Muscle hypertonicity, excitability, and insomnia were observed after improvement of cough, appetite loss, and general fatigue in four cases of severe mental and physical disability, and three cases of developmental disorder, while being medicated with bupleurum root-containing formulations for bronchial asthma, or other physical symptoms. By comparison with three trouble-free cases medicated with saibokuto, these four index double handicap cases used to react better to others with voice, gesture, and non-verbal communicative facial expressions, and they also used to have muscle hypertonicity with involuntary movements. In two cases with yokukansan, behavioral problems such as hyperactivity, excitability, and impulsive action were also prominent, and we might give more consideration toward both unapparent hot flushes or netsu-sho (hot states) of the head, and insufficiency of liver yin. We discuss the pharmacological function of bupleurum root drugs on the central nervous system, and suppose that the events presented in this paper might be adverse physical reactions rather than formulation side effects. Moreover, this should remind us to evaluate sho (Kampo diagnoses) carefully, and consult with parents on both mental and physical conditions, when prescribing Kampo medicines for handicapped children.

We retrospectively investigated the prevalence of influenza virus type A infection and the efficacy of Kampo medicine as a prophylactic for handicapped residents at our social welfare institution, during the 2004/5 flu season. Upon studying a nationwide surveillance report for said season, we supposed that it had been difficult to prevent mass infection at our welfare institution with the usual preventive methods, because type B had prevailed for most of the season, and because of the differing type A (AH 3) antigenicity which prevailed late-season, for which there were no type A vaccines.43 of 90 (47.8%) residents given flu vaccinations twice, and 25 of 110 (22.7%) of staff members given flu vaccinations once contracted type A influenza between March and May of 2005. Interestingly, residents who had been administered Hozai for either short-term health problems or chronic disease, demonstrated a low influenza prevalence, there being a statistically significant difference (p<0.05) between our “Hozai” and “non-Hozai” groups. Furthermore Juzentaihoto, known to enhance immune function, seemed beneficial because of its low associated morbidity rate, and only 2 of 8 residents administered it contracted flu. No difference was observed, however, between generalized “Kampo treatment” and “non-Kampo treatment” groups.We consider that certain Kampo medicines may be useful for the prevention of influenza infection, in institutionalized handicapped residents with short-term health problems. Immunological enhancements, and the influence of Hozai are discussed here.
Medicine, Kampo ; Seasons ; Infection as complication of medical care ; Influenza ; Prophylactic

A 22-year old man was referred for mental retardation, refractory epilepsy, and chronic renal failure due to congenital anomalies of the kidney and urinary tract since he was an infant. Although hemodialysis was introduced both 3 years and 8 months ago, neither its appropriate safe management nor good quality of life were obtained, because of polyhydruria, psychogenic polydipsia, and his aggressive disruptive behavior in refusing any proper direction. After the fourth making of a shunt vessel with an artificial material, we gave him Orengedokuto to reduce his insomnia, itching, and other indefinite complaints.
As a result, his complaints and behaviors improved and he stopped taking too much water on the days before hemodialysis; which then began to work preferably with the proper amount of water exclusion. Moreover, we could reduce the amount of carbamazepine and methylphenidate hydrochloride he required. This case demonstrates that Orengedokuto may have an effect on the central nervous system to improve behavioral problems stemming from developmental disorders in children, or adolescents.