On the followup study from prepleuritic stage to the postpleuritic pulmonary tuberculosis I found there is a close relationship between the pleuritis and tuberculous hematogenic dissemination. Concerning pathogenesis there may be an intimate relationship between secondary pleuritis and hematogenous dissemination as I found not a few cases of secondary pleuritis which supervened over the primary pleuritis.
Clinically considered the age factor has not been so emphasized as it should. Pulmonary lesions which develop before or with the occurrence of pleuritis in ages 1-15 years may belong to the primary affection. In above the age of 16 years which consists of about 50%, lesions are found more advanced.
I cannot agree with the socalled “hilar lymph gland theory” from my observations even if there is an intimate anatomical relationship between pleura and hilar gland.
Concerning tuberculous lesions which follow pleuritis it may be said that secondary pleuritis often occur on the contralateral side after the primary pleuritis has developed.
This fact has somewhat been overlooked. In most cases secondary pleuritis is not followed by pulmonary tuberculosis. Hematogenous dissemination often follows pleuritis. In short I consider that there is an intimate relationship between pleuritis and hematogenous tuberculous development.

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With the purpose of securing explanation of radiograph in acute pulmonary congestion, I made experimental radiography on cases of congestion produced by ligatiog pulmonary veins of rabbits by means of indifferent pressure thoracotomy, and have made a comparative study between my experiment and pathological observations on the subject. I reported the result of my study on the Nipp. Act. Radiol. Vol.13. Present report is the pathological observation on the experiment on using 46 rabbits.
1) At the time of the ligation of the entire pulmonary veins, the congestion in the operated lung was found more marked in the upper lobe and very slight in the upper, middle and cardiac lobes.
2) As to the ligation of single pulmonary vein of one lobe, symptoms were almost the same as the former cases and slight congestion was observed in other lobes.
3) The chief pathological observations on ligated lung are as follows: during the whole day immediately after the operation, pulmonary hemorrhage and edema as well as congestion are most marked. However, the climax of these symptoms remains only a day after which they gradually falls. Necrosis or necrobiosis of alveolar wall, anaplasis of alveolar epithelium, endarteritis obliterans, thrombosis in veins, incrassation and proliferation of alveolar wall, subpleural colateral vessels, pleural incrassation, and cell infiltration would appear. In three weeks pulmonary congestion, hemorrhage and edema disappear, and marked atrophy of the operated lung is noted owing to the incrassation of alveolar wall. These symptoms are seen even 5 weeks after the operation.

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Three spasm-producing-agents: A) Cardiaaol B) Vitacampher and C) Synthetic Vitacampher given into carotid or cubital vein on 14 mentally deranged persons, caused total of 79 typical convulsive attacks.
Following are the summary of the observations.
1) Stimulation threshold (absolute value) of B and C is somewhat higher than A, but except for the fact that the onset of spasm in C is sometimes slower than A and B, the symptoms are almost similar.
2) When given into the carotids a convulsive state is brought about by 1/13-1/25 or average of 1/14 of the amount which is required by, cubital route. The time to effect the spastic state is extremely shorter by the carotid method than that of cubital. It is an excellent agent to relieve pain.
3) B and C are by no means inferior to A in effecting convulsions. Hence it is worth considering to inject B or C into carotids.
4) Upon injecting into the vein both eyeballs were noted to turn to the front or upward at the onset of convulsions, but when given into the carotid the eyeballs turned at first to the contralateral side and then to the front or upward and finally to the same side as injected.
5) When given into the carotids convulsions on the same side seem to occur somewhat later than the contralateral side.
6) These two observations namely deviatio conjugee and convulsions of the body suggest following theory. Whent a spasm producing agent is given into the carotids one side of cerebral nerve cells is directly stimulated and perhaps via combination fibers stimuli are transmitted to other side and finally both sides of cerebral nerves are stimulated. When given into the veins both sides are at the same time stimulated. In other words these convulsions are similar to Jackson's epilepsy.

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It has been pointed out that mediastinal hernia as complication of artificial pneumothorax treatment may be caused by (1) an existence of a weakpoint in mediastinum, (2) inadequate thickness or adhesion of mediastinal pleura, and (3) difference of internal pressure between two pleural cavities as etiologic factors of mediastinal hernia.
I have thoracoscoped eleven cases of mediastinal hernia to find out intrathorax condition, The thoracoscopic examination was made within 84 days after the appearance of mediastinal hernia. Of these ten cases belong to a hernia at the anterosuperior part of mediastinum, and one in the postero-inferior mediastinum.
Intrathoracic pressure was found positive in four cases, Th epressure became positive depending on the positional changes of patient's body in seven cases.
The difference of pressure between the right and left pleural cavities has been regarded as a cause of mediastinal hernia, However, presence of thickening or adhesions of pleura may help in strengthening the mediastinal wall.
I found that majority of cases have only a slight thickening at the inner and outer sides of hernia. There was found a very little adhesions inside of hernia. In many cases the mediastinal hernia was produced within six months after the beginning of pneumothorax treatment.

