What "Dramatically Effective Kampo Medicine" Taught Me About Reading Myself, Not Just My Symptoms

Dr. Fusako Masuda's Dramatically Effective Kampo Medicine is the book behind this personal record of what I've actually started doing at 66. Dr. Masuda graduated from Hokkaido University's medical school, trained first in Western medicine, and later found her way to Kampo, traditional Japanese herbal medicine. I once studied at a national university medical school myself, and later retrained in acupuncture and Oriental medicine in the UK — so this book felt less like someone else's story than I expected. Its central idea runs through every chapter: where Western medicine starts from a diagnosis, Kampo starts from shō — the individual state of the person in front of you, not the name of their illness.

This illustration imagines cucumbers, aubergines, peppers, and tomatoes growing in the same greenhouse, each needing slightly different care.

Reading the person, not the label

One thing the book returns to again and again: two people with the same "headache" can need completely different remedies. Rather than sorting people into the box of a diagnosis, Kampo asks what this particular person's state actually is. It reminds me of growing vegetables in my greenhouse. Cucumbers, aubergines, peppers, and tomatoes all live under the same roof, but each wants different watering, different staking, different light. Treating an aubergine like a tomato just doesn't work. I've started applying the same logic to myself — instead of reaching for a general rule about what tired people "should" do, I try to notice what today's particular state actually is first. Healthy longevity, I'm starting to think, comes down to this habit of observing yourself individually, over and over.

Thinking about it further, life itself may not have one predetermined "correct" state either — it's more a continuous string of momentary states. When I was younger, I thought of health simply as the absence of symptoms. At 66, I've come to feel that living well means carefully observing whatever state I'm in, symptoms or not, rather than chasing some fixed idea of correctness.

Treating symptoms as clues to my constitution

At 66, I've noticed more breathlessness on the stairs and more stiffness in my joints in the morning. I might once have felt irritated by these changes. Since reading this book, I've been trying to receive them differently — not as something going wrong, but as signals about my constitution. The breathlessness is telling me something about how my energy is circulating right now. The stiffness is nudging me to reconsider how I start my mornings. Just reframing it this way has slowly turned some of my irritation at an ageing body into curiosity about a body I'm still getting to know. I can't make the difficulties of ageing disappear, but this book helped me notice that there's something to discover inside them too.

Mind and body as one thing

One point that stayed with me is how closely the book ties physical trouble to stress and emotional state. I've been investing in property and shares since 2015, and when markets get rough, I notice my shoulders tensing and my sleep getting shallower before I've consciously registered any worry. Now, when I catch that tension, I take a breath and put it into words: "this is a sign my energy isn't flowing smoothly." I can't make financial worry disappear entirely, but by watching how it shows up in my body, I spend far less time being swept along by it. For someone whose main work — investing — happens largely in the head, this mind-body view turned out to be unexpectedly practical.

This illustration imagines the raised bed with raspberries, asparagus, courgettes, strawberries, herbs, and potatoes, alongside a bed of David Austin roses.

Enjoying ageing, the Kampo way

The book's closing chapters, about learning to enjoy ageing rather than resist it, resonated with my own garden. Beyond the greenhouse, my raised beds carry raspberries, asparagus, courgettes, strawberries, herbs, and potatoes, and I tend more than ten varieties of David Austin roses. Younger, I might have thought in terms of efficiency — more yield, less effort. Now, watching each plant's small changes has become the point in itself: waiting for one rose to open, checking on the asparagus tips each morning. It's the opposite of efficiency, but I've come to think that a rich later life might simply mean learning to savour the waiting.

The irritation at my own ageing doesn't disappear entirely. Even so, there's a small excitement — one I didn't notice when I was younger — in the weeks it takes for strawberries to ripen, or in the surprise of a courgette that's grown far bigger than expected. Living each day with a little more joy and anticipation may not require going anywhere in particular; it may already be waiting in the garden.

Choosing distance the Kampo way

One chapter looks at compatibility between doctor and patient — the idea that keeping a sensible distance from someone you don't get on with matters just as much as finding a remedy suited to your constitution. Much of the pain in relationships, I suspect, comes from the belief that we're obliged to get along with everyone. I've become more careful about invitations I don't feel drawn to, and about time with people who leave me depleted. Rather than forcing a closeness that doesn't fit, I try to choose the kind of relating that suits my own shō. Support doesn't have to run both ways to count — sometimes just quietly receiving someone else's words is enough to lighten the load.

Keeping the record itself, as a practice

Living between the UK and Japan, I notice how differently the two cultures approach medicine. A visit to a GP here tends to be relatively brief — symptoms in, prescription out. In a Japanese Kampo clinic, by contrast, the doctor reads your complexion, your tongue, your pulse, and carefully records that day's particular shō. I realised this habit of recording while paying attention is exactly what I do when I write this blog. My memory and concentration aren't what they were, but writing lets me keep editing my own state, imperfect as the record may be. Just as this book's author spent decades recording each patient's individual shō, I want to keep writing down the state of my greenhouse, my raised beds, and my own body — however unpolished the record.

Reading the person, not the label. Treating symptoms as clues rather than enemies. Watching how mind and body move together. Finding pleasure in the slowness of ageing. Choosing distance where it's needed. And keeping the record, imperfect as it is. None of this is extraordinary, but at 66, these feel like habits worth holding onto deliberately.

