Many patients with palpitation consult outpatient cardiology departments. They may present with cardiac tuning abnormality (arrhythmia), which manifests as morbid palpitations. Appropriate diagnosis and treatment of palpitation are crucial to prevent adverse cardiac events. However, palpitations, in addition to anxiety and dyspnea, are often not considered as significant factor for morbidity in Western medicine. Conversely, Kampo (traditional Japanese medicine) can be used to treat the constitution of the patients, including those with or without disease diagnosed by Western medicine. However, there are no reports on the efficacy of Kampo in many examples. In this study, we diagnosed and provided appropriate Western medicine treatment for 101 outpatients with palpitation who consulted our department. We give priority to it if we evaluate the treatment of the disease of Western medicine was required (group W : n = 19). When an appropriate diagnosis could not be made by Western medicine, or when no therapeutic effect was noted with Western medicine, we administered Kampo medicine alone (group K : n = 62) or combination therapy (Kampo and Western medicine ; group KW : n = 20). The treatment efficacy was evaluated in each of the three groups. We observed high efficacy in all 3 groups (group W = 100%, group K = 96%, and group KW = 100%). Therefore, for patient with palpitation, combined treatment with both Kampo and Western medicine could improve their symptoms.

In auditory processing disorder (APD), hearing difficulties occur in noisy or otherwise difficult environments, despite no hearing loss. Most APD patients have developmental disabilities, weak cognitive function, or psychological problems. Here, we report a case of a child who was thought to have developed APD due to mental stress and had a good course using shokenchuto. The case was a 12-year-old girl. She began to be bullied 2 years ago, and from that time she began to find it was difficult to hear the words in a noisy environment. She visited our department and was diagnosed with APD without any abnormalities in various hearing tests. We administered her shokenchuto. After 12 weeks, she felt almost no inconvenience in hearing. She also regained her usual energy and became to be able to shrug off bullying without worrying too much. Afterwards, her symptoms subsided. After 20 weeks, the medication was discontinued.

Bruxism is a common condition often seen in daily practice. Although interocclusal appliances are often used, there are no established treatments to eliminate bruxism. Here, we report two patients who complained of bruxism and insomnia. Based on the diagnosis of Kampo medicine, we thought that stress was involved in the background of both cases. Therefore, we prescribed them yokukansan, and their symptoms improved. These results suggest that yokukansan may be effective for sleep bruxism and insomnia.

Kampo medicine containing Gardeniae Fractus is often used for agony of the chest, but there are few case reports about shishikankyoto. Here, we report a case of a 73-year-old woman with heat sensation in the chest and severe malaise successfully treated with shishikankyoto. She suffered from lung cancer five years previously, and received chemoradiation treatment. One year later, radiation pneumonitis developed, which was resolved naturally. After another year, she began to develop a slight fever, burning sensation and general malaise, which disappeared and recurred in cycles of about six months. She received Kampo medicine treatment for one year at another hospital, but lacked in improvement and was introduced to our hospital. We thought her symptoms were caused by deficiency heat pattern in the chest and cold in the epigastric region. By giving shishikankyoto in reference to a sentence in the Shang Hang Lun, her symptoms improved in about two weeks. Although, shishikankyoto is a prescription medicine with few reports, it is effective in a short period of time and is useful for similar symptoms.

We report two cases of older heart failure (HF) patients who improved pulmonary congestion and maintained functional capacity with tokishakuyakusan. Case 1 was an 83-year-old woman who previously treated with percutaneous coronary intervention for angina and had multiple comorbidities such as chronic kidney disease and rheumatoid arthritis. Despite of multiple medications including 3 kinds of diuretics, general fatigue that interferes with her daily life, marked pulmonary congestion, and leg edema remained. After prescription of tokishakuyakusan, urine volume increased rapidly and HF symptoms were alleviated so that 2 diuretics were successfully discontinued. Case 2 was an 88-year-old man with chronic atrial fibrillation and severe mitral regurgitation with worsening dyspnea on effort, paroxysmal nocturnal dyspnea, and leg edema. Tokishakuyakusan was effective for improving these HF symptoms and he returned to normal life without additional HF treatment. For elderly HF patients, tokishakuyakusan is considered to be effective to improve blood deficiency/stasis pattern and fluid retention, which enables these patients to make their daily life without being disturbed by severe HF symptoms.

Postoperative maxillary cyst is a late complication that occurs after maxillary sinus radical surgery. The only curative treatment is surgery, and endoscopic fenestration is currently performed in most cases. However, in some cases, it is difficult to form a permanent fenestration. Here, we report a case of postoperative maxillary cyst which was reduced by administration of kumibinroto and could avoid surgery. The case was a 58-year-old man. He received bilateral maxillary sinus radical surgery 40 years ago. He had swelling of his left cheek for half a year and took an antibacterial drug at a nearby doctor, but he was referred to our department because there was no improvement. We diagnosed him with a postoperative maxillary cyst based on CT findings, but it was considered difficult to form a permanent fenestration due to the small contact area between the nasal cavity and the cyst. He refused to puncture from the oral cavity, so we planned endoscopic surgery and administered kumibinroto to him. After 6 weeks, the swelling of the left cheek disappeared. After 12 weeks, CT showed shrinkage of the cyst, and surgery could be avoided. No further cyst shrinkage was observed, and we reduced the dose of kumibinroto after 20 weeks. He is now being followed up.

