The results of our general and medical survey are summarized as follows:
(A) About Shinjo Spa
1) Most of visitors to this spa are residents of Yamagata Prefecture and engaged in agriculture.
2) In age they are 20 to 50.
3) Visitors who are few in number came to this spa for the purpose of spa treatment. Most of them visit this spa for recreation.
4) Most visitors take bath 2 to 3 times a day.
5) The bathing reaction and its effect are obscure, because most visitors do not stay here long enough for observation of the effect. It is, however, verified that this spa is effective in keeping the body father warm for a long time.
(B) About Niiyama Spa
1) Most visitors are residents of Yamagata Prefecture and those from neighboring prefecture are small in number. Half of visitors are farmers.
2) Most visitors are old in age, male and female visitors are almost equal in number.
3) The larger number of visitors come here for balneotherapy of or rehabilitation from diseases, especially neuralgia, rheumatism.
4) Most visitors are conscious of the good effect of bathing, but those who are conscious of thermal crisis are relatively few in number, being 9.8% of the total number of visitors.
The authors are indebted to the Pharmaceutical Section, Sanitation Bureau, Yamagata Prefectural Office and the Sanitation Section, Shinjo City Office for assistance given to the present survey, and to Shinjo and Niiyama Spa Associations for careful cooperation.

The results obtained from a survey of balneal treatment and medical researches made at Hanezawa Spa in Yamagata Prefecture are summarized as follows.
1) Visitors to this spa vary in age, include both sexes in equal number and are, by far, farmers.
2) Visitors are mostly from the local area and surrounding villages and towns, 70% of whom come to the spa for recreation and 20% for therapeutic treatment and recuperation. The figures mentioned here greatly depend upon the time this survey was made, and it is quite probable that the number of visitors for balneal treatment should always be much larger.
3) In this survey, short-time visitors are largest in number, coming to the spa for recreation. Long-time visitors come there for balneal treatment. Visitors are mostly those with diseases of the digestive organs and those with the skin diseases.
4) The larger number of visitors bathe four to five times a day and about 40% of them drink hot-spring waters. Because of the presence of a large number of short-time visitors, the effect of balneal treatment and bathing reaction could not be made clear.
5) Only 4.4% of visitors came there under doctor's directions.
6) Observation of the effect of drinking hot-spring waters on the excretion of gastric juice revealed that it has power to neutralize acid in the stomach and to control the excretion of gastic juice. Such should naturally be the case because this spa is of alkaline muriated spring.
7) With a view to find the effect of drinking hot-spring waters at this spa, examinations were made of renal function. The results obtained from the dilution tests show that the urinary excretion has been delayed and the power of dilution has declined. It is advisable, therefore, that visitors should see whether they are afflicted with the diseases of kidney or circulatory system before they resort to drinking hot-spring waters at this spa.

Our overall surveys of medical consultations for balneal therapy and of balneal curation at the Namekawa Spa, Yamagata Prefecture may be summarized as follows.
1) The Namekawa Spa is one in the Iegatayama Spa family located in the border of Fukushima and Yamagata Prefecture, which is saline hydrogen sulphide spring in character.
There is only one hot-spring inn in this resort (Fukushimaya Inn). It is rich in natural scenery, without the atmosphere of an amusements center and isolated from the wordly things. It is purely a spa for balneal treatment.
2) The larger number of visitors to this spa are from within the prefecture, especially from the towns and villages around the spa, but, because of its nearness to Fukushima Prefecture, quite a number of visitors are from this prefecture.
The visitors are mostly farmers, especially those of advanced age.
Half the visitors have been at the spa before and many of them are in the habit of revisiting the spa year after year.
3) A majority of visitors come to the spa for therapy of diseases and for recuperation, which shows that this spa has the character of balneal therapy.