Presentation summary

Background :
Japan’s healthcare system uniquely integrates Kampo medicine with national insurance coverage. Keiho theory—established by Dr. Yoichiro Ebe—presents a systematic model of qi circulation,offering diagnostic clarity in cases where conventional Kampo and biomedical approaches prove inadequate.

Case Presentation :
A 58-year-old female presented with “sensation of knee collapse with dizziness” beginning in March 2023 and worsening to five episodes per hour by June. Despite Western evaluations (orthostatictests, neurological exams, blood tests, ECG, X-ray), no diagnosis was established. Examination showed thinbuild, posterior leg coldness, sunken pulse at chi positions, indicating kidney dysfunction, pale tongue with thincoating, reduced lower abdominal resistance.

Intervention :
Western approaches failed. Using Keiho theory’s concept of posterior defensive qi deficiency, maobushisaishinto extract (2.5g daily) was prescribed to enhance kidney qi.

Results :
At three weeks: symptoms only when standing. At six weeks: complete resolution, treatment discontinued.
Discussion: This case demonstrates integrating Keiho theory when conventional diagnostics reach limitations. Keiho theory focuses on qi circulation patterns crucial for prescription selection and pathological understanding. Defensive qi includes four pathways: 1) Anterior: lung-chest-heart to anterior surface, 2)Posterior: kidney-diaphragm to back skin, 3) Extravascular qi: parallel to vessels, 4) Skin qi: dermal defensive circulation. The patient’s posterior leg coldness and sunken chi pulse indicated posterior pathway dysfunction, specifically kidney qi deficiency. This guided selection of maobushisaishinto targeting Shaoyin disease withgastric-kidney qi deficiency.

Conclusion :
This case illustrates clinical utility of Keiho theory in resolving challenging conditions, highlighting how traditional knowledge complements conventional approaches in integrated healthcare.