What is Kampo?
Thinking about enrolling in our Kampo: Traditional Japanese Herbalism Program? You can read through this page to find out more about the history and practice of Kampo!
Kampo, sometimes written Kanpo, literally means “the way of the (Han) Chinese”. It refers to the traditional methods of prescribing herbs developed during the Han dynasty (200 BCE – 220 AD). These early ideas reached Japan by the 6th century and began to be incorporated into medical practice there. They were transmitted, usually via Korea, by Buddhist monks and scholars such as Te Lai (in 459 AD) and Zhi Cong (in 562 AD). Japan also adopted the Chinese written language at this time and began to incorporate Buddhism, Confucianism, governmental organization and the art of divination and astrology as well as various Martial Arts from mainland China, opening the way for Chinese Healing arts to follow. The first official classes in Chinese Medicine in Japan are said to have been given by a Korean physician in 602 AD by order of the Empress Suiko (reign: 592-628 AD).
There followed a period of fertile medical exchange between China and Japan which lasted until the beginning of the 11th century and was dominated by the Han Dynasty works of Zhang Zhong Jing (c.150-220 AD) and those of the Sui (589-618 AD) and Tang (618-907 AD) dynasties marked by the work of the famous physician Sun Simiao (581-682 AD). The earliest surviving Japanese Herbal text, the Ishimpo, was written in 984 AD by Yasuyori Tamba, and quotes more than 100 Chinese texts from the preceding 4 centuries.
Japan underwent a period of cultural and economic isolation between the end of the 9th century, soon after the publication of the Ishimpo, which lasted until the end of the 14th century. By then, just as China had done during the Jin Yuan period (12th CE), Japan developed distinctive schools of medical thought epitomized by the Goseiha school of Sanki Tashiro (1465-1537), based on the work of Chinese scholar-physicians such as Li Dongyuan (1180-1251) and Zhu Danxi (1281-1358) which focused on the center-tonifying and yin-tonifying principles respectively as well as on the 5-phase theory.
Later, the Kohoha school, developed by Todo Yoshimasu (1702-1773), claimed that most disease was caused by an invading toxin, not unlike the other two schools of the Jin Yuan period (Fire-purging and Wind-clearing) and the later treatise of the Wenbing Hiuichun (1587) describing the so-called four levels of disease, written by Gong Tingxian (1522-1619).
Kanpo went into decline with the advent of western influences in medicine and was all but relegated to folklore by the Meiji period (1868-1902). It was only revived in the first half of the 20th century by enthusiastic western-trained doctors who were interested in returning to their classical roots in medicine. Amongst them perhaps the most well-known, often called the “father of modern Kampo” was Keisastu Otsuka (1900-1980) who was widely published, helped set up the Kitasato Research Institute for Kanpo studies in Tokyo and is perhaps the best-known modern Kanpo practitioner in Japan.
Along with recognition in the medical world came validation of the herbs by rigorous research and clinical trials, mostly funded by the large drug companies who maintain a majority share of the Kanpo market to this day in Japan. Their legacy has been the delivery system of granular herbal extracts (Wakan-yaku in Japanese), a convenient and mass-produced method of taking the herbs with a high rate of patient compliance very popular in Japan. In addition, the Japanese health ministry officially recognizes more than 220 Kanpo formulas and more than 150 of these are covered by the national health insurance.
It is currently estimated that as many as 50% of all doctors in Japan use some form of Kampo medicine and that there are in excess of 10,000 pharmacies dispensing Kampo preparations. Kampo in Japan is taught in the traditional academic & clinical setting to M.D.’s & Pharmacists wishing to specialize in Herbal Medicine. These are the only professions licensed to practice & prescribe herbal medicine in Japan today. However, there are large numbers of specialist Kampo doctors who have usually studied in the formal apprenticeship tradition & who generally practice under the license of a collaborative physician. These individuals often have far superior knowledge & training in the medicine & are sought out by patients all over Japan. It is common for a patient to seek a prescription for herbal medicine over the counter at their local pharmacy or to visit their physician for such. Equally, it is also commonplace for hospital inpatients to receive Kampo medicines in place of or alongside their orthodox medication regime.
With the sanction of the orthodox medical community, the future of Kampo in Japan & worldwide is therefore assured by the increasing interest of the public & professionals & by the quality assurance of the products & of their research-based validation, financed in large part by several of the leading pharmaceutical companies. At a time when the FDA in the USA is becoming increasingly concerned about safety & toxicity issues with regard to the raw & prepared herbal materials being imported, it is comforting to note that the prepared formula format employed by most Kampo practitioners has already passed stringent quality control testing & is accepted as safe by the relevant government agencies. The same cannot be said of all countries manufacturing and distributing prepared formulas in East Asia.
Kampo carries the trade-marks of all traditional Japanese therapeutic systems - an emphasis on palpation (primarily abdominal in the case of Kampo), a diagnostic framework based on early theories from the classics (such as the Nei Jing Su Wen and Ling Shu “Yellow Emperor’s Classic of Internal Medicine” and the Nan Jing “Classic of Difficult Questions”) focusing on 5-Phase theory, Qi, blood & fluid differentiation (which predates zang-fu theory) and the prescribing of classical formulae exclusively taken from the Shang Han Lun (“Treatise on febrile diseases caused by cold”) & its sister text the Jing Gui Yao Lue (“Prescriptions from the Golden Cabinet”), both written in the later Han Dynasty. The unique features of this classical system include:
- Prescriptions and dosages are small in comparison to modern Chinese herbal formulas (typically one third) rendering a narrow therapeutic target.
- Herbs are never re-boiled (unlike in China).
- Primarily plant material used (very few animal parts)
- Knowledge of the clinical application of the formulas is emphasized over & above detailed memorization of the materia medica.
- Formulas are prescribed for short periods (usually one week or less) prior to re-evaluation.
- Herbs are often delivered as concentrated granular extracts that can be modified.
- Diagnosis employs the SHO & Qi, blood & fluid differentiation (instead of 8-principals).
- Pulse diagnosis is derived from the Shang Han Lun, with findings related directly to specific formulas rather than channel or organ pathology, though it is considered of secondary clinical importance as compared with Abdominal and tongue findings.
- Fukushin (Abdominal diagnosis) is a unique & important hallmark of Kampo.
- Formula synergy – classical formulas are valued for their uninterrupted clinical efficacy of almost 2000 years. A major emphasis of Kampo is therefore to respect the synergy of each formula by using it according to its exact classical dimensions and proportions. Modification or subtraction is rarely, if ever, considered; rather an alternative formula may be prescribed instead.
- Formula matching – the practice of composing a formula based on the perceived individual action of each herb was not discussed in the early classical texts. Prescribing was done on the basis of “matching” a formula to a patient conformation, called the Sho in Japanese. The Sho differs from the modern TCM concept of a pathological “syndrome” in that it includes not only a collection of identifiable signs and symptoms but also pays attention to the patient’s subjective complaints, the constitution, the state of the digestive function and diagnostic specialties such as abdominal palpation (Fukushin). In Kanpo terms, each formula is therefore said to have its own unique Sho and the practitioner’s job is to successfully “match” this Sho with that of the patient. This process requires a direct application of clinical knowledge of the formulas to a deep understanding of the patient without reference to abstract theoretical constructs or theories.