A 82-year-old patient with congestive heart failure visited our hospital complaining of dyspnea and orthopnea. Initially, treatment was given based on the western medicine. She responded very well to a diuretic, with her congestive heart failure improving in a relatively short period of time. However, she could not adhere to the restriction of water intake she was supposed to follow was hospitalized repeatedly. While she was in hospital, just rest and water restriction alone improved dyspnea. Although she was discharged from hospital and was given increased doses of a diuretic and a vasodilator, congestive heart failure recurred. Since there was moderate discomfort of the hypochondrium and disturbance of the body's fluid metabolism, we added Sairei-to to her treatment. Six weeks later, the discomfort of the hypochondrium cleared. Her appetite started to improve and she had less severe dryness of the mouth. she was therefore gradually able to follow the water restriction and has not had recurrence of heart failure since then. Although Moku-boi-to is frequently used in the treatment of heart failure, it is assumed that a formulation with a diuretic action such as Gorei-san was effective because heart failure represents a disturbance of the body's fluid metabolism.

The term “half exterior half interior” is not found in the Oriental Medical Classic, the ‘Shang Han Lun’. Rather, the phrase “half outside and half inside” appears. It was Cheng Wu Ji that first used the term “half exterior half interior” in the phrase “Those in whom the disease-causing agent is half in the exterior and half in the interior are considered to be of the fever manifestation-type” appearing in his ‘Shang Han Ming Li Lun’. In the ‘Zhu Jie Shang Han Lun’ which Cheng Wu Ji wrote shortly afterwards, he explains that the phrase “half outside and half inside” found in the ‘Shang Han Lun’ means half exterior and half interior. Since this commentary on the ‘Shang Han Lun’ was more frequently published and more widely circulated than the original text, it is thought to be this explanation that accounts for the popularization of the term “half exterior half interior”.

Many patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) complain of respiratory distress, chest pain, and arthralgia even after their recovery. We tried to give saibokuto to a 61-year-old man who has suffered from those symptoms as after effects of COVID-19 for more than 2 months. We report that after administration of saibokuto, almost all symptoms have disappeared within 3 weeks.