We reported a case of a 69-year-old male who had been diagnosed with left eye glaucoma with surgical indication complicated by an eyesight view obstacle. His left intraocular pressure did not decrease regardless of the eye drop treatment he underwent at another hospital. At the initial visit to our hospital, his left intraocular pressure was 27 mmHg. As we noted marked tympanitic sounds in his abdomen, we prescribed hangekobokuto. After one month of his medication, his left eye intraocular pressure fell to 22 mmHg ; furthermore, the marked abdominal tympanitic sounds disappeared. Two years after his initial treatment, his left intraocular pressure still stayed generally within the normal range, and it did not require surgery. In this case, predominant sympathetic nervous system may have been the mechanism behind some cases of increased intraocular pressure ; therefore, the possibility that hangekobokuto reduces intraocular pressure by acting on this was suggested. As there have been no such reports that hangekobokuto itself has an effect on intraocular pressure decrease, this is considered as a novel case.

We experienced a case of post-operative complication and chronic pain due to left pyeloplasty and uterine myomectomy successfully treated with Kampo medicine. A 55-year-old woman underwent pyeloplasty for ureteropelvic junction obstruction, and ureteral stent for ureteral stenosis caused by synechia after uterine myomectomy. She suffered from post-operative complication and chronic pain, which was becoming severe, and had a depressed mood. She visited our outpatient clinic for Kampo therapy. We prescribed bukuryoingohangekobokuto on the diagnoses such as qi deficiency, qi stagnation, and water retention. Her symptoms disappeared with this formulation. This case suggests the importance of considering qi disturbance when we treat patients with chronic pain using Kampo medicine.

We investigated prescriptions and drug costs at admission and discharge for 35 patients hospitalized in Department of Japanese Oriental (Kampo) Medicine, Chiba University Hospital from September 2006 to October 2008. They recovered after Kampo therapy from various non-acute diseases. The number of western drugs decreased from 3.7 at admission to 2.7 at discharge, thus their drug costs per day significantly decreased from302.1yen to 227.6 yen. The cost of Kampo medicines themselves, on the other hand, did not decrease significantly. Total drug costs, however, were significantly reduced from 437.8 yen at admission to 348.0 yen at discharge, so patients' overall costs were reduced by 20%. These results indicated that the proper use of Kampo medicine for various diseases would reduce drug costs and the impact of treatment expenses on medical economics, with improvement in disease outcomes.

In the Guideline for treatment of chronic headache published by Japanese Headache Society, Ibuprofen and Acetaminophen are proposed for the acute treatment of migraine in children. But prophylactic treatment of pediatric migraine is not established. We report the efficacy of Kampo medicine for preventing migraine in children and childhood periodic syndromes. We use a variety of Kampo medicine for 9 pediatric migraine and periodic syndromes patients from 8 to 15 years old. All 9 patients improve their headache and associated symptoms including abdominal pain, vertigo, nausea and vomiting. After treatment the mean average of Headache Impact Test-6 (HIT-6) improve from 63.66 points to 45.77 points. Kampo medicines is effective for migraine in children and childhood periodic syndromes.

It is essential to prolong the term as possible in the treatment of threatened premature delivery. We report a case of threatened abortion successfully treated with hochuekkito. The patient was 31 year-old pregnant woman with lower abdominal pain. She was diagnosed to be at the risk of premature delivery on 21 weeks and 5 days of gestation. Intravenous ritodrine hydrochloride was started and she had to stay in bed. Severe side effects of ritodrine hydrochloride such as palpitation, tachycardia, tremor, nausea, and loss of appetite were appeared and she was consulted to our department on 23 weeks and 1 day of gestation. Those symptoms were markedly improved after administration of hochuekkito extract. She delivered a male infant of 1230g birth weight on 28 weeks of gestation. Hochuekkito suppressed severe side effects, and enabled to continue the infusion of ritodrine hydrochloride, suggesting the usefulness of Kampo therapy in the treatment of threatened premature delivery.

Wells' syndrome (eosinophilic cellulitis), whose etiology is idiopathic, is clinically characterized by solitary or multiple cellulitis-like eruptions which occur on the extremities and trunk. Corticosteroids are usually used for palliative treatment, but relapses are often observed. We observed an 8 year-old patient with Wells' syndrome successfully treated with Kampo medicines. In 2001, skin eruptions appeared on his extremities. In 2002, a histopathologic examination determined his disease to be Wells' syndrome, and corticosteroids were subsequently used for treatment. In January 2007, his skin eruptions worsened, and he first visited our outpatient clinic in May. After oral administration with keigairengyoto, his skin eruptions were slightly improved, but afterwards, they again worsened. In June, jumihaidokuto was administered instead of the former prescription, and the skin conditions had begun to improve. Because dry skin appeared in November, keigairengyoto was again added. With these treatments, his skin eruptions stably improved. In previous reports, Kampo medicines had not been used for the treatment of Wells' syndrome. This case, however, suggests that Kampo medicines are a candidate for the treatment of Wells' syndrome.

Arteriovenous fistulae are known to be one of the causes of intractable leg skin ulcers. Because they raise peripheral venous pressure, decrease arterial blood flow to peripheral tissue, and cause venous blood congestion, symptoms of skin coldness, edema, pain, dermatitis and skin ulcers may appear in the legs. We observed a 32 year-old woman with multiple intractable bilateral leg skin ulcers due to arteriovenous fistulae successfully treated with Kampo medicines. In 1999, skin ulcers, edema, and pain presented in both her legs. She was diagnosed has having arteriovenous fistulae with various examinations in 2003. She had subsequently been treated with topical preparations on her legs, analgesics and other palliative treatments, but as symptoms had not improved, she first visited our outpatient clinic in August 2006. After an initial oral administration of tokishakuyakusan extract for 6 weeks, her pain improved. Afterwards, ogikenchuto was added for symptoms of qi deficiency. Moreover, bushi powder was added for the treatment of pain exacerbated in cold conditions. After 6 months, the size of her skin ulcers was fairly reduced, and she had no need of analgesic drugs. In past reports, Kampo medicines have not been used for the treatment of intractable skin ulcers due to arteriovenous fistulae. This case suggests that Kampo medicines are a treatment option in this condition.

Boiogito is mentioned in Synopsis of the Golden Chamber, in which it is written to add ephedra herb for patients with cough at the end of the chapter. We experienced 4 chronic cough cases of wind-wetness syndrome or edema caused by pathogenic Wind successfully treated with boiogitokamao. Subjective symptoms such as heaviness when moving, heavy sweating, and body chills, as well as objective findings such as pallor, and a weak pulse in the most distal region of the right wrist were common in these patients. Moreover, not only cough, but also accompanying symptoms such as obesity, dysmenorrhea, and eczema were improved. Observation of these four cases suggests that boiogitokamao can be effective for the treatment of the patients with chronic cough due to wind-wetness syndrome / edema caused by the pathogenic Wind.

We report six cases with honton disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (Zhouhou fang) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.

We report six cases with honton disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (Zhouhou fang) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.