Lesions 



405 



Once established in the body, the bacillus may grow in 

 the connective tissues and produce chronic inflammatory 

 nodes the analogues of tubercles ; or in the nerves, causing 

 anesthesia and trophic disturbances. On this account two 

 forms of the disease lepra nodosa (elephantiasis graecorum) 

 and lepra ancesthetica are described. These forms may 



Fig. 117. Lepra nervorum (McConnell). 



occur independently of one another, or may be associated 

 in the same case. 



The nodes consist of lymphoid and epithelioid cells and 

 fibers, and are vascular, so that much of the embryonal 

 tissue completes its transformation to fibers without necrotic 

 changes. This makes the disease productive rather than 

 destructive, the lesions resembling new-growths. The 

 bacilli, which occur in enormous numbers, are often found 

 in groups inclosed within the protoplasm of certain large 

 vacuolated cells, the ''lepra cells," which seem to be 



