An Experience of the "Thermalstollenkur" in Böckstein-Badgastein, Austria

The balneotherapeutic tunnel of Radha usberg is located in Badgastein 1280 meter above the sea level and was instituted to offer a new and unique thermal therapy in 1954. The ther mal therapy is performed for a period of 8 months from February to October seasonally on patients of more than 35,000 from all over the world. The information given by chief Dr. Beate Sandri is summarized as follows; There are 3 cooperative acting factors such as the heat inside the tunnel of 37.5-41.5℃, high humidity and high content of Radon. They stimulate a pituitary - adrenocortical system enough to sedate the vicious circle of pain pathology and to improve a peripheral tissue perfusion. This balneotherapy is completed preferably in combination with massage and exercise, and is repeated in each season with patience. The indications are as follows; 1. chronic rheumatic arthritis, 2. degenerative arthrosis, 3. collagen diseases, 4. gout, 5. peripheral vascular diseases, 6. posttraumatic disorders, 7. central and peripheral nerve disorders, 8. allergic diseases, 9. hormonal and autonomic nerve disorders. Cure effect is evaluated by the improvement of subjective symptoms such as relief from pain, extension of the range of movement, increase of daily activities and so on, regardless of the pathology of each joint. The balneotherapy aims to stimulate patients' own abilities, so that the potential curability of the patients is set forth as a premise; so called end stage patients are beyond the remedy as Prof. Scheminzky insists

An application of the artificial CO(2) bath for enuresis

The artificial CO(2) bath was prescribed for two enuretic boys with bladder-sensitive or parasympaticotonic type. A tablet of 50 g, made from sodium bicarbonate and succinic acid, was put in a bath-tub of 150-200 L at 40℃. Each patient was recommended to take a bath with his mother longer than ten minutes, and to mark the presence or the absence of enuresis every day. Outcome results of case 1 on CO(2) bath is shown in tabel 1 and results of case 2 on CO(2) bath is shown in table 3. Both two cases became free from enuresis 7-10 days after the initiation of the artificial CO(2) bathing. Etiological mechanisms of enuresis seem to be multi-factorious, with underlining networks of central- and autonomous nerve systems for the control of sleep and bladder. It is suspected that some improvement of peripheral circulation by CO(2)-bathing leading to keep the body warm may be one of the contributing factors which prolong the intervals of urination, resulting in autonomous normalization, at least, for the cases of bladder-sensitive enuresis, Further case studies are needed to support this assumption

Hypnotic effect of the peloid therapy applied on the right hypochondrium in reference to plasma L-tryptophan

Based on the EEG-observation of falling asleep when patients are under peloid therapy applied on the right hypochondrium, following assumption is made to clarify the mechanism of inducing sleep. While patients are under the peloid therapy, some chemical substance will be produced in circulating blood; L-tryptophan, an essential amino acid and a precursor of serotonin, gets over a blood-brain barrier easily to induce sleep. Six healthy volunteers, each sex by threes, were selected to apply peloid pack on the right hypochondrium for 30 minutes following 12-hour fasting. Significant increase in plasma L-tryptophan level was obtained in the clinical experiment. It is speculated from the preliminary data that L-tryptophan increased by the peloid therapy may possibly act as a specific physiological hypnotics

The effect on tissue perfusion by brine spring (solquellen)

Changes in partial pressures of each tissue gas and tissue perfusion were evaluated in the 2.5% artificial salt baths by means of medical mass spectrometry using 9 rabbits. The level of subcutaueous PO(2) lowered by 18% and PCO(2) elevated by 7 % compared with the plain water bath. The tissue perfusion volume was found increased by few %. It is assumed that we owe the warm feeling after taking concentrated salt baths to the improved tissue perfusion

