As symptom-differentiating factors for hot and cold diatheses, urinary PGF_1α level of cholelithiasis patients (lower than about 138ng/day represented cold diathesis and above, hot diathesis) and age of breast cancer patients (lower than about 50 represented hot diathesis and above, cold diathesis) were pointed out. In gastric and large bowel cancer patients, these factors were not indicative of hoot and cold diatheses.
These facts were considered to be attributed to the differences of the outside-inside situation of the diseases; namely breast cancer is of outside, gastric and large bowel cancer is of inside, and cholelithiasis is of intermediate (half outside-half inside) situation. Cholelithiasis representative of intermediate situation of illness proved to be one of the diseases showing delicate relationship between urinary PGF_1α level and pathophysiological state of the patients. When situation of illness was of outside or of inside, this relationship was not recognized, probably because it was concealed by stranger factors, for example, age, energy metabolism, water balance or visceral venous stagnation.

The relationship between the drug effect and the time interval from operation or onset of hepatitis or hepatic damage to the beginning of the administration of Chinese herb medicines allowed us to postulate the usual clinical course of the disease as follows from the viewpoint of traditional Chinese medicine: namely two months after surgery or onset of the disease being the Yang stage, the four months after the Yang stage being the Yang-Yin transitional stage and after this being the Yin stage. The Yin stage was further divided into earlier and later periods, the border line being five years after the operation or onset of the disease.
In the Yang stage the drug effect was mostly excellent, and the medicines used were mainly for Qi-fen and Re-zheng, as well as the medicines used in the Yang-Yin transitional stage when healing of the excellent cases and increase of the cases with good effect were characteristic. In the earlier Yin stage the cases with no effect began to increase, and the medicines used ranged from Qi-fen to Ying-fen . In the later Yin stage the cases with excellent effect disappeared, and the cases with good or no effect were dominant. In this stage the medicines for Xue-fen were sometimes added to the medicines for Qi-fen or Ying-fen, and relative increase of the medicines for Xu-han-zheng was noticed.

At the end of 1986, herb medicines were switched over to newly modified preparations, and at the same time the usual dosage was changed from 5g to 7.5g per day. Therapeutic results in our experiences on 1864 diseases seen in 1270 patients during fifteen years were nevertheless rather stable, attaining good and moderate effects in about 60%, fair effect in about 20% and unchanged in about 20% of the cases. This fact might mean that the dosage of 5g per day can be sufficient to obtain satisfactory results especially in the patients with good drug-“Sho” signs correspondence.
Better results than the average were obtained in the diseases of common cold, dysmenorrhea, headache, constipation, abdominal pain and piles. The incidence of adverse effects showed decreasing tendency from 2.0 or 2.8% to 1.4% in spite of the increase of usual dosage of herb medicines. Among apparent adverse effects there can be mixed some hyperreactive phenomenon infrequently seen in the cases with excellent drug-“Sho” signs correspondence. In such a case further reduction of dosage would be worthy of trial.
Positive treatment of in-patients with herb medicines proved to be of benefit not only to the patients, but also to doctors to attain proficiency in medical performance. Recent good retults obtained among younger patients and wider as well as deeper interest of younger doctors in traditional Oriental medicine could be interpreted as some signs of gradual maturity of social circumstances around Oriental medicine.

The regulatory effects of Gorei-san (Wu-Ling-San) on circulatory, metabolic and diuretic function were investigated analyzing the perioperative transition of serum sodium levels, peripheral platelet counts and urinary 6-keto-prostaglandin F₁α levels in fifty-eight female patients who underwent cholecystectomy because of cholelithiasis or gallbladder polyps.
The endothelial cells were considered to be activated by administration of Goreisan as shown by an increase of prostaglandin I₂ production, resulting in circulatory and metabolic stimulation and partly promotion of diuretic function by a dilatation of the renal vessels. The urinary 6-keto-prostaglandin F₁α, a metabolite of serum prostaglandin I₂ and also excreted by the interstitial cells in the renal medulla or by the epithelial cells of the renal collecting tubules, was considered to regulate diuretic function through suppressing the antidiuretic hormone.
The phenomena mentioned above were not recognized when Sho-saiko-to (Xiao-Chai-Hu-Tang) was administered instead of Gorei-san.

Female patients suffering from gallbladder stone disease were administered Sho-saiko-to (Xiao-Chai-Hu-Tang), Gorei-san (Wu-Ling-San) or Toki-shakuyaku-san (Dang-Gui-Shao-Yao-San) preoperatively, and were examined by cholangiomanometry during operation. Perfusion pressure was significantly elevated, when Sho-saiko-to or Gorei-san were administered, meaning that the pressure threshold of the sphincter of Oddi for volume load in the bile duct was lowered. This phenomenon tended to be more obvious in Gorei-san group, and will prevent duodenal fluid from transpapillary reflux. Parameters concerning the declining curve (T_1/2, T_1/4, T_1/5) showed a significantly rapid relaxation of the sphincter of Oddi only in Sho-saiko-to group, which will result in a prevention of stasis of bile. These modulating functions of Sho-saiko-to and Gorei-san for the sphincter of Oddi would be one of the main reasons why these formulas are used for hypochondriac fullness and distress or excessively accumulated intestinal fluid. Toki-shakuyaku-san showed no such effects on the sphincter of Oddi.