(I)Practical and analytical methode of Local Leads. The Local Leads Electrocardiograms in this study are obtained by Chest and Esophageal Leads and they are composed of two kinds of curves which have R and F as indifferent electrodes in the same lead point. This paper showed that it is possible to know the unipolarity of Local Lead Electrocardiograms by comparative observation on the resemblance of these two kinds of curves, and rneasurement of Stimulus Arrival Time by means of Maekawa's method can give accurate analysis of conduction disturbance not only in ventricle but also in auricle.

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(II)Normal Local Leads Electrocardiogram with normal axis deviation. Healthy 50 cases were analyzed. (1) Analysis of Ventricular curves and determination of Stimulus Arrival Time in ventricular lead points. Average Stimulus Arrival Time in Ventricular lead points were determined as follows : Right ventricle C_2 0.035(0.028-0.044) Sec. Apex of left. ventricle C_4 0.048(0.037-0.059) Sec. Base of left. ventricle Esoph. 34-40cm. 0.063(0.043-0.081)Sec. In normal pattern of Chest Leads ST-segment may lie 1-3mm. above the isolectric line and T attain a hight of 3mm. at least. (2) Analysis of Auricular curves and determination of stimilus Arrival Time in auricular lead points. Auricular curves obtained by Esophageal Leads are those of left auricle, in which Stimulus Conduction proceeds from the upper auricular part towards atrioventicular border. In the lower auricular part normally right auricular curves may be catched occasionally. Right auricular curves may be obtained also in C_1 or C_2, but the intrinsic effect in these curves are not so clear and average Stimulus Arrival Time showed 0.053(0.031-0.078)sec.

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II.On Bundle Branch Block According to "Chain-doublets Theory (Maekawa)", the intrinsic deflection crosses the base line at the moment when the stimulus reaches a point directly beneath the leading portion. From this standpoint I have analysed the bundle branch block curves. Those results are as follows;(1) The common type is left bundle branch block. (2) The rare type is incomplete block in the right branch and the left anterior subdivision, particularly in the former. (3) Wilson's block is right bundle branch block, accompanied by delayed conduction in the left anterior subdivision. That usual type is incomplete block in the main stem of the right branch, and that unusual type is complete block already in the main stem of the right branch and the left anterior subdivision. (4) From above-stated data it is concluded that modern terminology for bundle branch block is more reasonable than classical one, but not perfectly reasonable ; and that bundle branch block should not be classified distinctively left or right : and that incomplete block in the bundle branch or the bundle stem may be present with or without complete bundle branch block.

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III. 0n the ECG of Wolff-Parkinson-White Type I have analysed 4 cases which show the ecg of short P-R interval and prolonged QRS complex. (1) The conduction time in the left auricle is abnormal, as shown numerically. (2) The spread of the excitation process in the ventricles in peculiar; namely, the delayed conduction is demonstrable in the left ventricle generally, in the posterior wall of the left ventricle or in the right ventricle and the apex. (3) From these analysis data it is concluded that the pacemaker of the heart in this disease is heterotopic, and perhaps is located in the right or left side of the upper part of the Tawara's node. This conclusion denies the Theory of Accessary Muscle Connections between auricle and ventricle.

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In first part, to study the problems of the transitional zone, which remains unsettled in unipolar precordial electrocardiograms,the experiment was performed primarily to extend over all parts of the course of this zone in eleven normal human bodies. Moreover the effect upon this zone by changing from the supine to the right or the left lateral and the sitting posture was examined as well. The appearance of the transitional zone was almost alike in all cases; that is, this zone appeared from the left lateral chest wall to the right hypochondrial region. The width of this zone was multifarious, occasionally there were cases in which this zone branched off from its course. In accordance with the direction of the course of this zone, it resulted to have a doubt regarding the correlation between the transitional zone and the ventricular septum, which many authors have acknowledged it. And then the effect upon this zone of the alterations of posture was most remarkable when the subject turned into the left lateral posture, and the change occurring when the subject turned into the sitting posture was almost uniform; but as the subject turned into the right lateral posture, that change was unfixed.

