Tokishigyakukagoshuyushokyoto is known to be effective when tenderness in the inguinal region is observed during abdominal palpation. This herbal formula was discovered by Keisetsu Otsuka, and since 2016, its mechanism has been gradually elucidated by Katsutoshi Terasawa. The first case was an 85-year-old man who complained of right lower abdominal and right inguinal pain of unknown cause, which occurred six months before the prolapse of a right inguinal hernia. The second case was a 68-year-old man who experienced pain from the left inguinal region to the lower abdomen two years after surgery for a left inguinal hernia. Both cases were difficult to manage with conventional treatments. However, after taking tokishigyakukagoshuyushokyoto, which specifically targeted the tenderness in the inguinal region, both patients experienced significant pain relief.

It has been thought that the term “shukuben” does not mean a simple constipation but rather that a substance is stagnating in the digestive tract despite ordinary defecation. However, there has been no concrete evidence for this shukuben definition.
The authors have obtained evidence for what may be one type of shukuben, by means of X-ray photography after an upper digestive tract examination using a barium sulfate contrast medium, in a patient with irritable bowel syndrome. The X-rays showed the contrast medium adhering to the colon wall three days post-examination despite subsequent diarrhea, suggesting one type of shukuben. In this paper, the authors also reported the result of a historical search for the term shukuben in the past medical textbooks, which revealed that the first description of this term is found in hougizashi and was described by Yodo Odai. We also considered that this term is a derivation of shukushoku meaning a stagnation of digestive tract contents.

Since ancient times, acupuncture and moxibustion have been widely administrated for any emergency case. In this country, they have been endeavored at establishing the harmony between Kampo and Modern medicine. Based on such background, we report two cases of colic pain attack of lithiasis successfully treated with contact needle therapy established by Bunkei Ono.In case one, ureterolithiasis brought colic back pain. Symptoms were improved with satisfaction for one session and the stone discharged via following Kampo-medication.In case two, the patient suffered from colic epigastralgia of choledocholithiasis complicated by severe appetite loss. Although one session successfully extinguished the symptoms, blood chemistry revealed implying signs of cholangitis. A laparotomy with T-tube drainage was performed eventually.These cases pronounced the efficacy of contact needle therapy in the treatment of colic pain and invited deliberate estimation with Modern medicine. The harmony between Kampo and Modern medicine was considered as a prerequisite for clinical practice.

Sho-syndrome was analyzed by cluster analysis of answers to a set of questionnaire presented to first-visit patients at a hospital of Japanese-Oriental (Kampo) medicine. The answers from 270 new patients were classified into 3 groups by hierarchical cluster analysis, with a total of 202 non-female related items. We looked at which Sho-syndromes of metabolic (Mb: “Kan-” _??_-), gastrointestinal (Gi: “Hi” _??_-), respiratory (Rp: “Hai-” _??_-), or water and mineral-balance (Wm: “Zin-” _??_-) deficiency (“Kyo” _??_) disorders were included, in one of the groups at high frequencies. Water and mineral-balance deficiency disorders were in Group II and III, while metabolic deficiency disorders were in Group III. We conclude that the results of this analysis support the rationale for the empirical determination of Sho-syndrome, in addition to pulse diagnosis by Kampo-clinicians who examine patients.

Dai-kankyo-gan has traditionally been used for great resistance for tenderness upon pressure in the epigastric region (Shinkahiko) and rigidity of nape (Kohai-kyo). We treated two cases with Dai-kankyo-gan for years.
Case 1 was a 75-year-old male patient. He had been experiencing shortness of breath after slight exertion since 1986, and had been treated with theophyline, bronchodilator, and expectorants, as well as prednisolone for emphysema and pneumoconiosis. After receiving Dai-kankyo-gan, the patients Kohai-kyo and dyspnea improved and he was able to stop taking prednisolone. It is well known that Dai-kankyo-gan makes Shinkahiko and Kohai-kyo better. In this case, it improved throat discomfort as well.
Case 2 was a 56-year-old female patient who had been suffering from stiff shoulders and headaches. After receiving Dai-kankyo-gan, Kohai-kyo improved and the thick coating on the tongue was normalized.
Shinkahiko, which depends on stasis of body fluid, is usually normalized with the improvement of subjective symptoms. But in these cases, it was not cured.

