We report three cases of panic disorder treated with kampo formulae including shohangekabukuryoto. Case One was a 47-year-old driver. Sharp rises in blood pressure caused transient ischemic attacks in the brain. We suspected that anxiety over recurrent brain attacks stagnated his water and qi below the heart and caused phlegm heat, which lead to his panic disorder. His symptoms were cured with shohangekabukuryoto and the substance of orento. Case Two was a 49-year-old homemaker. Her domestic anxiety developed into a panic disorder. We suspected that her anxiety diminished the blood and the function of her liver, as well as her splenic sufficiency. Her attacks were cured with kamishoyosan, and with bukuryoingohangekobokuto which contains shohangekabukuryoto. Case Three was a 32-year-old homemaker. Overwork through her child-raising tasks developed into a panic disorder. We suspected that fatigue caused her splenic insufficiency and resulted in blood deficiency with the extra water below the heart. Shohangekabukuryoto and juzentaihoto were very effective, and resolved her attacks.These cases suggest that shohangekabukuryoto improved epigastric discomfort, dizziness and palpitation by justifying middle-jiao dysfunction, qi and water regurgitation. In each of the three cases, shohangekabukuryoto showed efficacy for panic disorder with other kampo formulae for respective signs and symptoms.
Panic Disorder ; Three ; Water ; Anxiety ; Cases

This paper reports the results of clinical research on spring pollen disease based upon the Oriental medical diagnoses. Sixty-nine patients (twenty-four males and forty-five females) who were afflicted with the spring pollen disease were categorized into groups according to the types of Oriental herbal medicine that they responded to. Then, the authors compared the respective periods when the disease first developed in the patients of each group. A comparison was also made based on the differences between their objective signs and subjective symptoms.
As a result of the research, the types of spring pollen disease observed have been classified into the following three groups, with one exceptional type (see Example 4). The first is a group for which “a treatment for superficies-syndrome” (Kai-hyo) was effective using “the drugs of acrid taste and warm nature” (Shin-on) (see Example 23). The patients of this type first manifested their symptoms in the period between the end of January and mid-February. It was found that most of them exhibited a predisposition to a “hypofunctioning condition” (Kyo-sho), and were diagnosed as having pollen disease with the “wind-cold symptom” (Fu-kan-sho). The second is a group for which “a treatment for superficies-syndrome” was effective using “acrid and coldnatured drugs” (Sin-ryo) (see Example 22). Most of the patients of this type first manifested their symptoms after mid-February. It was found that they exhibited the symptom of “cold in the superficies” (Gai-kan) and “the pathogenic factor blending wind-evil and heat-evil” (Fu-netsu), and that most of them manifested “a hyper-functioning condition” (Jitsu-sho). They were diagnosed as having pollen disease with the “wind-warm symptom” (Fu-on-sho) of a “warm disease” (On-byo) with a strong “wind-evil” (Fu-ja) and weak “warm-evil” (On-ja). The third is a group with the mixture of “the treatment for superficies-syndrome” with “the drugs of acrid taste and warm nature” and those of “acrid and cold nature” (see Example 20). It was found that the patients of this group carried little predisposition to “a hypofunctioning condition, ” and that they exhibited a mixed condition of coldness and heat, carrying both characteristics of the first and second groups. They were diagnosed as having the pollen disease with “auxiliary symptoms” (Ken-sho), “the wind-warm symptom” of “a warm disease” combined with “cold-evil” (Kan ja).

Introduction: Though the animal assisted therapy and the animal assisted activity with animal visiting are widely introduced to general hospitals in Japan, the report of those activities in palliative care units (PCU) of general hospitals are few. Methods: In June 2013 therapy dogs started to visit our PCU with the help of NHO Japan Animal Association. We discussed on the effects and the problems as a part of the palliative care about this activity. Results: Three therapists with 3 therapy dogs came to our hospital twice a month and the total number of 487 patients took part in 73 sessions until September 2016. Those activities made the patients and their families felt better and their communications with staffs were improved. No adverse effects concerning the safety and health were observed in those activities. Discussion: The reliable training and infection control of animals can make easy the introduction of animal therapy to the PCU of a general hospital. Visiting of therapy dogs can provide the healing to not only the patients and their families, but also the staffs in the PCU.

Dang Gui Liu Huang Tang (in the Lan Shi Mi Cang written by Li Dong-yuan) is a common medicine for treating night sweats. We describe its historical development and therapeutic uses. The use of Huan qi (Radix Astragali sen Hedysari) is based on the Han-Sui dynasty medical principle that night sweats are mainly caused by Deficiency of Yang. Herbs to enrich the lood and Yin, Dang gui (Radix Angelicae Sinesis), Seng di huang (Radix Remannia), Shu di huang Radix Rehmannia preparata) were later added because Son dynasty physicians mentioned that Yin deficiency caused night sweats. The addition of heat-reducing herbs, such as Huang lian (Rhizoma Coptidis), was based on the Song dynasty theory that night sweats are caused by pathologic heat in the body, which forces body fluid out of the skin. In the same period, the herbal medicine called Da Jin Hua Wan created by Liu Wansu, and this greatly influenced the principles for treating night sweats. The clearest explanation can be found in the medical treaties Huang Di Nei Jing Su Wen, and Xuan Ming Lun. This medical combination was based on medical theories from a number of historical periods, which may explain its effectiveness. Dang Gui Liu Huang Tang is not effective against types of weak heat (Dan xin xin fa), severe vital Qi Deficiency (Zhang shi yang), or serious deficiency of Yin (Yi xue xin wu). It sometimes hurts Pi and Wei (digestive system). It is useful in the treatment of spontaneous perspiration (Yi xue zheng zhuang, Jin xue quan shu). In summary, this medicine is most effective when the seriousness of heat and Yin deficiency are almost equal and a slight Qi Deficiency exists, or in cases of spontaneous perspiration.

Until the Sui Dynasty in China, night sweat and spontaneous perspiration had been thought to be caused by same pathophysiology, that is, lowered superficial resistance by deficiency of Qi.In the Tang Dynasty, these were considered to have different pathophysiologies and a new principle indicated that pathogenic heat caused night sweat.In the Song and Jing Dynasties, deficiency of blood and pathogenic heat by deficiency of Yin was also considered to cause night sweat.In the Jing Dynasty, exogenous pathogens, such as Cold were considered to cause night sweat, which indicated the principle that not only the deficiency syndrome but also the excess syndrome caused night sweat.In the beginning of the Yuan and Ming Dynasties, it was concluded that the deficiency of Yin caused night sweat and the deficiency of Yang caused spontaneous perspiration.In the middle of the Ming Dynasty, another new theory indicated that deficiency of Yang also possibly caused night sweat; therefore we should diagnose abnormal sweat depending on the pathophysiology in each case.In the Qing Dynasty, new theories were established stating that not only exogenous pathogens but also Damp-heat, undigested food and stagnation of blood, all of which are included in excess syndrome, cause night sweat, and that based on which part of the body sweats occurred we might understand pathophysiology of night sweat. The night sweat by Warm-heat, which is different from the one by Wind-cold, was considered to be caused with deficiency of Yin.Thus we conclude that the theories of night sweat developed over time, based on Chinese medical classics.