In the 6 years from 1949 to 1954, 381 case; were reported in Kyoto Prefecture with the clinical diagnosis of Japanese B encephalitis. They were classified into 4 grou saccording to complement fixation reaction, pathological findings, virus isolation and clinical symptoms. The present report includes the epidemiology and the results of laboratory examinations on 274 confirmed encephalitis cases, belonging to 3 of the above 4 groups.
1) The incidence rate of Japanese B encephalitis in Kyoto Prefecture was lowre but in exceptional years than the average of whole Japan.
2) The peak of incidence curve fell at the end of August. The year in which the first patirnt was reported early, brought a high total number of patients with a high case mortality rate.
3) The incidence in the male was higher than that in the female.
4) The age morbidity rate had its peaks at 5-9, 25-29 and over 55 in the male, and at 5-9 and over 50 in the female. In the latter an accumulation of incidence at 25-29 was not confirmed.
5) The age mortality rate was highest in the older ages over 45 in both sexes. On the whole, the mortality rate was higher in the female.
6) In 87% of total mortal cases the death occurred on five days from the 4th to the 8th day of disease. Patients over 50 years of age died earlier than those of other age groups.
7) In the city the regional morbidity rate was highest in such wards, which are situated along Higashiyama (eastern hill zone) and lowest in the central part. Outside the city, Amada Province had the highest incidence, which outnumbered that of every ward in the city. The lowest incidence was found in Soraku and Otokuni Provinces. It was below 1 in a year on an average.
8) The rate of positve complement fixation reaction with patients' serum was low at the early stage, but it already rose to 72% on the 8th day of disease. From the 12th day on the reaction turned to positive in almost all cases.
9) It was noticed that meningoencephalitis due to mumps virus was included in suspect cases of Japanese B encephalitis. Mumps virus was isolated from the cerebrospinal fluid in one of such cases.

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Differences in the properties of freshly isolated and stock Shigella strains were examined. The “freshly isolated strains” were those strains which were isolated from the stool of patients with Shigella dysentery at its acute stage and were not subcultured. They were submitted to necessary tests as soon as possible after the isolation. The results of the investigations are summarized as follows:
1) The majority of freshly isolated strains were provided with capsules, as demonstrated by the FeCl3 method recommended by K. Ando (Jap. J. Exp. Med., 1951, Vol.21, 41), while stock strains were devoid of capsules. To maintain the capsulated state and with that the “freshness” of Shigella strains, an egg medium was preferable.
2) The serum agglutinin of a dysentery patient against the freshly isolated strain from the respective patient, could not necessarily be completely absorbed by a homologous stock strain. Nor was the agglutinin perfectly eliminated from the serum of rabbits, immunized with a freshly isolated capsulated strain, by the absorption with a stock strain, serologically belonging to the identical type.
3) Contrary to other capsulated bacteria, freshly isolated capsulated dysentery bacilli were O-agglutinable. A different nature of the capsule of the latter was thus indicated from that of ordinary bacterial capsules.
4) Freshly isolated capsulated strains were more virulent to mice than the corresponding stock strains.
5) A remarkable difference was noticed between freshly isolated and stock strains in their behaviour toward phagocytosis. The former was more resistent to phagocytosis and exhibited extracellular multiplication, unimpeded by the presence of leukocytes. The latter was amenable to phagocytosis, and extracellular proliferation was hardly demonstrable.
6) Acid agglutination was not so constantly confirmable with freshly isolated strains, as reported by other investigators.
7) Strains isolated from the stool of severe dysentery cases were not thereby necessarily associated with a high acid agglutination rate. (The acid agglutination rate is represented by the number of acid-agglutinable Shigella strains to the total number of strains obtained from stool culture of the respective case.)

