It is a well-known fact that the death rate from cerebrovascular accident has been highest in Japan since 1951. About 160, 000 persons died of cerebrovascular accident during the year 1962 in Japan. The mortality of cerebrovascular stroke being about 50%, it follows that the number of hemiplegic patients will increase by 160, 000 every year. Recently people are much concerned over the rehabilitation of hemiplegic patients and that is why we are making a report on the results obtained from physical therapy such as hot-spring bathing, therapeutic exercise, etc.
Cerebral hemorrhage, thrombosis and embolism are considered to be causative of hemiplegia, 34 cases resulting from cerebral hemorrhage, and 64 cases from cerebral infarction, the latter being much larger than the former in number, The duration from the stroke to admission for rehabilitation was less than a month in 9 cases (9.2%), 1 to 3 months in 27 cases (27.6%), 3 to 6 months in 31 cases (31.6%) and so within 6 months in 67 cases (68.4%). According to our method for evaluation, the ability of movement of the patients at the time of admission was more than 5 in their lower extremities, that is, they could manage to ambulate, but slow of recovery in their upper extremities.
Nine cases of hemiplegia who had not bathed since cerebrovascular stroke were made to bathe by the electric hoist apparatus at 37° to 38°C for 10 minutes, Of 9 cases, 6 showed a slight rise of blood pressure immediately after bathing, but all nine cases showed a fall in blood pressure below the pre-bathing value after 90 minutes. Of these cases, the one who was made to bathe at the earliest date from stroke did so 24 days after the stroke. It seems that there are no risk in making a patient bathe at an early date from the stroke.
Observation was made of the effects of luke-warm bath, electric bath, massage and active exercise of the upper limbs on blood pressure and plecysmogram. It was found that blood pressure fell after luke-warm and electric bathing, but that it slightly rose after massage and active exercise. As to the effects on the plecysmogram, it may be said that all four mentioned above will act effectively on blood circulation, among which the electric bath is most effective.
The effect of rehabilitation was most remarkable in 19 cases, remarkable in 27 cases, slight in 32 cases, invariant in 18 cases, death in 2 cases, showing effectiveness in 46 cases, 47.2%. Invariant cases included those who had been admitted after they had recovered their movement almost completely. The recovery was better in the cerebral hemorrhage than in cerebral infarction and the recovery was better in the lower limds than in the upper limbs, The larger of cases in which rehabilitation was most effective and remarkable were those in whom the rehabilitation was instituted soon after the stroke, but there were cases in whom the rehabilitation proved effective even though the program was instituted over a year after the stroke, which is suggestive of the importance of rehabilitation. No definite relation seems to be present between the age of patients and the effect of rehabilitation, nor there seems to be any definite relation present between serum cholesterol and such laboratory findings as the function of kidney and the eyeground. The electromyograms taken before and after rehabilitation showed that there were signs of improvement in all cases, though different in all cases, though different in degree. It can be verified from the electromyograms the improvement was better in the lower limbs than in the upper limbs.
The replies to the inquiries on prognosis sent to 104 patients who were discharged from this hospital and the National Narugo Hospital from 1955 to 1962 were received from 79 persons, Compared with the condition at the time of discharge, 32 cases showed some improvement, 20 cases slight improvement, 17 cases invariant, 5 cases recurrence and 5 cases of death. Of the five cases of

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 results of our general and medical survey are summarized as follows:
(A) About Shinjo Spa
1) Most of visitors to this spa are residents of Yamagata Prefecture and engaged in agriculture.
2) In age they are 20 to 50.
3) Visitors who are few in number came to this spa for the purpose of spa treatment. Most of them visit this spa for recreation.
4) Most visitors take bath 2 to 3 times a day.
5) The bathing reaction and its effect are obscure, because most visitors do not stay here long enough for observation of the effect. It is, however, verified that this spa is effective in keeping the body father warm for a long time.
(B) About Niiyama Spa
1) Most visitors are residents of Yamagata Prefecture and those from neighboring prefecture are small in number. Half of visitors are farmers.
2) Most visitors are old in age, male and female visitors are almost equal in number.
3) The larger number of visitors come here for balneotherapy of or rehabilitation from diseases, especially neuralgia, rheumatism.
4) Most visitors are conscious of the good effect of bathing, but those who are conscious of thermal crisis are relatively few in number, being 9.8% of the total number of visitors.
The authors are indebted to the Pharmaceutical Section, Sanitation Bureau, Yamagata Prefectural Office and the Sanitation Section, Shinjo City Office for assistance given to the present survey, and to Shinjo and Niiyama Spa Associations for careful cooperation.

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.