There are many reports on the relationships between the complaints of the patients with thyroid disease, including Graves' disease. However, Iittle information is available on described thyroid hormone levels. The present study was undertaken to determine the relations between subjective complaints and serum thyroid indicators (T_4,T_3,F-T_4,F-T_3) in patients with Graves' disease. The complaints of the patients were analyzed, according to the Cornell Medical Index (CMI). The patients with nontoxic nodular goiter served as controls. The results obtained herein were as follows : 1) Serum thyroid hormone levels of the patients with untreated Graves' disease were much higher than those of treated ones and nontoxic nodular goiter. 2) Fifty-two percent of untreated Graves' disease patients belonged to the III+IV area of Fukamachi's classification on CMI due mainly to cardiovascular complaints. There was no difference in the frequency of other somatic and psychological complaints of CMI in those three groups. 3) During T_3suppression test, serum T_3 levels of treated patients with Graves' disease were as high as those of the untreated ones. However, the frequency of their cardiovascular complaints was the same as it was before T_3 administration. The results indicate that sustained levels of increased thyroid hormone affects subjective complaints of Graves' disease patients, while the elevation of T_3 for shorter periods had without effects.

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The most important portion of the original Morita Therapy is concerned with showing the patient how he is preoccupied by means of work and diary, and also with helping him learn through absorption in work, that he can do anything in spite of any pains and anxiety. But Morita Therapy is difEcult to practice under the current medical insurance system, or in the setting of modern cites where the doctor's ofEce is located in a high storied building with no provision materials for work. Therefore the author proposed "Walking Training Therapy (Modification of Morita Therapy)" in which walking is adopted instead of working. This therapy is conducted according to the following formula after the period of preparations which consists of one week of absolute rest. l. The patient decides together with the therapist where the final destination of walking will be. It is suitable to choose a station or a bus stop which is located within a 30 minute walk. 2. The patient decides the course of walking. 3. The patient decides the time of walking. 4. Speed of walking is left to the patient. 5. The patient walks by himself. 6. Distance of walking is gradually extended in so far as the patient can keep up the pace. 7. The stance the patient walked yesterday can certainly be covered today, despite the patients mood or the weather. 8. If the patient can walk to the final destination, he should begin to walk twice at his pace at different times. 9. The therapist must make a consistent evaluation of the patient according to the accomplishment of walking the routine distance in spite of pain or anxiety rather than the improvement of his symptoms. lO. It is desirable to guide the patient by means of the diary and also to add daily work besides walking. The author considers this therapy is more useful than the original Morita Therapy in psychosomatic medicine because it is possible for any doctor to practice it in hospitals of any modern city as well as on outpatients. Besides it does not change the essential part of the original Morita Therapy, that is, that he learns from experience. Also this therapy is very effective for such those with a phobia 6f going out, depressive state or anxiety neuroses and psychosomatic disorders.

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Fasting therapy is a very valuable treatment for psychosomatic disorders with elucidation of therapeutic mechanism which is recently developing. Although the cases of fasting therapy for liver disorders are increasing in order to correct the innappropriate life style, few researches have been done to investigate the influence of fasting therapy on liver function. The purpose of this study is to solve the above problem and to determine the indication of fasting therapy for liver disorders. The subjects were 30 cases with liver disorders (group A) and two control groups (group B and O whose age and sex were almost matched with the group A. Both of the group A and C consisted of 10 cases with alcoholic liver injury, 6 hypernutritional fatty liver, 2 druginduced liver injury, 2 chronic hepatitis, I Iiver cirrhosis, and 9 cause-unknown hapatic dysfunction. Liver function of all cases in the group B was normal. Basic liver protective regimen was performed to the all groups, fasting therapy including 10 days for fasting phase with drip infusion of 50% Pentose solution 500 ml and 5 days for convalescent phase followed it in the groupS A and B, and liver protective regimen continued in the group C. Liver function via blood sample was measured before, during, and after fasting therapy and was compared among the groups. The results were as follows ; (1) Serum liver enzymes decreased significantly after fasting therapy in the group A (for example, GPT before 47.7±4.3,after 30.5±3.6 IU/1,p<0.01l). (2) Delta values (before-after fasting therapy) of serum liver enzymes were significantly higher in the group A than in the group B and group C. (3) Significant positive correlations among the serum liver enzymes increased after fasting therapy only in the group A. (4) In the group A, Iiver function of alcoholic liver injury and hypernutritional fatty liver improved considerably and significantly. These results suggest that fasting therapy has beneficial effects on mild liver function disorders especially on alcoholic liver injury, hypernutritional fatty liver, and drug-induced liver injury via metabolic change, regulation of autonomic function, and behavioral modification due to alteration of consciousness during fasting therapy.

