Background and objective : Diet has been recognized as an important part of Kampo medicine, and various plants with which we often cook are included as components of many Kampo formulations. Accordingly, nutritional science is closely related to Kampo medicine. So there is a need for national registered dietitian and nutritional science students to learn Kampo medicine. Despite this, no survey has reported on the awareness of nutritional science students toward Kampo medicine in Japan. We conducted for the first time a survey on this awareness amongst nutritional science students about Kampo medicine.Methods : A 13-item anonymous questionnaire was distributed to the third-year students in a national registered dietitian training program in Japan.Results : We obtained answers from 509 students in 9 institutions. Of the respondents, 59.3% answered that they were interested in Kampo medicine, and 86.4% of the students who were not interested in Kampo medicine answered that the reason was they had no chance to learn it. However, 81.3% of the students answered that they would attend lectures on Kampo medicine if it was adopted as part of their curriculum.Conclusions : These results suggest that Kampo medicine should be included in educational programs for nutritional science students.

We report a case of chronic heart failure successfully treated with bukuryokyoninkanzotokaboiogi. The case was an 87-year-old woman whose chief complaint was chest oppression at rest. She had been diagnosed with chronic heart failure and treated at a university hospital for 6 years, including several episodes of hospitalization. The patient's chest oppression was so strong that she felt depressed. Therefore, she consulted our institute to receive a Kampo treatment in addition to the western medications she was taking. At the patient's first visit to our institute, her serum brain natriuretic peptide (BNP) value was 545pg/ml, and her cardiothoracic rate (CTR) on chest radiogram was 64.1. The severity of the patient's chest oppression was class IV, according to the classification system of the New York Heart Association (NYHA). After we prescribed bukuryokyoninkanzotokaboiogi, her chest oppression and depressive mood gradually improved. Approximately one year later, the patient's BNP value had lowered to 104pg/ml, and CTR was reduced to 57.5. Eventually, her chest oppression and depressive mood disappeared completely. At that time, the chest oppression was categorized as class I in NYHA classification. Treatment with western medicines was not changed over the total clinical course of this case. These results suggest that bukuryokyoninkanzotokaboiogi could be a useful formulation for the treatment of chronic heart failure.

We experienced 2 cases in which Kampo (Chinese medicine) treatment was effective for septic osteoarthritis. Case 1 : a 34-year-old female. Septic coxarthritis developed with no left hip joint abnormality being noted, while DIC (disseminated intravascular coagulation) from MRSA pneumonia was treated. Surgeries were carried out five times, but there was no wound closure, and exudate discharge continued. At first, she was treated with Hochuekkito, did not run a fever, and good granulation tissue was formed in the wound. After a change to Senkinnaitakusan, exudate quantity decreased. Moreover, after an external fixation operation and being treated with Juzentaihoto, epithelization progressed, and the wound eventually closed. Case 2 : a 79-year-old female. One year and 6 months after osteosynthesis with compression hip screw was carried out for a femoral neck fracture, operation scar complications and large quantities of exudate were seen, so we diagnosed her with late onset septic osteomyelitis. She gained weight with Juzentaihoto treatment, while a decrease in exudates and fistula closure with Astragali Radix and Ginseng Radix were confirmed by MRI, and her nutritional state improved. Generally speaking, septic arthritis and osteomyelitis are difficult to treat, but Kampo medicines were curatively effective for these diseases, particularly when increasing Astragali Radix and Ginseng Radix quantity.

Case 1 was a 40-year-old woman who used a facial treatment machine and felt burning facial pain at night.She then felt unpleasantness in her facial skin all day long and was too uncomfortable to leave her home. We prescribed kamikihito. Ten days later, she felt the positive effects of treatment. Forty-five days later, she did not feel the unpleasantness on her facial skin, and she was able to go out again. Case 2 was a 36-year-old woman who had intense inflammation of her face, because she had stopped treatment with a steroid ointment.After 6 months, her face still felt hot and strange, which decreased her quality of life. We prescribed yokukan sankachinpihange. Four weeks later, she felt the positive effects of the treatment, and 14 weeks later, she was able to restart her part-time job. Because both of these cases had received various types of conventional medi cal therapy in the beginning that were not effective, their Kampo therapy was begun a long after the start of their abnormal facial sensation symptoms. Kampo therapy demonstrated a positive effect after approximately one month in both of these refractory cases. Thus we recommend Kampo medicines for the treatment of abnor mal facial sensations.

We report a patient with hemifacial spasm in whom daijokito was effective. The patient was a 57-year-old woman who visited our clinic for treatment of fatty liver and asthma. She had been suffering from left blepharospasm and paroxysmal twitching movement of the left lower jaw in stressful situations during the 2 years prior to her first visit to us. After we prescribed daijokito because of her pot belly, she had no more asthma attacks and her left facial spasm improved. Seven months later, we added inchinko to daijokito for her liver damage. When we followed the test results of her clinical survey for two years, we found that her weight had decreased and liver function was improved after starting this dosage. We diagnosed her paroxysmal involuntary twitching on the left side of the face as hemifacial spasm, because these symptoms were unilateral. We regard that her hemifacial spasm was improved with relaxation, anticonvulsants, and the antianxiety action of daijokito.

