Papers & Research

The project continues organizing research on MLMN and the systematization of Japanese Kampo abdominal diagnosis into scholarly papers for external research communities. Papers are part of the process, currently at the stage of selecting publication venues and reconsidering paper structure . This page publishes the early paper in full as formation-history material and identifies what has been retained and revised.

Research languages: English ／ 简体中文 ／ 繁體中文

Publishing the Early Paper in Full as a Starting Point for Development

To make MLMN's origins and later changes open to criticism, the PDF is published without altering the original, including its opening production note. It is not a final, reviewed, or authoritative current version. Claims such as complete definition and established reflect the time of writing and are now being examined through sources and clinical records. AI extraction counts are provisional and may change with base editions, OCR accuracy, work boundaries, and image comparison.

The Paper's Central Proposition

The research seeks to reposition the systematization of Japanese Kampo abdominal diagnosis within the long history of East Asian medicine. Its central proposition is:

The systematization of abdominal diagnosis in the Japanese Koho school can be understood as a connection, across two millennia, between the deductive structure of classical Chinese medicine and the inductive achievements of Japanese empiricism. — Central proposition (translated from Japanese)

The systematization of abdominal diagnosis in the Japanese Kōhō school can be understood as a convergence, across two millennia, between the deductive structure of classical Chinese medicine and the inductive achievements of Japanese empirical practice. — Central thesis (English)

This position understands abdominal diagnosis not merely as a Japanese peculiarity, but as a long historical connection between Chinese classical theoretical structures and Edo Koho empirical methodology. MLMN attempts to describe this connection in a multilayer framework.

Clinical Starting Point: The “Two-Thousand-Year Problem of East Asian Medicine”

Ishihara's two-thousand-year problem arose from about 30 years of practice: even sophisticated classical theory can leave the relationship between a patient's history, responses, course, and specific treatment choice unclear. Some Japanese Koho and early modern clinical works concretely preserve physique, abdomen, life, medication changes, failures, and recovery sequences, revealing the patient and how treatment proceeded in depth.

Ishihara considers that the difference should be examined not as ethnic or systemic superiority, but asdifferences in original textual forms, density of retained clinical information, and presentation of treatment reasoning. Asking where Chinese deductive systems connected with Japanese accumulated inductive observation led through Todo's toxin theory and Kontai's Igaku Keigo and Kokun Iden toward MLMN.

How Does Japanese Koho Medicine Differ from Chinese Medicine?

The term Koho and its background may not be shared knowledge even among current acupuncturists and Kampo physicians. A brief explanation of the relationship helps contextualize MLMN's research history.

Japanese Kampo originated in Chinese medicine and developed through Japanese history and practice while inheriting its classics, medicinals, and formulas. In the Edo period, several physicians returned to classics such as Shanghan Lun in response to later-formula schools influenced by Jin–Yuan and Ming theory; they were later called Koho or ancient-formula medicine. Todo particularly emphasized concrete presentations and their prescription correspondence over conceptual explanation and developed distinctive views of formula–pattern correspondence and toxin.

This is not a simple opposition between theoretical China and purely experiential Japan. Koho medicine also relied on Chinese classics, reorganizing their reading and application. Goto Konzan, Kagawa Shuan, Yamawaki Toyo, Todo, Nangai, and their disciples and critics did not share one view. Japanese developments include abdominal emphasis, symptom–formula correspondence, and approaching pathology as something concrete, but common ground and individual innovations require comparison of original works and mutual criticism.

For the formation and distinctions of classical Chinese medicine, modern TCM, and Japanese Kampo, see the separate pageClassical Chinese Medicine, TCM, and Japanese Kampofor a fuller discussion.

References: Hiromichi Yasui,The Development of Japanese Kampo Schools(Japanese Journal of Oriental Medicine, 58(2), 2007); Masami Tateno,Yoshimasu Todo's Medical Thought in Comparison with Ancient Chinese Medical Thought(Japanese Journal of Oriental Medicine, 63(1), 2012).

How Dr. Hoshino's Comments Inform MLMN

In August 2026,Dr. Takayuki Hoshino, Director of the Kampo and Acupuncture Center at Kitasato University Kitasato Institute Hospital,reviewed the MLMN pages and offered valuable clinical and medical-historical comments. Explicit permission was obtained to introduce, quote, and summarize the emails on this site.

Following the three full emails above, the following presents Wisdom Terra's organization and intended implications for MLMN.

Dr. Hoshino's Observations

His experience of standardization at Kitasato showed how each practitioner's convictions affect preferred findings, interpretation, and treatment, making later alignment difficult. MLMN therefore aims not to erase differences but to preservepatients' own words, observed findings, practitioner interpretations, selected treatments, and subsequent changesseparately, allowing the judgment pathway to be retraced.

He also explained Yasuo Otsuka's emphasis on recording patients' actual words and Koho attempts to approach pathology through concrete symptoms rather than speculation. Rather than retrospectively inferring a state from the prescription name, records must show what was observed before treatment, why treatment was chosen, and what changed afterward.

