Crowned dens syndrome is a type of pseudogout that occurs in the elderly. It is associated with calcification around the dens of the atlas and can cause recurrent pain. We report successful treatment for crowned dens syndrome by using Kampo medicine. An 85-year-old woman was seen in our clinic after 3 days of neck pain and active exercise pain without trigger. Physical examination revealed tenderness in the bilateral upper cervical spine. Computed tomography (CT) revealed calcifications around the dens of the atlas and blood test data showed inflammatory reaction. Thus, she was diagnosed with crowned dens syndrome. In view of her medical history of gastric ulcer treatment, we prescribed Kampo medicine eppikajutsuto and daiobotampito, instead of nonsteroidal antiinflammatory drugs. The cervical pain and tenderness in her bilateral upper cervical spine disappeared, and her laboratory data also improved 6 days after treatment without side effects. Thus, her medications were discontinued.

We report three patients with acute lumbago who did not respond to nonsteroidal anti-inflammatory drugs (NSAIDs), but were treated successfully with daiobotampito and shimotsuto. Case 1 (86-year-old man) and Case 2 (56-year-old woman) were diagnosed with acute lumbago. Case 3 (69-year-old man) was diagnosed with acute lumbago and mild left sciatica. All three patients were initially administered orally NSAIDs, but this treatment was ineffective. Therefore, daiobotampito and shimotsuto were administered after choeikatsurakuto according to “Manbyokaishun.” Following this treatment, the patients' acute lumbago and sciatica resolved within 1-2 weeks. In conclusion, daiobotampito in combination with shimotsuto seems to be a useful Kampo medicine for treatment of lumbago.

Urinary tract infection (UTI) is a common disease, and administration of antibiotics should be the first choice for UTI. However, it often recurs, and recurrent UTI is generally treated with antibiotics. Many reports describe the use of choreito for the treatment of lower urinary tract symptoms and ureteral stones, but only a few reports are dedicated to the treatment of recurrent UTI with choreito. An 84-year-old woman had a UTI that recurred 4 times, and every time she was hospitalized. Although we treated her condition with an antibiotic and α 1-blocker for neurogenic bladder, and provided her home-care advice, her UTI recurred 4 times. Thus, we gave her choreito, which successfully treated her recurrent UTI. Before the treatment, she was hospitalized 4 times within 2 months. However, in the recent 7 months after the treatment with choreito, she did not need to be hospitalized. She is currently visiting a hospital once every 2 months. The present case indicates that choreito is beneficial in terms of health economics.

In our clinic, patients with relatively positive diseases, which form the orthopedic conditions with inflammation, were successfully treated with eppikajutsuto and daiobotampito after reisenjotsuin. Patients with pain due to orthopedic disorders where NSAIDs (non-steroidal anti-inflammatory drugs) were difficult to be used or ineffective were successfully treated with eppikajutsuto and daiobotampito. We present the representative cases and bibliographically discuss them.

De Quervain disease and carpal tunnel syndrome are major problems that occur after delivery. During pregnancy, hormone confusion readily causes inflammation of tendons ;furthermore, overuse of hands during care of other children contributes to symptom onset. We report four cases of de Quervain and carpal tunnel syndrome occurred after delivery. All patients were women, aged 33-­39 years. All patients breast-­fed after birth. One patient was diagnosed with de Quervain disease, two were diagnosed with carpal tunnel syndrome, and one was diagnosed with de Quervain disease accompanied by carpal tunnel syndrome. All patients received tokishakuyakusan ;thereafter, their pain decreased, but slight numbness from the carpal tunnel syndrome remained. Drugs that can be used during breastfeeding are limited ;however, tokishakuyakusan can be prescribed safely and effectively.