Case 1 was a 24-year-old female suffered from the feeling that her throat was obstructed ; this occurred after she had to talk loudly in front of many people. Case 2 was a 51-year-old female who complained of a palpitation attack ; this occurred after she underwent a hysterectomy. We diagnosed these symptoms as “hontonki.” Hontonki is a case of symptoms rising from the lower abdomen into the chest and throat with feelings of anxiety. When these symptoms appeared, the patients felt as if death were upon them, but when they disappeared, the patients soon felt healthy. There are certain medicines that can be used to treat hontonki. We administered Kinkiyoryaku hontonto (i.e. hontonto as described in Kinkiyoryaku) to them, and it was very effective.
We undertook a retrospective analysis of these two cases, along with 8 other cases successfully treated with Kinkiyoryaku hontonto at our hospital over the last 11 years. We found the common clinical characteristics of hontonki events were paroxysmal symptoms with feelings of anxiety. There are some differences between the clinical characteristics of Kinkiyoryaku hontonto from those of Chugobikyuho hontonto (hontonto as described in Chugobikyuho). The cases of Kinkiyoryaku hontonto are not kyosho (hypofunction) as those of Chugobikyuho hontonto are. Either they have heat symptoms or they do not have coldness, and they have shoulder stiffness or headache as some of the other oketsu symptoms.

The patient was a 45-year-old woman who began suffering from pain in her extremities 1 year and 6 months previously, and who received Oketsu-reducing Kampo. Her pain disappeared in a year. Six months after her treatment ended, she visited our hospital again complaining of the same symptom. Due to strong signs of Oketsu, we prescribed her a Kampo that reduces Oketsu, but her pain largely persisted. On re-examination, we noticed that her condition had occurred during the rainy season on both instances and speculated that high humidity and strong ‘wind' may be the reason. Therefore, Byakujutsubushito was prescribed for her, and her pain disappeared in 2 weeks. However, in the following rainy season, she visited us again complaining of the same pain, and Byakujutsubushito was again administered, and that relieved her from pain in 11 days. Although it is stated that Byakujutsubushito is useful for the treatment of pain resulting from dampness and ‘wind', there are very a few reports on this in the Kinkiyoryaku text. Nowadays, we live in air-conditioned spaces, and high humidity results in ‘cool wind’ and exterior dampness. Frequent movement in and out of such spaces worsens extremity pain, and we believe that the incidence of this condition is increasing. And we believe that Byakujutsubushito is one of the most useful formulations for the treatment of this condition that occurs during rainy season.

Ryokito is a Kampo formulation which has been administered for right upper quadrant pain since the Edo Era in Japan. Yet there are but a few reported cases in multiple clinical exams at one institution, on the usage of this formulation. We undertook a precise retrospective analysis of ryokito-prescribed cases at our institute over ten years, and reported cases published in the past to illuminate the clinical characteristics of ryokito effective cases.
Among the 21 cases at our institute, ryokito was effective in 11 cases and 10 of these 11 cases had right upper quadrant pain. Additionally, 7 of them reported abdominal distention.
Overall, this retrospective analysis revealed that amongst those ryokito effective cases, not a few patients had the right upper quadrant pain. This fact suggests that right upper quadrant pain is a reasonable characteristic for a usage of ryokito.
Likewise, abdominal distention was also a common symptom among the effective cases. It is likely that abdominal distention could be a characteristic for a usage of ryokito as well.

This report describes a case of cluster headaches that was successfully treated with Senkito. The patient was a 46-year-old female. She had been having attacks of cluster headaches that had continued for 3 days at the change of seasons since she was 30 years old. During an attack, she took a triptan preparation and non-steroid anti-inflammatory drug (NSAID), but they were not effective. Recently, the attacks had been increasing in frequency and continued for 1-2 weeks. She visited our hospital for Kampo treatment. We diagnosed her as having oketsu and kiutsu ; therefore, we prescribed tsudosan, and the frequency and strength of the attacks decreased. Even if NSAIDs were effective for headaches, they were not consistently effective. We re-examined her and found she had inside biryokotsu, which is tenderness in the orbital part of the frontal bone. We diagnosed her headache as including biryokotsu pain. We prescribed Senkito as required for her biryokotsu pain. It was very effective and the headache vanished after only 30 min. Generally, the potency of Kampo medicines with few structural components is higher than that of those with many structural components. Senkito has only five structural components ; therefore, we concluded that Senkito is effective not only for everyday use but also for use when required. Senkito is one of the most effective formulations for treatment of biryokotsu pain,especially the patient with inside of biryokotsu tenderness.

Soshikokito is a Kampo formulation used in the treatment of bronchial asthma, especially in those patients with hot flushes and cold sensation in their feet. But there is also a description in classical textbooks for its usage for the treatment of tinnitus. We report two typical cases of prolonged tinnitus treated successfully with soshikokito. Case1was a 70-year-old woman who visited our clinic complaining of tinnitus, dizziness and insomnia. She had a history of bilateral otitis media in her childhood, and had been suffering from tinnitus after being operated for it. The tinnitus had worsened during the three months prior to her first visit to us. After 3 months' treatment with soshikokito with additional shisoyo, her symptoms improved, so much so that after 8 months, she could live her life normally. Case 2 was a 58-year-old man who presented with tinnitus, hearing disturbance and a sense of irritation. He also complained of insomnia and cold sensation in his limbs. After1month's treatment with soshikokito with additional shisoyo and bushi, most all of his symptoms resolved. In addition, we also evaluated the clinical efficacy of soshikokito for prolonged tinnitus, retrospectively, and found that it was effective in five out of the ten cases we treated with this formulation. Most of the successfully treated patients presented with hot flushes or cold sensation in their feet. These case reports suggest that soshikokito may be a useful formulation for the treatment of not only bronchial asthma, but also of prolonged tinnitus.
Tinnitus ; therapeutic aspects ; seconds ; month ; Esthesia