Kampo remedies featured in the book (from Dr. Masuda's perspective)

What makes Dr. Masuda's writing so enjoyable is that she doesn't just list what each remedy treats — she describes the kind of person it suits, often in a wonderfully unvarnished way. Here are the nine remedies that stood out to me most, with as much of her particular flavour as I can carry over.

• Keishikaryukotsuboreito: The people it suits share a striking pattern, Dr. Masuda notes. Conscientious to the core, often to a fault — dependable at best, rigid and humourless at worst, with little patience for jokes. She observes that these people were often raised by equally conscientious parents, under a strict and orderly upbringing. It tends to suit hard-working, self-blaming women who take responsibility for anything that goes wrong before anyone else does.
• Juzentaihoto: Paired with keishikaryukotsuboreito, this remedy often deepens the improvement, she writes. Where the first addresses the conscientiousness itself, this one addresses what that conscientiousness has cost — stamina worn down from years of pushing through. The division of labour, as I understand it: one treats the character trait, the other treats the exhaustion it produces.
• Tokishakuyakusan: This suits women who never really took a proper maternity break, whose stamina has run thin. Dr. Masuda describes the telltale abdomen as soft, with no real resistance to the touch — what she calls a "floppy" feel. If keishikaryukotsuboreito suits people who push through on willpower, tokishakuyakusan, as I read it, suits people whose physical foundation was thin to begin with and who then overworked it. The book includes a striking case of a woman running her own business whose condition turned around dramatically once this remedy was paired with juzentaihoto.
• Ninjinto: The people it suits wear a particular expression, Dr. Masuda observes rather pointedly — something like having half-consciously given up on their own lack of stamina. It suits people prone to loose stools, dizziness, and an abdomen that feels distinctly unsteady to the touch. She notes that patients who need this remedy tend to become long-term relationships in her practice.
• Shokenchuto: Said to suit adults and children alike. The book follows a mother and her two daughters — pale-skinned, slight, with a delicate, almost wistful look — who all found their footing on this remedy as a base. It's a chapter that captures how strongly constitution can run in families.
• Gosekisan: This treats what's called "cold with flushing" — cold hands and feet paired, paradoxically, with sudden waves of heat and sweating. It's often combined with tokishakuyakusan, and Dr. Masuda notes that the combination can work "almost comically well" compared to either alone.
• Saikokeishikankyoto: One of her clinic's quiet workhorses, ranking among the most frequently prescribed remedies there. It belongs to the saiko family (used for conditions that have become chronic) and suits people of a depleted, deficient constitution. She notes it can resolve unexplained low-grade fevers that have dragged on for a long time, sometimes startlingly fast.
• Hangebyakujutsutenmato: Suits people with a weak stomach and a tendency to retain fluid. It tends to work well where swelling, dizziness, and headaches overlap, especially alongside stomach weakness.
• Goshuyuto: Used for headaches linked to cold, appearing in the book as one option doctors weigh against tokishakuyakusan and others when treating migraine.

Laid out together, a kind of comparative logic emerges from her descriptions. One remedy addresses depletion of character — the strain of being relentlessly conscientious (keishikaryukotsuboreito). Others address the physical exhaustion that conscientiousness produces (juzentaihoto, ninjinto). Others still suit people whose physical reserves were thin from the start (tokishakuyakusan, shokenchuto). And a further group addresses imbalances in circulation itself — cold-with-flushing, fluid retention, chronic low fever (gosekisan, hangebyakujutsutenmato, saikokeishikankyoto). The same complaint — "I'm tired," "my head hurts" — can point to entirely different remedies depending on where, in Dr. Masuda's reading, that tiredness actually comes from. It's never a simple lookup table matching symptom to pill.

The book I mentioned here:

Fusako Masuda, Dramatically Effective Kampo Medicine

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Dr. Fusako Masuda and her era

This illustration imagines the landscape of Asahikawa, Hokkaido, where the author was born, alongside the atmosphere of medical education in postwar Japan.

Dr. Fusako Masuda was born in 1937 in Asahikawa, Hokkaido. She graduated from Hokkaido University's medical school and began her career as a physician within Western medicine. She trained at a time when postwar Japan was still rebuilding, and Western medicine was widely regarded as the only "proper" medicine — Kampo, by contrast, was often dismissed as folk remedy with little scientific grounding.

Within that environment, Dr. Masuda began her career as a paediatrician, but grew steadily more drawn to Kampo. Sitting with patients whose constitutions and complaints didn't fit neatly into a Western diagnostic framework, she seems to have found real possibility in Kampo's core idea — reading the person's shō rather than assigning a disease name. In the book, she candidly describes how her early ambition — to become a doctor who supported women — gradually broadened into a practice that took on an extraordinarily wide range of complaints, almost by necessity.

She also writes, as the parent of a child with a mental disability, about how far behind Japanese society still was in understanding mental disability — a reminder that she carried the perspective of an ordinary person living daily life, not only that of a physician. In her afterword, she writes candidly that taking Kampo into her practice made her want to "live with fewer regrets" — a sign that even as an established specialist, she kept questioning how to live the second half of her own life.

The decision itself — to shift her footing toward Kampo, then a marginal field, at a time when Western medicine held near-absolute authority — says a great deal about who she was. One line from the book, "we doctors had been getting quite a lot wrong," captures a willingness to question an established framework and return, again and again, to what each patient was actually saying. Her career, built on a foundation of Western medical training but sustained by a willingness to listen closely to what patients actually said, offers a great deal to consider about how we relate to medicine at all.