Admittedly the various studies just referred to do all have their owninherent limitations, and would not necessarily represent the true extent of heart disease in the Orient, they may, nonetheless, give us sufficient insight as to characteristics of the heart problem in these areas.
Some of the interesting observations include the following:
(1) The prevalence of rheumatic heart disease in the Philippines, India, and China.
(2) The low coronary prevalence in Japan as a whole as well as among Chinese and Indians.
(3) The prominence of cor pulmonale, particularly in India and Malaya, and to a certain extent in the Philippines.
(4) The unusually high frequency of vascular lesions in the brain, as the major cause of mortality in hypertension, in Japan.
(5) The rather high frequency of congenital heart disease observed in postmortem material in Singapore.
In addition, within the same area, the following observations deserve further mention:
(1) In Japan, there are varying degrees of prevalence of coronary heart disease, bit being higher in Tokyo and Kyoto than in Fukuoka.
(2) In Singapore, the same disease is more frequent among Indians, Indian Muslims, Eurasian and Europeans than the Chinese in the same area.
(3) In Manila, hypertension, as a cause of heart disease among hospital cases, is found more often in Chinese patients than among Filipinos ; whereas the latter are apt to be more of the rheumatic types. Coronary disease occurs more frequently among Filipinos than among Chinese in Manila.
(4) In India, heart disease is more common among Christians, Parsees and Jews than among the Hindus, with syphilitic heart disease more frequent among Moslems and hypertensive and coronary types more common among Christians, Parsees and Jews.
Undoubtedly, this spectrum of heart disease in the Orient deserves further scrutiny, investigation and exploration. Whether differences are ethnic, cultural, and religious, dietary, environmental, etc., these factors have to be studied more extensively and intensively in order to arrive at some definitive conclusions. In the mean time, these data must serve us all as information and inspiration for future work.

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The present status of knowledge of how dietary constituents may be related to the development of cardiovascular disease has been generally reviewed and discussed. The factors other than diet are not included in this paper.
Dietary patterns and composition of many Pacific countries have also been reviewed. They were arbitrarily classified into the following four groups.
(1) The Caucasian diet: It contains characteristically high energy (around 3, 100-3, 300 Cal. per capita daily), high fat (37.5% of total Cal.) with a ratio between saturated and unsaturated fat (S/U ratio) of 9.5, high animal protein and relatively low but refined carbohydrate. This is the typical dietary pattern of North American countries (excluding Mexico), White Australia, part of USSR and of Caucasian immigrants to the other Pacific regions.
(2) The Latin American diet: It offers a moderate amount of energy around 2, 500-2, 700 Cal. per capita daily, derived about 20% or less from fat with a S/U ratio of 1.3, and high carbohydrate content. Such a diet pattern covers an area of the Pacific Coast of Latin American countries and a part of Central American countries.
(3) The Oriental diet: It can be considered as a high carbohydrate, high protein, mainly vegetable, and low fat diet with a total energy value of 2, 200-2, 500 per capita daily. Only 11.4% of total calorie is derived from fat, of which the S/U ratio is 0.2. It is composed mainly of rice and other cereals, fair amount of legumes and vegetables, with a small amount of meat, poultry, fish and egg and practically no dairy products. Vegetable oil is the main cooking fat. This diet pattern covers rice eating countries of the West Pacific Region.
(4) The South Pacific Islands diet: It is composed mainly of starchyVol. 3 No. 2 DIET COMPOSITION AND CARDIOVASCULAR DISEASE 143roots, sago and taro, some coconuts and sea foods and a very little fat. So it is high in carbohydrate and fiber but low in protein and fat. This dietary pattern covers the population groups who live on less-technically developed small islands of the South Pacific Region.
Thus, the Caucasian diet may favor the development of cholesterolemia and of degenerative cardiovascular disease most readily than the other three Pacific diets. The Latin American diet may stand next and then the Oriental and South Pacific Islands diets. The actual situation runs parallel with this trend, as the ratios between Caucasian-Latin American-Oriental diet countries on death rate of degenerative cardiovascular disease and its percentage in all types of heart diseases are approximately 5:1.5:1 and 6:4:2 respectively. So the correlation between diet composition and cardiovascular diseases does exist.
From the study of correlation between the caloric percentage of consumed dietary constituents and the death rate of arteriosclerotic and degenerative heart diseases of many Pacific countries, it may be safe to say that, the dietary fat, particularly saturated fat is the most important factor in the development of these diseases.
But the reverse order may be true for infectious and nutritional heart diseases, though supporting data are incomplete.
Relevant data for the South Pacific Islanders are insufficient, therefore, whether the above statements hold true or not requires further proof.

