<b>How Much Chilly Pain do You F</b><b>eel?</b> / 日本東洋医学雑誌

<p><b>PURPOSE </b>: To create a receiver operating characteristic curve (ROC curve) to screen for excessive sensitivity to cold (ESC).<br><b>PARTICIPANTS AND METHODS </b>: Subjects were 99 women who visited a specialty outpatient clinic for ESC. The controls were 371 female nurses. A numerical rating scale (NRS ; from 0 indicating someone is asymptomatic to 10 indicating profound discomfort) was used to determine the extent of chills in both groups. ROC curves were created to distinguish ESC based on their score on the NRS. An ROC curve was created for each premenopausal and postmenopausal woman.<br><b>RESULTS </b>: The ESC group had a mean score on the NRS of 7.3 (95% confidence interval [CI] : 6.9 to 7.6) while normal subjects had a mean score of 4.0 (CI : 3.7 to 4.3). The ESC group had a significantly higher mean score on the NRS. When the cut-off point for the NRS was set at ≥5, it had 98% sensitivity and 54% specificity for distinguishing premenopausal ESC. Similarly, that cut-off point had 96% sensitivity and 67% specificity for distinguishing postmenopausal ESC.<br><b>CONCLUSION </b>: If an individual with chills has an NRS score of ≥5, that individual may be experiencing discomfort sufficient to warrant being seen by a medical facility. Using an NRS to assess chills should help to screen for ESC.</p>

Fourteen Cases of Appetite Loss Treated with Shoyogan / 日本東洋医学雑誌

Shoyogan is a Kampo prescription described in the <I>Junqui Yaolue</I>. Few cases have been reported using this medicine. This time, we prescribed shoyogan for 14 patients who suffered from severe appetite loss. We had positive outcomes as follows. We administered shoyogan to 8 patients with malignant disease. Six of them suffered from lung cancer. Shoyogan was effective in these patients. Shoyogan was not effective for the other 2 patients, with bile duct carcinoma and malignant lymphoma. The dietary intake was increased from 28 percent of meals supplied to 79 percent in the appetite-improved group. We also administered shoyogan to 6 patients with nonmalignant disease. It was effective for 3 patients: 1 with congestive heart failure and 2 with great trochanteric fractures of the femur. It was not effective for the other 3 patients, who suffered from anorexia, pneumonia and depression associated with diabetes mellitus. Shoyogan seems to be effective for patients with terminal lung cancer and maintains their quality of life.

A Consideration for the Indication of Daikankyoto or Daikankyoganryo / 日本東洋医学雑誌

We studied contemporary indication of daikankyoto and daikankyoganryo. We administered either of these Kampo prescriptions for thirty-three patients with intractable muscle stiffness of neck, shoulder and back.Twenty-four patients were able to take the prescriptions for more than four weeks (long term group), and nine patients stopped taking the prescriptions less than four weeks (interrupted group). In long term group, fourteen patients (58%) improved their chief compliant. The Kampo formulations of fourteen effective cases were daikankyoto (13 cases) and daikankyoganryo (1 case). Comparative analysis has been done between long term group and nine cases of interrupted group. The characteristics of long term group were higher body mass index, firmer abdomen and more positive cases of epigastric resistance sign. Kansui root dose was 0.81 gram a day in long term group and 0.57 gram a day in interrupted group, which showed statistically-significant difference. We found twenty-seven side-effects in twenty four patients (73%) including eighteen patients with nausea and six patients with diarrhea. In side effects, there was no statistically significant difference between two groups. These side effects were promptly improved after discontinuation or dose reduction of Kansui root. We report clinical courses of six improved cases in this paper, two severe stiff neck, shoulder and back cases, each one case of psychosomatic disorder, depression, spasmodic torticollis and gastroesophageal reflux. These prescriptions should be administered more commonly to the patients with severe stiff neck, shoulder and back.

Four Cases Treated by Daikenchuto to the Patients with Recurrent Aspiration Pneumonia in Tube Feeding / 日本東洋医学雑誌

We administered daikenchuto to the patients having recurrent aspiration pneumonia with tube feeding, who had good responses. Case 1 : A 94-year-old-man with congestive heart failure suffering from recurrent aspiration pneumonia even after percutaneous endoscopic gastrostomy (PEG) placement : following daikenchuto administration, he did not suffer from pneumonia, and his general condition became stable. Case 2 : An 80-year-old-man suffering from severe pneumonia after PEG placement, and experiencing recurrent pneumonias after treatment with antibiotics:following daikenchuto administration, we did not find gastric contents in his oral cavity as before, and his general condition became stable. Case 3 : An 85-year-old-man with congestive heart failure and cerebral infarction also suffering from aspiration pneumonia : a nasogastric tube was placed, but he suffered from recurring pneumonias with tube feeding. After administering daikenchuto, he did not suffer from pneumonia and was discharged from the hospital. Case 4 : An 81-year-old-man with recurrent pneumonia and congestive heart failure : after treatment with antibiotics, we placed a PEG tube because of his severe anorexia caused by oral feeding difficulties. In order to prevent aspiration pneumonia, we administered daikenchuto prophylactically. He subsequently developed very little fever until his discharge to a nursing home.