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The word kampo is the Japanese pronunciation
for the combination of the Chinese
characters Kan (han) meaning "from
China" and po (ho) meaning the
"way". Thus, kampo is the
Japanese version of traditional Chinese
medicine, dating back several thousands
of years. To understand kampo, one
must first look to China.
According to Chinese legend, Shen
Nung, the god of husbandry, established
herbal medicine. The principles of
herbal medicine were first recorded
as a conversation between the yellow
emperor and his minister, Chi Po.
They discussed medical philosophy
in a book known as the Su Wen (Basic
Questions), and medical practice in
a book later named The Magic Pivot.
These writings became the world's
first known medical textbook, The
Yellow Emperor's Canon of Internal
Medicine (Huang ti nei ching su wen).
Although this book was perhaps the
earliest book listing herbal remedies,
it was mainly concerned with acupuncture.
It listed only 28 herbs, combined
into 12 formulas categorized by taste.
In 168 BC, shortly after The Yellow
Emperors Canon appeared, the first
book dealing mainly with herbal healing
was written. This work, Formulas for
52 Ailments (Wu shi er bing fang),
contained magical formulas in the
form of pills, potions, teas, etc.,
to fight the evil influences thought
to cause various forms of illness.
This medicinal/magical combination
later became known as Fang ji and
incorporated astrology, geomancy and
other quasi-sciences into its practice.
Understandably, Fang ji proved inadequate
for certain needs. Herbalist Zhang
Zhanjing, after losing much of his
family to the plague in AD190, decided
to replace magic with medicine. He
studied all of the old medical classics,
developed and collected many prescriptions,
and finally compiled the Shang han
a bing lun (Discussion of cold induced
disorders and miscellaneous diseases).
This book later became known in Japan
as the Sho Kan Ron, the forerunner
of all kampo manuals.
Zhang had unique ideas concerning
medical treatment. He taught that
herbal medicine should conform to
people - it should be customized for
the individual. Zhang's main precept
was that if the disharmonies within
the diseased individual could be discerned,
then the correct combinations of herbs
that would correct the imbalances
would naturally follow. If physicians
thoroughly understood herbs and their
effects on the body and the body's
energy, they could precisely match
the herbal combination with the affliction.
Zhang's idea was tremendously successful.
In fact, it became so reliable that
in time the name of the formula used
for treatment became synonymous with
the diagnosis.
Invaluable as it may be, the Sho Kan
Ron was not the only work to prove
itself useful even into modern times.
The third century herbalist Ge Hong
took Zhang's principle a step further.
He wrote the Bei ji zhou hou fang
(Emergency Formulas to Keep Up One's
Sleeve). This book is the source of
most of the asthma treatments kampo
has to offer.
Other works of this period, including
the Wai tai bi yao (Arcane Essentials
from the Imperial Library), contain
many formulas still in widespread
use.
As time progressed, herbal texts became
increasingly voluminous and disorganized.
The Tai ping hui min he ji ju fang
(Imperial Grace Formulary of the Tai
Ping Era), written around AD 990,
contained almost 17,000 formulas.
It became difficult for physicians
to determine which treatment to use
for a given condition - especially
so since many manuals began to use
substitutes for original ingredients.
Attempts to organize this vast wealth
of herbal knowledge were largely unsuccessful.
The 12th century scholar Cheng Wu-ji
wrote the Shang han ming li lun (A
Clarification of the Theory of Cold-induced
Disorders). He attempted to streamline
the system by categorizing all herbal
formulas into seven basic categories.
Cheng also made some advances by discussing
the location of disease in the body,
the strength of the disease itself,
the constitution of the patient and
the correct timing of the herbal treatment.
On the other hand, his system of classification
was rather inconsistent and some of
his observations had no logical basis
whatsoever. For instance, one of his
precepts still quoted today states,
"To induce sweating do not use
an even number of herbs. To drain
downward do not use an odd number
of herbs."
The logical inconsistencies and organizational
problems troubled many practitioners.
It was the Japanese who found that
they could simplify the enormous volume
of herbal information and knowledge
into a system that would be more efficient.
This uniquely Japanese system of medicine
became known as kampo.
The Japanese, like the Chinese, once
relied on magic and prayer to address
their medical needs. Sometime after
AD 593, the Empress Suiko sent her
armies to invade Korea, where Chinese
medicine was already in use. Reports
of the Chinese medical practices so
impressed the Empress that she sent
two emissaries to China to study.
Knowledge of kampo spread to the Buddhist
monasteries of Japan during the Nara
period (AD 710 - 794) when a Japanese
monk fell ill while traveling in China
and recovered after being treated
with kampo. Other emissaries were
soon sent to bring back more of the
Chinese herbal healing formulas. During
the Heian period (794-1192) a scholar
by the name of Yasuyori Tamba revised
the oldest Japanese medical text,
the Issinho (The Way of Medicine)
to include all the herbal formulas
discovered in China. The rewritten
work was hand copied into thirty volumes.
This enormous amount of information
posed the same problem for the Japanese
as it did for the Chinese, so, over
the years, the Japanese began their
process of simplification. Kampo practioniers
dropped the 17,000 formulas of the
Imperial Grace Formulary in favor
of the more ancient Shen nung pen
ts'ao. (Pharmacopoeia of Heavenly
Husbandry). The pool of available
herbal combinations was cut down to
365 herbal formulas, one for each
day of the year. There were 120 joyaku
(upper class medicine) formulas designed
to increase safely vitality and longevity
when taken regularly, 120 chuyaku
(middle class medicine) and 125 shimoyaku
(lower class medicine). The last category,
the shimoyaku, is intended as treatment
for serious ailments, and usually
produces negative side effects. Kampo
practioners tried to heal as gently
as possible, with the fewest possible
side effects.
