The patient was a 14 year-old female. She had been hospitalized repeatedly since infancy for suspected tonsillitis. During this time, she experienced high fever for about a week once a month. In her school years, she often had a recurrent fever with cervical adenitis, with only a mild inflammatory reaction. We diagnosed her symptom as one of a periodic fever syndrome, triggered by the frequent administered antipyretic drugs for fevers of unknown origin (FUO). We also suspected that there was liver tension, based on her abdominal and back examination, and we prescribed yokukansan. After a 3-month course of yokukansan, she no longer experienced these fevers. Most case reports of FUO describe the use of bupleurum root drugs and tonic formulas as treatment. Although yokukansan has traditionally been used for FUO in older texts, to our knowledge, there are no reports on such use clinically. In the present patient's case, the yokukansan may have reduced or eliminated some type of trigger for the fevers, or it may have affected the regulation of cytokines.

Shichimotsukokato is composed of shimotsuto with chotoko, ogi, obaku, and this formula has been frequently used for the treatment of hypertension, eye-fundal hemorrhage and headaches. Here we describe three cases of chronic dermatitis with hypertension and dry skin of legs, which were successfully treated with shichimotsukokato. Case 1 was a 67-year-old man whose chief complaint was pruritus and skin eruption on his chest. He also had dry skin accompanied with pruritus on his legs, and hypertension. Case 2 was a 59-year-old man who had skin eruption accompanied with pruritus on his trunk and extremities. He also showed diastolic hypertension and renal insufficiency due to the side effect of an immunosuppressant. Case 3 was a 64-year-old man who had dry skin with eruption on the upper trunk. Furthermore, his blood pressure fluctuated within the high normal range. After medication with shichimotsukokato, both the hypertension and dermatitis improved in all three cases.
According to these observations, shichimotsukokato may alleviate dermatitis along with dry skin of legs and hypertension, and it may be worth noting that shichimotsukokato is an option for the treatment of skin lesion.

Case reports of drug-induced liver injury caused by Kampo medicines are on the rise, but most of them are noted for related symptoms such as jaundice. Usually, severe liver injury is detected by chance upon routine medical checkup. Recently, we noted 3 cases of suspected drug-induced liver injury caused by orengedokuto, saikokeishikankyoto and bofutsushosan. In these 3 cases, maximum ALT was under 100 IU/l and no symptoms related to liver injury were observed. Early detection by blood test was useful, and appropriate treatment quickly improved and normalized the abnormal values associated with liver injury. We should always be alert for drug-induced liver injury caused by Kampo medicines, especially when prescribing formulations that include Scutellariae Radix. We also emphasize the importance of scheduling blood tests when prescribing these formulations.