In order to treat chronic diseases drinking thermal water has become popular among us as well as thermal bathing. Then, from the hygienic viewpoint, the question arises as to whether minute amounts of heavy metals contained in mineral water through “spa” treatment may have toxic effects on the human body. In an attempt to obtain a maximal permissible concentration of lead in mineral water, the author experimentally administered lead orally to rabbits and studied its poisonous effect.
Reslts:
1) Eight rabbits weighing 2kg each were divided into 4 groups. Each group was administered 10 of lead acetate solution in distilled water by stomach tube in a daily dose of 300γ, 3.0mg, 30mg and 300mg respectively. And after a month the pathological and hematological alterations such as anemia and reticulocytosis were observed in the 300mg group. And hypercoproporphyrinuria and positive Millon reaction in the urine were proved in all but the 300γ group. Histologically, the renal tubules are generally widened and partly degenerated.
2) Four groups of rabbits were given daily doses of 3mg of lead acetate in 10cc solution of distilled water, H₂SO₄ (pH 2), thermal water of Ito and boiled water of Ito respectively. In the first experiment 3mg of lead was found to be minimal dose that disclosed toxic effects of lead. The urinary excretion of coproporphyrin was increased in all groups at least up to 5 times the initial value, but its rise was delayed in H₂SO₄ solution and thermal water groups. However, after one month of administration, no remarkable difference was found in the coproporphyrin excretion between 4 groups.
In summary, the maximum permissible dose of orally given lead is greater than 300γ in 2kg-weighed rabbits or comparatively by body weight 7.5mg in human adult.
On an asumption that mineral water taken per os daily is less than one litre for one month, the maximal permissible concentration of lead in mineral water is estimated to be 7.5mg/litre. Therefore, it is concluded that there would be no probability of lead poisoning from drinking of mineral water in Japan for treatment purposes.

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The stainability of RNA was examined by staining the yeast nucleic acid-gelatin coacervates with basic dyes, pyronin and toluidin blue. Generally, it was observed that the grade of staining of the complex gel was increased in proportion to the concentration of RNA in the gel. When the amount of gelatin in the complex gel is too much, the staining of complex gel is decreased in spite of the constant concentration of RNA (0.1%).
These phenomena suggest that the stainability of RNA by pyronin and toluidin blue is not only determined by the concentration of RNA in the complex gel, but also by the amount of accompanying gelatin. The staining of complex gel containing RNA is supposed to be determined by the interaction of RNA, gelatin and dye molecules.

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With the discovery of several new antituberculous agents therapy of the tuberculosis has markedly improved. The effects of chemotherapy are splendid, but there are limitations as we know. As an example, many discuss the relapses after chemotherapy. However, a few report relapses during the chemotherapy, and they report a relationship between the disease type and the type of chemotherapy. We have often experienced relapses during chemotherapy and observed their progress. From these experiences, clinically we investigated these cases during chemotherapy with regard to various kind of background factors, and revaluated the present chemotherapy of pulmonary tuberculosis.
During three years from April 1955 to March 1958, the relapses during chemotherapy were observed in 75 cases out of 796 patients (9.4%) who received treatment at the Kyoto National Sanatorium.
With regard to the background factors of these relapses; some factors are considered:
a) The disease type before chemotherapy, due to the Gakken's classification by the Research Committee for Tuberculosis supported by the Ministry of Education, especially the fundamental type, existence of cavitation and extension of foci.
b) Whether the therapy is the initial treatment or the retreatment.
c) Whether the method of administration is daily or intermittent.
d) Whether tubercle bacilli can be found or not in sputum or other excretions.
e) Whether the tubercle bacilli is sensitive or resistant.
There was more roentgenographic evidence of spread than bacteriological and especially the appearance of new foci were recognized on the INH daily regimen.
Most relapses were of the early type and occured within six months after chemotherapy. Most were from the persons who had SM-resistant tubercle bacilli, but a few were from INH-resistant tubercle bacilli, and in addition the prognosis of the patients with positive cultures of INH-resistant tubercle bacilli after relapse was more favorable than of INH-sensitive tubercle bacilli.
Based on the above results, we could understand that the prognosis has more important relations to the type of disease than with the high rate of relapse, and particularly the faradvanced-mixed type has a poorer prognosis than fibro-caseous type. And so we conclude that we should change to the more strong chemotherapeutic agents instantly when the relapse in the advanced-mixed type is observed.

