Kampo medicine has been used for patients with pneumophagia to improve deficiency and stagnation of qi. Here, we report a case in which symptoms were alleviated by treating spleen yang deficiency and liver qi stagnation as the main pathogenesis. The patient was a 75-year-old woman. She was diagnosed with atrophic gastritis after a close examination of her gastric discomfort. She took antacids and proton pump inhibitors, but the condition did not improve. Her abdominal distension and belching also appeared and worsened, so she requested Kampo treatment. Since she had interior cold with qi stagnation, we prescribed tokito that is able not only to warm interior cold but also to adjust qi sufficiently. The pathology of pneumophagia is generally considered to be stagnation of qi mainly and concomitant with deficiency of qi. However, for those having interior cold like this case, a medicine that can firmly perform warm supplementation is necessary, and tokito is considered to be a candidate for the condition. Strangled pain is mentioned as the main targeted symptom of tokito, and it is often administered for abdominal or chest pain. Although, in this case, abdominal pain might have occurred if the condition had worsened further, it is important to utilize tokito in the case of qi stagnation and yang deficiency regardless whether patients have pain or not.

We had a female patient who had stagnation of qi and recovered not only by adjusting qi but also by warming interior cold. A 67-year-old woman visited our clinic for generalized anxiety disorder and whole body overstrain on the basis of domestic problems. She had taken anxiolytic, which brought about some relief. She also suffered from uterine cancer, and had operation of uterine resection. After operation, she took radiation therapy, which caused ileus. Although she took daikenchuto, ileus sometimes recurred. At first, we diagnosed her condition as stagnation of liver qi and deficiency of liver blood according to Kampo medical findings, and prescribed yokukansankachimpihange. However, she felt little effectiveness. We focused on her condition as spleen-stomach deficiency cold, and switched to anchusan, which gradually improved her symptom and led to discontinuation of daikenchuto and anxiolytic. She continued to take it for 7 years, and gradually reduced. She stopped taking medication 2 years later, and has had no recurrence ever since. It suggests that anchusan was effective in warming her latent severe interior cold. We should consider anchusan as a therapeutic candidate for stagnation of qi and interior cold, although it is well known Kampo medicine that is suitable for stomach pain.