The patients of vibration diseases were treated by balneotherapy. The effects of balneotherapy were judged from the ameliorating degree of subjective symptoms such as sensation of coldness, sensation of numbness, pains of physical signs for which peripheral functions were examined by cold water-dipping test, vibration sensation test, squeeze dynamometry, tapping test and thermography. There were no differences between balneotherapy for 1.5 months and for 3 months. This suggests that balneotherapy for 1-1.5 months is sufficient for treating the patients of vibration diseases.
Recently developed oxothermic packs (temperature 47-48°C, Duration of heat 2-3 hours) were used in combination with balneotherapy to warm the affected area. The application of the exothermic pack in combination with balneotherapy ameliorated markedly subjective symptoms and physical signs, comparing with balneotherapy alone.
A sound-cold loading apparatus was devised for physical examination of vibration diseases. A specific pulse curve was obtained in patients complaining of pains after using chain-saw.

More than 30 years have passed since the emergence of many patients with what is now called vibration syndrome.
We have been engaged in vibration syndrome therapy since 1973 using thermotherapy, therapeutic exercise, and herbal medicine. We have measured the skin temperature of both middle fingers of patients every year in spring and autumn. In 1985, 12 years after starting the treatment, we noted significant improvement in their skin temperatures.
This paper is a report on the changes in skin temperature as measured over 10 years (from 1980 to 1990) in ten patients with Raynaud's phenomenon.
From our study, we have concluded that a period of 10 years or more is required to treat patients with Vibration Syndrome.

Currently 1.5 million people a year visit the Gero hot spring. A total of 44 patients who suffered from disease while staying there and required treatment were admitted to our hospital during 1987. This paper presents a statistical analysis these 44 cases.
There was no large numerical difference between male and female patients, and about 60% of them were 60 to 70 years old. While some came from Aichi Prefecture, a notable number of patients came from remote places. Most of the patients were admitted to the hospital from the end of summer through winter and often at night. About 50% of patients suffered from heart diseases and cerebrovascular disturbances. The next largest percentage had gastrointestinal diseases. Fifty percent of the patients recovered within a couple of days of hospitalization and all other patients, except two patients who died, left the hospital within 20 days. About 70% of these patients were carried to the hospital by ambulance. About 30% of the patients were considered to have contracted the disease while they were drinking, and the majority of them had heart disease, cerebrovascular disturbance, or acute alcoholism. About 40% of the patients contracted the disease while bathing, and the majority of them had cerebrovascular diseases and respiratory disturbance. Although no correlation with weather was found in 21 cases of heart diseases and cerebrovascular disturbance, onset of the disease in other than optimum temperature and humidity was observed in many cases.
The following five factors were considered to have aggravated the diseases:
1) Advanced age.
2) Overwork.
3) Chronic disease or insufficient health checks.
4) Drinking heavily, bathing after drinking, or bathing for too long.
5) Seasonal factors (summer through winter) and improper temperature or humidity for those patients with circulatory diseases.
Results of the statistical analysis indicated the necessity for guidance in relaxation and at hot springs as well as improvement of spa facilities.

To re-examine the effectiveness of spa bathing for chronic pain. The comparison study was between spa bathing and usual hot baths, with 41 patients, 7 with rheumatoid arthritis, 11 with cerebrovascular hemiplegia, and 23 with vibration syndrome.
The patients bathed once a day for 10min, at 40°C and then once a day for six consecutive days for 10min. at 40°C
There was not much correlation between blood circulation and chronic pain: but spa bathing showed a significant longterm improvement in lessening pain than did hot bathing. The spa bathing in lessening was most efficacious 120min. and 180min. after bathing.