In all but a few cases, the treatment for elderly patients must be conservative owing to the unavoidably poor general condition of the patients.
We report on three cases of long-term bedridden patients with acute cholecystitis or cholangitis who were effectively treated with Kampo prescriptions. An 86-year-old male with choledecholithiasis and acute cholangitis responded to Inchin-ko-to. When he repeatedly relapsed after the discontinuance of Kampo treatment, Inchin-ko-to was effective, and Inchin-shingyaku-to successfully improved his general condition. In an 89-year-old male with acute cholecystitis, Dai-saiko-to extracts and Bukuryo-shigyaku-to were effective. An 88-year-old female with cholecystolithiasis and acute cholecystitis responded to Dai-saiko-to and Bukuryo-shigyaku-to.
Most elderly patients are Inkyo-sho (Yin-deficient). But, when they are suffering from acute sickness, it is important to treat them according to the principle of “Senkyukokan (treating acute symptoms before treating chronic internal symptoms).” The severe sickness is treated first, and then the mild phase of the disease is treated.

A Kampo formulation, Senkinho-Karo-to, is considered to be effective for chest pain or discomfort. However, there have been few case reports concerning this formulation. Here, we report four cases of patients suffering from chest pain or discomfort that were successfully treated with Senkinho-Karo-to. We compared the clinical features of these four cases where Senkinho-Karo-to was effective with those of four other cases where Senkinho-Karo-to was ineffective. The cases where Senkinho-Karo-to was effective had the following features: Deficiency, feeling of spasmodic uprising heat, shoulder stiffness, deficient pulse, impressions of teeth on the rim, palpitation of the abdominal aorta in the supra-umbilical region, reduced tension in the lower abdomen, tenderness in the para-umbilical region, and Ki-depression.

During a four-year period from 1994 to 1998, we treated 46 cases of rheumatoid arthritis (RA) with Kampo medicine. Clinical disease activity of RA was assessed using the Lansbury activity index (L. I.). After a year of treatment with Kampo medicine, 20 patients showed over 75% improvement by L. I Eleven cases were considered to be non-responders. Twenty-six cases out of 37 who had been treated with Western medicine were able to discontinue using, or reduce reliance upon, analgesic drugs and steroid hormones following Kampo treatment. Steinbrocker's functional classification of RA was improved from 2.3 to 1.8.
We used Aconiti Tuber for 40 patients, and 13 cases showed aconiti poisoning. Two cases represented adverse reactions to Astragali Radix.
In this study, Boi-ogi-to-ka-bushi was the most effective for RA, and Keishi-ka-ryo jutsubu-to was the second most effective. Efficacy of Boi-ogi-to was enhanced with large quantities of Sinomeni Caulis et Rhizoma and Astragali Radix. We mixed Boi-ogi-to with Keishi-ka-ryo jutsubu-to when Keishi-ka-ryo-jutsubu-to did not work well. RA is one of the representative diseases that respond to Kampo medicine.

Visceral fat obesity is closely associated with lifestyle-related diseases that include symptoms such as hypertension, diabetes mellitus, hyperlipidemia, etc. To examine the correlation between pulse, appearance of tongue, and abdominal palpation-diagnostic indicators according to Kampo medicine-and visceral fat obesity, we investigated 209 subjects who received health screenings, and obtained the following results. 1) The simply obese subjects, as determined by body mass index, showed symptoms of excess state, Kidepression, and stasis of body fluids according to the diagnostic techniques of Kampo medicine. 2) The visceral fat-rich subjects were diagnosed by means of abdominal ultrasonography and showed symptoms of pulsus maximum and Oketsu (blood stasis) state.

Literature on Bukuryo-shigyaku-to describes it as “those who perspire, have diarrhea, do not recover from disease and are afflicted by restlessness.” In this study we examined 4 cases where the administration of Bukuryo-shigyaku-to had an effect, where complaints which accompanied autonomic disorder and psychoneurosis brought about by automobile accidents were diagnosed as restlessness. With the experience of these cases and consideration of the literature, we consider the following to be appropriate states of illness for the administration of Bukuryo-shigyaku-to in psychoneural sicknesses.
1) states of illness where conditions of psychological introversion caused by such things as fear, heart palpitations, and depression exist, and it is necessary to lift spirits.
2) states of illness where such Ki-depressions as whole body weariness and lack of appetite exist.3) states of illness where such stasis of body fluids as dull headache and dizziness exist.
4) where epigastric region tenderness and abdominal palpitations exist.