Author: Thomas

The use of Kampo medicine in hospitals (in Japan)

By the end of July (2022) I was unfortunate enough to require major surgery. I won’t go into the details here, but I would like to complain a little about the use of Kampo medicine in the hospital.

As most people certainly know, after general anesthesia the intestines stop working and later have to resume their usual function in order to be able to drink or eat again. To promote that function de facto 100% of patients receive some sort of ‘laxative’. Asking the nursing staff, I was told ALL patients receive the same thing: magnesium oxide (mild laxative) and a sort of Chinese herbal medicine, which when applied according to Japanese rules is called a Kampo medicine (I will omit all the technical details here).

Since I did not want to establish myself as a complainer from day one, I took that Kampo medicine (大建中湯) and MgO for a while, but I believe the Kampo medicine did not work (the way it is supposed to) at all. An ignorant person like me probably should not speak up here, but I could not help myself. I felt I had to say something.

Physician prescribe appropriate (western) medicines according to “indications”. Most of which are stereotyped patterns, where every patient gets the same thing. Even if there is some minor room for variations among patients who had let’s say abdominal surgery and reconstructive orthopedic surgery, the effects of anesthesia on the intestines is the same, so everybody gets the same laxative. The current TV commercials carry on this tradition. They proudly announce that “Kakonal” (commercial name for a famous Kampo medicine) is the one to be used for ‘common cold’. This is just as stupid as using one particular antibiotic for ALL conceivable infections. No physician in his/her right mind would do that .. and the ones that actually do it, are called quacks! There is a very interesting name for this in Japanese, but it would require a more or less extensive explanation, so I omit it here.

It is exactly THIS pattern I have seen/experienced during my recent hospital stay. I caught the physician in charge away from other patients and mentioned this (the use of Kampo according to western medical indications) to him, but he replied, there is “evidence” that the Kampo medicine in question improves the movement of the guts. Meaning he is not capable and/or willing to see, that this “evidence” is always associated with a set of conditions to make any sense. Same as: ‘there is evidence that antibiotic xxx is bactericidal, therefore it can be used to cure every infection’.

I gave up pursuing the issue further, but not before I mentioned the well-documented “Shosaikoto (another famous Kampo medicine) incident” in the early 90s, where the wrong use of Kampo led to fatalities, compelling the Ministry of Welfare to order the manufacturer of these drugs used in hospitals to mark that particular drug with a big red warning. I doubt, however, that the physician will make the effort to look up this historic event.

Just for the “fun” of it, I used my own body to conduct a little experiment. For a few days I took twice the prescribed dose of the Kampo medicine. Naturally, it had no effect for me, because it is the wrong “indication”.

The use of herbal medicines has certain rules that have passed the test of time (+2,000 years!). And these rules differ from those applied to western medicines. Ignoring these rules will put patients in danger. Best scenario would be no effect at all, worst scenario could be as mentioned above severe side effects or even death.

So, if physicians have the ‘right’ (qualification) to use herbal medicine (here Kampo), I believe it should be in the interest of the patient to make sure, they are properly educated regarding AT LEAST the fundamentals of oriental medicine.