To diagnose liver injury related to Kampo medicine accurately is not easy. Lymphocyte transformation tests are likely to give a false positive for Kampo medicine. Diagnostic criteria with a scoring system provide low specificity for the diagnosis of Kampo-related liver injury. This article intends to outline the problems with diagnosing Kampo-induced hepatic injury, and to review previous studies to shed light on its incidence and clinical features. Kampo-related liver injury incidence was 0.1% or less, and that related to Scutellariae Radix was 0.5-1.0% in the literature. The symptoms, types, and recovery periods were similar to those for western drug-related liver injuries.

Using textbooks of Western medicine and Kampo medicine in Japan, we examined descriptions in classification and laxative therapy of chronic functional constipation. In terms of the relationship between stool shape and patient's age, description in Kampo textbooks was contrary to that in the textbook of Western medicine. The opinions on the long-term use of rhubarb also divided between Western medicine and Kampo medicine, although in Kampo medicine there was some opinion that the long-term use should be discouraged.

The relationship between feces shape and patient age was examined, in one hundred patients with chronic constipation. The scybalum-like feces group was significantly younger than the thick feces group. Kampo's theories about the relationship between feces shape and age should be re-examined.

Two theories have been suggested for the etiology of pseudo-aldosteronism with Glycyrrhizae radix intake : 1) Differing sensitivities to Glycyrrhizae radix between patients, 2) Differing daily Glycyrrhizae radix dosages between patients.We treated two patients who were relieved of their pseudo-aldosteronism, through a reduction in their daily Glycyrrhizae radix dosage. These cases suggest that Glycyrrhizae radix intake, rather than individual metabolic differences, influences the development of pseudo-aldosteronism.
Hyperaldosteronism ; Pseudo brand of pseudoephedrine ; Individual ; Quantity ; Human Development

We assessed the understanding of Japanese Oriental Medicine, as well as the connection between General Medicine and Japanese Oriental Medicine, among medical students, to improve the effectiveness of clinical practice and lectures. The questionnaires were sent to fifth-year medical students (n=66), and the responses were collected anonymously. Although 22.4% of the responding students were “very” interested in Japanese Oriental Medicine and 68.7% were “slightly” interested, the students who understood Japanese Oriental Medicine even “slightly”comprised only 23.9%. The majority of students considered that the system of Japanese Oriental Medicine was most useful in combination with Western Medicine for practicing General Medicine. Nine (60%) of 15 students who understood Japanese Oriental Medicine considered that the system of Japanese Oriental Medicine was most useful for practicing general medicine. In contrast, among students who did not understand Japanese Oriental Medicine, only 8 of 42 (19%) showed the same response. Similarly, more of the students who understood General Medicine showed this response than students who did not understand General Medicine.
These results permit us to speculate that medical students consider that understanding both General Medicine and Japanese Oriental Medicine might contribute to the development of a medical service.

We present a case of prolonged post-herpetic neuralgia (PHN), successfully treated by Uyaku-junki-san-ryo. A 76-year-old woman was referred for PHN for 5 months. Her pain was confined to the area of the maxillary nerve, and waving smart pains trouble her greatly, all day long. The stellate block or the administration of carbamazepine did not avail against her pain at a nearby hospital. She visited our hospital on ******, the degree of her pain was expressed as 7.0cm/10.0cm in visual analogue scale (VAS). We utilized Uyaku-junki-san-ryo three times a day. The therapy of Uyaku junki-san-ryo resulted in the improvement of her pain, as well as the increase of her quality of life (QOL). Additionally, her VAS score was diminished from 7cm to 2cm, after two months.
This case demonstrates that Uyaku-junki-san-ryo may be a useful agent for the treatment of PHN.

