152 THE MORE CHRONIC INFECTIOUS DISEASES 



diffuse swellings due to the growth and irritation of 

 the Bacterium leprce or leprosy bacillus. 



Forms of Leprosy. There are two forms, the nodular 

 and anesthetic. The former is usually painless through- 

 out its course, merely giving rise to the cutaneous 

 nodules. The anesthetic form is due to an involvement 

 of the sensory nerves, which are at first irritated with 

 the production of a painful early stage, followed by 

 destruction of sensation when the inflammation has 

 progressed farther. The disease gives rise to con- 

 siderable superficial destruction of tissue, which is 

 responsible for the horrible pictures of this disease 

 in the lay mind. Fingers, toes, nose, and pieces of 

 skin may be removed by ulceration. The disease is 

 an old and widespread one commonest in the tropics, 

 but by no means confined to them. Despite long 

 familiarity with leprosy, there are many points as yet 

 undecided about its nature. 



Transmission. The bacteria probably enter by the 

 nose and mouth, and it requires close association with 

 a leper for a long time in order to contract the disease. 

 The low contagiousness of leprosy should be empha- 

 sized. If one should say in a crowd, "There is a 

 leper!" the people would shun him as if he were a 

 maniac with a firearm. If one were to say under 

 similar conditions, "There is a consumptive!" he 

 would be pitied and perhaps not avoided at all. Tuber- 

 culosis is vastly more easily transmitted than leprosy. 

 The inhuman treatment accorded to lepers is due to 

 this misapprehension. The disease is probably not 

 hereditary. 



When the bacteria enter the mucous surfaces thev 



