The fact that the aberration of the function of the organ is produced by repeated stimulation, extraction of nerve, or diseased condition has been stressed by Prof. Y. Tokumitsu in 1945.
As has already been reported the author confirmed the aberration of the splenic function when infected with tubercle bacilli. When extract of spleen of a normal rabbit is injected to a healthy rabbit there is an increase of the number of leucocytes and throbocytes but when injected into a rabbit with tubercle bacilli it shows a distinct decrease just the opposite of the case of a normal rabbit.
It was proved that such a result was due to the aberration of the splenic function infected with tubercle bacilli. On applying the reaction clinically following conclusions were made.
1) When 5% solution of splenic extract is injected into tuberclous patient it shows a decrease in the number of leucocytes and thrombocytes contrary to the normal person but when recovery takes place the leukocyte count gradually returns to normal state. This adverse reaction coincides with the clinical observation.
2) The above reaction does not necessarily run paralell with the sedimentation rate in this disease.

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82 tuberculous patients were studied for the duration of between four and eight months during which the diameter of right and left pupils was measured at each progress and was observed in relation to the clinical symptoms. The results were as follows
1. At the inital observation 21 cases (26%) showed anisocoria.
2. Dilatation of pupil was noted mostly on the side of the affected in cases of unilateral tuberculosis whereas there was no recognizable relationship between diameter of the pupil and tuberculosis in the bilateral pulmonary tuberculosis.
3. Only 15 cases (18%) showed changes of the pupillary diameter during the whole process; no close correlation with clinical symptoms was recognized.
4. Of the 26 cases in which thoracoplatic operation was carried out in 23 (83%) no effect was noted. The 3 remaining cases showed anisocoria temporarily which disappeared shortly after thoracoplasty.

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This paper deals with the clinical experiment of the PAZOL administration of the far advanced type of pulmonary tubercurosis of mixed type with cavity, which has not responded to SM, PAS, TB-1. The series of experiment was arranged in two groups
PAZOL A Group: Advanced type of tuberculosis mentioned above was administered 9g of PAZOL together with sodium bicarbonate orally for 80-90 days.
PAZOL B Group: The same type of tuberculosis was given sulfathiazol 3g and PAS 6g together with sod, bicarbonate and the results are summarized as follows:
1) There was a general tendency of subsiding of temperature in A group and half of them showed even more decreased blood sedimentation rate.
2) Tubercle bacilli in sputum showed negative result throughout 1-4 months, though it was again increased after 6 months.
3) Although no marked increase of body weight was noted, the recovery of the decreased appetite was apparent in every cases.
4) In blood picture, a definite restoration of leucocytosis to normal level, 2% increase in eosinophilia, and some increase in lymphocyte were observed.
5) The rate of the appearance of PAS resistent strain in sputum was as little as 1/3 of independent PAS administration.
6) Hepatosulfalein test showed decreased rate 2 months after onset of treatment until the final stage of observation.
7) Even in these improved cased, there were definite recurrence was noted, this may probably due to the major severity of the disease and due to shortness of the duration of the treatment. Neverthless the result was far better than the control B group.
8) Although the scale of the experiment is not yet extensive in magnitude, good therapeutic effect of PAZOL in certain extent can be recognized for the advanced type of pulmonary tuberculosis which does not respond to SM, PAS, TB-1 etc.

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Studying on the data from diagnosis and therapy together with the blue dermatography of the adhesive spinal arachinitis, author reached the following conclusion.
1) In the differential diagnosis of this disease, the presence of the spondylitis should be taken into account at first. Neverthiess this condition is no tmerely a surgical case, but owing to the dysfunction of autonomic nervous system, it causes a lot of general symptoms in the realm of internal medicine.
2) For the treatment of this disease, subarachinoidal air infusion sometimes brings a dramatic result; it must therefore, always to be tried prior to every attempt of operation. In premature types of this disease even a single attempt of myelography alone can bring some improvement of the disease.
3) We have noted the existence of a peculiar dermatography in this disease, which we called“blue-dermatography”. As to the patho-physiological mechanism of the developement of this sign, we wish to paint out the presence of dysfunction of autonomic dermato-angio nerve having a definite connection with spinal cord.
This phenomena seems to have a significant value in the diagnosis of this disease.

