1923. No. 16. THE NEUROLOGICAL ASPECT OF LEPROSY. 3 1 



zation, that my observations allow is this : the sensory loss in the maculae 

 of the trioik is always much less pronounced than the sensory loss in the 

 maculae of the limbs. 



The existence of maculae without any sensory loss has to be recog- 

 nised, although this has not been a frequent finding in my cases (cpr. 

 case 7 & 59)'. 



It has to be mentioned that besides the simple loss of sensation, one 



sometimes meets with delayed sensation (although not so frequently as m 

 tabes) and disturbances in localisation (cpr. fig. ii, case No. i). 



As an illustration ot the superficial sensory loss encountered, I append 

 a few sensory charts giving the findings in some of my cases. 



Explanations concerning the following charts. 

 Case No. i. P. S. (Fig. 9 — 10.) 

 Chart of cutaneous manifestations (maculae and a perforating ulcer); the 

 macula marked "a" has developed during the last few years. 



For age of this and the other patients, and duration and type of the 

 disease, see the table of facial parah'sis on pages 15 — 20. 



Case No. i. P. S. (Fig. 11 — 12.) 



Chart of sensory loss. (The findings as regards tactile, algetic and 

 thermoaesthetic sensation were identical in distribution.) 



In the limbs there is complete tactile anaesthesia, — except in the 

 areas a and b where stimuli are as a rule felt. The stimuli applied to b, 

 however, are constantly localised by the patient to a. 



On the trunk the h^'poaesthesia is very slight. 



Case No. 2. J.H. (Fig. ij — 14.) 

 Chart of sensory loss and maculae. All qualities of superficial sensa- 

 tion are affected to the same extent. 



It is noticed how the sensory loss is much less profound on the trunk 

 than in the limbs. 



Case No. j. J. O. B. (Fig. i)—i6.) 



Chart of sensory loss. 



At the bend of both elbows — in the middle of the anaesthetic area — 

 there is an "island", where the sensory loss in only very slight. 



Such "islands" are not infrequent (cpr. also Case i). 



At the back in the middorsal segments on the left side there is a 

 limited area of dissociated sensory loss of the "classical" type. There is 

 just a faint suggestion of tactile hypoasthesia, and the dissociation is here so 

 nearly complete as I have never seen it in any other case of leprosy. This 



1 According to Beurmann this should be a relatively frequent occurrence. 



