A Case of Unexplained Long-Term Thumb Onycholysis Successfully Treated with Shimotsuto / 日本東洋医学雑誌

This report outlines the case of a 51-year-old female patient who had suffered from onycholysis of the thumbs for eight years. The patient complained of experiencing pain when she works in contact with water, affecting her quality of life. Before coming to our clinic, the patient was diagnosed and treated at three dermatology clinics. However, treatment proved ineffective and the cause was not elucidated. As the patient experienced symptoms of onycholysis and dry skin, we diagnosed her with ketsu deficiency and treated her with shimotsuto. The symptoms gradually improved with continuous oral administration, and were no longer present at eight months following the start of treatment. This case suggests that shimotsuto may be effective in treating instances of onycholysis where the cause is unknown.

<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>2 Cases of Children Successfully Administered Kampo Formulae that Included Bushi or Uzu </b> / 日本東洋医学雑誌

We administered a Kampo decoction containing bushi (prepared aconiti tuber) or uzu (un-prepared aconiti tuber) to two children in Aso Iizuka hospital. Case 1 was a thirteen year-old girl with atopic dermatitis that worsened after her topical steroid was stopped. When her itching sensation was reduced following a bath, we considered that she was suffering from coldness. Therefore we administered a half dose of bukuryoshigyakuto.The next morning her old skin flaked off and her skin appeared healthy. We administered bukuryoshigyakuto before every meal and there was rapid improvement in her dermatitis. Case 2 was a twelve year-old girl with orthostatic dysregulation who was unable to attend school. She had become aware of coldness the previous autumn and had not been able to go to school, nor even sit up, since the previous winter because of severe fatigue. We diagnosed her with severe coldness and so started sekiganryo administration, and included 2 g of uzu. We gradually increased the uzu. At a result, her severe fatigue improved to the extent that she could eat breakfast and go to school inside the hospital. Children may have severe coldness if they suffer from a long-term illness. Moreover, particular attention should be given to toxicity caused by aconiti tuber.

<b>A Case of Inflammation of the Lips Successfully Treated </b><b>with Otsujito </b> / 日本東洋医学雑誌

Otsujito is a well-known herbal preparation used for treating hemorrhoidal disease. However, we considered the anatomical similarities between the lips and the anus, and here report a case of inflammation of the lips with blood stasis successfully treated with otsujito as well.<br>The case was a 59-year-old woman suffering from eczema on her face and neck. The eczema showed a tendency to improve with herbal treatment, but inflammation and pruritus of the lips continued. Taking into account the presence of blood stasis, we included otsujito in the treatment and her symptoms improved.<br>Otsujito contains bupleurum, cimicifuga, scutellaria, and rhubarb, which dissipates heat, and angelica,which resolves blood stasis. Therefore, we consider that inflammation of the lips with blood stasis can be treated with otsujito.

<b>A Case of Respiratory Tract</b> <b>Infection Successfully Treated </b><b>with Low-dose Daisaikotokabosho </b> / 日本東洋医学雑誌

We report a 68 year-old woman being treated for anorexia. Despite our treatment, her body weight decreased to 22 kg and she was admitted to our hospital ER for Wernicke's encephalopathy and a hypoglycemic attack, which both occurred on January 21 st. She experienced respiratory failure and was placed on a respirator. On March 24 th she developed a fever due to a respiratory tract infection, and antibiotics and keishinieppiichito were administered.<br>On March 26 th she again developed a fever. One tenth of the normal daily dose of daisaikotokabosho was administered successfully. However, she had a fever again on March 31 st. The following day, one tenth of the normal daily dose of daiaikotokabosho was administered successfully. The formula was continued and the fever disappeared after April 3rd.<br>Whether the base formula of saikokaboshoto is daisaikoto or shosaikoto remains controversial. Our case was suspected of rinetsu, excessive pathogenic heating of the interior body, and her abdominal symptoms indicated daisaikoto. Therefore daisaikotokabosho, which is closely related to yomeibyo as a shoyobyo, was administered effectively.<br>This case suggests that a grossly underweight patient, in whom hypo function or yin condition would usually be seen, has the potential to change to hyper function or a yang condition. In such a case, dose adjustment for physical size and body energy is necessary.