Even patients judged to have the same symptoms or pattern differ in what appeared first, what was added later, and what treatment changed. Without sequence and time, the formation process cannot be adequately examined.

Nangai's views were not necessarily constant through life. We were advised to study not only his works but also his relationships with Todo, disciples, and contemporaries engaged in criticism.

Wisdom Terra's Interpretation

We understand this as a research obligation not to force patients into one easily understood theory, but to preserve actual changes with as little interpretive processing as possible.

Newly Recognized Scope and Limits of the Early Paper

The early paper states that 1,580 propositions were extracted from Kontai's Keihen and Ihen. The part describing two centuries of Japanese Koho medicine, however, mainly used 13 propositions from Sohaku's Sentetsu Iwa. Although that work is important for transmitting several physicians' views, excerpts from one text do not cover original works, changes of doctrine, transmission to disciples, or all criticism and replies.

Following Hoshino's comments, we recognized that Kontai's distinctiveness cannot represent the entire Koho school and that 13 propositions cannot establish two centuries of inductive completion. The historical connection in the early paper is now treated as a research hypothesis requiring verification.

Future comparison includes major works of Konzan, Shuan, Toyo, Todo, Nangai, and Kontai, alongside disciples, critics, and interlocutors such as Murai Kinzan and Nakagawa Shutei. Each source is distinguished by image verification, OCR-only status, dating certainty, and later quotation. Agreements and differences will inform MLMN. We revise while publishing scope and unchecked materials, rather than declaring all research complete in advance.

How This Informs MLMN

• Record what happened first and what was added later.
• Trace what changed and what remained before and after treatment.
• Separate classical content from later physicians' interpretation.
• Separate Ishihara's clinical thinking from MLMN reconstruction.
• Examine the broader Koho debate, not only one physician.

Specialist Notes

The sequence of principal and secondary presentations in Shanghan Lun may relate to the order around er and involve a time difference. Nangai developed qi/blood/water classification with location, but early and later descriptions change; many works are undated or circulated as manuscripts. We were advised to examine relative dating through changes in content.

Clues include movement from common Shanghan Lun readings to Nangai's own, and increasingly distinctive explanations of medicinals. Whether disciples and opponents accurately shared his final conclusions remains unclear.

We were also advised not to isolate Nangai, but to situate him within Koho debates involving Murai Kinzan, Nakagawa Shutei, criticism of Todo and replies, and Kazuo Nishioka's research.

Hoshino suggested that Koho physicians practicing today might be strongly interested in biological agents or molecularly targeted therapies approaching actual mechanisms. This is not a historical factual claim, but an invitation to see them as seeking concrete realities within available knowledge, medicinals, and formulas, rather than as a fixed traditional theory. Even their limited prescriptions show difficulty fitting qi/blood/water and location coherently, illustrating limits to a simple classification universally applied in the same way.

MLMN therefore records physicians, composition periods, and interpretive changes rather than fixing qi/blood/water or location as timeless categories. It retains what appeared first, what followed, and post-treatment changes through L9 and continuing records.

Current Submission Status

The paper has been submitted to two scholarly journals. In both cases, editorial decisions resulted in return of the manuscript without publication . The project understands the reasons as including journal-scope fit rather than necessarily rejection of the scholarly content itself. It does not equate return with refutation of the content.

Post-return review of Paper Recovery materials in Google Drive confirmed separation of early candidates, Japanese completion series, English versions, EAST submissions, and CMC submissions/returns. The CMC manuscript, cover letter, title page, and submission PDF are treated as one review unit, with return reasons recorded as venue fit rather than rejection of the text.

Restructuring the Paper

The current paper attempts to combine medical history, theoretical argument, and implementation/application. After the returns, the project is considering division into three strands where appropriate.

The three-way split is a working hypothesis, not a settled policy. The aim is to retain the central proposition while giving each paper an independent argument and mutual references.

Considering New Venues

Suitable venues are being considered for each strand, seeking editorial policies consistent with the central proposition. Venue selection proceeds alongside finalizing structure.

Preparing Related Research Materials

Prior research and references continue to be organized as the writing foundation. Candidate literature has been indexed; ten high-priority print candidates have been converted to PDF in Paper Recovery. This supports the literature review and access to historical research on Japanese Kampo and Koho medicine.

Free Research and Reference Essays

The early paper is public in full as formation-history material, versioned separately from future submissions. Background ideas, sources, and the place of classical works are also organized as free pages.

This makes differences between the early original and current theory open to examination. Detailed layer definitions, transcriptions, Japanese readings, modern translations, and abdominal databases are released according to collation, rights, and verification status.

Research Process

The project has proceeded through verification sessions, reconsidering structure through continued Chinese/Japanese source comparison and reorganizing into current L0–L9 in August 2026. Ministerial fire was removed as a layer but retained as a sourced mechanism connecting layers. Session records are held as internal working materials.

Handling Manuscripts

The May 16, 2026 candidate is public in full as unreviewed material for examining MLMN's formation. Future reconstructed submission manuscripts are managed as separate versions without overwriting it. Each version's claims, sources, verification, and differences from current theory are explicit.