Few reports have described the effect of phlegm-­fluid retention on the development of pain. We herein rep­ort two successful treatment cases of lower leg pain using chikujountanto in consideration of phlegm-­fluid re­tention. Case 1 (a 63-year-old woman) complained dull pain in the right calf. The pain persisted despite the ad­ministration of sokeikakketsuto for over two weeks. Case 2 (a 42-year-old woman) suffered from right buttock pain that had developed after a traffic accident. The pain persisted even at three months following the accident. The pain in both patients resolved within one week after treatment with chikujountanto, which was given on the basis of the patients' insomnia, thickened yellow fur on the tongue, and pain in the gallbladder meridian. We concluded that the concept of phlegm-­fluid retention should be considered for differential diagnosis when we treat pain.

There are cases of finger pain in which a definite diagnosis including rheumatoid arthritis cannot be made even after thorough examinations. We herein report the results of Kampo treatment in such cases with so called undifferentiated arthritis. Sixty­-two patients (male, n = 5 ; female, n = 57 ;average age, 49.7 years) were included in the present study. There is a tendency of the Kampo concept of a cold pattern (n = 39 ; 63%), static blood (oketsu, n = 47;76%), and qi stagnation (n = 44 ;71%). Among the 62 cases, excellent results were ob­tained in 29 cases (47%), good results were obtained in 10 cases (16%), and no effect was obtained in 23 cases (37%). Kamishoyosan, which was administered in 30 cases, was the most commonly used Kampo medicine. In most cases, Kampo treatment was given with a combination of two or more formulas. A paired formula of kamishoyosan and keishikaryojutsubuto was used in 9 cases, 8 of which showed good or excellent results (efficacy rate : 89%). Qi- and/or ketsu-­tonifying formulations and formulations with warming effects were often used for the treatment of undifferentiated finger arthritis.

The main symptoms of fibromyalgia are systemic pain and fatigue. The pharmacological treatments are usually performed for fibromyalgia in Western medicine. However, in some cases, pain that impairs everyday life continues even after medical treatment. We herein report a case in which fibromyalgia was successfully treated using jumizasan. The patient was a 28-year-old woman. Prior to admission to the author's clinic, she had complained of dull pain in the left upper arm for 4 years, and the pain had spread throughout the body for 2 years. Various other symptoms including fatigue, headache, heart palpitation, and shortness of breath coexisted. The pain resolved within 3 months after the initiation of treatment with jumizasan (a Japanese herbal medicine decoction), which was given based on pallid complexion, skin drying, strong upper arm pain, and walking difficulty. We concluded that jumizasan may be considered to be used for patients with blood deficiency, upper arm pain, and walking difficulty in Kampo concept of treatment.

We herein report the successful treatment of three elderly patients in an orthopedic clinic who were successfully treated using the Kampo formula of rokumigan and shimotsuto. The first patient was a 69-year-old woman with rheumatoid arthritis who complained of subjective coldness in her feet. The second patient was a 79-year-old man with lumbar spinal stenosis who presented with pain and paresthesia of his lower extremities, which aggravated by walking. The third patient was an 80-year-old man who complained of ambulatory pain in the body trunk and lower limbs, which had started more than ten years previously. The symptoms of these three patients resolved after the initiation of treatment with rokumigan and shimotsuto (a Japanese herbal medicine), which was given based on dry mouth, frequent urination, flushed face, insomnia, and skin drying. Tokaku Wada (a Kampo doctor in the Edo period) stated in the classical text “Shosohoikai” that the conditions of kekkyo (blood deficiency) and jinkyo (kidney deficiency) often exist together. We concluded that rokumigan and shimotsuto may be considered for patients presenting with the Kampo concept of kekkyo and jinkyo, even if they have different diagnoses under Western medicine.