Biochemical and immunological investigations were performed on the 50 strains of Alkalescens-Dispar group (A-D), which were sent to our laboratories for identification in 1952 from three different places (Tokyo, Kobe and Fukushima) in Japan. Six of these strains had been isolated from the feces of enteritis patients, while the others had been derived from healthy carriers.
For ty-f our strains (88%) belonged to A-D 01 group, and 3 strains (6%), 2 strains (4%) and 1 strain (2%) were identified as A-D 02, A-D 03 and A-D 07, respectively. From these results we might duly refer that the A-D 01 group was prevailing in our country.
There were no major crossing antigens among the somatic antigens (0 antigens) of A-D 01-08 groups, but the close relationships between the somatic antigens of Alkalescens-Dispar and those of Escherichia coli were recognized as already pointed out by Frantzen and Kauffmann. Somatic antigens of A-D 01, A-D 05, A-D 06, A-D 07 and A-D 08 were identified with those of E. coli 01, 02, 09, 07 and 081, respectively. It was further clarified that A-D 02 and E. coli 025 as well as A-D 03 and E. coli 04 had closely related antigens with each other, respectively, in agreement with Fratzen's results. A-D 03 and E. coli 025 possessed only the minor common antigen. Capsular antigen (K antigen) of A-D 01 group was immunologically identical with that of E. coli 01, but physicochemicallydifferent to some extent, mainly in the lesser resistance of the f ormer to acids.
Biochemical properties of these organisms were studied in comparison with standard strains. All of 01 and 07 strains showed biochemical reactions similar to those of standard bacilli. On the other hand, some strains in A-D 02 and A-D 03 groups gave different results in the fermentation of sorbitol, rhamnose, lactose and sucrose, as compared with standard organisms.

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Electrophoretic investigations were carried out of the sera obtained from rabbits immunized to dysentery bacilli, from human beings vaccinated with dysentery vaccine and from dysentery patients.
An increase in γ-globulin fraction was confirmed in the sera of immunized rabbits, with an elevation of agglutinin titers. Albumin fraction was found decreased, while α- and β-globulin fractions remained unchanged in quantity. These changes in the serum protein pattern were more distinctly induced by the inoculation of S-type dysentery bacilli, than by that of R-type.
Similar changes in the electrophoretic pattern of serum protein were observed with the sera of immunized persons and dysentery patients.
A remarkable reduction in γ-globulin fraction of the sera of immunized rabbits, vaccinated persons as well as dysentery patients, with a disappearance of agglutinin, was induced by the absorption with homologous dysentery bacilli. No reduction of γ-globulin fraction was observed by the absorption with other genera of Enterobacteriaceae than dysentery bacilli.
It was thus clarified, that bacterial agglutinins were contained mainly in the γ-globulin fraction of sera.

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Some genera of Enterobacteriaceae produce phenylpyruvic acid from phenylalanin. This phenomenon is called phenylpyruvic acid reaction (P. P. A. reaction). Henrichsen recommended this test recently for the differentiation of Proteus from other genera of Enterobacteriaceae. Further investigations revealed that the Providence group also gave a positive P.P.A. reaction. The Henrichsen's method, however, was too troublesome and complicated to find its way into the routine laboratory use. A simpler and more reliable method was proposed by the author for the laboratory work.
The mixtures of 0.5 ml. of bacterial suspensions (2 mg/ml.) and an equal amount of 0.2 per cent DL-phenylalanin solution or 0.1 per cent L-phenylalanin solution were kept in Kahn's test tubes for 2 hours at 37°C. After incubation 2-4 drops of half saturated ammonium ferro-sulf ate (FeNH₄ (SO₄) ₂) were added into each tube.
A positive reaction is indicated when the colour of the suspension turned green. If the colour remained unchanged, the reaction was a negative one.
A new method was further afforded by the author for a simultaneous examination of P. P. A. reaction and urea reaction in a single tube, and its utility and reliability in the routine laboratory work were discussed.

