Frequent bathtub bathing (BB) improves sleep quality and mental health of middle-aged and older Japanese individuals. This study investigated the chronic effects of BB with and without a bath additive (bathtub bathing with KIKIYU [BBK]) in healthy young adults. The study involved healthy young adults who habitually showered, as opposed to bathing. Nineteen participants were randomly assigned to either the BB or BBK groups for 14 consecutive nights. After a 2-week washout period (shower bathing), the participants were asked to switch their bathing styles (a crossover design). The artificial bath additive for the BBK group contained inorganic salts and carbon dioxide. The participants were evaluated by using the Oguri-Shirakawa-Azumi Sleep Inventory-Middle-aged version (OSA-MA) and 1-ch sleep electroencephalography (EEG) for sleep quality, the Profile of Mood States (POMS), Self-rating Depression Scale (SDS), and Apathy Scale (AS) for mental conditions.  Sleepiness on waking and refreshing scores in the OSA-MA significantly differed between the shower bathing and BBK groups. EEG results did not significantly differ among the bathing styles. Vigor T-score and total mood disturbance (TMD) scores showed significant differences in the two bathing groups (shower vs. bathing), and fatigue T-score was significantly lower in the BBK group compared with both the BB and shower groups. SDS score was significantly lower in the BBK group compared with the shower group. AS score was significantly lower in the two bathing groups (shower vs. bathing).   The OSA-MA score was possibly influenced by vasodilatation and circulation by using carbon dioxide and keeping the body warm after bathing by using inorganic salts. The OSA-MA score was possible also affected by fatigue alleviation and maintenance of vitality by using a citrus lemon scent and yellow-green hue. Furthermore, frequent body heating affects the central nervous function related to mood and emotion.  Based on these results, we can conclude that BB and BBK prior to shower bathing improved the mental health of the young adults in this study.

Objective: The purpose of this study was to examine the effects of bathtub bathing （BB） on sleep and working efficiency of healthy young adult students. Furthermore, the effects of BB and prolonged increased body temperature from the use of insulating sheets and sleeping bags after BB （warming after BB: BBW） on sleep and working efficiency were investigated. Subjects: Eighteen （six males, 12 females） healthy young students （19.6±0.7 years old, mean±SD） who habitually took showers instead of baths participated in this study. Informed consent was obtained from all of the subjects, and the study was approved by the Ethics Committee of Kumamoto Health Science University. Methods: Subjects were randomly assigned to two groups （n＝9 in each group）. The subjects in the BB group were immersed in their home bathtub to the supraclavicular level and instructed to rest for 10 min with the temperature regulated at 41°C. The subjects in the BBW group followed the same bathing protocol, and they then rested in a sleeping bag and sheet for 30 min in order to keep their bodies warm. The length of each study period was 2 weeks in a crossover design. After the 2-week-long washout periods, the subject groups were switched. The subjects were evaluated with the Oguri-Shirakawa-Azumi sleep inventory, MA version （OSA-MA）, which utilizes a visual analog scale （VAS） with which subjects rate their sleep when they wake up, and Purdue Pegboard Assembly test. These tests were employed before and after the BB and BBW sessions, resulting in four testing periods in the 6-week period. Results: Sleep rating on the OSA-MA was no significant difference in both the BB and BBW groups compared to ratings recorded after showering. The subjects in the BB and BBW groups had significantly increased VAS ratings for “Feeling of sound sleep,” “Refreshing,” and “Lightness of the body” compared to the ratings after showering. The mean Purdue Pegboard test scores of the subjects in both the BB and BBW groups were significantly higher than those recorded after showering. Discussion: Changing bathing style from shower to BB or BBW improved the working efficiency of students on the Purdue pegboard test. BB and BBW resulted in soothing effects owing to improvements in the subjects’ quality of sleep.

A 68-year-old female had been diagnosed with granuloma annulare a year earlier. She was prescribed tranilast and was recovering, but had to discontinue the tranilast because she suffered liver damage as a side effect.
She was also suffering from a worsening rash and so decided to try Kampo medicine. We prescribed orengedokuto because of thermal symptoms suggestive of hot flushes, the appearance of her tongue, and the character of her rash. Initially, the rash improved, but from the 3rd day following admission did not change greatly. We suspected the existence of interior cold and started combining maobushisaishinto. Five days later, the granulomas had rapidly shrunk. We believe she had overlapping diseases of a yin and yang pattern from the fact that she improved clinically.

We experienced a 56-year-old male who had suffered from diarrhea, epigastric discomfort and an enlarged abdomen feeling for 12 years, and who was diagnosed with irritable bowel syndrome. Although he had undergone treatment using Western medicine in many hospitals, his condition had not improved. He was therefore started on Kampo medicine 5 years ago. However, since the enlarged abdomen feeling worsened whenever he changed his prescription, it was difficult to treat him on an outpatient basis. Thus we tried hospitalization. His feeling of enlarged abdomen was near continuous, but the discomfort from a spasmodic enlarged abdomen feeling was greater. We recognized the spasmodic feeling to be hontonki disease and started ryokeikansoto. The spasmodic feeling disappeared promptly after hospitalization. On the 12 th day of hospitalization, we noticed that the circumference of his navel was cold. Therefore, we changed his prescription to ryokito, which is kind of ryokeikansoto, containing ryokyo, which dispels cold and stops pain, and then the near continuous feeling of enlarged abdomen also disappeared. He was discharged from hospital on the 24 th day. Although the original text for ryokito states that it cures a right fleshy tumor and pain, this suggests that ryokito is effective in cases of hontonki disease and cold, even when not necessarily accompanied by hypochondralgia.

