**7. Conclusion**

*An Overview and Management of Multiple Chronic Conditions*

and Zingiberis Rhizoma.

Banxia houpu Tang, Da Jian Zhong Tang, Buzhongyiqi Tang (補中益気湯), and Ma Zi Ren Wan (麻子仁丸) covering by Japanese national insurance, were reviewed and found to have a high Quality of evidence for the elderly (**Table 1**). In these 5 recipes, I already explained Yigan San, Banxia houpu Tang, Da Jian Zhong Tang above. Buzhongyiqi Tang was developed by Li Dong yuan (李東垣) in 13th century. He promoted the theory that disease results from the inhibition of digestive functions. In his book Pi wei lun (脾胃論), he wrote as below. Mongolian army attacked his country and closed in the capital many months. At that time, severe infectious disease spread in the capital and many people died. Doctors could not treat the disease. Then he thought that people went down because of food deficiency. Their digestion deteriorated and immune function declined so that infectious disease did not recover. Then he developed Buzhongyiqi Tang and treated many patients. Buzhongyiqi Tang was assessed in two small, open labeled RCTs [16, 17], the findings of which suggested that it improved systemic inflammation and nutritional status in elderly patients with chronic obstructive pulmonary disease and reduced systemic inflammation. It represents a unique therapeutic strategy to improve nutritional status and control chronic inflammation, something lacking in Western

medicine. Buzhongyiqi Tang contains Astragali radix, Atractylodis Lanceae Rhizoma, Ginseng Radix, Angelicae radix, Bupleuri Radix, Cimicifugae Rhizoma,

Ma Zi Ren Wan (麻子仁丸) is purgative, very easy to use for the elderly. It was described in 2 books, Jin kui Yao lue and Shang ha lun (傷寒論), both written by Zhang Zhong jin. It contains Rhei Rhizoma, Aurantii Fructus Immaturus, Armeniacae Semen, Magnoliae Cortes, Paeoniae Radix, and Cannabidis Semen.

The effect as purgative was proved the double blinded RCT [18].

**96**

**Table 1.**

*Screening tool to alert doctors to right treatment (START).*

As mentioned above, evidences of traditional medicine for geriatrics accumulated little by little, and a part of it is accepted modern medical doctors. Systematic education for traditional medicine and medical care needed.
