Created page with "==歴史== {{Anchor|History}} ===起源=== 中国の神話によれば、伝統的な漢方薬の起源は伝説上の3人の君主伏羲、神農、黄帝にまで遡る。神農は何百種類もの薬草を試食し、その薬効と人体への影響を確かめ、人々の苦しみを和らげる手助けをしたと考えられている。植物の薬用のみに焦点を当てた最古の文献..."
中国の[[:en:mythology|神話]]によれば、伝統的な漢方薬の起源は伝説上の3人の君主[[:en:Fuxi|伏羲]]、[[:en:Shennong|神農]]、[[:en:Yellow Emperor|黄帝]]にまで遡る。神農は何百種類もの薬草を試食し、その薬効と人体への影響を確かめ、人々の苦しみを和らげる手助けをしたと考えられている。植物の薬用のみに焦点を当てた最古の文献は、紀元前1世紀末頃に編纂された''[[:en:Shennong Ben Cao Jing|神農本草経]]''で、365種の薬草を分類したと言われている。
中国の[[:en:mythology|神話]]によれば、伝統的な漢方薬の起源は伝説上の3人の君主[[:en:Fuxi|伏羲]]、[[:en:Shennong|神農]]、[[:en:Yellow Emperor|黄帝]]にまで遡る。神農は何百種類もの薬草を試食し、その薬効と人体への影響を確かめ、人々の苦しみを和らげる手助けをしたと考えられている。植物の薬用のみに焦点を当てた最古の文献は、紀元前1世紀末頃に編纂された''[[:en:Shennong Ben Cao Jing|神農本草経]]''で、365種の薬草を分類したと言われている。
Chinese medical practices were introduced to Japan during the 6th century A.D. In 608, [[Empress Suiko]] dispatched E-Nichi, Fuku-In and other young physicians to China. It is said that they studied medicine there for 15 years. Until 838, Japan sent [[Japanese missions to Tang China|19 missions]] to [[Tang China]]. While the officials studied Chinese government structures, physicians and many of the Japanese monks absorbed Chinese medical knowledge.
In 702 A.D., the [[Taihō Code]] was promulgated as an adaptation of the governmental system of China's Tang dynasty. One section called for the establishment of a university (''daigaku'') including a medical school with an elaborate training program, but due to incessant civil war this program never became effective. [[Empress Kōmyō]] (701–760) established the ''Hidenin'' and ''Seyakuin'' in the Kōfuku-Temple ([[Kōfuku-ji]]) in [[Nara, Nara|Nara]], being two Buddhist institutions that provided free healthcare and medicine for the needy. For centuries to come Japanese Buddhist monks were essential in conveying Chinese medical know-how to Japan and in providing health care for both the elite and the general population.
In 753 A.D., the Chinese priest [[Jianzhen]] (in Japanese Ganjin), who was well-versed in medicine, arrived in Japan after five failed attempts in 12 years to cross the [[East China Sea]]. As he was blind, he used his sense of smell to identify herbs. He brought medical texts and a large collection of [[materia medica]] to the imperial palace in Nara, which he dedicated to the [[Emperor Shōmu]] in 756, 49 days after the emperor's death. They are kept in a log-cabin-style treasure house of the Tōdai-Temple ([[Tōdai-ji]]) known as [[Shōsōin]].
In 787 A.D., the "Newly Revised Materia Medica" (''Xinxiu Bencao'', 659 A.D.), which had been sponsored by the Tang Imperial Court, became an obligatory text in the study of medicine at the Japanese Health Ministry, but many of the 844 medicinal substances described in this book were not available in Japan at the time. Around 918 A.D., a Japanese medical dictionary entitled "Japanese names of (Chinese) Materia Medica" (''Honzō-wamyō'') was compiled, quoting from 60 Chinese medical works.
During the [[Heian period]], Tanba Yasuyori (912–995) compiled the first Japanese medical book, [[Ishimpo|Ishinpō]] ("Prescriptions from the Heart of Medicine"), drawing from numerous Chinese texts, some of which have perished later. During the period from 1200 to 1600, medicine in Japan became more practical. Most of the physicians were Buddhist monks who continued to use the formulas, theories and practices that had been introduced by the early envoys from Tang China.
