by Carmen Altomonte
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.
