Norovirus infection is a common cause of epidemic winter vomiting and diarrhea. The symptoms that present, such as vomiting, diarrhea, fever and abdominal pain, normally disappear within 1 to 3 days, although some fatal cases are reported in the elderly.During the two months from December 1, 2005 to January 31, 2006, we prescribed ogonto to twenty patients who presented with vomiting or diarrhea in a nursing home, and examined prescription times and illness durations, other drugs used, and whether there were any transfusion or complications.The number of ogonto doses given was from 1 to 12. Fifteen cases (75%) were dosed 3 times or less, and four cases were only dosed once. In terms of illness duration: eleven cases were cured in less than 24 hours; six cases were cured from 24 hours to less than 48 hours; two cases were cured from 48 hours to less than 72 hours; and one case was cured from 72 hours to less than 96 hours. Overall, seventeen cases (85%) were cured in less than 48 hours.Regarding the other treatment and complications: domperidone was used in four cases; and a transfusion was given in six cases. Aspiration pneumonia occurred in one case, but no patient required hospital treatment. Norovirus infection is usually treated only with symptomatic therapy, so we think Kampo therapy should be available because when started at an early stage, it can prevent this disease from becoming severe.

Ogikeishigomotsuto is a Kampo formula used for numbness or body pains. We experienced 29 cases in which attending physicians believed the drug would be effective. In 18 cases the drug was effective and in 11 cases it was not. We analyzed the difference in subjective symptoms between the responder group and the non-responder group. We concluded that some symptoms could be indicators for choosing the formula. Hypersensitivity to cold and heaviness of the whole body has previously been reported in many articles. In our cases, we observed a high incidence and specificity of the symptoms reported above, as well as arthralgia, dry skin and irritability in the responder group compared to the non-responder group. We believe these newly detected subjective symptoms can also be indicators for choosing Ogikeishigomotsuto.

We report three cases of pneumonia successfully treated with Kampo therapy. Case 1 was a 69-year-old female who was hospitalized with a fever and cough. Administration of Keishinieppiitto led to an improvement in her cough and a rapid reduction of fever, and we continued her treatment using Kampo medicine only. By the 7th day of admission, the infiltration shadow had disappeared, and on the 11th day, laboratory data on WBC and CRP had decreased to a normal range. Case 2 was a 66-year-old female who was hospitalized with cough, sputum and fever. She received modern western medical treatment, including antibiotics for one month, but her symptoms showed little improvement. After we administered Saiko-keishi-kankyo-to-go-Hange-koboku-to, her symptoms gradually improved. By the 15 th day of admission, her CRP levels had decreased to 0.7mg/dL, and the infiltrative shadow had disappeared. Case 3 was a 78-year-old male who was hospitalized with cough, sputum, anorexia and general malaise. A multiple nodular lesion in the lung was also detected by chest CT. Consequent diagnostic examinations were conducted, while providing him with Saikokeishito. Although the final diagnosis was pneumonia, of unknown etiology, his fever decreased and on further examination his laboratory data had improved. If a Kampo formula is selected in accordance with the diagnosis of Kampo medicine, we consider that pneumonia can be treated with Kampo medicine without the use of antibiotics.

