RESEARCHES ON ACARIDS AMONG LEPERS. 469 



apparatus? The microtomic sections of the nodules show them to be 

 full of bacilli, their formation to be due to the accumulation of these 

 bacilli, and, doubtless, also to their toxic products. 



Contrary to Una's theory, it is now known that the bacilli of leprosy, 

 at least for the most part, are contained in the cells. Some authors even 

 say that they are found only in the cells; this last opinion seems to me 

 open to dispute, but it is unnecessary to discuss the question here; it is 

 sufficient to state that the greater number of bacilli are intracellular and 

 that in these cells they undergo a process of destruction; a very large 

 number are separated into granules. Their aspect recalls in vivo Pfeif- 

 fer/s phenomenon in vitro : agglutination and destruction. One can follow 

 all the series of the stages of this disorganization, from the simple 

 vacuolated form to the reduction into smaller dissociated granules. In 

 short, there is an evident phagocytosis. This phenomenon appears more 

 clearly in the sections treated with erystal-violet-Gram. 



The first thought suggested by this examination is that the nodules are 

 produced by a defensive reaction of the organism, just as are the pul- 

 monary tubercles of phthisical patients ; they are a means of first collect- 

 ing, then destroying, and finally of eliminating the bacilli. Such is 

 the opinion of many leprologists ; and even if we admit, with others, that 

 the cells of the nodules contain bacilli in process of multiplication, this 

 must be looked upon merely as a case 3f accidental insufficiency in the 

 action of the former. But if this be so, the skin of the leper should much 

 more be considered as a means of elimination than as an open door for 

 infection. It is true that Babes thinks that both these functions may 

 be attributed to it. as we shall show below. 



Although it is a slight digression, I wish here to compare the sections 

 from cutaneous nodules with those taken from the tissue of the spleen. 

 It seems that the spleen also has a defensive function in leprous infection, 

 as in several other diseases. It is certainly a collector of bacilli: the 

 circulation brings them to this organ as to a storehouse. A very large 

 number of these organisms are still perfectly normal, scarcely vacuo- 

 lated; 12 next to them one finds others, more or less clotted, and a great 

 quantity of others in fragments up to the final stage of reduction. 



Other organs of the body also work with the same defensive aim; one 

 sees such a process in the nodules of the moniliform nerves. At one 

 autopsy I likewise collected numerous calcified concretions on the perito- 

 neum, which contained the bacillus of Hansen undergoing destruction. 



It appears that the spleen can exercise a defensive function better 

 than the skin or nerves, perhaps because of a more energetic activity which 



12 AH normal bacilli seem more or less vacuolated when the staining of the 

 actions has not been sufficiently prolonged, or when the decoloration according to 

 the method of Ziehl or Gram has been carried too far. On the contrary, with 

 good staining, one always finds many individuals uniformly colored. 



