We report a case of recurrent accumulation of pleural effusion, successfully treated with goreisan. A 61-year-old man had been receiving treatment in our hospital for congestive heart failure, aortic regurgitation, and alcoholic hepatitis. On **********, acute aggravation of congestive heart failure caused retention of this pleural effusion. Although the effusion initially disappeared, following puncture of thoracic cavity, this pleural effusion increased again and he was admitted to our hospital. We administered goreisan without a change in other oral medications, and the pleural effusion disappeared and did not recur thereafter. goreisan is generally prescribed for dry mouth and urinary problems associated with various disorders of the body's fluid metabolism. In this case, it is thought that goreisan showed an action which affected water regulation.

We report a case of giant pancreatic pseudocyst after acute pancreatitis, successfully treated with saikokeishitokabushi. A 71-year-old man had been undergoing treatment in our hospital for cerebral infarction and diabetes. He was complicated with acute pancreatitis. He received conservative treatment, showing a tendency toward symptomatic improvement, although abdominal pain and anorexia subsequently developed. A giant pancreatic pseudocyst was identified on abdominal computed tomography. Therefore, we administered saikokeishitokabushi without changing the other oral medication. Many of his symptoms disappeared, and cyst reduction was noted. saikokeishitokabushi is generally prescribed for epigastric pain or anorexia after febrile illness. In this case, it is thought that saikokeishitokabushi exhibited an action leading to cyst reduction.
Acute pancreatitis ; Large ; Treated with ; Reduction (chemical) ; Pancreatic polypeptide, avian

We report a patient successfully treated with the herbal formulation seihaito for decreased percutaneous oxygen saturation (SpO2) at night. A 90-year-old man was hospitalized for chronic obstructive pulmonary disease post-pneumonia, and the introduction of home oxygen therapy (HOT) was prescribed. He demonstrated dyspnea symptoms mainly at night. On examanination with oximetry for 24 hours, he also showed decreased SpO2 at night. So we administered seihaito without changing his other oral medications. Hypoxemia improved remarkably and the patient showed improvement in ADL. In this case, seihaito may have contributed to clearance of the respiratory tract, and improvement of tracheobronchial change due to the circadian rhythm of this disorder.
Chronic Obstructive Airway Disease ; Qing Fei Tang ; night ; Treated with ; Patients

We report the case of a 76-year old male patient who was able to discontinue home oxygen therapy (HOT) after developing severe pneumonia, for which he was hospitalized on February 17, 2004.We first administered antibiotics. Although blood inflammatory response markers became negative, his hypoxemia persisted, and HOT was introduced.We subsequently administered Seihaito, without changing his other oral medications. Hypoxemia and his general condition then improved remarkably. In the end, the patient was able to discontinue HOT. This case may demonstrate an ability of Seihaito to contribute to respiratory tract clearance, and inhibit inflammatory response in the alveoli.
Oxygen Therapy Care ; Pneumonia ; Hypoxemia ; After values ; Home

We report a patient who was successfully treated with a herbal formulation of goreisan (Wu-ling-san) for recurrent vomiting associated with pyloric stenosis, with significant simultaneous improvement of congestive heart failure.
A 78-year-old woman was in a bedridden state after cerebral infarction and was being fed through a nasal tube. She often experience repeated vomiting and aspiration pneumonia. Cicatricial stenosis was found in the pyloric region and we performed an expansion operation with balloon endoscopy. However, symptoms did not improve and her heart failure worsened. Therefore, we administered goreisan. Urinary output volume increased, edematous changes gradually disappeared, and pleural effusion decreased. The stenosis-related lesion did not change, but the vomiting ceased, even after nasal tube feeding was resumed.
Goreisan is an herbal formula used to promote diuresis that is considered to correct water absorption in digestive organs. In this case, goreisan was effective for the improvement of many symptoms.

We report a patient with Multiple system atrophy that was successfully treated with the herbal formulation Hachimijiougan.A 79-year-old man was hospitalized with Multiple system atrophy. He showed slow movement, frozen gait, finger tremor, dizziness on standing up with slowly progressive characteristics. Various medications had been administered for orthostatic hypotension, but the effect was insufficient.So we administered Hachimijiougan without changing the other oral medications. After administration, orthostatic hypotension was improved, and he became able to perform various activities of daily living.In this case, we thought that Hachimijiougan improved autonomic nervous system disorders such as the orthostatic hypotension in a patient with Multiple system atrophy.

We report a case of chronic heart failure with hypotension, successfully treated with goreisan (Wu lin san).In this case, goreisan improved both the heart failure symptoms and water regulation. This 91-old woman had been receiving treatment for congestive heart failure, mitral regurgitation, aortic regurgitation and atrial fibril lation, and had undergone pacemaker implantation due to sick sinus syndrome. She underwent repeated hospi talization due to aggravation of her chronic heart failure. She was re-admitted because of systemic edema as well as exacerbation of heart failure symptoms which included pleural effusions. Blood pressure remained constant at about 80/50 mmHg. She was prescribed furosemide 40 mg. Thereafter, cerebral infarction compli cations arose. Therefore, it became difficult to increase the quantity of diuretics. We administered goreisan without change to the other oral medications. Many of her symptoms improved and the pleural effusion resolved without affecting blood pressure.
Goreisan is one representative herbal formula for promoting diuresis. In this case, it is thought that goreisan showed actions that influenced water regulation.

We encountered two cases of diabetes mellitus treated with insulin that improved with the administration of Mashinin-gan and Hachimi-jio-gan for constipation.
The first case is an 84-year-old woman who had been treated with 16 units of insulin per day. After receiving Mashinin-gan for constipation, as well as the regular dose of insulin, her blood sugar values declined. Her insulin dose was then reduced, her constipation improved and finally she stopped taking insulin. The second case is a 77-year old man who was also being treated with 16 units of insulin per day. He took Mashinin-gan and Hachimi-jio-gan for constipation, which improved his constipation and allowed him to reduce his insulin from 16 units to 4 units per day.
Neither Hachimi-jio-gan nor Mashinin-gan caused any serious adverse effects and seemed to be beneficial for aged diabetic patients in preventing side effects such as hypoglycemia. We conclude that these drugs are useful for the treatment of diabetes mellitus for the aged.

The purpose of this study was to evaluate the effect of keishibukuryogan (KB) against the cognitive symptoms associated with silent brain infarction in a prospective cohort study. The subjects were 93 patients with silent brain infarcts who visited the Department of Japanese Oriental Medicine, University of Toyama, and its allied hospitals. They consisted of 24 males and 69 females, mean age (± S.E.) 70.0±0.8.Group SK (n=51) consisted of patients who used KB extract for more than6months per year. Group SC (n=42) consisted of patients who did not use Kampo formulas. The NS group (n=44) consisted of elderly subjects who had no silent brain infarction, 21 males and 23 females, with a mean age (± S.E.) of 70.7±0.7 years. Among the three groups, the revised version of Hasegawa's dementia scale, apathy scale and self-rating depression scale were compared between the study start and after three years. In the SK and SC groups, these scores, and the subjective symptom levels (head heaviness, headache, dizziness or vertigo, stiff shoulder) were also studied. The results showed that the self-rating depression scales at study start for the SK and SC groups were significantly higher compared to the NS group. In spite of the scores for the NS group increasing after three years, the SK group scores were significantly decreased compared to the SC and NS groups. KB was effective against head heaviness, which often complicates silent brain infarction. In the above mentioned, KB was effective in treating cognitive disorders and subjective symptoms related to silent brain infarction.
Infarction ; Brain ; seconds ; Ions ; symptoms <1>