In Japan, balneotherapy is now on fashion as one of complementary therapies. Nevertheless, in the ageing society, we are facing to needs in relation to evidence-based health care on every direction. This paper reviews current articles on the use of balneotherapy in health care.
We made a systematic review on related articles in the Medline and Cochrane Library database from 1966 to 2005 that included randomized controlled and non-randomized clinical trials using balneotherapy. We also tried to classify spas in determining the chemical composition and their health effects. Ten kinds of spas (acidic, salty, sulfur, magnesium, carbon dioxide, arsenical-ferruginose, selenium, radon, sulfate, bicarbonate) were classified, and three disorders such as skin, joint/muscleskelton and circulatory system have been mainly treated by balneothrapy. In half of articles, randomized controlled trial appeared as the comparative method.
In future, certain developed methods are requested to investigate effects of spas consisting of huge diversity of chemical content.

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Objective:
A rapid rise in blood pressure (BP) in the early morning is called morning BP surge and is known to be related to the onset of cerebrovascular or cardiovascular diseases. Exposure to cold temperature aggravates this condition. However, few studies have investigated the relationship between morning BP surge and bedroom temperature (BT). This study examined the effectiveness of a comfortable BT for mitigating morning BP surge.
Methods:
In this study, five healthy male university students (22.8±0.4 years old with BMI 21.7±1.3Kg/m²) volunteered to be subjects. The relative humidity in the bedroom was controlled to 50%, and the BT was set at 10°C and 250°C for two test conditions. From 0:00 to 8:00am, a Portapres Model-2 was used to measure BP continually at each beat. The average BP and heart rate (HR) from 2:00 and 4:00am were used as the baseline BP and HR. The changing rates of BP and HR from 4:00 to 7:30, the time and the BP value when BP started to rise, the time and the BP value when the BP reached the maximum, the BP value at the time of waking, and the time and rate of increase of BP until it reached the peak at temperatures of 10°C and 25°C were compared by means of the Wilcoxon signed ranking test.
Results:
The BP before waking started to rise later at 25°C than that at 10°C. BP rose more slowly at the higher BT than at the lower BT, especially 30 minutes after waking. At the lower BT, BP rose almost linearly, and the maximum rising rates were 37% (153.3mmHg) for systolic BP and 54% (97.6mmHg) for diastolic BP. At the higher BT of 25°C, however, BP reached the first peaks about 20 minutes after waking/getting up, and then remained stable. The maximum rising rate was 30% (14.2mmHg) for systolic BP and 33% (86.5mmHg) for diastolic BP. At the higher BT, BP reached the maximum value 40 minutes later for systolic BP and 60 minutes later for diastolic BP. At the lower BT, systolic BP exceeded the normal range, reached 140mmHg 35 minutes after getting up, remained stable for 55 minutes, and then rose to the maximum value of 153.3mmHg. In contrast, at the higher BT, the first peak of BP was significantly lower than that at the lower BT. Furthermore, the differences in BP between the first peak of BP and the BP value at the time of staring to rise and between the first peaks and the BP value at the time of waking up were significantly lower at the higher BT than those at the lower BT. The rising rates of BP from the time when BP started to rise and from the time of waking until reaching the maximum value were significantly lower at the higher BT than those at the lower BT.
Conclusions:
These results suggest that the margin of the rise in BP, the rising rate of BP, and the peak value of BP in the early morning are significantly lower at a BT of 25°C than those at a BT of 10°C. They also suggest that sleeping at a comfortable BT, especially during winter, may suppress morning hypertension or morning BP surge and indirectly prevent the onset of cerebrovascular and cardiovascular disease as well as related deaths. Although the subjects in this study were healthy young men, it was considered that the benefit of sleeping in warm bedroom for preventing morning BP surge may be increased for the elderly who are highly likely to have already suffered from such underlying diseases as hypertension.

