The Cases of Lumbago and Numbness of Legs Successfully Treated with Saikokaryukotsuboreito / 日本東洋医学雑誌

The low back pain is often intractable and leads to the drop of the daily living activity. These symptoms are good indications of Kampo medicine. We report 5 cases of low back pain that saikokaryukotsuboreito treatment succeeded regardless of psychogenetic presence. These patients complained of low back pain and lower melagra or numbness of limbs. Four of 5 cases did not have any psychogenetic presence. After administration of saikokaryukotsuboreito, their pain decreased and walking distance was improved in to 4 weeks and analgesics were not required. Generally, saikokaryukotsuboreito is prescribed for patients with psychogenetic symptoms, but these treatments based on abdominal patterns were effective even if they do not have subjective psychogenetic symptoms. Saikokaryukotsuboreito may be the differential prescription for such low back pain cases.

A Case of Psoriasis Vulgaris with Exanthema Concentrates on the Head Successfully Treated with Jizusoippo / 日本東洋医学雑誌

A 59 year-old woman with rashes of forehead and chest visited our hospital in hope of treatment with Kampo medicine. The rashes had occurred at the age of 50 years old and gradually spread. She had been diagnosed with psoriasis vulgaris by a nearby dermatologist. Though she had been treated with the steroid ointment, the symptom had repeated exacerbation and remission for nine years. At the first examination, her exanthems were damp, concentrated on frontlet and was seen in posterior cervical region, precordial region, upper and lower limb. Jizusoippo was prescribed, and the exanthem improved significantly in 4 months. In conclusion, jizusoippo can be effective in cases of psoriasis that the exanthems are damp and concentrate on head.

<b>Japanese Literature Survey of Tongue Findings for the Purpose of Creating a Unified Multicenter Description of Clinical Tongue Diagnoses</b> / 日本東洋医学雑誌

In Kampo medicine, a tongue examination, whereby the shape and color of the tongue is observed, is thought to reveal the constitution and condition of the patient. In Japan, numerous books on this tongue examination have been published. However, tongue findings are expressed differently in these books, and a standard description for such findings has yet to be established. A standard description would be useful when examining the tongue, and when educating students of Kampo medicine. We therefore compared how tongue colors and shapes were expressed in the Japanese literature on tongue examinations (12 publications).<br>Using these results, we have arrived at a standardized description for tongue findings in accordance with Kampo specialists of tongue diagnoses at many facilities. In the process, we focused on easily recognizable findings that can be noted with short clinical examination times, and that can also be understood by beginners.

Clinical Experience of Traumatic Cervical Syndrome Treated with Daisaikoto / 日本東洋医学雑誌

We administered daisaikoto to 13 patients with traumatic cervical syndrome and observed complete responses in the following 2 patients. Patient 1 was a 40-year male. He was in the xiaoyang stage, and showed high abdominal tension and marked chest oppression. These findings were indications for daisaikoto. Patient 2 was a female in her 50 s. She was in the xiaoyang stage, showed moderate abdominal tension and chest oppression, and was aware of chest tension and constipation. Evaluation using the VAS in the 13 patients showed a complete response in 3 patients, partial response in 6, minor response in 1 and no response in 3. To clarify indications for daisaikoto in this disease, findings of Japanese Oriental Medicine in the 13 patients were evaluated. Of 9 patients with high abdominal tension, 8 showed partial or complete responses. Of 4 patients with moderate abdominal tension, a complete response, partial response, and no response were observed in 1, 1, and 2, respectively. In addition, objective abdominal coldness was present in both patients with moderate abdominal tension who showed no response but not in the patient showing a complete response.We confirmed the importance of therapy based on oriental medical syndromes when daisaikoto is used for traumatic cervical syndrome. However, patients with moderate abdominal tension without abdominal coldness can be differentiated from others for this therapy.

