We report four patients suffering from dumping syndrome treated effectively with Keishito and its additional prescription. Case1was a 57-year old male who received subtotal gastrectomy 30 years ago. After the operation he felt shaking sensations and eyes flickering after meals for10minutes to 4 hours. These symptoms tended to occur along with hunger. After taking Keishito, these symptoms improved. Case 2 was a 63-year old male who received subtotal gastrectomy 7 years ago. In recent years, he has had noticeable sweat and fatigability 20-30 minutes after meals. After taking Keishito, these dumping syndrome symptoms disappear. Case 3 was a 71-year old female who received subtotal gastrectomy 9 years ago. Thereafter, cold sweats and dizziness came to appear regardless of what she ate. After taking keishikashakuyakuto or shokenchuto the aforementioned symptoms disappeared. Case 4 was a 72-year old female who received subtotal gastrectomy 2 years ago. Sweats and hot flushes began to occur after meals for 30 minutes to 3 hours, from last July. These symptoms were improved simply by licking candy. After taking Keishito, these symptoms also disappeared.
symptoms <1> ; Gastrectomy ; Dumping Syndrome ; Cases ; Hour

In the classical Oriental medical texts the “Shang Han Lun” and the “Jin Kui Yao Lue”, no clear distinction is made between Atractylodes japonica and Atractylodes lancea. Even today, no sharp critical distinction is made between the usage of these crude drugs in Kampo formulas. The authors have attempted to elucidate the differences in their clinical effect by investigating the way patients reacted when the two crude drugs were interchanged in Kampo formulas the patients were taking.
It was found that Atractylodes lancea was more effective than Atractylodes japonica for patients with arthralgia. Of the effective cases, 60% reported that the formula had a pleasant taste, while 9% reported it tasted bad. This suggested that taste may play a significant role in patient's responses to Kampo formulas.

Recently we treated two patients with Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu decocted with 400ml of water and 400ml of rice wine SAKE for 60 minutes.
Case 1 was a 46-year-old female patient. Feelings of coldness prevented her from sleeping, and she could not get to sleep without warming up the room and heating her arms with a dryer. After boiling Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu with sake, she was able to sleep well.
Case 2 was a 65-year-old male patient who had been suffering from polyarthralgia, low back pain and feelings of coldness. After taking Toki-shigyaku-ka-goshuyu-shokyo-to-ka-uzu boiled with sake, he felt numbness around the lips and limbs, although the amount of aconiti tuber was not changed.
It is believed that SAKE heats and enhances Yang-Ki in Kampo formulas. These characteristics are the same as those produced by aconiti tuber. At first, we suspected that aconiti tuber and alcohol combined synergistically and could therefore give rise to occurrences of aconiti poisoning. But ethanol, in amounts comparable to the alcohol content in sake, did not create this effect. The effect was dependent on the sake itself rather than the alcohol.

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.

Aconitum carmichaeli debeaux is an essential herbal medicine that possess anti-inflammatory, analgesic, and cardiotonic effects. Five hundred ninety-three subjects were treated with Shuchi-bushi (a powder type of this aconiti tuber that has been autoclaved) added to Kampo extract granules, between the years 1996 and 2002. The patient population consisted of 153 men and 440 women with an average age of 54.5 years. Four patients showed adverse reactions such as hypertension, nausea and hot flashes with Shuchi-bushi. There were no serious adverse effects, and the toxic symptoms disappeared quickly by reducing the Shuchi-bushi dosage, or cessation.
Shuchi-bushi has been used in small quantities because of its highly toxic alkaloids. However, this study indicates that Shuchi-bushi can be used more actively.

We prescribed Hyakugokokinto for four patients suffering from dryness in the throat. Dry throat improvements were observed in all patients, while improvements in insomnia were observed as well. Thus, insomnia may be a further indication for the use of Hyakugokokinto.