Daikenchuto is recorded in Kampo textbooks as a prescription for abdominal disorders. We considered fukuchukan (coldness in the abdomen) as equaling a sensation of coldness centering on the navel, and we examined the usefulness of using Daikenchuto as a medication for this symptom. We administered Daikenchuto to 90 patients who presented with coldness of the navel. The patients were divided into 2 groups:the first group had accompanying digestive symptoms, the second had no accompanying digestive symptoms. We then examined their response rates, and improvement rates for coldness centering on the navel. We also examined the abdominal strength and pulse strength for responders and non-responders, respectively.
The Digestive Symptoms group consisted of 64 patients. In this group, the response rate was 81.3%.The improvement rate of coldness centering on the navel was 92.3% in responders and 41.7% in non-responders, and the difference was highly statistically significant (p<0.001). The Non-digestive Symptoms group consisted of 26 patients. In this group, the response rate was 38.5%. The improvement rate of coldness centering on the navel was 100% in responders and 43.8% in non-responders, and the difference was statistically significant (p=0.022).
In a comparison of all 90 responder and non-responder cases, weak abdominal strength was 62.9% in responders and 42.9% in non-responders, intermediate abdominal strength or above was 37.1% in responders and 57.1% in non-responders, and the difference between abdominal strength and response rate (p=0.076) was non-significant. Weak pulse was 54.8% in responders and 40.7% in non-responders, intermediate pulse strength or above was 45.2% in responders and 59.3% in non-responders, and the difference between pulse strength and response rate(p=0.221) was non-significant. 13 of these cases were above intermediate, for both abdominal strength and pulse strength.
We conclude that for patients presenting with a sensation of coldness centering on the navel, there is a strong possibility that the efficacy of Daikenchuto-syo is suggested, regardless of whether or not there are other digestive symptoms. Moreover, Daikenchuto proved effective in 13 cases where both abdominal strength and pulse strength were above an intermediate level, suggesting that a sensation of coldness centering on the navel can be the key to finding the sensho of Daikenchuto-sho.

We report two cases successfully treated with tsumyakushigyakuto containing aconite root (uzu), instead of processed aconite root (bushi). The first case was a 33-year-old female. She had suffered from itching rashes in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because she was in an extreme cold state, we changed the processed aconite root in her tsumyakushigyakuto to aconite root. Her itching rashes subsequently improved. The second case was a 42-year-old male. He had suffered from watery diarrhea and general fatigue in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because he was in an extreme cold state, we changed the processed aconite root in his tsumyakushigyakuto to aconite root, and his watery diarrhea and general fatigue improved.
We consider that using tsumyakushigyakuto with aconite root may be more effective than using it with processed aconite root in an extreme cold state.

In general, keishikashakuyakuto or shokenchuto is used to treat abdominal pain. We experienced 2 cases that kanbakutaisoto were effective in treating abdominal pain, however keishikashakuyakuto and shokenchuto did not have any favorable effect on these cases. Case 1 : A 17-year-old female who consulted us because of abdominal distension and pain. We treated her with keishikashakuyakuto and shokenchuto, but they had no effect on her. As the abdominal pain was increased by anxiety, we prescribed for kanbakutaisoto to her and her symptoms disappeared after one and half months. Case 2 : A 13-year-old male who visited our clinic complaining of upper abdominal pain. He was treated with shokenchuto, but it had no favorable effect. As we knew that he had some anxiety over his club activities and school life, we changed the prescription to kanbakutaisoto, and he recovered after about 1 month. When keishikashakuyakuto or shokenchuto has no effect against abdominal pain, we posit that kanbakutaisoto is useful for the symptom if the patient has psychological problems.

