The significance of the cervix uteri in the diagnosis and prognosis of gonorrhea in women is greater than that of female urethra, since the gonorrheal organism can be demonstrated or cultured in 85% of cases.
Even though gonorrhea has become greatly reduced both in severity and incidence in recent years, the fact that the disease still today prevalis to the extent of 10% of prostitutes, or even 20-30% in some areas, can not be ignored entirely.
Numerous studies on uterine gonorrhea were published during the 1910-20 period, but histopathological investigations of the most important uterine cervix are encountered only in 2-3 reports. This fact is considered to indicate that the studies on gonorrhea of the female genitalia have been concerned chiefly with the body of the uterus.
Hitherto the gonorrheal organism has been thought to rapildy penetrate the tissues of the mucous glands where they survive for long periods. As well known, the cervix is provided with abundant glandular tissues, and consequently it is natural that the organism makes an invation, setting up an inflammatory process. Utilizing this fact the physicians rightly seek diagnostic data by examining the secretions, although it is regrettable that today no adequate results are to found in the histopathological aspects of the cervical tissues.
There is, however, a very difficult problem in the study of these tissues, namely, the presence or absence of the complex changes concomitant with the different phases of the sexual cycle. The reports of observations published by Wollner (1936), Sjovall (1938), Papanicolaou (1948), Duperroy (1951), do not give any concerted opinion. In any event, all agree as to the existence of rather complicated changes. Recently, Terutake Harada (1953) demonstrated the existence of definite changes in the cervic accompanying the various phases of the sexual cycle in many of the human materials which he studied. These consisted chiefly of those in the structure of glandular tissues, particularly of the epithelial cells of the glands, together with those of the interstitial tissue and blood vessels. Their details are described according to the menstrual, post-menstrual, mid-menstrual and pre-menstrual phases of the cycle. All these changes naturally appear in the specimens which I have studied and prove themselves to be quite complex. However, it is not difficult to imagine that not every cell group in many glandular tissues found in an extensive area shows transition to any definite changes. This fact may be taken to be the reason why discrepancies are often encountered in the observation in the post on the changes associated with the phases of the sexual cycle. Again, Prof. Kawazoe, in his histological study of the endometrium, reported that the changes of the uterine tissue, in the presence of an inflammation, do not often coincide with those of the sexual cycle. The facts must all be taken into consideration in the disposition of my observations on the materials of the present study.
On the other hand, there are numerous reports on the gonorrheal inflammation of the mucous membrane in general by Prof. Tabayashi and his pupils. After reviewing these reports, the present investigation covers studies on the gonorrheal tissues in 45 cases, those after treatment in approximately the same number, together with observations on the cervical tissues in 13 controls, making a total of 98 cases.
The histological findings obtained on these materials appear at first to be complicated and difficult of interpretation, but they can be readily analyzed when interpreted on the basis of either changes due to the sexual cycle, or those peculiar to gonorrheal inflammation, or to the effects of gonorrhea complicating the cyclic changes.
Gonorrhea, according to Prof. Tabayashi, can be classified according to its many-sided histological changes into the initial stage of acute inflammation

