Kampo medicine containing Gardeniae Fractus is often used for agony of the chest, but there are few case reports about shishikankyoto. Here, we report a case of a 73-year-old woman with heat sensation in the chest and severe malaise successfully treated with shishikankyoto. She suffered from lung cancer five years previously, and received chemoradiation treatment. One year later, radiation pneumonitis developed, which was resolved naturally. After another year, she began to develop a slight fever, burning sensation and general malaise, which disappeared and recurred in cycles of about six months. She received Kampo medicine treatment for one year at another hospital, but lacked in improvement and was introduced to our hospital. We thought her symptoms were caused by deficiency heat pattern in the chest and cold in the epigastric region. By giving shishikankyoto in reference to a sentence in the Shang Hang Lun, her symptoms improved in about two weeks. Although, shishikankyoto is a prescription medicine with few reports, it is effective in a short period of time and is useful for similar symptoms.

A 64 year-old female presented with fever and cough. She had suffered from a cough for one day and we treated her with saikokeishito. However, her symptoms got worse and she developed chest pain. She was diagnosed with bacterial pneumonia at another clinic and she was referred to our hospital 3 days after starting saikokeishito. Her X-ray showed right infiltration in her lung and her blood examination had signs of inflammation. Pneumonia with pleuritis was suspected, but she was allergic to antibacterial drugs and hoped to continue Kampo treatment. We switched saikokeishito to saikanto. Her chest pain decreased soon after taking saikanto and 4 days later only a slight cough remained. Eleven days later, her inflammatory reaction improved. Kampo formulas containing Bupleuri radix are usually selected for pneumonia or pleuritis according to a patient' s pattern identification. We gave her saikanto, a mixture of shosaikoto and shokankyoto, because she had chest pain. Saikanto was significantly effective. There have been few clinical reports about treatment for pneumonia with Kampo medicine alone without using antibacterial drugs. We believe this case shows that Kampo treatment is effective for pneumonia and pleuritis.

Hangekobokuto is often used for globus sensation. We herein describe two cases in which ryokeijutsukanto was effective for globus sensation, for which hangekobokuto was ineffective. Case 1 was a 28-year-old woman. She had been suffering from postprandial belching, fullness and stuffy throat for a year. She underwent examination, but could not find the cause of her symptoms and visited our department. She was prescribed hangekobokuto, but the feeling of stuffiness in her throat did not improve. Case 2 was a 50-year-old woman. She had been afflicted with a feeling of fullness in the ears, tinnitus, and pain in the back of the eyes for two weeks. She visited the otolaryngology department, but no abnormalities were found so she visited our department. She was prescribed kamishoyosan, and although her ear fullness and tinnitus improved by about 60%, she began to complain of dizziness and throat stuffiness. This did not improve even though she used hangekobokuto with kamishoyosan. In both cases, after changing treatment to ryokeijutsukanto, the symptoms were improved. For globus sensation, it is necessary to select Kampo medicines while paying attention to qi deficiency, qi depression, qi counter flow, static blood, liver depression, lack of fluid, fluid toxicity, and gastrointestinal disorders. We thought that ryokeijutsukanto could be a candidate.

We report a case of post coronavirus disease 2019 (COVID-19) condition, in which the patient suffered from a severe sense of fatigue and brain fog that was successfully treated with Kampo therapy. The patient was a 21-year-old man. He had been diagnosed with COVID-19 and hospitalized for follow-up examinations. He recovered without any complications and was discharged from the hospital, but continued to suffer from a severe sense of fatigue, coldness, dizziness, and a loss of concentration. Because of these symptoms, he had to spend most of the day lying down. One month later, he was hospitalized to receive Kampo therapy. We administered bukuryoshigyakuto for 2 weeks referring to his severe coldness and fatigue and then changed to renjuin for his fluid disturbance and blood deficiency. After starting Kampo therapy, his fatigue and dizziness gradually improved. He was discharged after 3 weeks of hospitalization and received Kampo therapy as an outpatient. One month later, he reported a dull feeling in his stomach and depression. We switched to kamikihitogohangekobokuto and added hachimigan. His activities of daily living improved and he could take 4.5-kilometer walk. He could return to work 4 months later. Kampo therapy may be useful for post COVID-19 condition that causes a sense of fatigue and brain fog.

