We observed peripheral circulation in patients suffering from peripheral neuropathy in order to quantify the effect of spa therapy on peripheral neuropathy.
The peripheral circulation was observed using thermography and Laser-Doppler blood flowmetry. Thirteen patients with a mean age of 71.9 years (range of 59-82) suffering from diabetic neuropathy with coldness, numbness, neuralgia in their feet or walk disturbance, and 11 patients with a mean age of 72.3 years (range of 60-84) suffering from lumbago, were examined by the methods. The blood flow, mass and velocity were measured by a Laser-Doppler blood flowmetry, after pre-loading with hot water at 36°C for 5min (hot loading), and after cold loading with cold water at 20°C for 5min. Thermographic results were analyzed quantitatively by calculating a recovery ratio as: Recovery ratio=[Total counts of thermography (Pixels) over 27°C after cold loading] ÷ [Initial counts over 27°C after hot loading]×100 (%).
The recovery ratio in diabetes mellitus was between 0-93.5% (mean=46.8%), whereas the recovery ratio in lumbago was between 0-91.3% (mean=41.3%). The blood flow in patients with diabetes mellitus was 1.11-5.36 (ml/min/100g tissue), (mean=2.44), the blood mass was 85-255 (mean=155), and the velocity was 0.447-0.784 (mean=0.591). The blood flow in patients with lumbago was 1.18-3.82, (mean=2.19), the blood mass was 89-195 (mean=144), and the velocity was 0.464-0.8 (mean=0.615). The recovery ratio and blood flow in patients with diabetes mellitus were correlated, r=0.62 and p<0.0002, as the recovery ratio and blood mass were correlated, r=0.59 and p<0.0001. However the blood flow and the velocity in these patients were not correlated, r=0.11. The recovery ratio and blood flow in patients with lumbago were not correlated, r=0.02, but the recovery ratio and blood mass showed some correlation, r=0.38. The recovery ratio and the velocity in these patients were correlated, r=0.64 and p<0.005. The blood flow in patients with diabetes mellitus was greater after hot loading (mean=2.89) than after cold loading (mean=2.44). The blood mass in patients with diabetes mellitus was greater after hot loading (mean=180) than after cold loading (mean=155). However, there was no significant change in the velocity after hot loading (mean=0.572) compared with the velocity after cold loading (mean=0.591).
It was revealed that patients with diabetes mellitus with low recovery ratios in thermography had low blood flow and blood mass in their peripheral circulation. Patients suffering from lumbago had different peripheral circulation compared with diabetes mellitus. Spa therapy was effective on diabetic peripheral neuropathy as the peripheral circulation improved with hot water at 36°C

Effects of spa therapy on asthma were studied in 64 patients with asthma in relation to the generation of leukotrienes B4 (LTB4) and C4 (LTC4) and bronchial hyperresponsiveness. 1. The efficacy of spa therapy was marked in 12 (18.8%), and moderate in 45 (70.3%) of 64 patients with asthma, and slight or no efficacy of the therapy was observed in the residual 7 patients (10.9%). 2. Bronchial hyperresponsiveness to methacholine was the highest in patients with slight or no efficacy of spa therapy, however, there were no significant differences among the three groups classified by clinical efficacy. 3. The generation of LTC4 by leucocytes was significantly higher in patients with slight or no efficacy compared with the generation in those with marked (p<0.01) and moderate efficacy (p<0.001). However, there were no significant differences in the generation of LTB4 among them. 4. The generation of LTC4 before spa therapy significantly decreased in patients with marked (p<0.001) and moderate efficacy (p<0.01) after spa therapy, but not in those with slight or no efficacy. The generation of LTB4 was not significantly different before and after spa therapy among patients with marked, moderate, and slight or no efficacy. These results show that the efficacy of spa therapy for patients with asthma is closely related to the generation of LTC4 by leucocytes, and that the generation of LTC4 significantly decreases after spa therapy in patients with spa efficacy.

Spa therapy has been performed at our medical center for last 20 years. The changes in number and frequency of patients with respiratory disease were analyzed every 5 year for last 20 years. The total number of patients with respiratory disease who were admitted at our medical center for last 20 years was 1934, of whom the number of patients with asthma was 1226 (63.4%), and the number of those with COPD was 415 (21.5%). The number of patients with asthma treated with spa therapy showed a tendency to increase form 57 for the first 5 years (first stage) to 465 for the last 5 years (forth stage). The number of patients with COPD also increased from 26 for the first 5 years to 227 for the last 5 years. The frequency of SDIA decreased from 68.4% for the first 5 years to 29.0% for the last 5 years. In contrast, the frequency of pulmonary emphysema increased 19.2% at the first stage to 76.7% at the forth stage. The number and frequency of elderly patients with asthma and COPD over the age of 60 tended to increase for last 20 years.

N-3 fatty acids are reportedly effective for asthma. In addition, spa therapy has been reported to be effective for patients with asthma. In the present study, the effects of spa therapy combined with perilla seed oil-rich diet (rich in n-3 fatty acid) were examined on asthma. A total of 14 asthmatic patients had a complex spa therapy and consumed a perilla seed oil-rich diet-rich in α-linolenic acid (α-LNA) for 8 weeks. Generation of leukotriene (LT) C4 by leucocytes, respiratory function were analyzed. The generation of LTC4 by leucocytes decreased significantly for 2, 4 and 8 weeks (P<0.05). Peak expiratory flow (PEF) values increased significantly for 2, 4, 6 and 8 weeks (P<0.05). The values of ventilatory parameters [forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), forced expiratory flow after 25% of expired FVC (FEF₂₅), forced expiratory flow after 75% of expired FVC (FEF₇₅), mean expiratory flow during the middle half of the FVC (FEF_25-75)] revealed a significant increase after 4 and 8 weeks of the modified diet (P<0.05). The results suggest that spa therapy combined with a perilla seed oil-rich diet are effective in the treatment of asthma in terms of its ability to suppress LTC4 generation by leucocytes, and in inducing an improvement of pulmonary function.