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Besides there convalescentt serum of scarlet fever patients, some other serum preparations have hitherto been effectively employed for the blanching test of scarlatinal exanthema. Recently, the author noticed that γ-globulin preparations, which were offered on sale for the treatment and prophylaxis of measles, could likewise induce blanching of scarlatinal exanthema. The present report deals with a comparative study, carried out on 297 scarlet fever patients and 15 Izumi fever patients, with re convalescent sera of scarlet fever patients and the above-mentioned γ-globulin preparations. The investigation is supplemented with some other experiments.
No significant difference was observed with the sera and the preparations mentioned above, in the rate of positive reaction, in that in terms of days since the appearance of exanthema, in the diameter of blanched area and the time from the injection to the beginning of blanching.
The rate of positive reaction was higher in the female regardless of the kind of the preparations.
The maximum effective dilution to cause blanching was 10 times with the γ-globulin preparations.
Electrophoretical determination of γ-globul in in the sera of re convalescent scarlet fever patients revealed no difference in its quantity, whether the sera were effective or ineffective in the blanching test.
No difference was confirmed in the diameter of blanched area, by purified γ-globulin of blanching effective re convalescent serum of scarlet fever patients and by γ-globulin preparations on sale.
In the majority of sporadic Izumi-fever patients, in which the diagnosis was confirmed clinically, neither re convalescent serum of scarlet fever patients nor γ-globulin preparations exerted a blanching effect upon the exanthema.
Purified albumin had no blanching effect on scarlatinal exanthema.

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1) Thorn's test through adrenalin injection was executed on scarlet fever patients at several stages of the disease. The fluctuation in the differential leukocyte count was summarized as follows:
i) Evident eosinophilic leukocytosis was observed immediately after the adrenalin injection during the febrile period of scarlet fever. The increase rate was higher in patients than in healthy persons. This initial increase in eosinophils was then followed by a temporary decrease, which was likewise demonstrated in healthy persons as well as in scarlet fever patients. In the former the decrease continued to progress even 2 hours after the adrenalin injection, and the eosinophil count after 4 hours still exhibited a reduction of 50% of the original value. At the febrile stage of scarlet fever, on the contrary, the reduction ceased to proceed already 2 hours after the injection, and the eosinophil count returned after 4 hours to the value observed prior to the injection.
ii) Lymphocytes showed an analogous fluctuation with slightly deviated phase in development.
iii) The fluctuation of neutrophils was less remarkable in febrile scarlet fever patients than in healthy persons. Monocyte count exhibited a tendency of decrease both in patients and healthy persons. The difference in both groups demonstrated a broader range of deviation in individual values in patients.
2) The results of the differential leukocyte count described above support the concept, that the mechanism of Thorn's test consists in a retention of leukocytes in organs. In scarlet fever, one of those diseases to which eosinophilic leukocytosis is characterstic, the organs partaking in the leukocyte retention are assumed to be in a condition, hypersaturated with eosinophils. Adrenalin stimulates the organs through the innervation to discharge eosinophils into blood stream. The velocity of re-retention must be the same both in patients and in hearty persons, so far as the organs concerned are not damaged in their function. A condition of hypersaturation is reached, therefore, earlier in the organs of scarlet fever patients than in those of healthy persons. This is the reason why the value of eosinophils in scarlet fever ceases to fall and begins to return to the former value already at the time (2 hours after adrenal in injection), when it still continues to decrease in healthy persons. This assumption explains at the same time the reduction in lymphocytes at the febrile stage of scarlet fever.
3) Accordingly, it is concluded that the eosinophilic leukocytosis in scarlet fever is attributable neither to a hypofunction of the hypophyseo-adrenocortical system, nor to an inability of organs to retain eosinophils.

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Differential leukocyte count, especially in regard to eosinophils and lymphocytes before and after the injection of adrenalin, ACTH or cortisone, was examined to reach the following conclusions.
1) The initial increase in eosinophils and lymphocytes after ACTH or cortisone administration in healthy persons was lower than after adrenalin injection. Consequently, the action of adrenalin to incite an initial increase in eosinophils was regarded to depend upon its stimulation on the nervous system, and could not be attributed to the activity of the hypophyseo-adrenocortical system.
2) A milder initial increase in eosinophils was likewise induced by ACTH or cortisone than by adrenal in at the febrile stage of scarlet fever. The increase was, however, still more evident in the patients than in healthy persons. This was due to a hypersaturated condition of the organs partaking in retaining eosinophils and lymphocytes in this disease. On account of saturation, these organs were sensitive to stimuli to discharge eosinophils into blood stream.
3) The reduction of eosinophils, which followed the initial increase, was so curtailed in scarlet fever patients that they ceased to fall already 2 hours after the injection of the above medicaments and began to resume the former value. This phenomenon, characteristic to scarlet fever, especially at its febrile stage, was attributed to a saturated condition of leukocyte retaining organs with eosinophils and lymphocytes at the time of the injection. The initial discharge of these cells could provide only little room for the re-retention.
4) On the basis of the reported experiments, the mechanism of Thorn's test is most reasonably defined by the view, which emphasizes the retention of leukocytes in organs.

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