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Antiphlogictic Decoction with Ten Herbs [Indications] External contraction of cold / [Drug actions] Fineleaf Schizomepeta Herb, Divaricate Saposhnikovia Root, Double-teeth Pulbescent Angelica Root, and Ginger work to dispel wind and cold of the skin surface by the modified formula of the original Schizonepeta action of dispelling wind and releasing the Antiphlogistic Decoction described in the chapter exterior. Bupleurum Root having the action of of “Yoso (malignant skin boils)” of “Manbyo releasing the exterior with pungent-cool has the Kaishun.” Seishu Hanaoka (1976-1835) ability of clearing heat produced by skin pyrosis. modified the original prescription 200 years ago Balloonflower Root and Quercus Bark, which has for the treatment of pyosis of the skin. Hanaoka the action of releasing toxins and dispelling pus, was a competent Japanese surgeon and is well are also effective for skin suppuration. Cnidium known for the excision of breast cancer under Rhizome activates blood and frees the collateral general anesthesia with a Kampo drug. Today, Antiphlogistic Decoction with Ten Herbs vessels, by which enhances local circulation is is enhanced and pure is promoted. Tuckahoe applied to a wide variety of skin disorders eliminates internal moist and deals with lesions including purulent skin lecisons, eczema, caused by moist in collaboration with the drugs that have the action of eliminating external moist, such as Divaricate Saposhnikovia Root and This prescription developed for ethical use Double-teeth Pulbescent Angelica Root. Licorice Root has the action of clearing heat and releasing toxins and concurrently works to harmonize been put to civilian use and said to be effective for furuncles, hives, dermatitis, and athlete’s foot. The drug actions of these two drugs are not much different each other. From the past experiences, however, it is thought that Wild Cherry Bark has the action of dispelling pus, whereas Quercus Double-teeth Pulbescent Angelica Root 1.5 gm. Bark is good for relieving itching. The medical Note: For the original formula, Double-teeth properties of these two, however, are not clear. It Pulbescent Angelica Root was used instead of is thought, however, that they are used in the “Rhizoma and Root Forbes Notopterygium.” For formula mainly for the purpose of dispelling pus Quercus bark, which is a crude drug often used in as they do not have a strong action of clearing Japan, barks of deciduous broad leaved trees such as Quercus Acutissima and Oak are used. Some makers use Pruni Jamasakura Bark instead of Antiphlogistic Decoction with Ten Herbs has effects of dispelling wind and cold, moving qi and [Efficacy] Dispel wind, relieve toxins, and expel The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM) 25 harmonizing the blood and it has also the effects furuncles did not become better. The patient was of healing through expelling pathogenic factors of average height and weight. Her complexion from the exterior of the skin. From this point of was not very good. No diabetes. Due to the view, indications of this formula become as nature of her business, the patient drank alcohol follows: First, because of the action of dispelling wind, I used Antiphlogistic Decoction with Ten relieving toxins, and draining pus, it has the Herbs for furuncles. After about one month of indications for pus-related disorders of any kind administration, furuncles did not develop, so the in the initial stage. Second, by releasing exterior medication was suspended. In a month, however, pathogens, this formula can remove exterior they began to appear. The medication was moist-heat (eczema, etc.) and water-moist (hives, resumed and continued for further about three etc.). However, only few drugs in the formula have the action to stop itching. Third, because of the (Keisetu Ootuka, Shoko ni yoru Kampo Chiryo action of dispelling wind, the formula has the indication for common cold in the initial stage. Kobayashi, et al. report that they administered This formula can be effectively applied from Antiphlogistic Decoction with Ten Herbs to17 the condition in which the affected areas turn red patients with chronic eczema, with the results of and become swollen in the early stage of skin markedly improved in 4 patients, improved in 7, disorders such as folliculitis and furuncle to the slightly improved in 3, remained unchanged in 3 condition in which inflammation