikei can
improve the swallowing reflex, reduces the amountof pharyngeal retention and aspiration and thus
may prevent aspiration pneumonitis.
These studies are characterized by
1) the needle stimulation consisted only of direct
insertion, retention for 15 minutes and removal of
the needles, not using any manual manipulation orelectrical stimulation of the inserted needles at all;2) this can conceivably be designated a clinical trialof acupuncture therapy of the examinees not basedon pattern identification, but from the perspective of
the western medical diagnosis; here (1) indicates,that even acupuncture therapy using only simple
retention of the needles alone can have marked
clinical effects, while (2) indicates that clinical trials
including examinees selected based on western
medical diagnosis may show the effectiveness of theacupuncture therapy.

14

This study showed great potential for
acupuncture treatment, but the medical educationin Japan almost does not include teaching about
acupuncture at all, so that even simple acupuncture
treatments present for the physicians in the clinicalsetting a great hurdle and obstruct the spread of
this treatment modality. For this reason we
performed trials using stimulation with low
frequency currents with surface electrodes attachedto Ashi Sanri and Taikei after completion of theabove described two trials. The results showed, thata similar degree of improvement of the LTSR was
observed. This indicates that both needle insertionand low frequency currents induce identical changes
in the human body. If improvements of theswallowing function can be obtained without
inserting needles, this treatment modality is
considered to become popular in the clinical setting.
On the other hand, comparing the degree of
improvement of the swallowing reflex between thestudies 1 and 2 and this latter study showed thatthe insertion of filiform needles produces a greater
degree of improvement as compared to low
frequency currents. The results of these studies arescheduled to be published in the Journal of The
American Geriatrics Society. (Akamatsu C, Seki T.
et al. Improvement of swallowing reflex after
electrical stimulation to lower leg acupoints inpatients after stroke. JAGS. in press.)

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

Volume 3, Number 1 | Spring 2008

Department

of

Kampo

MedicineofTohokuin patients with glaucoma and similar results.
In the acupuncture and Kampo outpatient

University
The Department of Kampo Medicine of Tohoku

service the therapeutic effects are evaluated before

University does not use only Kampo medicine, but

and after each acupuncture treatment session,embraces an integrated approach to traditional

using the results as therapy feedback, whereby amedicineusing

system that might be called 'Evidence Basedacupuncture treatment, Suina and traditional

Clinical Acupuncture' is being built. Building a

dietary guidance. In the past the departments ofsystem that will allow to put acupuncture treatment

geriatrics and respiratory diseases used Kampo

and Kampo medicine to use in clinic represents one

medicine and acupuncture in their outpatientof our goals.

service,originating

but

in

from

2003

the

China

also

TohokuUniversity

established a lecture for advanced Kampo medical

Medical education

practice within its faculty of medicine and also a

The education is not directed only towards

department of Kampo (internal) medicine within its

physicians, but also acupuncturists and medical

university hospital. Here a department using

students and thus the department represents one of

mainlyKampo

the few medical faculties that performs clinicaloutpatient service and an acupuncture and Kampo

practice in acupuncture and has therefore earned aoutpatient section using a combination of Kampo

very high reputation amoung the students. Fifth

preparations and acupuncture treatment wereyear students of the medical faculty are divided into

established. Since April 2008 a Kampo outpatient

small groups of 5-6 students and are taught once

section was also set up within the obstetrics andevery two weeks, including instructions in practical

gynecologic department.

examination, brewing Kampo medical decoctions

Kampo

preparations

in

its

and practicing insertion of acupuncture needles.
Demandfor

Kampo

outpatient

services

andFrom among the sixth grades 6-7 applicants canpartake in practical training courses of 1-2 months.

outpatient backgroundThe number of patients is steadily growing. The

Here they will receive lectures about the theoreticalbroad age range of the patients ranges from 0 to 90

foundations, participate in outpatient practice andyears. The acupuncture and Kampo outpatient service

participate in practical training in the pharmacy oris booked for one year ahead and cares mainly forpharmaceutical botany.

patients with intractable diseases. For this reason the

Using the advantages of a general hospital, amost frequent target illnesses are mysasthenia gravis,

system of cooperative care and research with each

Parkinsonism,

department is being established.

