I. Hiatological Examination. To solve the problem of the allergic nature of thromboangiitis obliterans, detailed histological examinations have been made in amputated limbs, cervical muscles, lumbar sympathetic ganglia etc. Results obtained are summarized in the following. 1. More or less histological changes can be observed everywhere in the body. 2. Histological findings characterizing allergy are found in blood vessels, muscles and peripheral nerves. 3. There are morphological evidences of the repeated occurrence of allergic reaction, explaining the progressive nature of the disease. 4. Althuogh an unknown allergy may be the primary cause, it is possible that additional changes take place as a result of another allergy from the infected and devitalized tissue in the gangrene. 5. The thrombosis in large blood vessels is supposed with good reasons to follow the allergic changes of vasa vasarum in thrombosed areas. 6. In this diseases, marked vascular newformation in rete arteriosus cutaneum is observed in feet and toes. As E. Jaeger has suggested, the constriction of these cutaneous arterioles may be the cause of aggravation of symptoms in cold winter. 7. The disturbance of blood supply and the degeneration of nerve fibers undoubtedly take some part in the occurrence of organic changes in the disease. II. Clinical Statistics 1. In my series of 185 patients of thromboangiitis obliterans, there are clinical evidences showing that it is a generalized disease. 2. In the heredity and past history of patients an allergic disposition is apparently suggested.

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In 1932, it was reported by Dr. Todd & her co-workers that the streptolysin "O" produced from group A hemolytic streptococci had a common antigen throughout almost other pathogenic groups (C, G etc.). Since then, in foreign countries, antistreptolysin,'O" titer in patients' serum has been measured quantatively as a routine work for the purpose of diagnosis and prognosis in the diseases which caused from hemolytic streptococcal infection particularly in rheumatic diseases. I am regret that we have ever got no reports about antistreptolysintiter of rheumatic and other diseases tested by any clinical laboratory worker in Japan. Since January 1949, I have examined antistreptolysin test according to Dr. Todd's method about rheumatic diseases (22 cases), scarlet fever (16 cases) and other diseases (13 cases) with a course of disease. (See Table 1, 2, 3) And I found that almost rheumatic patients had maintained the high titer in this test throughout every stage of the illness not refering to the genesis of the disease. On the other hand, in the scarlet fever I could observe that most of patients were demonstrated having gradually rising titer with the course of disease. About the genesis of rheumatic fever, a great many discussions have been disputed for a long time and recently it is suggested that it may be polygenetic and we also agree with theory. From above results, however, I can not help recognizing the fact that almost rheumatic patients have ever had the anamnesis of hemolytic streptococcal infection before, even if the direct cause of the disease is not clear.

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Up to the present, the quantity of phosphatide in sera was measured chemically by many investigators. If I put together what they said, I came to the following conclusion-on the easily infectious condition the phosphatide in sera increased and after exercise it increased in sera and decreased in muscles. I could measure serologicaly the quantity of phosphatide in sera by ACPR. Then, in the patients' sera with myocardial lesion, especially in the allergic condition the myocardial phosphatide increased, namely ACPR showed higher value.

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The Author studied the blood volume and the specific gravity of blood in 10 infectious diarrhoea cases, prior to its onset, during the actual course of the disease and in the convalescent stage, and observed that : (1). The total blood volume is found on an average 81.9 cc prior to the onset of symptoms, 80.1 cc during the actual course of the disease when it is, although so slightly, seen decreasing, and 84.5 cc in the convalescent stage per every kilogram bodyweight. (2) The plasma volume is found, on an average, 39.5 cc prior to the onset of symptoms, 32.2 cc during the actual course of the disease when a remarkable decrease is noted before it exhibits 40.9 cc as it takes a favourable turn. Such decrease takes place in every case without a single exception. (3) The volume of the blood-corpuscles is found, on an average, 42.4 cc prior to the onset, 47.9 cc during the actual course of the disease when a distinct increase is seen, and, 43.6 cc in the convalescent stage per kilogram bodyweight. Such increase takes place in every case without fail. (4) Haematocrit is found, on an average, 51.6% prior to the onset, 59.9% during the actual course of the disease and 51.8% in the convalescent stage, denoting a constant increase during the days the diarrhoea lasts. (5). The specific gravity of the blood and blood-plasma is found, on an averge, 1.0592 and 1.0273 respectively prior to the onset of the symptom, 1.0644 and 1.0286 during the actual diarrhoeal course when an increase is noted, and, 1.0584 and 1.0270 as it takes a turn for the better. (6). The amount of the portein in the blood-plasma is found, on an average, 7.6g/dl prior to the onset of symptom, 8.1g/dl during the course of disease to remind an increase and 7.5g/dl in the convalescent stage, while the total amount of the protein in tne circulating blood-plasma is found decreasing during the course of disease, to record on an averge, 173g prior to its onset, 146g during the actual morbid days and 176 when recovering.

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As the second experiment, rabbits were sensitized with the mixture of egg-albumin and rabbits-heart-muscle-phosphatide, and clinically electrocardiogram, blood-pressure, urine, hemogram etc. were observed. After killed, their organs, especially heart were investigated histologically to find whether the animals have specifically myocarditis or not. Clinically body weight, temperature, blood-pressure, urine and hemogram were not so changed, but Ecg showed myocardial damages.

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The author calibrated the blood capillaries which were affected by the negative pressure at -200mmHg and also at -300mmHg, and investigated the relation between the dilatation of blood capillaries and the edema, then got the following details. 1) Generally the blood capillaries expand 3〜6μ immediately after the beginning of application of negative pressure, and this state is continued through the whole period of application. The form of dilatated capillaries is quite different from what expanded by venous congestion. 2) There are differences about the form of dilatation in each capillary portion according to the kinds fo disease. 3) The intensity of the edema is not always seen parallel to that of dilatation, but it is directly proportional to that of negative pressure.

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