With recent changes in the structure of society, the pathology of diseases is also changing, which includes an increase in Kampo diagnosis of Tokaku-joki-to. This formulation is now frequently used in my clinic too. I studied the clinical effect of the extract of this formulation in 125 evaluable patients (12 males and 113 females) out of 183 patients who received the extract of this formulation from January to October 1992 on an outpatient basis.
The success rates, when shown in the order of the number of patients, were 82% in dysmenorrhea, 74% in hypermenorrhea, 69% in signs and symptoms associated with hypertension, 72% in climacteric disorder, 59% in lumbago, 55% in hot flash with cold feeling of foot, 55% in irregular menstruation, 38% in chloasma, 60% in acne, 57% in hemorrhoid, and 60% in atopic dermatitis. Other disorders included vulvular contusion, prostatic hypertrophy, and sequela of cerebral thrombosis.
According to the instructions and the herb components described in the classics (Toueki, this formulation is considered to be effective for Kigyaku (rush of blood to the head) such as anxiety and feelings of heat on the upper body and cold on the lower body. I believe this formulation can be widely applied to disorders caused by problems in modern society, such as a stressful life-style, palatable food, lack of exercise and constipation.

 Shoulder hand syndrome was one of the severe complications in stroke patients and often disturbed the QOL and the rehabilitation therapy. The reflex sympathetic dystrophy (RSD) was considered as the pathogenesis of shoulder hand syndrome, but the therapy had been not established. We analyzed the sympathetic nerve function of thermotherapy of shoulder-neck or passive exercise of limbs in stroke patients. ‹methods› In stoke patients suffering from shoulder hand syndrome, we set the thermisters (Terumo.Co. CMT-205) and local perspiration meters (Skinos Co. SKD 2000) on both forefingers and set the accelerated photoplethysmography (Tokyo Iken Co. SA.3000P). We analyzed the blood vessel tension (BVT) and the wave type. ‹results› The temperature of the paralytic fingers and hands was significantly higher than the temperature of the normal sides. The pulse wave patterns and blood vessel tension in paralytic fingers were more disturbed than those of intact fingers. The perspirations of paralytic hands were significantly correlated with duration and systolic blood pressures and the sympathetic nerve function was considered to concern to the disorders in early stage of stoke.

A large number of negative air ions have been detected in forests, at spas, and near waterfalls. The air ion had been reported to improve the feelings of comfort, feelings of fatigue and occupational efficiency. Almost all the studies were reported by the short-term exposure of the air ions (2-5 hours) on human. We analyzed the physiological effects and laboratory findings of the long-term exposure of negative air ion (ca. 5000/cc, 5 hours/day, 3 weeks) in double-blind methods.
For this study, we made the negative air ion producing machines, in which the steam was combined with electric discharge by high-voltage electrodes. The machines could constantly produce high amount of negative ions (ca. 5, 000 counts/cc). We set these machines in the rest rooms of ten volunteer and programmed to spout negative air ions when they were sleeping at midnight (AM1:00-6:00) for 3 weeks. After 3 weeks exposure of negative air ions or sham condition, we checked the physical and mental tests and sampled the blood.
In the exposure of negative air ions, some of the depressive scales and subjective feelings (scores from Arthritis Impact Measurement Scales (AIMS2)) were better than in those in the sham condition, and the local perspiration of palm, which reflected sympathetic nerve function, also decreased by mental and physical stress in the exposure ions more than in the sham condition. This showed that the negative air ion decreased the stress of the sympathetic nerve function. In laboratory findings, there were no significant differences between the clinical data with ions and without ions, and it was shown that ion was harmless in the range of 5, 000 counts/cc 5 hours/day. The percentage of natural killer (NK) cells with the exposure of the ions was lower than without ions. This also indicated the air ion decreased the stress of human.
It was shown that the negative air ion might improve human activities and remove the stress. The mechanism of the negative air ions for human is not clear, so that further studies will be needed.

Objective: We studied immunological and physiological effect by the polarized infrared light irradiation near the neck stellate ganglion. Methods: Subjects were eleven healthy volunteers (age 21-22 years old, male). The polarized infrared light irradiation system (Super Lizer HA-550) for 20 minutes was used for the irradiation near the stellate ganglion. In the dummy, they were treated by the same irradiation instrument that the light were obstructed completely. We analyzed hematological test and perspiration quantity and temperatures of limbs and blood pressure before and after the irradiation. Results: The leukocytes decreased (p<0.01) and NK cells decreased after the irradiation significantly. The hormone and blood pressure did not significantly change. The perspiration of right hand (irradiated side) was significantly decreased. The peripheral temperature of bilateral upper and lower limbs elevated after the irradiation. Conclusion: It was considered that the effect by the polarized infrared light irradiation near the stellate ganglion was the same with the sympathetic nervous ganglion block which dilated arteries and increased of peripheral circulation, and inhibited the sympathetic nervous function.