ALS andsimilarneuromusculardiseases, glaucoma, cancer, GVHD etc.
Research into Kampo medicine and acupuncture
treatmentThis department has published about the effects
of Yokkansan for the treatment of mental disorders
associated with dementia, acupuncture treatment(needling of Taikei and Ashi Sanri) for cerebral
stroke associated with dysphagia, the effects ofacupuncture treatment on lowering ocular tension

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

15

Volume 3, Number 1 | Spring 2008

Clinical Report 2 (Japan)
Infant Crying at Night
Zen’ichiro Watanabe
Fuji Niko-Niko Clinic

Case: One year and two months old, male infant,weight 9.8 kg

patient with weak spleen and stomach (digestive
function) was involved in his mother’s mental stress,
inducing him to feel anxious and start crying atnight. The treatment was made to recover the
spleen and stomach with shokenchuto and to
alleviate anxiety with kambakutaisoto. The author
also

Main complaint: Night crying
Past history & Birth history: Unremarkable
Present history: Two months ago, the patient began
to cry weakly and quietly three to four times during
the night. When picked up in mother’s arms and fed
with breast milk, he falls back to sleep. However, assoon as he is left on the bed, he starts crying. So themother stays up to hold him up. Although baby foodhas been introduced since he was 5 months old, heconsideredthat

ingredients

with

high

sweetness in these formulas of malt sugar, Chinesedate, and licorice root acted to ease tension.
From the standpoint of Chinese medicine, thepatient type is deficiency-cold in the spleen andstomach and susceptible to negative emotions. Coldin the abdomen of such type of infants congeals,
leading to qi stagnation, thus causing abdominal
pain based on the principle of “qi blockage causes

eats so little with a little weight gain.

pain. Furthermore, as cold belongs to yin, it tends toOriental medical findingor transportation and transformation of spleen qi[Inspection] Physical constitution: On the slim side,lack of energy with an anxious impression. Tongue:
Pale white.

often cause throwing up milk, diarrhea, eating solittle. The sound of crying is weak due to yangdeficiency, which is treated by warming the spleen
and[Listening] No special mention[Interview] Stools: Slightly loose. Mother: Looked alittle tired and frustrated.
[Palpation] Abdominal region: Distended withslightly strained rectus muscles and a slight senseof coldness. Pulse: Weak.
Diagnosis: Night crying due to heart-spleen (mental
status-digestive function) vacuity.
Therapy: shokenchuto (morning and evening) andkambakutaisoto (instructed same dosage for motherand the child before bedtime.)
Course: The night crying reduced to once on thethird day of the administration, and he could eat up.
Since the 7th days he has stopped crying. In theinterview of a later date, it was found that themother had felt mother-in-law stress. After thetreatment, the mother could have room to breatheand did not feel uneasy with every word hermother-in-law spoke. Her complexion has becomebright.
Discussion: The author considered that the infant

16

become worse during the night. Reduced movement

dissipating

cold

with

formulassuchasshokenchuto and ninjinto.
Patients having anxiety are sensitive to even asmall change in their environment and readily
recognize that they are separated from their mother,a safety zone for them. And this kind of separation
becomes quite a burden to such infants, who thensuddenly start crying. Therefore, for the reasons
above, such infants as the subject patient, who lookasleep in the arms of their mothers, start crying assoon as mothers put them into bed. Complexion has
little color due to anxiety. For these patients,
treatment is performed aiming to induce sedationand tranquillization (settle fright and quiet thespirit) using sansoninto, kambakutaisoto, andkeishikaryukotsuboreito.
We have studied other 11 cases of infants crying
at night. For night crying caused by physicaldisorders such as pharyngitis, tympanititis, nasal
stuffiness, asthma, itchy skin, or constipation,

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

Volume 3, Number 1 | Spring 2008

treatments for symptoms were performed withkakkontokasenkyushin’i,
makyokansekito, hangekobokuto, shofusan, andogikenchuto. For termination of breastfeeding, foodformulassuchasstagnation, and infants who always wanted to be in
the mother’s arms (high need baby), lifestyle
guidance was given to the mothers.
For the infants of the spleen-heart deficiency typethat had influences on the heart qi causing shallow
sleep, difficulty falling sleep, lack of energy, andpoor appetite with nervous temperament, and softstools, formulas such as kihito and kamikihito wereadministeredtoinvigorate

