Upper case Bee ; Therapeutic procedure ; Hepatitis, Chronic

Our hospital plays the role of a medical center for a rural district, giving medical service for the approximately 20, 000 settled farming population. There is no mixingof patients with other hospitals.
The author deliberated on the 242 female cases of appendicitis treated at this hospital. 1. Incidence of appendicitis.Female cases surpassed male cases in the ratio of 1: 0.75. Majority of the female cases consisted of the married women of 26-36 age group, who take the lead as housewives both in the household work and in farming. It was noted that acute cases increased in the April-June on-season, while chronic cases increased before and after the on-season, i. e. in February, March and June. The increase of acute cases may be due to the hard physical labor and overwork of rural women. 2. Histological classification of the resected specimens. Attention of the author was drawn to the existence of neuroappendicitis or appendicitis ascribed to disturbance in the vegetative nervous system.It may have something to do with the slackened mental tension before and after the on-season. 3. Affinity with gynecological diseases. Confusion in diagnosis of appendicitis and gynecological diseases occurred to 10% of appendicitis cases. Relationship with urinary diseases is not to be neglected either. Question of appendicitis in pregnancy was also taken into consideration. In conclusion, emphasis was placed on its close affinity with gynecological diseases, with the suggestion of hints for differential diagnosis.

It is statistically known that there are more cases of advanced pulmonary tuberculosis among rural people than among urban residents. The author worked on the difference in the behaviors of tuberculosis in such two groups of people from a point of view of pathological physiology and discovered the following facts:
As a result of comparison of the rural and urban patients with radiographically similar extent of lesions, the rural patients were found to be inferior to the other group at the time of their hospitalization with respect to haemoglobin values, albumin-globulin ratio, body weight, icterus index, etc., and to show higher values of γ-globulin and higher rates of positive Gros reaction, Among these items, haemoglobin value, albumin-globulinratio and body weight of the rural group showed a marked increase after 6 months' and 12 months' hospitalization.Such increase is ragarded to be a combined effect of improvement both in disease and nutriture.
There are many anemic cases in rural area even among the apparently healthy people free from hookworm infection, and they also present a decrease in total serum protein and albumin values, icterus index, etc., for which their inadequate or unbalanced dietary intake is said to be accountable.In the light of this fact, it is considered that prior to the attack of tuberculosis rural tuberculous patients have already been in more or less poor nutriture, which is further aggravated by the disease, while such poor nutriture assists the progress of the disease itself playing as a causative agent for its ingravescence.