Crowned dens syndrome (CDS) is a pseudogout of the cervical vertebra, which shows calcification around the dens of the axis. We report a case of CDS that was successfully treated with daiobotampito and shimotsuto. An 83-year-old woman visited our clinic because of neck pain. She was diagnosed with CDS and was initially administered daiobotampito and eppikajutsuto. Her neck pain improved slightly, but recurred. She was then administered daiobotampito and shimotsuto, after which her neck pain disappeared. We considered that daiobotampito and shimotsuto were effective for this prolonged illness based on persistent stasis and blood deficiency according to her treatment course and laboratory findings.

Tokishakuyakusan is well-known to be useful in infertility. We report 3 cases of infertility that resulted in pregnancy and childbirth due to oral administration of tokishakuyakusan after being led to tokishakuyakusan pattern by symptomatic treatment resolving blood stasis or regulating qi. Case 1 was a 39-year-old woman with unexplained infertility. She visited our hospital because of irritability and was initially administered keishibukuryogankayokuinin and yokukansankachinpihange, and then tokishakuyakusan. After a month of treatment, she conceived. Case 2 was a 33-year-old woman who was diagnosed with ovarian dysfunction and received ovarian stimulation. To support infertility therapy she was administered keishibukuryogan, and subsequently, tokishakuyakusan based on her pattern. After 3 months of treatment, she conceived. Case 3 was a 37-year-old woman who was diagnosed with unexplained infertility and was administered kamishoyosan and hochuekkito for premenstrual syndrome at another hospital. She visited our hospital because of sensitivity to cold and fatigability. The previous treatment was discontinued, and she was administered tokishakuyakusan based on her pattern. After 2 months of treatment, she conceived. All 3 patients continued tokishakuyakusan treatment during pregnancy and successfully delivered live babies. These 3 cases initially received other Kampo medicines and then, tokishakuyakusan, according to the changed Kampo medical pattern. It is important to administer tokishakuyakusan to patients with infertility, following administration of appropriate Kampo medicine to correct their imbalance of qi, blood and fluid and after further confirming the abdominal signs suitable for tokishakuyakusan.

Painful orthopedic diseases are sometimes aggravated because of weather changes ; this is referred to as meteorological pain. We report two cases of great occipital neuralgia (GON) due to traffic accident in patients whose pain was aggravated by weather changes. Case 1 involved a 41-year-old woman who developed lumbago and cervical pain following a traffic accident. Two months after the accident, she had irregular occipital pain. Three months after the accident, a great typhoon occurred, and she suffered from severe occipital pain since that morning. She was diagnosed with GON as meteorological pain and was administered goreisan ; her occipital pain then improved. Case 2 involved a 31-year-old woman who developed cervical pain following a traffic accident. Three months after the accident, she experienced severe occipital pain due to weather changes. She was diagnosed with GON as meteorological pain and was administered goreisan ; her occipital pain then improved. Goreisan is dramatically effective for GON as meteorological pain caused by cervical sprain.