thespleen(digestive-function) and calm the mind. For the
infants of the exuberance type of heart-liver fire,
who got excited after a parenting school or a festival,and had the heat qi overly agitated by theaccumulation of sweet, hot, and rich taste food,causing them to keep awake, moving around even in
the midnight and to cry in a loud voice, and in a
louder voice in the light, and for infants who were
red-faced and had constipation, treatment wasmade to clear the heated heart (exited emotion) and
clam

the

mind

with

formulassuchasryutanshakanto,
saikokaryukotsuboreito,
orengedokuto, and yokukansan. For those with yin
deficiency in the liver and kidney who got easily
angered and could not sleep due to a sense of
exaltation, yin was nourished with rokumigan andseishinrenshiin.
In diagnosing infants, physicians should know not
only the patients conditions, but also the mothers(family) conditions and the relationship between theinfants and mothers (family). In most cases infants
night crying is often triggered by their sensing
abnormal conditions of the mother, and thus
treatments are necessary for both infant patientsand the mothers and how to take the same herbal
medicine at the same time is effective.

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

17

Volume 3, Number 1 | Spring 2008

Clinical Report 3 (Japan)

doses

One Case that showed Effects of Jiinkokato in
Dry-Type Bronchiectasis
Mitsuyuki

Takamura1)

and Hiromichi

Course: After two weeks administration, the patient
claimed feeling light. In some days she did not

Yasui2)

1) Mie University Occupational Health Research Project2) Japan Institute of TCM Research

Past history: Have glaucoma. Due to hypertension,
amlodipine (5mg)/tablet/day is being taken since
early February of this year.
History of Present illness: Hemosputum developedon August 21 of last year (X-1 year). Any symptoms
had not appeared until then. On the following day,the patient visited a nearby otorhinolaryngologist,
and then was referred to the respiratory unit of M
university hospital. The chest x-ray and chest CTadiagnosis

of“bronchiectasis,” and the patient was treatedthrough medication. At present, shortness of breathdevelops on exertion with neither cough nor phlegm
production.

However,thepatient

experiences

occasional hemosputum, She takes clarithromycine(200mg)/2 tablets/day and levofloxacin (100mg)/2
tablets/day.

symptoms.

So,

the

Extractwasadministrationofjiinkokato,

even

a

singleexpectoration of hemosputum did not develop. In
April, she hardly experienced short breath onexertion.
In June, she did not suffer from short breath any
longer. In previous years she had been prone tocatching a cold, but this year she did not, even witha slight increase in weight. In October, the dose ofclarithromycine was reduced to 1 tablet/day andfurther several months later, it was discontinued.
On January 13 of X-1 year, the Extract ofmaobushisaishinto

wasresumed

due

to

the

recurrence of seasonal allergic rhinitis and used
together with the Decoction till the end of June.
Subsequently, she was making satisfactory progresswith neither hemosputum nor short breath. In Juneof X-2 year, she gained weight by 3 kg compared toConsideration:Good

Urine: 7 times/day, nocturnal urine (-)
Bowel movement: once a day, normal stools
During every winter, the skin is itchy.
Present symptoms:
Cold limbs (++), hot flashes (+), sweating (+), drymouth（＋）
Pulse: Thin and string-like pulse
Tongue: Slightly red, fissured (+) with slight furs
Abdominal sho: Soft as a whole. For others, no
special mention.
Diagnosis of Kampo medicine: Insubstantial Yin
and lung heat, and damage to the collateral lung
vessels
Prescription: jiinkokato 7.5g/day divided into 3
18

rhinitis,the initial visit and is doing well.

Appetite: Ordinary
Sleep:

allergic

discontinued at the end of May. Soon after the

Chief complaint: Hemosputum

indicatedseasonal

maobushisaishinto was started concomitantly onallergic

Initial consultation: February 26, X year

imageshavingMarch 3, resulting in the disappearance of mostCase: Female of 66 years oldscanexperience shortness of breath. Due to the patientThis case is of bronchiectasis of dry type. This
type of bronchiectasis produces little or no phlegm,
and does not accompany chronic sinusitis. In thecase of the patient, bronchiectasis was detected dueto the expectoration of hemosputum; nearly six
months administration of two kinds of antimicrobial
agents did not yield effects, leaving hemosputum
and shortness of breath unresolved. From thesymptoms of deficiency of Yin observed at the timeof her initial visit such as “in winder, the skinbecomes itchy,” and the red tongue with fissures andslight furs as well as the symptoms of upper bodyheat and lower body cold manifested in cold limbs
and hot flashes, and dry mouth, the conceivable