Daikenchuto is recorded in Kampo textbooks as a prescription for abdominal disorders. We considered fukuchukan (coldness in the abdomen) as equaling a sensation of coldness centering on the navel, and we examined the usefulness of using Daikenchuto as a medication for this symptom. We administered Daikenchuto to 90 patients who presented with coldness of the navel. The patients were divided into 2 groups:the first group had accompanying digestive symptoms, the second had no accompanying digestive symptoms. We then examined their response rates, and improvement rates for coldness centering on the navel. We also examined the abdominal strength and pulse strength for responders and non-responders, respectively.The Digestive Symptoms group consisted of 64 patients. In this group, the response rate was 81.3%.The improvement rate of coldness centering on the navel was 92.3% in responders and 41.7% in non-responders, and the difference was highly statistically significant (p<0.001). The Non-digestive Symptoms group consisted of 26 patients. In this group, the response rate was 38.5%. The improvement rate of coldness centering on the navel was 100% in responders and 43.8% in non-responders, and the difference was statistically significant (p=0.022).In a comparison of all 90 responder and non-responder cases, weak abdominal strength was 62.9% in responders and 42.9% in non-responders, intermediate abdominal strength or above was 37.1% in responders and 57.1% in non-responders, and the difference between abdominal strength and response rate (p=0.076) was non-significant. Weak pulse was 54.8% in responders and 40.7% in non-responders, intermediate pulse strength or above was 45.2% in responders and 59.3% in non-responders, and the difference between pulse strength and response rate (p=0.221) was non-significant. 13 of these cases were above intermediate, for both abdominal strength and pulse strength.We conclude that for patients presenting with a sensation of coldness centering on the navel, there is a strong possibility that the efficacy of Daikenchuto-syo is suggested, regardless of whether or not there are other digestive symptoms. Moreover, Daikenchuto proved effective in 13 cases where both abdominal strength and pulse strength were above an intermediate level, suggesting that a sensation of coldness centering on the navel can be the key to finding the sensho of Daikenchuto-sho.
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Nowadays, it is rare to see Yang min disease in the acute fever phase. We report three cases of acute fever successfully treated with daijokito.
Case 1 : An 82-year-old male with suspected viral infection. He had a persistent fever of 38 °C. Because of abdominal fullness, constipation and wheeze, we administered daijokito. These symptoms disappeared, his hypoxemia improved, and his fever went down to 36 °C, accompanied by considerable defecation.
Case 2 : A 67-year-old female with suspected central hyperthermia. She had a persistent fever of 38 °C. Because of abdominal fullness and constipation, we administered daijokito. These symptoms disappeared and her fever went down to 36 °C with considerable defecation.
Case 3 : A 43-year-old male who was diagnosed with paralytic ileus accompanied by cyclic neutropenia. Three days after his temperature rose to 38 °C, and constipation, abdominal fullness and pain appeared. After administering daijokito, these symptoms disappeared and his fever went down to 36 °C with considerable defecation.
When abdominal fullness and constipation appear after a fever continues, we believe the administration of daijokito should be considered whether western medicine has been applied or not.

We report a 68 year-old woman being treated for anorexia. Despite our treatment, her body weight decreased to 22 kg and she was admitted to our hospital ER for Wernicke's encephalopathy and a hypoglycemic attack, which both occurred on January 21 st. She experienced respiratory failure and was placed on a respirator. On March 24 th she developed a fever due to a respiratory tract infection, and antibiotics and keishinieppiichito were administered.
On March 26 th she again developed a fever. One tenth of the normal daily dose of daisaikotokabosho was administered successfully. However, she had a fever again on March 31 st. The following day, one tenth of the normal daily dose of daiaikotokabosho was administered successfully. The formula was continued and the fever disappeared after April 3rd.
Whether the base formula of saikokaboshoto is daisaikoto or shosaikoto remains controversial. Our case was suspected of rinetsu, excessive pathogenic heating of the interior body, and her abdominal symptoms indicated daisaikoto. Therefore daisaikotokabosho, which is closely related to yomeibyo as a shoyobyo, was administered effectively.
This case suggests that a grossly underweight patient, in whom hypo function or yin condition would usually be seen, has the potential to change to hyper function or a yang condition. In such a case, dose adjustment for physical size and body energy is necessary.

We administered a Kampo decoction containing bushi (prepared aconiti tuber) or uzu (un-prepared aconiti tuber) to two children in Aso Iizuka hospital. Case 1 was a thirteen year-old girl with atopic dermatitis that worsened after her topical steroid was stopped. When her itching sensation was reduced following a bath, we considered that she was suffering from coldness. Therefore we administered a half dose of bukuryoshigyakuto.The next morning her old skin flaked off and her skin appeared healthy. We administered bukuryoshigyakuto before every meal and there was rapid improvement in her dermatitis. Case 2 was a twelve year-old girl with orthostatic dysregulation who was unable to attend school. She had become aware of coldness the previous autumn and had not been able to go to school, nor even sit up, since the previous winter because of severe fatigue. We diagnosed her with severe coldness and so started sekiganryo administration, and included 2 g of uzu. We gradually increased the uzu. At a result, her severe fatigue improved to the extent that she could eat breakfast and go to school inside the hospital. Children may have severe coldness if they suffer from a long-term illness. Moreover, particular attention should be given to toxicity caused by aconiti tuber.