LEPROSY. 341 



with typical lepra lesions of all the viscera, especially 

 the cecum. 



While the lepra bacillus has much in common with the 

 tubercle bacillus, there is not the slightest evidence of 

 any real identity. It has already been shown that lepra 

 bacilli do not grow upon artificial media, and that they 

 cannot be readily transmitted by inoculation. The fol- 

 lowing description will show that the relation of the 

 bacilli to the lesions is entirely different from that of 

 the tubercle bacilli to the tubercles. 



Like the Bacillus tuberculosis, the Bacillus leprae proba- 

 bly only occurs in places frequented by persons suffering 

 from the disease. That individuals are infected by the 

 latter less readily than by the former bacilli probably 

 depends upon the fact that leprotis infection seems to 

 take place most commonly by the entrance of the organ- 

 isms into the individual through cracks or fissures in 

 the skin, while the tuberculous infection occurs through 

 the more accessible respiratory and digestive apparatus. 



The lepra nodes are usually superficial, affecting the 

 skin and subcutaneous tissues, but may occur in the 

 organs. Virchow has seen a case in which lepra bacilli 

 could be found only in the spleen. 1 



Sticker 2 (Lepra Konferenz) is of the opinion that the 

 primary infection in lepra takes place in the nose, sup- 

 porting his opinion by observations upon 153 accurately- 

 studied cases, in which 



1. The nasal lesion is the only constant one in both 

 the nodular and anaesthetic forms. 



2. The nasal lesion is peculiar — i. e. characteristic — 

 and entirely different from all other lepra lesions. 



3. The clinical symptoms of lepra begin in the nose. 



4. The relapses in the disease always begin with nasal 

 symptoms, such as epistaxis, congestion of the nasal 

 mucous membrane, a sensation of heat, etc. 



1 Mittheilungen und Verkandlungen der internationalen wissenschaftlischen 

 Lepra- Konferenz zu Berlin, Oct., 1897, ii. Thiel. 

 1 Ibid. 