A Case of Idiopathic Chronic Fatigue Successfully Treated with Sansonintokagen / 日本東洋医学雑誌

Chronic fatigue is a common symptom in primary health care and caused by various organic and functional diseases. Although improvement is attained by controlling underlying organic disease, it is sometimes difficult to relieve fatigue in patients with chronic fatigue syndrome or dysthymia. We have encountered patients with idiopathic chronic fatigue (ICF) successfully treated with sansonintokagen. A 62-year-old female complained of chronic fatigue several years after menopause, and had normal status in routine blood and image analyses at a nearby hospital. Her condition was diagnosed as ICF with sleeplessness. Treatment with sansonintoaogibakumondo for 8 weeks improved her chronic fatigue and sleeplessness, and enabled her to continue housekeeping. This observation suggests that this kampo formula may be a useful agent for ICF.

A Case of Idiopathic Chronic Fatigue Successfully Treated with Sansonintokagen / 日本東洋医学雑誌

Chronic fatigue is a common symptom in primary health care and caused by various organic and functional diseases. Although improvement is attained by controlling underlying organic disease, it is sometimes difficult to relieve fatigue in patients with chronic fatigue syndrome or dysthymia. We have encountered patients with idiopathic chronic fatigue (ICF) successfully treated with sansonintokagen. A 62-year-old female complained of chronic fatigue several years after menopause, and had normal status in routine blood and image analyses at a nearby hospital. Her condition was diagnosed as ICF with sleeplessness. Treatment with sansonintoaogibakumondo for 8 weeks improved her chronic fatigue and sleeplessness, and enabled her to continue housekeeping. This observation suggests that this kampo formula may be a useful agent for ICF.

Consideration to Clinical Indication of Boiogito / 日本東洋医学雑誌

Boiogito, which has been used for obesity, edema and arthritis by using flabby constitution as a clinical indication, is mentioned in Jin Kui Yao Lue (Synopsis of the Golden Chamber). We experienced five cases of wind-wetness syndrome or edema caused by the pathogen Wind successfully treated with boiogito. There were common findings in these cases, i.e., heavy sweating or perspiration while sleeping, chilly feelings and worsening of the evening subjective symptoms and pulse diagnoses, such as floating, string-like and congested pulse in objective findings. On the basis of these cases, we investigated the efficacy of boiogito extract in 10 patients having the all of common findings mentioned above. As a result, boiogito improved symptoms in 8 patients. This suggests that medical examination by interview and distinctive pulsation are important in deciding the Kampo diagnosis for boiogito.

A Case of Jugular Sense of Discomfort with Dryness and Nonproductive Cough Successfully Treated with Soshikokito / 日本東洋医学雑誌

We report a case with an intractable jugular sense of discomfort, with dryness and nonproductive cough successfully treated with soshikokito. A 62-year-old Japanese man developed jugular sense of discomfort with dryness and nonproductive cough, after odontotherapy in October. Although he was treated with Western drugs by an otolaryngologist, under the diagnosis of xerostomia with no mechanical problems, his symptoms did not disappear. The symptoms followed a protracted course, and he further developed a loss of appetite. At the time of first visit in October, otorhinolaryngological studies showed no structural lesions or problems, with the exception of minimum salivation in the normal range on a gum test. There was no evidence of dry eyes. With the diagnosis of xerostomia, Bakumondoto-go-hangekobokuto was administered for a month but showed no sign of improvement. Making a shift to bukuryoin-go-hangekobokuto regained his appetite, but did not produce any improvement on dryness. We then utilized soshikokito under the interpretation that both dryness and nonproductive cough is ki-gyaku. The soshikokito therapy reduced his dryness in a month's time. Additionally, his nonproductive cough gradually decreased, and within 11 months after, he had no symptoms, regardless of a gradual medication withdrawal.

Investigation of Clinical Indications of Hangekobokuto / 日本東洋医学雑誌

Hangekobokuto, on the basis of Jin-kui-yao-lue, has been used to treat acute and chronic gastric disease, psychiatric disorders, abnormal sensation in the throat, and edema which gives the feeling of a small food particle obstructing the throat. We experienced 2 cases involving a sense of incongruity in the interscapular region (pain and/or stiffness), which were successfully treated with hangekobokuto extract.On the basis of these first cases, we investigated the efficacy of hangekobokuto extract in 15 patients having both “ki-utsu” and “suitai”, and a sense of incongruity (pain and/or stiffness) in the interscapular region, without the throat-obstructive feeling of a small in-situ food particle.Improvements in complaints were observed in all patients, with a reduction or disappearance of their sense of incongruity in the interscapular region. Thus, it is possible that hangekobokuto could be widely applicable where symptoms of tenderness or a sense of incongruity in the interscapular region occur (especially the sides of the spinous process of thoracic vertebrae 4-7), in addition to the previously documented indications (heart burn, epigastric discomfort and abdominal fullness).

