1 86 PHYSIC 



tion and removal, leaving the overspread and involved 

 cutaneous and subcutaneous structures bereft of many of 

 their histological elements, functional, material, active and 

 passive, and, in short, in a state of "wreck and ruin" 

 more or less complete, in accordance with the intensity 

 and duration of the disease. 



The process of arrestment of cutaneous elimination, and 

 the consequent local or general formation of more or less 

 gross collections of effete but unshed dermal materials, 

 lay the foundation conditions and provide the required 

 pabulum for the invasion and support of armies of bacterial 

 organisms, which "batten and fatten" at the expense of 

 their host, and generally succeed, with intercurrent allies, 

 in completely undoing him, but not always, when mark 

 the result! is it not a "living death"? 



Underlying and lending itself to the production and 

 evolution of these lethal events is one main structural 

 peculiarity and histological arrangement of the elements 

 comprising the skin, viz. the co-existence in it of three 

 circulations, or rather systems of circulation, which are, 

 respectively, sanguineous, lymphatic, and neural. 



The first two may, we contend, be eliminated from the 

 list of possible primary etiological factors of leprosy, so 

 far as the principle of circulation and its arrestment is 

 concerned, inasmuch as these are concerned in the circula- 

 tion of fluids not likely to be primarily concerned in the 

 initiation of such disease, although they may, and do, 

 become secondarily involved by invasion and contiguity ; 

 moreover, they circulate their fluids mainly from the 

 periphery, and consequently away from the scene of the 

 disease, the exception being the pure arterial blood, which 

 cannot be looked upon as conveying to the peripheral 

 capillaries an effete and impure, and, therefore, excretional, 

 product. That being so, we are left alone with the neural 

 circulation, to find, if possible, in it what we are in search 

 of, i.e. the etiological factor^ which has in it a power and 

 cogency sufficient to explain the initiation and sequence 

 of the morbid events or phenomena characterising and 

 constituting this long familiar, hideous, and fell disease, 

 leprosy. 



That the neural circulation or system of circulations is 



