Livedo vasculitis is one of the most difficult dermatological diseases to cope with in routine clinical practice. We report the case of a 23-year-old woman, who was diagnosed with livedo vasculitis and was responsive to Kampo treatment. She had a rash-like bruise from the spring of X-2, being diagnosed with livedo vasculitis at another hospital. In April, X, painful multiple ulcers on both lower limbs were beginning to appear and were resistant to the western standard therapy. In May 6,X, we started Kampo therapy for her at our hospital. After 4 months, her painful ulcers disappeared. We used tokishigyakukagoshuyushokyoto as the main agent, along with kakobushimatsu, hainoto, senkinnaitakusan, hakushusan and tokishakuyakusan. Although her livedo symptoms still remain and may need long-term treatment to heal completely, she obtained relief from painful ulcers, returning to her normal daily life.

A study was carried out on the efficacy of a combination of Keishi-to and Maobushisaishin-to extract, which is a variation of Keikyososooshinbu-to. Remarkable improvement was seen when a combination of these extracte was administered to 15 cases (headaches, colds, rhinitis, feeling chilled, diarrhea, etc.) which exhibited a disk-shaped area of resistence in the epigastrium, a typical indication for the use of Keikyososooshinbu-to, as well as a tendency to feel chilled or coldness in the hands or feet. The progress of two of these cases (headache, diarrhea) are reported. The results suggested that the symptoms indicating the use of the combination of the two formulas were similar to those associated with Keikyososooshinbushi-to, and that if the differences between the two formulas is taken into consideration, the combination of Kelshi-to and Maobushisaishin-to extracts can be used as a variation of Keikvososoonshinbushi-to.

The only extract preparations listed in either the “Shokan-ron” or the “Kinki-yoryaku” are the “Daio-oren-shashin-to.” It is thought that the term “extract preparation” is used because of the speed of efficacy required of these formulas. The author tried three different varieties of these percolate extracts, “Daio, ” “Oren, ” and
“Ogon, ” in a group of hypertensive patients (5 men, 27 women). Blood pressure was measured both 30 minutes before and after administration. As a result, an antihypertensive effect of 10mmHg systolic blood pressure or more was seen across 68.8% of the group. There was even an antihypertensive effect in those not normally considered “Yo-jisshou” (resistant and robust constitution). And with this administration, none of the patients developed diarrhea. Extract preparations seemed to have more of an enhancing effect on sedative action, rather than on purgative action. And they are considered effective as antihypertensive agents in emergency cases of elevated blood pressure.

Hangekobokuto is a “kizai” (psychoactivity modulating drug), which is often used for “inchu-sharen” (feeling that something is obstructing the throat). Many previous papers have pointed out its importance when treating abdominal symptoms, especially “chukan-himan” (feeling of fullness/stomach mid-segment obstruction).
We administered an extract or decoction of Hangekobokuto, to the patients with oppressive “chukan” pain and discomfort, and examined their chief complaints, subjective symptoms and abdominal symptoms, especially the state of their “chukan” and the change of that “chukan” after administration. We found “inchu-sharen” (66.7%), sense of cold (55.6%), moderate abdominal strength (77.8%), changes in the epigastrium (38.9%), clapotage (11.1%).
We showed that in terms of the state of “chukan, ”, oppressive pain was eliminated or reduced in 69.2% of the patients except omission.