The influence of trauma on sexual functions was evaluated in patients with post-traumatic sexual disturbances. ( 1 ) Penile thermography was used for making an objective differential diagnosis between organic and functional impotence in patients with post-traumatic sexual disturbances. The differentiation was possible by checking the presence or absence of penile temperature elevation under visual sexual stimulations. Furthermore, this examination gave rise to good results in the treatment of patients with functional impotence as it presented the objective data. Penile thermography seems to be very useful for the diagnosis and treatment of impotence. ( 2 ) An evaluation of sexual function was made on patients with operative repair of the posterior urethral rupture following pelvic fractures. All of them had libido. Erectile potency and ejaculation were found in 80% and 70% Of the patients respectively. These results may suggest that there may be a lower incidence of sexual disturbance than it has been considered and that the erectile impotence in urethral trauma may be caused by psychosomatic factors.

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The purpose of this study is to make clear the factors essential to the effectiveness of autogenic training (AT). Questionnaires about such factors were sent out to'267 PSD out-patients who were taught AT during past five years from August l, 1974 till July 31,1979. The answers were received from 89 patients (43 males and 46 females) ; 36. 8% of the whole patients, and the mean age was 37. 8 years. Irritable bowel syndrome constituted 44% of 32 patients with digestive organ diseases, while anxiety neurosis was 23% of 57 cases with nondigestive organ diseases. On the whole, AT was found to be very effective in 8 patients, effective in 37,fairly effective in 25,non-effective in 17 and 4 patients could not judge its effect. At least 79% of 89 patients felt that AT was effective to some extent. Rather higher efficacy was shown in higher age patients ; those in their 30's felt AT was significantly more effective than those in their 20's. (X2 =9.91,p<0. 01). As for diagnosis, AT was very useful to esophageal neurosis, duodenal ulcer, nervous vomiting and migraine. In addition, AT was shown to be effective especially in depression, vegetative dystonia and anxiety. But correlation were found neither between CMI and AT effectiveness, nor between YG test and AT effectiveness. Significantly higher efficacy was shown by those patients who learned AT better (U test, p<0. 05), and 74% of the effective group felt their reactions within a month. Those who repeated AT every day showed significantly higher efficacy than those who did only once a month (X2 =4. 75,p <0. 05). Judging from these results, it may be said that l) AT is more effective to the higher age patients rather than the younger, 2) AT seems to be more useful to those who have a depressive tendency and /or anxiety, and 3) higher efficacy can be expected from repetition of AT.

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Hyperventilation (HV) induced by psychological factors or by other causes is considered to be one of the mechanisms underlying asthmatic attacks. The purpose of this investigation was to elucidate the role of HV in the production of asthmatic attacks. Ten asthmatics and seven normal subjects were asked to hyperventilate voluntarily for three minutes. Before and after voluntary HV, arterial blood-gas tension, the blood histamine level, the eosinophil count, the basophil count, the plasma cyclic AMP (cAMP) level, and the plasma cyclic GMP (cGMP) level were measured. Microvibration (MV) was recorded to observe the changes in the state of the autonomic nerve. The results were as follows : 1) Asthmatic attacks occurred after voluntary HV in asthmatics and symptoms of hyperventilation syndrome were observed in normal subjects. 2) Arterial blood-gas tension indicated respiratory alkalosis and hypoxemia after voluntary HV in both groups. 3) Plasma histamine levels tended to increase in asthmatics immediately after voluntary HV but showed no significant changes in normal subjects. Whole blood histamine levels revealed no significant alterations in either group. 4) There were no statistically significant changes of eosinophil count in asthmatics, but a significant decrease was shown immediately after voluntary HV in normal subjects. The basophil count did not show any changes in either group. 5) Both plasma cAMP levels and cGMP levels showed no significant changes in either group. 6) MV showed that there was a tendency for a sympathicotonic state to develop immediately after voluntary HV. Recovery was gradual in both groups. In asthmatics there was a tendency for recovery to be slower. In conclusion, it seemed that HV may l) work as a stressor, 2) be responsible for the release of a chemical mediator, and 3) change the state of the autonomic nerve. Therefore, it is suggested that HV induced by emotional stress etc. can produce an asthmatic attack.

