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.

De Quervain disease and carpal tunnel syndrome are major problems that occur after delivery. During pregnancy, hormone confusion readily causes inflammation of tendons ;furthermore, overuse of hands during care of other children contributes to symptom onset. We report four cases of de Quervain and carpal tunnel syndrome occurred after delivery. All patients were women, aged 33-­39 years. All patients breast-­fed after birth. One patient was diagnosed with de Quervain disease, two were diagnosed with carpal tunnel syndrome, and one was diagnosed with de Quervain disease accompanied by carpal tunnel syndrome. All patients received tokishakuyakusan ;thereafter, their pain decreased, but slight numbness from the carpal tunnel syndrome remained. Drugs that can be used during breastfeeding are limited ;however, tokishakuyakusan can be prescribed safely and effectively.

We report a case of qi-deficiency fever that was successfully treated with hochuekkito. A 26-year-old woman presented to our clinic with a complaint of pain of her fingers. Clinical findings revealed no evidence of rheumatoid arthritis. Since she wanted treatment for the recent mild fever, additional examination was performed. Infection, malignant tumor, and collagen disease were ruled out as probable cause of the fever. Clinically, she was diagnosed with qi-deficiency fever. After treatment with hochuekkito, her body temperature normalized, indicating that treatment with hochuekkito was effective. Hochuekkito was originally prescribed for treatment of qi deficiency due to yin fire ; however, it is currently used for treatment of other diseases. In this report, we described a case using hochuekkito.

At the 71st Annual Meeting of the Japan Society for Oriental Medicine in August 2021, we conducted a special program focusing on education in Kampo medicine, “Pre-graduate and post-graduate Kampo medicine education for the next generation.” As part of this project, we directed a symposium on the model core curriculum (core curriculum) in medicine, dentistry, pharmacy and nursing. The core curriculum in these fields includes Kampo education. Each institution shall promote education in accordance with the core curriculum, considering the characteristics of the field and the circumstances of the educational institution. We introduced the core curriculum in each field, and summarized and reported the current status of Kampo education in the field, points to note and suggestions for multidisciplinary cooperation, issues related to clinical practice and lack of educators, and future prospects.