<b>Three Cases of Fever Successfully Treated with Daijokito </b> / 日本東洋医学雑誌

Nowadays, it is rare to see Yang min disease in the acute fever phase. We report three cases of acute fever successfully treated with daijokito.<br>Case 1 : An 82-year-old male with suspected viral infection. He had a persistent fever of 38 °C. Because of abdominal fullness, constipation and wheeze, we administered daijokito. These symptoms disappeared, his hypoxemia improved, and his fever went down to 36 °C, accompanied by considerable defecation.<br>Case 2 : A 67-year-old female with suspected central hyperthermia. She had a persistent fever of 38 °C. Because of abdominal fullness and constipation, we administered daijokito. These symptoms disappeared and her fever went down to 36 °C with considerable defecation.<br>Case 3 : A 43-year-old male who was diagnosed with paralytic ileus accompanied by cyclic neutropenia. Three days after his temperature rose to 38 °C, and constipation, abdominal fullness and pain appeared. After administering daijokito, these symptoms disappeared and his fever went down to 36 °C with considerable defecation.<br>When abdominal fullness and constipation appear after a fever continues, we believe the administration of daijokito should be considered whether western medicine has been applied or not.

Kampo Therapies on an Isolated Island / 日本東洋医学雑誌

We report a situation involving Kampo therapies on an isolated island and three cases treated with Kampo medicine on the island. The first author received outpatient training at the department of Japanese Oriental Medicine in Iizuka Hospital and provided medical care on the island for 3 years, using Kampo therapies.<BR>About one quarter of patients (total, 134) were prescribed Kampo therapies in April 2009, and we surveyed the number of patients who had taken each Kampo medicine for 2 years from April of 2008 to March of 2010. As to prescriptions of less than 4 weeks, Kampo medicines used for a cold ranked high. As to prescriptions exceeding 4 weeks, hachimijiogan, daiokanzoto and keishibukuryogan were the most prescribed medications, in descending order.<BR>We consider Kampo therapies to have been effective on this isolated island where there are many elderly people, and patients who must be treated comprehensively while giving consideration to their familial states. We also presume the environment of an isolated island to cause certain clinical conditions, water imbalances included, such that Kampo medicines for water imbalances tended to be prescribed frequently.<BR>Finally, learning Kampo therapies has highly motivated the first author to practice community medicine.

Usage of Ogonto to Address the High Prevalence of Vomiting and Diarrhea amongst Senior Citizens in Nursing Home / 日本東洋医学雑誌

Norovirus infection is a common cause of epidemic winter vomiting and diarrhea. The symptoms that present, such as vomiting, diarrhea, fever and abdominal pain, normally disappear within 1 to 3 days, although some fatal cases are reported in the elderly.During the two months from December 1, 2005 to January 31, 2006, we prescribed ogonto to twenty patients who presented with vomiting or diarrhea in a nursing home, and examined prescription times and illness durations, other drugs used, and whether there were any transfusion or complications.The number of ogonto doses given was from 1 to 12. Fifteen cases (75%) were dosed 3 times or less, and four cases were only dosed once. In terms of illness duration: eleven cases were cured in less than 24 hours; six cases were cured from 24 hours to less than 48 hours; two cases were cured from 48 hours to less than 72 hours; and one case was cured from 72 hours to less than 96 hours. Overall, seventeen cases (85%) were cured in less than 48 hours.Regarding the other treatment and complications: domperidone was used in four cases; and a transfusion was given in six cases. Aspiration pneumonia occurred in one case, but no patient required hospital treatment. Norovirus infection is usually treated only with symptomatic therapy, so we think Kampo therapy should be available because when started at an early stage, it can prevent this disease from becoming severe.

Effectiveness of Syouhangekabukuryoto in Post Nasal Dripping / 日本東洋医学雑誌

Shohangekabukuryoto, an herbal mixture, was administered to 15 patients with postnasal drip. Ten patients responded to this therapy and 5 failed to respond to it. Subjective symptoms and objective findings were analyzed and compared between the responders and nonresponders. Nausea was not observed in any patient. In the responders, watery rhinorrhea and <I>shinsuion</I> was often noted. Patients showing viscous rhinorrhea without <I>shinsuion</I> were considered nonresponders. These results suggest that shohangekabukuryoto is an herbal mixture that may be used for treating patients with postnasal watery rhinorrhea accompanied by <I>shinsuion</I>, despite the absence of evident nausea.

