We administered hainosankyuto to seven patients before the operation to prevent surgical site infection in surgical dental treatment, including surgical periodontal therapy, surgical endodontics and tooth extraction. They had previously suffered from side effects of antibiotics. Surgical dental treatment was performed under local anesthesia. No surgical site infection occurred after the operation. The patient’s clinical parameters are currently stable. No recurrence for a year after the inflammatory symptoms disappeared was defined as short-term cure. There have been few clinical reports on surgical dental treatment with Kampo medicine alone, such as hainosankyuto, without using antibacterial drugs. These results suggested that surgical dental treatment using hainosankyuto could be one of the effective treatments where antibiotics cannot be used.

Bruxism is a common condition often seen in daily practice. Although interocclusal appliances are often used, there are no established treatments to eliminate bruxism. Here, we report two patients who complained of bruxism and insomnia. Based on the diagnosis of Kampo medicine, we thought that stress was involved in the background of both cases. Therefore, we prescribed them yokukansan, and their symptoms improved. These results suggest that yokukansan may be effective for sleep bruxism and insomnia.

A 66-year-old woman presented with a choking feeling in her throat. She was hospitalized three times and started nasogastric tube feeding one year before. She was diagnosed as somatic hallucination by a psychiatrist and started antipsychotic medication. She was admitted to our department in September due to worsening of choking sensation. Her body weight was 29 kg, and she was significantly lethargic and undernourished, and had difficulty in moving, parkinsonism, cognitive dysfunction, and apathy. She was considered to be in late yin stage pattern and started on tsumyakushigyakuto, which enabled her to walk with a walker, but her choking sensation did not improve. Two days after the conversion to yokukansankachimpihange, her speech and smile increased, and her motivation improved. After the switch to the extract of yokukansankachimpihange, the fullness and discomfort in left chest and hypochondrium disappeared, and she was able to take jelly and walk by herself. She was transferred to other hospital in January of the following year. Three months after the transfer, she was able to take enteral nutrition by herself and her weight increased to 37 kg. Eight months later after the transfer, she was able to take solid food orally and her weight increased to 41.5 kg. Yokukansankachimpihange may be useful for treating the patients with somatic hallucination and apathy.

The Japan Society for Oriental Medicine (JSOM) has made various efforts against coronavirus disease (COVID-19) to build evidence. JSOM has launched an academic society-led clinical research project on COVID-19 based on the concept and characteristics of Kampo medicine, including (1) prevention of disease by activating the immune system to regulate body conditions (pre-symptomatic stage of illness), (2) symptom alleviation in the mild and moderate stage and prevention of aggravation (acute to subacute stage of illness), and (3) early recovery and improvement of prolonged symptoms (late stage of illness). Since the declaration of the pandemic, the special working group has conducted the following activities : enlightening academic members, lobbying other academic societies, preparing research protocols, establishing research groups, conducting ethical reviews, responding to the research disclosure system, preparing protocol papers and review articles as the basis for the research, reporting research progress, soliciting case reports, warning against Chinese medicine use, requesting for research support funding, and revising the JSOM website. We also discuss the interpretation of COVID-19 from the perspective of Kampo medicine and the direction of the selection of Kampo formulas in this report.

A 40-year-old woman had suffered from genital herpes twice a year since approximately age 25 years. A year and a half before her first visit to our department, the frequency of her genital herpes had increased from 2 to 5 times a month. Continuous suppressive antiviral medication had not worked, and the patient was referred to our department. We discontinued the anti-herpes medication, and started treatment with Kampo (Japanese herbal) medicine. Initially, the patient’s symptoms did not improve with tokishigyakukagoshuyushokyoto for coldness of the hands and feet or hochuekkito for general fatigue. Then, on the basis of her symptoms of irritability, nightmares, dry skin and hair loss, we changed her prescription to juzentaihoto before meals and saikokeishikankyoto after meals. The frequency of genital herpes thereafter gradually decreased, and finally no further recurrences of herpes were observed as long as the patient was taking these two medicines. This result showed that some patients with recurrent genital herpes who fail to respond to antiviral therapy could be managed with Kampo medicine alone.