High levels of negative ions have been detected in the air in forests, at spas, near waterfalls, and so forth, and there have been reported that they have a favorable effect on human beings' feeling of comfort and their feeling of fatigue. In this study we prepared an experimental room in which it was possible to maintain temperature constant at 25°C and constant humidity, and turn the supply of negative ions on and off, and in addition to assessing comfort level and fatigue level subjectively, we assessed them by means of the -wave component of the EEG, which indicates the degree of relaxation, and by auditory evoked potential P300, which reflects attentiveness and degree of fatigue.
Methods: The subjects were 15 healthy physicians and nurses. The experiment was conducted in a room maintained at a constant temperature of 25°C and a constant humidity of 50% during a 2-hour period on different days without informing the subjects of whether the air was loaded with negative ions or not. Constant temperature and humidity were maintained, and the level of negative ions was adjusted by using a shinki genertor (Geochto Ltd.). The parameters measured were determined with a flicker test and P300 (auditory evoked) test, and the α-wave ratio was calculated from the 60-minute closed-eye resting EEG.
Results: A higher percentage of subjects reported subjective comfort when the air was loaded with neagtive ions (6/15, 40%) than when it was not (4/15, 27%).
Significant difference was not observed in the P300 tests, but the α₂ (10-13Hz) ratio of the EEG and flicker test tended to be higher with negative ion-air than without nagative ion-air.

A 61-year-old woman developed shock during transportation to our hospital in an ambulance under a diagnosis of acute myocardial infarction, Emergency coronary angiography showed left anterior interventricular descending branch #6 to be completely occluded. At the same time, ultrasonic cardiography showed pericardial effusion. Therefore we diagnosed left ventricular free wall rupture, and performed emergency surgery to repair the rupture site. After pericardiotomy massive hemorrhage occurred and we diagnosed blow-out type left ventricular free wall rupture. We immediately established extracorporeal circulation via the femoral artery and vein, and cross clamped the ascending aorta, then achieved cardiac arrest. Because the area of myocardial infarction was extensive, we applied the David-Komeda method to avoid bleeding due to left ventricular systolic pressure, left ventricular aneurysm or ventricular septal rupture. The postoperative course was good; the patient was weaned from PCPS on the 3rd day postoperatively, IABP on the 5th day postoperatively and from the respirator on the 8th day postoperatively. She was discharged on postoperative day 40. Currently she has no cardiac complains, no left ventricular aneurysm and no neurological problems. Left ventricular free wall rupture can remain a fatal complication after acute myocardial infarction. We consider the David-Komeda method useful for repairing left ventricular free wall rupture (blow-out type) after acute myocardial infarction as well as ventricular septal rupture without a risk of left ventricular aneurysm, bleeding or ventricular septal wall rupture.

The effects of physical exercise on psychologic variables during mental stress were evaluated. On each of two different days (for intraindividual control) 20 healthy dental students carried out four (modified) d2-tests (3.5min available for each test). After two such tests there was a rest period of 5 minutes. During this intermission either a standardized physical exercise was performed or -the other day- (cross over, balanced) the volunteers rested in a sitting position while listening to relaxing music. After the rest period another two d2-tests were carried out. Thereafter a questionnaire (“adjective list”, in German) defining 15 subscales (categories of the state of well-being) was completed by all volunteers to quantify parameters of their actual mood. For intraindividual control the results of the subscales obtained on both days were compared by the paired student-t-test. In the test with physical exercise during the break the scores of the subscale being activated were significantly (p<0.05) higher than in the test with music. The other subscales showed no significant difference. In all tests the scores of the d2-tests reflecting the capability to concentrate showed an increase after the break, which was significantly higher, if physical exercise was performed during the break. Physical exercise can alleviate certain symptoms of mental stress. Feeling more active is the predominant subjective effect.

Two experiments were performed to clarify the effects of balneotherapy on platelet glutathione metabolism. One experiment, in which healthy men were subjected to water immersion at temperatures of 25°C, 36°C, and 42°C for 10min, showed that the level of platelet lipid peroxides (LPO) tended to increase at 25°C and 42°C, suggesting the presence of oxidative stress at these temperatures. When an antioxidative defense system was induced at these temperatures, the levels of platelet glutathione (GSH), glutathione peroxidase (GPX) and glutathione reductase (GR) activities increased. The other experiment, in which 4 weeks of balneotherapy was applied to type II (non-insulin-dependent) diabetic patients, showed that the level of GSH on admission correlated well with that of fasting plasma glucose (FPG, r=0.692, p<0.050). After 4 weeks of balneotherpy, the level of GSH increased (p<0.01) in well-controlled patients (FPG<150mg/dl) and decreased (p<0.05) in poorly controlled patients (FPG≥150mg/dl), There was a negative correlation between GPX activities and the level of FPG (r=-0.430, p<0.05). After the balneotherapy, the activity increased in five patients, decreased in three patients, and showed no changes in four patients.
These results indicate that, in diabetic patients, 1) platelet GSH synthesis is obviously induced in response to oxidative stress, 2) lowered GPX activities suggest an impaired antioxidative defense system, and 3) platelet glutathione metabolism was partly improved by 4 weeks of balneotherapy but depended on the control status of plasma glucose levels. From these findings, we conclude that 1) patients whose platelet antioxidative defense system is damaged such as those with diabetes mellitus should not take hot or cold bath, and that 2) balneotherapy improves platelet glutathione metabolism, leading to normalization of platelet aggregability.