Significant materials and books in history of medicinal plants and medicine .
Historically, the Japanese began to use aromatic and medicinal plants for ritual activities, food flavor, and treatment of their bodies. The exotic plants, new ideas, and culture associated with medicinal and aromatic plants were introduced to Japan from other countries, primarily via Korea. In this way, experience and knowledge of uses were accumulated, and applications of aromatic and medicinal plants were expanded. The oldest Japanese medicine “Wa ho” leads the way to folk medicine today, and traditional Japanese medicine (Kampo) has spread into modern use. The elegance tradition of “Kodo,” an incense ceremony of Japan, was developed because of the use of aromatic incensed wood in sixteenth century as recreation. Paired along with this ceremony is the Japanese sa-do tea ceremony that the spirituality and esthetic sense are inherited to Japanese today. Japanese green tea is becoming popular in many countries due to the constituent, catechins, that medically treats vascular disease, several cancers, and type II diabetes. Today, the Japanese medical system has new direction, integrating medicine with the adoption of modern western and alternative medicine. Scientific data must continue to be collected for interactions between the two medicinal systems for integrative medicine to be ideal for body, mind, and spirit of humans and nature.
- Kampo (traditional Japanese medicine)
- green tea
- integrative medicine
- body and spirit
Aromatic and medicinal plants fill a significant role in human societies that have helped improve the lives of people since ancient times. Ancient people became aware of the value and attractiveness of aromatic and medicinal plants, and the significance of historical books is a guide for the use of the plant material (Table 1) . Initial books on use on medicinal and aromatic plants were sourced in various parts of the world, such as the Middle East, Greece, China, and India, indicating that these ancient civilizations used indigenous aromatic and medicinal plants to improve lives in their own separate ways before ideas were shared. Japan is no exception; names of some local aromatic and medicinal plants were recorded in the oldest Japanese history book “Kojiki” written in 712 A.D. Aromatic and medicinal plants, however, continue to influence human life, culture, and history. Currently, an estimated 70,000 plant species are used in traditional medicine .
|Timeline||Book and author||Book about||Country|
|~500–300 BC||Formalized medicine practices in diagnosis and treatments; list of medicinal plants and application||Greek|
|~150–100 BC||Huangdi Neijing (author unknown)||Theoretical foundation of Chinese medicine, diagnostic methods, and acupuncture||China|
|~100 BC-100 AC||Celsus wrote ||Alexandrian medicine; pharmacopoeia of herbs and the medicines||Greek|
|~200–300 AC||Agriculture and medicinal plants; 113 herbal prescriptions and six stages of disease||China|
|~750–800 AC||Lu Yu wrote ||Tea tree, making tea, and tea ceremony||China|
|~800–1000 AC||Avicenna writes ||Clinical trials on medicines; Encyclopedia of medical practices; Scientific and medicinal properties of various plants; Medical encyclopedia||Arabic countries and Germany|
|~1000–1500 AC||Ibn al-Baitar wrote ||Pharmacopoeia listing 1400 plants||Arabic countries|
|~1500–1600 AC||John Gerard wrote ||Heavily illustrated of 1000 plants||England|
|~1900–2000 AC||René-Maurice Gattefossé wrote ||Aroma and essential oil for Medicine||France|
In Japan, most aromatic and medicinal plants have been used in the crude drug system, Kampo, the traditional Japanese medicine system, and in herbal tea as alternative or complemental medicines. The production value of Kampo was $1.38 billion, accounting for only two percent of all Japanese pharmaceuticals in 2011 , and although a total of 83.5% of 684 medical doctors were using Kampo for their prescriptions, according to web survey by the Japan Kampo Medicines Manufacturers Association (JKMA) in 2008 , the market for Kampo medicines increased by 23% over 5 years (2007–2011). In 2008, the usage of crude medicine for Kampo was 20,000 metric tons, of which a total of 83 percent was imported from China . Almost 250 kinds of crude (not processed) medicines are used as Kampo materials in 2008, and the top 20 are listed as example (Table 2) .
