Chronic fatigue is a common symptom in primary health care and caused by various organic and functional diseases. Although improvement is attained by controlling underlying organic disease, it is sometimes difficult to relieve fatigue in patients with chronic fatigue syndrome or dysthymia. We have encountered patients with idiopathic chronic fatigue (ICF) successfully treated with sansonintokagen. A 62-year-old female complained of chronic fatigue several years after menopause, and had normal status in routine blood and image analyses at a nearby hospital. Her condition was diagnosed as ICF with sleeplessness. Treatment with sansonintoaogibakumondo for 8 weeks improved her chronic fatigue and sleeplessness, and enabled her to continue housekeeping. This observation suggests that this kampo formula may be a useful agent for ICF.

Using textbooks of Western medicine and Kampo medicine in Japan, we examined descriptions in classification and laxative therapy of chronic functional constipation. In terms of the relationship between stool shape and patient's age, description in Kampo textbooks was contrary to that in the textbook of Western medicine. The opinions on the long-term use of rhubarb also divided between Western medicine and Kampo medicine, although in Kampo medicine there was some opinion that the long-term use should be discouraged.

Medicine, Kampo ; Names ; Disease ; Diagnosis

A patient with systemic lupus erythematosus (SLE), complicated by severe thrombocytopenia was successfully treated with Juzen-taiho-to. The patient was a 38-year-old woman presenting thrombocytopenia in 1974. She was diagnosed as having SLE with the appearance of renal failure in 1975. In 1984, she began blood dialysis due to deterioration of renal function. In addition, she repeatedly suffered from severe bleeding episodes due to thrombocytopenia. In 1989, she visited our clinic to undergo Kampo therapy, with no significant results obtained with any of the formulas tried.
In September 1992, she suffered from duodenal ulcer bleeding and stopped Kampo therapy for some time. However, since she began taking Juzen-taiho-to in June 1993, her thrombocytopenia improved and her platelet count stabilized at 10-15×10⁴/mm³. This made it possible to taper the dosage of the steroids being administered. Since July 1994, the prednisolone (PSL) dosage has been 5mg on alternate days. Since July 1995, the anti-DNA antibody was negative. The platelet count has been maintained at 15-20×10⁴/mm³ (as of December, 1996).

We assessed the understanding of Japanese Oriental Medicine, as well as the connection between General Medicine and Japanese Oriental Medicine, among medical students, to improve the effectiveness of clinical practice and lectures. The questionnaires were sent to fifth-year medical students (n=66), and the responses were collected anonymously. Although 22.4% of the responding students were “very” interested in Japanese Oriental Medicine and 68.7% were “slightly” interested, the students who understood Japanese Oriental Medicine even “slightly”comprised only 23.9%. The majority of students considered that the system of Japanese Oriental Medicine was most useful in combination with Western Medicine for practicing General Medicine. Nine (60%) of 15 students who understood Japanese Oriental Medicine considered that the system of Japanese Oriental Medicine was most useful for practicing general medicine. In contrast, among students who did not understand Japanese Oriental Medicine, only 8 of 42 (19%) showed the same response. Similarly, more of the students who understood General Medicine showed this response than students who did not understand General Medicine.
These results permit us to speculate that medical students consider that understanding both General Medicine and Japanese Oriental Medicine might contribute to the development of a medical service.

We present a case of prolonged post-herpetic neuralgia (PHN), successfully treated by Uyaku-junki-san-ryo. A 76-year-old woman was referred for PHN for 5 months. Her pain was confined to the area of the maxillary nerve, and waving smart pains trouble her greatly, all day long. The stellate block or the administration of carbamazepine did not avail against her pain at a nearby hospital. She visited our hospital on ******, the degree of her pain was expressed as 7.0cm/10.0cm in visual analogue scale (VAS). We utilized Uyaku-junki-san-ryo three times a day. The therapy of Uyaku junki-san-ryo resulted in the improvement of her pain, as well as the increase of her quality of life (QOL). Additionally, her VAS score was diminished from 7cm to 2cm, after two months.
This case demonstrates that Uyaku-junki-san-ryo may be a useful agent for the treatment of PHN.

Chronic fatigue is a common symptom in primary health care and caused by various organic and functional diseases. Although improvement is attained by controlling underlying organic disease, it is sometimes difficult to relieve fatigue in patients with chronic fatigue syndrome or dysthymia. We have encountered patients with idiopathic chronic fatigue (ICF) successfully treated with sansonintokagen. A 62-year-old female complained of chronic fatigue several years after menopause, and had normal status in routine blood and image analyses at a nearby hospital. Her condition was diagnosed as ICF with sleeplessness. Treatment with sansonintoaogibakumondo for 8 weeks improved her chronic fatigue and sleeplessness, and enabled her to continue housekeeping. This observation suggests that this kampo formula may be a useful agent for ICF.

We administered daisaikoto to 13 patients with traumatic cervical syndrome and observed complete responses in the following 2 patients. Patient 1 was a 40-year male. He was in the xiaoyang stage, and showed high abdominal tension and marked chest oppression. These findings were indications for daisaikoto. Patient 2 was a female in her 50 s. She was in the xiaoyang stage, showed moderate abdominal tension and chest oppression, and was aware of chest tension and constipation. Evaluation using the VAS in the 13 patients showed a complete response in 3 patients, partial response in 6, minor response in 1 and no response in 3. To clarify indications for daisaikoto in this disease, findings of Japanese Oriental Medicine in the 13 patients were evaluated. Of 9 patients with high abdominal tension, 8 showed partial or complete responses. Of 4 patients with moderate abdominal tension, a complete response, partial response, and no response were observed in 1, 1, and 2, respectively. In addition, objective abdominal coldness was present in both patients with moderate abdominal tension who showed no response but not in the patient showing a complete response.We confirmed the importance of therapy based on oriental medical syndromes when daisaikoto is used for traumatic cervical syndrome. However, patients with moderate abdominal tension without abdominal coldness can be differentiated from others for this therapy.

In 1989, a 17-year-old male patient had fever and was admitted to a hospital in his neighborhood. He was then diagnosed as having Crohn's disease of the colon and ileum. His condition improved when treated with parenteral hyperalimentation via the central vein, an elemental diet, and salazosulfapyridine. Every time a normal diet was introduced, it recurred, which required a second hospitalization. At the third recurrence in July 1992, he expressed the desire to have Kampo medicine and subsequently visited our department. The inflammatory reactions were severe, and he had fever and was losing weight. He was fasted and given parenteral hyperali-mentation via the central vein. He received Kyuki-kyogai-to and Hange-shasin-to concomitantly which were prescribed according to his kampo diagnosis. One month later, CRP was negative and an elemental diet was started. Two months later, he was able to take both elemental and normal diets. Remission is still being maintainned even after he started the normal diet again.
Kampo medicine achieved a prolonged remission in this case where Crohn's disease kept recurring when hyperalimentation therapy was given, This suggests that a combination of an elemental diet and Kampo medicine may play an important role in maintenance therapy for this disease.