A 54-year-old female had cesarean sections at ages 26 and 29, a left salpingophrectomy for left ovarian cyst at age 31, and a total abdominal hysterectomy for fibroids at age 41. After total abdominal hysterectomy, she had repeated bouts of ileus and started taking daikenchuto (DKT), which is commonly used to prevent ileus. At age 54, she visited our hospital when DKT failed to relieve her constipation and lower abdominal pain and had occasional heat flash above her neck. Tongue examination revealed pale red tongue and fissured tongue signs with yellow fur and dilation of the sublingual collateral vessels. Kampo diagnosis was blood stasis and excess heat, for which keishibukuryogan was prescribed to be taken daily and with which her symptoms dissipated after 7 days. Despite the popular use of DKT, its potential to cause excess heat after long-term use is not as well known. It is extremely important to warn clinicians who prescribe Kampo not to focus solely on a disease-to-prescription model but also to be learned of the discipline and to take measures to prevent adverse long-term effects and complications.

ART (Assisted Reproductive Technology) is making impressive advancements. However, not all patients will successfully conceive even with this technique. Patients undergoing infertility treatment are predominantly in a state of mental stress for being unable to conceive, and the importance of stress care in treating infertility has been reported. This time, to investigate the relationship between infertility, mental stress and Kampo treatment, we have conducted a retrospective study on 7 patients who achieved conception by a combination treatment of Kampo medicine and ovulation day prediction. Patients'occupation, menstruation history, pregnancy history, premenstrual symptoms, and oriental medical examination findings were extracted from their medical records. The clinical background were age (mean age: 36 [29-39]), time to pregnancy (mean: 6 months [2-9 months]), and outcome (normal vaginal delivery [3 cases], caesarean section [2 cases], abortion [1 case], transfer to other facility [1 case]). The oriental medical diagnosis in all cases found stagnation of liver qi. Two cases had only stagnation of liver qi. As comorbidities, kidney deficiency (3 cases), blood stasis syndrome (1 case), and blood stasis syndrome with syndrome of dual deficiency of qi and blood (1 case) were found. The Kampo prescriptions were as follows: nyoshinsan (2), kamishoyosan (2), tsudosan (1), shigyakusan (1) and kyukichoketsuin (1). Stagnation of liver (TM) qi was considered to play a role in infertility and is one of the important factors in Kampo prescriptions.