We investigated the history and indications of Toenho, Kinseiho, and Cho-Sanshaku-Shinteiho, which are different formulae with the same name of seishoekkito. According to the description in “Futsugoyakushitsuhokankuketsu” written by Sohaku Asada, Kinseiho exhibits an immediate effect, while Toenho has preventive effects. However, according to the original text, Kinseiho was formulated such that it could be administered regularly in the summer for prophylaxis. Furthermore, Kinseiho is regarded as a simplified formula with the central structure of Toenho. This implies that Kinseiho is composed of selected crude drugs used in Toenho that are responsible for the main effects of Toenho, such as invigorating spleen energy, clearing fever and generating body fluids. Moreover, there is an instruction to arrange Kinseiho to fit each patient’s condition. In this study, it was found that Cho-Sanshaku-Shinteiho described in “Futsugoyakushitsuhokankuketsu” is a modification of Kinseiho prescribed by Katsuki Gyuzan for patients with fever, consistent with the concept of personalized medicine. The medical extract preparation seishoekkito, which is currently widely used, is Kinseiho. We may use it with heat-clearing formula, fluid-regulating formula or some modifications to make the appropriate formulation based on the patient's symptoms.

Soshikokito has long been used to treat cough in frail patients with cold sensation in their feet, based on the Japanese traditional Kampo textbook “Iryo-Shuhou-Kiku”. In many old documents including “Wazai-Kyokuho,” where soshikokito was first described, it is suggested that airways obstructed by a large quantity of watery expectoration should be the proper indication for the use of this formula. However, in the five cases that we successfully treated, the quantity of sputum was relatively small. To determine the practical indications for this, we examined their abdominal strength and the presence or absence of “cold feet” sensation. In addition, we investigated the nature of sputum in the past clinical reports in which successful treatment using soshikokito was described. It has become clear that we can prescribe soshikokito as an antitussive regardless of the patients' physical fitness as deduced from the abdominal strength. The “cold feet” sensation was not an essential symptom and was regarded as one of the symptoms of qi counterflow. Regarding the properties of sputum, it was viscous and small in quantity. In the cases where soshikokito was effective, it was speculated that viscous sputum would result in airway obstruction, coughing, and wheezing. These conditions will be ameliorated by the antitussive and expectorant effect of this formula, which improves qi counterflow and mildly tonifies water. In the treatment of cough with respiratory distress, “sputum with high viscosity and hard to discharge” is considered to be the targeted symptom in the practical usage of soshikokito.

We reported the case of a 9-year-old girl who complained of irritability with sounds, headache, nausea and ease of fatigability, who was successfully treated with the Kampo formulation, ryokito. Her irritability with sound occurred following bilateral ear pain. Her headache, nausea and antipathy towards smells appeared in conjunction with aggravation of this pain symptom. We recognized this patient as having a Ki-distribution imbalance, and so prescribed ryokito as a decoction. Following her use of this formulation, her complaints improved remarkably within about 8 weeks.

A 67 year-old women who suffered from painful palms and soles with burning sensation for 2 years was treated. At first, she visited the department of dermatology and then consulted our department. The authors considered these symptoms as already being described in the great classic Kinkiyoryaku (Chin Keiu Yao Lueh). We then prescribed shokenchuto, which resulted immediate clinical improvement. The authors have again realized that the classical textbook is based on proper clinical observations that are useful today.

We report three cases of skin disease successfully treated with juzentaihoto. Juzentaihoto has been used traditionally for deficiency of both Ki and Ketsu, and, at present, clinically for the treatment of various skin diseases. Toll-like receptors (TLRs) have recently been characterized as the receptors of innate immunity, which are mainly expressed on antigen-presenting cells. We previously reported that juzentaihoto enhanced interleukin-12 (IL-12) and interferon-γ (IFN-γ) production through modulation of TLR4signaling pathways in murine peritoneal exudative macrophages. Since Langerhans cells, a kind of the antigen-presenting cell, are known to exist in epidermis, we speculate that juzentaihoto improves T helper1and 2 (Th 1/2) balance through modulation of TLR signaling pathways in Langerhans cells. Our cases suggest that influence to acquired immunity through the innate immune signaling is assumed to be one of the mechanisms of juzentaihoto for controlling morbid states of the skin.
juzentaihoto ; Skin Diseases ; seconds ; Mechanism ; Possible

