Kampo medicine in modern medicine “1st International Symposium on Kampo Medicine”

To the editor The first presentation is ‘The features of Kampo medicine in modern medicine’. Kampo, traditional Japanese medicine, has unique features, such as an emphasis on abdominal examination for diagnosis. In Japan, the same physician can practice both modern Western medicine and traditional medicine. Furthermore, Kampo decoctions and extract preparations that have been developed over time are widely used in Japan. Kampo medicine is covered by Japanese health insurance in the same way as Western medicine, and most physicians practice a combination the two types of medicine. In addition, attempts are being made to document the traditional medical diagnostic system, disseminate evidence, and consider medical safety through research on adverse reactions such as herbal-medicine-induced pneumonitis. During undergraduate study, Kampo medical education is included in the core curriculum not only in medical school but also in pharmacy and nursing schools. After graduation from medical school, a system of medical specialization in Kampo medicine can be accessed through various standards and examinations. In acupuncture and moxibustion treatment, both acupuncturists, as independent professionals, and physicians work side by side. In this symposium, I would like to discuss the role of Kampo medicine in modern medicine. The second presentation is ‘Abdominal diagnosis as a hallmark of Kampo medicine in modern medicine’. In principle, the patient should be placed in supine position with the legs extended, as opposed to abdominal examination in Western medicine, which is performed with the knees bent. This is because, in abdominal examination in Western medicine, it is necessary to relax the abdominal wall to examine the intra-abdominal organs, whereas in Kampo medicine, the abdominal wall is examined to determine how the intra-abdominal organs are situated and physical abnormalities are manifested in the abdomen, on the basis of its tension, characteristics, and tenderness. This presentation will demonstrate the clinical significance of typical Kampo medicine abdominal diagnosis findings, such as abdominal strength, abdominal fullness, epigastric stuffiness and resistance, fullness and discomfort in the chest and hypochondrium, abdominal muscle tension, splashing sound in epigastric region, palpitation in the supraumbilical region, weakness of the lower abdominal region, and paraumbilical tenderness and resistance. The third presentation is ‘Kampo extracts frequently used in Japan and their clinical studies’. In Japan, the number of specialists in Kampo medicine is few, andmanyKampo extracts are prescribed by doctors who are not specialists in Kampo medicine. In many of these cases, doctors prescribe Kampo extracts not on the basis of Kampo diagnosis but on evidence reported by clinical studies. One of the tasks of the Evidence-Based Medicine (EBM) Committee of the Japan Society for Oriental Medicine is making evidence reports on randomized controlled trials of Kampomedicines. I belong to this EBMcommittee and have been making evidence reports. I looked at the number of evidence reports published from 1990 to 2020 and studied what kinds of diseases and formulas were investigated. Within the results, I found a large number of reports on gastrointestinal, respiratory, and genitourinary diseases; cancer; and the nervous system. With regard to formulas, I found a large number of reports on daikenchuto, rikkunsito, shosaikoto, shakuyakukanzoto, and goshajinkigan. Depending on the trends and needs of the time, the volume of reports on particular diseases and formulas varied over the period. Owing to this, the formulas used in clinical settings have been changing. With this information, selecting formulas based on the amount of evidence has become commonplace. The fourth presentation is ‘Differences between traditional Chinese medicine in Taiwan and Kampo medicine and the usefulness of Kampo medicine’. Traditional medicine, which originated in ancient China, has spread throughout East and Southeast Asia over the course of its long history, and each region has further developed its own unique medicine. Kampo (traditional Japanese medicine) derived from ancient China has evolved in a way that is particularly unique to Japan. Traditional Chinese medicine (TCM) in Taiwan is a clinical medicine developed with theories based on the contents of the HuangDi NeiJing and adopts the method of pattern identification and treatment and focuses on the discussion of theories such as the Yin–Yang, the five elements doctrine, the meridian theory, and the sixmeridian pattern identification for treatment. On the other hand, Kampo has developed a method of formulation Received: 25 May 2022 Revised: 27 July 2022 Accepted: 27 July 2022