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In second part, the experiment to study as regards the appearance of this distribution of the transitional zone of the patients with the hypertrophied heart or another heart disease, was performed and the various interesting results were gained; that is, the transitional zone at one time branched with complexity and at another time appeared to be curving to the large extent. In such instances, it should be expected to cross the transitional zone in many places when the unipolar precordial leads are carried out. In some cases, the transitional zone appeared in an island-like form and this zone was not found in the standard six precordial leads. In some instances as the transitional zone branched off from this course, this zone did not always limit the potential zone to be based on the right and left ventricular origins. The appearance of such phenomena was deduced from the membrane theory by Wilson et al, and it was considered that these experimental results proved the hitherto explained opinion connected with the transitional zone is unappropriate.

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Since the discovery of Penicillin (Fleming) and Streptomycin (Waksman), many investigators have turned their attention to the research on other antibiotics. There are cases, indeed, who can be completely cured of their infectious diseases by the application of the antibiotics. But at the same time, we must admit there are other infectious diseases which can not be cured or can hardly be cured by the use of such medicines alone. The reasons are: (1) in the latter case, disposition is generally as important as the pathogens for the onset of their diseases, and (2) the allergic reaction plays an important role both in the prognosis of respective diseases. Rheumatism of the joint may be safely included among these diseases. Accordingly, the use of both the antibiotics and the sulfamid-preparations generally failed to cure the patients of this disease. Hench and Kendal discovered that such hormones as pituitary adrenocorticotropic hormone (ACTH) and cortisone act very effectively, though transitorily, upon rheumatism of the joint. In my opinion, however, the relation between ACTH or cortisone and rheumatism is somewhat similar to that between adrenalin and asthma. It seems to me, therefore, that for the best therapy of this disease it is absolutely necessary to search not only for the agents that may act upon the pathogens, e.g., Streptococcus haermolyticus, but also for those that may act upon the allergic reactions. The latter agents were almost entirely left unnoticed, so far as the components of the microorganisms are concerned. A series of antihistamine preparation that resulted from the researches of the synthetic agents for this purpose, did not come up to our expectations. For the allergic reactions are not so simple as to be explained either with the histaminetheory or with the acetylcholine theeoy. As is already stated, however, I discovered, in 1949, a new antiallergic and neurotropic component in the lymph of the cow-pox. This component "Neurotropin" was the first component of micro-organism to be applied to such allergic diseases as asthma, eczema, hemicrania, gastric ulcer and Meniere's syndrome. A great many Japanese clinicians have already recognized that this medicine surpasses all the anti-histaminepreparations, and they all agree to imagine that this medicine will take the place of these preparations in the near future, as people come to realize what allergic and analogous diseases are, and how Neurotropin acts upon them. The effect of this medicine upon rheumatism, however, is not of great value when it is applied inr smaller dose (10- 20 microgram). The effectiveness of this medicine in much larger doses, 1-10 mg, fo instance, is still open to research. For we could successfully extract a certain component from the fluorescent bacteria of the cuttle-fish (sepiola maindroni) of the Inland Sea, in Japan, in my researches with Ichiro Kawamura, on some other agents that might act upon rheumatism. This component, "Florads", had far greater effect upon rheumatism of the joint than Neurotropin had. This product is non-protein, non-amino acid, and non-lipoid. The chemical analysis is now being continued by my coworker, Prof. Shiro Akabori and Naoichi Sakota of the Osaka-University.

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Lewis' test, e. g. thermo-reaction of the finger and toe-tip-skin, evoked by putting the finger and toe into the cold water, was studied through the application to normal adults and patients with peripheral vascular and central nervous disturbances. Results obtained: 1. Patients of Raynaud's disease and vasoneurosis showed some particular modes of reaction to each other and these findings were considered valuable to their diagnosis. 2. Between the initial reaction and the after effect in Lewis' test there was found a distinct difference in its mode of reaction and this fact should be attributed to their nervous mechanism, e. g. in the former a control was presumed to exist which come from the central nervous system, perhaps from higher centers of the brainstem, and in the latter a cerebral inhibitory mechanism.