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In this paper, the results of quantitative Millon's reaction in the bladder urine and the bilateral renal urine collected by ureteralcatheterisation on the patients of the various renal diseases are discribed.
1) There is almost no difference in Millon's rate (M. R.) between the sides of urine from the kidnies with normal function and pyelogram. The bladder urine shows a insignificantly higher M. R. than renal urine. The M. R. of these urines are below 11.5mg/dl.
2) In cases with the same renal function, the M. R. increases or decreases in parallel with Millon's substance in the system.
3) On the 12 patients of unilateral renal tuberculosis, the M. R. is highest in urine from normal kidney (12.4±3.1mg/dl), than in bladder urine (11.3±2.3mg/dl), and is lowest in the urine from affected kidney (7, 1±2.6mg/dl). As there is a definite difference between M. R. of normal and affected urine, the excreation of Millon's substance may be considered to depend upon the renal function.
4) On the 11 patients of unilateral renal tuberculosis, it is proven that a delay in the excreation time of indigocarmin test indicates a lowering in M. R. in affected urine and converse in normal urine. The M. R. of bladder urine is apt to increase.
5) On the 9 patients of unilateral renal tuberculosis, it is proven that when phenolsulfophthalein test is poor, M. R. of normal urine is higher than normal, and that of affected urine is converse. The M. R. of bladder urine is almost the same with normal urine.
6) On the same cases, it is proven that there is no intimate relation between the water test and M. R. of normal, affected and bladder urine.
7) On the 11 patients of unilateral renal tuberculosis, it is proven that a higher changes in pyelogram indicates a lower M. R. of affected urine, higher M. R. of normal urine and an increasing tendency of it in bladder urine. The same relationship exists between the degree of organic changes in the removed kidney and the M. R. of normal, affected and bladder urine.
8) In patients of bilateral or contralateral renal tuberculosis after a removal of a unilateral kidney, the M. R. is low and does not indicate the degree of liver function disorder.
9) In patients of non tuberculous renal disorders, the M. R. of normal urine is frequently higher than affected urine, the bladder urine has a higher level of M. R. than the other too. However, in patients of renal newgrowth, the M. R. of affected urine is higher than the other.

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The subject of the study was 5 patients in which bilateral cutaneous ureterostomy had been done and one patient in which splint catheter had been remained after and unilateral (right) ureterolithotomy. In these cases Millon's and urobilinogen reaction of urine, HST, cobalt reaction, total protein of serum as liver function test and indigocarmin test were carried out. Thus the following mutual relation was found as the results of comparing the pre- and postoperative conditions (10 days to 7-10 weeks after surgery):
1) Millon's reaction indicates well the disturbance of liver function. It may be one of the liver function test to be employed in parallel with HST or cobalt reaction, even if renal function is moderately trammeled, particularly in unilateral renal diseases.
2) But in the cases of high grade disorder of renal function, Millon's reaction is not valuable as a liver function test. The urobilinogen reaction also. HST and cobalt reactors, however, shows extent of liver function disorder having no relation to renal function. In addition, HST is more sensitive than cobalt reaction.
3) On the patients of renal function disorder, the results of Millon's reaction, HST and cobalt reaction are not always closely parallel. But if the renal function disorder is not so high in degree or the unilateral renal function is not so trammeled, HST changes is closely related and cobalt reaction appears almost in parallel with Millon's reaction.

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The emulsion of human tuberculous kidney, from which protein had been removed by boiling, was injected intravenously in normal male rabbits for three weeks. The body weight, total serum protein, HST (Hepatsulpharen test), and uric Millon's reaction were then examined (Group A). As the controls, non tuberculous renal emulsion (of calculus kianey) (group B) and 0.5% carbol physiolgical saline solution (group C) were injected in other group of rabbits. Afterwards the rabbits were killed by air embolus, and the liver, kidney, spleen, lung, and heart of the animals were examined histologically and histochemically.
1) In any rabbit of group A, B and C, the body weight and total serum protein dosis did not show any definite change.
2) In rabbits injected with tuberculous kidney emulsion (group A), a significant increase in HST was observed (α=0.05) after 3 weeks. In rabbits injected with normal kidney emulsion (group B), the HST showed an increasing tendency, though the increase after 3 weeks was not definite. In rabbits injected with phisiologic saline solution, the HST showed no essential change.
3) A change in the uric Millon's reaction was almost similar to that of HST. In the cases of group A, injected with tuberculous kidney emulsion, the uric Millon's reaction increased remarkably. After 3 weeks a significant increase of the uric Millon's reaction was observed. In some cases in group B, injected with normal kidney emulsion, the uric Millon's reaction increased. However, an increase of average value was not significant. In group C, the Millon's reaction showed no essential change.
4) In the liver of group A rabbits, a degenerative atrophy of liver cells, bleeding, necrosis, fat degeneration, disappearance or remarkable decrease of PAS reaction positive substances, and decrease of alkaline phosphatase reaction were observed remarkably. However, in the liver of group B rabbits, these change were not remarkable. In group C, these histological and histochemical changes were hardly observed. In rabbits in which uric Millon's reaction showed a very high value, these degenerative changes of the liver were more remarkable than the others.
5) The histological and histochemical changes of the kidney in all rabbits in group A, B and C, were not remakable. In the spleen, lung, and heart of these rabbits, the histological and histochemical changes were hardly observable.
6) It is concluded that an increase in uric Millon's reaction may cause degenerative changes of the liver as described above. Except for the patients complicated with a serious distarbance of total renal function, therefore, the uric Millon's reaction may be a reliable means of testing the liver function.