A Case Report of Recrudescent Cholangitis Successfully Treated with Kampo Medicine / 日本東洋医学雑誌

We report a case of recrudescent cholangitis successfully treated with Kampo medicine. The patient was a 31-year-old female. She was diagnosed with congenital biliary dilatation, and underwent an operation for partial resection of the liver, and a choledocho-jejunostomy. However, the cholangitis returned two years ago, when she was 29 years old. She had repeated abdominal pain and fever, and at that time received treatment with antibiotics. She desired pregnancy, and was hoping that Kampo treatment would enable her to decrease the amount of antibiotic she was taking. We prescribed inchinkoto as a base treatment and added to daisaikoto or shosaikoto. We changed the prescription according to her symptoms. As a result, her antibiotic quantity was reduced markedly, she safely conceived, and kept taking Kampo medicine while she was pregnant. She remained in good condition throughout her pregnancy. Thus, we consider that Kampo medicine may be useful for treating recrudescent cholangitis after an operation for reconstruction of the biliary tract.

Four Patients with Calf Cramps who did not Respond to Shakuyakukanzoto but Responded well to Sokeikakketsuto / 日本東洋医学雑誌

We encountered 4 cases of calf cramps in which the herbal mixture shakuyakukanzoto was ineffective but another herbal mixture sokeikakketsuto was effective. In case 1, the patient was a 73-year-old man. He had a history of calf cramps, and started experiencing calf cramps more frequently about1month before he made his first visit to our department. Shakuyakukanzoto (7.5g/day) was initially prescribed, but the frequency of cramps did not change. Then, shakuyakukanzoto was replaced with sokeikakketsuto (7.5g/day), and this resulted in rapid alleviation of the symptom. In case 2, the patient was a 67-year-old woman undergoing outpatient care for shoulder stiffness, low back pain, etc. She started experiencing calf cramps at night and underwent shakuyakukanzoto (7.5g/day) treatment. The frequency of cramps did not change, and hence, shakuyakukanzoto was replaced with sokeikakketsuto (2.5g at bedtime). The symptom was alleviated in response to this therapy. In case 3, the patient was a 66-year-old woman undergoing treatment for low back pain at our department. She experienced calf cramps and was treated with shakuyakukanzobushito (3.0g/day). The response was poor, and the herbal mixture was replaced with sokeikakketsuto (7.5g/day), which resulted in the disappearance of her cramps. In case 4, the patient was a 75-year-old man undergoing treatment for a cold sensation in the left leg. He experienced calf cramps and was treated with shakuyakukanzobushito (1.5g/day). This therapy resulted in only temporary relief from the symptom. After the herbal mixture was replaced with sokeikakketsuto (2.5g/day), the cramps disappeared rapidly. Thus, sokeikakketsuto, which improves blood flow and is thought to manifest analgesic effects, may be used for treating patients with calf cramps who do not respond to shakuyakukanzoto.

Two Cases of Vomiting Successfully Treated with Daisaikoto / 日本東洋医学雑誌

We encountered 2 cases of vomiting that were successfully treated with daisaikoto. In case1, the patient was a 16-year-old girl. She was vomiting in the hospital with pneumonia. Referring to the vomiting and kyokyo-kuman (Subchondrial resistance and discomfort), vomiting gradually disappeared after administration of daisaikoto. In case 2, the patient was a 73-year-old woman. After aspiration pneumonia, she developed nausea and vomiting and experienced constipation and kyokyo-kuman. The nausea and vomiting gradually disappeared after the administration of daisaikoto. These findings suggested that daisaikoto, in combination with a large amount of Zingiberis Rhizoma on classic text, suppresses nausea.

A Case of Cyclic Neutropenia Treated by Uzu-zai with Mengen, Unexpected Reaction / 日本東洋医学雑誌

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.

The Meaning of \lceilFukuchukan\rfloor in the Abdominal Symptom of Daikenchuto-syo / 日本東洋医学雑誌