|Ranking||Common name||Spices||Family||Parts used||usage (kg)|
|2||Chinese Peony||Paeonia lactiflora||Paeoniaceae||Root||1,164,126|
|4||Indian bread, tuckahoe||Poria cocos||Polyporaceae||Fungus||996,311|
|7||Oriental Ginseng||Panax ginseng||Araliaceae||Root||610,092|
|8||Angelica acutiloba||Angelica acutiloba||Apiaceae||Root||580,607|
|10||glutinous starch syrup||Oryza sativa||Gramineae||Seed||555,718|
|11||Kudzu vine, Japanese arrowroot||Pueraria lobata||Papilionaceae||Root||553,999|
|12||Atractylodes lancea||Atractylodes lancea||Asteraceae||Rhizome||501,647|
|13||Job’s Tears||Coix lacryma-jobi||Gramineae||Seed||449,253|
|14||Sickle Hare’s Ear||Bupleurum falcatum||Umbelliferae||Root||443,811|
|17||Alexandrian Senna||Senna alexandrina||Caesalpiniaceae||Leaves, pods||426,230|
|18||Chinese foxglove||Rehmannia glutinosa||Scrophulariaceae||Root||397,512|
|19||Baikal skullcap||Scutellaria baicalensis||Labiatae||Root||383,969|
2. Introduction and opening: medical systems and recreations
Several of the plants were discovered to have medicinal effects and were spread throughout the world along with traditional medicines, and some of were being as indigenous. At first, traditional medicines were introduced to Japan from China via Korea from the seventh to ninth centuries which is called traditional Chinese medicine (TCM). Before TCM was introduced to Japan, an older medicine called “Wa ho” existed. As TCM started flourishing, Wa ho declined and will likely remain as a folk medicine. TCM influenced traditional Japanese medicine (TJM) known as Kampo, in terms of fundamental principle and diagnosis, such as Yin-Yang (two opposites form the whole), Qi (life energy), and the Five Elements (interactions and relationships). Many ancient thin wooden strips which were excavated from a 7th century ruin recorded Chinese medicinal plant names that indicated their use as medicines In 756, a total of 60 crude medicines, for example, pepper, cinnamon, licorice, rhubarb, betel nut palm, and croton, were contributed to Shosoin, where the treasure house that belongs to Todai-ji, Nara, and 38 of them remained (Figure 1). At Shosoin, seven scent bags, included Borneo camphor, musk, and other fragrances from China also remained.
In 894, Japanese missions to Tang China were abolished by the imperial court of Japan, and the exchange of crude medicines, TCM, and culture was stopped. Thereby, medicine in Japan was developed uniquely until Sanki Tashiro (1465–1537) introduced Chinese medicine in 1498. Dosan Manase (1507–1594), Tashiro’s apprentice, encouraged the more formal Chinese medicine, known as “gosei-ho,” while Geni Nagoya (1625–1694), Gonzan Goto (1659–1733), Toyo Yamawaki (1705–1762), and Todo Yoshimasu (1702–1773) regarded “ko-ho” in which medicine should be clinical and adopted “
According to “
In the late Muromachi period during the sixteenth century, samurai started to pursue a holistic approach, including the senses, human spirit, and nature. This new approach was the start of “
3. Conventional and modern uses: spirit and daily life
In the Edo era, Kampo was a medicine for wealthy people only as Kampo doctors visited a home by basket palanquin (a litter for one passenger) and treated patients using expensive Kampo materials. Therefore, the common people had to use Japanese folk medicines developed in earlier times. Such folk medicines exist today, but are not as popular as compared with modern western medicines and Kampo. Folk medicine, however, is an important cultural heritage that the Japanese ancestors left to future generations, including recipes of folk medicines, remedies for home use (Table 3). Some manufactured folk medicines are sold at pharmacy as quasi-drugs such as medicinal teas, cosmetics, medicinal bath, and supplements (Figure 4a).
