Objective : This study aims to reinterpret Gyeolhyung (結胸) in the Shanghanlun (傷寒論) as a psychosocial-somatic mechanism by analyzing five clinical cases diagnosed with Greater Yang Disease-Gyeolhyung and treated accordingly. Methods : Five cases diagnosed with Gyeolhyung based on the Shanghanlun pattern-identification system were retrospectively collected from three Korean medicine clinics. Chief complaints, psychosocial triggers, symptom patterns, and responses to Hwangryeon-tang (黃連湯), Baekhogainsam-tang (白虎加人蔘湯), and Gamchosasim-tang (甘草瀉心湯) were reviewed. Results : Despite differing chief complaints-including tinnitus, dizziness, fatigue, halitosis, and cranial hyperhidrosis-all cases shared a common psychosocial background characterized by interpersonal tension, fear of social evaluation, and emotional suppression. Symptom patterns corresponded with Gyeolhyung pathology, and herbal medicine resulted in consistent improvement across neurogenic, gastrointestinal, and autonomic symptoms. Conclusions : The findings suggest that Gyeolhyung can be interpreted as a psychosocial-somatic condition in which interpersonal fear and emotional constraint disturb the stomach-autonomic axis, producing diverse clinical manifestations.

Objective: The purpose of this case study is to report the effect of Sogunjung-tang (SGJT) on Chronic Fatigue Syndrome (CFS) based on Shanghanlun diagnostic system. Methods: According to the diagnostic system based on the Shanghanlun provisions, the patient was interpreted as having the "Xinzhong Ji Er Fan (心中悸而煩)" pattern of provisions 102 and was treated with SGJT for 30 days. The treatment outcomes were evaluated using the Numeral Rating Scale (NRS) for palpitation, the Chalder Fatigue Scale (QOL-CFS), and changes in clinical symptoms. Blood tests including liver function were performed before the treatment to ensure safety. Results: After 30 days of SGJT administration, NRS for palpitation decreased from 9 at baseline to 0. The QOL-CFS score also improved from 28 at baseline to 5 after treatment. The patient reported marked improvement in fatigue, sleep quality, and daily functional capacity. No treatment-related adverse events or abnormal laboratory findings were observed during the treatment period. Conclusions: This study shows the effective treatment of Chronic Fatigue Syndrome using SGJT based on Shanghanlun provisions.

Objective : Rheumatoid Arthritis (RA) is a chronic autoimmune disease. We present the case of a 58-year-old woman with RA managed using the herbal medicine modified Sosiho-tang. Methods : A 58-year-old woman was diagnosed with RA 12 years ago. This patient was diagnosed with lesser yang disease pattern (少陽病) based on disease pattern identification diagnostic system by Shanghanlun provisions(DPIDS), and administered a modified Sosiho-tang. We used the Numeric Rating Scale (NRS), Clinical Disease Activity Index (CDAI), Korean Health Assessment Questionnaire-Disability Index (KHAQ-DI) to evaluate the effectiveness of the modified Sosiho-tang for RA. Results : According to DPIDS, the patient was diagnosed with provision 266. After 60 days of administration of modified Sosiho-tang, NRS and CDAI of RA, KHAQ-DI, and oral ulcers and fatigue showed improvement. Conclusions : Modified Sosiho-tang was effective to the patient RA diagnosed according to Shanghanlun provision 266.

Objective: The purpose of this study is to report a case of adolescent-onset rheumatoid arthritis presenting with severe pain in the knee, wrist, and plantar region, which was diagnosed with Lesser yin disease provision number 315 and treated with Baektong-tang (白通湯) based on the Shanghanlun Disease Pattern Identification System (辨病診斷體系). This report aims to explore the applicability of Lesser yin disease patterns and Baektong-tang to autoimmune inflammatory joint disease associated with overwork and constitutional exhaustion. Methods: The diagnostic process and prescription were conducted according to the Shanghanlun Disease Pattern Identification System, focusing on the Lesser yin disease category and the classical clause "少陰病 下利 脉微者 與白通湯". Clinical data were collected through structured medical interviews, physical examination, and follow-up assessments of joint pain, daily activity level, and general fatigue during a 45-day treatment period. Results: Baektong-tang (Allii Fistulosi Bulbus, Zingiberis Rhizoma, Aconiti Lateralis Preparata Radix) was administered for 45 days with good medication adherence and no adverse effects. Within 15 days, overall joint pain decreased from severe to moderate levels, and by 30 days the patient reported minimal pain, resumption of drum playing, and improved exercise capacity. At 45 days, daily function was largely restored, and the patient was able to enjoy social and musical activities without significant discomfort. Conclusions: This case suggests that Baektong-tang, a representative formula for Lesser yin diseasee with depletion and cold, can be applied to adolescent-onset rheumatoid arthritis accompanied by overwork, sleep deprivation, and constitutional hypersensitivity, when interpreted through the Shanghanlun Disease Pattern Identification System. Further prospective studies are needed to clarify the indications and mechanisms of Baektong-tang in autoimmune rheumatic diseases.

Objective: This case report was designed to contribute to a more advanced interpretation of provision 385 of the Shanghanlun through a retrospective evaluation of the clinical response to Hyeokgainsam-tang in a patient diagnosed with erosive gastritis. Methods: The therapeutic effect of Hoeyeokgainsam-tang on erosive gastritis was evaluated based on Numeral Rating Scale (NRS), Gastrointestinal Symptom Rating Scale (GSRS) and patient statements. Results : The patient was administered Hyeokgainsam-tang for a total of 84 days in accordance with Provision 385 of the Shanghanlun. During this period, epigastric pain showed marked improvement; the NRS score decreased from 6 to 0, and the GSRS score dropped from 13 to 0. Conclusions : This case suggests that Hyeokgainsam-tang, prescribed according to Shanghanlun provisions, may be effective in the treatment of erosive gastritis. Furthermore, the term '撞' in Provision 385 may be interpreted as a clinical phenomenon in which a localized mechanical impact is perceived within a visceral organ, as if aspecific region were being directly pierced or struck.

Objective: This study aimed to report a clinical case in which Hoeyeoksan was applied to Tourette disorder and to investigate its potential therapeutic mechanisms using network pharmacology. Methods: A 28-years-old male patient with Tourette disorder was treated with Hoeyeoksan for 75 days. The clinical course was analyzed, and network pharmacology was employed to predict the relevant genes, signaling pathways, and molecular mechanisms through which Hoeyeoksan may exert its therapeutic effects in Tourette disorder. Results: The 28-year-old male patient had longstanding Tourette disorder and recently experienced worsening symptoms associated with emerging anxiety and other neuropsychiatric complaints. During 75 days of treatment with Hoeyeoksan, the Korean version of the Yale Global Tic Severity Scale (YGTSS) score markedly improved from 114 to 8. Notably, tic symptoms, heat sensations, caffeine intolerance, and gastrointestinal discomfort showed substantial improvement within 15 days. Network pharmacology analysis suggested that the therapeutic potential of Hoeyeoksan may be mediated through modulation of dopaminergic signaling pathways and attenuation of neuroinflammation. Conclusions: These findings suggest that Hoeyeoksan may represent a potential therapeutic option for Tourette disorder. Further research is needed to validate and refine these observations.