Two Cases of Fibromyalgia Syndrome Succesfully Treated with Kampo Medicine / 日本東洋医学雑誌

We demonstrated two patients with fibromyalgia syndrome (FMS), successfully treated with Kampo medicine, and considered the resemblance between the clinical manifestation of FMS and SHO for Kanzo-bushi-to.The first case was a 52-year-old women who consulted a local hospital in 2001 due to althralgia and myalgia in the left hand, bilateral elbows, shoulders and foot. Her condition was diagnosed as FMS without abnormal findings in the thorough medical examination. Treatment with NSAIDs was not effective, so she consulted our department in 2004. She was treated with Keishi-ni-eppi-itto-ka-ryojutsu-ka-boi-ogi-kakkon. After two mouths, her symptoms had reduced to 50% by visual analog scale (VAS). By March 2006, her symptoms had significantly decreased to 20% by VAS and NSAIDs became unnecessary.The second case was a 58-year-old woman who had suffered from tolerable pain in her right elbow for 10 years. In 2004, she visited the Department of Orthology at her local hospital due to pain in the neck, bilateral arms and shoulders. There were no findings on cervical X-ray or neurological examination, and NSAIDs were administered. Her symptoms did not resolve, therefore, she consulted our department in 2005. She was diagnosed with FMS, based on fulfilling the diagnostic criteria for FMS of ACR (American college of rheumatology) in 1990. She was treated with Kanzo-bushi-to. After 3 months, her symptoms had reduced to 30% by VAS. By Mar. 2006, her pain had redused to 25% by VAS and she was physically fit enough for a daily life.

Clinical Indications of Jiinshihoto / 日本東洋医学雑誌

The source of Jiinshihoto, which has been used for patients troubled by chronic cough with Ki obstruction, is Wanbinhuichun. We report on 8 cases with various chronic inflammatory diseases in the airway successfully treated with Jiinshihoto. They had similar symptoms, i. e., chronic coughing both dry and moist, and the abnormal sensations in the throat. Our experience with these cases suggests that tympanitic sound on right half side of the abdomen increase the accuracy of Jiinshihoto usage.

Investigation of Clinical Indications of Choyoto based on 9 Effective Cases / 日本東洋医学雑誌

Choyo-to, which has long been used for acute and chronic intestinal disease, dermatological disorders and pulmonary abscess, is attributed to the writings of 7th Century physician Sun Simiao, known as the “Qian-jinyao-fang”. We have also successfully treated nine different patients suffering from various diseases, using Choyo-to. In most of these cases, patients complained of constipation. Thus far, our modern experience suggests that Choyo-to may be indicated for not only right-side pain upon naval palpitation, pressure sensation at the ileocecum and excessive strain of abdominal muscles, but also for cases of dry skin, edematous skin and tendency of normal tongue color.

Two Cases of Allergic Rhinitis Successfully Treated with Shimbuto / 日本東洋医学雑誌

We experienced 2 cases of allergic rhinitis successfully treated with Shimbuto. Shoseiryuto, Goreisan and Ryokankyomishingeninto did not have any favorable effect on these cases. They had similar subjective symptoms, that is, a mass of nasal mucus, became cold easily and developed taste for citrus fruits. There were common objective symptoms, such as, fullness of the upper abdomen, coldness of the epigastrium, epigastric throbbing pulsation and a fluid sound in the stomach upon palpation. These findings suggest that Shimbu-to might be practicable for the patients who did not received the blessing of the standard Kampo therapy.

