PRESIDENTIAL ADDRESS. 79 
and multiplying, even though in such an unusual environ- 
ment; finally, being given frequent opportunities of escape 
from its host through ulceration in the lungs and of in- 
troduction consequently to fresh individuals, its pathogen- 
icity increased and its saprophytic qualities were diminished 
or lost. If the leprosy bacillus has reached only the second 
of these stages it may eventually be found in the natural 
surroundings of cases of leprosy. The chief objection to 
this point of view is the difficulty or impossibility of grow- 
ing the organism artificially. If this supposition be correct, 
it may modify considerably our methods of control of lep- 
TOsy. 
Spirochetosis icterohemorrhagica. 
For many years occasional outbreaks of an acute 
infective disease with jaundice have been known in 
man. Special attention was drawn to the disease 
in 1886 by a paper by Professor Weil, of Heidelberg, 
and the complaint has until recently been com- 
monly associated with his name under the designation 
‘“Weil’s Disease.’? Now a more suitable name, indicative 
of its etiology, has been found for it. Recently this form 
of jaundice has been noticed in Japan to be unduly pre- 
valent amongst coal miners working in certain galleries, es- 
pecially liable to be flooded, and amongst sewermen. A 
spirochete, which Inada and Ino have called Spirocheta 
icterohemorrhagica, has been found in these cases, and 
seems clearly to be responsible for the condition. The dis- 
ease has also appeared on the western battlefront in Europe 
—its appearance during campaigns has been noted before, 
an infective jaundice having appeared, for instance, 
amongst Napoleon’s troops in Egypt—and the same organi- 
sation has been found in some of the patients. Further, fol- 
lowing on carefully reasoned epidemiological data, the 
Japanese searched for and found the Sp. icterohemorrha- 
