We experienced a refractory case of respiratory failure with CO2 narcosis after respiratory tract infection successfully treated with daikenchuto, ninjinyoeito, and bushimatsu. The patient was an 88-year-old woman with pulmonary tuberculosis sequelae and chronic obstructive pulmonary disease for which she had been receiving tiotropium, a budesonide inhalation suspension, and tulobuterol patches. She developed a fever and persistent dyspnea and was taken to our hospital by ambulance. Initially, artificial respiration was recommended because she had CO2 narcosis, but this intervention was rejected because of her advanced age. She showed persistent dyspnea and mild consciousness disturbance. Therefore, treatments by daikenchuto, ninjinyoeito, and bushimatsu were gradually introduced. As a result, her dyspnea, constipation, anorexia, and decreased consciousness improved, and the CO2 concentrations in arterial blood decreased with normalization of pH level. Artificial respiration management is the first-choice treatment for aggravated chronic respiratory failure with CO2 narcosis. However, when such medical management is not feasible, as in the present case, Kampo medicines may contribute to alleviating symptoms of respiratory failure. chronic respiratory failure, CO2 narcosis, daikenchuto, ninjinyoeito, bushimatsu

A 56-year-old woman visited our hospital with a persistent fever of 38 . Chest radiography and plain computed tomography (CT) showed scattered infiltrative shadows in both lung fields. She was diagnosed as having pneumonia and received antimicrobial therapy. Subsequently, the pneumonia was improved and defervescence was observed. Although pneumonia appeared 1 and 5 months later, antimicrobial therapy again recovered the patient's condition. At that point, we noticed from the patient's medical history that she had developed pneumonia 2 3 times a year over the past 4 years. Therefore, we prescribed low-dose macrolide therapy and an expectorant as prophylactic treatment. However, she developed pneumonia again after 4 months, but recovered with antibiotics.Jiinshihoto was administered, because the pneumonia repeated over short periods. Subsequently, no pneumonia developed during the 1.5 years following Jiinshihoto administration. In Japan's aging society, death due to pneumonia has increased and will increase. In many patients, antimicrobial therapy alone results in recurrent pneumonia despite of temporary improvement. Furthermore, because it is important to prevent the development of pneumonia, this case is considered of value in Japan, as Jiinshihoto proved effective in preventing recurrent pneumonia.the aging society, pneumonia, Jiinshihoto