Tokito is used to treat patients with an asthenic, cold constitution, who have symptoms of chronic pleuritic pain, epigastralgia, and backache. There is no previous report on treatment of pruritus cutaneus with tokito. However, here we report a case of combined cutaneus pruritus and coldness, successfully treated with tokito. Our patient was a 38-year-old female, who reported having had facial pruritus cutaneus for one year. She attended our clinic in May of the year, because she had taken a turn for the worse. She was sensitive to cold, had poor circulation, felt cold in the abdomen, and reported that sleeping was difficult due to a cold back. We prescribed tokito (5.0 g/day). Her symptoms improved within six days. However, her symptoms, especially cold abdomen and cold back, returned when she drank cold water or stopped taking tokito. She was quite informative in that she prepared detailed records of her symptoms on visiting our clinic.
Tokito contains herbal medicines common to daikenchuto and tokikenchuto and hangekobokuto. Therefore, tokito could be a suitable herbal medicine for patients with pruritus cutaneus caused by coldness and qi stagnation and spleen deficiency.

Allergic rhinitis is an allergic disease affecting the nasal mucous membrane, and is aggravated by many kinds of factors. Here we describe 4 cases of allergic rhinitis successfully treated with tokishakuyakusan. Case 1 was a 31-year-old woman who suffered from coldness and irregular menstruation. We administered tokishakuyakusan, and her allergic rhinitis improved. When she stopped taking tokishakuyakusan, her allergic rhinitis recurred. Case 2 was a 40-year-old woman who suffered from seasonal pollenosis every year. Her pollenosis did not respond to keishibukuryogankayokuinin, administered for uterine myoma, but when we switched to tokishakuyakusan, her pollenosis improved. Case 3 was a 49-year-old woman who suffered from allergic rhinitis. She had not responded to many herbal medicines, but when we administered tokishakuyakusan, her allergic rhinitis rapidly improved. Case 4 was a 65-year-old woman who suffered from allergic rhinitis. She did not respond to kakkontokasenkyushin'i, but when tokishakuyakusan was added, her allergic rhinitis improved. Efficacy of tokishakuyakusan for rhinitis is not described in the classic literature. Our results suggest that tokishakuyakusan could be a suitable herbal medicine for asthenic, cold constitution of patients with allergic rhinitis caused by blood stagnation and blood deficiency as well as water disturbance.