Modification to an Abdominal Diagnosis Simulator to Educate Standard Abdominal Patterns of Toki-shakuyaku-San or Keishi-bukuryo-Gan in Kampo Medicine.

Purpose: Within the Kampo medical system, there exists a system of abdominal diagnosis called "Fukushin", specific to Japan, which is used to obtain an abdominal pattern, a holistic picture of the physical indications in the abdominal area. In order to educate students in this system, we have devised and continued to develop a Fukushin Simulator, incorporating various improvements as appropriate. The present study describes some recent modification to an abdominal diagnosis simulator to educate standard abdominal patterns of Toki-shakuyaku-San or Keishi-bukuryo-Gan in Kampo Medicine. Materials and Methods: To construct them, we made a base of a hard synthetic resin, and placed other synthetic parts on that base to form costal and sternal bones and a pelvis. The simulator is the lower chest and abdomen of a artificial adult female, from which we took a mold using a flexible silicon resin. We placed cotton wool in the interiors of the models and coated it in soft urethane foam. We adjusted resistance to pressure by adding numerous holes. We have prepared slight weak resistance female abdomen for Toki-shakuyaku-San pattern model or slight strong resistance female abdomen in Keishi-bukuryo-Gan pattern model. For the lower abdominal fullness, we added to the soft urethane foam in the area corresponding to the hypogastrium silicon rubber parts that we had fashioned in the shape of a horseshoe. In Toki-shakuyaku-San pattern model we have set softer soft urethane foam than that in Keishi-bukuryo-Gan pattern model. And in Keishi-bukuryo-Gan pattern model, to represent Oketsu tenderness we made a sound system that shout "ouch!" by appropriate abdominal palpation at appropriate 4 lesions in the lower abdomen. Results: By such adjustments, we were able to reproduce adult female abdominal model. We could have Toki-shakuyaku-San pattern model with slight weak resistance to the touch representing a slight deficiency pattern, slight increased resistance in lower abdomen as is characteristic of the slight lower abdominal fullness. Also we could have Keishi-bukuryo-Gan pattern model with slight strong resistance to the touch representing a slight excess pattern, increased resistance in lower abdomen as is characteristic of the lower abdominal fullness and representing Oketsu tenderness. Conclusion: It appears that the Toki-shakuyaku-San pattern model or Keishi-bukuryo-Gan pattern model of Fukushin Simulator have great promise not only in education medical students in the clinical technique of abdominal diagnosis but also in the standardization of abdominal patterns. [ABSTRACT FROM AUTHOR]