Daikenchuto is recorded in Kampo textbooks as a prescription for abdominal disorders. We considered fukuchukan (coldness in the abdomen) as equaling a sensation of coldness centering on the navel, and we examined the usefulness of using Daikenchuto as a medication for this symptom. We administered Daikenchuto to 90 patients who presented with coldness of the navel. The patients were divided into 2 groups:the first group had accompanying digestive symptoms, the second had no accompanying digestive symptoms. We then examined their response rates, and improvement rates for coldness centering on the navel. We also examined the abdominal strength and pulse strength for responders and non-responders, respectively.The Digestive Symptoms group consisted of 64 patients. In this group, the response rate was 81.3%.The improvement rate of coldness centering on the navel was 92.3% in responders and 41.7% in non-responders, and the difference was highly statistically significant (p<0.001). The Non-digestive Symptoms group consisted of 26 patients. In this group, the response rate was 38.5%. The improvement rate of coldness centering on the navel was 100% in responders and 43.8% in non-responders, and the difference was statistically significant (p=0.022).In a comparison of all 90 responder and non-responder cases, weak abdominal strength was 62.9% in responders and 42.9% in non-responders, intermediate abdominal strength or above was 37.1% in responders and 57.1% in non-responders, and the difference between abdominal strength and response rate (p=0.076) was non-significant. Weak pulse was 54.8% in responders and 40.7% in non-responders, intermediate pulse strength or above was 45.2% in responders and 59.3% in non-responders, and the difference between pulse strength and response rate (p=0.221) was non-significant. 13 of these cases were above intermediate, for both abdominal strength and pulse strength.We conclude that for patients presenting with a sensation of coldness centering on the navel, there is a strong possibility that the efficacy of Daikenchuto-syo is suggested, regardless of whether or not there are other digestive symptoms. Moreover, Daikenchuto proved effective in 13 cases where both abdominal strength and pulse strength were above an intermediate level, suggesting that a sensation of coldness centering on the navel can be the key to finding the sensho of Daikenchuto-sho.

The Meaning of "Fukuchukan" in the Abdominal Symptom of Daikenchuto-syo / 日本東洋医学雑誌

Daikenchuto is recorded in Kampo textbooks as a prescription for abdominal disorders. We considered <i>fukuchukan</i> (coldness in the abdomen) as equaling a sensation of coldness centering on the navel, and we examined the usefulness of using Daikenchuto as a medication for this symptom. We administered Daikenchuto to 90 patients who presented with coldness of the navel. The patients were divided into 2 groups:the first group had accompanying digestive symptoms, the second had no accompanying digestive symptoms. We then examined their response rates, and improvement rates for coldness centering on the navel. We also examined the abdominal strength and pulse strength for responders and non-responders, respectively.<br>The Digestive Symptoms group consisted of 64 patients. In this group, the response rate was 81.3%.The improvement rate of coldness centering on the navel was 92.3% in responders and 41.7% in non-responders, and the difference was highly statistically significant (p<0.001). The Non-digestive Symptoms group consisted of 26 patients. In this group, the response rate was 38.5%. The improvement rate of coldness centering on the navel was 100% in responders and 43.8% in non-responders, and the difference was statistically significant (p=0.022).<br>In a comparison of all 90 responder and non-responder cases, weak abdominal strength was 62.9% in responders and 42.9% in non-responders, intermediate abdominal strength or above was 37.1% in responders and 57.1% in non-responders, and the difference between abdominal strength and response rate (p=0.076) was non-significant. Weak pulse was 54.8% in responders and 40.7% in non-responders, intermediate pulse strength or above was 45.2% in responders and 59.3% in non-responders, and the difference between pulse strength and response rate(p=0.221) was non-significant. 13 of these cases were above intermediate, for both abdominal strength and pulse strength.<br>We conclude that for patients presenting with a sensation of coldness centering on the navel, there is a strong possibility that the efficacy of Daikenchuto-syo is suggested, regardless of whether or not there are other digestive symptoms. Moreover, Daikenchuto proved effective in 13 cases where both abdominal strength and pulse strength were above an intermediate level, suggesting that a sensation of coldness centering on the navel can be the key to finding the <i>sensho</i> of Daikenchuto-sho.

Two Cases Successfully Treated with SANO-TO (Senkin-Ho) / 日本東洋医学雑誌

We reported two cases successfully treated with sano-to (Senkin-Ho). Case 1 was a 63-year old female, who visited our department in December 2004 complaining of polyarthralgia, a burning sensation in the hands and feet, irritability and chilliness. We prescribed sano-to (Senkin-Ho). The visual analogue scale (VAS) decreased from 100 mm on the first visit to 23 mm 10 months later in October 2005. Case 2 was a 62-year old female, who came to our department complaining of whole body pain in August 2004. Various Kampo medicines were tried but proved ineffective, and in June 2005 she was hospitalized. At that time, in addition to whole body pain, she complained of a burning sensation in her feet, psychological anxiety, and chillness. We prescribed sano-to (Senkin-Ho). After 2 months, her VAS decreased from 80 mm to 20 mm. We consider that sano-to (Senkin-Ho) should be prescribed more actively when patients suffer from painful diseases accompanied with subjective symptoms such as a burning sensation in the hands and feet, psychological symptoms, and chilliness.

