The Shigella group consists of numerous sero-types characterized by the possession of a distinctive antigen. Regarding the acquired immunity to bacillary dysentery, therefore, especially in cases of relapse or reinfection the Shigella sero-types must be confirmed and investigated in detail in contrast with strains in the first attack. The pathogenic organisms in cases of recrudescence, relapse and reinfection, together with changes of the serum agglutination titers during the course of the disease have been examined, and the development of immunity after recovery from dysentery has been observed clinically. The results were as follows:
1) In cases of “clinical recrudescence” the same Shigella sero-types were usually observed.
2) In cases of “clinical relapse” there were cases recognized as true relapses where the same Shigella sero-types were observed and cases recognized in fact as reinfections where the different types were found.
3) In cases of “clinical reinfection” readmitted there were cases recognized as true reinfections where the different Shigella sero-types were found and cases recognized in f act as relapses where the same types were observed.
4) The clinical symptoms in the subsequent attack were as follows;
a) The symptoms were similar to those in the first attack when infected with strains possessing entirely different antigenic structure.
b) They were less severe in the second attack than in the first attack when infected with strains possessing similar antigenic structure belonging to the same group (Flexner group).
5) The above results indicate that, after recovery, a certain degree of acquired immunity or cross-immunity develops to the same or similar Shigella types, but no immunity develops to the different types belonging to another group.

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Attempts were made to isolate dysentery bacilli from flies caught in the houses of dysentery patients, and from the fingers of nursing persons. The results were summarized as follows.
1) The flies in 7 of 100 houses of dysentery patients were found to harbour dysentery bacilli.
2) From the larvae of flies, which had been contaminated experimentally with dysentery bacilli, the bacilli could even be recovered 47 days after the contamination.
3) Dysentery bacilli were isolated from the fingers of one of the 17 nursing persons examined.

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Up to this time, we treated severe Japanese B encephalitis patients with PANS-25 in 1951, PANS-326 in 1952 and PANS-610 in 1953. Of these PANS-preparations, only one, PANS-610, proved to be clinically effective, but it was associated with considerable side effects, as thrombophlebitic symptoms and hematuria due to its hemolytic action.
In 1954, we treated encephalitis patients with PANS-610 AN and AS, which were newly prepared by Ueda and Toyoshima, and expected to have less side effects. The new PANS-preparations could not, however, display so distinct an effect upon some of the important symptoms, such as the disturbance of consciousness, fever, convulsion, as PANS-610. Side effects were almost the same with that of PANS-610 in some cases. In spite of these rather unsatisfactory clinical impressions, statistical analysis of the total results revealed a more favourable effects of these medicaments than that of PANS-610. The sequela rate was reduced and the rate of complete recovery increased, as shown in table 3.

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A twenty-six year old male and a twenty-five year old female, complaining fever, abdominal pain and diarrhea, were admitted to the Joto Hospital, Nagoya: on 11th July 1953. A Salmonella strain was isolated from the stool of the patients. The patients general condition was not serious, and a recovery took place in two or three days. Theisolated strain presented typical cultural and biochemical characteristics of Salmonella group. The agglutinin titer of the serum of the patients against the isolated bacilli was 320-640× and the agglutinin was completely absorbed by Salmonella nagoya and by the isolated strain. Agglutination and absorption tests further indicated that the bacilli had O-antigen, 6 and 8, and H-antigen, b for the first phase and 1, 3 and 5 for the second phase. This demonstrated that the antigenic structure of the isolated strain coincided with that of Salmonella nagoya, and it was concluded that the reported cases belonged to those of gastroenteritis caused by Salmonella nagoya.

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1) Antibiotic resistance of staphylococci was examined with the sensitivity tablets of the Roskilde Medical Company Ltd. Denmark in 65 strains, which were isolated at the Iwase Hospital from December 1953 to May 1955. The obtained results were as follows.
Penicillin-resistant 62 strains (95%)
Sulfathiazol-resistant 64 strains (98%)
Streptomycin-resistant 20 strains (31%)
Chloromycetin-resistant 3 strains (5%)
Aureomycin-resistant 9 strains (14%)
Terramycin-resistant 12 strains (18%)
2) Fourteen strains of staphylococci, which were isolated f rom the throats of healthy adults, were likewise examined for the antibiotic resistance. Similar results were obtained as those described above.
3) Four cases of staphylococcal infections were reported, in which penicillin therapy was unsuccessful, but therapies with other antibiotics, selected according to the results of antibiotic resistance tests, brought about a good recovery.
4) Various infections caused by the penicillin-resistant staphylococci were also observed in Sukagawa city and in its neighbouring farm villages.
The importance of the antibiotic resistance test in the treatment of suppurative diseases must be emphasized. It seems that Chloromycetin, Terramycin, Aureomycin and Erythromycin are more effective and hopeful antibiotics in the treatment of these staphylococcal inf ections.

