<b>Clinical Characteristics of Cases Treated with Ryokito</b> / 日本東洋医学雑誌

Ryokito is a Kampo formulation which has been administered for right upper quadrant pain since the Edo Era in Japan. Yet there are but a few reported cases in multiple clinical exams at one institution, on the usage of this formulation. We undertook a precise retrospective analysis of ryokito-prescribed cases at our institute over ten years, and reported cases published in the past to illuminate the clinical characteristics of ryokito effective cases. <br>Among the 21 cases at our institute, ryokito was effective in 11 cases and 10 of these 11 cases had right upper quadrant pain. Additionally, 7 of them reported abdominal distention. <br>Overall, this retrospective analysis revealed that amongst those ryokito effective cases, not a few patients had the right upper quadrant pain. This fact suggests that right upper quadrant pain is a reasonable characteristic for a usage of ryokito. <br>Likewise, abdominal distention was also a common symptom among the effective cases. It is likely that abdominal distention could be a characteristic for a usage of ryokito as well.

<b>A Case of Irritable Bowel Syndrome Causing the Abdomen to feel Enlarged, Successfully Treated with Ryokito</b> / 日本東洋医学雑誌

We experienced a 56-year-old male who had suffered from diarrhea, epigastric discomfort and an enlarged abdomen feeling for 12 years, and who was diagnosed with irritable bowel syndrome. Although he had undergone treatment using Western medicine in many hospitals, his condition had not improved. He was therefore started on Kampo medicine 5 years ago. However, since the enlarged abdomen feeling worsened whenever he changed his prescription, it was difficult to treat him on an outpatient basis. Thus we tried hospitalization. His feeling of enlarged abdomen was near continuous, but the discomfort from a spasmodic enlarged abdomen feeling was greater. We recognized the spasmodic feeling to be hontonki disease and started ryokeikansoto. The spasmodic feeling disappeared promptly after hospitalization. On the 12 th day of hospitalization, we noticed that the circumference of his navel was cold. Therefore, we changed his prescription to ryokito, which is kind of ryokeikansoto, containing ryokyo, which dispels cold and stops pain, and then the near continuous feeling of enlarged abdomen also disappeared. He was discharged from hospital on the 24 th day. Although the original text for ryokito states that it cures a right fleshy tumor and pain, this suggests that ryokito is effective in cases of hontonki disease and cold, even when not necessarily accompanied by hypochondralgia.

<b>A Case of Irritability with Sound, Antipathy for Food Smells Successfully Treated with the Kampo Formulation, Ryokito </b> / 日本東洋医学雑誌

We reported the case of a 9-year-old girl who complained of irritability with sounds, headache, nausea and ease of fatigability, who was successfully treated with the Kampo formulation, ryokito. Her irritability with sound occurred following bilateral ear pain. Her headache, nausea and antipathy towards smells appeared in conjunction with aggravation of this pain symptom. We recognized this patient as having a <i>Ki</i>-distribution imbalance, and so prescribed ryokito as a decoction. Following her use of this formulation, her complaints improved remarkably within about 8 weeks.