RESUMO
A 76-year-old patient with double valvular replacement was hospitalized every year during the last four years because of congestive heart failure. It was thought that the patient had difficulties in maintaining appropriate water intake because of a lack of understanding about the disease. However the findings of his tongue indicated that the patient suffered from severe deficiency of Yin-fluid. We therefore hypothesized that the thirst derived from deficiency of Yin-fluid. Diuretics may have affected the patient's control of water intake. After he was discharged from hospital, we avoided increasing the dose of diuretics and administered Seihai-to (TJ-90), Gosha-jinki-gan (TJ-107) and then Bakumondo-to (TJ-29). After we used Bakumondo-to, the diameter of the inferior vena cava (IVC) was significantly decreased (IVC=8mm, P<0.01 smirnoff's test) as compared with the estimated IVC before Kampo treatment (19.6±2.2mm, α=0.05, n=13). Because the amount of Bakumondo-to administrated was not very large, it is unlikely that Bakumondo-to directly reduced the blood volume. Bakumondo-to may prevent heart failure by modifying the sensation of thirst as the cause of inappropriate water intake.