Shuan kagawa has been known as the pioneer who initially used Jidabokuippou as an effective Kampo medicine for treating contusion, sprain and other pains. According to his report, Jidabokuippou is mainly used for the treatment of sub acute or chronic bruise.
Recently Jidabokuippou has popularly been used for the bruise, however the effectiveness of Jidabokuippou on physical signs has not yet been reported.
In 18 patients with the history of bruise and pains, the condition and physical signs were examined before and after treatment of Jidabokuippou. All cases had showed the abdominal tenderness at the right side of paraumbilical site before treatment. After the treatment, both of the complain of pain and the abdominal tenderness were disappeared simultaneously in all cases.
Jidabokuippou is proved to be effective for alleviating the pain from the bruise and the abdominal tenderness at the right of paraumbilical site.

Two cases of mental disorder with the tender point at the left paraumbilical region two fingerbreadths away from the umbilicus were successfully treated with shimbuto. These cases appeared shimbuto symptoms corresponding to the provisions of the early yang stage pattern and the middle yin stage pattern in the classic textbook ‘Shanhanglun'. The pathogenesis of these cases of the patients who improved with shimbuto would be qi and fluid intimidating. The tender point at the left paraumbilical region by palpation is considered as ‘Huangshu KI 16' of kidney meridian in ‘WHO Standard Acupuncture Point Locations in the Western Pacific Region'. This tender point is a very useful diagnostic sign to prescribe for simbuto. It suggests that an acupuncture point on the meridian and collateral theory might appear the condition of three yin and three yang disease in ‘Shanhanglun' and be useful to choose Kampo medicine.

We describe our surgical experience of inflammatory abdominal aortic aneurysm (IAAA) in a 54-year-old man. Computed tomography (CT) with contrast enhancement revealed an infrarenal abdominal aortic aneurysm with marked thickening of the aneurysmal wall (mantle core sign) and left hydronephrosis. The left ureteral stenting was performed. Preoperative laboratory findings showed high levels of serum IgG4. The IAAA was removed and replaced with a woven-Dacron graft in situ. Histological examination revealed the IgG4 positive plasma cell, and demonstrated IAAA associated with IgG4. The postoperative serum IgG4 was reduced, but remained high. The postoperative CT revealed new right hydronephrosis, and the ureteral stent was performed. The mantle sign reduced in CT scan after steroid therapy. IAAA with hydronephrosis seems to be associated with IgG4-related sclerosing disease. In this case, the levels of serum IgG4 seems to be a good index for treatment efficacy.