Experiments were designed to provoke the Raynaud's phenomenon by immersion of hands into cold water (4°C) for 1 min. under three levels of conditions in order to observe changes of the skin temperature under these conditions and also to see the disappearance of this imitiation of the Raynaud's phenomenon. Subjects were used as two groups. One was the user of vibrating tools who complained Raynaud's phenomenon, the other was the control. The obtained results were as follows: (1) The ratio of provoked cases among the examinees was 0% under the room temperature 28°C, it was 14.2% under the air temperature of 6°C hands being kept at 25°C, and it was 78.5% under the air temperature of 6°C. These findings seemed to indicate that the Raynaud's phenomenon of occupational origin occured by the constriction of surface vessels, partly by a direct action of cold to the finger, and partly by the reflex action through the vasomotor nerves. (2) As the ratio of provoked cases was low under the condition which kept both hands warm, the prevention of attack would be realized by keeping hands warm. (3) It was also found that the Raynaud's phenomenon could be provoked by the provocation test to the user of vibrating tools who had not yet complained Raynaud's phenomenon. (4) The remarkable decrement of the skin temperature and the delay of its recovery to the former level were confirmed under the air condition of 28°C in a subject who had experienced the white finger 40-50 times during three years. This example suggested that the critical temperature which was sufficient to provoke the phenomenon had been changed according to the change of microcirculation function and that the threshold had been raised. (5) The skin temperature of finger which provoked Raynaud's phenomenon (appearance-finger) was not always lower than the control finger which did not (non-appearance finger). This means that blood volume in the arterioles and arteriae was showing almost no difference between them. And also, the temperature of the appearance-finger before the cold immersion was not necessarily be lower than the non-appearance finger. (6) The rapid increase of the skin temperature was observed at the non-appearance finger before disappearance of Raynaud's phenomenon, while at the appearance finger it occurred after disappearance. The degree of increase of skin temperature was by 8.9±1.9°C higher than the skin temperature before immersion. This was named "Rebound phenomenon of skin temperature" and this was never observed in the control group. Therefore, this phenomenon seems to be specific pathological phenomenon during Raynaud's phenomenon being provoked, and it is not identical with reactive hyperemia or vascular reaction to cold.

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This investigation was performed to solve the following three problems. First, whether the unbalance of the autonomic nervous system due to the whole body effect is recognized in the occupational Raynaud's patient or not; secondly, whether the test of autonomic nervous function can screen such patients or not; and thirdly, whether the Raynaud's phenomenon appears only in the user of vibrating tools showing the unbalance of the autonomic nervous system or not. The function of the autonomic nervous system was assessed by a modified Wenger's method, namely by measuring sublingual temperature, systolic pressure, diastolic pressure, pulse pressure, pulse rate and arhythmia respiratoria; and the cold pressor test was used to measure the reactivity of the vasomotor mechanism. Both of these were performed twice, i.e. in summer and in winter. Subjects were chain-saw workers with Raynaud's phenomenon, chain-saw workers without Raynaud's phenomenon, bush-cleaning workers without Raynaud's phenomenon, and controls. Obtained results were as follows: The data of the function of the autonomic nervous system and cold pressor reaction did not reveal any significant difference between the Raynaud's patients and other groups. Therefore, it is difficult to screen the Raynaud's patients at the time of absence of white attack by the tests of the autonomic nervous function. As the significant difference was not seen between chain-saw workers with Raynaud's phenomenon and those without it, unbalance of the autonomic nervous function does not seem to be a main factor on the side of the host with regard to the appearance of the Raynaud's phenomenon.

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The present study was performed in order to spot the patient having the Raynaud's phenomenon by inducing iontophoresis while the Raynaud's phenomenon is latent. Ten subjects were divided into two groups each of which was composed of five, one group of patients having the Raynaud's phenomenon and the other serving as the control. As the pain was felt when a current 2 mA or more was introduced and when the current was rapidly increased, a current of 0.5 mA at the beginning and 1.9 mA at the end, increasing by 0.1 mA in every two minutes, was applied. The method of iontophoresis was as follows. At first, a solution of 0.1% noradrenalin was introduced by the above procedure, and next, a solution of 0.5% histamin was perfused by the same procedure. Plethysmogram after noradrenalin iontophoresis was round-shaped and its amplitude (mean) corresponded to 4.3 μl in the patient group. On the contrary, plethysmogram of the control group was sharp and its amplitude (mean) corresponded to 7.4 μl. Namely, a reduction of pulse wave amplitude had occured after the noradrenalin iontophoresis in the patient group. When histamin iontophoresis was operated subsequently, pulse wave amplitude of the control group increased above the amplitude of the patient group. The pulse wave amplitude at the time of histamin iontophoresis was compared with that before histamin iontophoresis, and it was observed that the increment of the pulse wave amplitude of the patient group was larger than that of the control group. However, this tendency was not found in a few persons among the patient group. This might be related with the functional abnormality in individuals among the patient group.

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