A Case of Prolonged Post-Herpetic Neuralgia Successfully Treated with Uyaku-jyunki-san-ryou / 日本東洋医学雑誌

We present a case of prolonged post-herpetic neuralgia (PHN), successfully treated by Uyaku-junki-san-ryo. A 76-year-old woman was referred for PHN for 5 months. Her pain was confined to the area of the maxillary nerve, and waving smart pains trouble her greatly, all day long. The stellate block or the administration of carbamazepine did not avail against her pain at a nearby hospital. She visited our hospital on ******, the degree of her pain was expressed as 7.0cm/10.0cm in visual analogue scale (VAS). We utilized Uyaku-junki-san-ryo three times a day. The therapy of Uyaku junki-san-ryo resulted in the improvement of her pain, as well as the increase of her quality of life (QOL). Additionally, her VAS score was diminished from 7cm to 2cm, after two months.<br>This case demonstrates that Uyaku-junki-san-ryo may be a useful agent for the treatment of PHN.

Comparison of Description of Functional Chronic Constipation between Kampo and Western Medicines / 日本東洋医学雑誌

Using textbooks of Western medicine and Kampo medicine in Japan, we examined descriptions in classification and laxative therapy of chronic functional constipation. In terms of the relationship between stool shape and patient's age, description in Kampo textbooks was contrary to that in the textbook of Western medicine. The opinions on the long-term use of rhubarb also divided between Western medicine and Kampo medicine, although in Kampo medicine there was some opinion that the long-term use should be discouraged.

The Recognition by Medical Students for General Medicine and Japanese Oriental (Kampo) Medicine / 日本東洋医学雑誌

We assessed the understanding of Japanese Oriental Medicine, as well as the connection between General Medicine and Japanese Oriental Medicine, among medical students, to improve the effectiveness of clinical practice and lectures. The questionnaires were sent to fifth-year medical students (n=66), and the responses were collected anonymously. Although 22.4% of the responding students were “very” interested in Japanese Oriental Medicine and 68.7% were “slightly” interested, the students who understood Japanese Oriental Medicine even “slightly”comprised only 23.9%. The majority of students considered that the system of Japanese Oriental Medicine was most useful in combination with Western Medicine for practicing General Medicine. Nine (60%) of 15 students who understood Japanese Oriental Medicine considered that the system of Japanese Oriental Medicine was most useful for practicing general medicine. In contrast, among students who did not understand Japanese Oriental Medicine, only 8 of 42 (19%) showed the same response. Similarly, more of the students who understood General Medicine showed this response than students who did not understand General Medicine.<br>These results permit us to speculate that medical students consider that understanding both General Medicine and Japanese Oriental Medicine might contribute to the development of a medical service.

A Case Report of Rheumatoid Arthritis Successfully Treated with Dai-seiryu-to-ka-daio / 日本東洋医学雑誌

We report a case of rheumatoid arthritis (RA) that showed improvement after treatment with Daiseiryu-to-kadaiou. The patient was a 77-year-old woman diagnosed with RA in 1988. She had been visiting our department regularly since 1994. Oral steroids were used for two weeks in May 1994, but were discontinued due to a bacterial infection of the artificial femoral head. Thereafter, treatment was continued with bucillamine, nonsteroidal anti-inflammatory drugs, and various Kampo medicines. Joint pain worsened in November 2001. She was hospitalized on **********, as the CRP level had elevated to 15.2mg/dl. She had been taking bucillamine for seven years, but it had already been assessed as ineffective. It was discontinued upon hospitalization, and treatment with Daiseiryu-to-kadaiou was immediately begun. By ******, the patient judged the pain in both knees to have improved by about 50 percent. Moreover, the CRP level decreased to 2.4mg/dl by *******. The Lansbury index also improved from 100 percent to 69 percent during her hospitalization, and she was discharged on *******. Based on this experience, it is suggested that the prescription of Daiseiryu-to-kadaiou be considered in the treatment of RA patients.