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We have examined 60 cases of arachinitis adhesiva spinalis and obtained following results.
1) This disease is by no means rare. It carries a great clinical significance.
2) For the causation of this disease trauma plays an important role, but perifocal infection or allergic inflammation is also important.
3) Symptoms of this disease are so complicated and different that it simulates traumatic neurosis. However, the characteristic course it takes from the onset, and irregular irritation or absence of symptoms relative to the spinal cord or root make one suspect this disease.
4) The disharmony of the curve of spinal interpeduncular distance gives an important clue for the diagnosis of this condition, and the “blue dermography” is also a valuable point in diagnosis.
5)This condition is not a simple surgical disease, but owing to the functional lesions of autonomic nervous system, it frequently induces different symptoms in the digestive, respiratory, urogenital, EENT, and oricular organs with night sweat and slight fever.

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Although herpes zoster has been known as a disease of the spinal ganglia due to virus infection it has been considered similar to a skin disease since its diagnosis is dependent on the cutaneous changes. Following are the results obtained in the comparative study of the amount of protein, sugar, Cl, NPN, and globulin reaction of the spinal fluid in 32 cases of herpes zoster on one hand and 42 cases of Japanese encephalitis, 10 cases of acute poliomyelitis, one case of polyneuritis. and 2 cases of intercostal neuralgia on the other.
1) Herpes Zoster: Intraspinal pressure was found slightly higher than normal in most of the cases. In all cases the fluid was found clear but zamthochromia was found in several cases. Cell count was increased in almost all cases and mononuclear cells were increased. In some cases the amount of protein is slightly increased. Pandy's reaction was positive in almost all cases. Nonne's reaction was positive in about half of the cases. The amount of NPN and triptophan reaction was normal. Cl was found to be increased in 13 cases but its significance is obscure. These changes were independent of the severity of the skin changes and pain. The spinal fluid was found entirely normal in several cases. In 8 cases in which the course of the disease was followed the recovery of the skin condition was not rapid in spite of only slight changes of spinal fluid were noted.
2) Japanese Encephalitis: The changes were almost similar to those of herpes zoster. However, the decrease of the amount of Cl and increase of mononuclear cells as noted in herpes zoster were not observed.
3) Acute Poliomyelitis and Polyneuritis: No difference of the changes of the fluid was noted between herpes zoster and these conditions.
4) Intercostal Neuralgia: Spinal fluid was found quite normal.
On the basis of above results, namely the changes of the spinal fluid, it is assumed the presence of certain changes also occur in the meninges and in the central nervous system. Furthermore as found in the literature that certain cases of facial paralysis, Landry's paralysis, encephalitis and Parkinson's syndrome being caused by herpes zoster virus, it is difficult to differentiate herpes zoster from these conditions by the spinal fluid alone, and only by the skin conditions the diagnosis is possible.
There were cases in which no pain was accompanied. It is possible to assume that there may even be cases in which no skin changes occur. These cases may be considered as nonmanifest infection. From these facts it is considered that there may be cases of peripheral paralysis, neuralgia, Guillain-Barre's syndrome, acute poliomyelitis, transverse myelitis, Parkinson's syndrome, polyneuritis, disseminated encephalomyelitis, multiple sclerosis and serous meningitis which are also due to herpes zoster virus.

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A convenient and universal one channel, electro-physiological recording apparatus was designed by us in cooperation with T. Sakamoto and S. Takagi of Tokyo University Engineering Dept.
It consists of four blocks: pre-amplifier, mainamplifier, Wheatstone bridge and recorder. As to the general characteristics of the apparatus, it may be stated that it fulfils the minimum requirements of American EEG Association in EEG and of American Medical Association in EKG.
The unique point of this apparatus is that GSR can be recorded by following three methods: 1) Potential recording (Tarchanoff) being time constant to such extent (1.5″) that monophasic curve can be recorded, 2) resistance recording (Veraguth) can be done with time constant 3″, and 3) resistance recording (Righter) can be made by means of Wheatstone bridge and direct coupling mainamplifier.
From these charateristics it can be said that this is one of the most convenient apparatuses in laboratory and clinical use for GSR. In addition to the advantages as above noted the time constant can be varied from 0.08″ to 3.0″ and even to infinitive if mainamplifier alone is used, and since the maximum deflection shows over 10mm for 20 microvolts and the discrimination ratio can go higher than 70bd, other various electrical phenomena of the body can be recorded without having a electrically shielded room.

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