In the early diagnosis of this disease the possibility of demonstrating the bacil lus is of great importance. J. Darier (Ann. de Derm. et de Syph., vol. viii, No. 12).
Leprosy is contagious only after a very intimate and long-continued intercourse. Autoinfection within the body takes place by dissemination of the bacilli through the muscular system. E. Baelz (Berliner klin. Woch., vol. xxxv, Nos. 46 and 47).
Secretions and tissues of a case of lep rosy examined; bacilli found in the blood of diseased tissue, sweat, epidermis, and sperm, but not in the blood of healthy tissues, in the urine, or sputum. Faber (Deut. mcd. Woch., June 1, '97).
In cases with tubercles the bacilli are found in many tissues of the body, while in those without tubercles they are con fined to the nerves. In the amestlfetic forms the bacilli cease to exist after a few years. Many cases will present no bacilli at the end of three or tour years. The tubercular forms are the only ones con cerned in spreading the disease. S. P. Impey (Lancet, Sept. 25, '97).
The bacillus of leprosy cultivated in human blood-serum. Two forms were observed: long and slender bacilli, and short and almost elliptical in shape. The bacillus was Hansen's bacillus, because it resists decoloration by 30-per-cent. nitric acid; there was no reason to be lieve that any other organism was intro duced when the tubes were inoculated; the filtered fluid from the cultures when injected into horses produced the same reaction as serum from lepers' blood; the serum of horses subjected to injections of culture filtrates produced the same reactions in lepers as the serum from lmrses infeeted with serum of lepers' blood; the bacillus stains in the same way as Hansen's bacillus. Carrasquilla (Nat. Acad. of Med. of BogotA, '99; 13rit. Med. Jour., Oct. 14, '99).
The blood of lepers in various stages of the disease was carefully studied by Winiarski. When leprosy has not given rise to great changes in the organism, the composition of the blood is not much altered. No change in its composition, in the various forms of leprosy (arms thetic, nodose, and mixed) could be dem onstrated. In chronic cases the number of blood-corpuscles was always found to be diminished, on an average, 17.9 per
cent. in men and 12.3 per cent. in women. The limmoglobin was decreased, on an average, 6.3 per cent. in men and 2.4 per cent. in women. The white blood-corpuscles were usually normal in quantity. In all cases of leprosy a large preponderance of multinuclear leuco cytes was noted.
Prophylaxis. — At the International Conference on Leprosy, held in Berlin in 1897, the conclusions reached were the following: (1) the leprosy bacillus discovered by Hansen is the true cause of the disease; (2) man is the only ani mal in which that bacillus exists; (3) leprosy is contagious, but is not an hereditary disease; (4) isolation of lep rous patients is desirable, and under such circumstances as exist in Norway; (5) compulsory isolation is to be recom mended.
Results of segregation in Norway: In 1856 there were 2871 lepers in Norway and now there are hardly 800.
In all countries where leprosy is met with endemically, isolation has proved the most useful method of preventing the spread of the disease. The worse the social relations, the greater is the danger frotn contagion. IIansen (Monats. fUr prak. Derm., 11. 25, No. 9).
That segreg,ation is an effective pro phylactic measure for the protection of the public at large against leprosy is undoubted. The same statement would be applicable, however, were syphilitic, tuberculous, and other infectious sub jects to be compulsorily isolated and ostracized from society. Indeed, it would apply more forcibly, since all the evi dence at our disposal tends to prove that leprosy is one of the least contagious of infectious disease, though undeniably so in predisposed individuals.
A handsome young lady of good family married a leper, and lived with him eight years. Partly through jealousy on his part, and partly through devotion on hers, they made every effort to share the leprosy in common. The leprous husband caused her to kiss his ulcerated tongue constantly, and numerous attempts at inocnlation were made. Nevertheless, the husband finally died of leprosy, while the widow still lives in perfect health. Zanibaco ("Des Affections Nerveuses Syphilitiques," '62).