The author had a trial test in the experimental studies on the effect of morphine hydrochloride upon the excretion of bile with normal dogs, and the results obtained were as follows.
1) Morphine brought about the elevation of gallbladder pressure as well as that of bile duct pressure, and on the contrary it brought about the repression of bile flow to the duodenum.
2) Morphine brought about the elevation of gallbladder pressure as well as that of bile duct pressure at the same time, especially that of the bile pressure was remarkable.
3) Morphine brought about the remarkable repression to the Oddi's sphincteric perfusion.
4) Morphine brought about the elevation of the duodenal tonus, and also the remakable rise of duodenal internal pressure curve.
5) The variation of the Oddi's sphincteric perfusion by morphine was entirely agreed to the variation of duodenal tonus.
6) The effects of morphine to the gallbladder and to the distal end of the common bile duct were both the elevation and the descent of the tonus at the same time, and were not act as on the low of Meltzer.
7) The effecting times of morphine were for a fairly long (above 60-120min.).
8) The action of morphine was especially stronger to the distal end of the common bile duct, so that it showed a remarkable function in both repression of bile flow to the: duodenum and the elevation of bile duct pressure.
9) The given excitation by the use of morphine on the bile duct system was approximate to Barium chloride and was rather different from Pilocarpine hydrochloride.
10) When biliary colic was recognized, for the relief of pain, morphine was proved useless, because morphine brought about the stasis of the gallbladder and the increase of pain, if it were used individually. In these cases, Morphine, Atropine, Papaverine, high unit Vitamin C, and Chlorpromazine, should be to use at the same time.

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Study of the many kinds of “the tender point” in the cases of cholecystopathy were reported by many researchers already and their methodes has been useful on clinical. task, however, this author atempted to now procedure from 200 cases of cholecystopathy obtained. Of the new methode used the tender point (named by prof. Kudo) that is explained as follow, drawing horizontal lines over the median right scapula that is called “Zone of tender point”, paticulary pickup the clossed to middle line of scapula.
Then the following results were obtained from 200 cases of the cholecystopathy that were experimented by author.
(1) This phenomenon was presented to be positive 83 per cent in cases of 200 patients. with cholecystopathy, and observed that this “scapula-cholecyst-tender-point” had not: only large par centage compare to other kind of tender point but also small percentage in other patients without cholecystopathy.
(2) In 11 cases of cholelithiasis exhibited to be positive 100 per cent of “scapulacholecyst-tender point”, also positive in the 72.6 per cent that phenomenon of infrascapulatender point (this possessed on middle point of the line that drawing line between scapulacholecyst-point and angul of infrascapula).
(3) The degree of phenomenon described to (+) =56.5 per cent of all cases with cholecystopathy, in cholelithiasis also to (4).54.5 per cent positive sign.
(4) I observed that the “scapula-cholecyst-tender point” presented larger rate ever when the examination of duodenal drainage indicated abnormal signs than in that proce dure is normal, so the more that abnormal sign indicated result on that examinations, the more this “scapula-cholecyst-tender point” appeared positive sign.
(5) The phenomenon was showed more frequently in cases of that was recognized. abnormal signs resulted from cholecystography than cases that is without abnormal. symptomes at the methode, further the more the abnormal signs at the cholecystogram increased, the more that point is large rate.
(6) The relation between the signs on examination of gastric juice and “scapulacholecyst-tender-point” was not so fixed revealded by authoer's study the phenomenon, in that case bile flowered backward to stomack in examination of duodenal sondig, exhibited large rate of 94.5 per cent.
(7) The stomach roentogengraphy relation with “scapula-cholecyst-tender-point” was so conciderable closed that of functional for morphologic abnormal signs at X-ray examination from 85 to 100 per cent of cholecystopathy reveald positively.
(8) In cholecystopathy the “scapula-cholecyst-tender-point” at the enddisapperd in 58.8 per cent of cases improved in 45 per cent of patients with cholecystopathy and the-other side in case of cholelithiasis 9.1 per cent of was disappered, 45 per cent of improved.
(9) It was found that the “scapula-cholecyst-tender-point” inclined to remission or disapperence graduatly in consequent of that other symptomes of cholecystopathy comes to slight and recure.
(10) It's diagnostic value of the “scapula-cholecyst-tender-point” assessed by this author in conjuction with the other data avilavle from 200 cases of cholecystopathy.

