A 68-year-old female had been diagnosed with granuloma annulare a year earlier. She was prescribed tranilast and was recovering, but had to discontinue the tranilast because she suffered liver damage as a side effect.
She was also suffering from a worsening rash and so decided to try Kampo medicine. We prescribed orengedokuto because of thermal symptoms suggestive of hot flushes, the appearance of her tongue, and the character of her rash. Initially, the rash improved, but from the 3rd day following admission did not change greatly. We suspected the existence of interior cold and started combining maobushisaishinto. Five days later, the granulomas had rapidly shrunk. We believe she had overlapping diseases of a yin and yang pattern from the fact that she improved clinically.

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.
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.
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.

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.

A 64 year-old female presented with fever and cough. She had suffered from a cough for one day and we treated her with saikokeishito. However, her symptoms got worse and she developed chest pain. She was diagnosed with bacterial pneumonia at another clinic and she was referred to our hospital 3 days after starting saikokeishito. Her X-ray showed right infiltration in her lung and her blood examination had signs of inflammation. Pneumonia with pleuritis was suspected, but she was allergic to antibacterial drugs and hoped to continue Kampo treatment. We switched saikokeishito to saikanto. Her chest pain decreased soon after taking saikanto and 4 days later only a slight cough remained. Eleven days later, her inflammatory reaction improved. Kampo formulas containing Bupleuri radix are usually selected for pneumonia or pleuritis according to a patient' s pattern identification. We gave her saikanto, a mixture of shosaikoto and shokankyoto, because she had chest pain. Saikanto was significantly effective. There have been few clinical reports about treatment for pneumonia with Kampo medicine alone without using antibacterial drugs. We believe this case shows that Kampo treatment is effective for pneumonia and pleuritis.