A Case of Excessive Sweating and Hot Flushes Successfully Treated with Yokukansan / 日本東洋医学雑誌

We report a case of a 49-year-old woman who presented with 6-month period menopausal syndrome including excessive sweating and hot flushes in her face, chest and back. She was also frustrated with her sons, but she reflected on her own anger and wondered why she got so irritated with them. We prescribed yokukansan to her and her all symptoms improved one month later. We need to differentiate between yokukansan and kamishoyosan in the treatment of menopausal syndrome and irritation, and it may be useful to evaluate the detail of irritation in selecting formula.

Experience in Kanzobushito for Rheumatoid Arthritis and Headache with Hypersensitivity / 日本東洋医学雑誌

We report a case of a patient with rheumatoid arthritis who refused Western medical treatment and was able to improve concomitant symptoms including arthralgia and headache by using kanzobushito. The patient was a 35-year-old. Eight years previously, she was diagnosed with rheumatoid arthritis due to joint stiffness. Although receiving methotrexate therapy, she developed methotrexate-associated lymphoproliferative disorders and the treatment was discontinued. Due to a feeling of rejection for Western medical treatment, she visited our hospital and was hospitalized for Kampo therapy. We prescribed kanzobushito for qi imbalance, coldness, and severe pain. Her joint pain, headache, and secondary symptoms were improved.

A Case Report of Painful Legs and Moving Toes Syndrome and Painful Arms and Moving Fingers Syndrome with Severe Blood Stasis and Panic Disorder Successfully Treated with Tokakujokito-Based Kampo Prescriptions / 日本東洋医学雑誌

The patient was a 47-year-old woman. Four years previously, she began to suffer from left lower leg pain and numbness, and involuntary movements. She received further examination in the department of neurology at other hospitals, but had an uncertain etiology and was provisionally diagnosed with restless legs syndrome. She was treated with Western medicine such as gabapentin and gabapentin enacarbil, but they were ineffective. She subsequently visited our hospital and was hospitalized. She was diagnosed with painful legs and moving toes syndrome, and painful arms and moving fingers syndrome after further examination. We prescribed tokakujokito because she had severe blood stasis and panic disorder on Kamp medical findings. As a result, her left lower leg numbness disappeared and pain was reduced. We report a case of a patient who could not be effectively treated using Western medicine and was successfully treated with tokakujokito-based Kampo prescriptions.

A Case of Post Coronavirus Disease 2019 (COVID-19) Condition, in which the Patient Suffered from a Severe Sense of Fatigue and Brain fog Successfully Treated with Kampo Therapy / 日本東洋医学雑誌

We report a case of post coronavirus disease 2019 (COVID-19) condition, in which the patient suffered from a severe sense of fatigue and brain fog that was successfully treated with Kampo therapy. The patient was a 21-year-old man. He had been diagnosed with COVID-19 and hospitalized for follow-up examinations. He recovered without any complications and was discharged from the hospital, but continued to suffer from a severe sense of fatigue, coldness, dizziness, and a loss of concentration. Because of these symptoms, he had to spend most of the day lying down. One month later, he was hospitalized to receive Kampo therapy. We administered bukuryoshigyakuto for 2 weeks referring to his severe coldness and fatigue and then changed to renjuin for his fluid disturbance and blood deficiency. After starting Kampo therapy, his fatigue and dizziness gradually improved. He was discharged after 3 weeks of hospitalization and received Kampo therapy as an outpatient. One month later, he reported a dull feeling in his stomach and depression. We switched to kamikihitogohangekobokuto and added hachimigan. His activities of daily living improved and he could take 4.5-kilometer walk. He could return to work 4 months later. Kampo therapy may be useful for post COVID-19 condition that causes a sense of fatigue and brain fog.

