170 PATHOLOGY 



the site of infection, toxins are formed which cause con- 

 stitutional symptoms of varying intensity. There is 

 anemia, wasting, afternoon rise of temperature, and 

 more or less weakness. The nature of the toxic products 

 are not well understood. The well-known reaction to 

 tuberculin in the presence of tuberculous infection and 

 absence of reaction where infection does not exist, would 

 indicate a process differing somewhat from the ordinary 

 toxin production of toxic infections. 



LEPROSY 



Definition. A chronic infectious disease caused by 

 the Bacillus leprae. Characterized by the formation 

 of tuberculous nodules in the skin and mucous mem- 

 branes, or by trophic changes in the nerves, or by both 

 together. 



Etiology. Of the mode of infection little is known. 

 Some particular susceptibility must be necessary for 

 infection to occur, because, with a single exception, 

 attempts at direct inoculation have failed, while physi- 

 cians and nurses who care for lepers rarely ever con- 

 tract the disease. Heredity is supposed to play a part, 

 yet no case is on record of leprosy in the newborn. 



Morbid Anatomy. In the tuberculous form, nodules 

 composed of granulomatous tissue occur on the skin 

 of the face, hands, and forearms, less frequently upon 

 other parts of the body. Between the nodules are some- 

 times seen areas of ulceration and cicatrization. On 