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The author examined the mumps skin test on three groups of inhabitants, who were exposed to the mumps epidemic in 1954. The three groups had different aspects of epidemic from one another at the time of the investigation.
Henle's S and V antigens, which were confirmed to be the best among the antigens in the first report, were employed throughout the study, and their practical value was estimated from the epidemiological standpoint.
The results were as follows:
1) Of those, who had history of mumps in the past, 85.7 per cent showed a positive reaction with Henle's S antigen, and 74.3 per cent, with Henle's V antigen.
2) With Henle's skin test antigens, frequency distribution curves determined by the diameter of erythema were different in their forms according to the three groups examined. This was reasonably explained by the difference in herd immunity of each group. With Henle's V antigen such difference in frequency distribution curves was not observed.
3) The incidence rate of mumps, f ollowed up after the examination of the skin test, was 5.1 per cent in those, who had shown a positive reaction, and 24.1 per cent in those, who had shown a negative reaction.
4) From the results of this field experiment it was concluded, that the boundary of positive and negative skin reactions should be set at 10 mm in the diameter of erythema, 24 hours after the injection, if either of Henle's S and V antigens was so standardized as to contain an unit of complement fixation antigen in 0.2 ml.
5) Some differences in the results were noticed between Henle's S and V antigens. Henle's S antigen was regarded to give a better index of mumps susceptibility or immunity than Henle's V antigen. With the former a fairly distinct correlation of the skin reaction to the blood antibody level was observed.

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Cholecystectomy was performed on a protracted carrier of typhoid bacilli, in whom oral administration of Chloromycetin had proved to be ineffective. The removed gall bladder showed no other macroscopic change than that it contained a small gallstone. From the bile typhoid bacilli were recovered almost in a pure culture
However, typhoid bacilli continued to be excreted even 7 months after the operation, and could be cultured from the bile and the stool.
Fifteen reported cases of cholecystectomized carriers in Japan were summarized and investigated on the presence of typhoid bacilli in C bile, the changes in the gall bladder and the results of cholecystectomy. It was concluded that cholecystectomy was not an adequate procedure to eliminate typhoid bacilli of the carriers, who had the source of bacilli in the liver or had nearly normal gall bladder.
The author referred to the excellent results obtained by W. Briihl, who treated 4 cases of typhoid and paratyphoid carriers with the application of gall bladder fistula and the perfussion of the bile duct with Chloromycetin solution. His method was recommended for the treatment of typhoid and paratyphoid carriers, who did not respond to internal therapies.

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The authors reported a mass incidence of diarrhea in the above-mentioned f actory in August, 1953. Fifty-eight patients were recorded with an incidence rate of 28.2 per cent. The cause of diarrhea was attributed to a contaminated diet. The incubation period ranged from 4 to 11 days, mostly from 7 to 9 days.
Investigations were performed on 17 hospitalized patients. The clinical symptoms showed a striking resemblance to those of epidemic diarrhea. The stool cultures for dysentery bacilli, Salmonellae, and other pathogenic organisms were not contributory. The Widal reaction and the Paul-Bunnel reaction of the patient sera were negative. In the earlier stage of the disease leukopenia was observed in most of the cases with a leukocyte count of 5000 to 3000.
Virus research was unfortunately not available, and the identification of the disease with epidemic diarrhea and Mobara diarrhea remained undetermined.

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1) The present study includes ten cases of mild Shigellosis. The intestinal contents of the patients, aspired with Miller-Abbott's double lumen tube at several levels of the intestinal tract, were bacteriologically examined. In four cases Shigella organisms were found in a concentration of 10⁴ per ml. of intestinal fluid approximately, at the level of lower ileum. The specimen of one of these cases contained approximately 10⁴ Shigella organisms per ml. without concomitant Escherichia coll.
2) Diluted bouillon culture of Shigella sonnei were infused into the rectum of four adult volunteers from the anus with Nelaton's catheter. No abnormal clincal findings were induced in two of the cases, which received 10⁴ to 10⁵ organisms. Sigmoidoscopic observations revealed nothing particular and fecal specimens 24 hours after the infusion were free from, the infused bacilli. The other two cases, in which 10⁶ Shigella organisms had been infused, developed mild diarrhea with slight tenesmus. Sigmoidoscopic examinations revealed an inflammation of mucous membrane. The babilli persisted until treatment.
3) Based on the results of these experiments, it seems to be reasonable to conclude, that the development of clinical disorders of Shigellosis depends upon the multiplication of the bacilli, which exceeds a certain quantitative limit in the terminal ileum at some stage of infection. The results of this study may further support Brauer's hypothesis on the pathogenesis of Shigellosis and Letterer's histological studies.

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