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We studied the effect of hot-spring bathing by pregnant women on the Apgar score of their vaginally delivered babies by retrospective investigation.
The subjects were classified into four groups: group 1 consisting of 33 pregnant women who took hot-spring baths everyday, group 2 consisting of 166 pregnant women who took plain-water baths with additives everyday, group 3 consisting of 308 pregnant women took plain-water baths without additives everyday, and group 4 consisting of 34 pregnant women who showers everyday.
In group 1, the Apgar score was 9 for 27 babies (81.8%) and 8 for six babies (18.2%). In group 2, the Apgar score was 10 for two babies (1.2%), 9 for 125 babies (76.2%), 8 for 37 babies (22.6%), 7 for one baby (0.6%), and 6 for one baby (0.6%). In group 3, the Apgar score was 10 for five babies (1.6%), 9 for 227 babies (73.7%), 8 for 69 babies (22.4%), 7 for four babies (1.3%), 6 for one baby (0.3%), 4 for one baby (0.3%), and 3 for one baby (0.3%). In group 4, the Apgar score was 9 for 30 babies (88.2%) and 8 for four babies (11.8%).
No significant correlations were observed between the Apgar score and the groups who bathed in different ways (hot-spring bathing, plain-water bathing, or showers).
In conclusion, pregnant women can bathe in hot springs without fear of affecting their babies.

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The purposes of this study were to develop a low-impact underwater exercise program that can be implemented at water temperatures around 40 degrees C, an environment commonly available in many hot-spring bathing facilities in Japan, and further to verify the effectiveness of the program by experiments.
This program assumes three patterns of bathing, i. e., foot bathing, hip bathing, and chest bathing, considering the designs of bathtubs in such facilities. It also incorporates five categories of underwater exercise, i. e., warming up, toning, flexibility exercise, relaxation, and cooling down, for each pattern of bathing.
The underwater exercise program was tried by ten elderly female subjects (aged 67±5).
The results indicated significant differences in rectal temperature and heart rate from those in plain-water bathing but with little physiologic damage. Therefore, these results suggest that the aged can participat in the newly developed underwater exercise program while they are bathing in hot springs.

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我々は、気管支喘息の治療に温泉療法とn-3系多価不飽和脂肪酸を多く含むエゴマ油食の併用が有効であることを報告してきた。その作用機序としては、白血球からのロイコトリエンC4 (LTC4) 産生能の抑制が示唆されたが、その解明は不十分である。そこで、今回我々は、温泉療法とエゴマ油食の気管支喘息の病態に対する作用機序を明らかにすることを目的として喘息患者の血清 eosinophil cationic protein (ECP) 値に対する併用療法の効果を検討した。症状の安定した10名の喘息患者に温泉療法及びエゴマ油食の摂取を4週間行い、その間の末梢血白血球LTC4産生能、血清ECP値、呼吸機能の変化を比較検討した。その結果、白血球LTC4産生能、血清ECP値は治療開始4週後有意に抑制された (P<0.05)。また、呼吸機能の中では、努力肺活量 (FVC) が治療開始4週後に有意に改善した (P<0.05)。4週間で血中好酸球数は低下傾向が見られたが有意の変化ではなかった。これらの結果より、温泉療法とエゴマ油食は白血球LTC4産生能、血清ECP値を抑制することにより呼吸機能を改善させ、気管支喘息の治療に有効であることが示唆された。

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閉塞性動脈硬化症 (ASO)、糖尿病性末梢循環障害に合併する難治性下肢潰瘍、壊疽の治療、予防として人工炭酸泉浴は有用であると考えられている。今回、人工炭酸泉浴による足浴の末梢循環改善作用を定量的に明らかにする目的で健常成人6例 (年齢27～52歳、男性5例、女性1例) について検討した。右下肢腓骨外果より頭側10cmの背側にレーザードップラー血流計を固定し、さらに防水用のテープで覆った。42度の温水10lをバケツに入れ、バブ錠1個を投入し、対象患者の両足を膝下まで10分間浸水した。観察は、浴前、浴中、浴後5分、15分、25分、35分に行なった。次に、足浴の全身の末梢循環血流量に及ぼす影響を検討する目的で、右上肢手関節より頭側10cmにレーザードプラー血流計を固定し、足浴時と同時に上肢の末梢血流量を測定した。足浴前の血流量を100%とした時、足浴中10分では264±135 (%) (p<0.05)、足浴後5分では256±174、浴後15分では146±60、浴後25分では112±23、浴後35分では107±24と漸減し、足浴前値に低下した。上肢の血流量は、浴前の血流量を100%とした時に、浴中10分では119±49、浴後5分では120±66、浴後15分では113±28、浴後25分では109±16、浴後35分では95±14と漸減し、浴前値に低下した。人工炭酸泉浴を用いた足浴の末梢循環に及ぼす血流増加効果が数量的 (2.6倍) に認められた。しかし、その効果は浴後5分間は持続するものの15分後より低下する事が示された。簡易で効果的な人工炭酸泉浴を用いた足浴は、下肢の難治性潰瘍や壊疽の治療・予防に有効であることが示唆された。

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