Boiogito, which has been used for obesity, edema and arthritis by using flabby constitution as a clinical indication, is mentioned in Jin Kui Yao Lue (Synopsis of the Golden Chamber). We experienced five cases of wind-wetness syndrome or edema caused by the pathogen Wind successfully treated with boiogito. There were common findings in these cases, i.e., heavy sweating or perspiration while sleeping, chilly feelings and worsening of the evening subjective symptoms and pulse diagnoses, such as floating, string-like and congested pulse in objective findings. On the basis of these cases, we investigated the efficacy of boiogito extract in 10 patients having the all of common findings mentioned above. As a result, boiogito improved symptoms in 8 patients. This suggests that medical examination by interview and distinctive pulsation are important in deciding the Kampo diagnosis for boiogito.
findings ; Clinical ; symptoms <1> ; Indication of ; CONSIDERATION

Yokukansankachimpihange has been applied to practical use for some indications such as irritability, excitability, anxiety and insomnia. We report 6 cases of chronic headache patients (tension-type headache [1], migraine [2] and mixed-type headache [3]) with the significant pulsation at pit of stomach and navel, who were successfully treated with Yoku-kan-san-ka-chimpi-hange for prophylaxis. These findings suggest that Yokukansankachimpihange might be useful for not only tension-type headache but also migraine and mixed-type headache.
Headache ; Prevention ; Application, NOS ; Chronic Headache ; Migraine

We experienced four cases of urticaria (two patients with cholinergic urticaria, one patient with chronic idiopathic urticaria and one patient with cold urticaria) successfully treated with Kampo therapy. The factors for outbreak or aggravation of urticaria were stress of looking after the father in law and hysterectomy in the first case, psychological stress due to familial trouble in the second case, panic disorder like episode in the third case, and solicitude and anxiety for family in the fourth case. The effective Kampo formulae that improved the dermatological symptom were keishibukuryogan, hangekobokuto, yokukansankachimpihange and kamishoyosan, respectively. It was helpful that to clarify the psychological background affecting the dermatological symptom in the determination of Kampo formulae. It would be useful that careful and repetitious question and answer about psychological background in the treatment of intractable urticaria.
Urticaria ; Medicine, Kampo ; Chronic ; Therapeutic procedure ; Cases

Objects : The purpose of this study is to evaluate objective measurements of skin moisture and its usefulness in the Kampo clinic.Methods : We measured the skin moisture of 6 male volunteers using a sensor twice, in a one to two week interval, and calculated the correlation of both data sets at 66 points. Secondly, we compared the skin moisture data at 10 regions in 81 patients without any skin disease, in a wide age range from 30 s to early 70 s. The ten regions measured were : face, chest, back, abdomen, leg and 4 forearm points, i.e. the inside and outside of the bilateral center forearm, and palm.Results : The correlation of two successively measured data sets showed excellent relation (r=0.716, p<0.0001). The sensor measurement of skin moisture was quite reliable. Measurements of the face, chest and back showed them to be significantly wetter than the abdomen, leg or any of the 4 forearm points. Palm measurements indicated a wetter tendency than for any forearm measurements. Back and abdomen measurements in males were significantly wetter than those in females. There were no significant differences among the data sets, with regards to age. Therefore, any forearm points are clinically useful for the standard measurement of skin moisture. We also demonstrated a case in which skin moisture measurements with a sensor were useful in prescribing and observing the effects of shigyakusan.Conclusion : Utilizing this method may be helpful in acquiring much more objective measurements for Kampo medicine.
Integumentary system ; seconds ; Forearm ; Medicine, Kampo ; Measurement

We experienced four cases of urticaria (two patients with cholinergic urticaria, one patient with chronic idiopathic urticaria and one patient with cold urticaria) successfully treated with Kampo therapy. The factors for outbreak or aggravation of urticaria were stress of looking after the father in law and hysterectomy in the first case, psychological stress due to familial trouble in the second case, panic disorder like episode in the third case, and solicitude and anxiety for family in the fourth case. The effective Kampo formulae that improved the dermatological symptom were keishibukuryogan, hangekobokuto, yokukansankachimpihange and kamishoyosan, respectively. It was helpful that to clarify the psychological background affecting the dermatological symptom in the determination of Kampo formulae. It would be useful that careful and repetitious question and answer about psychological background in the treatment of intractable urticaria.