We encountered a patient with chronic pain due to reflex sympathetic dystrophy (RSD) that was relieved by Uzu-keishi-to (Wu tou gui zhi tang) therapy. A 69-year-old man was diagnosed with RSD in 1995. Intractable pain of the extremities and trunk persisted despite several therapies such as spinal cord stimulation, local anesthetic blocks, and a variety of conventional medications. The patient was admitted to our hospital in June 2000, and was diagnosed as having stage II RSD. Thermography demonstrated that the left side of the back and the hand were lower in temperature than the corresponding areas of the right side. “Perfusion” images of three-phase bone scintigraphy showed a lower flow in the lower left extremity. Uzu-keishi-to was administered in addition to the Western medicines. After administration of Uzu-keishi-to, the pain was relieved and the value of the face scale decreased from 20 to 11. Moreover, after 16 weeks of Uzu-keishi-to therapy, the decreased blood flow on the left side of the body detected by thermography and three-phase bone scintigraphy increased to a level equal to that of the right side. Uzu-keishi-to is effective not only in reducing the intractable pain of RSD but also in preventing the development of “dystrophy.” Further evaluation of Uzu-keishi-to therapy for patients with RSD is warranted.

We successfully treated two chronic hepatitis B patients with Hochuekkito-go-Keishibukuryogan. Case 1 was a 27-year-old male diagnosed with chronic hepatitis B in 1998, who had received interferon (IFN) therapy. Liver function tests did not improve with this therapy. He visited the department of Japanese Oriental Medicine at Yukiguni-Yamato Hospital, complaining of fatigue, on **********. We initiated treatment with Hochuekkito-go-Keishibukuryogan. At two months of treatment, marked improvement in liver function tests was noted, with normalization of ALT, seroconversion (SC) and negative HBV-DNA. Case 2 was a 26-year-old male diagnosed with chronic hepatitis B in 2001 who had received IFN therapy. Seven months after termination of this therapy, on **********, he visited our department for a flare-up of hepatitis. Treatment with Hochuekkito-go-Keishibukuryogan was begun. Almost immediately, marked improvements were observed in the form of ALT and SC normalizations, and only slightly positive HBV-DNA.

Pulmonary atypical mycobacteriosis is a refractory pulmonary disease that has become resistant to the commonly used medicines. Here we report a case in which shakanzoto with yokuinin was useful in the treatment of bloody sputum caused by pulmonary atypical mycobacteriosis through Mycobacterium avium complex infection. An 86-year-old woman was diagnosed with pulmonary atypical mycobacteriosis four years before hospital admission because of repeated incidents of bloody sputum that had been unsuccessfully treated with stypsis. We administered shakanzoto with yokuinin, after which the bloody sputum disappeared rapidly. Although shakanzoto is usually prescribed for arrhythmia and cardioneurosis, our results suggest that shakanzoto is also useful for pulmonary diseases in which the pulse rate is irregular.

We report a case of a 74-year-old male with hyponatremia complicated with small cell lung cancer. His hyponatremia worsened even with water restriction. Oral administration of sodium was difficult because of nausea and vomiting. We recognized this patient as having illness caused by excessive water accumulation within the body, and so prescribed goreisan 7.5 g/day to treat his hyponatremia. His hyponatremia improved after the administration of goreisan. Later his hyponatremia deteriorated while being administered of meloxicam, a cyclooxygenase-2 inhibitor. This case suggests that goreisan might inhibit water reabsorption by antidiuretic hormone at the collecting duct of the kidneys via stimulation of prostaglandin synthesis.

