Volume 8, Number 4 | Winter 2013

Clinical Report 2 (Kampo Medicine)
Autistic Spectrum Disorder, 5-year-old Boy

Hideaki Yamaguchi
Tosei General Hospital[Chief complaint]
Self-injury behavior, insomnia[History of present illness]
The patient was diagnosed with childhood
disintegrative disorder (CDD) at two and a halfyears of age, and went to a preschool in a
specialized facility. He visited a medical
institution around once every six months. He
knew only a few words and one two-word phrase,and exhibited a marked delay in language
development. He appeared nervous and restless,and panicked at subtle changes on a daily basis.
In a state of panic, he would hit his mother, anddisplay self-injury behavior by hitting his own faceand banging his head against the wall, whilecrying. He had trouble falling asleep, and suffereda sleep disorder, such as being able to sleep only
lightly. On his first outpatient visit, he tended toavert his eyes, and restlessly wandered about
crying and looking troubled.
[Diagnosis/Treatment]
Heart fire and liver fire, emotional weakness
yokukansankachinpihange extract
Tsumuragranules 5g twice a day
Tsumura kanbakutaisoto extract granules 2.5g
before sleep(The patient proactively took the aboveprescription mixed in cocoa.)[Progress]
The prescription had an effect from the day it was
taken, such that two weeks later, the patient’ssleep stabilized, and his panic and self-injury
behavior subsided dramatically.
Two months later, practice and preparation for aschool sports day caused the patient’s panic toincrease, so 5g of kanbakutaisoto wasadministered twice a day to alleviate thesymptoms. According to the patient’s mother, theprescription seemed to have an overall effect ofalleviating the symptoms from a level of 10 to 3,and QOL in the home improved significantly.
Ten months later, the patient entered primaryschool (special needs class), and has adapted to his
school schedule.
In recent years, emotional and psychologicalconditions are increasing among children.
Development disorders, in particular, aretranscending the bounds of medicine and arebecoming a social issue. Pharmacotherapy is one
means of treatment, but there are extremely few
psychotropic drugs that could be used on children.
Some Kampo drugs have a psychotropic effect, andhave been used mainly on adults. They may not be
strongly effective, but they are considered moresuitable to children than psychotropic drugs, as
they have little side effects. However, emotional
and psychological conditions among children aremodern phenomena, so the application of suchdrugs to children has yet to be established. I havethus referred to Chinese traditional medicine andcategorized Kampo drugs that could be used totreat the mind-state of children as follows.
Categorization of state of mind based on
traditional medicine, and applicable prescriptions
Category 1 (mainly emotional weakness, heart
blood deficiency, lack of courage)
Characterized by a worrying temperament, fear,
lack of confidence, insecurity, sense of pathos,etc.
Negative emotions such as depression,insecurity and fear mainly persist.
Prescription: kanbakutaisoto, kamikihito,keishikaryukotsuboreito, etc.
Category 2 (mainly liver depression qi stagnation)

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

19

Volume 8, Number 4 | Winter 2013Characterized by a sense of melancholy,insecurity, anxiety, hysteria, etc.
Physical stress is strong, and mood swings tend
to occur readily.
Prescription: shigyakusan, saikokaryukotsuboreito,
saibokuto, etc.
Category 3 (mainly excessive heart fire, flaring ofliver fire, gallbladder stagnation withdisturbance from phlegm)
Characterized by anxiety, short temper,restlessness, irritation, etc.
Excitatory symptoms mainly persist.
Prescription: yokukansan, yokukansankachinpihange,
daisaikotokyodaio, orengedokuto, etc.
In this case, panic symptoms of autism standout, but strong anxiety related to low feelings ofself-esteem was thought to be behind thosesymptoms, so kanbakutaisoto for Category 1 andyokukansankachinpihange for Category 3 wereprescribed simultaneously. As a result, thepatient’s symptoms were alleviated, and QOL of
his family also improved significantly.

20The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)