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A clinically applicable chromatographic method was devised by the author for the diagnosis of Japanese encephalitis in its early stage. The principle of the methodconsisted in detecting a remarkable increase of fatty acids in the cerebrospinal fluid of encephalitis patients. Fatty acids as such did not participate in the colour reaction, but, when converted into hydroxamic acids, they were sensitively demonstrated by delivering purple colour by ferric chloride. By means of the so-called hydroxamic acid chromatography, the hydroxamic acids derived from fatty acids in cerebrospinal fluid were made visibleas purple spots, when developed and treated with ferric chloride on filter paper.
With the cerebrospial fluid of encephalitis patients 3 spots were discerned on the chromatogram, of which only one, corresponding to a Rf 0.78, was of diagnostic significance. This spot was confirmed in 30 of the 35 encephalitis cases, observed in the period of 1953-1955. On the contrary, this spot was demonstrated in none of the 19 non-encephalitis cases, including tuberculous meningitis, serous meningitis, epidemic cerebrospinalmeningitis and subarachnoid hemorrhage. The diagnosis of encephalitis could even be confirmedon the 3rd day of the disease by the characteristic chromatogram. It was accordingly concluded, that the hydroxamic acid- chromatography of cerebrospinal fluid offered a valuable method for the diagnosis of encephalitis in its early stage.

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The diagnosis of mumps is confirmed by serological reactions as well as by the skin tests, reported by Enders, Henle, Cabasso and others. The author performed fundamental, comparative studies on various skin test antigens, such as Henle's S and V, Enders', Cabasso's and Habers, and attempted to estimate their practical value in the diagnosis, of, and in the mass-examination of susceptibility to, mumps. The results were as f ollows:
1) Enders' skin test antigen and its control solution were injected intracutaneously, on both forearms of the volunteers simultaneously. The antigen gave rise to an erythema over 10 mm in diameter in 14.8 and 18.2 per cent of the recipients after 24 and 48hours, respectively. No erythema was induced by the control antigen. The skin reaction to Enders', antigen was regarded to represent a specific relation to experienced mumps virus infection, for the antibody titer of hemagglutination inhibition of those with a positive reaction was remarkably higher than that of those with a negative reaction.
2) Henle's S and V antigens proved to be superior to other antigens.
3) The examined antigens showed difference in several respects, as in the frequency distribution curves of the diameter of erythema, in the appearance of induration, in the extinction time of erythema and so f orth.
4) The lyophilization procedure was the most satisfactory, method for the preservation of antigens.

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The multiplication of pathogenic bacteria introduced into the intestines is an important prerequisite in the mechanism of the onset of intestinal infectious diseases. Thisknowledge has been derived from many observations in experimental studies and clinical experiences.
It is known that, in the intestinal tract of man and animals, a few kinds of bacteria, which may be called “residents”, usually occupy certain parts of the tract and the distribution and the population of residents can not be changed even when fairly large amounts of other bacteria are given orally. Furthermore, the given bacteria are removed from the intestinal tract in a short time.
On the other hand, it was recently noted, that the orally given bacteria could replace residents in the intestinal tract, when made resistant to, and given together with, streptomycin. This kind of experiment was regarded by the author to give a promising clue to elucidate the interaction between the pathogenic bacteria introduced from without and normal residents previous to the onset of infection.
In this experiment an E. coli strain, 0-55 B4, resistant to 5.000γ/ml. of streptomycin, was given to mice orally with and without oral pre-administration of streptomycin. The feces were cultured once a day for 9 days on BTB-lactose agar, BTB-lactose-streptomycin agar and 10% blood agar, under aerobic and anaerobic conditions. The isolated bacteria on these media were classified into 14 groups according to the biological characteristics revealed, and the administered strain was identified immunologically. (Table 1)
Almost all species of the isolated bacteria were sensitive to streptomycin, being inhibited by 1007/ml. of streptomycin as shown in Table 2. This result indicated a disappearance or a remarkable decrease in number of normal residents by streptomycin.
The bacteria which were inhibited temporarily by streptomycin, regained their number in several days to the same level as before the streptomycin administration. A striking reciprocal relation was observed between the administered and some streptomycin sensitive resident strains. The prominent number of the latter were constituted by Lactobacillus and Streptocodcus lactis.
The author could not, however, confirm any antagonism in vitro, between the administered strain and these two groups of bacteria.
Although further investigations are required to reach a final conclusion, not only E. coli but also some other members of normal residents in the intestinal tract must be regarded to have a close relationship to the multiplication of bacteria introduced from without.

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