It was said that balneotherapy caused an elevation of peak values of plasma cortisol (PC) at 0400 in the patients with rheumatoid arthritis (RA), but there has been no study on plasma aldosterone (PA). From five patients, 35-77 years old, with mild or inactive RA blood was withdrawn in supine position every four hours one day from 1200 to 1200. After regular bathing (20min. in 39°C hot spring water twice a day) during two weeks a second circadian rhythm study was performed under the same way. Cosinor method was used as a rhythm analysis. Normal circadian rhythmicity of PA and PC was preserved in all patients both before and after balneotherapy. Elevation of peak PC value after balneotherapy was found in all patients but PA was in four only. As for increase of amplitude (obtained from single cosinor method) it was the same as above. Acrophase of PA circadian rhythm was shifted to earlier in the day in three patients and that of PC was shifted in four patients. According to group cosinor method, PA amplitude was altered from 29 to 33pg/ml and PC amplitude was altered from 4.5 to 6.5μg/dl. Acrophase of PA was also changed from -97 to -86 deg., PC was from -96 to -82 deg. after balneotherapy respectively. Conclusion: PA amplitude of circadian rhythm was less affected by two weeks balneotherapy than PC amplitude although a small change may be related to an improvement of autonomic nervous function in chronic disease as RA.
Usefulness of balneotherapy in diabetics were discussed. Plasma glucose levels in diabetics treated with insulin decreased significantly after thirty minutes exercise under 38°C hot springs pool. There were positive relationships on plasma glucose levels between before and after exercise in hot springs. Lipids metabolism were improved during three months' balneotherapy. The ratio of VLDL·LDL-cholesterol/HDL-cholesterol decreased. Basal levels of plasma cyclic AMP decreased slightly and plasma cyclic GMP significantly increased. Intrathecal injection of vitamin B12 (mecobalamin, 2500μg) was apparently effective to reduce the pain on under limb in patients with diabetic peripheral neuropathy whose subjective symptom could not improved by any medications. The effect of mecobalamin was increased by bathing in hot springs. Usually, balneotherapeutic hospitals have facilities of rehabilitation system in Japan. In conclusion, the balneotherapy by adding physical treatment is very benefit to normalize carbohydrate and lipid metabolism. Tranquilizing function of hot springs are effective on psychological disturbance, diabetic autonomic and peripheral neuropathy.
Eleven hospitalized patients (mean age of 53 years) who suffered from hepatic cirrhosis with esophageal (or gastric) varices were brought to a physical training program. The program consisted of voluntary walking, stair climbing and exercise on a treadmill or on a bicycle ergometer, lasting for 14 days-3 months. All of the 11 patients acquired general well-being after the training program. Six of them who received an exercise testing showed improved physical fitness after the training program as proved by the reduced pulse rate during exercise or increased tolerance to an exercise load. Some of the patients showed slightly or moderately increased values in hepatic function tests, however, none of them showed physical signs indicating aggravation of the disease. Among 6 patients with so-called hepatogenic diabetes mellitus, amount of insulin required was reduced in 4 patients and glucose output in urine was reduced in all of the 6 patients after the training program, indicating an improved glucose metabolism in those patients. All of the patients, including 6 patients who underwent surgical treatment for varices, were discharged from the hospital in good performance status. These results indicated that patients with hepatic cirrhosis could safely undergo physical reconditioning which benefits the patients in terms of regaining physical fitness for surgical treatment or for social life.
Huaqing Hot Springs are situated 25km north-east of Xian. There are four springs. Water temperature: 43°C. Simple radioactive thermals with Radon content of 365.4×10-10c/l. In 1964 a sanatorium with 240 beds was established for railway employees. Thermal bath is administered once daily for 20min. at a temperature between 37°-40°C. 15 baths make a series and then a pause of 3-5 days is given. The duration of spa treatment is mostly 3 months. Rheumatic diseases, mild hypertension, skin diseases, digestive disorders, and nervous diseases are the chief indications. Longmen Hot Springs are situated 14km south of Luoyang. Longmen Grottoes are one of the three most famous caves with stone budha statues in China. A spa sanatorium is built in the last year. Water temperature ranges from 24°-60°C. Transparent and odorless, presumably simple thermals.