The authors investigated the clinical effects of Hachimi-jio-gan in the form of handmade pills containing the steamed root of Rehmaniae Radix. There were 11 subjects involved in the study (eight women and three men), with a patient age of 56.7±11.1 (mean±S. D.) years old. All of the subjects suffered from chronic asthma, and their attacks had begun in adulthood. The patients were classified into three grades of severity: mild—one patient; moderate—two patients; and severe—eight patients. Ten of the patients received this medication for eight to twelve weeks, but one patient discontinued administration due to epigastrial discomfort.
The clinical efficacy of this agent was judged by changes in asthmatic attacks. Treatment scores in seven patients improved, two were unchanged and one worsened. Of seven patients taking oral steroids in conjunction with the Hachimi-jio-gan, two were able to decrease the dosage and two were able to discontinue the oral steroids, The peak expiratory flow rates in improved patients increased about 20% compared to the preadministration rates.
The authors considered that this Kampo formula may act to increase the anti-inflammatory action of corticosteroids or theophylline, because the bronchial dilatory effect was remarkable when it was administered in conjunction with these drugs, but less pronounced when used alone. This study suggest that wider application of this Kampo formula in patients with chronic asthma may improve respiratory function.

Physical and psychological symptoms were evaluated in 9 cases with unidentified clinical syndromes who were effectively treated with kami-shoyo-san (KS). Before and after administration, the patients were tested with the 43-question Abe questionnaire for vegetative syndrome and 51 questions (M-R) of the Cornell Medical Index. After administering KS for three months, the mean number of physical symptoms decreased from 19.9 to 9.1, and the psychological symptoms decreased from 16.7 to 9.3.
In order to clarify the clinical features for which KS is efficacious, the physical and psychological symptoms were divided into 7 and 6 categories, respectively. The average complaint rates responding to those categories before administration were evaluated. Physically, the average complaint rates related to locomotion and fatigue were high, and those related to digestion were low. Psychologically, the average complaint rates related to hypersensitivity and anger were high, and those relating to depression and tension were low.

Recently we observed three cases in which symptom-producing doses of Kampo medicine with aconiti tuber dramatically ameliorated primary diseases. The symptoms were similar to intoxication caused by aconiti tuber. Case 1 had been suffering from rheumatoid arthritis. After the daily dose of Keishi-ni-eppi-itto-ka-ryojutsubu, a Chinese herbal medicine containing aconiti tuber, was increased from 6g/day to 7g/day, the patient briefly experienced palpitation and nausea. At the same time, polyarthralgia and laboratory data dramatically improved. Case 2 suffered from lumbago due to osteoarthritis. Numbness around the lips and in the limbs and gait disturbance occurred in this patient after the basal prescription was changed from Shakuyaku-kanzo-bushi-to to Hachimijio-gan-ryo with the 4g/day dose of aconiti tuber remaining the same. The patient's lumbago disappeared almost completely. Case 3 had osteoarthritis and began taking Hachimijio-gan-ryo, containing aconiti tuber (8g/day), in early June. Numbness around the lips and limbs occurred after administration of Hachimijio-gan-ryo containing aconiti tuber (4g/day) in late July. After that, her gonalgia was recovered. Based on our experience above, we had the impression as follows: 1) Symptoms similar to intoxication due to aconiti tuber may be caused not only by increasing the daily dose of aconiti tuber, but also by changes of basal description or climate variations such as a rise in temperature. 2) In order to use aconiti tuber effectively, it is sometimes necessary to increase the daily dose to the level where it provides treatment, in spite of the risk of intoxication.

A 72-year-old woman was admitted with a sensation of compression and shortness of breath. A mass was detected in the right atrium (RA) by transthoracic echocardiography. Preoperative chest computed tomography showed an RA tumor measuring 30×24 mm in the lateral wall. We performed resection under the cardiopulmonary bypass. Histopathological examination confirmed that this tumor was a lipoma.

We investigated the clinical effects of Hochu-ekki-to on symptoms, biological properties, quantities of hepatitis C virus, and fibrotic markers of 25 patients with chronic hepatitis C for six months. Results were analyzed by comparison of sex, age, and Ki-deficiency symptoms. Transaminase levels did not change in total, although decreases in scores of malaise and fatigability were statistically significant. Nevertheless, in patients 60 years old or older, GOT levels were elevated and total cholesterol levels decreased as compared to younger patients. Decreases in transaminases after administration of Hochu-ekki-to were statistically significant only in the 60+ age group. Decreases in transaminases were also statistically significant in patients who suffer from malaise, who are highly susceptible to colds, or who have reduced tension of the radial pulsation and faint red color or edema of tongue. Decreases were not observed in patients without these symptoms. These results suggest that the diagnosis of Ki-deficiency in Kampo medicine is very important in treating hepatitis C with Hochu-ekki-to.