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

Volume 3, Number 1 | Spring 2008

the bleeding, for which the formula of Lily Bulb

Rehmanniae
Radix,
Asparagi
Radix,
Ophiopogonis Radix, Paeoniae Radix, and Angelicae
Acutilobae Radix supplement Yin and blood, andespecially Rehmanniae Radix and Asparagi Radix
supplement the kidney Yin. Asparagi Radix and
Ophiopogonis Radix cure coughing caused by thelung Yin deficiency while Phellodendri Cortex andAnemarrhenae Rhizoma remove deficiency-heat

Decoction is used, whereas jiinkokato is often usedcaused by deficiency of Yin and effulgent fire. Thesein Japan.

drugs for nourishing the Yin are slightly thick andpathological conditions are that insubstantial Yin
and flourishing Yang resulted in lung heat, whichthen damaged the collateral lung vessels, leading to
the production of hemosputum.
In China, the treatment principles for suchconditions should be enriching Yin and moistening
Lung and calming collateral vessel and arrestingThis formula first appeared in the chapter of

may lie heavy on the stomach, so that Citri Unshiu

asthenic disease in Ting-Xian Gong (Wan Bing Hui

Pericarpium, Atractylodis Lanceae Rhizoma, andChun) with the description of curing deficiency of

Glycyrrhizae Radix that invigorate the spleen and

Yin and moving the fire, fever onset, coughing,harmonize the stomach may be blended to prevent

expectoration

it.

of

phlegm,asthma,nocturnal

sweating, and dry mouth. The formula is composedof the following:

This

case

had

the

lung

heat

causedbyinsubstantial Yin and flourishing Yang, resulting inAngelicae Acutilobae Radix 2.5g
Paeoniae Radix 2.5g
Rehmanniae Radix 2.5g
Asparagi Radix 2.5g
Ophiopogonis Radix 2.5g
Citri Unshiu Pericarpium 2.5g
Atractylodis Lanceae Rhizoma 3.0g
Anemarrhenae Rhizoma 1.5g
Phellodendri Cortex 1.5g
Glycyrrhizae Radix 1.5g

damage to the collateral lung vessels. Jiinkokato
was an appropriate formula for these pathologicalconditions.

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

19

Volume 3, Number 1 | Spring 2008

Kampo Dermatology – Clinical Studies
Treatment of Alopecia (hair loss) with Kampo (1)Fumino Ninomiya
Aoki Clinic

Alopecia or excessive loss of hair is adermatological disease mostly caused by a damaged
flow of qi. With involvement of qi, stress is strongly
related to alopecia. It may develop due to depression
or feeling down. Or it may be involved withsweating caused by a response of the autonomic
nervous system.
The state of hair loss varies from partial tocomplete loss of scalp hair (alopecia totalis)
involving loss in the frontal region or loss in thetemple regions, or loss in the occipital head region.
Alopecia totalis is largely related to kidney failure.
Frontal hair loss is observed in many cases withweak spleen and stomach. Temple hair loss, which isoften the indications for prescription including
Bupleuri Radix, is mostly related to liver andgallbladder problems while ocipital hair loss ismostly related to lung problems.
Alopecia or hair loss is broadly divided into threesubgroups of senile alopecia (hair falls out
spontaneously as people age), premature alopecia(the hair line recedes progressively) and alopecia
areata.
In case of water toxin or blood stasis, the scalp
becomes weak to tighten the hair roots, which easily
induce alopecia. It is easy to know whether water
toxin exists or not by taking and holding thehairless area between fingers. If it exists, the area
wrinkles.
In terms of the general condition, qi deficiency,
cold and blood deficiency in hair roots exist in manycases with hair loss. In case of kidney problems,hachimijiougan is used. In case of liver andgallbladder problems, formulas containing Bupuleri
Radix are used. If qi is involved with these problems
and there are palpitations, formulas such as
shigyakusan are used. In order to reduce qi,
decoctions containing Cinnamomi Cortex such as
keishikaryukotsuboreito is used with kamishoyosan
20

