The preparation of lepromin must be made at present using the leprous nodules, because the leprosy bacilli can not be cultivated in the artificial medium. With a progress in the chemotherapy of leprosy, however, it becomes more and more difficult to obtain leprous nodules containing many bacilli. Therefore, it will be important that the diluted lepromin can be used for the skin either or not. The relation between the skin reaction caused by the diluted antigen and that due to the standard antigen, therefore, was investigated on the frequency distribution curves of the reaction size. The results obtained were as follows;
The size of the non-specific reaction did not change so much due to the dilution of Dharmendra antigen. On the other hand, the size of the specific reaction decreased in the reaction caused by the diluted Dharmendra antigen. Considering the decrease of the size of the specific reaction by means of the dilution of antigen and the rate of the negative reactor due to the diluted antigen in the positive reactor to the standard antigen, it seemed that the dilution of Dharmendra antigen will be under 1: 2 for the practical use. The criteria for reading the reactions due to the diluted antigen should be settled newly apart from the criteria due to the standard Dharmendra antigen. Therefore, the auothers settled a new criteria in the reactions caused by the antigen in a dilution of 1:2.

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I. Leprosy patients in relation to their sexual difference
1. On the male and female ratio of leprosy patients
a. On Japanese patients
Male and female ratio calculated at the time of national census held on several occasions in the past showed some difference depending on the time of census, but is 237.6 in average. Ratio of the patients hospitalized in leprosaria 50 years ago was 418 males against 100 females, while it is approximately 167at present.
b. On the patients in abroad
According to the informations obtained from literatures, in Okinawa, Korea, Formosa, South-East Asia, South Africa, South and North America etc., though variant depending on the place and the time of examination, male patients were always larger in number than female patients showing a ratio of 150at the lowest and over 300at the highest.
2. Sexual difference in relation to the disease type
According to the investigation on the in-patients of National Leprosarium Tama zensho-en, though the figures are variant to some extent depending on the year examined, 72.1% of male patients and 60.1% of female patients are lepromatous type with a difference of 12% in average. Of female patients, on the contrary, tuberculoid type was 12% higher than males.
3. Sexual difference and the disease course
In the year 1954, there were 56 patients hospitalized in Tamazensho-en for a period longer than 30 years. Their percentage against the total in-patients in 1924, was 1.87 for males and 5.06 for females, namely, the female percentage was 3 times as high as that of males. As for their disease types, contrary to usual findings, tuberculoid type was dominant, 72.7% of female patients being tuberculoid and only 27.3% lepromatous. It can be understood from these findings that females follow a longer disease course with milder symptoms than males.
II. Observations on the leprosy of twins
Similarity of disease type and clinical symptoms between a pair of monozygotic twins are described by showing photographs and pictures of 2 such cases reported by this author and by Miyazaki and Yagi.
III. Observations on the leprosy among relatives
1. Comparison by the difference of sex and diease type of the patients in two different categories of (A) that there are more than 2 patients, and (B) that there is no other patient among relatives. The percentage of lepromatous type among the patients in the category (A) is 81.7, and that in (B) is 71.3 with the difference of 10%. While their sexual ratio is 171 in the former and 270in the latter.
2. On the patients in the category (A)
a. There were 217 cases, namely 434 patients, of 2 patients coming from the same family line, and the rate of lepromatous type was high as 83.4%, and the rate of disease type agreement was also as high as 80.6%.
b. There were 47 cases of 3 patients coming from the same family line, and in 55.3%, namely in 26 cases, all the 3 patients were of lepromatous type.
c. There were 9 cases of 4 patients coming from the same family line, and in 44.4% of them, namely in 4 cases, all the 4 patients were lepromatous type.
There was 1 ts coming from the same family line, and in this case all the 5 patients were lepromatous type.
There were 2 cases, moreover, of 6 patients coming from the same family line, and in these cases too, all the 6 patients were of lepromatous type.
The rate of agreement in disease type among the patients in category (A), therefore, was 78.4%.
3. On parent and child infection
a. There were 8 cases of parent and child infection, and in 4 cases, both the parent and the child were lepromatous type.
b. There were 79 cases (174 patients) of father and child infection, namely,
i, 65 cases of father and a child, of which 50 cases, 76.9%, showed the agreement in disease type;
ii. 12 cases of father and 2 children, of which 8 cases, 66.7%, showed the agreement in disease type, and

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Rehabilitation, in a general sense, has developed as a counter measure against both physical and mental functional disturbances which have remained or nearly stabilized by usual medical treatments given on a disease or a trauma. Accordingly, it is apt to be regarded as a measure which should be started after confirmation of symptomatic stabilization or the stabilization of functional disturbances. Rheumatoid arthritis is a disease difficult to expect symptomatic stabilization and its functional disturbances are always progressive causing an important problem in the social rehabilitation of such patients. It is a disease, moreover, difficult to decide when to start rehabilitation. This is the reason why patients of rheumatic disorders occupy only 2% of the total patients of physical disturbances taken care by the rehabilitation centers existing in each districts all over Japan. On the contrary, 16.9% of heavy cases of physical disturbances hospitalized in wo national sanatoria, which are taking care of medical rehabilitation, are the patients of rheumatic origin. Rehabilitation of rheumatic disorders, therefore, should be performed in conjunction with general medical treatments.
Patients of rheumatoid arthritis are apt to become depressed by severe pain and stiffness, and it has become difficult to motivate them for rehabilitation. This depressed state, however, is symptomatic and disappears in most cases by removal of pain and stiffness. For this purpose, adreno-cortico-steroids are positively effective. These steroids, moreover, have a psychomotor stimulating effect, and their intra-articular injections facilitate rehabilitation as well. Prolonged administration of steroid hormons may sometimes invite development of side effects. In a considerable number of cases, administration of steroids has become indispensable. Even intra-articular injections may cause aggravation of weight loaded joints by an excessive use of such joints.
Some people prefer salicylates or butazolidin preparations to steroids.
Physiotherapies, especially hot water and massage are the measures indispensable for removal of pain in rheumatic patients though both of them have begun to lose their positions as the most valuable measures in rehabilitation program.
The next is orthopedic surgery like synovectomy or to provide a window. There is a lot to expect from the orthopedic surgery of deformed joints. Further developments of counter measures against deformed joints are strongly desired.
It is not easy to set a goal of rehabilitation for patients of rheumatic disorders. If expected too much, the patient must suffer from a heavy psychological burden and may precipitate reccurence or exacerbation and sometimes even cardic complication. Too much burden may spoil invalid joints involved. On careful investigation of the daily lives of rheumatic patients, it was found that they do not always have an optimisitic future.
At present, in Japan, there exists a considerable gap between the progress in medical insurance and the socio-economical programs of rehabilitation causing the patients of chronic diseases like rheumatoid arthritis to remain in medical facilities without having adequate employments. It is considered to be an utmost imprortance to provide ways to accept these patients in society, and also to establish hospitals specialized in rheumatic disorders including rehabilitainon.

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