In Chinese medicine, Saiko-ka-ryukotsu-borei -to (SRT; Chai-hu-jia-long-gu-mu-li-tang) and Saiko-keishi-kankyo-to (SKT; Chai-hu-gui-zhi-gan-jiang-tang) are frequently used for patients with nervous constitutions who exhibit psychoneurotic symptoms. Specifically, SRT is used for patients of the excessive constitution type (Shi Zheng), and SKT is used for patients of the deficient constitution type (Xu Zheng).
In this study, in order to clarify the action of SRT and SKT on the central nervous system, the effects of these formulas on the monoamines and their metabolism in discrete brain regions in mice were examined.
1) Single-dose administration of SRT and SKT increased the levels of neurotransmitters and stimulated the metabolism in the dopaminergic nervous system of the corpus striatum (including the serotonergic nervous system for SRT).
2) Repeated administration of SRT stimulated the metabolism in the dopaminergic nervous system of the hypothalamus and hippocampus, and inhibited metabolism in the adrenergic nervous system. On the other hand, SKT stimulated dopamine metabolism in the hippocampus and inhibited the metabolism of serotonin.
From these results, it became apparent that single-dose administration of SRT and SKT caused the hyperfunction of the dopaminergic nervous system, and that repeated administration of the agents caused the hyperfunction of the dopaminergic nervous system and the dysfunction of the serotonergic nervous system. This suggests that the actions of SRT and SKT on the central nervous systems may exert an influence on the regulation of psychoneuroic symptoms by stimulating the doperminergic nervous system and inhibiting the serotonergic nervous system.

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In order to determine the effectiveness of Orengedoku-to in the treatment of schizophrenia, Orengedoku-to was added to the drug regimens of 10 patients who had been hospitalized with onset episodes or acute exacerbation of this condition. Before Orengedoku-to was added, the schizophrenic symptoms associated with the active phase had already been ameliorated with administration of antipsychotic drugs such as haloperidol for 4-12 weeks, with administration continuing at least two weeks after these symptoms had stabilized. Symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS) three times: before Orengedoku-to was added, immediately following cessation of administration, and four weeks after administration had ended. The BPRS scores indicated significant decreases both immediately following cessation of administration and four weeks later (from 36.3±9.8 to 30.5±6.7). In particular, significant improvement was noted for the symptoms of guilt feelings, depressive mood, suspiciousness and excitement. These improvements were not thought to be due to haloperidol, because the plasma haloperridol levels did not change. No adverse effects were noted.

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Isho-ho was used to successfully treat three cases of muscular weakness. The first case was a 59-year-old woman. In May of 1993, she began to suffer from a feeling of general lethargy. The condition was diagnosed as multiple myositis, and prednisolone was administered. However, since she still experienced loss of strength in the lower limbs, she was introduced to the authors' department for treatment in August of 1994. Administration of Isho-ho improved the loss of strength in the lower limbs and increased her grip strength.
The second case was a 42-year-old woman who complained of unusual sensations in the tips of her fingers and toes starting in mid-September, 1994. In November of the same year, she began to experience a loss of strength in the limbs. In February of 1995, the condition was diagnosed as chronic inflammatory demyelinatory multiple neuropathy by the same department, and large doses of steroids were administered. Although this treatment delayed the loss of strength in the lower back and legs, actual improvement in the condition did not occur until Isho-ho was given.
The third case involved a 63-year-old man who began to experience a loss of strength in the lower limbs in 1984. In 1988, the loss of strength became pronounced. In June of the same year, he sought treatment at the authors' department, and the condition was diagnosed as bulbar myelinic muscular atrophy. In October of 1993, he was unable to get out of bed unassisted, and was admitted to the authors' department. He was given Isho-ho, and reported a decrease in the feeling of a loss of strength in the lower limbs, and a disappearance of greater pectoral muscle spasms. These results suggest that Isho-ho is not only effective for loss of strength in the lower limbs, but may also be efficacious for loss of strength, numbness and muscle spasms in the upper limbs.

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Sixteen male swine were utilized to study the occurrence of acetylcholine (ACh) induced coronary spasm using catheters. The left anterior descending coronary arteries (LAD) of the swine were denudated by catheterization under anesthesia. The swine were divided into three groups and fed for four weeks. Group A received Tokishakuyaku-san (0.66g/kg/day; Tsumura Co. Ltd.; n=6) in addition to the basal rations; group B received Mokuboi-to (0.25g/kg/day; Tsumura Co. Ltd; n=5) in addition to the basal rations; and the control group were fed for four weeks on the basal rations alone. The Kampo formulas were administered via stomach tubes in groups A and B.
Coronary spasms induced by catheter administration of ACh (100-250μg) were evaluated by elevation of the ST segment as measured by electric cardiography, and vasoconstriction of the LAD as ascertained by cineangiography.
The ACh-induced coronary spasms were found to either be of the diffuse type or LAD segmental type. Coronary spasms were noted to occur at a frequency of 5/13 in group A, 5/12 in group B and 7/13 in the control group, without significant differences among the groups. Groups A and B, however, exhibited a tendency towards a decreased rate of coronary spasm (40%) when compared to the control group (53.8%).
The vasoconstriction rate (VCR) was also calculated, interpreted as a morphological index of spasms as proposed by Takeuchi (1974). The VCR was higher in the spastic segment of the LAD than in the non-spastic LAD. It was suggested that Tokishakuyaku-san and Mokuboi-to have antispasmodic effects and may reduce the occurrence rate of spasms in swine LAD.

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The author treated a 70-year-old woman suffering from pneumatosis cystoides intestinalis, who complained of diarrhea and bleeding, with Kampo medicine. The formula Keishi-ka-shakuyaku-daio-to-ka-bosho was prescribed, and the patient's symptoms disappeared. Approximately six months later, colonoscopy revealed normal intestinal mucosa.

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Sairei-to was administered to 19 women who had experienced recurrent abortion of unknown cause, at a dose of 8.1g/day. Their prognosis of pregnancy was evaluated by observing the changes in autoantibody titer over time. Sixteen of the 19 women became pregnant, and 11 of these patients delivered live newborn infants. All of these newborn infants were within normal range in body weight, and had Apgar scores of 8 points or more (at one minute). Seven women were positive for autoantibodies. Four of these seven women showed a decrease in antibody titer or diasappearance of autoantibodies following treatment with Sairei-to, and became pregnant with good prognosis. The remaining three women, however, showed no changes in antibody titer. Two of these women had unsuccessful pregnancies, and one had a successful pregnancy and delivery. No adverse drug reactions were noted in either mothers or infants. These results suggest that Sairei-to possesses excellent clinical efficacy in women with recurrent abortion of unknown cause. Use of Sairei-to in such cases is thus likely warranted, although further investigation is required to clarify the mode of action and to establish the optimal dosage regimen.

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The authors developed an innovative apparatus for analyzing pulse waves which uses a new type of pulse sensor. Based on the principles of Oriental medicine, this pulse wave machine takes measurements from the radial artery to determine the subject's state of health. Three sensors were used in place of the fingers to assess changes in the pulse wave pattern induced by reducing pressure in a cuff. A cuff with sliding components proved to be the most suitable in that it was less likely to be affected by the subject's movements. Using this type of cuff, the authors were able to observe the pulse-wave amplitude as cuff pressure was reduced after the blood flow had been stopped. The signal in each channel changed according to the degree of pressure reduction, and a characteristic pulse wave pattern was produced. This pattern enabled the authors to observe how the pulse behaved under each sensor and how the pulse wave changed. The authors were also able to observe and measure the condition velocity as the artery opened as well as assess the condition of the palmer arterial arch.

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