Lesions 359 



partly degenerated endothelial cells. vSometimes they are 

 anuclear; rarely they contain several nuclei (giant-cells). 

 Bacilli also occur in the lymph-spaces and in the nerve- 

 sheaths. 



Lepra nodules do not degenerate like tubercles, and the 

 ulceration, which constitutes a large part of the pathology 

 of the disease, seems to be largely due to the injurious action 

 of external agencies upon the feebly vital pathologic tissue. 



Fig. 103. A case of lepra nodosa treated in the Medico-Chirurgical 

 College of Philadelphia, in the service of Prof. John V. Shoemaker. 



According to the studies of Johnston and Jamieson,* the 

 bacteriologic diagnosis of nodular leprosy can be made by 

 spreading serum obtained by scraping a leprous nodule, upon 

 a cover-glass, drying, fixing, and staining with carbol- 

 fuchsin and Gabbet's solution as for the tubercle bacillus. 

 In such preparations the bacilli are present in enormous 

 numbers, thus forming a marked contrast to tuberculous 

 skin diseases, in which very few can be found. 



*" Montreal Med. Journal," Jan., 1897. 