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Spontaneous regression of cancer (SRC) was classified according to the definition by Everson and Cole in 1966 and it was decided to recognize as the proper cases those which met the following requirements. 1) The reduction of a cancer which has been pathohistologically confirmed. 2 ) The reduction of a cancer in spite of unsatisfactory therapy or in the absence of any anti-cancer therapy. 3 ) The long survival of the host body due to extremely delayed progress or prolonged arrest of cancer with no rapid growth of a malignant tumor. 4 ) The long survival of the host body with no cachectic change of cancer in the presence of some anti-cancer therapy or the death of the host body after long survival due to some cause other than cancer. We have collected 35 cases of SRC. We studied each case from pathohistological findings and immunological characteristics (mainly digestive cancer patients) and found some interesting facts. The SRC cases are all primary cancers identified as 17 digestive cancers, 6 lung cancers, 4 vocal cord cancers, 2 liver cancers, 2 rectal cancers, and others. 54. 3% were males whereas 45. 7% were females. The classification of cancer according to histological findings are as follows ; 19 adeno carcinoma, 8 squamous cell carcinoma, 2 hepatoma, 2 carcinoma simplex, 2 scirrhous carcinoma, 1 undifferentiated carcinoma and 1 osteosarcoma. Now* we would like to review pathohistological studies of the organism's reaction to cancer. Watanabe stated that the degree of the lymphocyte infiltration of gastric cancer stroma and the histiocyte reaction of regional lymphocytes are related to the prognosis of cancer (lymphoid stroma). We found many cases of lymphoid stroma as the result of our histological study of the SRC in digestive cases. Psychological evaluation revealed that they had marked tendency to repress their feelings. But after they knew they had cancer, they stopped their bad habits completely and started to live a meaningful life on a day-to-day base by doing service to their surroundings. This can be called what Booth says " an existential shift." It was characteristic of these cases that the patient showed no sign of depression, fear of death and loss of meaning of life after they found their cancer.

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For the simultaneous recording of the intraluminal pressure in proximal and sigmoid colon, we designed a new method named endoscopic retrograde bowel insertion method (ERBI method). Thirty subjects studied were consisted of 7 normal controls, 9 patients with diarrhea and 14 patients with constipation, The basal pressure was recorded for 15 minutes and then O. 5 mg of prostigmin was given i. m. and the pressure was measured for the periods of 60 minutes. The true effect of prostigmin appeared to begin about 15 minutes after the injection and end about 40 minutes after the injection. For qualitative analysis, colonic motility index (CMI) was calculated from basal 15 minutes recordings and 30 minutes after an interval of 15 minutes from the injection of prostigmin. Constipation was classified into two groups according to the patient's reaction to prostigmin in sigmoid colon : one was the hyperactive group which showed CMI over 200,another was the hypoactive group which showed CMI under 200. The former corresponded to spastic constipation in irritable bowel syndrome and the latter corresponded to simple constipation. In the normal control, and in diarrhea and simple constipation, proximal colon was more active than sigmoid colon, whereas in spastic constipation, sigmoid colon was significantly much more active than proximal colon in basal and after prostigmin. In diarrhea the pressure was diminished in the proximal and sigmoid colon. Furthermore, there was a statistically significant correlation between the basal sigmoid pressure and aging.

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We detected 41 patients with muscle contraction headache, 12 with migraine and 26 with psychogenic headache and conducted some psychophysiological examinations in order to explore the differences in characteristics among these headaches. The definition of the diagnostic criteria of those headaches are ' the headache which continues more than a month unaccompanied with a few psychic symptoms and social maladaptation ' for the muscle contraction headache, ' the headache which is the chief complaint and comes from psychic problems such as anxiety, hypochondriasis and depression ' for the psychogenic headache, and ' attacks of headache of pulsating pain which comes at intervals with few symptoms ' for the migraine. The results of examinations are as follows. 1. For the psychological characteristics, Cornell Medical Index (CMI), Yatabe-Guilford Test (Y G) and Minnesota Multiphasic Personality Inventory (MMPI) were applied. The result of CMI showed that most of the psychogenic headache patients and migraine patients were in the third and forth areas whereas the muscle contraction headache patients were not. The result of YG showed that the psychogenic headache patients had a tendency to be the E type, while the muscle contraction headache patients and the migraine patients showed a tendency tQ be the C type. The result of MMPI showed that muscle contraction headache patients and the psychogenic headache patients had high scores of 1,2 and 3 items, while the migraine patients showed the normal pattern. In addition, the psychogenic headache patients showed high scores of 7 and 8 items also. In summary it was found that psychogenic headache patients were neurotic whereas the muscle contraction headache and the migraine patients were not always so. 2. Polygraphic examination (EMG of frontalis muscle, plethysmograph of finger and superficial temporal artery, and microvibration(MV))was applied to 11 patients with muscle contraction headache, 6 patients with psychogenic headache, 4 patients with migraine and 9 controls. The muscle contraction headache patients have high EMG and low 'α%' of MV at the beginning, but lower EMG and higher 'α%' of MV after rest. After mirror drawing test (MDT), their EMGS become higher and 'α%' of MV lower. The psychogenic headache patients show the same pattern of MDT response as one of the muscle contraction headache patients but their EMG and MV at rest are similar to the control. Migraine patients show high EMG and low 'α%' of MV unrelated with MDT.

