In order to examine the effectiveness of Kami-kihi-to for changing bone mass, we measured for osteopenia in ovariectomized (OV) rats using two methods: computed X-ray absorptiometry and a metabolism measuring system.
Materials and methods: 24 female Wistar rats (8 weeks old, 160-180g) were divided into three groups. Group one and group two Wistar rats were OV rats in which systemic osteoporosis was induced. After that group one (OVX [Kampo]) was administered Kami-kihi-to (500mg/kg) for 6 months. Group two (OVX [CTL]) was administered only water. Group three (NR) was untreated as the control. In each group, bone mineral density was measured before starting treatment and after 1, 3, and 6 months of treatment, and locomotor activity was determined before starting treatment and after 6 months of treatment.
Result: Bone mineral density showed little change over 6 months in the NR group. However, it was significantly lower in the OVX (CTL) group than in the NR group 3 months after ovariectomy. But in the OVX (Kampo) group, its decrease was obviously inhibited after 6 months of treatment compared with the OVX (CTL) group.
Moreover, in the NR group, the pattern of activity was regular. In the OVX groups, there was no clear difference between the active and resting phases and the pattern of activity was irregular. In the OVX (Kampo) group, the pattern of activity became diphasic, with clear active and resting phases as was observed in the NR group.
Conclusion: These results demonstrated that the pattern of regular activity affected increase of bone mass secondary due to the administration Kami-kihi-to.

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We treated two patients with rheumatoid arthritis (RA) who demonstrated different signs from the perspective of traditional medicine. The first case was a 73-year-old woman. In 1977, she consulted a nearby hospital due to bilateral knee joint pain. Her condition was diagnosed as RA. In 1984, she consulted our department for Stage IV and Class III disease. She was treated with Keishi-ni-eppi-itto-ka-ryojutsubu-kagen, and her condition stabilized. In 1994, she received total replacement of the bilateral knee joints. Her ADL increased, but pain at her bilateral wrist, elbow, shoulder and ankle joints persisted. Although she was treated with Yokuininto, as well as bucillamine and salazosulfapyridine, arthralgia persisted. In 1996, her condition was as follows: general malaise, pain at the bilateral shoulder and elbow joints, severe deformity at the wrist joints, dry skin and slender limbs. She walked with a cane. Therefore, we changed the formula from Keishi-shakuyaku-chimoto to Daibofu-to. Thereafter, her symptoms significantly decreased. The second case was a 50-year-old woman. In 1994, she suffered from pain in the right hand, bilateral feet and knee joints. Her condition was diagnosed as RA at a local hospital. In 1996, polyarthralgia increased and she consulted the department of orthopaedic surgery in our hospital. She was administrated bucillamine, but it was discontinued due to eruptions. Then she consulted our department. She was first treated with Keishi-ni-eppi-itto-ka-ryojutsubu, and then with Yokuininto, which did not change her symptoms. Therefore, we tried several DMARDs; however, her condition worsened. In June 2000, her laboratory data were as follows: RF 860U/ml, ESR 72mm/hr, CRP 4.0mg/dl. Although she complained of pain at the bilateral wrist, elbow and ankle joints, there was no deformity in the bilateral wrist or finger joints of either hand. She was a medium-sized person, and without dry skin or edema at the limbs. The administration of Daibofu-to improved her symptoms as well as laboratory data after 3 months of treatment.
The clinical signs of case 1 were in accordance with the traditional indications for Daibofu-to. In contrast, those of case 2 differed from these indications with regard to blood-deficiency, since there was no dry skin, change in the nail, dizziness or deformity of the joints. These observations suggest that a subset of patients with RA, who have poor deficiency of blood or Ki, may be another population that can be successfully treated with Daibofu-to.

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Choto-san was administered to 6-week-old spontaneously hypertensive rats (SHR) at the usual dose used for humans and at a 10-times higher dose, and its effects on blood pressure and the autonomic nervous system were examined. Significant blood pressure elevation was noted in the SHRs administered with the 10-fold dose, but no such changes were observed in the SHRs that were administered the usual human dose. Since the urinary levels of adrenaline and noradrenaline and the granulocyte count significantly increased in the 10-fold dose group, the elevation in blood pressure in this group appears to be attributable to stimulation of the sympathetic nervous system. Accelerated sympathetic nervous activity is noted in SHRs during the growing stage, and the excessively high dose of Choto-san probably further stimulated the sympathetic nervous activity.

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We report two elderly cases in the extended care unit who were successfully treated for emitting a strange squealing sound with Sansonin-to. Case 1 was a 97-year-old female who was hospitalized with a strange squeal after repeated aspiration pneumonia. She made this strange sound especially during the night. This sound disappeared with the administration of Sansonin-to (TJ-103: 7.5g/day) except at the times of position change and diaper change, and she also became able to eat after practicing swallowing. Case 2 was an 80-year-old female who was hospitalized after a cerebral hemorrhage. She also made a strange squealing sound during the night. After administration of Sansonin-to, this sound was decreased, and she became able to sleep well at night and live actively with rehabilitation training in the daytime. With an aging society, troublesome behaviors due to dementia will be an increasing problem. These cases suggest that there may be certain conditions of elderly nighttime delirium that are treatable with Sansonin-to.

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The Oriental medical therapies are increasingly used in medical treatment in conjunction with the Western medical health care system in our country. As Oriental medicine and Western medicine are based on different scientific systems, there is no curriculum of Oriental medicine in Western medical school education. In 1996, we investigated opinions about Oriental medicine among medical students and teachers at Showa University. A mini follow-up survey was done in 1999 and 2000. Awareness of Oriental medicine was still limited, but those surveyed were remarkably interested in Oriental medicine. Moreover, they recognized Oriental medicine as an important and useful tool for the care of illnesses that do not respond to Western medicine. About 40% of the medical doctors at Showa University hospitals used Oriental medicine with their patients in 1996, and traditional knowledge was learned in its own way. According to the pharmaceutical department of Showa University, both the number and variety of Kampo prescriptions increased between 1996 and 2000. These results suggest that it is necessary to properly learn Oriental medicine from the foundations during medical school. More research on Oriental medicine in terms of clinical and basic science is necessary, and the opportunity to exchange information about Oriental medical diagnosis and treatments should be included in postgraduate curricula.

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