The Raynaud phenomenon of fingers, a specific physical disturbance, frequently occurs in those who have used pneumatic vibrating tools such as chain saws for many years. Only a few pathological studies of this lesion have been reported although there are many clinical physiological studies. We conducted an autopsy of a 71-year-old man, who was a patient with cholecystocarcinoma and died of pneumonia. He had worked for 17 years using pneumatic vibrating tools and had been an out-patient of the surgical department, where he received physical treatment and spa therapy because he suffered from the Raynaud syndrome in his left fingers. The findings obtained from a microscopic observation of the finger tip skin of the corpse are summarized as follows:
1. Many dilated small arteries, accompanied by local thickening of the intima and torn medial elastic fibers, were noticed between the subpapillary and deep layer of the dermis.
2. Stenotic arterioles due to muscular hyperplasia of the media were relatively few.
3. Dilatation of capillaries was found in the subpapillary layer of the dermis, and dilatation of small veins, in the deep layer.
4. Atrophy was noticed in the peripheral neurofibers, Vater-Pacini corpuscles, and sweat glands.
5. The dermis showed sclerotic changes with marked diffuse fibrosis.

A comparative study on spa bathing alone and bathing in combination with herbar medicine was carried out on 21 patients with vibration syndrome of grades III and IV.
Eleven patients (group A) were treated with spa bathing alone; the other ten patients (group B) were treated with spa bathing in combination with herbar medicine (“Goshajin-kigan, ” “Bushi-powder” or “Touki shigyaku kago syuusyo syoukyoutou, ” “Bushi-powder”). All patients were male from 55 to 73 years old.
Subjective symptoms, capillary blood flow volume, skin temperature, and velocity of peripheral nerve conduction were examined before and after each treatment.
In subjective symptoms, the ratio of improvement in group B was significantly higher than that in group A, especially in “numbness, ” “coldness, ” and “discoloration.”
Volume of capillary blood flow in group B was significantly larger than that in group A. Skin temperature in group B was significantly higher than that in group A. However, no significant difference was found in the velocity of peripheral nerve conduction before and after treatment or between group A and group B.

[Background]Functional abdominal pain syndrome (FAPS) represents a chronic pain disorder localized in the abdomen and the symptoms largely are unrelated to food intake and defecation, which differ from other painful functional gastrointestinal disorders.
We report a case of FAPS whose symptom was successfully improved by acupuncture.
[Case Report]A 75-year-old female had been hospitalized at Meiji University of Integrative Medicine Hospital because of left lower abdominal pain from which she had repeatedly suffered for more than 2 years. Despite strict medication, her symptom had not been improved. After admission to the hospital, according to recommendation by her physician, acupuncture treatment was started. The patient received TCM-based acupuncture treatments five times a week over 13weeks. Primary acupuncture points used for the patient were LV3(Taichong), SP6 (Sanyinjiao), ST36 (Zusanli) and PC6 (Neiguan). Evaluation of the left lower abdominal pain was carried out with a Visual Analogue Scale (VAS). The Gastrointestinal Symptom Rating Scale (GSRS) was used to evaluate QOL related to the digestive symptoms. VAS for the left lower abdominal pain showed a remarkable decrease immediately after the initial acupuncture session. The symptom disappeared within 4 weeks after commencement of the treatment and never appeared during her hospitalization. GSRS was also improved and it was maintained during hospitalization.
[Conclusion]We suggested that acupuncture treatment might be one of the useful, non-pharmacological alternatives for symptoms of FAPS.

A 73-year-old man visited our hospital with complaints of fever, epigastric painand jaundice. Laboratory examinations showed elevation of GOT, GPT, ALP, LAP and amylase. Abdominal ultrasonography revealed gall bladder stones. Endoscopic findings showed parapapillary diverticulum, but the common bile duct stone was not revealed by endoscopic retrograde cholangiography. He was conservatively treated and then discharged. Two months after, the patient was readmitted for cholecystitis and underwent cholecystectomy. After further 2 months, he was again admitted for the same symptoms as those on first admission. We diagnosed this case as Lemmel's syndrome and performed emergency endoscopy. Endoscopic findings revealed the meal rest inside the parapapillary diverticulum. After we removed the meal rest obstructing the orifice of the papilla of Vater using grasping forceps, we performed EST. Purulent bile gushed out from the orifice. Two years have elapsed since them. Cholangitis has not recurred during this period. Therefore, we concluded that EST is effective in treating Lemmel's syndrome.