Kyukichoketsuin is commonly used for ki-deficiency and ketsu-deficiency, especially postpartum physical and mental complaints. However it does not contain ninjin and ogi, which are actually known to be major crude drugs for ki-deficiency. The 16th century Manbyokaishun gives many ways of treatment, some including the use of ninjin and ogi with kyukichoketsuin.
We report 2 cases treated with kyukichoketsuin and hokizai. The first case was a 33-year-old woman who had dyspnea with exertion and general malaise undergoing treatment for amenorrhea. The second case was a 39-year-old woman who had fatigue, irregular menstruation and headache after childbirth. We treated the first with kyukichoketsuin and hochuekkito extract, and the second with kyukichoketsuin and rikkunshito extract. In both cases, the symptoms improved remarkably over a few weeks with kyuchichoketsuin and hokizai. Thus, this combination therapy may have efficacy for gynecological symptoms with remarkable signs of ki-deficiency.

We report two cases effectively treated with Kampo medicines for comorbid sleep disorder in developmental disorder. Case 1 was a 15-year-old woman diagnosed Asperger's syndrome, and her main complaints were difficulty in rising, difficulty in falling asleep and fatigability. We thought that the symptoms might be caused by in and ketsu deficiency, which lost control of kanki hyperactivity and evoked tension/excitement state easily. The difficulty in rising was improved with yokukansan and kambakutaisoto and she was able to go to school every day. Case 2 was a 17-year-old man diagnosed the attention-deficit/hyperactivity disorder. His symptoms were difficulty in rising, feeling of weariness, fatigability, and frequent tension/excitement state. The previous use of shokenchuto had improved the symptoms slightly. After shigyakusan was added to cure kanki dysregulation, he succeeded in going to school every day. In the oriental medicine, ketsu has important roles in mental stability and sleep, whereas qi and ketsu tend to be insufficient in childhood. Our results suggest that replacement of in and ketsu would be useful in treating comorbidities in developmental disorder.