ABSTRACT
Mengen is an acute symptom that sometimes occurs after administration of a Kampo formula. It is a shortterm phenomenon and its onset indicates that the patient's clinical course will improve rapidly. It is important to distinguish it from other adverse events, which are not temporary. However, to date, detailed analysis of mengen characteristics such as its frequency, time of onset after Kampo administration, and duration have not been reported. Therefore, we report a precise analysis of mengen characteristics through a literature review of case reports published between 1945 and 2009 in Japan, and retrospective analyses of the cases in our institute.<br>The literature review revealed that 42% patients developed symptoms of mengen within a day of administration, and 79% developed symptoms within 3 days. In terms of mengen duration, the symptoms persisted for 1 day in 35% cases and 3 days in 63% cases. A diagnosis of mengen proved difficult in 39% cases that presented with atypical symptoms.<br>Overall, the retrospective analysis of the cases in our institute revealed that 11 patients (7.7%) developed mengen, among 143 patients treated with Kampo between May 2010 and November 2011.
ABSTRACT
A 51-year-old male with cyclic neutropenia, on whom we previously reported, was admitted to our hospital with severe abdominal pain and diarrhea four years and seven months after his last hospitalization. Since then, he has received Kampo treatment at our hospital every three weeks, with good clinical results. This time, he was at first treated with Kampo daikenchuto combined with bushikobeito, which had been effective during his last hospitalization, although this time the remedy had no effect. From the viewpoint of Japanese traditional (Kampo) medicine, it was considered that the patient had severe cold syndrome. He was given uzukeishito three times a day (at 10.00, 15.00 and 20.00 hours). The dose of uzu in uzukeishito was gradually increased. Daiuzusen, in which the dose of uzu (an aconite) was 1g or 2g, was also administered five times a day due to the patient's very severe abdominal pain. On the fourth day of uzukeishito administration, the patient felt very hot and still had severe abdominal pain, although this pain was different from the previous pain, thirty minutes after daiuzusen (with 2g dose of uzu) was administered. This reaction can better be explained as <I>mengen</I> rather than uzu poisoning. Very soon he had a good appetite, his abdominal pain was reduced and the cycle of neutropenia was normalized. The case suggests that in cases of very severe cold syndrome, frequent and high-dose administration of aconite component medicine can be effective.
ABSTRACT
A 51-year-old male with cyclic neutropenia, on whom we previously reported, was admitted to our hospital with severe abdominal pain and diarrhea four years and seven months after his last hospitalization. Since then, he has received Kampo treatment at our hospital every three weeks, with good clinical results. This time, he was at first treated with Kampo daikenchuto combined with bushikobeito, which had been effective during his last hospitalization, although this time the remedy had no effect. From the viewpoint of Japanese traditional (Kampo) medicine, it was considered that the patient had severe cold syndrome. He was given uzukeishito three times a day (at 10.00, 15.00 and 20.00 hours). The dose of uzu in uzukeishito was gradually increased. Daiuzusen, in which the dose of uzu (an aconite) was 1g or 2g, was also administered five times a day due to the patient's very severe abdominal pain. On the fourth day of uzukeishito administration, the patient felt very hot and still had severe abdominal pain, although this pain was different from the previous pain, thirty minutes after daiuzusen (with 2g dose of uzu) was administered. This reaction can better be explained as <i>mengen</i> rather than uzu poisoning. Very soon he had a good appetite, his abdominal pain was reduced and the cycle of neutropenia was normalized. The case suggests that in cases of very severe cold syndrome, frequent and high-dose administration of aconite component medicine can be effective.
ABSTRACT
Recently we observed three cases in which symptom-producing doses of Kampo medicine with aconiti tuber dramatically ameliorated primary diseases. The symptoms were similar to intoxication caused by aconiti tuber. Case 1 had been suffering from rheumatoid arthritis. After the daily dose of Keishi-ni-eppi-itto-ka-ryojutsubu, a Chinese herbal medicine containing aconiti tuber, was increased from 6g/day to 7g/day, the patient briefly experienced palpitation and nausea. At the same time, polyarthralgia and laboratory data dramatically improved. Case 2 suffered from lumbago due to osteoarthritis. Numbness around the lips and in the limbs and gait disturbance occurred in this patient after the basal prescription was changed from Shakuyaku-kanzo-bushi-to to Hachimijio-gan-ryo with the 4g/day dose of aconiti tuber remaining the same. The patient's lumbago disappeared almost completely. Case 3 had osteoarthritis and began taking Hachimijio-gan-ryo, containing aconiti tuber (8g/day), in early June. Numbness around the lips and limbs occurred after administration of Hachimijio-gan-ryo containing aconiti tuber (4g/day) in late July. After that, her gonalgia was recovered. Based on our experience above, we had the impression as follows: 1) Symptoms similar to intoxication due to aconiti tuber may be caused not only by increasing the daily dose of aconiti tuber, but also by changes of basal description or climate variations such as a rise in temperature. 2) In order to use aconiti tuber effectively, it is sometimes necessary to increase the daily dose to the level where it provides treatment, in spite of the risk of intoxication.