We report a case of sciatica showing improvement by treatment with Gorei-san-ryo. The patient, a 66-year-old woman with right gonarthrosis, had been receiving treatment at the orthopaedic surgery department since May 19, 2000. She felt left hip pain and left leg numbness on May 10, 2002. She was diagnosed with left-side sciatica on May 15, 2002. She was treated with loxoprofen, eperisone, and epidural steroids at the orthopaedic surgery, but her symptoms hardly improved. She visited our department on August 7, and treatment wiht Busi-to was begun. After four weeks, her symptoms had not improved. Busi-to was stopped and Gorei-san-ryo was begun on September 4. After two weeks, her hip pain had improved. Keishi-bukuryo-gan was administered in addition to Gorei-san-ryo on September 18. On December 25, her sciatica as evaluated by visual analogue scale, had decreased from 100 to 35 since first visiting our department. Based on this experience, it is suggested that Gorei-san-ryo be considered in the treatment of sciatica.

We report three cases of dysesthesia that showed improvement after treatment with Ougikeishi-gomotsu-to. Case 1 was a 70-year-old woman diagnosed with post-herpetic neuralgia in 1998 (left trigeminal nerve level). She visited our department with left facial dysesthesia and pain on ****, 2002. We initiated the treatment by Ougikeishi-gomotsu-to. She judged the dysesthesia to have disappeared by about 50% after 4 weeks, and by about 10-20% after 6 weeks. We used Rokumi-gan with Ougikeishi-gomotsu-to on ********. She felt a little dysesthesia and pain on *****.
Case 2 was a 55-year-old woman diagnosed with carpal tunnel syndrome in March 2002. She had felt dysesthesia in both hands since 1999. She visited our department for the first time in April 2002. We initiated the treatment by Ougikeishi-gomotsu-to. After 1 week, she felt dysesthesia in only the fingertips. Now, we are using Boui-ougi-to, acupuncture and moxibustion in combination with Ougikeishi-gomotsu-to. She feels only a little dysesthesia.
Case 3 was a 72-year-old woman diagnosed with post-herpetic neuralgia on ********, 2002 (Th 12 and L 1 level). She was treated at the anesthesiology department on *****. But her pain and dysesthesia hardly improved. She visited our department on ****. We initiated the treatment by Ougikeishi-gomotsu-to. She judged her dysesthesia and pain to have disappeared by about 40% after 23 days, and by about 20% after 6 weeks.

We report a case of a patient with steroid-dependent nephrotic syndrome, who achieved complete remission with a combination of steroid therapy and Bunsho-to. The patient was a 27-year-old female who became aware of edema, and was diagnosed as suffering from focal glomerular sclerosis (glomerulosclerosis) with nephrotic syndrome in November 1992. She responded to steroid therapy, but nephrotic syndrome relapsed frequently after the repeated reduction of steroids. In July 1995, she came to our hospital, and was diagnosed as having a recurrence of nephrotic syndrome. Although the combination therapy of steroid and Kampo formulas, Shinbu-to or Shimotsu-to and/or Keigairengyo-to, was effective, an exacerbation of nephrotic syndrome occurred after steroid therapy was discontinued, in July 1997. The prescription was changed to Bunsho-to, and steroid therapy was re-initiated with 10mg of prednisolone daily. As a result, she achieved complete remission. The steroid therapy could be discontinued in July 1999, and now she has taken Bunsho-to only for 18 months. But the complete remission of nephrotic syndrome has been maintained.

We report a case of loss of consciousness multiple times with and without focal to bilateral tonic-clonic seizure-like episodes that we diagnosed as psychogenic non-epileptic seizures, and successfully treated with shigyakusan and hangebyakujutsutemmato. The patient did not have fullness and discomfort in the chest and hypochondrium (kyokyokuman), nor spasmodic bilateral rectus abdominis in an interictal state. On the other hand, she had extremely cold limbs, especially feet and hands, with fingers being flexion and rigid under the status of loss of consciousness even without tonic-clonic seizure-like episodes in the ictal state. After being warmed and loosened, her consciousness level slowly recovered. She had headaches frequently in a non-ictal state, too. We identified that she had qi deficiency (kikyo), qi depression (kiutsu), fluid retention (suitai) and qi counter flow (kigyaku) in the interictal state, while kiutsu and kigyaku were extremely strong in the ictal state. In this case, the combined use of shigyakusan and hangebyakujutsutemmato was useful, considering that the patient had two different locations of disease (byoi) that required treatment.

This report describes a case of cluster headaches that was successfully treated with juzentaihoto. A 39-year-old male had been having attacks of cluster headaches for 7 years. During an attack, he took a triptan and nonsteroid anti-inflammatory drug (NSAID), but they were not effective and he had lost his good eyesight after the attack. Recently, as the attacks had become more frequently and stronger, he visited our hospital. Physical examination including dry skin suggested that he had kikyo and kekkyo. Therefore, we prescribed juzentaihoto. After 3 months of treatment, the frequency and strength of the attacks decreased. The underlying pathophysiology of cluster headaches incompletely solved. When the responsible localization of organic disease is not clear, Western medicine sometimes have difficulty in relieving pain. On the other hand, we can analyze the case through “yin-yang and xu-shi categorization,” “life force, blood and colorless bodily fluids (3 elements that constitute an organism)” and Gozo-roppu-setsu according to traditional Chinese medicine. Understanding the bodily functions from an Oriental medicine viewpoint, we can prescribe effective oriental medicine to relieve pain.

Venipuncture pain is rare complication. The underlying pathophysiology of venipuncture pain is incompletely solved and there is no standard treatment. Though most venipuncture pain is accepted as neuropathic pain, some venipuncture pain does not meet neuropathic pain criteria. Case 1 was a woman punctured dorsal vein for blood sampling. She visited pain clinic 9 days after injury because of residual pain and numbness. Case 2 was a woman punctured dorsal vein for intravenous line and radial artery for artery line at the time of operation. She visited pain clinic 16 days after injury because of residual pain. Case 3 was a woman punctured median cutaneous vein for blood sampling. She visited pain clinic 6 days after injury because of residual pain. We thought internal hemorrhage, local pain and tenderness as static blood and prescribed jidabokuippou for all 3 patients. All their pain improved. This report describes 3 cases of venipuncture pain successfully treated with jidabokuippou that shows the excellent analgesic action to nociceptive pain.