In dentistry, it is empirically known that the acute exacerbation of periodontal disease often occurs at the time of fatigue, but scientific verification has never been made about the relationship of fatigue and bleeding. In Kampo medicine, there is the concept of spleen failing to control the blood as bleeding at the time of fatigue. Kihito and kamikihito are often used for this condition. Spleen failing to control the blood means that lack of vital energy causes the bleeding. Kamikihito is most often used in the treatment of idiopathic thrombocytopenic purpura. Moreover, there have been some reports on the use of kamikihito in the treatment of gynecological fraud bleeding and aplastic anemia. However, there has been no report on the use of it in the treatment of gingival bleeding. In this case, neither cytopenia nor obvious coagulopathy was recognized. In Kampo medicine, not only spleen failing to control the blood but also blood stasis or blood heat is considered to be the cause of bleeding, but the effectiveness of kamikihito for this case suggested pathophysiology of spleen failing to control the blood. Kamikihito could be a choice to treat gingival bleeding at the time of fatigue.