We report here the case of a 40-year-old female patient who presented at our outpatient clinic complaining of headache related to multiple systems, including the bowels, the viscera and meridians. She had two types of headache with different characteristics, which were enhancing factors and alleviating factors : (1) Squeezing pain in the posterior occipital area related to the kidney meridian, and (2) Pain in the lateral occipital area and areas deep beneath the eyes and ears, related to the large intestine, the stomach, and the triple energizer meridian and gallbladder meridians. Following a traditional logic-based therapy, we diagnosed her with edema due to a kidney yang deficiency and a liver-qi ascending counter flow. Both types of headache were alleviated and resolved, after shimbuto was administered to clear the channels by both draining the water due to warming yang and soothing the liver, and sending down abnormally ascending liver qi. The original cause of the disease was the kidney yang deficiency, and the immediate cause was the liver qi ascending counter flow. We believe that these affected each other fundamentally and incidentally because the lateral occipital pain, which was the incidental symptom, was resolved with shimbuto.
Headache ; Liver ; Pain ; Kidney ; System

We report a case of a 35-year-old woman with fibromyalgia who was successfully treated with acupuncture only after identification of syndromes using the Four Examinations. After working hard for years, she suffered from severe chest and back pain, fever and insomnia. At one hospital, no abnormality was found after detailed examinations. The pain gradually worsened and she was eventually diagnosed with fibromyalgia at a university hospital. She wanted to be treated with Kampo medicine and consulted us. We identified her symptoms as liver qi stagnation, qi stagnation causing blood stasis and qi stagnation damage to yin, and treated with acupuncture mainly using only two shendao (GV 11) and zhaohai (KI 6) points. Pain was relieved by 30% after her 37 th treatment. Her fever also disappeared. Almost no pain was reported by the 91st treatment. A Fibromyalgia Impact Questionnaire score of 78 at her first examination had improved to 23 by the 82 nd treatment at 17 months, indicating that her QOL had improved.