Chronic hepatitis C has a high incidence of proceeding to liver cirrhosis, and a natural healing from chronic hepatitis C is extremely rare. We observed a case of chronic hepatitis type C, in which the virus was eliminated after Kampo treatment. The patient was a 37-year-old female who underwent a blood transfusion following delivery of her first child in 1982. In January 1983, she became aware of general malaise, and was diagnosed as having chronic hepatitis. She was treated with Stronger Neo Minophagen C, but her symptoms and laboratory data were unchanged. A liver biopsy disclosed chronic active hepatitis in 1988, and she was transferred to our hospital for Kampo treatment in May. Although the symptoms rapidly disappeared after treatment with the Kampo formulas, Hochu-ekki-to and Keishi-bukuryo-gan, her transamilase values did not change. Her transamilase level decreased gradually after the prescription was changed to Saiko-keishi-to-go-Toki-shakuyaku-san-ryo, and returned to normal after her prescription was changed to Kami-shoyo-san-ryo in May 1996.
Concerning HCV-RNA in the serum, in March 1995, when Saiko-keishi-to-go-Toki-shakuyaku-san was administered, the amount of HCV-RNA in the serum was 10⁴ Kcopies/ml. But that was less than the detectable sensitivity in April 1998. We believe this to be a case in which elimination of HCV was achieved by Kampo treatment alone.

We report on two cases of relapsing aspiration pneumonia caused by dysphagia due to cerebrovascular disease. Sei-hai-to (Qing Fei tang) offered useful palliation in both cases. Case 1 was an 83-year-old-woman who was hospitalized for multiple lacunar infarction and lumbago in 1996. She gradually became bedridden within two years of the admission period. She was admitted to a long-term care hospital affiliated with our department in January 1998. Dysphagia and productive cough appeared in May, and enteral tube feeding was started after she developed pneumonia in August. Pneumonia persisted against some antibiotics, and feverish periods ranged from 8 to 18 days a month. CRP values were elevated to more than 5mg/dl. Administration of Sei-hai-to provided negative CRP values and decreased feverish periods to 0-2 days a month. Case 2 was a 93-year-old-man who suffered from cerebral bleeding in the right thalamus in 1984. He developed many attacks of aspiration pneumonia after starting oral feeding. He was admitted to a long-term care hospital affiliated with our department in April 1999. Sputum culture yielded P. aeruginosa and MRSA. Moreover, fluoroscopy showed aspiration into the lower airway. Aspiration pneumonia relapsed continually without antibiotics. Administration of both Sei-hai-to and clarithromycin decreased feverish periods and provided negative CRP values. Pneumonia relapsed easily either with Sei-hai-to therapy alone or Clarithromycin therapy alone.

We report a case of a 3-year-old girl who suffered from alopecia areata and was successfully treated with rokumigan modified formula. Initially, alopecia areata appeared on her left temporal region at the age of 3. The hair loss range had spread rapidly over the whole head. She visited our Kampo clinic because of insufficient effect of antiallergic drug. We prescribed her yokukansan, shimotsuto and juzentaihoto but the effect was insufficient. Finally, we thought this might be caused by kidney yin deficiency and liver blood deficiency because she had symptoms of pale white complexion, fine pulse, pale tongue with thin fur, and night sweating. Therefore, we administered rokumigan modified formula : rokumigan, tokiinshi and lycium fruit. Her hair began to grow after administering this formulation. There was not the re-hair loss during taking medicine for about 4 months. According to the traditional Chinese medicine, alopecia areata can be classified into 4 types : blood heat type, blood stasis type, dual deficiency type of yin and blood, dual deficiency type of qi and blood. We diagnosed this case as a dual deficiency type of yin and blood and selected rokumigan modified formula. Rokumigan is effective for various symptoms of kidney yin deficiency, and rokumigan modified formula may be useful for the treatment of infant alopecia areata.

We performed a preliminary study of the reliability of the lymphocyte stimulating test (LST) for Kampo medicine. LST for three kinds of Kampo medicines was performed in both a Kampo-administrated group and a non-administrated group. LST for each of the medicines was negative for seven of eight subjects in the non-administrated group, but was negative for four of 11 subjects in the Kampo-administrated group. The LST-positive participants had no allergic state, and some among them were negative in challenge test. This preliminary study suggests that LST for Kampo medicine is likely to be false-positive.

BACKGROUND: The prognosis of recovery following microneurosurgery for injured lingual nerves varies among individual cases. This study aimed to investigate if recovery ratios of sensory and taste functions are improved by the microneurosurgery within 6 months after lingual nerve injury. METHODS: We retrospectively assessed 70 patients who underwent microneurosurgery at the Wakayama Medical University Hospital for lingual nerve injuries between July 2004 and December 2016. Sensory and taste functions in lingual nerves were preoperatively evaluated using a static two-point discrimination test, an intact superficial pain/tactile sensation test, and a taste discrimination test. They were evaluated again at 12 and at 24 months postoperatively. The abundance ratio of Schwann cells in the excised traumatic neuromas was analyzed with ImageJ software following immunohistochemistry with anti S-100β antibody. RESULTS: In early cases (microneurosurgery within 6 months after the injury), recovery ratios of sensory and taste functions were not significantly different at 24 months after microneurosurgery compared with later cases (microneurosurgery more than 6 months after the injury). Meanwhile, the ratio of patients with taste recovery within 12 months after microneurosurgery was significantly decreased in late cases compared with early cases. The abundance ratio of Schwann cells in traumatic neuroma was also significantly lower in later cases. CONCLUSION Microneurosurgery more than 6 months after lingual nerve injury did not lead to decreased recovery ratio of sensory and taste functions, but it did lead to prolonged recovery of taste. This delay may be associated with a decrease in the abundance ratio of Schwann cells in traumatic neuromas.