There are many indications for Ryo-kei-jutsu-kan-to, such as orthostatic hypotension, cardiac neurosis, migraine, congestive heart failure, benign paroxysmal positional vertigo and eye disease. Although in oriental medicine Ryo-kei-jutsu-kan-to is used as a hydragogue agent for sui-doku (disorders of the body's fluid metabolism), its actual effect on hydragogue action remains unclear. We previously carried out hemodynamics tests before and after administration of Ryo-kei-jutsu-kan-to for a patient with orthostatic hypotension due to peripheral autonomic disorder. The pathosis of the patient before administration of Ryo-kei-jutsu-kan-to was found to be sui-doku caused by the excessive increase of circulating blood volume. We reported that after administration of Ryo-kei-jutsu-kan-to the blood pressure of the patient in the standing position was elevated by increased peripheral vascular resistance, while excessively increased circulating blood volume decreased. This time we administered Ryo-kei-jutsu-kan-to for four cases, such as orthostatic hypotension with migraine, cardiac neurosis, congestive heart failure, and hypotension in dialysis. We again realized that it also increases peripheral vascular resistance. As one of the dimensions of so-called hydragogue action, it is important to understand that Ryo-kei-jutsu-kan-to has a hydragogue effect against the retention of excess fluids (sui-doku) in the body through increasing peripheral vascular resistance by vasoconstriction.

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.

Zentai (Cicadae Periostracum) is classified by traditional Chinese medicine as one of the “pungent cool-natured” drugs, but its pharmacological action is not well known yet.
Zentai is used in Shofu-san as an expelling pathogenic wind component for relieving itchiness for patients with eczema, dermatitis, urticaria, etc.
We examined a number of patients with atopic dermatitis whose condition worsened after they were treated with Zentai to relieve itchiness.
In the current study, five male and ten female adolescent/adult patients were randomly selected to receive 2.5g of Zentai. These patients had been treated with Kagen-ichiin-sen-ka-kiban-kyo and their skin conditions had been stable so far.
In a follow-up two weeks later, the water content of the horny layer of skin at the forehead and the anterior side of the forearm decreased significantly (p<0.05). In terms of the level of itchiness, two patients (13.3%) improved, nine patients (60%) worsened, and the other four (26.7%) remained unchanged.
The current study indicates that Zentai worsens dry skin and exacerbates itchiness. Care will be required in the use of Zentai for the treatment of atopic dermatitis because of its drying pharmacological character.

We analyzed the differences between responder and non-responder groups using Choyoto for hand eczema. In 7 cases the drug was effective, and in 6 cases it was not. Most patients in the effective group had white-complexioned skin, and the eczema tended to localize on the hands. In contrast, most patients in the non-effective group had with sleep difficulties and/or a smoking habit. In addition, they showed marked symptoms of Oketsu such as dark red gingiva, indicating that many of the non-effective hand eczema cases had elevated Oketsu scores. It was shown that objective and subjective symptoms could be indicators for the choosing of Choyoto for hand eczema treatment.

Approximately 40% of women during the course of their menstrual cycles suffer from premenstrual syndrome (PMS). The cause of this syndrome is unknown, furthermore diagnostic criteria and treatments have not been established. Kampo medicines were applied using Kami-shoyo-san as a first choice, and several other alternative Kampo medicines, to 33 PMS patient cases. To evaluate the effectiveness of this therapy, PMS scores were recorded prior to treatment. Patients' scores were recorded as; score 0 (symptomless), score 1 (endurable), score 2 (unbearable without medicine), as well as the five major characteristics of PMS, 1) psychiatric symptoms, 2) headache, 3) breast pain, 4) swelling, 5) lower abdominal pain or lumbago. The scores were verified subsequent to two menstrual cycles. Kampo medicine was found to be effective in 24 cases, with scores declining in average from 4.4 to 1.5. Further treatments were requested in 4 cases, moreover, 5 cases were discounted altogether. Thus Kampo medicine proved to be a very useful method for patients suffering from PMS.