A Case of Anorexia and Drooling Improved by Targeting “Excessive Saliva Secretion” Using Bushirichuto / 日本東洋医学雑誌

A 65-year-old man, with a history of surgery for esophagogastric junction cancer in X-3, was admitted to the Department of Internal Medicine in our hospital in March for anorexia that had developed since January X. The patient was diagnosed with adhesive small bowel obstruction, and underwent surgery to relieve the obstruction in early May. However, his symptoms did not improve, and he was referred to our department in mid-June. His drooling was considered to be due to “excessive saliva secretion.” He started taking a decoction of bushirichuto for epigastric discomfort and resistance and coldness of the hands and feet. On the 5th day, he started to feel more energetic, and on the 8th day, his saliva production decreased. Furthermore, on the 12th day, his sense of taste and appetite improved. As the oral intake increased, tube feeding could be reduced and rehabilitation progressed ; from an almost bedridden state, he was able to walk continuously for 150 m with a cane. On the 29th day, he was transferred to a chronic care hospital. His weight increased from 34.1 kg, when he was referred to our department, to 39.7 kg at the discharge time. Anorexia and drooling, which had otherwise continued for 5 months, were improved within a short period of time by using bushirichuto.

The Reason Why the Order of Shanghanlun (shōkanron) is the Early Yang Stage Pattern (taiyōbyō), the Late Yang Stage Pattern (shōyōbyō), and the Middle Yang Stage Pattern (yōmeibyō) in Japan / 日本東洋医学雑誌

Yang diseases of the Shanghanlun (shōkanron) list the Three Yangs in the order of early yang stage pattern (taiyōbyō), middle yang stage pattern (yōmeibyō) and late yang stage pattern (shōyōbyō). However, in Japan, the order is early yang stage pattern, late yang stage pattern, and middle yang stage pattern. A survey of Japanese disease history revealed that by the Edo period smallpox, measles, and influenza were infectious, febrile, and highly lethal. Furthermore, these diseases exhibited bimodal fever. We investigated and examined how Kampo doctors viewed the order of the Three Yangs in the Shōkanron from the literature of the Edo period, and found that the epidemic period of these three diseases coincided with the increase in the number of doctors advocating late yang stage pattern. It is thought that the Three Yangs in Japan came to be recognized in the order of early yang stage pattern, late yang stage pattern, and middle yang stage pattern through these three dis­eases that became prevalent from around 1700.

Cigarette Beetles (Lasioderma Serricorne) Occurring in Plantago Seed / 日本東洋医学雑誌

In the pharmaceutical department of Iizuka Hospital, larvae of the cigarette beetle (Lasioderma serricorne) were found in Plantago seed for the first time since the Department of Japanese Kampo Medicine started in 1992. The larvae grew into pupae and then adults. The plastic-packaged Plantago seed was left for about 3 months, during which several larvae and adult cigarette beetles appeared. Cigarette beetles are very common insects in summer and it is important that we store crude drugs in hard closed containers in our refrigerators. The larvae can bite strongly and puncture plastic packaging, however they cannot live under 15 ℃. Education of crude drug storage for patients is very important.

Five Cases of Breast Cancer-Related Therapy Complications Successfully Treated with Kampo Medicine / 日本東洋医学雑誌

Five cases of various diseases associated with breast cancer treatment including arthralgia, menopausal symptoms, chemotherapy-­associated symptoms (nausea, vomiting, numbness, pain, general fatigue), and anxi­ety neuroses during follow-­up were treated with Kampo medicine and a favorable course was obtained. Com­bined use of Kampo treatment can reduce the suffering caused by the side effects of breast cancer treatment, alleviate mental symptoms, prevent recurrence, and improve the patients' health. Kampo medicine plays a role in cancer supportive care for breast cancer.

Two Cases Successfully Treated with Mokuboito on the Basis of Shinkahiken (Epigastric Stuffiness and Strong Resistance) / 日本東洋医学雑誌

Mokuboito is usually used for the treatment of patients with dyspnea and edema due to chronic heart failure. We herein report two cases successfully treated with mokuboito on the basis of shinkahiken (epigastric stuffiness and strong resistance). Case 1 was a 28-year-old woman. She had been experiencing occasional bouts of epigastralgia for 12 years, but they had worsened two months before the first visit to our department. When she was examined, however, the cause of epigastralgia could not be determined and she was diagnosed with functional gastroenteropathy. After being introduced to our department, she was treated with various Kampo formulas, but the symptom was poorly improved. Case 2 was a 74-year-old man who was prescribed hachimijiogan and shoseiryuto for an overactive bladder and perennial allergic rhinitis. His symptoms were stable, but suddenly deteriorated after two months. In both cases, when changing treatment to mokuboito on the basis of shinkahiken, the symptoms were improved. These results suggest that mokuboito can be used in a wide range of cases with shinkahiken.