Clinical trials with artificial CO(2) bathings

パブ浴（人工炭酸浴剤浴）は，組織に酸素を供給し，また組織循環の改善により組織に賦活力を与え，さらに末梢毛細血管の拡張作用を有する。外来患者を対象に，末梢循環障害5例，高血圧症2例，不定愁訴症例2例を選び，半年より1年にわたって家庭でパブ浴を連浴させた。全例に，併用薬の減量，あるいは中止をみた。とくに蛋白尿を伴った高血圧症例では，血圧の正常化に伴って蛋白尿の減少をみた。炭酸泉の効果は連浴によっても変化を認めず，人工炭酸泉浴は家庭においても療養泉としての効果がえられ，疾病の自然予後に有為に作用する。Clinical trials for 5 cases of peripheral circulation insufficiency, 2 cases of hypertension, 2 cases of general malaise and 2 cases of liver function insufficiency were performed with artificial CO(2) baths using BUB-KAO, a 50 g sodium hydogencarbonate and succinic acid tablet, KAO Co. Ltd., Japan, in 150-litre-tub at 40℃ for 10-20 minutes in a period of 6 to 12 months. By virtue of an increase of tissue PO(2) and an improvement of tissue perfusion with artificial CO(2) baths, favorable effects were obtained in all cases but in 2 patients with liver function insufficiency, leading to reduce or discontinue the regular medications. Remarkable effect was observed in 2 cases of hypertension, being brought under control in 2 months, keeping normal range thereafter due possibly to lowering the peripheral resistance caused by capillary dilation effect. A greate favor of hypotensive effect was granted in reducing the excretion of urinary protein. It is very advantageous in maintaining homeostasis to ameliorate natural course of diseases with artificial C (2) baths which are effective by repeated routine use for a long period of time, leading to assist modern way of medical treatment

The effect of artificial CO(2) bathing on peripheral circulation insufficiency.

末梢動脈の慢性閉塞性疾患に対する血行再建術の予後は不良で，虚血肢の治療には一定の見解が乏しく非常に難澁するものである。組織循環の概念にもとづいた評価法によると，医用質量分析装置を用いた虚血肢運動負荷後のPtCO(2)の脱飽和曲線の型により組織循環の良否が定まる。組織循環の良好な型では，自然予後は良好で，いかなる保存的治療にもよく反応する。一方，組織循環の不良な型の自然予後は不良であるので，人工炭酸泉浴によるPtO(2)の増加，および組織循環量の改善により予後は良好となる。人工炭酸泉浴は，組織循環の良好な症例には治癒促進的に作用し，組織循環の不良な症例にも有効に作用する。Arteriography provides clear and useful information of ischemic leg anatomy. The method is limited, in that measurement of less than 100μ can not be made. The hemodynamics or functional consequences of the ischemic state should be evaluated by tissue circulation or perfusion methods that depend principally on systemic blood flow. Tissue perfusion is classified in two groups, insufficient and sufficient, depending on the type of clearance curve of PCO(2) in leg muscle following ankle exercise by means of medical mass spectrometry, Medspect Ⅱ, Chemetron, U.S.A. Either artificial CO(2) bathing or CO(2) vapour bath are efficacious for peripheral ischemic wound. Artificial CO(2) bathing is prepared with BUB-KAO 2tab., a 50g sodium hydrogen-carbonate and succinic acid tablet, Kao Co. Ltd. Japan, in 280-litre-tub at 40℃ for 20 minutes. CO(2) vapour bath is prepared with UKS CO(2) Trockengas Badkabine, Hansen Co., Ltd. West Germany, 20-litre-CO(2) per minutes at 40～42℃ for 20 minutes. In the case of insufficient tissue perfusion, ischemic wound is met promising outcome with CO(2) bathing even though no hope is expected with any medicine for peripheral circulation. Whereas, in the case of sufficient tissue perfusion, ischemic wound is expected much help of CO(2) bathing, as well as of all kinds of medicine, in healing process

Evaluation of tissue perfusion in ischemic legs of dogs by CO2 clearance rate.

Improvement in tissue perfusion following surgically induced ischemia in limbs of dogs was experimentally evaluated to clarify the improvement of hemodynamics following walking exercise in chronic, peripheral arterial occlusive diseases. With the use of a computer system in conjunction with medical mass spectrometry, the local tissue perfusion rate was calculated on the basis of the clearance curve of tissue partial pressure of CO2 following electrical stimulation of the ischemic leg to simulate exercise. Ischemia was created in the leg by ligation of the proximal and peripheral arteries. In one month, intermittent claudication improved in accordance with improvement in muscle tissue perfusion. Angiographic evidence of distal runoff became visible six months after surgery, indicating that tissue perfusion played an important role in peripheral hemodynamics. The local tissue perfusion rate improved from 9.51 +/- 2.62 ml/100 g/min to 12.41 +/- 2.42 in one month, to 14.59 +/- 3.19 in three months, to 15.11 +/- 3.24 in six months and to 17.19 +/- 2.63 in twelve months. The improvement of ischemic symptoms following long-term exercise is attributed to improvements in tissue perfusion or collateral circulation.</p

