Examinations to some extent were made on yearly transitions of 52 patients with bronchial asthma who were hospitalized in Misasa Medical Branch, Okayama University Medical School and received spa therapy during the five years from 1982 to 1986.
1) In the first two years (1982 to 1983), we had many patients from Okayama Prefecture. The majority of them had suffered from severe asthma attacks. They included a higher rate of cases of dependency on steroid-therapy as compared to those patients in the last three years (1984 to 1986). Some cases exhibited a remarkable airways obstruction in spite of high dosage of steroid hormone.
2) From 1984 to 1986, the patients with bronchial asthma from Tottori Prefecture increased. Their involvements were less severe with a lower dependency on steroid-therapy as compared to those hospitalized during the first two years.
3) Terms of hospitalization were generally reduced in the last two years as compared to the preceding three years. The average term was about two months from 1985 to 1986.
4) No difference in clinical symptoms based on the patient's age, age at onset, or asthma types was found between the first two years and the last three years.

Factors of spa therapy in relation to clinical effects were studied on 36 patients, who were admitted to Misasa Branch Hospital in 1987 with respiratory diseases.
1. The patients who received the spa therapy comprised 30 cases of bronchial asthma, 3 cases of diffuse panbronchiolitis, 3 cases of allergic granulomatous angitis, and 1 case of bronchiectasia.
2. Most bronchial asthma patients were over 40 years old, and 16 cases (53.3%) of 30 patients had long-term glucocorticoids. The serum cortisol level was generally low and was especially low in the cases with glucocorticoids therapy (4.9±5.6mcg/dl in female patients and 3.5±3.2mcg/dl in male patients). The incidence of each clinical type of asthma was as follows: 12 cases (66.7%) of bronchospasm type (Ia), 6 cases (33.3%) of bronchospasm plus hypersecresion type (Ib), and no case (0%) of bronchiolar obstruction type (II) out of 18 female patients. For male patients, there were 5 cases (41.7%) of Ia, 5 cases (41.7%) of Ib, and 2 cases (16.7%) of II. Spa therapy was obviously effective in 25 out of 30 cases (83.3%).
3. Spa therapy was also effective for respiratory diseases other than asthma, especially for diffuse panbronchiolitis.

Twenty-nine patients with bronchial asthma received spa therapy at Okayama University Medical School, Misasa Branch Hospital. Twenty out of 29 cases were steroid-dependent intractable asthma.
Spa therapy was markedly effective in 8 cases (27.6%), moderately effective in 14 cases (48.3%), slightly effective in 5 cases (17.2%) and not effective in 2 cases out of 29 cases.
Spa therapy was more effective in the cases with age over 40 years than in the cases under 40 years. Non-atopic type asthma was more successfully treated with spa therapy compared to atopic type asthma. Regarding pathophysiological classification, spa therapy was greatly effective in the cases with bronchiolar obstruction and with hypersecretion.

Allergological characteristics were studied on 36 patients with respiratory diseases (30 cases of bronchial asthma, 3 cases of diffuse panbronchiolitis, 3 cases of allergic granulomatous angitis, and 1 case of bronchiectasia) who received spa therapy at Misasa Branch Hospital.
1. The results obtained in patients with bronchial asthma were as follows:
Serum IgE levels were generally low, and many cases with less than 301IU/ml were observed (185±184/ml in female patients and 469±532IU/ml in male patients). The rate of positive skin reactions to various allergens was low in these asthma cases. A rather low rate of positive skin reaction to house dust, in particular, was characteristic. In regard to the rate of releasing chemical mediators such as bistamine and leukotrienes from leukocytes stimulated by Ca ionophore A 23187, a wide variety of cases were observed (histamine, 3.4-51.1%; LT B₄ 9.8-119.8ng/10⁶ cell; LT C₄, 3.5-43.8ng/10⁶ cells). By analyzing cell components in bronchoalveolar lavage fluids (BALF), notable increase in the number of eosinophils were observed especially in male patients, although no other significant differences were shown between the two groups.
2. In those patients with respiratory diseases other than asthma, a remarkable increase in the number of neutrophils in BALF was seen in diffuse panbronchiolitis cases and a remarkable increase in the number of eosinophils in BALF was seen in the cases of allergic granulomatous angities. Serum IgE levels were low in both of these cases.