Unveiling the Surge of ‘Kampo’ Medicine in Japan: A Fusion of Tradition and Innovation

  Japanese young people are also keen on “TCM” health care recently. Their “TCM” is actually called “Kampo”, but it has the same origin as traditional Chinese medicine.
  In Japan, the purchasers of Kampo medicines were originally mainly elderly people suffering from chronic diseases. In recent years, the average age of buyers of Kampo medicines has been declining year by year. Tsumura Pharmaceutical holds more than 80% of the market share of prescription Kampo medicines in Japan and is the largest Kampo pharmaceutical company in Japan. A person in charge of this company told Japanese media: “Now it has become the flagship product of over-the-counter Kampo medicine. In addition to the traditional people over 60 years old, it has also attracted new demands, especially those in their 40s.”
  In order to allow more people to accept the bitter Kampo medicine, the Japanese racked their brains and came up with many ways to take medicine. Merchants not only powder or granulate the medicinal powder, but also wrap the medicinal powder in glutinous rice paper, and even recommend consumers to take it with jelly. This is all to make this traditional treatment method more acceptable to ordinary people.
  Chinese people have mixed feelings when they see this scene. Some people follow the trend and rush to Japan to buy Kampo medicine, while others are worried about whether local Chinese medicine will be upstaged by Japanese Kampo medicine. However, Japanese pharmaceutical companies are also worried that the rising prices of Chinese medicinal materials will eventually leave them with no medicines to sell.
  Advertisements for Kampo medicines frequently appear on social media, attracting young people and foreign tourists to pharmacies to buy them. According to Japanese private surveys, the product with the fastest sales growth in 2022 will be “Ophiomendon Soup” for dry cough and bronchitis.
  Other popular Kampo medicines mostly target symptoms that Western medicine cannot take care of, such as edema, dizziness, hangover, shoulder pain, etc. No matter what difficult or complicated disease you have, you can almost always find a corresponding Kampo medicine.
  In recent years, many people have experienced physical disorders such as fatigue and headaches due to adverse changes. These symptoms are difficult to describe, and the Japanese collectively refer to them as “weather sickness.” In the eyes of Western medicine, this may not be considered a disease that needs treatment at all, but it is a kind of torture when it falls on the patient. More and more people are starting to buy “Wuling Powder” for meteorological diseases.
  In fact, the Japanese people’s demand for Kampo medicine has increased significantly in recent years. A representative of a large Japanese pharmaceutical company said that since the COVID-19 epidemic, more and more families have begun to stock Kampo medicines to regulate their bodies. Many people use Kampo medicines to treat chronic diseases, and a few days’ worth of medicine can no longer meet the demand. Merchants must be able to provide large-capacity products that last for 10 to 20 days.
  In just five years, the market size of Kampo medicine has gradually expanded. According to data from a Japanese market research company, total sales of non-prescription Kampo physical stores in Japan in 2022 will be 63.8 billion yen (approximately RMB 3.176 billion), an increase of 16.6% compared with 2017. Sales on the Internet doubled directly to 11.6 billion yen (approximately RMB 577 million).

  Chinese salted egg yolk, Chinese taro paste, Chinese coffee, Chinese milk tea, etc., any delicacy can be prepared with Chinese medicine.

