Leprotic mal-perforation is one of the serious surgical complications of lepers. We conducted study on this problem and have obtained some results. As for the objects, we selected most severe mal-perforation cases. These were 10 cases of neural type (having the total of 14 mal-perforations ) and 16 cases of lepromatous type ( having the total of 19 mal-perforations). All of these cases were serious more than the average in their leprotic nervous symptoms. Main treatment conducted was the extention treatment of N. ishchiadicus under the M. glutaeus maximus. The following local treatments were conducted jointly:
1) Penicillin ointment and chlorophyll ointment administration: 2) Reverdin's skin transplantation was conducted instead of Tiersche's techinigue: 3) Instead of the immediate suture of the surgical wound, we administered adhesive plaster to close the lack of tissues after sequestrotomy at the time of improving granulation: 4) It was necessary to give local rest-sequestrotomy and cutting off the incrassated skin around the border of the wound; 5) As for the general care, bed-rest and anti-biotics were ordered.
Results of the treatments were as follows:
ratio of permanent cure by type: neural type…64.3%; lepromatous type…78.9% ratio of recovering by type: neural type…7.1%; lepromatous type…15.8%
ratio of no change, impairment or other categories by type: neural type…28.6%; lepromatous type…5.3%
Results of sympathicotomy upon the surrounding artery were as follows: ratio of permanent cure by type: neural type…20.0%: lepromatous type…60.0% ratio of recovering by type: neural type…0%: lepromatous type…13.3% ratio of no change, impairment of other categories by type : neural type…80.0%: lepromatous type…23.3%
We may give conclusion that the former treatments are better than the sympathicotomy in the treatment of mal-perforation.
Ratios of relapse cases were also studied: ratio of relapse by type neural type…33.3% lepromatous type…13.3% ratio of relapse in the group which had any bone complications…42.9% ratio of relapse in the group which had no bone complocations…11.8% ratio of relapse in the group which had clubfoot…33.3% ratio on relapse in the group which had no clubfoot…13.3%
As for the symptoms of relapse, we confronted the following symptoms: 1) Inflammation on the location in 2 cases and 2) Hematoms or edema in 3 cases.
Before closing our reports, we want to state the following items : 1) Examination of the tension of sympathetic nerves, expansion grade of blood vessels should precede the operation, in order to find the best indication; 2) Ointment administration, skin transplantation, sequestrotomy, adhesive plaster and anti-biotics are helpfull when they are used jointly; 3) In order to prevent relapse, treatment of deformity of foot and iatent infection should be taken care of; 4) Extention operation of nerve is better than the sympathicotomy of the sruuounding artery.

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Through some laboratory tests on INAH in vitro, the following results obtained:
1) The bacteriostatic concentration of INAH in vitro against tubercle bacilli was 0.025-0.1γ/cc by the observation of 20 days period and 0.05-0.33γ/cc by that of 6 weeks period.
2) Its bacteriostatic effect against streptomycin- and PAS-resistant bacilli was maintained.
3) Its antimicrobial effect could not be found, however, against M. t. bovis and M. t. avium.
4) The antimicrobial effect of INAH, through a long period of observation, seemed to be affected by pH, i. e. if it became acidic, its antimicrobial action decreased.
5) INAH was proved to be of bacteriocidal. If INAH was mixed with tubercle bacilli for 4 weeks, it revealed complete bacteriocidal effect even at the concentration of 1γ/cc.
6) INAH delayed the growth of tubercle bacilli.
7) INAH was proved not to have antimicrobial effect against bacilli other than tubercle bacilli.

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Since it is practically convenient, so-called resistance method by Veraguth has been used commonly in the investigation of the galvanic skin reflex (GSR). However, this method has some difficulties in the quantitative measurements of reflex curves, as they are influenced by the basal resistance or the strength of electric currents through the skins of the objects.
In our study, it was purposed to study the effects of variable strength of the currents upon reflex curves. The experiments were conducted on 8 female adults during the period from June to September at the room temperature of 24.0° to 31.5°C. Two reflex curves were recorded from both palms and forearms simultaneously by means of a pair of so-called simple circuits which consist of battery cells, vibrator-F (5 × 10^-1A, 35c/s, 60Ω), microammeter and two Zn-ZnSO₄ kaolin electrodes.
It is remarkable that by means of this method the reflex curve can be recorded accurately, both in time and in shape. In our experiments, the strength of the currents of one side (left side) were increased from 50 μA upto 100μA, step by step, while that of the other side (right side) were kept constant at 100μA, to be the control side. It is a characteristics in our device to compare the corresponding reflex curves of both palms, instead of statistical observation of the reflex curves at different times, as it is the customary used method of measurements.
Our results were as follows:
1) At 100μA, the mean latent time out of 60 to 90 reflexes of each subject was 1.22 to 2.40 seconds and the mean top time (reaction time) was 0.97 to 2.25 seconds, showing normal distributions.
2) The reflex appeared out to one correspondence at both palms, and if the skin temperature and the strength of the current applied were kept constant during each series of experiments, latent time, toptime and amplitudes of reflex curves showed almost the same value in both sides. If the amplitudes of reflex curves increased, latent time showed the tendency of decrease and reaction time became longer.
3) If the strength of the current was increased from 50μA, step by step, upto 300μA, the latent time became gradually short, the reaction time became long and the amplitude measured by μA increased gradually.

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The clinical progress, the findings of electrocardiogram and X-ray findings of affected legs were studied in 18 idiopathic gangrene cases who were admitted to our clinic during the last 4 years.
1) There were relatively few cases in which the relationship between the cause and the attack of the disease were clear. The 4 complicated cases were explained and discussed in detail.
2) At the time of admittance, the findings upon electrocardiogram examination were found in 9 cases out of 18 cases. In 3 cases, low potential difference, decension of ST and relatively serious trouble in heartmuscle were found.
3) The close relationship between the electrocardiogram and clinical symptoms of idiopathic gangrene were observed, and in those serious cases (having delayed progress of attack, tendency of reccurence, and the extension of gangrene) the electrocardiogram pictures had definite findings.
4) The atrophy of phalanx of the affected side were observed in almost all the cases.
5) There were close relationship between the symptoms and the atrophy of bone which were supposed to be caused by the abstraction of the peripheral circulation. More incurable and extensive the disease were, so were the bone-atrophy remarkable and extensive.
6) As the gangrene in peripheral parts of the affected leg was cured and general condition of body recovered upon sympathicoganglionectomy, the pathological findings of electrocar diogram and atrophy of bone by X-ray examination found to be recovered gradually, but in very serious cases upon electrocardiogram examination and cases having sclerosis of bone in their extremities, no changes were observed.

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