Objective: The purpose of this study was to clarify the chronic effects of bathtub bathing (BB), whole body warming after bathtub bathing (BBW), and bathtub bathing with herbal extracts (BBH) on the mental condition of healthy young persons. Subjects and Methods: Experiment 1: Eighteen (6 male and 12 female; age: 19.6±0.7 years, mean ± SD) healthy young persons who were taking a shower habitually but not bathtub bathing participated in this study.   From November 2012 to December 2012, subjects were randomly assigned into two groups (each 3 male, 6 female): those who had BB or 30-min BBW 14 times for 14 consecutive nights during a 2-week period. After a 2-week washout period, subjects were asked to switch their bathing conditions (a cross-over design). Experiment 2: Twenty (8 male and 12 female; age: 21.3±1.6 years, mean ± SD) healthy young persons who were taking a shower habitually but not bathtub bathing participated in this study.   From October 2013 to November 2013, subejects (4male and 6 female) were randomly assigned to undergo BB or BBH.   The herbal extract contained Dong dang gui (Japanese Angelica Root), Chimpi (Citrus Unshiu peel), Chamomilla recutita, and ginger extracts.   After a 2-week washout period, subjects were asked switch to the other bathing condition (a cross-over design).   All participants provided informed consent for participation in these studies, and these studies were approved by the Ethics Committee of the Kumamoto Health Science University.   The subjects immersed their bodies up to the supraclavian for 10 min, in tap water adjusted to a temperature of 41 °C in their bathtub at home. The subjects’ mental conditions were assessed using Profile of Mood States short version questionnaire.   The differences in the effect of BB and BBW, as well as those of BB and BBH on the subjects’ mental conditions and their mental conditions pre-BB and post-BB, pre-BBW and post-BBW, pre-BBH and post-BBH were analyzed using Wilcoxon’s signed-rank sum test. Results: The points for depression-dejection, fatigue, and confusion in those who had BBH significantly converged to the median average (50 points) compared to the points in those who had BB.   The points for anger-hostility before BBW and BBH significantly converged to the median average (50 points) after BBW and BBH, and there were no significant differences in points before and after BB. Conclusions: The subjects’ anger-hostility was influenced by body warming in BBW and the vasodilatory components of the herbal extracts.   The subjects’ depression-dejection and fatigue was influenced by the fragrance and color of herbal extracts.

Introduction: Some students take showers instead of baths for economic reasons or because they dislike cleaning the bathtub. The purpose of this study was to examine the effect of bathing routines on students’ working efficiency. Subjects: Seventeen (six male and 11 female) healthy young students (19.6 ± 0.7 years old, mean ± SD) who habitually took showers instead of baths participated in this study. Informed consent was obtained from all the subjects and the study was approved by the Ethics Committee of Kumamoto Health Science University. Method: Subjects were randomly assigned into two groups. The subjects in the first group (bathtub bathing [BB]) were immersed to the supraclavicular level in their home bathtub and instructed to rest for 10 minutes with the temperature regulated at 41°C. The subjects of the second group (whole-body warming after BB [BBW]) followed the same bathing protocol and then rested in a sleeping bag and sheet for 30 minutes to keep their bodies warm. Each period was carried out over 2 weeks in a cross-over design. Washout periods were 2 weeks long. The evaluation items of this study included the obstructive sleep apnea (OSA) sleep inventory MA version (OSA-MA), a questionnaire containing a visual analog scale (VAS) to judge the subjective bathing effect, profile of mood states, salivary stress marker (α-amylase), and the Purdue Pegboard test. These tests were evaluated before and after the BB sessions, BBW sessions, and washout interval for a total of four times in a 6-week period. Result: Participants tended to report a better sleep feeling on the OSA-MA after the BB or BBW sessions than after showering. There were significantly better changes in both the BB and BBW in the VAS for bathing effect in terms of “Sense of deep sleep,” “Body fatigue,” “Light feeling of the body” than after a shower. The mean α-amylase value in the saliva of the BBW group participants was significantly lower than that after showering. The mean Purdue Pegboard test scores of both the BB and BBW sessions were significantly higher than that after the shower. Discussion: Sleep quality seemed to be more improved after BB or BBW than after showering, perhaps due to reduced stress. Work efficiency also increased in the BB and BBW groups.

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.

Otsujito is a well-known herbal preparation used for treating hemorrhoidal disease. However, we considered the anatomical similarities between the lips and the anus, and here report a case of inflammation of the lips with blood stasis successfully treated with otsujito as well.
The case was a 59-year-old woman suffering from eczema on her face and neck. The eczema showed a tendency to improve with herbal treatment, but inflammation and pruritus of the lips continued. Taking into account the presence of blood stasis, we included otsujito in the treatment and her symptoms improved.
Otsujito contains bupleurum, cimicifuga, scutellaria, and rhubarb, which dissipates heat, and angelica,which resolves blood stasis. Therefore, we consider that inflammation of the lips with blood stasis can be treated with otsujito.

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.