During the 15th and 16th centuries, Japanese physicians began to achieve a more independent view on Chinese medicine. After 12 years of studies in China [[Tashiro Sanki]] (1465–1537) became the leading figure of a movement called "Followers of Later Developments in Medicine" (''Gosei-ha''). This school propagated the teachings of Li Dongyuan and Zhu Tanxi that gradually superseded the older doctrines from the [[Song dynasty]]. [[Manase Dōsan]], one of his disciples, adapted Tashiro's teachings to Japanese conditions. Based on his own observation and experience, he compiled a book on internal medicine in eight volumes (''Keiteki-shū'') and established an influential private medical school (''Keiteki-in'') in Kyōto. His son Gensaku wrote a book of case studies (''Igaku tenshō-ki'') and developed a considerable number of new herb formulas.
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17世紀後半からは、中国の古典である『傷寒論』の教えと処方を重視する「古典方便派」という新たな運動が展開された。この流派の病因論的概念は「碁聖派」と同様に推測的であったが、治療的アプローチは経験的観察と実践的経験に基づくものであった。この「古典的方法」への回帰は名古屋玄以（1628-1696）によって始められ、[[:ja:後藤艮山|後藤艮山]]（1659-1733）、[[:ja:山脇東洋|山脇東洋]]（1705-1762）、[[:ja:吉益東洞|吉益東洞]]（1702-1773）といった有力な支持者によって提唱された。吉増は最も影響力のある人物と考えられている。彼は、特定の哲学的背景に関係なく、効果的なテクニックであれば何でも受け入れた。吉益の腹診は一般的に、近世の日本の伝統医学と[[traditional Chinese medicine/ja|伝統中国医学]]（TCM）を区別するものとして信じられている。
From the second half of the 17th century, a new movement, the "Followers of Classic Methods" (''Kohō-ha''), evolved, which emphasized the teachings and formulas of the Chinese classic "Treatise on Cold Damage Disorders" (''[[Shanghan Lun]]'', in Japanese ''Shōkan-ron''). While the etiological concepts of this school were as speculative as those of the ''Gosei-ha'', the therapeutic approaches were based on empirical observations and practical experience. This return to "classic methods" was initiated by Nagoya Gen'i (1628–1696), and advocated by influential proponents such as [[Gotō Gonzan]] (1659–1733), [[Yamawaki Tōyō]] (1705–1762), and [[Yoshimasu Tōdō]] (1702–1773). Yoshimasu is considered to be the most influential figure. He accepted any effective technique, regardless of its particular philosophical background. Yoshimasu's abdominal diagnostics are commonly credited with differentiating early modern traditional Japanese medicine from [[traditional Chinese medicine]] (TCM).
During the later part of the Edo period, many Japanese practitioners began to utilize elements of both schools. Some, such as Ogino Gengai (1737–1806), Ishizaka Sōtetsu (1770–1841), or Honma Sōken (1804–1872), even tried to incorporate Western concepts and therapies, which had made their way into the country through physicians at the Dutch trading-post [[Dejima]] ([[Nagasaki]]). Although Western medicine gained some ground in the field of [[surgery]], there was not much competition between "Eastern" and "Western" schools until the 19th century, because even adherents of "Dutch-Studies" ([[Rangaku]]) were very eclectic in their actual practice.
Traditional medicine never lost its popularity throughout the Edo period, but it entered a period of rapid decline shortly after the [[Meiji Restoration]]. In 1871, the new government decided to modernize medical education based on the German medical system. Starting in 1875, new medical examinations focused on natural sciences and Western medical disciplines. In October 1883, a law retracted the licenses of any existing traditional practitioner. Despite losing legal standing, a small number of traditional physicians continued to practice privately. Some of them, such as Yamada Gyōkō (1808–1881), Asada Sōhaku (1813–1894), and Mori Risshi (1807–1885), organized an "Association to Preserve [Traditional] Knowledge" (''Onchi-sha'') and started to set up small hospitals. However, by 1887, the organization was disbanded due to internal policy dissent and the death of leading figures. The "Imperial Medical Association" (''Teikoku Ikai''), founded in 1894, was short-lived too. In 1895, the 8th National Assembly of the Diet vetoed a request to continue the practice of Kampō. When Azai Kokkan (1848–1903), one of the main activists, died, the Kampō movement was almost stamped out.