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In connection with a series of studies on the comprehensive medical treatment of peptic ulcers, the authors have previously reported : (1) results of studies on the basic mechanisms of ulcer healing, (2) the influence of psychoneurotic factors on the healing process of gastric ulcers and (3) the influence of minor tranquilizers on the psychoneuroendocrine functions and the healing process of ulcers in patients with gastric ulcer. This report deals with the prevention of relapse of gastric ulcers in psychosomatic cases. A long-term study, 4-lO years, was undertaken on a total of 27 patients with psychosomatic recurrent gastric ulcers. The patients were classified into two groups, a group of 10 cases with medical treatment and a group of 17 cases with psychosomatic treatments. The control period was laid down as the duration from healing to relapse on each case to evaluate the effects of the therapy. The healing was determined by endoscope. The results were as follows : 1) Psychosocial factors were divided into seven groups, such as stress of life events, domestic and life problems, interpersonal problems, work related problems, gluttony, irregular meals and sleep, and general character. Depression was also an etiology in gastric ulcer relapse. Each consisted of two basic factors, actual (external) component and character (internal) component. 2) Psychosomatic treatment for the prevention of relapse of gastric ulcers was effective in 53% of the cases studied. Insight therapy, supportive therapy, autogenic training, and/or environmental readjustment were effective for the cases that relapsed due to the actual external etiology. But they were little effective for the cases with hyperadaptation and with poor self control of behavior. 3) Preventive signs of gastric ulcer relapse in the cases studied were found gastric juice secretion, blood pressure, and biorhythm of serum cortisol. These results support the usefulness of psychosomatic treatment as better than medical treatment in the prevention of relapse in psychosomatic cases with gastric ulcers, and point to the possible mechanism of effectiveness.

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A 24-yearold male was admitted to our hospital with his complaints of severe polydipsia, polyuria and headache. The total volume of urine reached up to nearly 15 liters per day. He showed nausea, vomiting, aggravation of headache and polydipsia by psychic stress during his hospitalization. No remarkable organic changes were observed in the laboratory data and other examinations. Being given a water deprivation test, he was diagnosed as psychogenic polydipsia. Psychological and environmental factors were considered to be related to the development of the disorder. He received supportive psychotherapy as well as drug treatment with no marked improvement. When the intake of water was restricted to the volume of 2 liters per day by using a scaled polyethylene vessel, the patient made a rapid recovery.

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The patient was a 55-year-old male who had suffered from various neuro-muscular psychosomatic symptoms for 35 years. He was admitted to our clinic twice, and records were available to diagnose the case for twenty years prior. The symptoms included tremor of fingers, extremities and head, blepharospasm, torticollis, shoulder muscle pains and painful muscle spasm in lower extremities. These symptoms were intensified when he was with other persons, but subsided when he was home, or by himself. He had also developed alcohol and drug dependence to eliminate his tension and tremor. When he was forced to confront an unavoidable situation, he sometimes showed unconscious self-destructive tendencies such as obsessive suicidal ideas or actual accidental injuries. As to the genetic and developmental factors of the symptoms, the authors pointed out two important aspects ; that is, one was some unknown physiological disposition which was easily resulted in tremor or spasm in muscles when he became auxious. The other was his personality, in that he easily became tense with other people, dependent on drugs and even self-destructive without accepting alternative methods to relieve his anxiety .

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