# Creating a Diagnostic Assistance System for Diseases in Kampo Medicine
## 1 Introduction  
The general medical care received in hospitals worldwide is based on Western medicine. However, in China and other East Asian countries, the field of traditional medicine--called Kampo medicine in Japan--has developed over the past 1500 years. Western medicine and Kampo medicine differ greatly in their diagnostic methods. In Kampo medicine, the pathology is assessed using the three elements of \"qi,\" \"blood,\" and \"fluid\" that comprise the qi, blood, and fluid theory [1]. A healthy state is one in which these three elements circulate normally and in sufficient quantities. Qi represents the energy of the entire body, blood represents the blood and its flow through the body, and fluid represents fluids other than the blood (such as lymph and digestive fluids) and its flow through the body. The conditions in which qi, blood, and fluid are \"insufficient\" are called \"qi deficiency,\" \"blood deficiency,\" and \"yin deficiency,\" respectively, and those in which qi, blood, and fluid are \"stagnated\" are called \"qi stagnation,\" \"blood stagnation,\" and \"fluid stagnation,\" respectively [2]. Doctors practicing Kampo medicine diagnose diseases via inspection, inquiry, palpation, and aural and olfactory examinations [3]. Inspection, especially visual examination, is among the most important diagnostic methods in Kampo medicine but is rarely applied in Western medicine. One reason for this is that it is not possible to make a quantitative diagnosis because inspection is subjective and based on the doctor's experience. To solve this problem, a quantitative descriptive diagnosis method has been formulated using image processing in recent years [4; 5]. By using a computer to perform an advisory diagnosis based on images of the face and tongue, it is possible to quantify the diagnosis without prior experience and identify the relevant disease. In addition, Kampo medicine contains many concepts useful for preventive medicine. The qi deficiency, blood deficiency, blood stagnation, yin deficiency, and fluid stagnation that we evaluated indicate imbalances in the body. In Kampo medicine, doctors take appropriate treatments to adjust these imbalances in order to prevent diseases. There are no clear distinction between healthy people and patients; in this study, the closer to 0, the better the condition is, and the closer to 4, the worse the condition is. About 0 indicates a healthy state, 1 and 2 indicate conditions that require follow-up, and 3 and 4 indicate conditions that require treatment., but there are individual differences among doctors. Table 1 lists diseases that can be diagnosed based on an inspection of the face and tongue of the patient using Kampo medicine. To computerize descriptive diagnosis, [PERSON] et al. [6] proposed a method to assess diseases of Kampo medicine using the facial images of patients. Blood deficiency, blood stagnation, and yin deficiency can be diagnosed using facial images. However, this facial image assessment might not be sufficient to achieve a Kampo medical diagnosis. Observations of the patient's tongue increases the number of conditions that can be diagnosed using computer image analysis. By observing the color, fluid content, and shape of the tongue, and the condition of the tongue coating, five of the six conditions--qi stagnation, qi deficiency, blood deficiency, blood stagnation, yin deficiency, and fluid stagnation--can be diagnosed. As the tongue is closely related to the internal organs with exposed mucous membranes, it is regarded as an important indicator of many diseases in Kampo medicine. The tongue is very glossy under normal lighting conditions owing to its moist surface, which makes it difficult to obtain accurate information on the color of the tongue with normal imaging methods. However, Kampo doctors consider gloss to be just as important as color information in making a diagnosis. Therefore, to perform a computerized tongue-based diagnosis, it is necessary to use an imaging method that can accurately acquire information on both color and gloss.