The change in color tone of crude drugs during storage of decoctions is one of the factors leading to poor drug compliance of decoctions. We experienced a case of a decoction including Aluminum Silicate Hydrate with Silicon Dioxide (Kasseki) turned into bright blue color after it was combined with goreisan. We therefore examined to find out possible causative crude drugs using an airtight container and performed a component analysis by the TLC. As a result, we found the following: Kasseki under the coexistence of Cinnamon Bark (C. Bark) and Atractylodes Rhizome (A. Rhizome) turned into a bright blue color in several hours. In this coloration, aluminum silicate hydrate, cinnamaldehyde and atractylon, which derive from these 3 crude drugs, were involved. This coloration change of Kasseki under coexistence of C. Bark and A. Rhizome was a vivid and sharp reaction generated in several hours. From the perspective of maintaining medication compliance, it is important to provide a full explanation to patients about the change in coloration of Kasseki, when decocting crude drugs that contain C. Bark, A. Rhizome, and Kasseki. To avoid coloration, it is considered useful to put Kasseki in a separate sachet, isolated from other crude drugs in storage, and to mix in Kasseki just before decocting.

Hiccups can sometimes become intractable. We report two cases of hiccups in which acupuncture practices to the lump of the infraspinatus muscle (Terasawa point) were effective. Case 1 was an 85-year-old male, an inpatient with bacterial pleuritis. His hiccups had persisted for 11 days. Several pharmacotherapeutic approaches were partially effective, but the hiccups were not completely abolished. In situ acupuncture therapy to bilateral Terasawa points was done, and his hiccups disappeared the next day. Case 2 was a 68-year-old male. He experienced insufficient sleep due to hiccups. We inserted needles into bilateral Terasawa points and heated the surrounding area with an electrothermo-acupuncture device using a curved heating plate. When this combination therapy was done, his hiccups disappeared during treatment. Acupuncture at the Terasawa point is one of the therapeutic approaches for hiccups and a rapid effect can be expected.

We report four cases of anxiety disorder where psychiatric symptoms were effectively treated with combination therapy utilizing keishikaryukotsuboreito and kanbakutaisoto, which are two herbal formulas. The patients had common symptoms and experienced episodes leading to emotional stress. Moreover, in all four cases aggravation of psychiatric symptoms due to emotional stress, re-experience and memory retrieval were commonly observed. Additional treatment with kanbakutaisoto was effective for such aggravation. On the objective assessment, rapid pulse, deficient pulse, weak abdominal strength and brisk pulsation in the supraumbilical region were present. Yawning was not necessarily present. There are many patients with anxiety disorder or mental disorder associated with emotional stress, and Kampo treatment is often considered to be effective for these cases. However, a single administration of Kampo extract formulae does not often provide adequate results. When a single Kampo administration is ineffective, the combination of keishikaryukotsuboreito and kanbakutaisoto may be useful.

Idiopathic mesenteric phlebosclerosis (IMP) is a rare chronic ischemic intestinal disease, mainly in the right hemicolon, characterized by dark purple mucosa on colonoscopy and calcifications of the intestinal wall and mesenteric veins on abdominal radiography and computed tomography. In recent years, many patients who developed IMP over the long-term administration of Kampo medicines have been reported. However, the present status of IMP in patients under long-term treatment with Kampo medicines in departments specializing in Kampo therapy is unclear. We surveyed whether there were any IMP outpatients followed for 5 years or more at the Department of Oriental Traditional Medical Center, Suwa Central Hospital. We detected 2 of 257 (0.8%) patients having IMP. Both patients had undergone long-term treatment with Gardenia fruit. One of them underwent surgery due to acute abdomen, but the other was asymptomatic. The etiology and pathogenesis of IMP are still unclear. However, in patients undergoing long-term treatment with Kampo medicines, particularly containing Gardenia fruit, the possible presence of IMP should be taken into consideration, and active screening using imaging examinations is necessary even in asymptomatic patients.

For the purpose of investigating weights in the era when the Shan Han Lun was set forth, the weight and measures described in the Ben Cao Jing Ji Zhu, written in the period slightly after the Shan Han Lun, were studied. Some descriptions of the metrological standards are confusing in the Ben Cao Jing Ji Zhu. We focused on the measuring container, whose volume is equal to that of the one cun square spoon (fang cun bi), shown in the dun huang version of the Ben Cao Jing Ji Zhu. The volume of this measuring container was calculated on the assumption that the measures in this text follow those of the Han Shu Li Li Shi, and a result of 5.07 cm³ was obtained. The result was confirmed by using the actual measured values of the crude drugs. The result was also considered to support measurements of the volume in the Ben Cao Jing Ji Zhu as following the Han Shu Li Li Shi. With those results, descriptions of the density of honey and lard were examined, and the weight in the Ben Cao Jing Ji Zhu was clarified to follow that in the Han Shu Li Li Shi.