Ancient Kampo Medicine Integrated into Japan’s Medical Institutions
Can we successfully integrate natural medicine into conventional Western medicine? This is a question that has been posed by institutions that have sought to integrate the traditional practices of herbal medicine, acupuncture and other natural medicines into one medical institution – meaning that medical insurance will cover natural treatments and so on.
And surely there have been attempts to integrate traditional medicine into Western conventional medicine. But among many Western countries, including Western Europe and the United States, these attempts have not been very successful.
Yet we can now cite Japan’s successful attempt to fuse the ancient traditional medicine called Kampo into Japanese Western medicine institutions.
Today, new research illustrates that some 90% of Japanese physicians utilize Kampo medicines in their clinical practices, and almost all obstetrics and gynecology physicians utilize the ancient Kampo medicine in their clinical practices.
Kampo medicine is also used together with the most advanced forms of modern medicine, including robotic surgery and various diagnostic tools. When it comes to chemotherapy, Japanese hospitals combine the best of modern western therapies with the natural therapies of Kampo medicine.
Today there are 148 different Kampo herbal formulations that are approved as prescriptive drugs in Japan. These are also covered by insurance.
This did not come about by accident. It began in the 1950s when the Japan Society for Oriental Medicine (JSOM) was founded to promote the ancient Kampo medicine in Japan. By the late 1960s, their efforts resulted in four Kampo herbal formulations being approved by the Japanese government for insurance coverage.
JSOM formed a Committee for Terminology and Classification, and took a direction of not using the same disease names as used by Western medical doctors at the time. This was a smart move because otherwise – as has happened among Western traditional therapies – there is confusion and an overlapping of disorders between the two medical traditions.
Rendering duplicating diagnoses names also creates a competitive atmosphere between differing methods and diagnostic tools. What the JSOM committee did was develop their index of treatments with symptom-oriented descriptions rather than disease names as assumed by Western medicine. This allowed particular remedies to be applied as it had been done through the ages.
Yes, traditional medicines of Chinese medicine, Ayurvedic medicine, Malaysian medicine, Western European herbalism, Arabian medicine, Greek medicine as well as Kampo have used disease names. But these mostly described the ailment by its signs and symptoms, as well as organs and temperature gradients. There were certainly general conditions names given, but these were made distinct by signs and symptoms.
What is Kampo medicine?
Today’s Kampo medicine descends from the ancient Chinese therapies – over three thousand years old. It derives treatments from the diagnosis of deficiency-excess, cold or heat, and the orientation of qi and yin-yang components among the meridians and organs of the body. Clinical applications of Kampo treatments have been passed down over centuries of use among both Chinese and Kampo medical doctors.
Kampo is a successor of many Chinese medicine principals, but its application is distinct, and focused upon the Japanese culture, climate and diet.
The Kampo science also sees pathogens as more critical, impacting the body when the body’s energy is weakened. When the body’s energy is weaker, it is called “deficiency” and “excess” relates to teh build up of a foreign pathogen. This is described in the Huangdi Neijing (8 AD to 220 AD).
The Kampo system used today follows the “matching of pattern and formula” derived from the Koho school, and the later-integrated Setchu school of natural medicine. These based treatments on the combination of symptoms and signs seen among the patient, rather than a specific disease name.
As a result different patterns – signs and symptoms – were matched with the use of particular herbal medicine formulations together with specific acupuncture and moxibustion therapies.
Research supports Kampo medicine
This has been illustrated in the research on Kampo medicine as well. Study after study has shown that Kampo can relieve ailments of various kinds, while increasing vitality in general. In a recent review of four clinical studies on irritable bowel syndrome, Kyushu University medical school researchers found that:
“Basic research studies have demonstrated that these Kampo medicines have multiple sites of action to improve subjective symptoms. For example, rikkunshito improves gastric motility dysfunction, including impaired adaptive relaxation and delayed gastric emptying, gastric hypersensitivity, and anorexia via facilitation of ghrelin secretion. It also exhibits anti-stress effects, i.e., it attenuates stress-induced exacerbation of gastric sensation and anorexia, as well as the hypothalamic-pituitary-adrenocortical axis and sympathetic activation. Keishikashakuyakuto exhibited not only an antispasmodic effect on intestinal smooth muscle, but also antidepressant-like effects.”
“Multiple sites of action” refers to having benefits throughout the body. The foreign-sounding names are Kampo herbal formulations.
Kampo was used exclusively in Japan from about the Second century and until the middle to late Eighteenth century, when modern anatomy and surgery techniques began to be employed by Japanese physicians.
But these physicians also acknowledged Kampo treatments. They simply added conventional Western tools. In the late Nineteenth century the Japanese government made a turnaround and accepted German conventional medicine while dropping Kampo education from medical schools, despite a stellar history of success over the centuries.
Today, all 80 of Japan’s medical schools teach Kampo along with conventional medicine. Over 260,000 physicians in Japan practice Kampo medicine in their clinics and hospitals.
One of the weaknesses in Japan’s Kampo system is the lack of Kampo specialists. Only 2,150 physicians have been certified by JSOM to practice expert Kampo. This and the fact that 92% of Kampo medicines given also accompany chemical drugs indicates a lack of focused practice – which the JSOM is aiming to change.
In 1972 the World Health Organization founded its Division of Traditional Medicine. This was to support traditional medicines around the world within primary care. The result has been a significant increase in the access to health care for many people around the world.
S. Yakubo, M. Ito, Y. Ueda, et al., “Pattern Classification in Kampo Medicine,” Evidence-Based Complementary and Alternative Medicine, vol. 2014, Article ID 535146, 5 pages, 2014. doi:10.1155/2014/535146
Katayama K, Yoshino T, Munakata K, Yamaguchi R, Imoto S, Miyano S, Watanabe K. Prescription of kampo drugs in the Japanese health care insurance program. Evid Based Complement Alternat Med. 2013;2013:576973. doi: 10.1155/2013/576973.
Oka T, Okumi H, Nishida S, Ito T, Morikiyo S, Kimura Y, Murakami M; JOPM-EBM Working Team. Effects of Kampo on functional gastrointestinal disorders. Biopsychosoc Med. 2014 Jan 21;8(1):5. doi: 10.1186/1751-0759-8-5.