A Case Report of Recurrent Chronic Subdural Hematoma Successfully Treated with Jidabokuippo / 日本東洋医学雑誌

We report a case of recurrent chronic subdural hematoma (CSDH) successfully treated with jidabokuippo. The patient was an 81 year-old woman who was performed burr hole surgery for left CSDH. Residual hematoma was gradually increased in postoperative serial brain CT. Although goreisan and saireito were administrated to prevent recurrence, the treatment was not effective. Thereafter, reoperation was performed because of the appearance of aphasia and right hemiparesis. Intraoperative findings revealed that the hematoma was viscous and was not enough drained. Since there was little improvement in clinical and CT findings, a phenomenon of the hematoma was considered as oketsu and jidabokuippo was administrated. Three weeks after the medication, right hemiparesis was improved. Seven weeks after the medication, the hematoma was markedly reduced. Taken together, these results strongly suggest that jidabokuippo is effective for postoperative recurrent CSDH which is difficult for drainage and has no response to the administration of goreisan and saireito.

A Case of Bullous Pemphigoid Completely Remitted with Formulation of Seihijoshitsuinkagen (Qing Pi Chu Shi Yin Hua Cai) / 日本東洋医学雑誌

We report one case of bullous pemphigoid that did not respond to the standard western medical treatment with topical and oral steroid therapy. This case achieved complete remission after the application of Yizongjinjion seihijoshitsuinkagen (Yizongjinjion Qing Pi Chu Shi Yin Hua Cai), a spleen-dampness-eliminating beverage. The patient was a 78-year old female who had soy bean or 5 mm to 25 mm sized blisters covering a wide area of her back since two years ago. She had visited a neighborhood physician who diagnosed her with bullous pemphigoid and initiated the standard treatment. Although some improvements were observed after the start of western medical treatment, her symptoms eventually grew worse. Therefore, she visited our clinic and requested the traditional Chinese treatment. We diagnosed her skin blisters as the heart-fire spleen-dampness type of bullous pemphigoid using the four diagnostic examinations, and treated her with the modulated spleen-dampness-eliminating beverage which resulted in a complete remission within 10 months. Taken together, our results suggest that the modulated spleen-dampness-eliminating beverage (Yizongjinjion seihijoshitsuinkagen) is effective for the treatment of the heart-fire spleen-dampness type of bullous pemphigoid.

Relationship between the Metabolic Syndrome and Abdominal Tension / 日本東洋医学雑誌

Metabolic syndrome develops because of an accumulation of intra-abdominal fat. In Kampo medicine, an abdominal examination is commonly performed for the diagnosis of diseases. Thus, we examined the relationship between metabolic syndrome and abdominal tension. Our subjects were 999 people (619 males and 380 females) who underwent regular physical check-ups. Metabolic syndrome was diagnosed in 14.5% (21.3% of males and 3.4% of females) and the prevalence rate of subjects with metabolic and pre-metabolic syndromes was 40.8% (55.9% of males and 16.3% of females). In addition, abdominal examinations detected 19.1% of hyperfunction, 64.6% of intermediate function, and 16.3% of hypofunction. Almost subjects with abdominal hyperfunction were classified as metabolic or pre-metabolic syndrome, and neither metabolic nor pre-metabolic syndrome was present in subjects with abdominal hypofunction. In conclusion, assessment of abdominal tension may become an additional valuable screening method for metabolic syndrome.

Pathogenesis and Treatment of Shao Yang Disease Learned in the Shang Han Lun / 日本東洋医学雑誌

The Shaoyang lies next to the Interior of the Taiyang and to the Exterior of the Yangming, and is located in the half exterior and half interior position, containing both the parts and its physiological function which belong to the Gallbladder Channel of Foot-Shaoyang and the Triple Warmer Channel of Hand-Shaoyang. The Gallbladder Channel of Foot-Shaoyang controls the dispersing and discharging function of the vital energy (qi), and the Triple Warmer Channel of Hand-Shaoyang controls the function which distributes and transports the vital energy (qi), the fire and the water. When the wind-cold pathogen enters Shaoyang, anti-pathogenic vital-qi and exopathogen conflict each other, the distribution and the transport of the vital energy (qi), the fire and the water in the Triple Warmer Channel is obstructed due to the impairment of the dispersing and discharging function of the Gallbladder Channel of Foot-Shaoyang, the malfunction of Shaoyang pivots is then occured and results in the Shaoyang disease which is characteristic of the symptom complex such as bitter taste in the mouth, dryness of the throat, blurring of vision, alternate fever and chills, fullness in the chest and hypochondrium, hypochondria and anorexia, restless in mind, incessant vomiting, wiry and thready pulse and so on. This syndrome is treated by using Xiao chai fu tang which can harmonize Shaoyang. If various inproper treatments are given repeatedly to the Shaoyang disease, the syndrome to which Xiao chai hu tang must be given disappears, and a delirium as a deteriorated case appears newly, it is important to make clear what kind of inproper treatments were given, and the most appropriate treatment must be done in accordance with different present syndromes.