Another important reason for the simplification
was the fact many original ingredients
were simply unavailabile. Early on,
Japan was open to trade with foreign
countries, but during the Tokugawa
period (1603 - 1867), all trade with
foreign countries was cut off and
Japan became an isolated nation. This
eliminated foreign herbal sources.
The religious motivations of the Buddhist
monks also became a reason for simplification.
For centuries, monks were the only
source of kampo medicine for the commoners.
The only other practioners were court
scholars who would not administer
to anyone outside the imperial court.
The Chinese used a vast array of animal
products in their preparations, such
as rhinoceros horn, whole wasps and
tiger bone. Since Buddhist doctrine
forbade the taking of life, the Japanese
had a general distaste for animal
by-products, and the pool of materials
was necessarily reduced.
Except for the use of shells and fossilized
bone, Japanese medicine became almost
entirely plant-based.
At one point, the simplification process
reached its limit. Todo Yoshimasu
(1702 - 1773) stated that all diseases
stem from the presence of toxins,
and, once the toxin was removed, the
cure would follow. Yoshimasu invented
a treatment called meigen, a belief
that "like cures like" using
very high concentrations of toxins.
However, since most of his patients
died, this method was quickly discarded.
One school of Kampo, composed of followers
of the 16th century master Dosan Manase,
held on to the five elements and energy-circuit
ideas of ancient China. The Koho School
of kampo, however, rejected these
concepts in favor of their own, uniquely
Japanese method. The practitioners
of the Koho School returned to the
Sho Kan Ron, and proceeded to simplify
even this quite basic text. They then
identified five basic causes of disease:
wind, cold, heat, dampness and improper
diet and/or overwork. Elaborate theories
of the interplay of yin and yang were
discarded and subsequently used only
as diagnostic indicators. Kampo, as
it is practiced today, is largely
a result of the reforms of the Koho
School.
After looking at the history of kampo,
one can see that the theories behind
diagnoses and treatments are considerably
different than those of conventional
western medicine. Western medicine
utilizes disease-based diagnosis,
in which the physician tries to isolate
a specific case of the illness. Eastern
medicine utilizes patient-based diagnosis,
in which the doctor looks for recognizable
patterns of disharmony within the
patient. To more thourghly understand
kampo, you must first have a general
understanding of this "patient-based"
theory of medicine.
The
underlying premise behind Asian medical
theory is that all forms of life are
animated by an essential life force
called chi in Chinese (ki in Japanese).
It is the quantity, quality, flow
and balance of chi that ultimately
determines one's state of health.
Important factors affecting chi are
the air we breathe and the food we
consume. Thus, the stomach and lungs
play vital roles in the absorbing
chi from the environment. If these
organs are not functioning properly,
the physician must correct the condition
by prescribing proper diet, exercise,
breathing, etc. If the imbalance has
progressed to the point that a vital
organ or system is affected, the physician
may prescribe an herbal formula to
correct the imbalance. The chi of
the herb, in theory, goes straight
to the target organ.
The concepts of yin and yang (Japanese
in and yo) are central to herbal medicine.
The precarious balance between the
two must be maintained in order for
life to thrive. Yin represents the
negative, passive, female force and
yang represents the positive, active,
male force. The balance is often disturbed,
throughout one's life. For example,
during winter, the cold yin influences
dominate and might need to be counteracted
by warming, yang herbs. Usually, the
body can adjust this balance automatically.
Only when it does not must a physician
intervene.
To explain the interdependence of
the various organs, the ancient Chinese
used the theory of the five elements.
Wood represents the liver; fire, the
heart; earth, the spleen; metal, the
lungs and water, the kidneys. Wood
burns to generate fire, fire produces
ashes, which generates earth, earth
produces metal which, when molten,
becomes like water, and water promotes
the growth of plants, which produces
wood. Since each vital organ corresponds
to an element, the interplay of the
elements creates analogs by which
physicians can understand bodily systems
and functions.
Japanese historical chronicles abound
with accounts of kampo being used
by the samurai. The Bonsen Shukai
has two recipes for pills, one to
combat hunger and the other for thirst.
The Zohyo Monogatari has an entire
section devoted to medical care, offering
proof that the wounded were cared
for and not just left to die. Umeboshi
(pickled plums) were considered great
if one was having difficulty breathing,
and pepper grains were taken on campaign
to encourage warmth. Shikimi (star
anise oil) was taken to help alleviate
frostbite.
As far as wounds were concerned, there
were several herbal remedies available,
including narcissus root and wheat
flour paste. Pulverized leeks were
said to help heal gunshot wounds and
burns were treated with a mixture
of tannin and ink. If such herbal
remedies were unavailable, one might
mix horse dung in water and apply
it to the wound, or urinate in a copper
hat and wash with it.
In light of the alternative remedies,
you can easily see why the samurai
sang the praises of kampo herbs.
Reference
Dunn, Charles J. Everyday
Life in Traditional Japan. Charles
E. Tuttle Company, Inc., 1969.
Reid, Daniel. The Complete Book of
Chinese Health and Healing. Shambhala
Publications, Inc., 1994.
Rister, Robert. Japanese Herbal Medicine.
Avery Publishing Group, 1999.
Tsumura, Akira. Kampo. Japan Publications,
Inc., 1991.
Turnbull, Stephen. The Samurai Sourcebook.
Arms and Armor Press, 1998.
Ziyin, Shen and Zelin, Chen. The Basis
of Traditional Chinese Medicine. Shambhala
Publications Inc., 1996.
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