We present a 35-year-old male with palpebral hemispasm, which often occurred while at work. Because there were no ophthalmological findings, he consulted our clinic to receive Kampo therapy. He easily became fatigued and he had subchondral resistance and discomfort (kyo-kyo-kuman), so we treated him with saikokeishito and shakuyakukanzoto. However, they were ineffective, and therefore we reconsidered his symptoms.
Although he complained of fatigue, he was well built and had been a heavy drinker until a few years before presenting. Furthermore, he easily blushed and sweated in the upper body during the daytime, and his palpebral hemispasm often occurred during this blushing and sweating, and was accompanied by headache. We considered that this represented an excess-heat pattern rather than a deficiency pattern, and prescribed orengedokuto. His symptoms improved, and disappeared after six months.
There has been no detailed report of orengedokuto for the treatment of palpebral hemispasm. Orengedokuto may be useful for palpebral hemispasm in the context of symptoms of excess-heat pattern, such as blushing, sweating in the upper body and headache.

We describe 3 cases of easy fatigability successfully treated with hangekobokuto. Case 1 was a 44-year-old woman who had been experiencing fatigue for a long time due to her busy work schedule. Juzentaihoto was ineffective, and she felt abdominal swelling and showed epigastric resistance upon abdominal examination. Case 2 was a 13-year-old woman who became easily tired, had palpitations, felt uneasy, and showed epigastric resistance upon abdominal examination, after moving from overseas to Japan. Case 3 was an 18-year-old woman who became easily tired under the pressure of her studies after entering university, felt uneasy, felt abdominal swelling, and showed epigastric resistance upon abdominal examination. Hangekobokuto relieved these symptoms. In Case 2 and Case 3, there were obvious stressors, and qi stagnation was strongly suspected. In Case 1, although the patient did not complain of obvious stress, she did not respond well to juzentaihoto, which compensates for qi deficiency, so we also considered qi stagnation. For symptoms such as “get tired easily,” qi-tonifying formulas are often used, but qi-regulating formulas including hangekobokuto may also be effective. It is also important to focus on the patient’s mental state and living environment.

To help medical doctors practicing Kampo medicine suggest appropriate acupuncture treatments for individ­ual patients, a study group made up of 7 acupuncturists and 5 medical doctors developed an acupuncture cur­riculum. The group provided a learning program based on the curriculum for 16 medical doctors in charge of outpatient Kampo services in a research institute. The learning program consisted of a lecture and practical training, and a total of 4 sessions were held. At the end of each session, a test was conducted to examine the participants' level of understanding. After the completion of the learning program, a questionnaire survey was conducted to confirm the usefulness of the acupuncture curriculum for the practice of Kampo medicine. The mean number of participants per session was 10.8 ± 1.3. The mean test score was 9.3 ± 0.5 (full score : 10). In the questionnaire, 14 out of the 16 (88%) answered that the acupuncture curriculum was useful or relatively useful for the practice of Kampo medicine. On comparing the numbers of new acupuncture patients with a his­tory of outpatient Kampo service use before and after the acupuncture curriculum, there was a 1.8-fold increase after it. The results support the usefulness of the acupuncture curriculum to understand acupuncture and practice Kampo medicine. Further evaluation is necessary.