LEPROSY. 247 



son, 1 the bacteriological diagnosis of nodular leprosy can 

 be made by spreading the 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 the tubercular skin diseases, in which very few 

 can be found. 



In that form known as anesthetic leprosy, nodules form 

 upon the peripheral nerves, and by connective-tissue 

 formation, as well as the entrance of the bacilli into the 

 nerve-sheaths, cause irritation, then degeneration, of the 

 nerves. The anesthesia which follows these peripheral 

 nervous lesions is one of the conditions predisposing to 

 the formation of ulcers, etc. by allowing injuries to occur 

 without detection and to progress without observation. 

 The ulcerations and occasional loss of phalanges that 

 follow these lesions occur, probably, in the same manner 

 as in syringomyelia. 



The disease advances, having first manifested itself 

 upon the face, extensor surfaces, elbows, and knees, to the 

 lymphatics and the internal viscera. Death ultimately 

 occurs from exhaustion, if not from the frequent inter- 

 current affections to which the conditions predispose. 



1 Montreal Med. Journal, Jan., 1897. 



