1646 



LEPROSY 



various theories, more or less ably defended, which will be men- 

 tioned later. Marchoux and Bourret consider that they have 

 successfully inoculated a chimpanzee, and Nicolle and Blaizot have 

 produced lesions resembling leprosy in lower monkeys. The con- 

 dition of the €ye has been much neglected until recent years, when 

 the researches begun by Ball and Hansen as far back as 1873 have 

 been extended by Grossman in igo6, de Silva in 1907, but most 

 importantly by Borthen in 1899. 



Deycke and Reschad inoculated the surface cream of sterilized 

 unskimmed milk with material obtained from the under aspect 

 of leprotic tubercles by throwing back a flap of skin. Incubated 

 at 30° C, a growth forms in fourteen days, which is characterized 

 by its bright orange tint. This organism they called Streptothrix 

 leproides, and from this they obtain a neutral fat, ' nastin,' which 

 is similar to a fat found in Hansen's bacillus, and this Deycke 

 considered to be the agent which produced favourable symptoms 

 when cultures of Streptothrix leproides were injected into patients. 

 Later he noticed that these favourable conditions were associated 

 with a leucocytosis, and therefore used nastin mixed with cinnamic 

 acid, which is excreted ashippuric acid, the two acids being connected 

 by benzoic acid as an intermediate product. He therefore used 

 benzoyl chloride to extract the ' nastin,' and injected the ' benzoyl 

 nastin ' into patients, producing a reaction. Deycke believes that 

 the nastin is only a carrier of the benzoyl chloride to the bacilli, 

 which it deprives of their fat, and so allows the phagocytes to attack 

 them. Four solutions were prepared: Nastin B o, Nastin B i, 

 Nastin B 2, and K., this last being only benzoyl chloride, and being 

 used to shorten and reduce the severity of the reaction if required. 

 The others represent nastin in varying degrees of strength, 

 Nastin B 2 containing an excess of nastin, while Nastin B i is that 

 usually employed. Unfortunately no general success has followed 

 this line of treatment. 



Climatology. — At the present time there is but little leprosy 

 in many parts of Europe, but it is still common in Iceland, while 

 it is found in Spain, Italy, the Balkans, Turkey, Crete, and Cyprus. 

 It is less frequent than formerly in Norway, Sweden, Greece, and 

 some of the Mediterranean islands, rare in France and Germany, 

 and almost extinct in Denmark, Belgium, Holland, Austria- 

 Hungary, and England. 



It is very common throughout the whole of Asia. In Ceylon 

 there are numerous lepers, many of whom are treated in a leper 

 asylum at Hendela, near Colombo, which is believed to be one of 

 the best in the world. 



In Australia the disease is known principally in Queensland and 

 New South Wales, and also in Victoria; while in New Zealand it is 

 known among the Maoris. It occurs in New Caledonia, Tahiti, 

 and the Sandwich Islands. 



It is spread sporadically over the United States, but is rare in 

 Canada, while it is well known in Mexico and Central America^ 



