We report a case of chronic heart failure successfully treated with bukuryokyoninkanzotokaboiogi. The case was an 87-year-old woman whose chief complaint was chest oppression at rest. She had been diagnosed with chronic heart failure and treated at a university hospital for 6 years, including several episodes of hospitalization. The patient's chest oppression was so strong that she felt depressed. Therefore, she consulted our institute to receive a Kampo treatment in addition to the western medications she was taking. At the patient's first visit to our institute, her serum brain natriuretic peptide (BNP) value was 545pg/ml, and her cardiothoracic rate (CTR) on chest radiogram was 64.1. The severity of the patient's chest oppression was class IV, according to the classification system of the New York Heart Association (NYHA). After we prescribed bukuryokyoninkanzotokaboiogi, her chest oppression and depressive mood gradually improved. Approximately one year later, the patient's BNP value had lowered to 104pg/ml, and CTR was reduced to 57.5. Eventually, her chest oppression and depressive mood disappeared completely. At that time, the chest oppression was categorized as class I in NYHA classification. Treatment with western medicines was not changed over the total clinical course of this case. These results suggest that bukuryokyoninkanzotokaboiogi could be a useful formulation for the treatment of chronic heart failure.

We experienced 2 cases in which Kampo (Chinese medicine) treatment was effective for septic osteoarthritis. Case 1 : a 34-year-old female. Septic coxarthritis developed with no left hip joint abnormality being noted, while DIC (disseminated intravascular coagulation) from MRSA pneumonia was treated. Surgeries were carried out five times, but there was no wound closure, and exudate discharge continued. At first, she was treated with Hochuekkito, did not run a fever, and good granulation tissue was formed in the wound. After a change to Senkinnaitakusan, exudate quantity decreased. Moreover, after an external fixation operation and being treated with Juzentaihoto, epithelization progressed, and the wound eventually closed. Case 2 : a 79-year-old female. One year and 6 months after osteosynthesis with compression hip screw was carried out for a femoral neck fracture, operation scar complications and large quantities of exudate were seen, so we diagnosed her with late onset septic osteomyelitis. She gained weight with Juzentaihoto treatment, while a decrease in exudates and fistula closure with Astragali Radix and Ginseng Radix were confirmed by MRI, and her nutritional state improved. Generally speaking, septic arthritis and osteomyelitis are difficult to treat, but Kampo medicines were curatively effective for these diseases, particularly when increasing Astragali Radix and Ginseng Radix quantity.

Background and objective : Diet has been recognized as an important part of Kampo medicine, and various plants with which we often cook are included as components of many Kampo formulations. Accordingly, nutritional science is closely related to Kampo medicine. So there is a need for national registered dietitian and nutritional science students to learn Kampo medicine. Despite this, no survey has reported on the awareness of nutritional science students toward Kampo medicine in Japan. We conducted for the first time a survey on this awareness amongst nutritional science students about Kampo medicine.Methods : A 13-item anonymous questionnaire was distributed to the third-year students in a national registered dietitian training program in Japan.Results : We obtained answers from 509 students in 9 institutions. Of the respondents, 59.3% answered that they were interested in Kampo medicine, and 86.4% of the students who were not interested in Kampo medicine answered that the reason was they had no chance to learn it. However, 81.3% of the students answered that they would attend lectures on Kampo medicine if it was adopted as part of their curriculum.Conclusions : These results suggest that Kampo medicine should be included in educational programs for nutritional science students.

Case 1 was a 40-year-old woman who used a facial treatment machine and felt burning facial pain at night.She then felt unpleasantness in her facial skin all day long and was too uncomfortable to leave her home. We prescribed kamikihito. Ten days later, she felt the positive effects of treatment. Forty-five days later, she did not feel the unpleasantness on her facial skin, and she was able to go out again. Case 2 was a 36-year-old woman who had intense inflammation of her face, because she had stopped treatment with a steroid ointment.After 6 months, her face still felt hot and strange, which decreased her quality of life. We prescribed yokukan sankachinpihange. Four weeks later, she felt the positive effects of the treatment, and 14 weeks later, she was able to restart her part-time job. Because both of these cases had received various types of conventional medi cal therapy in the beginning that were not effective, their Kampo therapy was begun a long after the start of their abnormal facial sensation symptoms. Kampo therapy demonstrated a positive effect after approximately one month in both of these refractory cases. Thus we recommend Kampo medicines for the treatment of abnor mal facial sensations.

Ryokito is a Kampo formulation which has been administered for right upper quadrant pain since the Edo Era in Japan. Yet there are but a few reported cases in multiple clinical exams at one institution, on the usage of this formulation. We undertook a precise retrospective analysis of ryokito-prescribed cases at our institute over ten years, and reported cases published in the past to illuminate the clinical characteristics of ryokito effective cases.
Among the 21 cases at our institute, ryokito was effective in 11 cases and 10 of these 11 cases had right upper quadrant pain. Additionally, 7 of them reported abdominal distention.
Overall, this retrospective analysis revealed that amongst those ryokito effective cases, not a few patients had the right upper quadrant pain. This fact suggests that right upper quadrant pain is a reasonable characteristic for a usage of ryokito.
Likewise, abdominal distention was also a common symptom among the effective cases. It is likely that abdominal distention could be a characteristic for a usage of ryokito as well.

