Volume 11, Number 1 | Spring 2016

Clinical Report 2 (Kampo Medicine)
Case Studies from Ehime Prefectural Central Hospital (4)– Situations Where Western Medicine Cannot be Used–

Genki Shimizu, Hiroshi Kakuto, Den-ichiro Yamaoka
The Internal Departement of East Asian Traditional
Medicine of Ehime Prefectural Central Hospital

cold knees and feet and stiffness in his lower back, so hewas referred to the East Asian Traditional Medicine
Department in September 2015.
[Physical health]his feet are susceptible to swelling. He tends to get leg[Case 10 (Dr. Shimizu’s case)]
Successful treatment of cold feet and ambulation difficulty
in a 90-year-old man

cramps in the morning when waking up. He cannot sit on
the heels of his feet on the tatami mat. He has a lot of urine
at night, and goes to the toilet every hour. No symptoms[History of past illnesses]
Herpes zoster at age 40, compound fracture of left leg andfracture of right hand as traffic injuries at age 56, onset ofdiabetes at age 64, development of high blood pressure atage 65, surgery for bladder tumor at age 89of hot flashes. No sense of fatigue. Good bowel
movement. Good sleep. Good appetite.
[Observations]
Uses a wheelchair to visit the hospital. Tongue:
Geographic tongue, dark red. Pulse: Smooth. Abdominal[Oral medicine]
Linagliptin 5mg, 1 tablet once a day after breakfast
Glimepiride 0.5mg, 0.5 tablet once a day after breakfast
Silodosin table 4mg, 2 tablets twice a day after breakfast
and dinner

symptoms: Abdominal strength 2/5, weakness of thelower abdominal region. Strong coldness in lower legs.
[Diagnosis]
Kidney yang deficiency, fluid retention[Progress][External medicine]
Loxoprofen sodium hydrate 100mg, applied once a day
Diclofenac sodium 1% gel, applied to upper arm once aday

The patient was prescribed goshajinkigan extract granule7.5g three times a day after each meal, for three weeks. By
his return visit three weeks later, the coldness and edema
in his feet had improved, and his frequency of nighttime[Life history]
Smoking: 20 × 20 years (ages 23 – 42); no drinking;nursing care service 3 days/weekurination decreased, such that he goes to the toilet only
three times during the night, where he used to go every
hour. His feet had come to become warm even while[Occupational history]

sleeping at night.

Ex civil-service worker[Allergy][Case 11 (Dr. Kakuto’s case)]

None

Bukuryoshigyakuto for hiccups in a 61-year-old man[Chief complaint][Chief complaint]

Cold feet, ambulation difficulty

Hiccups[History of present illness]
The patient has been visiting the orthopedic department
2014

scapulohumeral

duetoosteophytic

periarthritis

in

both

spondylosis,
shoulders,

osteoarthritis in both knees, and cervical spondylotic
myelopathy (C3/4). From January 2015, his leg
movements became difficult. Surgery was recommended,
but due to his old age, the patient did not wish to undergo
survey, so the wait-and-see approach was decided to be16

improved somewhat, but he still displayed symptoms of

The patient has had lower back pain for some time, andType 4 Cases

sincetaken. With rehabilitation, the patient’s leg movements[History of past illnesses]
The patient visits the dermatology department in ourhospital every three months for MCTD treatment
Oral medicine: Prednisolone 5mg, Nifedipine, Beraprost,Alendronic acid
[Life history]
Smoking: 8 × 40 years
Drinking: 7 times/week; Type: 1 canned beer

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

Volume 11, Number 1 | Spring 2016

Eating: 3 meals/day regularly
Occupation: Assembly of farm equipment[History of present illness]
On October 8, XXXX, the patient developed a fever andsore throat, and came to our hospital. Diagnosed withacute epiglottitis, he was immediately admitted that dayand received treatment by antibiotic and a steroid. He
showed good progress, but from around October 13,
hiccups began to occur along with nausea. He consulted
the Gastroenterological Medicine Department, where hereceived gastroscopy and other inspections, but noabnormalities were found. Even after being discharged on
the 14th, the hiccups continued, such that the patient said
he could not sleep at night and could not stand it anymore.
He therefore made a return visit to the General Medicine
Department after being discharged.
[Progress]
On the patient’s first visit (Oct. 20), he was prescribedChlorpromazine 25mg to be taken as needed + Tsumura
Hangeshashinto

7.5g.

Thepatient

said

theChlorpromazine had an immediate effect, but made him
dizzy and unsteady, and that the effect lasted for only
about 30 minutes.
Second visit (Oct. 22): The patient was referred to the East
Asian Traditional Medicine Department and wasprescribed shiteito (decoction), but it did not work
effectively.

[Summary]
I have three teachers. One is the late Dr. Yoshinaru
Fujioka, a cultural anthropologist who developed theimage theory, another is the late Dr. Judo Ono, whotaught me Jungian psychology and psychiatric hospitaltreatment, and the other is Dr. Hidehiko Mitsufuji, first
director of the East Asian Traditional Medicine
Institute, who developed the chronological (timeseries) analysis method and taught me about
moxibustion and Kampo. Owing to these threeteachers, I have found the path to take and a place tostand, and now have two apprentices. I have also
received supervision from Dr. Hiromichi Yasui inpresenting case reports herein. Needless to say, it ismeaningful to summarize daily cases, but to have theopportunity to present them within KAIM has been atruly great honor. We hold a conference every morning,and begin by offering a silent prayer so that we mayinteract with all patients who come to our hospital, theirfamilies, and other staff members in a safe, appropriate
and caring manner. To this, we have recently added thephrase, “from the rural bedside to the global podium,”with hopes of presenting our daily clinicalachievements on the global stage. Through theadministration of East Asian traditional medicine, weaim accumulate clinical practice with an eye towardeven higher global podiums.

Third visit (Oct. 24): The hiccups continued, and thepatient said he was so tired that he wants to lie down.
Tongue: Slightly dark purple, small amount of yellow
coating toward the back, slight varicosis
Pulse: Sunken and weak
Moderate abdominal strength. Epigastric discomfort
and resistance.
When bukuryoshigyakuto (Kanzo (licorice) 4.5g, hobushi(prepared aconite tuber) 2g, ninjin (ginseng) 2g, kankyo(steamed ginger) 1.5g, bukuryo (poria) 4g) wasprescribed, the hiccups disappeared in half a day and did
not occur thereafter.

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

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