Three Cases of Pneumonia Successfully Treated by Kampo Therapy / 日本東洋医学雑誌

We report three cases of pneumonia successfully treated with Kampo therapy. Case 1 was a 69-year-old female who was hospitalized with a fever and cough. Administration of Keishinieppiitto led to an improvement in her cough and a rapid reduction of fever, and we continued her treatment using Kampo medicine only. By the 7th day of admission, the infiltration shadow had disappeared, and on the 11th day, laboratory data on WBC and CRP had decreased to a normal range. Case 2 was a 66-year-old female who was hospitalized with cough, sputum and fever. She received modern western medical treatment, including antibiotics for one month, but her symptoms showed little improvement. After we administered Saiko-keishi-kankyo-to-go-Hange-koboku-to, her symptoms gradually improved. By the 15 th day of admission, her CRP levels had decreased to 0.7mg/dL, and the infiltrative shadow had disappeared. Case 3 was a 78-year-old male who was hospitalized with cough, sputum, anorexia and general malaise. A multiple nodular lesion in the lung was also detected by chest CT. Consequent diagnostic examinations were conducted, while providing him with Saikokeishito. Although the final diagnosis was pneumonia, of unknown etiology, his fever decreased and on further examination his laboratory data had improved. If a Kampo formula is selected in accordance with the diagnosis of Kampo medicine, we consider that pneumonia can be treated with Kampo medicine without the use of antibiotics.

A case of Megacolon Successfully Treated by Re-dosage of Kobokusanmotsuto; After an Attack of Pseudoaldosterenism induced by Chukenchuto / 日本東洋医学雑誌

We present a case of megacolon successfully treated with Kampo medicine. A 65-year-old male diagnosed with megacolon in 1999, came to our department in July 2003 complaining of severe abdominal distention. We successively used different Kampo formulae, in accordance with the diagnostic standard known as “SHO” which were: Daikenchu-to, Koboku-sanmotsu-to, Chukenchu-to, and Koboku-sanmotsu-to again. Daikenchu-to was only partly effective. Koboku-sanmotsu-to made the abdominal distention worse, forcing a change of drug. Chukenchu-to relieved the symptoms for some time, but the patient had to be hospitalized because of pseudoaldosteronism caused by the drug. Koboku-sanmotsu-to, however, worked smoothly on the second occasion and the symptoms disappeared. The efficacy of Koboku-sanmotsu-to was completely different on the two occasions it was used. This suggests that the pathological conditions were in a state of change, and these changes were identical to changes of SHO. This case reinforces the importance of detecting changes of the SHO accurately.

Subjective Symptoms that can be indicators for Choosing Ogikeishigomotsuto / 日本東洋医学雑誌

Ogikeishigomotsuto is a Kampo formula used for numbness or body pains. We experienced 29 cases in which attending physicians believed the drug would be effective. In 18 cases the drug was effective and in 11 cases it was not. We analyzed the difference in subjective symptoms between the responder group and the non-responder group. We concluded that some symptoms could be indicators for choosing the formula. Hypersensitivity to cold and heaviness of the whole body has previously been reported in many articles. In our cases, we observed a high incidence and specificity of the symptoms reported above, as well as arthralgia, dry skin and irritability in the responder group compared to the non-responder group. We believe these newly detected subjective symptoms can also be indicators for choosing Ogikeishigomotsuto.

A Case of an Anorectic Post-gastrectomy Patient Treated with Kososan and Rikkunshito / 日本東洋医学雑誌

We report a case of an anorectic 71-year-old male post-gastrectomy patient who was successfully treated with Koso-san and Rikkunshi-to. The patient underwent resection for early gastric cancer (0-IIa+IIc). After partial gastrectomy, he suffered from nausea and vomiting. He was treated with endoscopic balloon dilatation at the anastomotic site, and was simultaneously treated with some western drugs. However, he was completely unable to eat because of nausea and vomiting. Oriental medicine was then recommended. We treated him with Kampo medicines in combination with parenteral nutrition. After the administration of Koso-san, his nausea and vomiting disappeared immediately and he could ingest a fluid diet. Further, after the administration of Koso-san and Rikkunshi-to, his food intake increased. Finally, he could eat ordinary meals and his food intake reached an adequate level. This suggests that Koso-san and Rikkunshi-to are useful in the treatment of anorectic patients after gastrectomy.