Esophagus hiatal hernia with special reference to the early stage

In the aged, hiatal hernia should be recognized as it has developed; it develops progressively. Special attention should be given to the early stage of hiatal hernia from the genetic point of view. Like other organs in the aged, aging changes around a hiatus are inevitable; relaxing of esophageal diaphragmatic ligament and weakening of muscle power of diaphragmatic vertebral part move on with age. After all, valve structure at hiatus, Goubaroff's valve, is so weakened its function and in the stomach, "His angle" is so widened, that the stomach becomes wedge shaped against the hiatus. The more the pressure in the stomach increases, the larger the wedge shapes. Under these conditions, when the abdominal pressure rises by the acts of coughing or defecation, hiatus may be widened and the wedge may be pushed into the hiatus. There are no strong valve and or ligament enough to keep the wedge part of stomach in peritoneal cavity. In the stomach, the pressure of the expelling meal is equal to that of the widening wedge. On the other hand, in the peritoneal cavity, pressure produced by the act of defecation is equal to that of ejecting the wedge through hiatus. These are self-evident from the Pascal's principle. Hiatal hernia is produced under these conditions. We, therefore, should call the attention to the early genetic stage of hiatal hernia. In Japan, hiatal hernia has been recognized when it gets larger and fixes out of the peritoneal cavity. But in the early stage, it also must be noted as hiatal hernia

Esophagus hiatal hernia with special reference to the early stage

In the aged, hiatal hernia should be recognized as it has developed; it develops progressively. Special attention should be given to the early stage of hiatal hernia from the genetic point of view. Like other organs in the aged, aging changes around a hiatus are inevitable; relaxing of esophageal diaphragmatic ligament and weakening of muscle power of diaphragmatic vertebral part move on with age. After all, valve structure at hiatus, Goubaroff's valve, is so weakened its function and in the stomach, "His angle" is so widened, that the stomach becomes wedge shaped against the hiatus. The more the pressure in the stomach increases, the larger the wedge shapes. Under these conditions, when the abdominal pressure rises by the acts of coughing or defecation, hiatus may be widened and the wedge may be pushed into the hiatus. There are no strong valve and or ligament enough to keep the wedge part of stomach in peritoneal cavity. In the stomach, the pressure of the expelling meal is equal to that of the widening wedge. On the other hand, in the peritoneal cavity, pressure produced by the act of defecation is equal to that of ejecting the wedge through hiatus. These are self-evident from the Pascal's principle. Hiatal hernia is produced under these conditions. We, therefore, should call the attention to the early genetic stage of hiatal hernia. In Japan, hiatal hernia has been recognized when it gets larger and fixes out of the peritoneal cavity. But in the early stage, it also must be noted as hiatal hernia

日本に於ける二酸化炭素泉療法の現況

Natural CO(2) springs have been scarcely utilized in Japan, whereas artificial CO(2) bathing has become popular by the introduction of CO(2) tablets and other apparatus for CO(2) water supply. Artificial CO(2) bathing is indicated for degenerative connective tissue disorders such as scleroderma, common stiff and painful shoulders, chronic joint pain, lumbago, and trophic changes due to insufficient peripheral circulation by virtue of the increase of tissue pO(2) and the improvement of tissue perfusion. Artificial CO(2) bathing promotes recovery from fatigue and is beneficial in women whose health has been adversely affected by cold.日本では，天然の二酸化炭素泉は殆ど利用されていない。一方，CO(2)錠剤，CO(2)給水装置が開発されて人工二酸化炭素泉がよく用いられるようになってきた。皮下組織の酸素分圧の上昇と組織循環の改善という好ましい生理作用により，結合織の退行性変化による慢性障害，すなわち強皮症，関節症，慢性関節痛，腰痛症，および末梢循環障害に伴う組織の栄養障害に適応がある。また，疲労回復を促進し，いわゆる冷え症に好ましく作用する