  The increase in demand has stimulated an increase in the price of Kampo medicines. From 2017 to 2022, the average unit price of over-the-counter Kampo medicines increased by nearly 13.7% in these five years, from 1,488 yen to 1,692 yen. In the e-commerce field, this number increased by 17%, from 1,950 yen to 2,281 yen.
  It is important to note that Kampo prescription drugs, like any other prescription drugs, cannot be purchased by anyone unless approved by a doctor. The “Kampo medicines” bought in Japanese drug stores contain lower amounts of active ingredients and have slower effects than prescription medicines. Even if they are regarded as placebos, it is not an exaggeration at all.
  The loss in efficacy will not affect people’s enthusiasm for purchasing. Chinese medicine focuses on recuperating the body, that is, improving the body’s balance as a whole. Consumers believe that as long as the product is related to Chinese medicine, it will have some health-preserving effects. Japanese merchants will even put medicinal materials into food or drinks, such as Chinese salted egg yolk, Chinese taro paste, Chinese coffee, Chinese milk tea, etc. Any delicacy can be made with Chinese medicine.
  Since the 1990s, Japan has become popular about the “homology of medicine and food”, which is the “homology of food and medicine” in traditional Chinese medicine. The original meaning is that there is no clear boundary between medicine and food. Many medicinal materials are originally food, but this concept is not a claim of the medical community in Japan, but a commercial gimmick. Businesses add medicinal materials to food to attract consumers who believe in health preservation. This has completely deviated from the original intention of “medicine and food come from the same source”.
  In February this year, the “Watashi Kampo” company also sold chocolate containing Kampo ingredients online for a limited time. This company’s approach to selling chocolate is like prescribing medicine. Consumers must first answer their physical conditions and common symptoms on a dedicated website, and then the merchant will recommend products suitable for the consumer’s constitution, “chocolate for the right condition.” There are 5 types of chocolate products, with Chinese ingredients such as jujube, hawthorn, and ginger added. There are 9 questions that consumers need to answer, including “How much mental stress do you feel”, “How much pain in your shoulders and neck” and so on. “Watashi Kampo” mainly operates e-commerce business, and its service group is mainly women in their 30s and 40s, with a registered number of about 100,000.
  However, adding medicinal materials to chocolate is not the company’s original invention. Three years ago, “Kisaeng”, a Japanese company that deals in Kampo medicines, launched a “flavor choco” chocolate, which was made of “flavor powder” prepared by adding 10 kinds of herbs (including five-spice powder).
  Of course, these merchants dare not overly promote the curative effects of chocolate, but they all believe that their products can “lower the threshold for young people to access high-end Kampo medicinal materials.”
Kampo medicine between China and the West

  The biggest difference between Japanese Kampo and traditional Chinese medicine is its reliance on patent medicines. Traditional Chinese medicine emphasizes first looking, smelling, asking, and prescribing the right medicine. According to each patient’s condition, the type, dosage, and even the way of taking the medicine need to be adjusted. But in the world of Kampo, once a prescription is formed, it almost never changes. When a patient has a certain disease, the doctor prescribes ready-made medicines, and there is absolutely no room for increase or decrease in the variety and dosage.
  Many prescriptions have already been formulated during the planting stage. The medicinal materials in the same prescription may even be planted in the same field. For example, peony and licorice are planted together, and after picking, you will get a peony and licorice soup—this is in line with the Japanese national spirit of conformity.
  Japanese Kampo prescriptions have remained unchanged for a long time, which is actually the result of compromising with Western medical ideas. Before the 15th century, Japan relied on the exchanges of Buddhist monks to learn and absorb Chinese medical knowledge. Most physicians were Buddhist monks who followed the prescriptions, theories, and practices introduced by Tang Dynasty envoys. From the 15th to the 16th century, Japanese doctors began to have their own views on traditional Chinese medicine. The abdominal diagnostic method developed by Ji Yidongdong, a representative of the “Ancient Medicine School”, was considered to be a sign that Japanese traditional medicine was independent of traditional Chinese medicine.

  The prescriptions of Japanese Kampo have remained unchanged for a long time, which is actually the result of compromising with Western medical ideas.

  However, after the Meiji Restoration, Japanese traditional medicine declined rapidly, and the new government decided to modernize medical education based on the German medical system. It was not until the early 20th century that some medical school graduates who had received training in Western medicine began to restore traditional medicine. They used Western medical discoveries to interpret ancient Chinese medicine books.
  Modern Japanese “Kampo medicine” holds a “waste medicine to test medicine” attitude towards the traditional medicine introduced from China, that is, it abolishes the Yin-Yang, Five Elements and Bagua thinking that cannot be scientifically verified, and adopts Those standardized and scientific prescriptions and other medical technologies.
  From 1972 to 1974, Japan’s former Ministry of Health and Welfare issued internal regulations on the review and approval of Kampo medicines four times, which became the standard for general Kampo prescriptions. In 2010, the Ministry of Health, Labor and Welfare issued a communiqué stating that starting from that year, a reference model will be established between patients’ constitution, symptoms and treatment effects to find scientific basis for the use of Kampo medicines.
  For example, “Wuling San” comes from Zhang Zhongjing’s “Treatise on Febrile Diseases”. The practice of traditional medicine for hundreds of years has already verified the effectiveness of “Wuling San”. However, the Japanese medical community does not accept the theory of traditional Chinese medicine. They try to use a more “scientific” way to verify the efficacy. At the 2021 Annual Meeting of the Japanese Pharmacological Society, a Kumamoto University scholar pointed out that when atmospheric pressure drops, cerebral blood flow increases, causing headaches. “Wuling Powder” can help patients inhibit the increase in cerebral blood flow caused by the drop in air pressure. This serious “scientific attitude” is admirable but also makes people laugh.
  However, Kampo medicine was not initially covered by the National Health Insurance that was implemented in 1961. Since 1967, different types of Kampo medicines have gradually been included in medical insurance. Now, a total of 148 kinds of patent medicines and 200 kinds of medicinal materials can be covered by medical insurance. Japanese doctors have no room for free “dialectics” when prescribing Kampo medicines. These doctors have actually received Western medicine education. They diagnose diseases in a strict way and can only prescribe medicines from these 148 kinds of patent medicines and 200 kinds of medicinal materials.