|Japanese and common name||Scientific name||Medicinal effects||Uses||Part used|
|Hechima, Luffa||Heat rash, chapped skin, sunburn||Cosmetic||Water from fruit|
|Yomogi, Japanese mugwort||Dry skin, acne||Cosmetic||Leaf|
|Biwa, Loquat leaf||Heat rash, eczema, insect bite, rash||Cosmetic||Leaf|
|Shiso, Perilla herb||Eczema, acne, oily skin||Cosmetic||Leaf|
|Obako, Plantago seed||Water metabolism, poor visibility, phlegm||Tea||Seed|
|Gobo, Burdock fruit||Heat diffusion, inflammation, promote eruption||Tea||Fruit|
|Dokudami, Houttuynia herb||Laxative, diuretic||Tea||Upper ground (flowering time)|
|Senna, Senna leaf||Laxative||Tea||Leaf|
|Kuko, Lycium fruit||Weak constitution, fatigue, cold hands and feet, insomnia||Liquor||Fruit|
|Toki, Japanese angelica root||Tonic, circulatory disorder, analgesic, sedative, compensate blood||Bath||Root|
|Senkyu, Cnidium Rhizome||Anemia, cold hands and feet, menstrual irregularity||Bath||Rhizome|
|Kamitsure, German Chamomile||Inflammation, sedative, calm spasm, excrete gas||Bath||Flower|
|Syobu, Calamus||Backache, neuralgia||Bath||Root, leaf|
|Yuzu, Yuzu||Circulation improvement, cold prevention, backache, neuralgia||Bath||Fruit|
The latest Japanese Pharmacopoeia (No. 17 issued 2016) included 324 crude medicines for Kampo . Usually, Kampo medicines are a mix of several kinds of crude medicine, and each prescription has a name. Recently, many medical doctors prescribe Kampo medicines because of an increase in patients who prefer crude medicine rather than synthetic medicine. Patients can get Kampo medicines easily even without prescription (Figure 4b).
Aromatic and medicinal plants have spread broadly into Japanese spirit and daily life. The tea and aroma activities were simply an amusement for people until the Muromachi period that was started before the Japanese “sa-do” (tea ceremony) and “ko-do.” At the end of the Muromachi period, Buddhist monks reformed the philosophy of tea to express conjointly with ethics and religion, changing the societal view about man and nature . This innovative philosophy reflects the esthetics and world view of Japanese, for example, “wabi” and “sabi.” Wabi expresses an esthetic of beauty of deficiency, in other words, senses which try to find sufficiency of mind from humble and deficiency. Sabi is beauty which could feel profoundness and richness inside of tranquility naturally. Subsequently,
In Japan, Buddhists worship ancestors with incense sticks as one of the traditional manners in appreciating all generations of family in daily life. The incense sticks are made from mixed lots of materials, including charcoals, incensed woods, crude medicines, and fragrances. Such incense sticks are used mostly in homes and temples (Figure 6).
4. Representative plant: Japanese green tea
Tea is the second consumed drink in the world after water. Tea is called by different names in different countries or areas. The origins, however, were split into two generally, “cha or chai” and “te or tea” depending the proximity to either China or Europe, respectively . Almost all teas such as green, white, oolong, black, and pu’erh except maté and rooibos are made from
As well-known, drinking tea was introduced from China by a Japanese Buddhist monk in seventh to eighth century. The manner became common among aristocrats and monks in ninth century at the time, and tea was hardened tea leaves like ball named “
The most famous tea production area is Sizuoka prefecture, where tea is exposed to a strong wind and rain and cultivated on the hillside or riverside where other crops could not survive (Figure 7). The different quality of soil produces a different color and quality of tea leaf (Figure 7). In 2015, the total area of picked green tea was 35,600 ha, a one percent decline The yield of fresh leaf, 357,800 metric tons in 2015, declined by four percent from the previous year in Japan . According to survey, more than 82% Japanese drink green tea every day . In Japan, green tea is drunk in the morning after waking, after or during every meal, for break in the afternoon, to show hospitality whenever guests visit. Usually, Japanese enjoy many kinds of flavors and tastes, for example, “
Processing green tea is delicate and has several significant steps that require specialized skills. After the leaves are picked from the tree, a total of eight work sequences are necessary for ready to drink tea (Table 5).
