The author made an examination, as a part of systematic studies on the effects of hot-spring bathing on the functions of the circulatory system in his institute, of the effects of gradually warming partial bathing apparatus by SUGIYAMA on the functions of the circulatory system with reference to the circulating blood volume and pulse rhythm, which led to the following conclusions.
1) In hypertensive patients average circulating plasma volume was 48.2±1.3ml/kg, circulating blood volume 83.4±2.0ml/kg, and circulating blood cell volume 35.3±0.9ml/kg, the range of distribution being wider than that of normal persons and each value was increased in most cases. No correlations seemed to be present between blood pressure and circulating blood volume.
2) In patients with normal blood pressure (13 cases) the pulse interval was 0.96±0.0697″, there being 11 cases (84.6%) of single-peak type and 2 cases (15.4%) of double-peak type. In hypertensive patients (24 cases), the pulse interval was 0.935±0.0543″, there being 20 cases (83.3%) of single-peak type and 4 cases (16.7%) of double-peak type. No remarkable difference could be observed between the two.
3) The examination of the effects of single bathing with reference to the circulating blood volume and pulse rhythm revealed that the magnitude of the effect is in the following order:
Steam bathing for hypertensive patients>steam bathing for normal pressure persons>gradually warming partial bathing for hypertensive patients>gradually warming partial bathing for nomal pressure persons.
This clearly shows that gradually warming partial bathing acts on the bather more mildly than steam bathing. This is generally observable in normal pressure persons, but individual difference is observable in hypertensive patients. For these reasons, the bathing effect is more unstable in hypertensive patients than in healthy persons.
4) With the progress of this gradually warming partial bathing cure, the changes in the circulating blood volume and pulse rhythm occurring after this single bathing decreased gradually. This is especially clear in the case of hypertension in which the changes are great and unstable. No definite tendency can be seen, however, in the steam bathing cure.
5) Consequently, the examination with reference to the circulating blood volume and pulse rhythm has confirmed that this gradually warming partial bathing is not only good for the function of the abnormal circulatory system, but also improves it.

This paper deals with general survey of hot spring curative treatment at Higashine Spa, Yamagata Prefecture, and the effect of this spa on the capillary resistance and the variation in the blood pressure.
The results of the medical survey are summarized as follows:
1) Higashine Spa consists of saline weak common salt springs, in each of which chemical components are almost the same.
2) The visitors to this spa are inhabitants of Yamagata Prefecture, farmers being the largest in number.
3) Most of them (78%) are old men and women over 50 years of age, and the number of women are four times that of men.
4) The examination of spa visitors reveals that hypertension stands at the top. However, in most cases, the chief complaints are of rheumatic disorders in natwe and hypertension is found at the time of medical examination.
5) Those who bathe five times a day are the largest in number.
6) Those who noticed the bathing reaction are small in number. The bathing reaction may be considered as a serious thermal crisis.
7) Bathing in this hot spring increases the capillary resistance and lowers the blood pressure.
Accordingly, bathing in this spa, under a proper guidance, may be effective in the treatment of hypertension. For balneal treatment of hypertension, physicians' directions as to how and when patiens should bathe, will be necessary: unplanned bathing cannot be approved of.

The result of our general and medical survey are summarized as follows:
1) More than half the number of visitors to this spa are those who live in Yamagata Prefecture, and the rest are inhabitants of neighboring prefectures. Compared with the reports of our previous surveys, the number of inhabitants of neighboring prefectures is larger. Farmers are the largest in number, and their ages range from 20 to 60.
2) Considering the fact that more than half the number of spa visitors come here with therapeutic or convalescing purpose, this spa be said to be a spa where the sole object of visitors should be the hot spring curative treatment.
3) Form the viewpoint of classification of diseases, it may be said that patients with rheumatism and neuralgia are more than half the number, followed by those with the diseases of the stomach. This clearly shows the reason why this spa is called “the hot spring for rheumatism and neuralgia”.
4) More than half the number of spa visitors stay for about 2 weeks, and most of them take bath 5 to 6 times a day for curative treatment. Generally the spa visitors tend to bathe in excess.
5) 37.4% of the spa visitors drink hot spring water for curative treatment and this rate of drinking cure is higher than that in our previous reports.
6) Only 5.7% come to the spa under doctors' direction. 31.6% of them are conscious of the bathing reaction, symptoms of which are headache, feeling of weakness, anorexia, constipation, etc.
7) Observation of the effect of hot spring bathing on Thorn's test shows that in the larger number of patients with rheumatism and neuralgia the rate of decrease in eosinophilic leucocyte count becomes clearly higher after single bathing, but in healthy persons it is not uniform. And observation of changes in these rate of variations after succesive curative bathing reveals that in the group in whom the rate of decrease is low at the beginning of the bathing the vate tends to become higher after a week of curative bathing, while in the group in whom the rate of decrease is high it tends to become lower.

The results of our general and medical surveys are summarized as follows:
1) The visitors to this spa are inhabitants of Yamagata prefecture, farmers being the largest in number.
2) Considering the fact that more than half the number of spa visitors come here with therapeutic or convalescing purpose, this spa may be said to be a spa to which visitors come with the sole object of curative treatment.
3) Visitors came for the treatment of common cold, hypertension, neuralgia and diseases of the stomach and intestines respetively from the frequency of diseases. The fact that the visitors with cold were largest in number was probably because of the prevalence of common cold at the time of our survey.
4) Half the number of spa visitors stayed for about 2 weeks, and most of them took bath four to five times a day for curative treatment.
5) 40.1% spa visitors drank hot spring water for curative treatment. Which incidence is higher than that in our previous reports for other Tohoku Area.
6) Only 6.1% of the visitors came to the spa under doctor's direction. Those who noted the bathing reaction: anorexia, feeling of weakness etc., were 23.1%
7) In the tubeless gastric analysis (Gastrotest) scarcely any change was observable for successive drinking of hot spring water.
8) In most cases the oral temperature measured at the time of bathing in this spa never returned to the value before bathing for two hours and the feeling of warmth remained for a long time. This is probably due to the chemical properties of the spring waters and proper treatment after bathing.