At present, the disclosure of medical information to patients is mainly the release of their medical records. In surgery, however, as a patient usually lies unconscious during operation, the disclosure of surgical information is one of the most difficult tasks. Oral explanation after surgery is often inadequate even with drawings. Thus, in order to make a more precise disclosure, we edited the images taken by a digital camera in the operating theatre, and handed the print to the patients and their family members.
Questionnaires were sent to 33 patients who were given the print (disclosed group), and to another 33 patients who were not given (non-disclosed group). Seventynine percent of the questionnaires could be collected from the disclosed group, and in the non-disclosed group 91% were recovered.
Indication of the operation was understood in all the patients in the disclosed group, but in the non-disclosed group the rate was 93%. Proposed operative procedures were understood in 91% of the patients in the disclosed group, whereas the rate was 93% in the non-disclosed group. After operation, there was no difference between two groups concerning understanding of the explanation. However, while all the patients in the disclosed group remembered the postoperative diagnoses and operative procedures, only 83% of the patients in the non-disclosed group did (chi-square test, P=0.0397). Eighty-three percent of the patients in the disclosed group and 93% of the patients in the non-disclosed group were satisfied with the outcome of the operation. In the disclosed group, 83% of the patients could understand the contents of the print, and 96% of them mentioned that it was a good trial.
In conclusion, the disclosure of the information about surgical operations was effective when a print was used togethr with images taken by a digital camera. This trial contributed greatly to the improvement of patients' understanding of the details of surgical operations and the precise memory of the postoperative diagnoses and procedures.

A 61-year-old female had suffered from diarrhea, abdominal pain and vomiting since 1984. Although she had been treated with anticholinergics, antidiarrhoics, and Lactobacillus derivatives, the symptoms were unchanged. In July 1988, a partial resection of the distal ileum was performed to overcome adhesive ileus, but soft or mucous feces remained after surgery. The pathological diagnosis of the specimen was Crohn's disease. From July 1994, oral administration of Sairei-to (9g/day) was started. Within two weeks, the feces became normal. The patient gained 2kg of weight in 2 months. In May 1996, the dose of Sairei-to was reduced to 6g/day without changing her condition. In September, she started to take 30g of Perilla oil every day. Sairei-to was discontinued in May 1997 after the dose was reduced to 3g/day for a month. The total duration of Sairei-to therapy was 2 years and 10 months. Ordinary defecation has been observed for 1 year and 3 months since Sairei-to was discontinued. In conclusion, a remission was achieved in a patient suffering from Crohn's disease with a long-term administration of Sairei-to, and the prescription was discontinued for more than a year without recurrence.

Nasolacrimal duct stenosis, which causes epiphora and eye mucus, is generally treated with probing and irrigation of the nasolacrimal duct. A 57-year-old woman was treated with probing and irrigation of the nasolacrimal duct three times, however, her symptoms of refractory nasolacrimal duct stenosis did not improve. Following 3 days administration of saisoin, her epiphora ameliorated. Based on this experience, we treated 11 adult patients with nasolacrimal duct stenosis using saisoin, and 10 (90.9%) achieved remission within a week. All the adult patients had received treatment by probing and irrigation of the nasolacrimal duct at an ophthalmological clinic, and their symptoms had not improved. Two such cases in infants, moreover, were cured with saisoin in a week. This is the first report on the efficacy of saisoin for the treatment of nasolacrimal duct stenosis in Japan.

Medicine, Kampo ; Future

From December 1997 to February 1998, prescriptions for 875 patients with colds at the three institutions listed were investigated. The prescriptions were divided into three groups according to the nature of the drugs; modern drugs, Kampo medicine and combined use of modern and Kampo medicine. Mean age, the number of prescribed drugs and the days of prescription were checked and the medicinal expenses were calculated. When using only modern drugs, daily expenses were 203.8yen in average. On the other hand, using only Kampo medicine they were 119.6yen. When using combination of modern and Kampo medicine, the expenses reached to 215.9yen. These results indicated that Kampo medicine was the most economical, because using only Kampo medicine made the expenses approximately 60% less than those using only modern drugs. Thus, at least 41.5 billion yen could be saved in 1998 calculating from the market share of the national medical supplies in each therapeutic category. In conclusion, treatment of colds with only Kampo medicine was considered to be the most cost-efficient way.

Prior to the current pandemic caused by Coronavirus disease 2019 (COVID-19), there was a worldwide pandemic of H1N1 subtype influenza during 1918-1920. One of the most notable records of treatment in Japan is the story of Hiroaki Kimura in Tokyo. He used a formula including saikatsugekito and no patients died. The case was a 31-year-old woman testing positive for COVID-19 was treated with kakkonto (ge-gen-tang) and shosaikotokakikyosekko as an approximate prescription for saikatsugekito for one week from the first day of follow-up at the hotel. On the first day of treatment, the patient had severe headache, decreased oxygen saturation, increased heart rate and shortness of breath at rest as well as during physical activity, and the next day, smell and taste disorders appeared. However, by the time she left the hotel, these symptoms almost completely disappeared. This suggests the efficacy of combination of kakkonto and shosaikotokakikyosekko. Since COVID-19 often presents with symptoms of the interior organs from the early stage of the disease, combination of kakkonto and shosaikotokakikyosekko is considered to be one of the options of Kampo treatment for COVID-19.