Sanitation 407 



In anesthetic leprosy nodules form upon the peripheral 

 nerves, and by connective-tissue formation, as well as by 

 the entrance of the bacilli into the nerve-sheaths, cause 

 irritation, followed by degeneration of the nerves. The 

 anesthesia following the peripheral nervous lesions pre- 

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

 to occur without detection and to progress without observa- 

 tion. The ulcerations of the hands and feet, with frequent 

 loss of fingers and toes, follow these lesions, probably in the 

 same manner as in syringomyelia. 



The disease usually first manifests itself upon the face, 

 extensor surfaces, elbows, and knees, and for a long time 

 confines itself to the skin. Ultimately it sometimes invades 

 the lymphatics and extends to the internal viscera. Death 

 ultimately occurs from exhaustion, if not from the frequent 

 intercurrent affections, especially pneumonia and tubercu- 

 losis, to which the conditions predispose. 



Specific Therapy. Carrasquilla's* "leprosy serum" is 

 prepared by injecting the serum separated from blood with- 

 drawn from lepers, into horses, mules, and asses, and, after 

 a number of injections, bleeding the animals and sepa- 

 rating the serum. There is no reason for thinking that such 

 a product could have therapeutic value. 



Rostf prepares massive cultures of the lepra bacillus, 

 filters them through porcelain, concentrates the filtrate to 

 one-tenth of its volume, and mixes the filtrate with an equal 

 volume of glycerin. The resulting preparation is called 

 Leprolin and is supposed to be analogous to tuberculin. 

 With it he has treated a number of lepers at the Leper 

 Hospital at Rangoon, Burrnah, many of whom have greatly 

 improved and some of whom seem to be cured. Confirma- 

 tion of the work by others is greatly desired, and it is too 

 early to judge the merits of the treatment. It is, however, 

 the most promising method yet published. 



Sanitation. While not so contagious as tuberculosis, 

 it has been proved that leprosy is transmissible, and it may 

 be regarded as an essential sanitary precaution that lepers 

 should be segregated and mingle as little as possible with 

 healthy persons. The disease is not hereditary, so that 

 there is no reason why lepers should not marry among 

 themselves. The children should, however, be taken from 

 the parents lest they be subsequently infected. 



*" Wiener med. Wochenschrift," No. 41, 1897. 

 f'Brit. Med. Jour,," Feb. 11, 1905. 



