A 64-year-old female who had suffered from rheumatoid arthritis (RA) for many years was admitted to our hospital because of acute abdominal pain and diarrhea. She was diagnosed with RA, Sjögren syndrome and protein-losing enteropathy (PLE) with GI tract amyloidosis. She was treated with total parenteral nutrition, prednisolone, tranexamic acid and a variety of Kampo medicines, for example: kanzo-syashin-to, keishi-kashakuyaku-shoukyou-ninjin-to, and bushi-kobei-to. However, diarrhea continued and paralytic ileus occurred. Then she was treated with Ubai-en, which is known as an anti-ascarid drug or anti-diarrheic drug. Ubai-en was effective on her diarrhea in 2 weeks. This suggests that Ubai-en may be an effective treatment for PLE.

We gave Borei-takusya-san to six patients with intractable edema under the waist. This treatment cured three of the six. Two of the cured patients had Ki-deficiency or Yang-Ki-deficiency in the kidneys. In these cases, we first intensified Ki in the kidneys and improved their conditions to Yin-disease, first stage. We noticed improvement of their subjective symptoms and objective signs after we gave them Borei-takusya-san in combination with their prescriptions. All of the ineffective cases presented some conditions of hypo-tonus or hypo-reactivity.
With reference to many ancient medical books and our own experience we studied the use of Borei-takusyasan. It applies to patients (1) with oliguria, (2) with edema under the waist, (3) without Ki deficiency and Yang-Ki-deficiency in the kidneys and with (4) more reactive stage than Yang-disease, second stage and Ki between excess and deficiency. (5) If they had Ki-deficiency or Yang-Ki-deficiency in the kidneys, we should first replenish with Ki sufficiently, and make out prescriptions for the patients.
We consider that Borei-takusya-san is capable of wide application to the patients with edema under the waist, following our indications.

In Kampo medicine, a tongue examination, whereby the shape and color of the tongue is observed, is thought to reveal the constitution and condition of the patient. In Japan, numerous books on this tongue examination have been published. However, tongue findings are expressed differently in these books, and a standard description for such findings has yet to be established. A standard description would be useful when examining the tongue, and when educating students of Kampo medicine. We therefore compared how tongue colors and shapes were expressed in the Japanese literature on tongue examinations (12 publications).
Using these results, we have arrived at a standardized description for tongue findings in accordance with Kampo specialists of tongue diagnoses at many facilities. In the process, we focused on easily recognizable findings that can be noted with short clinical examination times, and that can also be understood by beginners.

A 64 year-old female presented with fever and cough. She had suffered from a cough for one day and we treated her with saikokeishito. However, her symptoms got worse and she developed chest pain. She was diagnosed with bacterial pneumonia at another clinic and she was referred to our hospital 3 days after starting saikokeishito. Her X-ray showed right infiltration in her lung and her blood examination had signs of inflammation. Pneumonia with pleuritis was suspected, but she was allergic to antibacterial drugs and hoped to continue Kampo treatment. We switched saikokeishito to saikanto. Her chest pain decreased soon after taking saikanto and 4 days later only a slight cough remained. Eleven days later, her inflammatory reaction improved. Kampo formulas containing Bupleuri radix are usually selected for pneumonia or pleuritis according to a patient' s pattern identification. We gave her saikanto, a mixture of shosaikoto and shokankyoto, because she had chest pain. Saikanto was significantly effective. There have been few clinical reports about treatment for pneumonia with Kampo medicine alone without using antibacterial drugs. We believe this case shows that Kampo treatment is effective for pneumonia and pleuritis.