A Case of Goreisan with hoketsuzai (Blood-Tonifying Formula) that was Remarkably Effective for Severe Malnutrition / 日本東洋医学雑誌

We report a case in which goreisan with hoketsuzai (blood-tonifying formula) was successful in the treatment of a marked nutritional disorder. A 17-year-old woman was screened for prominent emaciation of unknown cause. After the administration of goreisan, edema was reduced and her body weight increased. Subsequently, anemia improved and muscle mass increased with a combination of shimotsuto or sokeikakketsuto. It is possible that goreisan with hoketsuzai improved the water balance of the whole body including the digestive tract, and restored the digestive and absorptive function.

The Role of Kampo Therapy to Treat Cellulitis / 日本東洋医学雑誌

In this report, we present three cases of lower limb cellulitis. The first case was an 88-year-old woman and the second case was a 36-year-old man. In addition to standard therapy, both of them received Kampo therapies with keishinieppiitto and jidabokuippo during the acute phase of cellulitis and were promptly cured. The third case was a 52-year-old woman with severe obesity suffering from repeated and intractable cellulitis. She received Kampo therapy including keishibukuryogan. The redness and swelling in her leg gradually disappeared. Administration of adequate antibiotics and elevation of affected areas are important for the treatment of cellulitis. Even with appropriate therapy, some patients are slow to respond and difficult to treat. The skin findings in cellulitis are swelling, redness, heat, and pain, which can be recognized and treated as water imbalance, heat, and blood stasis in Kampo medicine. This case report suggests that cellulitis during the acute phase can be treated with keishinieppiitto and the treatment of water imbalance and heat is important. After the acute phase, the treatment of blood stasis is important. Considering the time of onset and skin findings in cellulitis, Kampo therapy can contribute to the rapid recovery of cellulitis.

Six Cases of Psychiatric Symptoms Successfully Treated with Shimotsuto-Containing Medication / 日本東洋医学雑誌

Six patients with psychiatric symptoms were successfully treated with shimotsuto-containing medication. Case 1 was a 13-year-old boy who complained of difficulty in getting up ; however, when he was treated with a focus on the decrease in his concentration, he was able to go to school after treatment. Case 2 was an 18-year-old girl who had also difficulty in getting up, but was able to go to school. Case 3 was a 10-year-old girl who was able to go to school partially after treatment. Case 4, a 42-year-old man with apprehension in socializing, showed improvement in socializing after taking medication containing shimotsuto. Case 5 had various complaints that were relieved after taking medication containing shimotsuto. Case 6 was a 56-year-old woman who had also multiple complaints ; however, the symptoms were alleviated with shimotsuto-containing medication. All patients experienced depression and anxiety. Four patients with decreased cortisol recovered after treatment with shimotsuto. From these results, shimotsuto is considered to improve concentration, judgment, and psychiatric symptoms by treating blood deficiency.

Applications of Orento Based on“Upper Heat and Middle Cold” / 日本東洋医学雑誌

Orento is generally used for upper gastrointestinal symptoms. We have used orento for various diseases based on “upper heat and middle cold”. As a result of the evaluation of 30 responders to orento, the most frequent sign of “upper heat” was “yellow tongue coating” (29/30 responders), while the most frequent sign of “middle cold” was “preference for warm foods and beverages” (27/30 responders). Compared with the non-­responder group, the responder group showed significantly higher frequencies of “gastrointestinal cold”, which is the sum of “preference for warm foods and beverages” and “aggravation of gastrointestinal symptoms by cold foods and beverages” (29/30 responders, p = 0.047), and “upper/lower gastrointestinal symptoms” (29/30 responders, p = 0.014). These results suggest that “yellow tongue coating” is the most important sign for “upper heat” while “gastrointestinal cold” is the most important sign for “middle cold”. As Kampo patterns for orento, gastrointestinal symptoms often occur, but there is a possibility of upper or lower gastrointestinal symptoms, skin disorders, and sleep disorders.