This report describes a case of cluster headaches that was successfully treated with Senkito. The patient was a 46-year-old female. She had been having attacks of cluster headaches that had continued for 3 days at the change of seasons since she was 30 years old. During an attack, she took a triptan preparation and non-steroid anti-inflammatory drug (NSAID), but they were not effective. Recently, the attacks had been increasing in frequency and continued for 1-2 weeks. She visited our hospital for Kampo treatment. We diagnosed her as having oketsu and kiutsu ; therefore, we prescribed tsudosan, and the frequency and strength of the attacks decreased. Even if NSAIDs were effective for headaches, they were not consistently effective. We re-examined her and found she had inside biryokotsu, which is tenderness in the orbital part of the frontal bone. We diagnosed her headache as including biryokotsu pain. We prescribed Senkito as required for her biryokotsu pain. It was very effective and the headache vanished after only 30 min. Generally, the potency of Kampo medicines with few structural components is higher than that of those with many structural components. Senkito has only five structural components ; therefore, we concluded that Senkito is effective not only for everyday use but also for use when required. Senkito is one of the most effective formulations for treatment of biryokotsu pain,especially the patient with inside of biryokotsu tenderness.

Soshikokito is a Kampo formulation used in the treatment of bronchial asthma, especially in those patients with hot flushes and cold sensation in their feet. But there is also a description in classical textbooks for its usage for the treatment of tinnitus. We report two typical cases of prolonged tinnitus treated successfully with soshikokito. Case1was a 70-year-old woman who visited our clinic complaining of tinnitus, dizziness and insomnia. She had a history of bilateral otitis media in her childhood, and had been suffering from tinnitus after being operated for it. The tinnitus had worsened during the three months prior to her first visit to us. After 3 months' treatment with soshikokito with additional shisoyo, her symptoms improved, so much so that after 8 months, she could live her life normally. Case 2 was a 58-year-old man who presented with tinnitus, hearing disturbance and a sense of irritation. He also complained of insomnia and cold sensation in his limbs. After1month's treatment with soshikokito with additional shisoyo and bushi, most all of his symptoms resolved. In addition, we also evaluated the clinical efficacy of soshikokito for prolonged tinnitus, retrospectively, and found that it was effective in five out of the ten cases we treated with this formulation. Most of the successfully treated patients presented with hot flushes or cold sensation in their feet. These case reports suggest that soshikokito may be a useful formulation for the treatment of not only bronchial asthma, but also of prolonged tinnitus.
Tinnitus ; therapeutic aspects ; seconds ; month ; Esthesia

We report four cases which were successfully treated with keishikyokeikabukuryobyakujutsuto. Case 1 was a 53-year-old female who presented with a 15-year history of fatigue, headache and shoulder stiffness. After 1 month's treatment with keishikyokeikabukuryobyakujutsuto, her complaints improved remarkably. Case 2 was a 29-year-old female who was suffering from allergic rhinitis. After 6 month's treatment with keishikyokeikabukuryobyakujutsuto, her symptoms completely resolved. Case 3 was a 37-year-old female who was diagnosed with Meniere's disease. Some formulas had been prescribed before, but provided no relief. After the start of treatment with keishikyokeikabukuryobyakujutsuto, however, the patient's symptoms resolved completely within 2 weeks. Case 4 was a 50-year-old female who presented with tension headache. After 2 week's treatment with keishikyokeikabukuryobyakujutsuto, her headache had almost completely resolved. Most of the cases presented with slight epigastric tenderness and superficial-like symptoms such as headache and shoulder stiffness. Many of them also showed symptoms suggestive of fluid imbalances in the body, such as dizziness, rhinorrhea and teeth marks on both sides of the tongue. Keishikyokeikabukuryobyakujutsuto is a useful formula for patients with superficial-like symptoms accompanied by disorders of the body fluid homeostasis.
symptoms <1> ; seconds ; therapeutic aspects ; Female ; Headache

We report a case of atopic dermatitis that was successfully treated with daiseiryuto. The patient was a 31-year-old Japanese female, who had atopic dermatitis and bronchial asthma since childhood. Recently, her itching, as well as her bronchial asthma, had simultaneously worsened. We diagnosed the patient with “exterior excess” (hyoujitsu), because she complained of anhidrosis. She also complained of being thirsty, suggestive of “interior heat” (rinetsu). Furthermore, her severe itching reminded us of “restlessness” (hansou). According to these Kampo observations, we prescribed daiseiryuto. After several weeks of taking the medication, the patient's asthma attacks had disappeared completely. The severe itching had also improved within a couple of months, and the skin eruptions disappeared in about 6 months. We think that daiseiryuto is a useful formulation for itching of the skin, and that it could be applied to many skin disorders besides atopic dermatitis, because severe itching of the skin can be interpreted as “restlessness” (hansou) in many cases. Daiseiryuto is safe for long-term use by comparatively young, strong patients, but a precaution must be taken in prescribing it to patients with a past history of ischemic heart disease, because daiseiryuto has a high Ephedrae herba content.
Pruritus ; Dermatitis, Atopic ; Integumentary system ; Patients ; Asthma

Treating tinnitus with modern Western medicines is difficult. Several studies have reported that Kampo medicines are efficacious for treating tinnitus, and therefore, it is expected that these medicines will gain widespread use in the future for tinnitus treatment. We retrospectively examined the efficacy of Kampo medicines prescribed on the basis of Kampo diagnoses for chronic tinnitus patients. The study population included 331 patients (114 men, 217 women) and average age was 57.8 years. The overall effective rate of Kampo medicines in tinnitus was 38.4% and increased to 64.6% after including effects for the accompanying symptoms (e.g., dizziness, insomnia, and headache). Hangekobokuto was prescribed most frequently. The effective rate for hangekobokuto in tinnitus was 32.1% and significantly increased when it was used in combination with a herb, chotoko (Hook of Uncaria, rhynchophylla Miquel) (p < 0.05, Fisher's exact test). The effects and modern pharmacological action of chotoko indicate that it may be effective for tinnitus. Given that tinnitus was intractable in study subjects who had been treated using other therapy approaches earlier (84% of the population), the findings indicate that Kampo medicine may be partially effective for tinnitus.