We encountered three patients with edema and menstrual disorder that was improved by boiogito. Case 1 was a 17-year-old woman with fatiguability and irritability, treated with kamishoyosan. After adding boiogito to kamishoyosan because of facial and foot edema, palmar sweating and weight gain, her menstrual period became regular. Case 2 was a 15-year-old woman with headache as well as facial and foot edema, who was receiving goreisan. She complained of knee discomfort and worried about weight gain even though she was thin. So we prescribed her boiogito, and her menstrual disorder improved. Case 3 was a 42-year-old woman with fluid retention, who suffered from general fatigue, coldness, and menstrual disorder. She was prescribed boiogito because of weight gain as well as foot edema and coldness, and her menstrual cycle gradually became regular. Boiogito appears to be effective in patients with menstrual disorder who show “exterior deficiency edema” that is maldistribution of fluid on the body surface, such as water retention, sweating, or edema. Boiogito resulted in a feeling of lightness. Even if water retention is not clearly observed, the symptoms of rapid weight gain, edema or edematous feeling, and subjective coldness may be indications for boiogito.

The case is a 38-year-old obese woman with complications such as idiopathic thrombocytopenic purpura, thyroid dysfunction, endometriosis, and uterine myoma. She had a wide variety of medical histories and had a long history of infertility treatment, and received various treatments. She has also undergone laparotomy for uterine myoma after the start of infertility treatment. We treated her with Kampo medicine for multiple complaints that appeared during infertility treatment. She received a combination therapy of tokishakuyakusan and shokenchuto, and after about 3 months, her symptoms improved and she became pregnant. In addition, bukuryoin and ryokankyomishingeninto, which were additionally used for hyperemesis gravidarum and cough during pregnancy, were also effective. The course of the pregnancy was uneventful and she gave birth to a girl at term. The girl is growing and developing normally without asphyxia, malformations, etc. It was suggested that it is necessary to pay attention not only to blood stasis and renal deficiency but also to spleen deficiency and consumptive disorder in Kampo medicine treatment for infertility and recurrent miscarriage.

One of the symptoms of COVID-19 is olfactory dysfunction. Most of them resolve spontaneously at an early stage, but there are some cases that remain as sequelae, and there is no established drug treatment at present. This time, we report two cases of olfactory dysfunction after COVID-19 successfully treated with Kampo medicine centered on kososan. Case 1 was a 32-year-old woman. She was diagnosed with COVID-19 eight months ago, and olfactory dysfunction remained after that. She was yin pattern and slight deficiency pattern, and tenderness was found in the groin. We prescribed her tokishigyakukagoshuyushokyoto. After 8 weeks of administration, she felt warm and well, but her olfaction did not change. Depression due to olfactory dysfunction was also conspicuous, so we administered her kososan in combination. Since then, her olfaction has gradually improved. Case 2 was a 17-year-old man. He was diagnosed with COVID-19 four months ago, and olfactory dysfunction remained after that. He was yang pattern and medium or slight deficiency pattern, and with noticeable signs of qi stagnation. We administered him kososan, and his olfaction has gradually improved.

To clarify the educational effect of the acupuncture and moxibustion practical training for a short time, we conducted a questionnaire survey of 112 fifth-year medical students gathering clinical experience for one hour of acupuncture and moxibustion practical training, including the therapeutic experience before and after the practical training. In 8 items out of 10, the percentage of “positively yes” responses after the practical training were significantly higher than before the practical training. The items that showed a large difference (range of change) in the percentage of “positively yes” responses before and after the practical training were “Do you think it is scientific? (+ 47.4% after the practical training),” “What is your general image? (+ 39.3%),” and “Do you want to use acupuncture and moxibustion in the future? (+ 39.3%).” Securing more opportunities to learn traditional medicine is desirable; however, the problem of limited time and personnel requires improvement. This survey showed a beneficial educational effect in a short time signifying the importance of implementing acupuncture and moxibustion practical training. Additionally, the possibility of expecting similar effects in other medical students and overall students in the medical field can also be expected.

In 2015, the Japan Council for Kampo Medical Education was established to create a basic curriculum for Kampo medical education that could be implemented in medical schools nationwide. After conducting a needs assessment, we decided on a lecture time of 240 minutes. To set learning objectives, we formed groups for “history,” “examination methods and patterns,” “effects of Kampo medicine,” “clinical cases,” “acupuncture and moxibustion,” and “evaluation.” The teaching contents were incorporated. Then, model slides and lecture guides containing these teaching contents were created, and textbooks based on these contents were published in 2020. In 2021, these overall efforts and contents were made public nationwide, providing an opportunity for the introduction of this curriculum at each university.

We focused on the traditional processing method which generates the superior quality of Yamato-shakuyaku. First, we assessed the historical literature written around Edo and Meiji period and rediscovered the traditional air drying method still inherited in Nara Prefecture. Then, we gathered and analyzed the data of medicinal plants production in Nara Prefecture among 1938 and 2019, and investigated the decline of local production and experienced agricultural techniques of peony through the transition of its yield. In order to visualize the ancient knowledge of crude drug manufacturers that contributes to the instruction of the skills for supply of seedlings, cultivation, and processing, we settled the meteorological observation devise at the outdoor drying shelf for 3 years, and recorded the real drying environment. When comparing the meteorological data with other cultivating area of peony using the estimated values of Agro-Meteorological Grid Square Data, the climate of Nara Prefecture was with high temperature and low humidity than other areas, and it seems to be quite suitable for air drying with adequate topography. The wind rose calculated by measured values of wind direction and wind speed showed the wind conditions in Nara that west wind was frequent in daytime and wind conditions are mildly but diversely changing. Among other producing areas of peony, the mechanical drying is major, whereas air-drying with low cost utilizing local environment features is still applied in Nara. We revealed the rationality of traditional methodology by digitization of meteorological factors which can be high added value.