Traditional botanical medicine has been used in Japan for centuries but it is still developing. Some of the classical Kampo formulas are amazingly versatile in their effects for a wide range of health conditions. An important traditional formula is called “Goreisan” in Japanese and “Wulingsan” in Chinese (五苓散). It is called “Hoelen Five Herb Combination” or “Poria Five Combination” in English. Its traditional indications are well known to trained Kampo practitioners. These symptoms and signs include scant urination, edema, swollen eyelids, thirst, headache, dizziness and digestive discomfort. It is a very safe remedy, even for infants and pregnant women, but its effects can be powerful. Modern Kampo doctors have found numerous exciting new applications for this formula for a variety of annoying and even some very dangerous conditions.

The annoying symptoms include headache from changes in air pressure, both from a drop in air pressure from a coming storm or from being at a high altitude, even aboard an airplane. Some people suffer a headache or neck pain when a typhoon is approaching even if the weather is mild where they are. People who get earaches from a drop in cabin pressure when they fly in an airplane can also get relief. These earaches are usually caused by edema in the auditory canal and Goreisan seems to effective for edema in any part of the body. Goreisan can also be used for stomach pain, especially during the summer season. Headache and stomach upset from hangover or carsickness are also indications for this formula. If any of these conditions are accompanied by swelling or dizziness it is even more likely that Goreisan will be effective. Various types of swelling are indicated, such as swelling of pregnancy or leg swelling from overheating or sunburn during the summer months.

Trigeminal neuralgia is more than an annoyance. It is a more severe type of head pain, but several doctors have reported that they were able to obtain relief from this intense spasmodic facial pain for their patients by giving them Goreisan. Post-herpetic neuralgia, which sometimes occurs after a bout of shingles, is another type of pain that can be severe, but sometimes responds to administration of Goreisan.

Goreisan has proved its value in serious and even life-threatening conditions. Acute pediatric gastroenteritis can be life-threatening to small children, especially if either vomiting or diarrhea is pronounced. Dehydration is a matter of serious concern to medical professionals treating this condition. Since it is difficult to get the necessary cooperation to swallow a medication with an infant, especially if there is vomiting, some hospitals have produced rectal suppositories of Goreisan in-house because there is no suppository product available on the market. In a research study of 71 cases of pediatric acute gastroenteritis treated with Goreisan, the results were encouraging, to say the least. In 86% of cases there was an immediate beneficial effect. In another 8% it was effective within 8 hours, and there was no effect in only 6%.

Patients undergoing hemodialysis for treatment of kidney failure also have benefitted from using Goreisan. Many dialysis patients complain of headache during dialysis and also frequently in regular daily life. In addition to headaches, patients undergoing hemodialysis also suffer from dialysis disequilibrium syndrome, commonly abbreviated DDS. This is the occurrence of neurologic signs and symptoms attributed to cerebral edema during or following shortly after intermittent hemodialysis. These symptoms include nausea, muscle cramps, headaches, drops in blood pressure and hyperkalemia, or high blood potassium. Hyperkalemia is common in patients undergoing dialysis. Extremely high levels of potassium in the blood (severe hyperkalemia) can lead to cardiac arrest and death. Goreisan prescribed twice a day has been found to safely lower the level of potassium, maintain blood pressure and prevent disequilibrium syndrome.

Brain edema can result from blood clots and brain tumors. Goreisan has reduced intracranial pressure caused by both tumors and blood clots. Blood clots occur at the acute stage of a cerebral infarction or stroke. They can also be caused by impact trauma to the head, a so-called subdural hematoma. In all of these cases Goreisan has been shown to be effective in relieving intracranial pressure. Brain scans have shown dramatic shrinkage of subdural hematoma resulting in reduced pressure and accelerated healing. This could possibly prevent brain surgery to remove the clot in some cases.

Brain swelling can occur from various types of malfunctions. Malfunction of a protein in the brain called Aquaporin 4 can result in problems in regulating the flow of fluids through the blood-brain barrier. It has been presumed to play an important functional role in the transport of water in and out of the brain. Strong evidence links Aquaporin-4 in the physiopathology of brain edema. Research on Goreisan has found that it can relieve brain edema caused by a malfunction of Aquaporin 4.Aquaporin-4 may have a role in several diseases including Alzheimer’s disease, amyotrophic lateral sclerosis, Parkinson’s disease, multiple sclerosis, and epilepsy. It also appears to have a role in pathological response to traumatic brain injury and stroke.

Goreisan is a safe and useful medication that has been used since the 3^rd century A.D. It has proven its value to modern medicine as a safe and effective treatment for common conditions as well as medical problems for which pharmaceutical medicine has few solutions. Further discoveries may lie ahead.