A Case of Lower Back with Extremity Pain Successfully Treated with Kanzobushito / 日本東洋医学雑誌

We report a case of lower back with extremities pain, whose cause could not be established in the medical sense nor relieved by analgesic drugs, was successfully treated with kanzobushito. The patient was a 69-­year-old male. Because of extremity pain of his lower left back, he could not move by himself and was transported to our hospital by an ambulance. Having persistent pain, he could not turn over or stretch his left leg and anal­gesic drugs and sacral nerve blocks were ineffective. We administered kanzobushito referring to the phrase “pain that gets worse as someone approaches” in the Shokanron. After administering kanzobushito, his pain was reduced remarkably and he could sit down on the bed. And his activities of daily living improved immedi­ately. Thus, kanzobushito may be useful for severe pain and should be administered to neuropathic pain compli­cated with psychogenic factors referring to coldness, severe pain and abnormality of qi (irritable).

A Case of Uncontrolled Cancerous Ascites Reduced by Sekiganryo / 日本東洋医学雑誌

Abdominal pain and marked coldness were observed in a 56-year-old male with cancerous ascites associated with cancer of unknown primary, and the patient was treated with sekiganryo. The abdominal pain resolved from day 2 after the initiation of sekiganryo administration, and the ascites markedly decreased with an increase in the urine volume on day 3. Although the mechanism of the effect of sekiganryo on cancerous ascites was unclear, it was considered that the improvement of coldness promoted the metabolism and subsequently promoted diuresis. No case of the improvement of cancerous ascites by sekiganryo has been reported to date. We report this case along with a literature review.

Successful Treatment of an Adolescent Male with Periodic Fever Using Byakugokassekisanryo / 日本東洋医学雑誌

The patient was a 13-­year-­old male who had experienced periodic fever since he was in the 5th grade. After he moved into the 8th grade, he developed fever, abdominal pain, and vomiting continuously, which caused him to miss school or leave school early once every one to two weeks. Various Kampo extract preparations prescribed at a nearby clinic did not improve the symptoms, and the patient was referred to our hospital. Ad­ministration of bukuryoshigyakuto and shokenchuto reduced the fatigue, but the fever could not be controlled. Subsequently, a grasp of “the disease byakugobyo turned into fever” was made, and he was put on byaku­gokassekisanryo, which eliminated the fever. Therapeutic approaches for disease known as the disease ebyo that arises after treatment of cold damage diseases (shokan) are discussed in the On Pulse Syndrome Complex and Treatment of Bai He, Hu Huo, and Yin Yang Du Diseases section of the synopsis of prescriptions of the golden chamber “Kinkiyoryaku”. Children, especially adolescents, are prone to fall ill because of rapid changes of the body, including sexual maturation. Clinical manifestations of such illnesses further change with growth and maturation, and it can be difficult to find clues for treatment at first glance due to complicated states of yin­yang and deficiency-­excess. As seen in this case, illnesses of adolescence is likely to include un­diagnosed cases of byakugobyo that manifests clinical signs similar to those of ebyo.

<b>Review of 33 Patients in Whom Sokeikakketsuto was Used to Treat Recurrent Cramps of the C</b><b>alf</b> / 日本東洋医学雑誌

<p>Sokeikakketsuto was administered to 33 patients with recurrent cramps of the calf appearing once a week or more and persisting for 2 weeks or more. Treatment response was evaluated 1 month after the start of drug therapy. Patients whose cramps disappeared immediately after starting were regarded as showing a complete response, those with disappearance after 1 month as showing a partial response, those with a reduction to <50% after 1 month as showing a slight response, and those in whom 50% or more of cramps persisted after 1 month as showing no response. A complete response was achieved in 12 patients, a partial response in 11, a slight response in 9, and no response in 1. In 23 (69.6%) of the 33 patients, cramps disappeared within 1 month after the start of drug therapy. In 32 (96.9%), there was a reduction to <50%. In 29 (87.8%) of the 33 patients, cramps disappeared within 3 months, suggesting the efficacy of this drug. Two-package administration in the evening/at bedtime was more effective than 1-package administration for controlling cramps of the calf at night until early in the morning. The intensive pre-attack administration of 2 packages before sleep was the most effective. Sokeikakketsuto may be useful for treating recurrent cramps of the calf.</p>