becomes with the improving rates of 64.7% of more than localized and infiltrations are indurated or improved and 82.4% of more than slightly hardened. It is often the case that continued use of the formula gradually decreases the emergence effectiveness levels between the formula and and over time the symptoms do not appear. clemastine fumarate used for comparison were similar with no differences of statistical Moriya Okuma used Antiphlogistic Decoction significance. However, the group of Antiphlogistic with Ten Herbs for the protection of cellulitis Decoction with Ten Herbs showed marginally observed in lymphatic edema in a female of 58 high levels with the result of “more than years old and reports that cellulitis that used to appear once a month could be suppressed1). Ryosaburo Senaga reports that he used this formula for furunculosis and pyoderma of infant’s Antiphlogistic Decoction with Ten Herbs for 18 heads in the pediatric field with successful results patients with chronic eczema with the results of markedly effective in 2 patients (11%), effective in 5 (27%), effective in 7 (39%) and remained unchanged in 4 (23%). They also used the formula A woman, 36 years old, had furuncles on the for four patients with asteatotic eczema with the face and nape of the neck all through the year. results of markedly effective in 1 (25%), effective Soon after one was cured, another one appeared. in 1 (25%), and remained unchanged in 2 (50%)4). Although she used various kinds of antibiotics, 26 The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM) achieved quickly. However, with the use of only One day, a well-built plump man in his 40s about 7g/day, it takes many days for treatment or who suffered from rashes/eczema visited me for the skin disorders cannot be cured,” and if the a clinical examination. The size of a lesion was extract formula cannot be modifieda, “I combine about the head of a match stick and the eczema Coptis Detoxificating Decoction if inflammation is was slightly tinged with red and bumpy. The intense, such as a red flare. Skin rashes in the areas of hands, legs, and the lower abdomen to arm pits and the umbilical region become wet the lower back were severely affected. Tolerating from sweat and swelling becomes intense during the summer season. In that case, I combine Wind cautious not to scratch the affected areas during the night so that he asked his family to tie both hands to the bed. He received various injections and used various ointments without results. No abnormalities in urination, bowel movements, and appetite. I previously had used Pueraria [Past medical history] Present condition and Decoction for this type of a patient and this medication had exacerbated the condition. He had an itchy scalp with a lot of dandruff. Therefore, I decided to use Antiphlogistic In recent days, from 5mm-1cm of the hairline of the forehead towards the hair of the head there were erythemas with a clear boundary line This formula was very effective. Itching where, in particular, there were pityroid scales. rapidly disappeared and a cure was attained Under the both arm pits, there were also within about two months. After this, whenever erythemas having a relatively clear boundary drinking beer, he had a recurrence indication. and there were pityroid scales in the boundary Therefore, the formula was used for 2 to 3 days after drinking beer to prevent a recurrence. In And there were keratotic papules (raised the meantime, the formula was not required at rashes) and erythemas on the dorsal surface. Diagnosis was seborrheic dermatitis and Extract year-interval and said that rash-like something Powder of Antiphlogistic Decoction with Ten slightly appeared. This could be recovered by the Herbs 10g/day divided into equal 3 portions was administered. After one week, rashes on the (Keisetu Ootuka, “Kampo Shinryo 30-nen” p166 trunk area disappeared and those on the head and armpits also improved. However, the central parts in the armpit areas were difficult to cure and tended to become exacerbated. So the volume Yamamoto pointing out that adult seborrheic of Extract Powder of Antiphlogistic Decoction dermatitis is one of good indications of with Ten Herbs was increased to 15g/day from Antiphlogistic Decoction with Ten Herbs says5) as May 26. Because a flare-up in the central part follows: “I use Antiphlogistic Decoction with Ten was intense and it was not easy to cure, Extract Herbs for seborrheic