ON LEPROSY 187 



a great histological and physiological reality, we have 

 already attempted to make plain ; therefore, it is not here 

 necessary to re-describe it in detail, or to do more than 

 claim for it that power and cogency, which we hold it 

 possesses, to unlock the secret of the true nature and 

 incidence of leprosy. 



Thus the neural circulations one and all conduct to 

 the neural periphery wherever situated, either internally 

 or externally, and externally, of course, as in this case, they 

 must necessarily end in the skin, to which they convey or 

 circulate whatever of neural lymph may find its way along 

 the inter-neurilemmar spaces, and whatever of plastic 

 nervine substance is elaborated in and passed out of, or 

 excreted by, the afferent or sensory neuronal common- 

 wealth or sensory nerve cell community, whether situated 

 in brain, spinal cord, or ganglia. The excrementitious 

 matters here must, therefore, be neural lymph, in the 

 form of sweat, and axonal process substances consisting of 

 neuro-keratinous or containing membrane material, with 

 the medullary and axis cylinder substances or nervine 

 substance proper truly, a series of devitalised and shed- 

 ding materials abundantly and naturally able to take on 

 agglutinative action, hardening and accumulative accretion, 

 ideally adapted to the formative growth and prolonged 

 cuticular adherence or dermal retention of leprous encrus- 

 tations the cemented and solidified equivalent of the 

 total dermal debris of the surfaces involved. 



That leprous skin developments are primarily due to 

 such accumulations we deliberately believe, and that the 

 bacterial or microbic organisms discovered in the accumu- 

 lations and permeating the connected tissues are secondary 

 we further believe ; therefore, we are prepared to assert 

 that without an initial stasis and more or less permanent 

 arrestment of the neural circulations with local effete 

 accumulations, we could not have leprosy nor the develop- 

 ment of the leprous bacillus. 



Such views necessitate the further belief that leprosy is 

 essentially a disease primarily of the nervous system in 

 relation to the non-patency and debarred function of its 

 cutaneous, excretional, and exfoliative apparatus, and, there- 

 fore, that it is a disease of "dirt and uncleanliness," with 