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In the frrst report we made a psychosomatic health investigation of Tanshin-Funin (employees of some enterprises living alone apart from their own families. "married bachelors") in Kagawa, using the General Health Questionnaire (GHQ). Since such a mode of living of an employee presents an important problem to his spouse, we examined the psychosomatic influence of this mode of living on employees and their spouses, using GHQ and YG test. The subjects consisted of 74 couples. The following items were examined : Comparison of Tanshin-Funin and spouses in GHQ, YG test in Tanshin-Funin, correlation between GHQ and YG test, correlation between TanshinFunin and spouses in GHQ total score. 26 questions were prepared for their spouses. Results were as follows : There was no significant difference between TanshinFunin and their spouses in the GHQ total score. But, there was a significant difference in severe depressive scale. YG test concerned B and E types of 2 and 4 employees of living apart from their spouses, respectively. B and E types of employees were higher than other types in GHQ total score, and this was the same with their spouses. There was no significant correlation between TanshinFunin and their spouses in GHQ total score. Psychosomatic influences related to separation on their spouses were also observed. B and E types of employees engaged life style tended to show a higher neurotic trend than those of the other types, and this was the same with their spouses. Spouses tended to be in a stronger depressive state than their husbands, and were thought to be in neurotic and mild depressive states. These results suggest that some improvement could be observed in mother and child relationship. We would like to proceed with our studies on psychosomatic influence of such a mode of living.

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The study on the function of the autonomic nervous system was performed chiefly by the digital plethysmogram in 37 normal adults and 66 depressive patients. First each subject was studied on both psychic and physical signs by Hamilton rating scale, Beck depression inventory, and Abe's list of autonomic nervous signs. Next such physical tests as Aschner's test, CzermakHering's test, Schellong's test, and Cold pressor test were examined. Thirdly such studies as the digital plethysmogram (PTG), the electrocardiogram (ECG), and the respiration curve by means of the polygraph were examined on each subject. The part of depressive patients was reexamined in the remissive period by the same procedure in the depressive phase. Several parameters (patterns, height, t", t', Dl, and B) of some waves of the plethysmogram were analysed. And also, the mean (M) standard deviation (SD), and coefficient of variation (CV= SD/M×100) of the continuous 100 heart beats were analysed. The positive results are as follows : l) Sclerotic pattern of PTG was seen more often in depressive subjects than in normal adults. 2) The height of PTG at rest, at 5 min., and 10 min. after standing in the depressvie was significantly lowered than in the normal. 3) CV of the continuous RR intervals on ECG at rest and at 10 min. after standing in the depressive was significantly lowered than in the normal. 4) Although the average of heart beat in the depressive, at rest, not significantly differed from that in the normal in each age except 20's, it significantly differed in 20's, 40's, and 50's at 10 min. after standing. 5) The height of PTG of the Group B which had more autonomic complaints was significantly lowered than the group A which had less complaints both at rest and after standing. 6) The height of PTG and CV of the continuous RR intervals were more significantly heightened on the remissive period than on the depressive phase. Therefore, it was suggested that the sympathetic function of the depression was exaggerated because of exciting mode by Yoshimura in PTG, to which the above results were ascribed, and that the secondary hypofunction of parasympathetic system attended on the depression because of the lowered CV of the RR ' t I the results shown above And it was shown merva as. especially from the results of PTG that the function of the autonomic nervous system was well connected with physical signs, the former being recovered as the latter disappeared in depression.

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[in Japanese]

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