Volume 5, Number 1 | Spring 2010

Clinical Report 2 (Japan)
One Case that had Effect of Bakumondoto on Post-Herpetic
Neualgia caused by Yin Deficiency
Mihoh Koga, M.D. – Kampo Specialist
Division of Clinical Pharmacology and Therapeutics,
Division of General Medicine

Jikei University School of Medicine

Different types of individual therapies havebeen attempted to treat post-herpetic neuralgia,
which is one of the conditions for which Kampo
medicines are very frequently used. As we
recently had a successful case that had benefits ofbakumondoto, we will hereunder report it withour observations and a bit of our views.

the Department of Neurology and Internal
Medicine of a certain university hospital, he hadreceived MRIs due to walking with unsteadysteps and it was found that there were small
cerebellar infarctions x 3 places. He had been toldby the physician that the symptoms would not be
associated with the infarctions and Perkinsonim
was suspected, for which Madopar had been
administered “experimentally to see his reactions
to the medication.” When he visited us, it did notseem that words did not come out easily although
he had the dry tongue that prevented his smooth
speaking. While talking, he incessantly drankwater from a plastic bottle.

[Case]
Male of 85 years old. Small build and thin, aged
person with fair complexion.

[Drugs currently being taken]
Candesartan /Disopyramide / Arotinolol /Magnesium Oxide / Biofermin / Neurotropin /[Chief complaint]

Trimebutine

1. His speech began to slur 2 to 3 years ago.

keishikaogito+Processi

2. 10 years suffering of postherpetic neuralgia

Dipotassium(left lumbar area L3/Level 4).

Brotizolam / Etizolam

3. Habitual constipation.

the left lumbar area L3/Level 4 and then PHS
was induced. The pain was severe and even therubbing of clothing against the skin caused pain.
The patient had been receiving treatment by thepain clinic of a certain university hospital withthe prescription of keishikaogito+Processi Aconiti
2.5months.

/

Aconiti

Clorazepatate→

Levodopa/

Radix

/

Zolpidem/

He had been living in a care facility for about a

About 10 years ago, herpes zoster developed infor

Amitriptyline[Living environment][Origin and course]

Radix/

Hesaidthatyear.
[Findings]
Food intake, frequency, and time were well
regulated so that he had a weight loss to 44 kg
from 50 kg. Now he prepared by himself
in-between snacks and eat them. Although hewas sensitive to cold by nature, he claimed thatthethe feet felt warm and burning in this winter.

administration of this medicine brought a pain

There was no itchy sensation in the skin but therelief for a while. Lying down on the bed for a

tongue was dry and red colored. The abdominal

clinical examination produced pain.

strength was reduced with the soft abdominal

He had had the feeling of being unable towall and stools were palpated.

speak articulately and properly for 2-3 years. At20

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

Volume 5, Number 1 | Spring 2010

[Diagnosis]

The author considered that the root cause ofThe dryness of the body was intense and his

the patient’s symptoms was yin deficiency lacking

pattern/syndrome was diagnosed as being caused“the amount of fluids” to enrich yin and that theby yin deficiency.

pain[Treatment]

nourishment.” As the mouth was severely dry and

Neurotropin, Amitriptyline, and famotidine

wascausedbythe“stagnationofthe large intestine of the stomach-intestines wascausing the side effect of dry mouth werealso

discontinued. Likewise, Biofermin and Levodopa

stomach-yin

were discontinued because of the uncertainty of

Bakumondoto which works on the lung, wasthese drugs’ effectiveness. keishikaogito+Processi

effective because the inextricable relationshipAconiti Radix was also discontinued as itexists between the large intestine and the lung.

contributes to dryness.

dry,leadingtodeficiency

constipation,
wasfirstlyapproached.

The pain-relief action ofAconti tuber, one of the ingredients of this Kampo
medicine may help kill pain temporarily, but its
continuedusehasahigh

potentialof

exacerbating 2 above.
The administration of 3 packs each of TSUMURA

bakumondoto（Tsumura & Co., Ltd., Tokyo, Japan）
and TSUMURA mashiningan（Tsumura & Co., Ltd.,Tokyo, Japan） was started in equal doses threetimes a day.
[Treatment and course]
The amount of saliva increased within 2 weeks
and the patient became aware that he was able tospeak smoothly. However the pain remained as ever.
After 5 weeks, he did not complain of the painin the lumbar region in abdominal examinations.
After 8 weeks, when he was asked about thepain, his reply was “have forgotten about it!”His complexion was good with healthy glow.
He was aware of skin moist. Sleep improved andbowel movements became regular.
Same medication was continued.
In this patient, the symptoms might have
improved only by excluding excessive drugs andan inappropriate Kampo medicine.
This was a case that provoked the author tothink about iatrogenic diseases.
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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