418 Discussion 



had the opportunity of finding some cases of these deficiencies and to investigate them. 

 In most of these cases a peculiar malignant inflammation over the oral region was 

 observed which started from the root part of the teeth and resulted in severe pro- 

 gressive gangrenous ulcers. Often, the ulcer progressed to the jaw bone. The dis- 

 turbance has been designated as Takahara's disease after the name of the first dis- 

 coverer. The pathogenesis has so far been explained as the result of bacterial infections 

 and the tissue disturbance is caused by a toxic action of hydrogen peroxide produced 

 continuously by the infecting bacteria. These grow well at the gingiva, especially where 

 gingiva and teeth root touch. In some cases, the infection was reported to have started 

 from fissures in the tonsil. Among bacteria which are found in the infected gingiva 

 are strains of Lactobacillus, Streptococcus haemolyticus, Diplococcus pneumoniae and 

 others. They are known to produce hydrogen peroxide and have no catalase. 



The above-mentioned abnormality has long been reported in Japan and so far in 

 Japan only. It was found for the first time by Takahara in 1946 at the polyclinic of the 

 Okayama University. Until now, we have had 35 cases of the abnormality originating 

 from 16 families which have been described by various physicians in different places 

 in Japan (see Nishimura at al.. Science 130, 330, 1959). 



