470 LEFEBVRE. 



it possesses in the work of destroying the bacilli, and in consequence also 

 of the abundant circulation of which it is the seat. The spleen also 

 seems better protected from the serious hypertrophies which manifest 

 themselves in the cutaneous tissues and in the nerves. The nodules of 

 the nionilil'omi nerves are due to the accumulation of the bacilli and 

 to their toxic products, but in this situation the bacilli can remain, as 

 there is no powerful circulatory current compelling them to move. The 

 same conditions surround the cutaneous nodules and the latter, after 

 having defended the organism by localizing and digesting the bacilli, 

 end by becoming victims of their own work; the cells deteriorate and 

 succumb for want of power to rid themselves rapidly enough of the 

 parasites and their products. Such deteriorated cells can be seen in 

 all sections of the cutaneous nodules. The nodule in the end becomes 

 disorganized and degenerates into an ulcer. 



The conclusions to be drawn from these theoretical views and the 

 observed facts may be- summed up as follows : 



1. The external lesions of leprosy, not only the deformations, the 

 mutilations and the anaesthetic areas, but even those disturbances which 

 end in the formation of the cutaneous nodules, do not primarily originate 

 at the point where they are observed, but are dependent on deeper causes., 

 sonic simply nervous, others circulatory. 



'i. The accumulation of leprosy bacilli in the hypertrophies of the 

 skin is the result of (/// exportation from the interior of the organism. 

 the object of these formations being to localize, to destroy, and to 

 eliminate the bacilli. 



It seems as if this reasoning is but an argument against the theory of 

 the transmission of leprosy by means of the skin. 1 do not wish to 

 overrate its value, for I myself retain doubt on the question. 



Although these ideas are fairly generally accepted by authorities on 

 leprology, it must be acknowledged that they contain as .much theory 

 as observation. Xow, a theory is most useful in guiding the seeker, but 

 nothing is more dangerous than to regard it as an accepted truth, instead 

 of a means of arriving at the truth. Moreover, I do not wish to present 

 my observations as conclusive, for, it I believe others to be mistaken, I 

 see no reason why they should not think the same of me. 



if the cutaneous lesions of leprosy are reactions due to internal, 

 nervous and circulatory causes, it does not follow that the contagion may 

 not first of all have entered through the orifices of the skin, for it may 

 be true that the first bacilli enter by means of the skin in the neighbor- 

 hood of the parts where the nodules afterwards have formed. One can 

 imagine these organisms gaining admission through the sebaceous glands, 

 then penetrating deeper into the tissues and multiplying there, and 

 lastly, a part of them stopped in their migration, and brought by the 

 circulation into the parts near which they had entered. This would more 