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(1) A new and clinically useful method with Au¹⁹⁸ colloid for the determination of hepatic arterial and portal blood flow by the external counting method is introduced.
(2) In 37 cases of control persons, the ratio of hepatic arterial blood flow to hepatic blood flow was 37.6±3.4 per cent and in 24 cases of liver cirrhosis the ratio was 59.8±6.3 per cent. This mean of the ratio of the liver cirrhosis showed a definitely increased value as compared with the controls (P<0.01).
(3) Hepatic arterial blood flow was 281ml./min. in controls and 293ml./min. in liver cirrhosis, but portal blood flow was 468ml./min. in controls and 196ml./min. in liver cirrhosis on an average.
(4) Hepatic circulation time via hepatic artery or via portal vein was measured.
(5) The ratio of hepatic arterial blood flow to hepatic blood flowshowed a correlation with appearance time of hepatic circulation via portal vein.
(6) From the stepwise changes of the disappearance-rate-constant of Au198 before and after the occlusion of the hepatic artery and the portal vein, the ratio of hepatic arterial blood flow was obtained experimentally in 6 dogs. The mean of the ratio was 21.5 per cent.
(7) A micro G. M. counter was utilized first in analyzing hepatic circulation in 7 dogs experimentally. With the counter inserted into the hepatic vein, the separative recording of hepatic arterial and portal circulation was obtained.

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(1) The RS-T and T changes were observed in 27 of 57 cases (47%)with gastrointestinall cancer, in 12 of 19 cases (63%) with liver cirrhosis, and in 5 of 26 cases (19%) with hepatitis, respectively. Most cases with RS-T changes were revealed to have hypopotassemia lower than 3.5mEq./L., while cases with lowering of the T wave alone had hypalbuminemia lower than 3.0Gm./100ml. It was assumed that the hypalbuminemia rather than dysproteinemia on the one hand and hypopotassemia on the other hand might be contributing factors to the RS-T and T changes in these diseases.
(2) In biliary tract diseases, the RS-T and T changes were observed in 27 of 83 cases (33%). The serum albumin and potassium levels were ranged mostly above the critical level regardless of the electrocardiographic findings. Of 23 cases, in which the electrocardiogram was recorded during colic attack, the RS-T or T changes appeared or became aggravated in 14 cases. The anoxia or double two-step tests revealed the positive results in 3 of 7 cases examined. In autopsied series, coronary sclerosis was more common in cases with gallbladder diseases than in the control. From these findings, the RS-T and T changes in the biliary tract diseases can be attributed to the coronary disorders, which may be functional, organic or both.
(3) In peptic ulcer, the RS-T and T changes were observed in 14 of 93 cases (15%) and in gastroptosis in 4 of 54 cases (7%). It is known that these diseases frequently have hypotension and that T wave often becomes flat or inverted in upright position In the hypotensive patients. In our series, 49% of peptic ulcer and 81% of gastroptosis were hypotensive and lowering of the T wave in upright position was seen in 43% of the former and in 53% of the latter. From these viewpoints, the RS-T or T changes observed in these diseases in recumbent position may be interpreted to be a higher degree of the findings observed in upright position and attributed to the autonomic nervous dysregulation or circulatory dysfunction, as interpreted in hypotension.

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A simple new method of recording low-frequency precordial vibrations has been presented.
(1) The pressure type transducer is deviced. The frequency response of this transducer displacement is very suitable for recording these precordial vibrations, of which frequency components usually lie between 0 and 5 cycles per second. This transducer has several special features such as a simple structure, electric stability, large electric output and good S/N ratio.
(2) The amplifier contains a condenser for the stability of the baseline and time constant becomes 2 second. Four or multi-channel electromagnetic oscillograph used is suitable for recording these vibrations with electrocardiogram, phonocardiogram or other tracings.
(3) In subsequent reports results and interpretations of patterns obtained from normal and pathologic hearts will be described.

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A case of aortic arch syndrome associated with hypertension due to unilateral renal lesion was reported.
Results of examination indicate that the disease process withi its inflam-matory nature primarily involved the aorta and its main branches. Unilateral renal lesion was probably due to an occlusive process in the renal artery.

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One case of chaotic heart action which appeared in rheumatic heart disease was reported and mechanism of fibrillation was discussed from the point of membrane potential and clinical aspect.

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