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Before, and 3, 6 and 12 months after the thoracic surgical operations of patients with pulmonary tuberculosis, bronchospirometric measurements were performed in order to study the condition of the operated and non-operated sides of the lungs.
1) Secondary thoraco-plasty-resection of VIIth to VIIIth rib. The percentage of vital capacity after a 3 months' period as compared to the pre-operative period is 47.7, indicating a definite decrease of vital capacity in the operated lung and mild affected on the opposite side. However, by the 6th month the loss of the function almost recovers.
2) Primary thoraco-plasty-resection of IVth rib. The percentage of vital capacity of the same condition as above is 59.9, this shows a moderate functional decrease. General functional improvement has been recorded by 12th month after surgery.
3) Resection of upper lobe-supplementary thoracoplasty of IIth to Vth rib and resection of right upper lobe or left S_1∼3. The percentage of vital capacity of the same condition as above is 45.9. Functional decrease is most marked on the operative side but it is stabilized by the 6 month. Influence on the opposite side is minimal.
4) Resection of upper lobe-non-supplementary thoracoplasty; the resected region is same as above. Compare with the 3 above more prominent functional decrease is seen on the operated side with a difference of 20∼30%, but it varies according to pleural thickening and re-expansion of the remaining lung which may envolve after the operation. Little unfavorable effect is seen on the opposite side.
5) Resection of lower lobe-anesthetizing the nerves of the diaphragm simultaneously. The percentage of vital capacity of the same condition as above is 49.3. Although the functional decrease in the operated side is marked, improvement is comparatively fast. By the 6th month after surgery it recovers almost 2/3. Little unfavorable effect is seen on the opposite side. The recovery after the 6th month is slow.
6) Two segments' resection of upper lobe. The percentage of vital capacity of the same condition as above is 71.6. In comparison with cases of upper lobe resection (nonsupplementary thoracoplasty, three segments) the two segmental resection of upper lobe has less operative functional decrease.
7) One segment resection of upper lobe. The percentage of vital capacity of the same condition as above is 75.6. Although less decrease is seen than that of the preceding casee, the functional decrease becomes identical at the 12th month after surgery.
8) Group with special symptoms.
A very slight decrease is seen on the cases with S₆ removal. Two segmental resections of each kind and two segmental resections of upper lobe resulted in similar decrease. Three segmental resections of S_{1, 2, 5} showed less decrease than the three segmental resections of the upper lobe. In the left upper lobe resection the functional decrease is Imore apparent than in the case of the right upper lobe resection showing a change in vital capacity of 62.2%. This decrease is the same as with the lower lobe resections.

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Using 24 male guinea-pigs, comparison of treatment effects of SM or INH for experimental tuberculous meningitis was made. Simultaneously the variations of their encephalograms were studied in consideration of their clinical symptoms, progress, prognosis, survival days, increaserate of body weight, tuberculin reaction, quantitative bacterial cultures, pathological indications, etc.
Results.
1) The variation of encephalogram appears before any discernible symptoms.
2) With chemotherapy the improvement of encephalogram is seen after the improvement of clinical symptoms.
3) Treatment effect of chemotherapy is noted on the encephalogram from the 20 to 30th day of the infection.
4) The aggravation of symptoms by cessation of therapy is recorded on the encephalogram as less among the group treated by INH than SM group.
5) Fw appears shortly before the death indicating an organic change of the brain substance.
6) The earlier the appearance of abnormal wave is, the shorter are the survival days, and the later the appearance of abnormal wave is, the longer are the survival days.
7) In the group treated by SM, increase-rate of body weight and discernible symptoms correlate with encephalogram indication, while in the group treated by INH, the correlation can not be found and the encephalogram at the time of death is not aggravated. This fact is interpreted that compare with the group treated by SM the INH group has slight brain morbidity.
8) In regard to the capacity to prevent tuberculin reaction to turn into positive, INH is more apparent than SM. However, neither does weaken nor change the tuberculin reaction which already has been turned into positive.
9) The number of living bacilli found in brain, pathological indications and encephalogram indications at the time of slaughter or death coincide.

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End results of 105 cases of tuberculosis of bone and joint treated surgically with bone graft and followed up over one year through 12 years after surgery, were reported and our treatments up to present were studied retroactively.
When thoracoplasty was performed, the ribs of the patient with pulmonary tuberculosis were obtained and they were dipped in saline solution to keep 5 days through 2 weeks in the refrigerator at 2° to 4°C. The stored homogeneous bones, being sentisized with tuberculosis, were applied as bone graft.
Results.
Tuberculosis spondylitis: 63 cases were excellent in 63.5 per cent, good in 11.1 per cent, fatal in 4.8 per cent and 20.6 per cent staying in the sanatorium, in which 15.8 per cent are cured on their operated sites.
Tuberculosis of bone and joint: 69 per cent excellent, in 2.4 per cent good, unchanged in 2.4 per cent. fatal in 9.6 per cent and 16.6 per cent staying in the sanatorium, in which 14.6 per cent attained clinical healing.
Multiple tuberculosis of bone and joint: 8 out of 15 cases showed excellent result, one each case was good, fatal or uncertain, while 4 cases are still in the sanatorium in which the operated foci of 2 cases were already healed and the other 2 cases were improved.
There was no case in which following the surgical intervention any bad effect happened upon the tuberculosis of other bone or joint, lung or kidney.
Over 2 years after the surgery roentgenographic follow up study was made on 96 cases and in 36 per cent and for rather a long period after surgery, progression of bone destruction and spreading of bone atrophy were noted, but then they showed a favorable roentgenographic findings. It is noteworthy that the bone graft is detectable many years.
Comparison of our end results with that of autogenous bone grafting and debridement revealed that our results were far superior to that of autogenous bone grafting but were inferior to that of debridement. However, considering the back ground of our patient and our operative procedure, our results may not necessarily be said to be worse. The superiority of our treatment may be thought to be due to the fact that our stored homogenous bone grafts sensitized with tuberculosis are not only superior in their ability of grafting but also they may have some kind of healing effect on the tuberculous foci at the donated site many years after surgery.

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