Nyoshinsan is a Kampo formulation commonly prescribed to women in cases of hot flashes and dizziness typically seen in “chinomichisho” (“blood road syndrome” in English, characterized by physical and/or mental symptoms related to female hormone fluctuations). This formulation contains several crude drugs (Cyperi rhizoma, Arecac semen, etc.), which improve qi-depression; therefore, nyoshinsan can be applied in depressive episodes in modern clinical practice. Here we report five cases of female patients with mild and moderate depressive episodes who were effectively treated with nyoshinsan. These included two postpartum cases, two cases accompanied by hypermenorrhea, and one postmenopausal case. In these cases of depressive episodes, the patients had qi depression and qi deficiency. Additionally, they had findings of blood stasis accompanied by some heat symptoms such as a reddish face or palm, heat sensation, and hot flashes. Moreover, palpitation or palpable abdominal aortic pulsation was found to be a common symptom. Nyoshinsan has its origin in “an’eito,” which was used to treat psychosomatic suffering of soldiers injured in battle ; thus, this prescription may hold promise in cases of depressive episodes in women that associated with postpartum and hypermenorrhea.

Tokito is a Kampo prescription to treat abdominal bloating and abdominal cramping which radiate to the back associated with deficiency pattern and cold pattern. There are few reports on the use of tokito in gynecology, especially for menstrual-related symptoms. Here, we present a case in which tokito was successful in treating armpit back pain, abdominal bloating, diarrhea and anxiety, which are recognized as symptoms of premenstrual syndrome and endometriosis. The patient was a 34-year-old woman with endometriotic cysts on both ovaries. She started taking hormone treatment for dysmenorrhea and endometriosis, but the treatment was discontinued because of depression caused by drug side effects. While Western medical treatment options were limited due to multiple complications, her various symptoms improved after taking tokito. In addition, the edema, which had remained unchanged despite seven years of treatment with goreisan alone prescribed by her previous physician, rapidly improved with the combined use of tokito. Thus, we report a case in which traditional Japanese medicine was effective when Western medical treatment was not an option or was difficult.

We herein report a case of a 19-year-old male patient who presented with traumatic alopecia and was successfully treated with Kampo formulation saikoseikanto (Ikkando). This patient was referred to the Kampo outpatient department of Hoshi General Hospital from a neurosurgery hospital located near his workplace. The reason for the consultation was alopecia with subcutaneous hemorrhage that appeared several days after a blow to his parietal region. The patient presented with kyokyokuman on the right side along with chronic pharyngitis. We suspected that the alopecia was caused by folliculitis, so we prescribed saikoseikanto. The results of this medication were dramatic ; his alopecia and pharyngeal inflammation resolved within three months. His depressive mental state and his irritability improved significantly. We recognized that this Kampo formulation controlled both physical and mental disorders.

To deepen students’ interest in and understanding of Kampo medicine, a course on Kampo medicine (7 lessons) was conducted using gamification techniques. Quests (mandatory in-class and extracurricular optional) were set up throughout the course, incorporating game terminology (exploration tasks : quests, points : EXP) and four game elements: (1) goals (high EXP), (2) rules (how to gain EXP), (3) feedback (immediate confirmation of EXP), and (4) voluntary participation (optional quests). The EXP for all quests and the EXP for the final quests were calculated. The EXP from all quests and the EXP from the group work in the final class were used as the final EXP, and the top 10 students were awarded. We conducted questionnaires before and after the class to survey students’ awareness. The response rate for the optional extracurricular quests was 50.8%, and about half of the students voluntarily worked on the assignments. After the class, students’ awareness of the effectiveness of Kampo medicine (p=0.02) and the necessity of Kampo medicine (p=0.07) increased. The use of gamification in the class led to active learning and a deeper understanding of Kampo medicine.

In recent years, expectations and demand for Japanese Kampo medicines have increased in Japan. However, the self-sufficiency rate of raw materials for crude drugs in Japan is approximately 10%, with most imported from China. Although discussions on the domestic production of raw materials are gaining momentum, achieving self-sufficiency of crude drugs for Kampo preparation poses several challenges, including production costs, sales channels, and distribution prices. However, it is well-known that a diverse array of crude drugs can be cultivated in the Japanese climate. Since 2013, Ibara City in Okayama Prefecture has been promoting a medicinal plant cultivation project to utilize fallow land effectively. Currently, we have achieved successful cultivation of ‘benishizuka,’ a medicinal peony known as Paeoniae radix, with sufficient quality. However, the present circumstances in Japan limit its sales channels for medical use. The project initiated by Ibara City has evolved from its inception, primarily involving farmers, the government, and national research institutes, to now encompass an unprecedented collaboration among medical professionals as well as local construction companies and a local university. This transformation has propelled Ibara City’s various new medicinal plant cultivation businesses into a new phase of development. In this report, we investigated the local history and climate from the perspective of a Kampo medicine practitioners and discuss the path to successful peony cultivation. Additionally, we delve into the innovations and outcomes pertaining to peony cultivation. Moreover, we report the challenges and prospects for the domestic production of crude drugs for Kampo preparation from the perspective of multiple professions.