The patient was a 47-year-old woman. Four years previously, she began to suffer from left lower leg pain and numbness, and involuntary movements. She received further examination in the department of neurology at other hospitals, but had an uncertain etiology and was provisionally diagnosed with restless legs syndrome. She was treated with Western medicine such as gabapentin and gabapentin enacarbil, but they were ineffective. She subsequently visited our hospital and was hospitalized. She was diagnosed with painful legs and moving toes syndrome, and painful arms and moving fingers syndrome after further examination. We prescribed tokakujokito because she had severe blood stasis and panic disorder on Kamp medical findings. As a result, her left lower leg numbness disappeared and pain was reduced. We report a case of a patient who could not be effectively treated using Western medicine and was successfully treated with tokakujokito-based Kampo prescriptions.

We report a case of a patient with rheumatoid arthritis who refused Western medical treatment and was able to improve concomitant symptoms including arthralgia and headache by using kanzobushito. The patient was a 35-year-old. Eight years previously, she was diagnosed with rheumatoid arthritis due to joint stiffness. Although receiving methotrexate therapy, she developed methotrexate-associated lymphoproliferative disorders and the treatment was discontinued. Due to a feeling of rejection for Western medical treatment, she visited our hospital and was hospitalized for Kampo therapy. We prescribed kanzobushito for qi imbalance, coldness, and severe pain. Her joint pain, headache, and secondary symptoms were improved.

We report a case of a 49-year-old woman who presented with 6-month period menopausal syndrome including excessive sweating and hot flushes in her face, chest and back. She was also frustrated with her sons, but she reflected on her own anger and wondered why she got so irritated with them. We prescribed yokukansan to her and her all symptoms improved one month later. We need to differentiate between yokukansan and kamishoyosan in the treatment of menopausal syndrome and irritation, and it may be useful to evaluate the detail of irritation in selecting formula.

Yang diseases of the Shanghanlun (shōkanron) list the Three Yangs in the order of early yang stage pattern (taiyōbyō), middle yang stage pattern (yōmeibyō) and late yang stage pattern (shōyōbyō). However, in Japan, the order is early yang stage pattern, late yang stage pattern, and middle yang stage pattern. A survey of Japanese disease history revealed that by the Edo period smallpox, measles, and influenza were infectious, febrile, and highly lethal. Furthermore, these diseases exhibited bimodal fever. We investigated and examined how Kampo doctors viewed the order of the Three Yangs in the Shōkanron from the literature of the Edo period, and found that the epidemic period of these three diseases coincided with the increase in the number of doctors advocating late yang stage pattern. It is thought that the Three Yangs in Japan came to be recognized in the order of early yang stage pattern, late yang stage pattern, and middle yang stage pattern through these three dis­eases that became prevalent from around 1700.

In this report, we present three cases of lower limb cellulitis. The first case was an 88-year-old woman and the second case was a 36-year-old man. In addition to standard therapy, both of them received Kampo therapies with keishinieppiitto and jidabokuippo during the acute phase of cellulitis and were promptly cured. The third case was a 52-year-old woman with severe obesity suffering from repeated and intractable cellulitis. She received Kampo therapy including keishibukuryogan. The redness and swelling in her leg gradually disappeared. Administration of adequate antibiotics and elevation of affected areas are important for the treatment of cellulitis. Even with appropriate therapy, some patients are slow to respond and difficult to treat. The skin findings in cellulitis are swelling, redness, heat, and pain, which can be recognized and treated as water imbalance, heat, and blood stasis in Kampo medicine. This case report suggests that cellulitis during the acute phase can be treated with keishinieppiitto and the treatment of water imbalance and heat is important. After the acute phase, the treatment of blood stasis is important. Considering the time of onset and skin findings in cellulitis, Kampo therapy can contribute to the rapid recovery of cellulitis.

We report a case in which goreisan with hoketsuzai (blood-tonifying formula) was successful in the treatment of a marked nutritional disorder. A 17-year-old woman was screened for prominent emaciation of unknown cause. After the administration of goreisan, edema was reduced and her body weight increased. Subsequently, anemia improved and muscle mass increased with a combination of shimotsuto or sokeikakketsuto. It is possible that goreisan with hoketsuzai improved the water balance of the whole body including the digestive tract, and restored the digestive and absorptive function.