A Study on a Quantity of Imbibition of Natural Medicines at Boiling / 日本東洋医学雑誌

As many natural medicines absorb water at boiling, yields of the decoctions are affected by absorbed water. Therefore, we examined the quantity of imbibition of each crude drug at boiling. We used 75 kinds of crude drugs. After boiling 600ml of water, each natural medicine was boiled for 70 minutes. The medicine was left for 60 minutes, and then boiled again for 20 minutes. The quantity of imbibition of each natural medicine was measured at 10, 20, 30, 40, 60, 130, and 150 minutes. The maximum data among the quantity of imbibition at each point was labeled “maximum quantity of imbibition.” With regard to the maximum quantity of imbibition in natural medicines of plant origin, the range was from a maximum of 69.10g in Chrisanthemi Flos to a minimum of 3.26g in Persicae Semen. The average maximum quantity of imbibition was 22.51±13.00g, and there were large differences among each of the natural medicines. The quantity of imbibition at 10 minutes or 20 minutes was above 80% of each maximum quantity of imbibition on many crude drugs, but that gradually increased over the time course for some crude drugs.

Clinical Experience of Dai-bofu-to for Patients with Rheumatoid Arthritis / 日本東洋医学雑誌

We treated two patients with rheumatoid arthritis (RA) who demonstrated different signs from the perspective of traditional medicine. The first case was a 73-year-old woman. In 1977, she consulted a nearby hospital due to bilateral knee joint pain. Her condition was diagnosed as RA. In 1984, she consulted our department for Stage IV and Class III disease. She was treated with Keishi-ni-eppi-itto-ka-ryojutsubu-kagen, and her condition stabilized. In 1994, she received total replacement of the bilateral knee joints. Her ADL increased, but pain at her bilateral wrist, elbow, shoulder and ankle joints persisted. Although she was treated with Yokuininto, as well as bucillamine and salazosulfapyridine, arthralgia persisted. In 1996, her condition was as follows: general malaise, pain at the bilateral shoulder and elbow joints, severe deformity at the wrist joints, dry skin and slender limbs. She walked with a cane. Therefore, we changed the formula from Keishi-shakuyaku-chimoto to Daibofu-to. Thereafter, her symptoms significantly decreased. The second case was a 50-year-old woman. In 1994, she suffered from pain in the right hand, bilateral feet and knee joints. Her condition was diagnosed as RA at a local hospital. In 1996, polyarthralgia increased and she consulted the department of orthopaedic surgery in our hospital. She was administrated bucillamine, but it was discontinued due to eruptions. Then she consulted our department. She was first treated with Keishi-ni-eppi-itto-ka-ryojutsubu, and then with Yokuininto, which did not change her symptoms. Therefore, we tried several DMARDs; however, her condition worsened. In June 2000, her laboratory data were as follows: RF 860U/ml, ESR 72mm/hr, CRP 4.0mg/dl. Although she complained of pain at the bilateral wrist, elbow and ankle joints, there was no deformity in the bilateral wrist or finger joints of either hand. She was a medium-sized person, and without dry skin or edema at the limbs. The administration of Daibofu-to improved her symptoms as well as laboratory data after 3 months of treatment.<br>The clinical signs of case 1 were in accordance with the traditional indications for Daibofu-to. In contrast, those of case 2 differed from these indications with regard to blood-deficiency, since there was no dry skin, change in the nail, dizziness or deformity of the joints. These observations suggest that a subset of patients with RA, who have poor deficiency of blood or Ki, may be another population that can be successfully treated with Daibofu-to.

Case Report of Subchorionic Hematoma Successfully Treated with Shimi-kyogai-to-kami / 日本東洋医学雑誌

A pregnant woman suffering from subchorionic hematoma (which had not responded to any Western medicine) was in danger of having a miscarriage. She was treated successfully with Shimi-kyogai-to-kami. When she was in the tenth week of pregnancy, lower abdominal pain and genital bleeding started and continued despite the administration of carbazochrome sodium sulfonate, tranexamic acid and ritodrine hydrochloride. We initiated Shimi-kyogai-to-kami in the 17th week of the pregnancy, and her symptoms improved within four weeks. The hematoma disappeared in less than five weeks. She made satisfactory progress without recurrence and gave birth to a baby boy weighing 2628g in the 37th week of the pregnancy. It is possible that therapy based on Kampo diagnosis is useful in the treatment of subchorionic hematoma. Moreover, it seems that Shimi-kyogai-to is safer than Kyuki-kyogai-to in the treatment of pregnant women.