TRANSMISSION 619 



that infection occurs only through intimate and 

 prolonged association with the diseased, in which 

 doubtless uncleanliness plays a very important 

 role" (Grotschlich). A leprous husband eventually 

 infects his wife, and the children of lepers com- 

 monly develop the disease early in life. The high 

 percentage of leprosy which is noted among the 

 laundresses of infected localities indicates that the 

 disease may also be transmitted by indirect contact. 

 Gotschlich throws some doubt on the importance 

 of dust infection since so many of the bacilli found 

 in sputum appear to be degenerated. Nothing is 

 known of the resistance and viability of the organ- 

 ism outside the body. 



On account of the early appearance and almost infection 

 constant occurrence of leprous lesions in the nasal Atrla - 

 passages Strieker believes that the latter constitute 

 the chief infection atrium; of this Hansen is not 

 positive. Nasal ulcers may be present in latent 

 or apparently healed cases. Kolle cites a case show- 

 ing extensive involvement of the spleen and liver 

 in which the intestinal tract was considered the in- 

 fection atrium. In some instances in which the 

 disease is first noted in the feet, the organisms 

 are supposed to gain entrance with infected soil 

 through abrasions in the skin. According to Cor- 

 nii and Babes, infection may take place through 

 the hair follicles and sebaceous glands. The theory 

 of Jonathan Hutchinson that leprosy may be con- 

 tracted through eating diseased fish, or that the lat- 

 ter in some way may render individuals susceptible 

 to infection is not now credited. Hereditary 

 acquisition of the disease is of doubtful occur- 

 rence, although the bacilli have been found in ova 

 (Babes) and commonly are present in enormous 



