We report a case of systemic sclerosis complicated with primary biliary cirrhosis successfully treated with orengedokuto (wanbinghuichun) and sekiganryo. The patient was a 68-year-old female. She had been diagnosed with systemic sclerosis 20 years previously, and primary biliary cirrhosis 17 years previously. She received modern Western medical treatment for skin itching and scleroderma, but her symptoms showed little improvement. Therefore, she consulted our clinic in order to receive Kampo therapy. We prescribed orengedokuto (wanbinghuichun), and the skin itching improved in 5 days. As a result of administering sekiganryo in addition to orengedokuto (wanbinghuichun) for severe coldness, the scleroderma was also ameliorated. We consider this to be a case of diseases overlapping between yin and yang syndrome.

Trigger finger develops because of stenosis around the A1 annular ligament, which causes inhibition of smooth expansion and contraction of the finger. It is effectively treated by an anti-inflammatory analgesic and/or steroid infusion, and by Western style medical surgery. Here, we report 3 cases of trigger finger effectively treated with unkeito. The first case was a 71-year-old female who had been treated with Kampo medicine for an enlarged feeling in the abdomen. She complained of trigger finger, in the knuckle of her right third finger, dry lips, and hot flashes in her hands and feet. The second case was a 56-year-old female who had been treated with Kampo medicine for polyarticular pain in her fingers. She complained of trigger finger of the left fourth finger and hot flashes in her hands. The third case was a 71-year-old female who had been treated for chronic renal failure. She complained of trigger finger in the left first finger and dry skin but had neither hot flashes in the hands nor dry lips. One of the target symptoms of unkeito is hot flashes in the hands and dry lips. Unkeito is composed of herbs which improve ketsu deficiency, oketsu, inflammation, and dry skin. It is possible that these actions of unkeito are effective in trigger finger as well.

The use of orento for dermatosis is commonplace. We report herein the effective treatment of five cases of facial erythema and flushing using orento, based on the observation of heat symptom patterns in the upper part of the body and cold symptoms in the middle part of the body. Few reports have described specific symptoms of upper heat and middle cold ; however, interpreting ‘facial erythema and flushing exacerbated by warming',‘red face', ‘hot flashes', ‘hot sweats' and ‘yellow fur on the tongue' as “upper heat” , and ‘preference for warm drinks', ‘diarrhea exacerbated by cold drinks', and ‘objective coldness in the epigastric region' as “middle cold” enabled the application of orento for dermatosis in our experience.

PURPOSE: Deciding on treatment carcinoma of the tongue when the tumor has a thickness of 1.5 cm or more is difficult. Surgery often requires wide resection and re-construction, leading to considerable functional impairment. A cesium implant is an attractive option, but according to the Manchester System, a two plane implant is needed. MATERIALS AND METHODS: According to the textbook, a tumor is sandwiched between the needles, which are implanted at the edge of the tumor. This may cause an unnecessarily high dose to the outer surface of the tongue, which sometimes leads to a persistent ulcer. To avoid this complication, we invented a modified implantation method, and applied the method to five consecutive patients. RESULTS: With a minimum follow-up of 2 years, all primary tumors in 5 consecutive patients have been controlled. No complications occurred in soft tissue of the tongue or in the mandible. CONCLUSION: Our modified Manchester System was feasible and effective for tumors that has a thickness of 1.5 cm or more.