|Name of task||Action||Time (min)||Water contents (%)|
|Sassei (steam)||Fresh leaves are steamed at 100°C, and oxidation is stopped||0.5–1||100|
|Reikyaku (cool down)||Wait until room temperature and some water is removed from leaf surface||5||–|
|Sojyu (first hand-rolling)||Wield leaves and some mass of leaves come up by light hand-rolling at 35°C||60||40|
|Jyunen (second hand-rolling)||Push and make a mass bigger by knead hand-rolling and remove some water from inside of leaf at 100°C||20||–|
|Chujyu (third hand-rolling)||Loosen a mass up and twist leaf by hand-rolling at 95°C||30||30|
|Seijyu (forth hand-rolling)||Shape like needle and polish by hand-rolling at 85°C||60||10|
|Kansou (dry)||Dry at 65°C||120||5|
|Shiage (finishing)||Removed leaf powder and piece of stem with some heat for dry||–||4|
Manufacturing Japanese green tea takes more than 5 h with much labor if all sequences are done by hand. Recently, most of the processing steps have become automated. Hand making tea, however, is still practiced by some processors as the hand-rolling technique is a cultural heritage (Figure 8a–e).
Recently, a number of scientific studies have suggested that green tea has medicinal effects, reducing high cholesterol and treating cancer, diabetes, and liver disease . In the natural elements and nutrients in Japanese green teas, the most consumed
|Vitamin A (μg)||21,000||13,000||6,700||29,000|
Most convenience stores and supermarkets in Japan sell many kinds of bottled green tea. Some brands put a mark “food for specified health uses” indicating healthy effects, such as cholesterol reduction or gentle rising of blood sugar after meals, and have received approval for special marking from the Consumer Affairs Agency (Figure 10) . These types of foods are used for sustaining health and preventing pre-symptomatic disease.
5.1. Integrative medicine
Integrative medicine is a person-centered care system that uses both modern western medicine, to take advantage of pharmaceuticals, operations, radiology, and other complementary and alternative medicines have become popular among advanced countries to change the structure of disease control. Many complementary and alternative medicine systems exist. Phytotherapy has been actively adapted into integrative medicine in United States because herbs and the origin of several pharmaceuticals and the accumulated scientific evidence are comprehended easily. For example, Dr. Andrew Weil of University of Arizona, a leading figure of integrative medicine, is an herbalist and prescribes medicinal plants for treatment .
Aromatherapy was introduced to Japan from the UK in 1985, and became popular as a relaxation technique. Subsequently, aromatherapy has become better known by medical professionals and researchers. This activity advanced clinical application in psychosomatic medicine, obstetrics and gynecology, and palliative care coupled with the spread of integrative medicine. In 2008, the Japanese Society of Integrative Medicine was established, a project team of integrative medicine in Ministry of Health, Labor, and Welfare was launched in 2010, and the Japanese Society of Phytotherapy was established in 2012 for study of medicinal herbs.
Although still controversial, functional mechanisms of complementary and alternative medicines are thought to have the improved the spontaneous healing power of humans. Currently, this understanding is compatible with oriental thought in a regimen and a balanced diet lead to a healthy body. Accumulation of scientific evidence, culture, and history exists behind the rapid spread of aromatherapy and medicinal herbs in Japan. The next generation of integrative medicine that creates inclusive correlation between body, mind, spirituality, natural environment, and local community can be expected to help those suffering from aging and improve the health of a maturing society.