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Since the author's attention have long been called to the facts that there are many clinical cases which attribute focal infections as the cause of biliary cyskinesia, they have divised their original method by employing normal dogs in order to trace the origin of it, and have studied the effect of various kinds of bacteriotoxin upon the choledochusgallbladder pressure and bile excretion. Having reproduced the endo and exotoxins of staphylococcus aureus and citreus, streptococcen, pneumococcen, bacillus Coli O₁₁₁or O₅₅, and typhus bacillus by Hosoya's method; the intravenous injections with these toxins were administered to the dogs. The results of the experiment were as follows: in the case of intravenous injections with staphylococcus, streptocaccus and pneumococcusexotoxin, the choledochus-gallbladder pressure raised remarkably. Meanwhile the bile excretion showed a marked increas, just after the injection. Then frequent time intravenous injections with a small dose of it caused a gradual raise of the choledochusgallbladder pressure and when it reached a fixed quantity the gallbladder pressure showed a marked raise higher than, the choledochus pressure and bile excretiog. In the case of staphylococcus, streptococcus, pneumococcus, bacillus coli O₁₁₁and typhus bacillus endotoxin its sinked slightly but in the case of bacillus coli O₁₁₁endotoxin its raised after about 30 minutes of the injection and the pressure Varied greatly.
Its action lasted for a long duration and an increase of the bile excretion was recognized in the cases of the ligated cystic duct and also if the case of oddi's sphincter is excluded besides the ligation of cystic duct, the bile excretion was only slightly inreased but on the other hand a marked raise of the gallbladder pressure was seen.
It is considered that various keinds toxin has a special action to contract the gallbladder. Furthermore, having used a perfusion apparatus, oddi's sphincter was perfused with physical saline, only for temporary period the perfusion fluid was decreased in the casesof staphylotoxin and streptotoxin, and also by the perfusion with the endotoxin of bacillus coli it was suspended, but oddi's sphincter became very active in its opening, and shutting movement and it brought about the increase of perfusion fluid.
Thus as was explained above, the various kinds of bacteriotoxin were confirmed in their remarkable influence upon the extra hepatic bile duct.
Furthermore, Studies have been made on biliary dyskinesia caused by the allergic: mechanism of bacteriotoxin for several years, in this time, employing dogs sensitized bybacillus coli O₁₁₁, staphylococcus aureus exotoxin and streptococcus haemolyticus exotoxin, the auther devised their original methods which enable to observe the dynamic conditions of the organs, that is, choledochus-gallbladder pressure, bile excretion, and oddi's sphincter perfusion. Furthermore, inset a balloon into the duodenum and enable to observe the tensness of it synthetically and simultaneously. On 3rd to 25th day after sensitization, performed aseptic laparotomy on the dogs in order to observe the condition of those extra hepatic biliary system. On the other hand observed comparatively the respones of extra hepatic biliary system after giving an intravenous injection to dogs with 1cc of the same toxin and obtained the interesting results: That is, bacillus coli endotoxin caused the reduction of chloedochus-gallbladder pressure and that of bile excretion, however, especially on 7th day for the intravenous injection of 1cc of the toxin, gallbladder pressure became four times higher than that of normal dogs and an increase of bile excretion was recognized. Oddi's sphincter at temporary duration was stimulated and a decrease of perfusion was brought out.

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As a part of the research project on pathologic physiology in the Matsukura Surgical Clinic, the author has made clinical and experimental investigations on the changes in the activity of certain enzymes, particularly of cholinesterase of serum and liver, in patients with digestive disease.
The results of observation are summarized as follows.
1) The average value of serum cholinesterase in 18 normal subjects was 174.5 CO₂mm³/0.1ml/30min, while that of erythrocyte cholinesterase was 324.5 CO₂mm³/0.1 ml/30min, both exhibiting individual differences to a considerable extent. The values in male patients tended to be greater than those in females.
2) However, with serum cholinesterase in the blood 0.1ml the average value was 99.0CO₂mm³/0.1ml/30min, while the average of the cholinesterase index was 0.71 CO₂mm³/30 min, and these apper to show nearly constant levels with very little individual or sex differences.
3) The activity values of liver cholinesterase in 6 patients who appeared to be fairly normal gave the average of 190.9CO₂mm³/0.1g/30 min, but there were considerable individual differences and the males give higher values than the females.

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