dermatitis in adults. If it is Powder of Coptis Detoxificating Decoction 5g/day an extract form, the daily dosage is 10g to 20g or was concomitantly used from June 9. On June 30, more. It is very effective and a cure can be The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM) 27 The reason of selecting the prescription is as effectiveness to those of clemastine fumarate used Diagnosis was seborrheic dermatitis. As the patient’s condition was relatively mild, the extract preparation of Antiphlogistic Decoction with Ten Herbs was used. From my experiences, The patient had a moderate degree of atopic seborrheic dermatitis in adults can be cured with dermatitis. There were erythemas and papules modified Antiphlogistic Decoction with Ten mostly all over the body with mild lichenification, Herbs regardless of age, sex, being fat or thin, desquamation, and rupture scars. According to the enveloped method, clemastine fumarate was As the patient’s condition was comparatively given orally from August 1992. Eight weeks later, mild, the extract preparation was used. In some effectiveness was assessed as mildly improved. cases, 6-7 gm per day yields effects. But with this Although the internal administration was dose amount, treatment often becomes prolonged, continued for a while, I thought the symptoms of the patient seemed to be the “sho” of In the case of this patient, the starting dosage Antiphlogistic Decoction with Ten Herbs because was 10g/day, which was increased as necessary he tended to become constipated and has a according to the progress of the condition to muscular build. In December of 1992, Tsumura determine the effective dosage. The dosage of Jumihaidokuto (Antiphlogistic Decoction with about 20g/day as a standard would markedly Ten Herbs) was started. After two weeks of (Iwao Yamamoto, Clinical Lecture of improved significantly. After a few months, the Department of Dermatology THE KANPO Vol.4, skin disorder was nearly recovered. Then, the skin condition is well managed only with the Antiphlogistic Decoction with Ten Herbs is (Kinuko Kobayashi, et al. , Treatment Effect of sometimes applied to atopic dermatitis but its Antiphlogistic Decoction with Ten Herbs for application is limited to a very narrow range. Chronic Eczema and Atopic Dermatitis, 12th Ninomiya says that “the formula is good for Hifu-ka Toyo Igaku Kenkyu Kai Kiroku p29-30, suppurative eruptions in the individuals having a moderate degree of physical strength.6)” Kinuko Kobayashi, et al. report that they Case 5: Modified Antiphlogistic Decoction with administered Antiphlogistic Decoction with Ten Herbs to18 patients with atopic dermatitis and the results showed markedly improved in 2 employee patients, improved in 7, slightly improved in 7, and remained unchanged in 2 with the overall [Past Medical history] Summer rashes developed improvement rates of 50% of more than improved and 88.9% of slightly improved. They further [Current medical history] Last summer, the reports that the formula had similar levels of patient had mosquito bites on both upper 28 The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM) extremities, which became indurated like warts preparations in the field of dermatology and the and felt itchy. That is, urticaria perstans. Bowel results showed complete cure in 3 patients and movements were twice a day and normal. No relieved in 3, and no effects in 3 with an effectiveness rate of 66% (6/9 patients)8). Koga [Present condition] Height 158cm, weight 54kg. White furs on the tongue. No special mention (Antiphlogistic Decoction with Ten Herbs) to 30 patients of over 15 years old with the diagnosis of [Course] Antiphlogistic Decoction with Ten Herbs 6.0g divided into equal 2 portions and dermatology in eight university hospitals in the regions of Kyushu and Okinawa with the results of markedly improved in 6 patients (20%), more August of the year, the condition was mostly than useful in 19 (63.3%), and slightly more than good, but there were new traces of mosquito useful in 28 (93%)9). Yamaguchi, et al. used bites. The overall skin, however, was becoming Kampo preparations for ethical use for various dermatological diseases. And they report that in the patients for whom Antiphlogistic Decoction with Ten Herbs was used according to the sho, In November of the year, the patient claimed 42.9% of the group of chronic urticaria (with an that the number of wort-like indurations addition of Rhubarb tablets) showed more than increased. Antiphlogistic Decoction with Ten effective and 85.7% of the group of eczema and Herbs 6.g with an addition of Coix Seed Extract dermatitis showed more than effective10). 