In November, 1956, a 3 years and 8 months old female, suffering from an eruptive feverish disease, complicated with nephritis, convulsion and disturbance of consciousness was investigated by the authors. The diagnosis of aseptic meningitis caused by Izumi-fever virus was given. Such a case has never been reported except by Dr. Izumi and a few reporters.
The results were as follows:
1) The eruptions were those of Izumi-fever.
2) Leucocytosis, relative neutrophile leucocytosis and 10% virocytes were observed by means of bloodexamination.
3) The findings of serous meningitis, i.e. the rise of pressure and a slight pleocytosis were obtained by means of spinal fluid examination.
4) The complement fixation test for Izumi-fever turned positive.
5) Hemolytic streptococcus was negative in her pharynx.
6) The rise of A.S.L.O. titer was not noticed.

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The virus treated with varying doses of glucuronolactone or sodium ethylmercurithiosalicylate (Merzonin: Takeda Co.) at 37°C for 4 hours was inoculated intradermally into rabbit and into chick chorioallantoic membrane. The lesions in rabbit were measured every day for a week and pocks of chorioallantoic membrane were counted after 72 hours' incubation. The results are summarized as follows:
1. More virus was required for producing skin lesion in rabbit than for producing pocks on chorioallantoic membrane.
2. The skin-lesion-producing activity was closely related to the infectivity of the virus.
3. The inactivation of the virus by glucuronolactone may be due to the effect of the hydrogen ions of the solution.
4. Chlorpromazine or tetraethylammonium bromide, administered previously to the rabbit, had no effect on the skin-lesion-producing activity of the virus.
5. These results conflict with the data of McCrea and Duran-Reynals (Science, 118: 93, 1953).

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The carrier rate of staphylococcus aureus in hospital personel and patients were compared with that of pupils of public schools, inhabitants of asylums and industry workers for epidemiological and bacteriological studies on the hospital staphylococci. Moreover, the biological properties, bacteriophage typings and drug senseitivities of the strains detected were also compared. The results were as follows.
I) The isolation rate of staphylococcus aureus: Staphylococcus aureus was detected from nasal mucus in 45-47% of a toal of 970 persons invetigated. Almost no difference was found between the hospital group and healthy group outside the hospital. However, the rate from feces of the hospital group was higher than that of the healthy group. The rate from purulent materials of patients was 100%, whereas that from resected lungs of pulmonary patients was very low.
II) The biological characteristics of 333 isolated strains: There were few differences in the Maenit fermentation reaction, 7.5% salt tolerance and hemotoxin production between the groups. However, the positive rate of coaglase test hospital group was 80-100%, i.e. significantly higher than the healthy group.
III) The bacteriophage-typable rate of 256 coagulase positive strains: the bacteriophage typable rate of 256 coagulase positive strains was within 60% in each group, and the joint phage patterns were mainly 6/7/42E/54/75 (phage group III) and 3C/3B/3A//55/71 (phage group II).
IV) The relationship between phage typing and drug sensitivity: PC resistant strains were in general frequently found in group II and III, and PC, SM and Tc cross resistant strains in phageuntypable group. With respect to the sources, the resistant strains against PC, SM and TC were observed more frequently in the hospital group than in the healthy group. Generally speaking, resistant strains against CM and EM were not numerous in both groups.

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The distribution of antibodies of influenza A₂, A₁ and B was investigated after the epidemic of A₂ (/Asia/57) in 1957 among the population of a district of Tochigi Prefecture divided into some groups according to the age and living modes. Furthermore, the shift of antibody titer was examined from 1957 to 1958 after the vaccination of influenza A₂ (Adachi strain).
I) The distribution of antibodies among 1, 152 inhabitants, from newborns to old persons under various living modes.
i. Antibody titer>-1: 16
Pupils of primary, middle and high schools
A₂ 86.2%, Al 87.5%, B 85.4%
Usual family members
A₂ 80.0%, Al 41.9%, B 49.3%
The distribution of all the antibodies were higher in the first group.
II) The shift of antibody titer after the A2 (Adachi strain) vaccination The percentage of the persons with decreased antibody titer among the inha bitants of Sanraku-En 3 months after the vaccination:
Decrease by one figure number 14.1%
Decrease by two figures number 8.2%
The percentage 6 months after the vaccination:
Decrease by one figure number 32.9%
Decrease by two figures number 28.2%
Decrease by three figures number 18.8%
Decrease by four figures number 2.3%
The percentage 12 monts after the vaccination:
Decrease by one figure number 17.3%
Decrease by two figures number 27.8%
Decrease by three figures number 34.6%
Decrease by four figures number 6.7%
Decrease by five figures number 0.9%
The percentage of the persons with decreased antibody titer among the pupils of Tomita and Hishi middle schools 6 months after the vaccination:
Decrease by one figure number 35.5%
Decrease by two figures number 22.2%
The percentage 11 months after the vaccination:
Decrease by two figures number 24.2%
Decrease by two figures number 31.2%
The percentage of the persons with decreased antibody titer among the pupils of a school for the deaf and dumb and among the inhabitants of Unjaku-Ryo 5 months after the vaccination:
Decrease by one figure number 36.5%
Decrease by two figures number 33.9%
The percentage 9 months after the vaccination:
Decrease by one figure number 25.0%
Decrease by two figures number 36.6%

