The present experiments were performed to investigate effects of a Kampo (Japanese herbal) medicine, Kambaku-taiso-to (Gan-mai-da-zao-tang), on incidence of yawning in rats. Physostigmine, a cholinesterase inhibitor, 0.05-0.1mg/kg s. c., induced yawning responses with a marked effect at 0.05mg/kg. Pilocarpine, a muscarinic receptor agonist, 1-2mg/kg s. c., also induced yawning responses, the maximum effect being observed at a dose of 2mg/kg. Talipexole, a dopaminergic D-2 receptor agonist, 0.02mg/kg s. c., also induced yawning. Kambaku-taiso-to, 250-1, 000mg/kg, was orally administered 30min before injection of physostigmine, pilocarpine or talipexole. The yawning induced by both cholinergic and dopaminergic agents was reduced in a dose-dependent manner by Kambaku-taiso-to. All the yawning responses to cholinergic and dopaminergic agents were also reduced by rauwolscine 0.5mg/kg, yohimbine 2.5mg/kg, α-2 adrenoceptor antagonists, and by scopolamine 0.5mg/kg—muscarinic receptor antagonist. The present findings thus suggest that Kambaku-taiso-to exerts a suppressive effect on the incidence of yawning, and dopaminergic and cholinergic suppression and the indirect suppressive mechanism mediated by the central adrenergic nerve are associated with this suppression.

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A 43-year-old diabetic man with a diabetic history of 8 years had been treated with insulin (Penfil 30R), 12μ in the morning and 4μ in the evening, for two months. The patient had only slight numbness and pain of the inferior limbs until **********, when he complained of intractable pain in the left back. The pain spread generally except for the face, bilateral palms and the pen-anal area in a few days. Although vitamin E, epalrestat, nonsteroidal anti-inflammatory drugs (NSAIDs) and Gosha-jinki-gan were not effective, Mao-bushi-saishin-to was very effective for the intractable pain, Hochu-ekki-to was effective at reducing succeptibility to fatigue, but had no effect on the intractable pain. Diabetic control gradually became good with combination of Mao-bushi-saishin-to and Hochu-ekki-to in two months. HbAlc improved from 10.2 to 6.5% about two months after the beginning of treatment with Mao-bushi-saishin-to and Hochu-ekki-to. Therefore, insulin was discontinued five months later. In conclusion, combination of Mao-bushi-saishin-to and Hochu-ekki-to was useful for diabetic control in a patient with intractable pain.

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We experienced a case with symptoms ranging between greater yang and lesser yang disease after fluid administration. A 62-year-old woman complained of abdominal fullness, systemic feebleness, dull headache and buzzing in the ear. As she had the symptoms of greater yang disease such as chillness, fever and headache, and those of lesser yang disease such as vertigo, bitter taste in the mouth, thirst and fullness beneath the heart, she was diagnosed as having the complication of greater yang and lesser yang disease. As a result, fluid administration was stopped and Shirei-to was administered. The following was found; eliminated systemic feebleness, restored appetite, improved fullness beneath the heart and loss of body weight. Saikokeishi-to was effective for nausea and sense of epigastric pressure. The patient recovered her vitality sufficiently to travel. For cold and pain of legs and loins, Toki-shigyaku-ka-goshuyu-shokyo-to was effective. Fluid administration is usually for alimentation and the treatment of dehydration, however, it should be indicated with caution for common cold syndrome.

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To clarify the correlation between pulse, appearance of the tongue and abdominal palpation signs as measured by Kampo medicine diagnostic techniques, we investigated 488 cases who received health screening. In addition we investigated the effects of smoking and drinking alcohol on pulse, tongue and abdominal palpation signs, and also the correlation between the findings of blood biochemical tests, and the pulse and appearance of the tongue, and obtained the following results.
1) In normal pulse the abdominal power and the tension of lower abdominal wall elevate, and the subjective palpitations of the upper umbilicus and the fluid sound in the stomach upon palpation were faint.
2) In elevated pulse abdominal power increased and the subjective palpitations of the lower umbilicus were faint.
3) As the oppressive pain on bilateral area near the umbilicus increased, the petechia often occurred.
4) The epigastric throbbing pulsation over epigastric region showed the positive correlation with transverse dehiscence.
5) Positive correlation was shown between the oppressive pain on the left area near the umbilicus and the purple tongue coating.
6) Smokers are apt to have red or purple tongue and tend to show yellow, thick, or ? residue-like (_??__??_) tongue coating. During abdominal palpation the positive correlation was shown between the frequency of smoking and the tonus of the left rectus abdominis muscle.
7) The amount of drinking alcohol and the abdominal power show positive correlation, and negative correlation with the subjective palpitations of the upper umbilicus.
8) The value of hemoglobin and hematocrit were often increased when a red tongue coating, purple tongue coating, petechia or a thick tongue coating were shown, and were decreased in ? emaciation (_??__??_).
9) The value of amylase showed a negative correlation with the red, thick, ??_??__??_, ? residue-like (_??__??_) tongue coating.

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Keishi-ka-ogi-to or Keishi-ka-ryukotsu-borei-to was administered to two patients with bronchia asthma. Patient 1 was a 52-year-old woman, and patient 2 was a 40-year-old man. In both cases, asthma attacks began in adulthood and occurred in any season. According to the criterion of asthma severity established by the Japanese Society of Allergology, patient 1 was severe and patient 2 was moderate. Patient 1 was in the condition of hypofunctioning (Kyo-Sho), and her asthmatic state was improved with administration of the Kampo extract, Keishi-ka-ogi-to, which is a kind of Ho-zai. Patient 2 was a case of psycho-modified asthma and his asthmatic state was improved with administration of the Kampo extract, Keishi-ka-ryukotsu-borei-to, which is a kind of tranquilizer (An-shin-zai).

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We administered active vitamin D (AVD) to female patients with osteoporosis at a dose of 1μg, or Kami-kihi-to (KKT) at a dose of 7.5g every day for 6 months. To measure bone mass in patients with osteoporosis we employed the computed X-ray densitometer (CXD) method and examined change of bone mass and blood biochemical analysis in patients on long-term therapy with AVD or KKT. Patients with osteoporosis were divided into three groups: Control group, AVD group and KKT group. One year after administration, the bone mass of AVD and KKT groups significantly increased compared to that of the control group. Moreover, the KKT group clearly showed an increased red blood cell (RBC) count and an improvement of the simple menopause index (SMI) which correlated with bone mass and induced hemopoiesis. Two years after administration, the difference in bone mass between the AVD and control groups further increased. In contrast, the KKT group did not show any recovery of osteoporosis, anemia or SMI compared with 1 year previously. This indicates that the increase in bone mass associated with AVD is transient. These results demonstrate that KKT gradually activated bone metabolism and indirectly increased bone mass. Further modified methods of KKT administration such as increasing dose and duration may have potential for the treatment of osteoporosis with reduced cortical bone formation.

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