In the fields of psychosomatic medicine, we often encounter depressed patients who are resistant to treatment with conventional antidepressants. In modern western medicine, these cases are usually recognized as treatment resistant depression but in Kampo medicine, by using thermal therapy, we can approach some of these cases effectively. In this paper, we will present three cases who are successfully treated with thermal therapy using Kampo medicine. Case 1 was a 66 year old female who

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... ed a stoma surgery as a result of rectal cancer resection. She was suffering from depressive state, nausea and appetite loss since she had to experience the stoma management. We first administered antidepressants without any amelioration of the symptoms. Because she complained about the coldness throughout the body, we administered the combination of Shimbuto extract and Ninjinto extract. After two weeks, her appetite and depression were improved dramatically, with the sense of the whole body warmed up. Case 2 was a 33 year old female. Her complaints were low grade fever, diarrhea, and depressive mood. The combination of Simbuto extract and Ninjinto extract improved her fever and abdominal pain. Thereafter, we administered Tsumyakushigyakuto(decoction)in reference to the results of electrothermo acupuncture instrument. After that, her coldness of extremities and scores of psychological tests improved markedly. Case 3 was a 35 year old female. She was diagnosed depression four years ago, and had administered various types of antidepressants and Kampo formula without any improvement. When she visited our outpatient department, she complained about her coldness urgently. Focusing on her subjective coldness, we changed the drug regimen to Tsumyakushigyakuto. As a result, she could go out in just two days after administration, and two weeks later, her appetite and coldness were dramatically improved. Six weeks later, she could comfortably sleep without the use of a sleep medication. Based on our cases, it is possible that internal cold modulates not only physical symptoms but also psychological symptoms, such as depression those are treatment resistant in modern western medicine. In such cases, thermal therapy with Kampo medicine, would be an effective approach in the fields of psychosomatic medicine.