ASSOCIATED MICRO-ORGANISMS 355 



(b) Stain sections of tissues hardened in alcohol and embedded in paraffin 

 by Ziehl-Neelsen's method : if necessary, the differential tests given above 

 can be applied. 



A good diagnostic point is afforded, as has been said, by the enormous 

 numbers of bacilli to be seen in the lepra cells : tubercle cells never contain 

 more than a few bacilli. Finally, the inoculation of a guinea-pig [will exclude 

 tuberculosis]. 



Sub-cutaneous inoculation of tuberculin produces a reaction in persons 

 suffering from leprosy while the ophthalmo-reaction is negative (Nicolle and 

 Uriarti, Gaucher and Abrami). 



Associated micro-organisms. 



The lesions of leprosy being so frequently situated in the skin and mucous 

 membranes or in the lungs are particularly liable to secondary infection. 



Lesions of the skin and mucous membranes are very soon invaded by the ordinary 

 organisms of suppuration (staphylococci, bacillus pyocyaneus, etc.). In the case of 

 a leper in Tunis the author was able to demonstrate in the discharge from the specific 

 lesions in addition to a few leprosy bacilli, staphylococcus aureus, bacillus pyocyaneus 

 and bacillus coli. These organisms of secondary infection may invade the tissues 

 in cases of leprosy and give rise to a rapidly fatal pyaemia (Babes). 



Babfes has frequently found the tubercle bacillus in persons suffering from leprosy, 

 and the two organisms are frequently found in association especially in the lung : 

 and in pulmonary lesions the pneumococcus may also be present. 



In three cases of leprosy, Babes found as a secondary infection in the bone marrow, 

 spleen, and kidneys, a bacillus which was easily cultivated outside the body and did 

 not stain by Ehrlich's or Ziehl's methods. 