5.2. Dietary supplements
In recent years, diffusion of dietary supplements is remarkably increasing worldwide, and the trend to use natural substances in healthcare and wellness will continue to rapidly expand dietary supplement markets. In one of the highest dietary supplement consuming countries, 53% of the adults in the United States used at least one dietary supplement each day in 2003–2006 . This number was more than two times that of Japan , and comes from different systems of health insurance. To enter health insurance is not necessary for USA citizens have a relatively expensive medical care system, making individuals concerned about their health and wellness. In contrast, Japan citizens are basically mandated to enter a health insurance. According to various reports, some consumers in Japan have the wrong knowledge about dietary supplements. For example, an inappropriate meal is no problem if you take dietary supplements . Nevertheless, the Japanese market of dietary supplement keeps growing rapidly, and the prospect of dietary supplement in Japan will continue to shift more to prevent disease and maintain health and wellness.
Medicinal and aromatic plants help people remain healthy and have influenced culture, nature, and history of humans from ancient times. Further study of medicinal and aromatic plants may discover new constituents that become future medicines. In future research, more clinical trial and interaction between medicinal plants and pharmaceuticals need to be examined and useful information shared throughout the world. The important thing is to appreciate the blessings of nature and sustain all of genetic resources. Today, the society of severe aging and maturity needs to shift from animalistic world view, such as the stronger prey upon the weaker in a high-growth period, to a cooperative vegetative world view with the key factor being medicinal and aromatic plants.
Mamedov NA, Craker LE. Man and medicinal plants: a short review. Acta Hortic (ISHS). 2012;964:181–190.
Farnsworth NR, Soejarto DD. Global importance of medicinal plants. In: Akereb O, Heywood V, Synge H editors. Conservation of Medicinal Plants. Cambridge University Press: Cambridge; 1991. p. 362. ISBN 0521392063, 9780521392068
Ministry of Agriculture, Forestry, Fisheries. Medicinal crops program of Ministry of Agriculture, Forestry, Fisheries (in Japanese). [Internet]. 2013. Available from: http://www.maff.go.jp/j/keikaku/pdf/yakuyou_sesaku1.pdf [Accessed: 2016-08-10].
Motoo Y, Seki T, Tsutani K. Traditional Japanese Medicine, Kampo: Its history and current status. The Chinese Journal of Integrated Traditional and Western Medicine. 2011;17(2):85–87.
Japan Kampo Medicines Manufacturers Association. Report of usage of crude materials (in Japanese). [internet]. 2011. Available from http://www.nikkankyo.org/topix/news/111001/shiyouryou-chousa.pdf [Accessed: 2016-08-11].
Sashida Y. Pharmacognocy. (in Japanese) Nankodo: Tokyo; 2002. p 394. ISBN978-4-524-40224-3
Hatano T. Herbal drugs in traditional Japanese medicine. In: Sakagami H, editors. Alternative Medicine. InTech: Rijeka; 2012. p 306. doi:10.5772/53126
Watanabe K, Matsuura K, Gao P, Hottenbacher L, Tokunaga H, Nishimura K, Imazu Y, Reissenweber H, Witt CM. Traditional Japanese Kampo medicine: Clinical research between modernity and traditional medicine – The state of research and methodological suggestions for the future. Evidence-Based Complementary and Alternative Medicine, Volume 2011. Hindawi Publishing Corporation: Cairo; 2011. ID 513842 doi:10.1093/ecam/neq067
Irie Y. Kampo Medicine for Beginners (in Japanese). Sogensha: Osaka; 2008. p. 269. ISBN978-4-422-41078-4
Pybus D. Kodo: The Way of Incense. Tuttle Publishing: North Clarendon; 2001. 96 p. ISBN13: 9780804832861
The Japanese Pharmacopeia, 17th edition. Ministry of Health, Labour and Welfare [Internet]. 2016. Available from: http://jpdb.nihs.go.jp/jp17e/ [Accessed: 2016-08-25].
