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.

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.