Any further attempt to save traditional practices had to take into account Western concepts and therapies. Therefore, it was graduates from medical faculties, trained in Western medicine, who began to set out to revive traditional practices. In 1910, Wada Keijūrō (1872–1916) published "The Iron Hammer of the Medical World" (''Ikai no tettsui''). Yumoto Kyūshin (1876–1942), a graduate from Kanazawa Medical School, was so impressed by this book that he became a student of Dr. Wada. His "Japanese-Chinese Medicine" (''Kōkan igaku''), published in 1927, was the first book on Kampō medicine in which Western medical findings were used to interpret classical Chinese texts. In 1927, Nakayama Tadanao (1895–1957) presented his "New Research on Kampō-Medicine" (''Kampō-igaku no shin kenkyū''). Another "convert" was Ōtsuka Keisetsu (1900–1980), who became one of the most famous Kampō practitioners of the 20th century.
This gradual revival was supported by the modernization of the dosage form of herbal medicine. During the 1920s, the Nagakura Pharmaceutical Company in Osaka began developing dried decoctions in a granular form. At about the same time, Tsumura Juntendō, a company founded by Tsumura Jūsha (1871–1941) in 1893, established a research institute to promote the development of standardized Kampō medicine. Gradually, these "Japanese-Chinese remedies" (''wakan-yaku'') became a standard method of Kampō medicine administration.
In 1937, new researchers such as [[Dōmei Yakazu|Yakazu Dōmei]] (1905–2002) started to promote Kampō at the so-called "[[Takushoku University]] Kampo Seminar". More than 700 people attended these seminars that continued after the war. In 1938, following a proposal of Yakazu, the "Asia Medicine Association" was established. In 1941, Takeyama Shinichirō published his "Theories on the Restoration of Kampō Medicine" (''Kampō-ijutsu fukkō no riron'', 1941). In that same year, Yakazu, Ōtsuka, Kimura Nagahisa, and Shimizu Fujitarō (1886–1976) completed a book entitled "The Actual Practice of Kampō Medicine" (''Kampō shinryō no jissai''). By including Western medical disease names he greatly expanded the usage of Kampō formulas. A new version of this influential manual was printed in 1954. This book was also translated into Chinese. A completely revised version was published in 1969 under the title "Medical Dictionary of Kampō Practice" (''Kampō Shinryō Iten'').
In 1950, Ōtsuka Keisetsu, Yakazu Dōmei, Hosono Shirō (1899–1989), Okuda Kenzō (1884–1961), and other leaders of the pre- and postwar Kampō revival movement established the "Japan Society for Oriental Medicine" (''Nippon Tōyō Igakkai'') with 89 members (2014: more than 9000 members). In 1960, raw materials for crude drugs listed in the Japanese Pharmacopoeia (''Nippon Yakkyoku-hō'') received official drug prices under the National Health Insurance (NHI, ''Kokumin kenkō hoken'').
Today in Japan, Kampō is integrated into the Japanese national health care system. In 1967, the [[Ministry of Health, Labour and Welfare (Japan)|Ministry of Health, Labour and Welfare]] approved four Kampō medicines for reimbursement under the National Health Insurance (NHI) program. In 1976, 82 Kampō medicines were approved by the Ministry of Health, Labour and Welfare. This number has increased to 148 Kampō formulation extracts, 241 crude drugs, and 5 crude drug preparations.
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漢方薬は、[[traditional Chinese medicine/ja|伝統中国医学]]のように処方を変更するのではなく、中国医学の古典的な文献に従って、標準化された割合で決まった組み合わせの生薬を使用する。漢方薬は様々な製造業者によって製造されている。しかし、漢方薬は漢方薬局の標準化手法のもと、それぞれまったく同じ成分で構成されている。そのため、医薬品は製薬会社に匹敵する厳しい製造条件のもとで調製されている。2000年10月の全国調査では、登録[[physician/ja|医師]]の72％が漢方薬を処方していると報告されている。新しい漢方薬は、その作用機序を評価するために最新の技術を使って評価されている。
Rather than modifying formulae as in [[traditional Chinese medicine]], the Japanese Kampō tradition uses fixed combinations of herbs in standardized proportions according to the classical literature of Chinese medicine. Kampō medicines are produced by various manufacturers. However, each medicine is composed of exactly the same ingredients under the Ministry's standardization methodology. The medicines are therefore prepared under strict manufacturing conditions that rival pharmaceutical companies. In October 2000, a nationwide study reported that 72% of registered [[physician]]s prescribe Kampō medicines. New Kampō medicines are being evaluated using modern techniques to evaluate their mechanism of action.