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The rise of antibody titer was investigated after the sub and intracutaneous inoculation of the single vaccines and the combined vaccine prepared from 57 strains of A₂ (Adachi), 53 of A₁ (Omachi) and 56 of B (Setagaya) to 830 persons of an oldpeoples's home, middle schools, a school for the deaf and dumb and a poor children's home.
Six methods of inoculation were applied ; i.e. single vaccine, subcutaneous 0.5 cc, 0.3 cc, intracutaneous 0.1 cc and combined vaccine, subcutaneous 0.5 cc, intracutaneous 0.1 cc lx, 0.1 cc 2x. The percentage of the persons with antibody titer<1: 64 before the inoculation, which rose to>1: 128 after the inoculation:
Old-people's home
with a single subc. inj. of A₂ 0.5 cc 41.9%
with a single intrac. inj. of A₂ 0.1 cc 69.6%
Tomita middle school
with a single subc. inj. of A₂ 0.3 cc 90.4%
with a single intrac. inj. of A₁ 0.1 cc 82.1%
School for the deaf and dumb
with a single subc. inj. of Ai 0.3 cc 20.5%
Tomita middle school
with a single subc. inj. of B 0.3 cc 40.6%
Sanraku-En
with a single subc. inj. of combined vaccine 0.5 cc
A₂84.0%
A₁ 65'5%
B 35.8%
Unjaku-Ryo
with two intrc. inj. of combined vaccine 0.1 cc
A₂ 73.1%
A₁ 46.5%
B 33.3%
Nogaku-Ryo
with a single intrac. inj. of combined vaccine 0.1 cc
A₂ 34.0%
Al 21.3%
B 20.9%
These data may be summarized as follows:
1. There is no significant difference in the antibody-producing effect between the. single intracutaneous injection of 0.1 cc A₂ vaccine and the single subcutaneous injection of 0.1-0.3 cc A₂ vaccine.
2. In the inoculation of the single vaccines of A₂, Al and B as well as the corn-. bined vaccine of 3 types, the antibody titer against A₂ rises higher than those against A₁ and B.
3. A single subcutaneous injection of 0.5 cc combined vaccine of 3 types induces, a higher rise of antibody titer than a single or two intracutaneous injections of 0.1 cc

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With 58 cases in our hospital, from which pathogenic coli bacilli were isolated from August 1955 to May 1959, clinical investigations were carried out on the signifi-cance of pathogenic coli bacilli in adult diarrheal patients in comparison with that in children. The incidence of diarrhea caused by pathogenic coli bacilli among adult diarrheal diseases was reported together refering to the data for the past one year presented by a medical office in Tokyo.
1) Pathogenic coli bacilli were found in 2 cases out of 182 patients who came to that office in Tokyo complaining of diarrhea.
2) In our hospital, pathogenic coli bacilli were found in 58 cases out of 2, 884 diarrheal patients, 27 cases out of 58 being adults. As for types of the bacilli, 0-124 and 0-75 were more often found than 0-126, 0-119, 0-111, 0-86a, 0-55 and 0-25.
3) Regarding clinical symptoms, mucous and bloody stool were frequently observed in cases by 0-124, and less frequently in cases by 0-119 and 0-75. In some cases, differential diagnosis from bacillary dysentery was difficult on clinical grounds alone. As for the frequency of high fever, frequent diarrhea, vomiting and abdominal symptomes, no statistically significant difference was found between children and adults.
4) In adult patients, mucous and bloody stool, intestinal cramp and tenesmus were observed more frequently in cases caused by 0-124 than in cases by 0-75.
5) Sulfa drugs were effective, but antibiotics seemed to be better.
6) 0-126, 0-124, 0-119, 0-111, 0-75, 0-55 and 0-25 were sensitive to sulfa drugs, and even more sensitive to antibiotics. No resistant strains against these drugs were observed.
7) There was no remarkable increase of agglutinin-titer in serum due to infection with pathogenic coli bacilli.