Daikenchuto is recorded in Kampo textbooks as a prescription for abdominal disorders. We considered fukuchukan (coldness in the abdomen) as equaling a sensation of coldness centering on the navel, and we examined the usefulness of using Daikenchuto as a medication for this symptom. We administered Daikenchuto to 90 patients who presented with coldness of the navel. The patients were divided into 2 groups:the first group had accompanying digestive symptoms, the second had no accompanying digestive symptoms. We then examined their response rates, and improvement rates for coldness centering on the navel. We also examined the abdominal strength and pulse strength for responders and non-responders, respectively.The Digestive Symptoms group consisted of 64 patients. In this group, the response rate was 81.3%.The improvement rate of coldness centering on the navel was 92.3% in responders and 41.7% in non-responders, and the difference was highly statistically significant (p<0.001). The Non-digestive Symptoms group consisted of 26 patients. In this group, the response rate was 38.5%. The improvement rate of coldness centering on the navel was 100% in responders and 43.8% in non-responders, and the difference was statistically significant (p=0.022).In a comparison of all 90 responder and non-responder cases, weak abdominal strength was 62.9% in responders and 42.9% in non-responders, intermediate abdominal strength or above was 37.1% in responders and 57.1% in non-responders, and the difference between abdominal strength and response rate (p=0.076) was non-significant. Weak pulse was 54.8% in responders and 40.7% in non-responders, intermediate pulse strength or above was 45.2% in responders and 59.3% in non-responders, and the difference between pulse strength and response rate (p=0.221) was non-significant. 13 of these cases were above intermediate, for both abdominal strength and pulse strength.We conclude that for patients presenting with a sensation of coldness centering on the navel, there is a strong possibility that the efficacy of Daikenchuto-syo is suggested, regardless of whether or not there are other digestive symptoms. Moreover, Daikenchuto proved effective in 13 cases where both abdominal strength and pulse strength were above an intermediate level, suggesting that a sensation of coldness centering on the navel can be the key to finding the sensho of Daikenchuto-sho.
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We report the case of a 76-year-old woman diagnosed with refractory anemia arising from myelodysplastic syndrome. Vitamin K 2 was administered, but pancytopenia continued to progress. At the initial visit to our department, her white blood cell count was 2150/μL, hemoglobin (Hb) was 9.6 g/dL and platelet count was 2.3×10⁴/μL. Juzentaihoto was administered for Qi and blood deficiency. A dosage of shimotsuto was increased from 3 to 5 g, and juzentaihoto was changed to ogikenchuto go shimotsuto, but the anemia did not improve. Juzentaihoto was again administered, and the dosage of shimotsuto was increased to 6 g. Malt sugar, 10 g, was added to the decoction, after which her Hb and platelet count markedly increased. There was no significant difference between pre- and post-treatment bone marrow findings. It is possible that malt sugar enhances the hematopoietic function of juzentaihoto.

We report five cases of acute hyperventilation attack, with bilateral fullness of the chest and hypochondrium, and bilateral rectus abdominis muscle strain, that were successfully treated with shigyakusan. Case 1 was a 47-year-old female ; case 2 was an 18-year-old female ; case 3 was a 23-year-old female ; case 4 was a 39-year-old male ; and case 5 was a 40-year-old male. All five patients visited the emergency department with complaints of severe dyspnea and tetany. Their abdominal signs were characteristic, with remarkable bilateral fullness of the chest and hypochondrium and bilateral rectus abdominis muscle strain. In cases 1 to 4, the patients were given 2.5 g of shigyakusan extract, and their symptoms promptly improved. In case 5, as the patient could not swallow the prescribed medication at presentation, intramuscular diazepam was given. Thereafter, he complained of continuous severe numbness ; we subsequently gave him shigyakusan, and his numbness promptly improved. In conclusion, shigyakusan seems to be a useful Kampo drug for the treatment of acute hyperventilation attack.

We reported that Interferon (IFN) induces the analogous state of the initial stage of Yang disease with ectodermal symptoms (tai yang bing). Flu-like symptoms from IFN treatment were reduced or disappeared with Mao-to and Dai-seiryu-to. We consider that flu-like symptoms induced by IFN can be a symptomatic model of hyper-functioning condition of tai yang bing. Pulse of sinking and deficiency was seen in all five patients with the symptoms of having caught a chill. These results suggest that there is the possibility that pulse of sinking and deficiency is seen in the very early stage of tai yang bing.

The source of the herbal mixture named Jiin-koka-to is Wan bing hui chun. Jiin-koka-to has been used mainly as a decoction for the treatment of bronchitis and tuberculosis. The cases of bronchial asthma treated with Jiin-koka-to in this report had similar symptoms: abnormal sensations in the throat and irritation. We investigated the efficacy of Jiin-koka-to in 11 asthma patients having both symptoms. Improvements were observed in all patients; these improvements included reduction of peripheral eosinophil count and serum IgE, loss in quantity of prednisolone, increment of peak expiratory flow rate, and cessation or decrease of asthma attacks. Thus, it is possible that Jiin-koka-to is a controller rather than a reliever in the treatment of bronchial asthma. Abnormal sensations in the throat and irritation might be one of the indications for Jiin-koka-to.

We developed a new electrothermo-acupuncture instrument which employs a curved heating plate, and we compared this new one and the old hitherto used electrothermo-acupuncture instrument in terms of radiation temperature, using two male volunteers. The results showed that the 2nd step in the old instrument equaled the fifth channel in the new one. The radiation temperature increase of 140°C seen in 10 minutes was the same, between the two instruments, but the old one continued to increase its temperature, whereas the new one held at a plateau of about 140°C. Therefore, we considered that the new electrothermo-acupuncture instrument is safer than old one.
Next, we investigated the relation between effective Kampo formulas and endurance time in the fifth channel of the new electrothermo-acupuncture instrument, in nineteen patients. We found that Kampo formulas used in the resistant phase of Yang-syndrome disease, is effective in less than 10 minutes of endurance time, and the Kampo formula containing Aconite Tuber is effective for over 30 minutes.
We considered, because of the relation between endurance time and Kampo diagnosis, that the new electrothermo-acupuncture instrument can be useful in a supplementary way in deciding Kampo diagnosis.