or yokukansankachimpihange. In case of blood
deficiency, shimotsuto is used. In case of blood stasis,
formulas to expel blood stasis such as
keishibukuryogan are used. And if water toxin
co-exists with these problems, goreisan is added.
It is important to look to the circulatory relation
between qi circulation - blood and qi circulation water, while giving consideration to the areas ofalopecia occurrence.
Case: Multiple alopecia
Female of 13 years old
Present illness: Multiple alopecia exacerbated sincea year ago
Present condition: Multiple alopecia started fromthe top of the head, progressing to the temple
regions, frontal region, and to almost total head.
The first menstrual onset was one year ago andsince then regular. Lots of dreams. Cold feet (＋＋),
constipation (–), frequent urination, blood pressure
98/60. Height 152cm, weight 46kg.
Abdominal sho: Tense rectus muscles on both sides(easily become ticklish)
Tongue sho: White fur, sublingual veins (＋).
Family background: Father divorced three times.
Her biological mother was his third wife but soon
got divorced and then married to other man. The
patient has a half blood brother.
Patient’s psychological course: In depressedstate and reticent. As cold was dissipating andthe hair began to grow, the patient began totalk and paint pictures. Paintings in the initialperiod and recent days are shown below forcomparison. The patient and her separated
mother seem to keep in touch with one anotherin a sort of way.
Treatment and course:

hachimijiougan and kamishoyosan
Hair loss stopped within five weeks of theadministration. Tension type. With relief of tension,
the strained skin became soft.
keishibukuryogan 5.0g, kamishoyosan 5.0 g

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

Volume 3, Number 1 | Spring 2008

In 8 months, sweating was improved; the amountof growing hair increased and hair growth became
faster. In her dreams the patient played with acartoon character, claiming that she felt better.

Due to excessively cold feet, sufficient local
treatment of the head skin was administered.
The above treatment continued for about 12
months and cure was attained.

Before treatment– right ear

Before treatment– top of head

Eight months later– left side

Eight months later– top of head

Before treatment– left ear

Eight months later– front side and forehead

Paintings by the patient before treatment(left) and after treatment (right). The painting
before treatment is monotone whereas thepainting after the treatment is colored androunded out, giving a soft impression.

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

21

Volume 3, Number 1 | Spring 2008

Medical History in Japan
Origin of Japanese Acupuncture: Waichi Sugiyama and his
Text - Sugiyama Shindenryu (1)Jikan Ourapine needle (matsuba). This is said to be the origin
of Japanese acupuncture with the feature of thinnerneedles and the use of a guide tube for painlessinsertion.

Medical Historical Research Department
Kitasato University Oriental Medicine Research Center

Later, Sugiyama went to Kyoto to study underToyoaki Irie and learned the Irie style acupuncture

Waichi Sugiyama built a unique monument toas an inner chamber disciple, and was also exposed

the development of Japanese acupuncture. The

to the “Dashin*” acupuncture technique. This styleextensive acupuncture techniques performed by

was also popular at that time in Kyoto. Sugiyama

Sugiyama and his students were subsequently

had gained confidence in his ability and so hedocumented in his text, Sugiyama Shindenryu. I see

returned to Edo. His fame spread as the “master oftoday that there seems to be strong interest in

guide tube acupuncture.” So much so that he camealternative medicine in Europe and America, and into be known by the Shogun himself.

this article, I would like to contribute something by
introducing the story of Waichi Sugiyama, his

In 1685, Sugiyama treated and cured a chronic
disease of Tsunayoshi Tokugawa Shogun. He

historical significance and his techniques.

received 20 shares of monthly payment and a
1. Short biography of Waichi Sugiyama

mansion as a reward. Thereafter he gained the

Waichi Sugiyama was born the eldest son of afavor of Tsunayoshi and became the doctor of thesamurai family in Mie prefecture in 1610. His father,

Shogun and was also designated as "Sokengyo”, theShigemasa Sugiyama, was the vassal of Takatora

highestTodou, a famous military commander of the“Todoza,” for the benefit of the blind. There is a

Tokugawa shogunate. Although expected to inherit

famous story about this. One day the Shogun asked

his father’s position, it was unfortunate that Waichi

Sugiyama if there is anything that he desired.

was infected with smallpox as a child and was left

Sugiyama responded, “I would like some good eyes.

