116 The Philippine Journal of Science 1917 



literature as the type of the organism. However, from the large 

 number of examinations that I have made, I think that the form 

 illustrated in Plate I, fig. c, is the true type. The question 

 arises, what significance have the granules? I am not able 

 definitely to answer this, but believe them to be indicative of 

 a degenerative process for the reason that bacilli containing 

 them are rarely found in active lesions, but are much more 

 frequently seen in old inactive nodules or in the lesions of 

 patients undergoing treatment with chaulmoogra oil. 



The solid type (Plate I, figs, e, f) is rare, but is to be found 

 in the discharge from an ulcer of the nasal septem or from the 

 margins of chronic ulcers. In the case of the latter, satisfactory 

 specimens may be obtained by the employment of Tschernoga- 

 bow's technic.(6) 



The fourth division is believed to be the parent form of 

 Bacillus leprae as ordinarily seen in the tissues and leproma 

 juice (Plate I, figs, a, 0, h). I am wholly in accord with 

 the views of Kedrowski(2) and Bayon(i) that the organism 

 causing leprosy has two stages in its life history: a nocardial 

 or streptothrical nonacid-fast form and a bacillary and acid-fast 

 one. 



MICROSCOPIC EXAMINATION OF NASAL MUCUS IN LEPERS 



Ever since Sticker (5) called attention to the presence of 

 leprosy bacilli in smears made from the nasal mucosa, much 

 stress has been laid upon this fact as a means of diagnosis in 

 doubtful cases. Dr. Victor G. Heiser, formerly Director of the 

 Bureau of Health of the Philippine Islands, always laid especial 

 stress on the microscopical examination of nasal mucus in anaes- 

 thetic cases of leprosy, but he also laid stress on the fact that 

 an ulcer or its cicatrix should be present at the junction of the 

 bony with the cartilaginous septum. McCoy, (3) in an article 

 published in 1915, states: 



I would especially emphasize the necessity of being cautious in drawing 

 conclusions from the examination of nasal smears. 



From my experience there is nothing to be gained from the 

 examination of nasal mucus when definite clinical lesions are 

 present. In the absence of clinical signs acid-fast bacilli in the 

 nasal mucus should not be regarded as prima facie evidence of 

 the existence of leprosy. The individual should be regarded as 

 suspicious perhaps, and repeated examinations should be made, 

 not omitting the examination of the circulating blood by the 

 method of Smith and Rivas(4) during febrile paroxysm. This 

 technic should receive far more attention than has hitherto 