The results of a trial treatment of primary biliary cirrhosis using combined Kampo and conventional drug therapy are reported.
A 79-year-old female with a chief complaint of pruritis was diagnosed as having primary biliary cirrhosis because of elevations in serum alkaline phosphatase, serum bilirubin, serum IgM, and positive tests for antimitochondrial antibodies and anti-M2.
In accordance with the Kampo diagnosis, she was first treated with Shinbu-to, which, however, did not cause any clinical alleviaton of the itching. Shishihakuhi-to was then given concomitantly, which resulted in the disappearance of the pruritis on the second day. Ursodeoxycholic acid was also added to her treatment from the 2nd month on. The serum level of bilirubin was observed to decrease gradually thereafter.
This case suggests that Kampo therapy, combined with the Western medical drug ursodeoxycholic acid, may be effective in the treatment of primary biliary cirrhosis.

A patient with gas symptom-predominant irritable bowel syndrome (IBS) who complained of recurrent severe abdominal pain was successfully treated with Saiko-sokan-to.
The patient was a 31-year-old male. Beginning in November, 1994, he repeatedly visited the emergency clinic with severe abdominal pain and abdominal distension. He was hospitalized three times, but no organic disorder was found. He usually had alternating constipation and diarrhea. He was diagnosed as gas symptom-predominant IBS because he mainly complained of gas symptoms such as abdominal distension, borborygmus and flatus together with abdominal pain. He was also suspected of having splenic flexure syndrome because his abdominal roentgenography revealed apparent intestinal gas at the splenic flexure. After treatment with Igakutoshi Saiko-sokan-to was begun in June 1996, his abdominal pain disappeared. Furthermore, emotional instability, lightheadedness, and skin troubles were also alleviated.
Saiko-sokan-to is indicated for patients having Sigyaku-san syo with severe Ki-depression, and appears to be a useful agent for gas symptom-predominant IBS.

In Japan chronic constipation is divided into two groups: atonic constipation and spastic constipation. Stimulant laxatives are unsuitable for patients with spastic constipation, and routine use of stimulant laxatives over long periods of time should be discouraged. Nevertheless stimulant laxatives are often used continually among these patients because their stools are too hard and infrequent without stimulant laxatives.
In this report, we present 4 cases of chronic constipation treated with Kami-shoyo-san. Cases 1, 2 and 3 were patients with spastic constipation and case 1, 3 and 4 had used stimulant laxatives continually. In all cases both stimulant laxatives and Kampo medicines containing Rhei Rhizoma caused adverse effects such as abdominal discomfort and pollakisuria. Kami-shoyo-san improved bowel movement as well as other complaints: irritability, heat in the upper part of the body, painful tension of shoulder muscles, fatigue, dysmenorrhea and pollakisuria. Withdrawal from stimulant laxatives was achieved in the patients except for case 2. In drug treatment of chronic constipation, Kampo medicines such as Kami-shoyo-san seem to be useful in withdrawal from stimulant laxatives.

We present here two cases of relapsing infection of the lower airway caused by the recurrent laryngeal nerve paralysis. Seihai-to offered useful palliation and symptom control in the two cases described below. Case 1 was a 50 year-old-man who received surgery and radiotherapy for a cervical tumor in 1970. Thereafter he suffered from cough reflex at meals and a hoarse voice. He has suffered from airway infection four or five times a year since 1992. In May 1995 he was hospitalized for pneumonia. Two more attacks of pneumonia followed in the next two months. Administration of Seihai-to provided a palliation period of 15 months at first and decreased frequency of recurrence to as few as three times during the follow-up period of 43 months; one was pneumonia and two were bronchitis. Case 2 was a 76-year-old man who received surgery and radiotherapy for lung cancer in the left upper lobe in 1984. Thereafter he suffered from cough, sputum, cough reflex at meals, and hoarse voice. Lower airway infection was exacerbated five or six times a year since 1984. He was hospitalized for pneumonia in May 1997 and March 1998, and came to our hospital asking for Kampo therapy in April 1998. Administration of Seihai-to improved his symptoms and achieved a palliation period of 8.5 months. The original text “Man-byo-kai-shun” mentioned that loss of voice is one of the indications of Seihai-to. We took notice of hoarse voice in the two cases at selection of formulae.