Is Kampo medicine on the rise?

  Japanese Kampo medicine is developed on the basis of traditional Chinese medicine, but it often gives people the feeling of catching up from behind. Every holiday, a large number of Chinese tourists flock to Japanese drugstores just to stock up on Kampo medicines. However, the ingredients of these Kampo medicines are similar to those of traditional Chinese medicines.
  In April this year, Japan’s Tsumura announced that it would acquire Shaanxi Ziguang Chenji Pharmaceutical for 250 million yuan, giving the Chinese people a sense of crisis. There are rumors that the Japanese took the essence of our ancestors and used cheap medicinal materials from China to process Kampo medicine, but they have monopolized the world’s traditional Chinese medicine market, accounting for 90% of the world’s traditional Chinese medicine market. Others claimed on social media that Japan had applied for a patent on “Treatise on Febrile Diseases”, but these sensational data and news were actually fabricated.
  In fact, the target sales market of Kampo medicine is mainly in Japan. It is rarely exported and its share in the international market is not high. Tsumura is the largest Kampo pharmaceutical company in Japan, and its market share of Kampo preparations in Japan has exceeded 80% all year round. According to the company’s annual report, its revenue in 2022 will be approximately 140 billion yen (approximately RMB 7.3 billion). Among them, the Japanese domestic market revenue is approximately 125 billion yen (approximately RMB 6.5 billion), and the Chinese market is approximately 15.3 billion yen (approximately RMB 800 million).
  Data shows that this year, the revenue of Yunnan Baiyao and Pien Tze Huang, two representative traditional Chinese medicine companies in my country, was close to five times that of the Japanese national market.
  In addition, as early as 2019, some scholars pointed out that classic prescriptions derived from traditional Chinese medicine classics belong to the category of “existing technology” in the patent law and cannot obtain patent authorization in Japan.
  Although these rumors can be proved to be false, they cannot eliminate the anxiety of some Chinese people about the survival of traditional Chinese medicine. But in fact, the Japanese also have a sense of worry about the development of Kampo. Every few years, Japanese news will report news like “Japanese Kampo pharmaceutical companies want to expand the localization of medicinal materials and reduce their dependence on China.” This is because China is the largest source of raw materials for Japanese Kampo pharmaceutical companies. Among the thousands of tons of Chinese medicinal materials purchased by Tsumura every year, 80% are produced in China and only 15% are produced in Japan.
  In recent years, pharmaceutical companies like Tsumura have begun to gradually expand the scale of purchasing Chinese herbal medicines in the country. There are not many farmers in Japan with experience in growing Chinese herbal medicines. These companies need to visit the planting areas multiple times every year to teach local farmers cultivation methods or rent agricultural machinery and processing equipment. Such efforts are thankless, but for pharmaceutical companies, they are a last resort.
  Fujii Ryuta, the president of the time-honored Japanese brand Ryukakusan, once gave the Japanese media a high-sounding reason. He said: “If Chinese medicinal materials can also be purchased in Japan, we can vigorously promote ‘Made in Japan'” ‘.”
  But the more pressing reason is that Japanese companies are worried that China’s supply of Chinese medicinal materials exceeds demand. Due to economic stagnation in Japan, it is difficult for prices to rise. However, in China, where the economy is developing rapidly, prices are rising faster than in Japan, and Chinese medicinal materials are no exception. Japanese companies are worried that in order to curb the rise in prices of traditional Chinese medicine raw materials, the Chinese government may restrict exports.
  From this point of view, Japan’s Kampo medicine may be further away from being able to promote “Made in Japan” than imagined.

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