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Bacteriological, serological pathological and therapeutic investigations were carried out with mice infected by brucellosis for a long time period with special refernce to the shift of agglutinin titer due to the therapy, its diagnostic value and the reappearance of bacilli after the therapy.
The results were as follows:
A) Bacteriological observations on infected mice:
The bacilli were isolated from almost all organs of the mice till 3 months, after 0.1 and 0.2 mg of Brucella abortus Bang bacilli were injected into their abdominal cavity. Four months after the injection, the isolation turned occasionally negative in heart blood, bile, urine, ascites etc., whereas a fairly great amount of bacilli were still recovered in liver, spleen, kidneys and lymphnodes.
B) Pathological findings on infected mice:
Macroscopical findings were as follows; infected spleen, 4 times as great as a normal one, swelling of lymph nodes and occasional formation of superficial abscess n liver and kidneys. In addition, the lungs and genital organs were hemorrhagic and more or less marked pathological findings were extended over the entire viscera.
Histologically, the following findings, known to be characteristic of brucellosis were found in all internal organs, i.e. proliferation of reticulo-endothelial cells, hyperemia, congestion and appearance of juvenile cells. Particularly, the granulomata in spleen were striking.
C) Agglutinin titer of infected mice:
Agglutinin titer in the groups receiving 0.1 and 0.2 mg bacilli respectively showed 800 x and 1, 600x rise about 10 days after the injection, likely to remain in this level for a fairly long period and tended to decline slightly about 180 days after the injection
D) Agglutinin titers of treated mice:
1) The agglutinin titer continued to show 200 x in the group treated immediatly t the day of infection and 1600±x in the group in which the therapy was initiated on the 10th day. These agglutinin titers were probably related to the time of production of antibody. (infection with 0.2 mg)
2) The agglutinin titers remained on 800±x in all of the groups treated 1, 2 and 3 months respectively after the infection, being slightly lower than those of nontreated mice. (infection with 0.2 mg)
E) Results of treatment (combined use of aureomycin and streptomycin)
1) The therapeutic results regarding the recovery of the bacilli were by far better in the two groups in which treatment was started on the 1st and the 10th day of infection than in the non-treated groups. An extremely small number of bacilli remained, however, in liver, spleen and kidneys.
2) The therapeutic results were much better even in the groups in which treatment was initiated 1, 2 and 3 months after the infection, as compared with the nontreated groups. No particular difference was seen between one group treated for 10 consecutive days and the other treated every other day for 20 days. But, occasionally the remaining bacilli were detected in liver, spleen and lymphatic system.
3) Pathological observations on treated animals: Macroscopically, hardry any pathological findings were observed. Histological investigations revealed, however, abnormal cell arrangement, congestion and hyperemia. But, these pathological changes were exceedingly slight, showing an apparant tendency toward recovery.
Moreover, these mice, when examined long after the treatment, demonstrated no Bang bacilli in their body.
These bacteriological, epidemiological and pathological investigations led the author to the conclusion, that the combined use of aureomycin and streptomycin is undoubtedly superior to the other therapeutic agents.

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Filtrate of low nitrogen culture fluid, in which dysentery bacilli had been cultured for 24 hours was investigated on it's toxicity, in order to study “ekiri”-inducing factors.
1) Rabbits previously given disodium malonate was investigated on the influence of this filtrate. It was made evident, that the blood level of aceton, acetacetic acid, 13-oxy-butyric acid, lactic acid, pyro-racemic acid, citric acid and a-keto-glutaric acid was markedly increased 2-4 hours after the use of this filtrate as compared with contrast culture fluid.
2) The influence of this filtrate on glycolysis was investigated by means of lactic acid determination.
In aerobic conditions, lactic acid production was more increased by this filtrate than by the contrast culture fluid.
In anaerobic conditions, no difference was recongnized between these two filtrates. At the same time, the endotoxin and the filtrate were compared on their activity. The former did not elevate the lactic acid production.
3) Regarding enzyme inhibiting activity, aconitase was inhibited by the filtrate, but isocitric dehydrogenase was not influenced. However, the aconitase inhibiting activity depended also on the amounts of hydrolysate of casein contained in the culture fluid, the highest activity being caused by 100-500 mg/L. The endotoxin demonstrated no such activity.
From these experimental results, it might be concluded, that toxic substance in the filtrate of culture fluid of dysentery bacilli is endowed with a different activity as endotoxin i. e. with an aconitase, an enzyme of T.C.A. cycle, inhibiting activity. In this connection, it is an interesting fact that an inhibition of T.C.A. cycle, particularly an obvious rise of citric acid and pyro-racemic acid is observed in the blood of “ekiri” patients.

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