blind. So when he was 18 he decided to make his

He was then granted land called Honjo Hitotsume

career as an acupuncturist. He traveled to Edo(One Eye Palace) and he built the place to honor(Tokyo)blind“Benzaiten.” Later, “Edo Soroku residence” (the Edo

acupuncturist by the name of Takuichi Yamase.

headquarters of Toudoza) and also his acupuncture

However, he was expelled from the Yamase school

school “Shinchi Gakumonjo” were built in this place.

after a few years because of his poor memory andToday “Ejima Sugiyama Shrine” is in this location.

his slow development of the skills. Feeling dejected,

Sugiyama died in his sleep May 20, 1694 at the age

he left Edo and was on his way home when heof 85. At his request, his body was buried indecided that he would do a ritual fast on the island

Enoshima.

andbecameastudentofaofficialofthenationalorganization,

Enoshima. Continuing his ascetic practices for sometime he came to be quite faint. Then, on the last day

Under the reign of the 5th Shogun Tsunayoshi

of his fast, he stumbled over a stone in the road andTokugawa in the Edo Genroku period, there was afell. Lying there he noticed something in his hand.

flourishing of the Japanese cultural arts in many

Examining it, he realized it was a pine needle inside

fields. It was during this time that Sugiyama’s

the interior hollow of a small section of bamboo.

school began and prospered. Sugiyama established

Following this experience he went on to invent thethe school “Shinchi Gakumonjo” of acupuncture for

guide tube and a thin needle with a tip shaped like a

the blind so as to provide a means for them to

22

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

Volume 3, Number 1 | Spring 2008

achieve self-sufficiency. This school became his

Even today, in modern Japan, acupuncture andhighest priority in later life. Sugiyama Sanbushomassage training is provided for the blind, and“Three-part Text of Sugiyama Style” was the“Kanshin acupuncture technique” that is to insert ageneral introductory text for students at Shinchi

needle through guide tube is now widely used. This

Gakumonjo. As the name suggests, it consisted offact is a direct result of the original efforts by

three parts; Ryouchi No Daigaisho (Important

Sugiyama.

PointsofTreatments),

SenshinSanyoshu*Dashintechnique:A

Japanese

unique(Principles of Acupuncture) and Igaku Setsuyoshu

acupuncture introduced by Zen monk Mubun and(Foundations

text

Isai Misono. The technique involves tapping theprovided a general introduction to the practice ofhead of a thick pestle-shaped needle like Inriclinical acupuncture but there were no descriptions

acupuncture needle with a small wooden malletof needle techniques, nor was there any mention of

only for treatment of bad vibes on stomach. It is thethe use of the guide tube. These practices werebeginning of the development of stomach diagnosis

transmitted directly from teacher to student.

in Japan.

ofClinicalMedicine).

The

The school “Shinchi Gakumonjo” was very
successful and spread to 45 locations throughout
Japan under the guidance of his top student andsuccessor, Yasuichi Mishima. The school became thestandard for acupuncture education in Japan andcontinued its legacy through the Edo era.

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

23

Volume 1, Number 1 | Spring 2006

Ominedo is the only professional manufacturer of herbal extracts.

Poria Powder with Five Herbs
Wu-Ling-San
goreisanComposition
Arisma rhizoma
Tuckahoe
Atractylodes ovatae rhizoma
Umbellate pore fungus
Cinnamon bark

Ominedo Pharmaceutical Industry Co., Ltd.
574, Nenarigaki, Yamatotakada-City, Nara 635-0051, Japan
URL：WWW.ominedo.co.jp
Contact：info@ominedo.co.jp
Phone: (81) 745-22-3601 Fax: (81) 745-23-2540
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

35

Volume 1, Number 3 | Fall 2006

Kanebo Pharmaceutical, Ltd.
Like the cherry trees along Potomac River, Kanebo wishes
to play a role of the bridge for friendship and healthbetween Japan and U.S.A.

History of the Cherry Trees in Washington, D.C.
The plantings of cherry trees originated in 1912 as gift of friendship to the United Statesfrom the people of Japan. In Japan, the flowering cherry tree or “Sakura”, as it is called by
the Japanese people, is one of the most exalted flowering plants. The beauty of the cherry
blossom is a potent symbol equated with evanescence of human life and epitomizes thetransformations Japanese Culture has undergone through the ages.
2

Excerpted from National Park Service

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