We report two cases of patients with intractable upper abdominal pain and histories of injury or surgery. The patients' pains were successfully treated with tokishigyakukagoshuyushokyoto (TSG). Case 1 involved a 59-year-old woman with left upper abdominal and thoracodorsal pain lasting 5 years. Kampo drugs such as tokito or prescriptions containing saiko were ineffective. Two years after her first visit, we noticed an injury scar from childhood that passed near the left hikon (pi-gen, ExB4) and induration and tenderness of the left hikon. TSG was administered, and the pain promptly improved. Case 2 involved a 66-year-old woman. She complained of epigastric, right­-upper-­quadrant abdominal and back pain lasting 7 years. Two years before presentation, the pain had worsened, but the cause was unclear. Although keishibukuryogan or Kampo drugs containing saiko were ineffective, her pain improved when TSG plus bushi was administered. A wound from a cholecystectomy was observed on her right abdomen. Induration and tenderness of the right hikon were demonstrated. The combination of past history of injury or surgery of the upper abdomen or back and induration of hikon can be associated with development of indications for TSG.

The number of patients with taste disorder and halitosis has recently increased in Japan. Some of these patients have no abnormalities identified in blood tests and no apparent dental problems, so they are diagnosed with unidentified complaints. In this paper, we report 2 patients who were diagnosed with psychogenic taste disorder and pseudohalitosis. Kampo medical examination found their symptoms to be related to qi deficiency. They were prescribed 5g of hochuekkito extract per day, and their symptoms were relieved. These results suggest that hochuekkito is effective against unidentified complaints such as psychogenic taste disorder and pseudohalitosis.

Abdominal pain and marked coldness were observed in a 56-year-old male with cancerous ascites associated with cancer of unknown primary, and the patient was treated with sekiganryo. The abdominal pain resolved from day 2 after the initiation of sekiganryo administration, and the ascites markedly decreased with an increase in the urine volume on day 3. Although the mechanism of the effect of sekiganryo on cancerous ascites was unclear, it was considered that the improvement of coldness promoted the metabolism and subsequently promoted diuresis. No case of the improvement of cancerous ascites by sekiganryo has been reported to date. We report this case along with a literature review.

Ryokeijutsukanto consists of four crude drugs, Hoelen, Cinnamonmi Cortex, Atractylodis Rhizoma, and Glycyrrhizae Radix. In Kampo medicine, it is used for the yang stage, fluid disturbances, and qi counterflow. It is also used for orthostatic disturbance, which does not change smoothly from parasympathetic nerve dominance to sympathetic nerve dominance. This time, we report that ryokeijutsukanto is also effective for disturbance with function regulation of autonomic nervous system. Case 1: a patient who had headache after exercise and working. Case 2: a patient who had dizziness and cold sweat that appeared in the evening. Case 3: a patient who had headache after working or on holidays. In these cases, ryokeijutsukanto was effective for symptoms that appeared when the patient could not change smoothly from sympathetic nerve dominance to parasympathetic nerve dominance. Furthermore, we found that ryokeijutsukanto was effective, even if there was no sign of fluid disturbance in conjunction with the yang stage and qi counterflow. We identified a new category of patients for whom ryokeijutsukanto is effective.

Thalamic pain is an intractable central pain caused by thalamic hemorrhage and infarction. Unfortunately, there is no established method for its treatment. We report five cases of thalamic pain effectively treated with keishikaryukotsuboreito. Case 1 was a 63-year-old man who complained of pain in the right side of his body for three years after thalamic infarction. Case 2 was a 68-year-old-man who complained of pain in the right side of his body for 13 years after left thalamic hemorrhage. Case 3 was a 74-year-old woman who complained of left limb pain for three years after right thalamic hemorrhage. Case 4 was a 67-year-old woman who complained of pain in the upper and lower right limbs for two years after right thalamic infarction. Case 5 was an 82-year-old man who complained of pain in the right lower limb for two months after left putaminal hemorrhage including left thalamus. All cases were treated with keishikaryukotsuboreito and their symptoms improved. However, in Case 5, thalamic pain recurred after three months and the effect was not sustained with keishikaryukotsuboreito alone, but it was effective when combined with keishibukuryogan. From the imaging findings, keishikaryukotsuboreito would be a useful option for the treatment of thalamic pain with localized lateral thalamic lesions.