The 14th edition of the ''Japanese Pharmacopoeia'' (JP, ''Nihon yakkyokuhō'') lists 165 herbal ingredients that are used in Kampō medicines. Lots of the Kampō products are routinely tested for heavy metals, purity, and microbial content to eliminate any contamination. Kampō medicines are tested for the levels of key chemical constituents as markers for quality control on every formula. This is carried out from the blending of the raw herbs to the end product according to the ministry's pharmaceutical standards.
[[Medicinal mushrooms]] like [[reishi]] and [[shiitake]] are herbal products with a long history of use. In Japan, the ''[[Agaricus blazei]]'' mushroom is a highly popular herb, which is used by close to 500,000 people. In Japan, ''Agaricus blazei'' is also the most popular herb used by cancer patients. The second most used herb is an isolate from the shiitake mushroom, known as [[active hexose correlated compound]].
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==日本以外==
==Outside Japan==
{{Anchor|Outside Japan}}
In the [[United States]], Kampō is practiced mostly by acupuncturists, Chinese medicine practitioners, naturopath physicians, and other [[alternative medicine]] professionals. Kampō herbal formulae are studied under clinical trials, such as the clinical study of Honso Sho-saiko-to (H09) for treatment of hepatitis C at the New York Memorial Sloan-Kettering Cancer Center, and liver cirrhosis caused by hepatitis C at the UCSD Liver Center. Both clinical trials are sponsored by Honso USA, Inc., a branch of Honso Pharmaceutical Co., Ltd., Nagoya, Japan.
[[:en:United States|アメリカ]]では、漢方は主に鍼灸師、漢方医、自然療法医、その他の[[alternative medicine/ja|代替医療]]の専門家によって実践されている。漢方処方は、ニューヨーク記念スローンケタリングがんセンターでのC型肝炎治療に対する本草逍遥散（H09）の臨床試験や、UCSD肝臓センターでのC型肝炎による肝硬変の臨床試験など、臨床試験の下で研究されている。両臨床試験とも本草製薬株式会社（名古屋市）の子会社であるHonso USA, Inc.がスポンサーとなっている。
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[[File:Hepburn-1867-Kampo.jpg|thumb|350px|現代的な意味での「漢方」を示す最初の資料のひとつである（James Curtis Hepburn: ''A Japanese and English Dictionary; with an English and Japanese Index''. London： Trübner & Co., 1867, p. 177）]]
[[File:Hepburn-1867-Kampo.jpg|thumb|350px|現代的な意味での「漢方」を示す最初の資料のひとつである（James Curtis Hepburn: ''A Japanese and English Dictionary; with an English and Japanese Index''. London： Trübner & Co., 1867, p. 177）]]
漢方（かんぽう、kampo あるいは Kanpō medicine (漢方医学, Kanpō igaku)）は、単にKanpō (漢方, Chinese medicine)として知られることもあり、7世紀に始まった伝来後、日本における伝統中国医学の研究である。日本の文化や伝統に合うように適応・修正された。日本の伝統医学では、鍼、灸、漢方伝統療法、漢方伝統食品療法など、中国の方法のほとんどを用いる。
アメリカでは、漢方は主に鍼灸師、漢方医、自然療法医、その他の代替医療の専門家によって実践されている。漢方処方は、ニューヨーク記念スローンケタリングがんセンターでのC型肝炎治療に対する本草逍遥散（H09）の臨床試験や、UCSD肝臓センターでのC型肝炎による肝硬変の臨床試験など、臨床試験の下で研究されている。両臨床試験とも本草製薬株式会社（名古屋市）の子会社であるHonso USA, Inc.がスポンサーとなっている。
現代的な意味での「漢方」を示す最初の資料のひとつである（James Curtis Hepburn: A Japanese and English Dictionary; with an English and Japanese Index. London： Trübner & Co., 1867, p. 177）
"Current Kampo Medicine"(PDF). The Journal of Kampo, Acupuncture and Integrative Medicine (Special ed.). International Institute of Health and Human Services, Berkeley. November 2005. ISSN1559-033X. Archived from the original(PDF) on 2016-03-03. Retrieved 2014-08-25.
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