Twenty cases of salmonellosis, excluding typhoid fever, were admitted to our hospital during the threeyear period from 1965 to 1967.
In this paper, clinical observations of these cases are described first, then, based on these observations, a tentative criterion with the main emphasis on eradicating effect against causative agents is proposed for the judgment of effects of antibiotic administration. And, further, resistant patterns of isolated salmonellae to usual antibiotics are demonstrated, and finally the results of animal experiments with the organisms are presented.
1) The incidence was most frequent in summer.
2) Clinically, these cases were lacking characteristic features distinguishable from other resembling diseases without recoverying causative agents.
3) Various types of salmonellae were isolated from them, but the pattern of their ype distribution was much the same to that of other's recent reports in Japan.
4) It is noteworthy that only small number of cases took smooth course, while pretty many cases took lingering course excreting salmonellae in the feces for a long time in spite of repeated antibiotic treatments.
5) A criterion for the judgment of antibiotic effects was proposed here. Giving marks such as, 0, 1, 2, 3, and 6, to clinical features and laboratory findings, like this if no salmonella were detected, give 0, if the pus appeared in the feces, give 1, and if salmonellae were isolated, give 6- and, finally, the sum total of marks gotten prior to antibiotic treatments is devided by those gotten after antibiotic treat. ments. The quotients are used for the judgment. Less than 0.29; good, 0.3-0.69; fair, and bigger than 0.7; ineffective.
6) In susceptibility tests of isolated strains against various antibiotics, the number of SM-resistant strains was predominant, followed by TC-resistant ones. Out of strains isolated, those which belong to. B group such as S. typhimurium and S. heidelberg tended to be more resistant than others.
7) In mice orally administrated of various types of salmonellae, they were usuallymaintained in the liver and the spleen. The longest maintenance was recorded in the case of S. heidelberg.

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Since first reported by Takasaki in 1961, increasing number of reports of the so-called subacute myelooptico-neuropathy with abdominal symptoms (SMON) has been coming from many places throughout Japan and drawing much public attention.
As the knowledge on its symptomatology and pathology advanced, it has now become recognized as an independent clinical entity and a new disease, though its etiology still remains unknown.
As of the end of 1968, SMON cases occurring in Ibara city, Okayama prefecture, western part of main land Japan, have accumulated up to 114 in number. Of them, 111 cases were able to be treated at Ibara Citizen's Hospital.
This paper describes epidemiological features of this disease in this city and some clinical observations made in this hospital.
1) Eighty two cases were able to be put under precise clinical observations in the hospital. About 70% of them were typical SMON showing signs of lateral cortico-spinal tracts and posteriol columns (mainly Goll's tracts) disturbances ensuing from abdominal symptoms. Of these typical ones, 45% were accompanying visual disturbances (12% catastrophed into blind). Remaining 30% were generally mild in their symptoms and considered to be abortive form of SMON, though they had abdominal signs and ensuing nerve disorders in the lower half of the body.
2) Incidence by year, season, sex and age:
SMON victims were 1 male (M) and 1 female (F) in 1962, 2 M 1 F in 1963, 1 M 3 F in 1964, 4 M 7 F in 1965, 3 M 6 F in 1966, 5 M 27 F in 1967, 19 M 31 F in 1968. As shown above, the number was demonstrably on increasing trend since 1967. Generally, the incidence was higher in warmer season like June to October, but considerable number was also seen in March. Looking all instances as a whole, female is predominant to male, the ratio being 2: 1, and, above all, the incidence of female in 50S was highest (720 persons per 100, 000 livings) followed by that of 40S (550 per 100, 000 livings).
When observed by year, the incidence of female in 60S was highest in 1966, that of female in 50S and 40S was predominant in 1967, and that of female in 30S was highest in 1968. It means the distribution of favorable age for this disease was shifting to younger side year by year.
3) Some other epidemiological findings:
1. There had been large scale epidemics of non-bacterial meningitis (ECHO 6 was then claimed as causative agents) in 1964, wrapping almost the whole city. Since then, in some districts of this city, the incidence was lingering, but in the other, no incidence at all. In the former districts, SMON appeared since 1965, the ensuing year of the non-bacterial meningitis epidemic. On the other hand, in the latter districts, SMON appeared first in 1966 or 1967, one or two years interval from that. Interestingly, the victims of non-bacterial meningitis were all under 16 years of age, and those of SMON were over 15.
2. The incidence was lower in districts where there was tap water supply system. Drinking water seems to have some relationship to this disease.
3. In this series, 5 instances of intra-familial multiple occurrence (11 cases) were observed. Three instances of multiple outbreaks of this diseases within small circles were also observed; one in a factory workshop, one in a high school athlete club, and one in a hospital pharmacy.
4. Three persons were found to have developed SMON two to three months after they moved to this city from other districts.
All these epidemiological facts are more or less suggestive of the infectious nature of this disease.

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