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Bei den 31 Hunden, an denen ich die Nierennaht nach Prof. Kitagawa bei der Nephrolithotomie ausführt, habe ich wöchentlich durch supravitale Färbung, Uria Clearance test, Aortographie und retrograde Pyelographie den Verlauf verfolgt und bin zum folgenden Schluss gekommen.
1) Histologisch vollendet die Wunde 4 Wochen nach der Operation die narbige Heilung, in den Nahtteilen und den entfernteren Teilen aber wurde die Erscheinung der vorübergehenden. Degeneration bemerkt.
2) Innerhalb einer Woche flack der Operation sieht man am Rinde das Bild der Anaemie.
3) Die Zahl der Karmingranula in den Epithelzellen vermindert sich während 2 Wochen. nach der Operation, in der 3. Woche schon vermehrt sich. Die diffuse Rotfärbung der Protoplasmen und der Kerne in den Endothelzellen der Glomerulen und Epithelzellen des Hauptstücks ist in der ersten Woche stark, in der zweiten wird schon bedeutend schwächer. Dies bedeutet, dass die Funktionsstörung der Niere eine Woche nach der Operation noch schwer ist, aber in der zweiten Woche schon leichter wird.
4) Nach Uria Clearance test zeigt die Funktion der Niere eine Woche nach der Operation 50% von derjenigen vor der Operation und steigt danach allmählich auf.
5) In den Aortogramm und dem retrograden Pyelogramm zeigt sich die Funktionsstörung der Niere nach der Operation auch nur vorübergehend.
6) Bei den Tierexperimenten habe ich die unangenehmen Erscheinungen wie Blutung, Harnfistelbildung u. s. w. nie bemerkt. Durch klinischer Beobachtung bei 24 Fällen der Nephrolithotomie und 5 der Teilresektion der Niere in unserer Klinik während 9 Jahren bestätigte ich folgend:
(1) Es gibt keinen Todesfall, ausser 3 Fällen der sekundären Haematurie, 2 Fällen der Harnflstelbildung sind alle Operierten völlig geheilt.
(2) Einer der sekundären Haematurie-Fälle ist durch Ruhe, Bluttransfusion und Blutstillungstherapie leicht wieder hergestellt worden. Demnach kann man einsehen, dass man auch bei einer hochgradigen Haematurie die Nephrektomie nicht ausführen soll. Nach einem grossen. Schnitt aber, wenn der Verlauf auch so günstig ist, ist die Ruhe wenigstens 2 wochen Lang dring end nötig.
(3) Einer der Harnfistelbildungsfälle war vorüergehend; beim anderen steckte man “Spongel” in die Wunde hinein, zwar mit Misserfolge. Die Misserfolge geschahen ausnahmslos bei den grossen, mehr als 3cm langen Schnitten.
Nach alledem glaube ich, dass unsere Methode, die die Nierensubstanz 2 bis 3 fach solgfältig zunäht, eine sehr empfehlenswertige ist.

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