Okakura K. The Book of Tea. Duffield & Company: New York; 1906. p. 160.
Ukers WH. All About Tea. The Tea and Coffee Trade Journal Company. New York; 1935. p. 559.
Yamada S, Tsunoyama S. Cha 108 Chapters-Culture Health Amenity (in Japanese). Fukujyuen: Kizugawa; 1990. p. 223.
History of green tea. HIBIKI-AN [Internet]. 2004–2016. Available from: http://www.hibiki-an.com/contents.php/cnID/17 [Accessed: 2016-09-15].
The area of green tea picked and the yield of fresh and arachain 2015 (in Japanese). Statistics of Agriculture, Forestry and Fisheries [Internet]. 2015. Available from: http://www.maff.go.jp/j/tokei/kouhyou/sakumotu/sakkyou_kome/pdf/syukaku_1tya_15.pdf [Accessed: 2016-08-27].
The actual consumed condition of green tea. (in Japanese) Ministry of Agriculture, Forestry, Fisheries [Internet]. 2005. Available from: http://www.maff.go.jp/j/heya/h_moniter/pdf/h1702.pdf [Accessed: 2016-09-15].
Ehrlich S. Green tea. University of Maryland Medical Center [Internet]. 2015. Available from: http://umm.edu/health/medical/altmed/herb/green-tea [Accessed: 2016-08-25].
Green tea for health. HIBIKI-AN [Internet]. 2004-2016. Available from: http://www.hibiki-an.com/contents.php/cnID/10 [Accessed: 2016-09-15].
Hoffmann D, Ahgv F. Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press: Rochester; 2003. p. 666. ISBN-978-089281749-8
Velayutham P, Babu A, Liu D. Green tea catechins and cardiovascular health: An update. Current Medicinal Chemistry. 2008;15(18):1840–1850.
Singh BN, Shankar S, Srivastava RK. Green tea catechin, epigallocatechin-3-gallate (EGCG): mechanisms, perspectives and clinical applications. Biochemical Pharmacology. 2011;15;82(12):1807–1821.
Park JH, Bae JH, Im SS, Song DK. Green tea and type 2 diabetes. Integrative Medicine Research. 2014;3:4–10
Fukino Y, Shimbo M, Aoki N, Okubo T, Iso H. Randomized controlled trial for an effect of green tea consumption on insulin resistance and inflammation markers. Journal of Nutritional Science and Vitaminology (Tokyo). 2005;51:335–42.
Iso H, Date C, Wakai K, Fukui M, Tamakoshi A, JACC Study Group. The relationship between green tea and total caffeine intake and risk for self-reported type 2 diabetes among Japanese adults. Annals of Internal Medicine. 2006;144:554–62.
Tanaka H, Kaneda F, Suguro R, Baba H. Current system for regulation of health foods in Japan. LMAJ. 2004;47(9):436–450.
Weil A. Dr. Andrew Weil’s Integrative Medicine Clinic. Healing Cancer [Internet]. Available from: http://www.healingcancer.info/ebook/andrew-weil [Accessed: 2016–09-13].
Gahche J, Bailey R, Burt V, Hughes J, Yetley E, Dwyer J, Picciano MF, McDowell M, Sempos C. Dietary supplements use among U.S. adults has increased since NHANES III (1988-1994). NCHS Data Brief. 2011;Apr(61):1–8
Situation of dietary supplements in Japan. (in Japanese) Holistic Health Academy [Internet]. 2013. Available from: http://h-h-a.com/archives/417/ [Accessed: 2016-09-04].
Kaimoto T, Shibuya M, Maeda H. Study on dietary supplement use of university students: Comparative study between educational students and nutritional sciences students. (in Japanese) Bull. Shikoku Univ. 2012;35(B):23–27