3.0, both divided into equal two portions, was Horiguchi, et al. used Antiphlogistic Decoction with Ten Herbs for 11 patients with urticaria February 1986, a cure was achieved and the persistent for more than one month with the results of 91% of slightly more than effective11). persistent but Antiphlogistic Decoction with Ten Herbs is often effective for the disorder. It takes The patient was a female of 19 years old. time for the treatment. In the case of this patient, According to the patient, in her childhood, she had repeatedly had autotoxication and her (Kunio Matsuda, Shorei ni yoru Kampo Chiryo constitution was fragile. However, over the years, she was gradually becoming fat. She had ruddy cheeks and obese. Appetite and bowel movements are normal, but mouth dryness was intense. Her Nakai, et al. report that they administered main complaint was urticaria, which had been Extract of Antiphlogistic Decoction with Ten persistent for about a year since last summer. The Herbs to 26 patients with chronic urticaria and abdomen distended with almost no bloated feeling obtained an effective rate of 65% including in the chest and hypochondriac regions. “slightly effective”7). Maeda, Morita, et al. report that they administered Antiphlogistic Decoction Antiphlogistic Decoction with Ten Herbs with an with Ten Herbs to nine patients with urticaria from their experience of using Kampo Dihydrate) for these symptoms and a cure was The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM) 29 achieved with three weeks administration. adequately effective without the use of other However, in end June of this year, urticaria began external medicines (steroids, sulfur compounds, to develop again and the same medication was given. About one month later, full recovery was Case 7: Modified Antiphlogistic Decoction with (Ootuka, Keisetu, “Kampo Shinryou 30-nen” [Present medical history] Around February 1978, Antiphlogistic Decoction with Ten Herbs cannot a large number of pimples developed and were be used for acne very extensively. It can, however, treated by a dermatologist for three months and be applied if acne has a strong tendency of recovered at the time. In around September of the year, pimples recurred and treated by the Makoto Tanaka reports that he administered same dermatologist. However, they were not this formula together with Minomycin (100 cured and rather became reddened, swollen, and mg/day) the subjects of 35 patients with acne map-like rashes. The patient’s face looked pitful. and had the result of effectiveness in 23 She was recommended extract tablets of Minor patients (66%). Subsequently, he added 135 subjects, making a total of 170, who were Tuckahoe Pill by a Kampo pharmacist and took assigned to the group of Antiphlogistic Decoction with Ten Herbs alone, the group of minomycin [Present condition] The physical frame and alone, the group of Lurid alone, the group of nourishment were moderate. The whole body Antiphlogistic Decoction with Ten Herbs + seems to contain excessive water. The patient minomycin, and the group of Minor Bupleurum was fatigable, irritable, and easily became angry. Decoction + Lurid and obtained the result that The face had many rashes that were map-like the group of Antiphlogistic Decoction with Ten and swollen. Other conditions were ringing in Herbs + minomycin showed the most excellent the ears, congested nose, stiff shoulders, stuffy stomach, sweater (face), cold hands and legs, constipation, irregular menstruation (delayed), Moriya Okuma performed the treatment of 128 good appetite, can eat anything, and eat much patients with acne vulgaris who were assigned to three groups; the group of Antiphlogistic The tongue was covered with white furs, moist Decoction with Ten Herbs alone, the group of and there was an accumulation of saliva in the Antiphlogistic Decoction with Ten Herbs + mouth. The pulse was sunken and weak. The external medication, and the group of external abdomen was soft in general and there was a medication alone. As a result, the group of bloated feeling in the chest and hypochondrium Antiphlogistic Decoction with Ten Herbs alone on both sides. Right and left rectus muscles were had a complete disappearance of skin rashes with markedly effective in 22 patients, effective