<b>Five Cases of Hymenoptera Stings and Centipede Bites Treated with Ourengedokuto and </b><b>Inchingoreisan</b> / 日本東洋医学雑誌

<p>We report five cases of painful swelling caused by hymenoptera stings and centipede bites treated with <i>ourengedokuto </i>and <i>inchingoreisan </i>soon after the time of injury. The first case was a 70-year-old male. He was stung by a hornet on the left hand 30 minutes prior. The second case was a 45-year-old male. He was stung by a hornet on the left face 20 minutes prior. The third case was a 55-year-old male. He was stung by a hornet on the left lower thigh 10 minutes prior. The fourth case was a 39-year-old male. He was stung by a hornet on the right thigh 60 minutes prior. The fifth case was a 35-year-old male. He was bitten by a centipede on the right first toe 20 minutes prior. All cases received Kampo therapies immediately and continued them every few hours. In all cases, their pain, redness and swelling at the site of injury were relieved by the next day. We consider Kampo therapies can contribute to the healing of hymenoptera stings and centipede bites at an early stage.</p>

<b>Efficacy of Kampo Medicine for Acne of the Face with Nonreactive Standard Dermatological Therapy</b> / 日本東洋医学雑誌

[<b>Objective</b>] In this study, we retrospectively investigated the efficacy of Kampo medicine for refractory acne patients with standard therapy in Japan.<br>[<b>Patients</b>] Two hundred and thirty nine patients with inflammatory acne completed the study. Six Patients discontinued their systemic treatment because of adverse events. The patients included 193 females and 46 males, with a mean age of 26.5 years. They took Kampo medicine three times daily for 3 months, in a manner according to our protocol.<br>[<b>Result</b>] For females, 163 of 199 patients (82%) were in the KUOKETSUZAI Group taking medicines such as keisibukuryogankayokuinin, tokishakuyakusan, tokakujyokito, and kamishoyosan. Here, 124 of 163 patients (76%) had a significant decrease in new and inflammatory eruptions after taking the Kampo medicines alone or in combinations with other KUOKETSUZAI medicines. Fourteen of 19 patients (74%) took seijobofuto, of which 6 of 7 females (86%), and 1 of 3 males (33%) had decreased acne eruptions. Also in KUOKETSUZAI group, significant efficacy was shown in females over 21 years of age on combinations. For males, 18 of 23 patients (78%) taking keigairengyoto and 14 of 20 patients (70%) taking seijobofuto, also had decreased inflammatory acne eruptions.<br>[<b>Conclusion</b>] Kampo medicines exhibit significant efficacy for the treatment of the refractory acne.<br>KUOKESTUZAI : category of oriental medicines that improve peripheral blood flow while concurrently facilitating wound healing, and that regulate hormone balance, and improve gastrointestinal motility ; e.g. keisibukuryogankayokuinin, tokishakuyakusan, tokakujyokito, kamishoyosan.

<b>Effective Treatment of Five Cases of Facial Erythema and Flushing Using </b><b>Orento</b> / 日本東洋医学雑誌

The use of orento for dermatosis is commonplace. We report herein the effective treatment of five cases of facial erythema and flushing using orento, based on the observation of heat symptom patterns in the upper part of the body and cold symptoms in the middle part of the body. Few reports have described specific symptoms of upper heat and middle cold ; however, interpreting ‘facial erythema and flushing exacerbated by warming',‘red face', ‘hot flashes', ‘hot sweats' and ‘yellow fur on the tongue' as “upper heat” , and ‘preference for warm drinks', ‘diarrhea exacerbated by cold drinks', and ‘objective coldness in the epigastric region' as “middle cold” enabled the application of orento for dermatosis in our experience.