We will report 2 cases of posttraumatic neck syndrome being successfully treated with Hochu-ekki-to and Goreisan.
A 52-and a 47-year-old women suffered the posttraumatic neck syndrome (whiplash injury) by the traffic accident. They did not respond to NSAIDs (nonsteroidal anti-inflammatory drugs) for several months. According to the “Shou” (“Kikyo” and “Suitai”) of these patients, we prescribed Hochu-ekki-to and Goreisan.
Whiplash injury is a soft tissue injury of the neck, and said to be “Oketsu” because the presence of the internal hemorrhage in the soft tissue is believed. But we did not find “Oketsu” in our 2 cases. Chronic pain patients are often “Kikyo”, thus we assume treatments on “Kikyo” should be effective in posttraumatic neck syndrome.

We evaluated the effect of jidabokuippo for postoperative finger swelling with a ring gauge. We recruited 112 patients who took jidabokuippo and 134 patients who did not take jidabokuippo after surgery of the upper extremities. Postoperative finger swelling was evaluated using a ring gauge. The size difference between affected and unaffected fingers was measured. The mean time to remission of swelling after surgery for traumatic/non-traumatic disorders was 4.3/2.2 weeks in the jidabokuippo group and 7.2/3.4 weeks in the nonjidabokuippo group. Time was significantly shorter in the jidabokuippo group. The size difference between affected and unaffected fingers at 1, 2, 4, 8, 12 weeks after traumatic/non-traumatic surgery was 0.9, 0.4, 0.3, 0.1, 0.1/0.4, 0.3, 0.3, 0.2, and 0.1 respectively in the jidabokuippo group and 3.3, 3.0, 2.1, 1.2, 0.8/1.2, 0.8, 0.4, 0.2, and 0.2 in the non-jidabokuippo group. The jidabokuippo group had significantly more robust remission effect in finger swelling (P < 0.01)

Hansen's disease (HD) is a chronic infectious disease caused by the Mycobacterium leprae, which parasitizes skin macrophages and Schwann cells of peripheral nerves. Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes due to sensory disturbance and neuritis. Many HD patients suffer from refractory neuralgia for which neither painkillers nor other western medicine are usually effective. Here, we will report the case of an 85 year-old male, whose refractory neuralgia remarkably improved with goreisan. The mechanisms by which goreisan was effective may be as follows : (1) neuralgia pathology is an interstitial edema of peripheral nerves, and can explain as a local Sui-doku, a specific Sho for goreisan ; (2) peripheral nerve ischemia, caused by scar formation from chronic inflammation, leads to dysfunction of Na⁺/K⁺ ATPase, and extracellular potassium concentration increases. This environmental change leads a neural hypersensitivity, and goreisan is known to decrease extracellular potassium concentrations. This case suggests goreisan might be worth considering for use in refractory neuralgia, not only in HD patients, but also in other neuropathies.

Typically, Japanese Kampo doctors use formulas classified for treating blood stasis, to treat pain. However,there have been few reported cases where pain was treated with formulas classified for treating qi stagnation. Here, we report a case of right lateral epicondylitis in a 48-year-old woman who was treated with a focus on qi stagnation and with uyakujunkisan. She underwent conservative treatment at an orthopedic clinic for ten months, but her pain was not relieved. Hence, she opted for Kampo treatment. She was in a state of melancholy, felt heaviness throughout her body, and had irregular menstruation. These symptoms were mainly related to qi stagnation, and hence, we chose uyakujunkisan without white silkworm, but with aconite root. One month later, the stiffness in her shoulder improved and the pain was reduced. Magnetic resonance imaging taken 2 months later showed an improvement in the lesion. Nine months later, her menstruation became regular, and 11 months later, the pain had almost completely resolved and she could comfortably perform activities of daily living. Uyakujunkisan is introduced in the classical textbooks, and we interpret uyakujunkisan as a formula that can treat pain with qi stagnation. In Kampo treatment, effective pain treatment involves consideration of not only local blood stasis but also general qi stagnation.