A 48-year-old woman started to have dizziness after experiencing an earthquake. Her clinical signs improved with the use of shimbuto that was prescribed based on her symptom of yin-syndrome and hypofunction. At the same time, there was a decrease in reading errors with her finger, in a vein authentication device. One of the common reading errors that the security system makes is due to a change in blood flow due to vasoconstriction caused by low temperature. It is speculated that the use of a warming formula increased peripheral blood circulation, which contributed to the improvement of vein authentication.

Case 1 was a 72-year-old man with a generalized pain after 6 months of heavy physical work. Kakkonto was prescribed based on his symptoms of severe shoulder stiffness and pain, and keishibukuryoganryo was added to treatoketsu. It caused dysuria because of ephedra herb, so the dosage was reduced. Atractylodes lancea rhizome and processed aconite root were added to enhance the effect of treatment. And then, his pain was alleviated. Case 2 was a 53-year-old man with a generalized pain. He had a previous history of whiplash and two surgical operations. Daisaikoto was prescribed based on his symptom of bilateral costal arch pain, and keishibukuryoganryo was added because of oketsu. It caused an increased frequency of bowel movement due to crude drug of rhuharb, so the dosage was reduced. Pueraria root was added for the purpose of relieving severe shoulder stiffness. And then, his pain went away. It is often difficult to treat fibromyalgia. The decoction can be effective with increase or decrease and deleting or adding of the dosage of crude drug. Decoctions become handy as it allows dosage adjustment of crude drug to minimize the side effects and improve the efficacy.

A 31-year-old woman started to have a yellowish-white scab with exfoliation on her lip after delivery. Her exfoliative cheilitis did not improve with kigikenchuto nor juzentaihoto for treating deficiency of vital energy and lack of blood. After she developed upset stomach, her prescription was changed to hochuekkito which supports the digestive system. Her symptom improved dramatically. The characteristic of exfoliative cheilitis consists of chronic inflammation of lips which is considered to be yang-syndrome, therefore hochuekkito was effective as it covers yang-syndrome as well as yin-syndrome. It is suggested that psychological factors play a role for a pathogenesis of exfoliative cheilitis. We consider that antistress effect of bupleurum root and sedative effect of citrus unshiu peel in hochuekkito might also be key factors.

A42-year-old man presented with a history of tidal fever almost every evening to night with 10-year duration. We could not find out the cause of his fever, so we thought he was classified in fever of unknown origin. The patient suffered from an anhydrosis phase during the temperature rose, but his fever broke after perspiration occurred at the end. The lack of perspiration with fever is a typical symptom of excess pattern of tai yang stage, and fever at night is suggestive of shao yang stage. Saikatsugekito was thought to be best suited as it would address both stages. The formula promoted perspiration, and the body temperature remained stable thereafter. It is not unusual to encounter complicated symptoms due to combined or overlapped pattern in clinical setting. This case represented successful outcome by identifying and analyzing the concept of gobyo and heibyo and prescribing a formula accordingly.