Employing healthy dogs of one year old, varying regions of paralysis were produced by amputation of the sciatic nerve, injury of the spinal anterior horn, chordotomy, and injury of the spinal cord etc. for the observation of the healing mode of the tendon. In either of the paralyzed regions thus produced, the healing processes of the tendon were inferior to those observed on healthy regions. This weakening of healing processes was most remarkable in the case of spinal injury, amputation of the sciatic nerve came next followed by the injury of the spinal anterior horn. Chordotomy gave the best healing-processes among the varying kinds of paralysis stated above.

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Reparative processes of injuries of tendon are the rapid formation of granulation tissue from the surrounding tissue followed by the deposition of fibrin and replacement by connective tissue to complete firm healing. Quantitative and qualitative difference in the kind of paralysis employed produces changes of varying degree in the processes of healing. Formation of mucoid stroma, however, is not observed.

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Difference produced in the healing processes of tendon depending on the region of paralysis is mostly due to the primary effect of the disturbance of autonomic nerve system, especially, parasay mpathetic nervec control. Then, secondary effects, such as the lowering of muscular tension, nutritional disturbance of tissues, reduction in the amount of circulating blood, loss of sensation, cease of motility etc. by the dissociation of sympathetic nerve and pyramidal fascicle, produce difference in the processes of healing. By secondary effects alone, however, the inpairme-nt of healiing processes is not so much pronounced. Weakening and retardation of healing proces-ses appear when thesee secondary effects are combined with the primary effect.

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On applying tendinosuture, it is recommended to connect the two cut ends when they are long enough, but if not, it is much better to leave them apart. In either case, it is highly im-portant to minimize stitches. As for the vagina, a longitudinal incision improves the healing of tendon. After tendinosuture in the paralized region, fixing should be maintained at least for 3 to 4 weeks.

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Mass examination of all leprosy patients admitted to Tama Zenshoen has been conducted once a year from 1948 to 1959. All patients were photofluorographed, and cases with definite or suspi cious tuberculous findings on photofluorogram were radiographed. For active cases, medical trea tment of any kind was administered, and for inactive cases, periodical check examination was repeated at least twice a year. The results of mass examination were summarized as follows:
1. Prevalence rate of tuberculous findings, including healed lesions increased from 20.5% in 1954 to 29.4% 1959. Prevalence of active and inactive tuberculosis was 13.3% in 1948, and kept nearly the same level until 1959 (13.2%). Prevalence of active cases was 8.9% in 1954, decreased with advances in tuberculosis control, and 3.5% in 1959. Bacilli pasitive cases were decreased from 2.5% in 1954 to 0.5% in 1959.
2. Prevarence of active and inactive cases was higher among male than in female. Highest value was obtained in age group 50 to 59 from 1954 to 1956, and in age group over 60 from 1957.
3. Observing by the grade of disease, severe cases including cavitary cases decreased markedly, and slight cases relatively increased.
4. Prevalence of active and inactive cases newly admitted to Zenshoen was nearly the same to that of already admitted patients, but prevalence of active cases were very high among newly admitted cases.
5. Incidence of tuberculosis is decreasing markedly in recent years.
6. Death from tuberculosis showed marked decline since 1952. The results mentioned above show that by intensive tuberculosis control, tuberculosis in leprosy patients can be diminished remarkably, and leprosy patients will no more die of tuberculosis.

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On the same subjects mentioned in Report 2, the author compared the prevalence of tubercu losis by the type of leprosy, and obtained the following results. Prevalence of both tuberculous findings and active or inactive cases were slightly higher among lepromatous type than in tuberculoid type, however, the difference was statistically not significant. Observing by the type and grade of tuberculosis, distribution of two types of leprosy were nearly equal among any type or grade of tuberculosis. The results show that there is no significant correlation between the type of leprosy and tuberculosis.

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A report was made on the clinical and autopsy findings of a case of subacute mveloid leukemia developed in a neural type female leprosy patient aged 27 years. The patient showed characteri-stic symptoms of repeated periodical pyrexia, hepatic swelling and metorrhagia developing leukemia in the end. Internal factors like the hereditary disposition and endocrinological disorders (ovary, adrenal) are considered responsible as causes for the present leukemia. As for hematological findings, the patient was under observation as early as from the time of the development of leucopenia with a small number of young cells followed by the restoration of the leucocyte count and gradual increase in the number of young cells. And by the end of 5 months, there was leucocytosis with the remarkable increase in number of young cells. Leucocytes were irregular in size with abnormal forms of nuclei. An extremely large number of immature young cells appeared in the peripheral blood and bone-marrow cytologically corresponding to the findings of acute leukemia. Morphologically, these abnormal cells were identified as myeloid cells. The patient died of leukemia 6 months after the appearance of fever for the first time.

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A statistical investigation was made on the percentage of leprosy patients in leprosaria, on the new patients in leprosaria, patients at home and slight patients discharged from the hospital, on December 1, 1959 (Each district made its statistics.) Then discussion is added about the sum mary of the diagnosis made since 1951, (especially in the last two years).
1) Number of patients in Ehime prefecture Male 199 Female 94 Total 293 In Leprosaria 248 At Home 45 Percentage of Leprosy patients (to population 10.000) 1.90 Average in Japan 1.66
2) Severe patients are in the leprosarium. The 45 patients at home have no possibility of making infection. The 22 out of 45 are very slight and from the hospital. They have been at home for average 11 years and 8 months. Their illness is immovable.
3) A quite large number of the suspected patients diagnosed as leprosy. So the assistance and cooperation of the people engaged in sanitary section is desperately needed.
4) It will be neccessary to continue regular visit to leprosy families, suspected patients and slight patients to prevent epidemic of leprosy in communities.

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To research an adequate antigen available for the testing of leprosy patients instead of Dha-rmendra antigen, comparative studies were carried out in leprosy patients by intradermal reactions using the bacillary antigens of avian tubercle bacillus, Myc. phlei, Johne bacillus and Dharmendra antigen. The results reveared that none of the antigens tested gave reactions similar to those of Dharmendra antigen.

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Antigenicity of pyridin extract of Kedrowsky bacillus prepared by Chatterjee's original method was compared with that of Dharmendra antigen in sensitized animals and in leprosy patients.
1. Pyridin extract of Kedrowsky bacillus contains much amount of polysaccharide and rather small amount of protein.
2. Intradermal reaction was tested on three groups of animals sensitized either with heatkilled Kedrowsky bacillus, tubercle bacillus or human leprosy bacillus respectively. The results revealed that the reaction provoked by the Kedrowsky bacillus was specific. Human leprosy bacillus did not show any positive reaction in the animals sensitized with Kedrowsky bacillus and pyridin extract of this microbe gave no positive reaction in those sensitized with human leprosy bacillus.
3. Correlation between the pyridin extract as well as PPD of Kedrowsky bacillus and the Dharmendra antigen was found to be very low also in the leprosy patients.

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