This is the case of a 13-year-old girl. The patient became aware of difficulty using school lunch utensils, chopsticks, and pencils, along with tremors, weakness, and speech difficulties. The patient was referred to our hospital for further examination. Despite detailed tests, no abnormalities were detected. Suspecting psychological factors, the patient was referred to our department in October 20XX. Considering the patient’s developmental history, which indicated autism spectrum disorder as the underlying cause of her symptoms, and her apparent indifference to her symptoms, we made a diagnosis of conversion disorder. The physical symptoms improved with 0.75 mg of aripiprazole, However, about six months after the initial consultation, the patient began experiencing tremors and weakness in her left hand, along with headache, nausea, and stomach pain. Organic causes were ruled out, and the patient was prescribed 2.5 g of yokukansan extract granules, which quickly resolved her symptoms. Yokukansan is a commonly used medication in psychiatry, and is prescribed to treat fits in autism spectrum disorder and the behavioral and psychological symptoms of major neurocognitive disorder. Conversion disorders can be challenging to treat because of the lack of suitable psychotropic medications. However, Kampo medicine can be a useful alternative.

We report a case of a 53-year-old woman who suffered from persistent tic symptoms around her mouth and right eyelids. She visited our Kampo clinic because of a poor response to Western medicine. We focused on symptoms including palpitations, anxiety symptoms and fullness in the chest and hypochondrium, and prescribed Kampo formulas containing Bupleurum root, which had little effect. Finally, we thought this might be caused by liver qi depression, heart heat, blood stasis, liver blood and yin deficiency as well as liver yang transforming into wind, because she had symptoms of not only fullness in the chest and hypochondrium, but also nocturnal awakening, constipation, a pale red and purple tongue with yellow fur, pressure pain beside her umbilicus, calf pain and fine pulse. Therefore, we administered modified formula of nyoshinsan and shoyosan. Her symptoms have markedly improved after taking this formulation and have been stable for 18 months. In addition, the number of Western medications has been reduced. It is known that some cases of persistent tic disorder are resistant to standard Western treatments. Kampo medicine may be a useful alternative and provide relief in such cases.

We herein report a case of a 72-year-old man who complained of recurrent hyperalgesia in the right big toe, which was successfully treated with the Kampo formulation ninjin’yoeito. The unusual pain felt like being cut with a utility knife whenever his skin was lightly scraped with a toothpick. There was mild tactile loss at this area, however, there were no other sensory disturbances in the sense of pain, cold, or vibration. This patient’s hobby was Iaido, a type of Kendo, which places stress on the soles of the feet. Therefore, we speculated that the clinical disorder in this case was related to his exercise. This patient exhibited a pattern of qi and blood deficiency with qi uprising, which suggested the use of ninjin’yoeito. After taking this Kampo formulation, his abnormal hyperalgesia with coldness in the big toe resolved. There have been no prior reports of ninjin’yoeito effectively treating unusual hyperalgesia.

The history and treatment of Japanese medicine, including Waho (Japanese traditional medicine), Kampo medicine, and folk medicine, were examined from a pediatric perspective to the extent possible, focusing on available literature. Due to the sanitary conditions and high infant mortality rate at the bygone time, past pediatric books mainly dealt with birth, child rearing, night crying, diarrhea with melena, infantile convulsion, etc. Shokenchuto, now commonly used for children, was not prescribed until the Showa era after it had been mentioned for pediatric usage by Goto Gonzan. Also, kanbakudaisoto cannot be not yet found written for children before Tokaku and Sohaku. From the myth of Prince Ohkuninushi, which appeared in the story of the white rabbit of Inaba, “Daidoruijuho” which contains collected various handed down medical methods, “Wahoichimanho” which compiled folk remedies and drug prescriptions during the Edo period, till “Kyuminmyoyaku” said to be the oldest home remedy book, Waho has been around since ancient times without written letters in our country, and today it remains as a folk remedy. After “Ishinpo,” which can be said to be an abstract of those old-day Chinese medical books, this Waho gave its supremacy to Kampo medicine originated from ancient China. Kampo medicine achieved its own development during the Edo period, but after the Meiji period it was dominated by Western medicine and declined, then it was revived in the Showa era. Pediatric medical care was also under the influence of that history.

Hot flashes decrease the quality of life and increase the risk of cardiovascular diseases, but there are no established therapies for them. In this report, we describe two cases of hot flashes after hematopoietic stem cell transplantation successfully treated with jiinkokato. Case 1 was a 61-year-old woman with acute myeloid leukemia. She received cord blood transplantation and suffered from hot flashes, hyperhidrosis, and night sweat during tapering of immunosuppressants. She started to take jiinkokato and her symptoms improved immediately. Case 2 was a 51-year-old man with myelodysplastic syndrome. He received bone marrow transplantation, and developed hot flashes during taking bakumondoto and goshajinkigan for dry cough and dysuria. He switched from these Kampo medicines to jiinkokato and his symptoms improved gradually. In both cases the patients had conditions of the pattern of yin deficiency with excessive heat caused by strong cancer chemotherapy, so we considered jiinkokato to be effective for their hot flushes. We believe that jiinkokato may be an option for the treatment of hot flushes associated with hematopoietic stem cell transplantation.