in 13, slightly effective in 6 and remained [Treatment and course] unchanged/exacerbated in 5. He further says that When Antiphlogistic Decoction with Ten Herbs Antiphlogistic Decoction with Ten Herbs is plus Forsythia Capsule, Coix Seed, and Rhubarb 30 The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM) was administered for about seven days, pimples patients with Palmoplanter pustulosis and the overall results of the formula for skin lesions were markedly improved in 3 individuals (7.9%), medication with a sense of security as “this is the effective in 7 (18.4%), slightly effective in 9 sign that the prescription was working.” When (23.7%), remained unchanged in 13 (34.2%), and about 40 days passed, pimples mostly exacerbated in 6 (15.8%), whereas, relating to disappeared. subjective symptoms, markedly improved was in Then, the medication was continued for 90 4 (10.5%), effective in 12 (31.6%), slightly effective in 12 (31.6%), remained unchanged in 7 (18.4%), completely disappeared. However, as there were scars/spots after pimples treated by the previous dermatologist, the patient was continuously on Case 11: Antiphlogistic Decoction with Ten the medication. As of end January, 1980, her face Male, 50 years old. A rash began to develop on (Genpo Ogata, Kampo Chiryo Shorei Senshu I the palms and soles 1.5 years ago. Nails became P289-290 Gendai Shuppan Planning Co., Ltd.
dirty colored. It was Palmoplanter pustulosis. He had a medium build. Abdominal strength was slightly weak or intermediate. Under the right hypochondrium, weak resistance and Nakanishi reports that he administered oppression when compressed were felt, which was Antiphlogistic Decoction with Ten Herbs to 50 considered as a light bloated feeling (fullness) in patients with diffuse erythema (redness) of the chest and hypochondriac region. rosacea and had the results of markedly improved Antiphlogistic Decoction with Ten Herbs was in 46 patients (92%), moderately improved in 1 administered and about one month later, effects (2%), slightly improved in 1 (2%), and no effect in appeared and three months later, a rash mostly 2 (4%). As for the 42 patients (91%) out of 46 who had marked improvements, the effects appeared medication but a rash recurred after 1.5 months. within 7 days after the start of the He hastily visited the clinic and received the administration14). He further reports that there same medication for four weeks. He has not was no big difference in the rates of marked visited the clinic since then. He might possibly improvement between the combination group of Antiphlogistic Decoction with Ten Herbs and I think that there are a substantial number of doxycycline, which was combined due to the patients who will have similar effects of presence of rosacea-like papules, and the group of Antiphlogistic Decoction with Ten Herbs as this no combination. In the meantime the rate of marked improvement in atopic dermatitis with a (Koin Yamada, Katsu Vo. 22, No. 12, 1981) complication of rosacea was 90%, a similar rate to that of the group without the complication15). Antiphlogistic Decoction with Ten Herbs to 38 The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM) 31 Pharmaceutical Society for WAKAN YAKU 5, 14) Nakanishi T: Shusa no Biman-sei Kohan ni 3) Ninomiya F: Atopi-sei Hifuen no Shinryo Atopi-sei Hifuen to Shusa no Gappei ni tsuite, 4) Kobayashi K, et al.: Mansei Shisshin, 15) Nakanishi T: Shusa no Chiryo ni okeru Atopi-sei Hifuen ni taisuru Jumihaidokuto no 5) Kimura T, et al.: Kakushu Shisshin ni taisuru jumihaidokuto no Yuyosei, Kampo & Newest 7) Nakia T, et al.: Jinmashin ni taisuru Jumihaidokuto no Chiryo Koka, Rinsho to Kenkyu Vol.59 No.7 p123-125, 1995 8) Maeda M, Shunji MORI: Hifu-ka Ryoiki ni okeru Kampo Seizai no Shiyo Keiken, Journal of New Remedies & Clinics Vol.29 p2115-2125, 1980 TSUMURA jumihaidokuto no Koka, JAMA (Japanese version) Vol.16 No.11 p40-41, 1995 10) Yamaguchi Z, et al.: Kakushu Hifuka Shikkan ni taisuru Iryou-yo Kampo Seizai no Shiyo Keiken, Journal of Medicine and Pharmaceutical Science Vol.10 No.1 p299-313, 1983 11) Horiguchi Y, et al.: Mansei oyobi Kyusei Jinmashin ni taisuru jumihaidokuto to inchingoreisan no Shiyo Keiken, Hifuka Kiyo Vol.82 No.3 p365-368, 1987 jumihaidokuto, shosaikoto to Koseibusshitu Heiyo no Koka, Hifuka no Kampo Chiryo – Saikin no Wadai p75-80 32 The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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