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Although there has been a numbers of observations on the sensitivity of human type of tubercle bacilli, the report on the nature of their mutants seems to be relatively scarce.
In this caper the author has undertaken an investigation on the sensitivity of mutant tubercle bacilli, obtained by Aoki et al. previously, against the various anti-tuberculous agents (SM, PAS, TB-1, OM, INAH) and a series of other chemotherapeutics (Salsol, Gantolisin, Homosulfamine, Penicillin and Kative) with the intension to clarify the correlation of mutants strain to the original strain of tubercle bacilli if possible. The results are as follows;
1) The sensitivity fo the mutants against above mentioned drugs was the same as that of essential human tubercle baciland the mean value of sensitivities ranged between 1:5×10^-7 and 1:1×10^-8, in spite of the slight deviation of titre among the strains.
2) As to the difference of susceptibility of these strains against these drugs: ranges are INAH≈SM>TB-1>PAS≈OM Sensitivity of non-pathogenic acid fast bacilli and E. coli used as control was 1:500.
3) This evidence indicates the presence of a closed relationship between human type of tubercle bacilli and their mutants, which was proved before by Aoki et al. on the course of cycle of mutation of hauman types of tubercle bacilli.

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The authors investigated the prognosis after thoracoplasty, particularly of tuberculouss lesions of contralateral lung, on 359 cases during the period of five years ending 1951 in which patients lived half a year or longer after operation. Of this number, 118 were treated with streptomycin at operation and 241 were not treated. In general post operative progress was good in about 80%. The results are as follow:
1) 125 cases (34.3%) had no tuberculous lesion in contralateral lung before operation and their improvement-rate was about 85%. There was no remarkable difference between streptomycin treated-group and non-treated-group. In only 2 cases now lesions appeared.
2) Of the cases which had some lesions in the contralateral lung, 148 (63.2%) were not managed by any operative procedure. Their aggravation-rate was about 12%, all of which accurred more than 6 months after operation. The streptomycin-treated group showed a lower aggravation-rate than the non-treated group. In the former there was no case in which cavitation was obserable while in one-third of the latter cases, new cavitation appeared. However, the natural healing was found in considerable number of cases. 20-30% of the cases with increased infiltration and no cavity and 30-50% of those with cavity improved. Therefore, the authors believe that streptomycin can be used with advantage when the contralateral lung is involved.
3) In one half of 46 cases (19.6%) in which pneumothorax treatment was instituted pleural adhesion developed on the contralateral lung operation, regardless streptomycin treatment was given or not. And one half of adhesion cases were not benefited by the pneumothorax therapy. Of 21 cases (8.9%) treated with pneumothorax after operation spontaneous pneumothorax developed one month after operation in 3 cases. The other cases in which artificial pneumothorax treatmeut given at the period when the operation influences became no longer effective, showed a favourable progress. The authors interpreted that when the artificial pneumothorax of contralateral lung becames necessary, it must be induced within 2 or 3 months after thoracoplastic operation.
4) The thoracoplasty of contralateral lung was carried out in 15 cases (6.4%) and the artificial pneumoperitoneum in 4 (1.7%). No discussion is made on these as the number so treated is small.

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In cases in which such medicinal agents as STREPTOMYCIN, PAS, Tbl and ISO-NICOTINIC-ACID HYDRAZID have been used for chronic pulmonary tuberculosis, the number of death caused by haemoptysis or acute cardiac conditions has recently increased, in spite of no turn for the worse in pulmonary disease from the anatomical viewpoint. Therefore, I tried to study this problem from the pathologico-anatomical and histological viewpoint, and have arrived following conclusion as a result of anatomical examination of 6 autopsied cases with chronic pulmonary tuberculosis treated with the above medicinals.
1) Regarding lungs affected with tuberculosis and treated with chemotherapeutics, disappearance of perifocal inflamation, atrophy of tubercle, collagenic alteration, cicatrization and hyalinization are remarkably seen, and expediting of absorption of Gaseous pneumonia and capsuleformation with connective tissue was also very remarkable. However, such changes as above noted are sometimes seen in cases of natural healing and, on the other hand, it can be indicated the lameness of natural healing as wss described by Dr. Shimamura.
2) In cases of haemoptysis, granulation tissue with many views are recognized in cavity wall, and slough of caseous necrotic mass followed by such haemorrhage as is seen in typhoid fever can also be seen. Cicatrized foci has many dilated veins and showed to be angiomatous. It is supposed that those are the causes of haemoptysis. Formerly great haemoptysis has been thought to be csused by bursting of trabecular aneurysma, but after implementing chemotherapeutics, we must pay attention to massive haemoptysis as coming from granulation of cavity wall or veins within cicatrized foci.
3) In order to prolong life, after treating with chemotherapeutics, lung consolidation which occur in succession as an healing phenomenon is accelerated. In this case, however, cor death which may be due to the above condition should be taken into consideration.
4) Congetion or bleeding of foci caused by the use of various antituberculosis chemical agents is most remarkable in cases of ISO-NICOTINIC-ACID HYDRAZID, and such phenomenon is considered to be due to expansion based on pharmacologycal action of peripheral vein.

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