Two cases of malignant exophthalmos, one with and the other without thyroid abnormality, were treated with Kampo, Japanese traditional medicine. Case 1-62 years old female complained of exophthalmos (r 23mm, l 22mm), visual disturbance (visual acuity r 0.1, l 0.5), total ophthalmoplegia, hyperemia and edema of the eye lids and conjunctiva without thyroid function abnormality, was treated by the administration of Ryokeijutsukanto and Tokishakuyakusan without any other medications. Seven days after the administration, the exophthalmos was reduced (r 21mm, l 20mm), the visual acuity improved (r 0.6, l 0.7), the hyperemia and edema of the eye lids and conjunctiva almost disappeared and the eye movement improved toward normal. Case 2-66 years old male complained of exopthalmos, ophthalmoplegia, hyperemia and edema of the eye lids and conjunctiva with euthyroid Graves' disease was treated by the administration of Ryokeijutsukanto and Tokishakuyakusan followed by improvement of the visual acuity and the eye movement, and reduction of the hyperemia and edema of the eye lids and conjunctiva.
These observations suggest that treatment with Kampo can be effective in malignant exophthalmos with or without thyroid abnormality.

Summary Interrelationship of diabetic retinopathy and “Oketsu” Syndrome was analysed. 615 diabetics were physically examined by the system of Kampo, Japanese traditional medicine, and 26 kinds of signs were recorded. Among these signs, the tincture of violet in the tongue, the pigmentation and/or the subcutaneous bleeding and the telangiectasis, the recognized signs of “Oketsu” syndrome, were showed significant association with the retinopathy in these patients by chi-squared test.
These observations suggest that diabetic retinopathy would be associated with “Oketsu” syndrome.

Nineteen untreated hyperthyroid patients were divided into 4 groups. The control group was treated by methimazole and propranolol and the other groups by methimazole, propranolol and herbal medicine (Shakanzoto, Saikokarkotsuboreito or Keishikaryukotsuboreito extracts) together. In Shakanzoto-treated group the reduction rate of serum thyroxine in the early stage of treatment and the reduction rate of serum triiodothyronine in the whole period of treatment were significantly higher than the control. These observations suggest that treatment with Shakanzoto can be effective in hyperthyroidism by reducing the increased serum thyroid hormone.

Eight cases with heart failure in hyperthyroidism treated by Saikokarhukotsuboleito extract were reported. All patients, 2 males and 6 females aged 30-71, were diagnosed as hyper-thyroidism by physical findings, serum thyroid hormone assay and TRH test. Heart failure with various severity from edema of the legs to pulmonary edema occurred in 3 untreated patients and during antithyroid therapy with beta blockade in 5 patients. After administration of Saikokarhu-kotsuboleito extract with antithyroid drug and beta blockade in 5 patients, with only antithyroid drug in 2 patients and no other medications in 1 patient, all patients recovered from the heart failure in 3-21 days. These observations in hyperthyroidism suggest that in the classical indications for administration of Saikokarhukotsuboleito, “startle and confusion” and “talk in delirium” would be neuropsychotic states caused by adrenergic hyperactivity and “fullness in the chest”, “dysuria” and “heavy sen-sation in the whole body and difficulty to turn over or lie down” would be states caused by high output heart failure.

The coefficient of variation (CV) of R-R interval in Electrocardiogram has been used to express the function of the autonomic nerves. To observe the effect of herbal medicine on the autonomic function, CV in the resting supine position was measured before, during and after treatment by extracts of herbal medicine-Kampo in 26 type-II-diabetics with autonomic dysfunction.
Before treatment the CV was found to be reduced significantly analyzed by t-test than in the age and duration matched control patients with diabetes mellitus without autonomic dysfunction. But during and after treatment the CV increased to the level of the controls. In the individual patient the CV was increased by the extracts in 18 out of 20 patients. And this increase were significant analyzed by paired t-test.
These observations suggest that the herbal medicine-Kampo could effect on the autonomic function and this effect would express as an objective and quantitative manner by a non invasive tecnique-determination of the CV.

Quantitative specification of color of the tongue was performed by chroma meter (Minolta CR-100) according to the Commission Internationale de l'Eclarirage 1976 (L*a*b*) Space, the color was analyzed with digital expressions as L* (value), a* (hue of red-green), b* (hue of yellow-blue) and c* (chroma) values.
The difference of the color of the tongue of the patients before and after administration of herbal medicine extracts for 12 weeks was detected by the chroma meter with statistical significance. The change of the color of the tongue of a diabetic female was also able to record on the course of the cerebrovascular accident.
To analyze the correlation between these quantified values and the findings of the tongue by inspection, 116 patients were devided into four groups (whitish, red, dark and violet) according to the color of the tongue by inspection. Most patients in the violet tongue group showed small b* value. As a group the violet group showed significantly smaller b* value than those of the whitish, red and dark groups. In the L*a*b* space as the b* value becomes small the hue becomes blue.
Analyzing the relationship between the diabetic retinopathy and the b* value, color of the tongue of 21 diabetics was examined by the chroma meter. As the result eight patients with diabetic retinopathy indicated significantly smaller b* value than those of 13 patients without retinopathy.
These obsevations suggest that the color of the tongue would be able to specificate quantitatively by chroma meter, the value measured would be correlated to the finding by inspection of the tongue, and that diabetic retinopathy would related with the hue of blue of the tongue detected by this specification system.