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The author tried to investigate the manner of tumor metastasis into the lung concerning hepatoma and came to the following conclusions:-(1) Excepting intrahepatic, portal or hepatovenous metastasis, hepatoma makes metastasis most abundantly into the lung as one of the extrahepatic appearances. (2) The pulmonary metastasis of hepatoma appears more abundantly into the blood vessel of the small dimension and rather rare into the greater one. (3)The pulmonary metastasis of hepatoma through the pulmonary artery appears most likely at the part of miliar aneurysm existing almost always in the pulmonary arteries. This miliar aneurysm is apt to be found at the bifurcating part or the curving part of the blood vessel (convex side in the latter) so that the tumor metastasis is inclined also to appear in such places. (4) The tumor tissue, being hooked within the miliar aneurysm, develops gradually making tumor embolus to destroy the wall of the artery from the inner surface and to make a true metastasis into the lung tissue then and then. (5) The manner of the metastasis formation in the lung is observed to be similar between chorionepithelioma and hepatoma as described in the former report and in the present one; one different thing is the formation of fibrinous thrombus in the former but not in the latter.

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At this experiment, male rabbits were injected with the phosphatide pf uterine muscle or ovahormon (estrogen) before the sensitization by oxen-sera. In 3 weeks after the sensitization by oxen-sera, all animals were reinjected with the mixture of oxen-sera and myom-phosphatide. During this experiment, clinically, blood-pressure, urine, blood, and electrocardiogram was examined. Afterwards, animals were killed and their organs were investigated histologically. These clinical examinations revealed no remarkable change except the hypothrombocytemia and the lowering of T wave electrocardiographically in some animals after the reinjection. Histologically, hearts of male animals which were injected with the phosphatide of uterine muscle, showed the allergic myocarditis consisting of moderate cell-infiltrations and periarteriolitis, and hearts of animals which were injected with the ovahormon showed also the similar allergic myocarditis of more slightly degree. But, in comparison of changes of hearts in female rabbits in the preceeding report, I found that these were very slightly. Comment and Summary: Although many students had discussed the problem of the myom-heart, at present, the pathogenesis of this disease is not yet established definitely. On the first report, by means of the Myom-Phosphatide Precipitation Reaction, I showed that the myom-phosphatide had the affinity to myocardium. On the second and third reports, I showed that I succeeded to produce the allergic myocarditis due to the myom-phosphatide. According to these three experiments, I believe that the disorders of the so-called myom-heart are the cardiac disturbances due to the allergic myocarditis that is caused by combined antigens of the foreign proteins, probably derived from the focal infection etc., and the myom-phosphatide which act as the determinant group in the allergic reaction.

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At this experiment, male rabbits were injected with the phosphatide pf uterine muscle or ovahormon (estrogen) before the sensitization by oxen-sera. In 3 weeks after the sensitization by oxen-sera, all animals were reinjected with the mixture of oxen-sera and myom-phosphatide. During this experiment, clinically, blood-pressure, urine, blood, and electrocardiogram was examined. Afterwards, animals were killed and their organs were investigated histologically. These clinical examinations revealed no remarkable change except the hypothrombocytemia and the lowering of T wave electrocardiographically in some animals after the reinjection. Histologically, hearts of male animals which were injected with the phosphatide of uterine muscle, showed the allergic myocarditis consisting of moderate cell-infiltrations and periarteriolitis, and hearts of animals which were injected with the ovahormon showed also the similar allergic myocarditis of more slightly degree. But, in comparison of changes of hearts in female rabbits in the preceeding report, I found that these were very slightly. Comment and Summary: Although many students had discussed the problem of the myom-heart, at present, the pathogenesis of this disease is not yet established definitely. On the first report, by means of the Myom-Phosphatide Precipitation Reaction, I showed that the myom-phosphatide had the affinity to myocardium. On the second and third reports, I showed that I succeeded to produce the allergic myocarditis due to the myom-phosphatide. According to these three experiments, I believe that the disorders of the so-called myom-heart are the cardiac disturbances due to the allergic myocarditis that is caused by combined antigens of the foreign proteins, probably derived from the focal infection etc., and the myom-phosphatide which act as the determinant group in the allergic reaction.

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