The low back pain is often intractable and leads to the drop of the daily living activity. These symptoms are good indications of Kampo medicine. We report 5 cases of low back pain that saikokaryukotsuboreito treatment succeeded regardless of psychogenetic presence. These patients complained of low back pain and lower melagra or numbness of limbs. Four of 5 cases did not have any psychogenetic presence. After administration of saikokaryukotsuboreito, their pain decreased and walking distance was improved in to 4 weeks and analgesics were not required. Generally, saikokaryukotsuboreito is prescribed for patients with psychogenetic symptoms, but these treatments based on abdominal patterns were effective even if they do not have subjective psychogenetic symptoms. Saikokaryukotsuboreito may be the differential prescription for such low back pain cases.

A 59 year-old woman with rashes of forehead and chest visited our hospital in hope of treatment with Kampo medicine. The rashes had occurred at the age of 50 years old and gradually spread. She had been diagnosed with psoriasis vulgaris by a nearby dermatologist. Though she had been treated with the steroid ointment, the symptom had repeated exacerbation and remission for nine years. At the first examination, her exanthems were damp, concentrated on frontlet and was seen in posterior cervical region, precordial region, upper and lower limb. Jizusoippo was prescribed, and the exanthem improved significantly in 4 months. In conclusion, jizusoippo can be effective in cases of psoriasis that the exanthems are damp and concentrate on head.

We report a case of post coronavirus disease 2019 (COVID-19) condition, in which the patient suffered from a severe sense of fatigue and brain fog that was successfully treated with Kampo therapy. The patient was a 21-year-old man. He had been diagnosed with COVID-19 and hospitalized for follow-up examinations. He recovered without any complications and was discharged from the hospital, but continued to suffer from a severe sense of fatigue, coldness, dizziness, and a loss of concentration. Because of these symptoms, he had to spend most of the day lying down. One month later, he was hospitalized to receive Kampo therapy. We administered bukuryoshigyakuto for 2 weeks referring to his severe coldness and fatigue and then changed to renjuin for his fluid disturbance and blood deficiency. After starting Kampo therapy, his fatigue and dizziness gradually improved. He was discharged after 3 weeks of hospitalization and received Kampo therapy as an outpatient. One month later, he reported a dull feeling in his stomach and depression. We switched to kamikihitogohangekobokuto and added hachimigan. His activities of daily living improved and he could take 4.5-kilometer walk. He could return to work 4 months later. Kampo therapy may be useful for post COVID-19 condition that causes a sense of fatigue and brain fog.

We report a case of a 49-year-old woman who presented with 6-month period menopausal syndrome including excessive sweating and hot flushes in her face, chest and back. She was also frustrated with her sons, but she reflected on her own anger and wondered why she got so irritated with them. We prescribed yokukansan to her and her all symptoms improved one month later. We need to differentiate between yokukansan and kamishoyosan in the treatment of menopausal syndrome and irritation, and it may be useful to evaluate the detail of irritation in selecting formula.

Kampo medicine containing Gardeniae Fractus is often used for agony of the chest, but there are few case reports about shishikankyoto. Here, we report a case of a 73-year-old woman with heat sensation in the chest and severe malaise successfully treated with shishikankyoto. She suffered from lung cancer five years previously, and received chemoradiation treatment. One year later, radiation pneumonitis developed, which was resolved naturally. After another year, she began to develop a slight fever, burning sensation and general malaise, which disappeared and recurred in cycles of about six months. She received Kampo medicine treatment for one year at another hospital, but lacked in improvement and was introduced to our hospital. We thought her symptoms were caused by deficiency heat pattern in the chest and cold in the epigastric region. By giving shishikankyoto in reference to a sentence in the Shang Hang Lun, her symptoms improved in about two weeks. Although, shishikankyoto is a prescription medicine with few reports, it is effective in a short period of time and is useful for similar symptoms.

Hangekobokuto is often used for globus sensation. We herein describe two cases in which ryokeijutsukanto was effective for globus sensation, for which hangekobokuto was ineffective. Case 1 was a 28-year-old woman. She had been suffering from postprandial belching, fullness and stuffy throat for a year. She underwent examination, but could not find the cause of her symptoms and visited our department. She was prescribed hangekobokuto, but the feeling of stuffiness in her throat did not improve. Case 2 was a 50-year-old woman. She had been afflicted with a feeling of fullness in the ears, tinnitus, and pain in the back of the eyes for two weeks. She visited the otolaryngology department, but no abnormalities were found so she visited our department. She was prescribed kamishoyosan, and although her ear fullness and tinnitus improved by about 60%, she began to complain of dizziness and throat stuffiness. This did not improve even though she used hangekobokuto with kamishoyosan. In both cases, after changing treatment to ryokeijutsukanto, the symptoms were improved. For globus sensation, it is necessary to select Kampo medicines while paying attention to qi deficiency, qi depression, qi counter flow, static blood, liver depression, lack of fluid, fluid toxicity, and gastrointestinal disorders. We thought that ryokeijutsukanto could be a candidate.

Orthostatic dysregulation often occurs during adolescence and presents with symptoms such as dizziness, difficulty waking up in the morning, nausea, anorexia, general malaise, and headache. Herein we describe a case of delayed sleep-phase syndrome in a 16-year-old female who had been treated with Kampo medicine since the age of 14 for orthostatic dysregulation. After taking renjuin, her condition improved and she was able to attend school. However, two winters later, her symptoms flared up and she was hospitalized. Electro-acupuncture test revealed her severe interior cold, and a simple sleep analysis showed that she was not getting deep sleep. We hypothesized that her interior cold contributed to her sleep disorder. After taking sekiganryo for the purpose of warming therapy, her waking time and sleep depth improved. This case showed that interior cold can cause sleep disorders and that warming therapy with sekiganryo may contribute to the improvement of sleep disorders.

A 64 year-old female presented with fever and cough. She had suffered from a cough for one day and we treated her with saikokeishito. However, her symptoms got worse and she developed chest pain. She was diagnosed with bacterial pneumonia at another clinic and she was referred to our hospital 3 days after starting saikokeishito. Her X-ray showed right infiltration in her lung and her blood examination had signs of inflammation. Pneumonia with pleuritis was suspected, but she was allergic to antibacterial drugs and hoped to continue Kampo treatment. We switched saikokeishito to saikanto. Her chest pain decreased soon after taking saikanto and 4 days later only a slight cough remained. Eleven days later, her inflammatory reaction improved. Kampo formulas containing Bupleuri radix are usually selected for pneumonia or pleuritis according to a patient' s pattern identification. We gave her saikanto, a mixture of shosaikoto and shokankyoto, because she had chest pain. Saikanto was significantly effective. There have been few clinical reports about treatment for pneumonia with Kampo medicine alone without using antibacterial drugs. We believe this case shows that Kampo treatment is effective for pneumonia and pleuritis.

The persistent genital arousal disorder (PGAD) is a condition in which intense abnormal sensations and pain appear in the genital area without sexual stimulation. Here, we report two cases of PGAD successfully treated with tokishigyakukagoshuyushokyoto. Since dysfunction of nerves and blood vessels is thought to be involved in the cause of PGAD, we believed that tokishigyakukagoshuyushokyoto, which improves ischemia of the pelvic cavity organs, would be a good indication for this treatment. Tokishigyakukagoshuyushokyoto should be considered especially when tenderness in the inguinal region is observed.