502 
LEPROSY AND ACID-FAST BACTERIA 
become enlarged, in which case large protuberances appear which 
destroy the symmetry of the face and give the victim a lion-like appear- 
ance, hence the name facies leontina. 
Animal.— It must be remembered that tubercle bacilli are very 
frequently found in lepers; in fact, a not inconsiderable number of 
lepers die of tuberculosis rather than leprosy. Consequently it is 
not suprising to find that many experiments on animals have resulted 
in the production of lesions from which acid-fast bacilli have been 
obtained. These experiments must be interpreted with a great deal 
of caution for this reason. Xicolle^ claims to have successfully infected 
a monkey (Macacus) with leprous material. Lesions appeared which 
were nodular in character, but the>' disappeared spontaneously 
within six months. The result is questionable and successful inocula- 
tions of leprosy bacilli from lepra nodules into the lower animals are 
not definitely proven as yet. 
Fig. G9. — Lepra bacilli in skin. (KoUo and Hctsch.) 
Portal of Entry. — Leprous lesions appear early and are fairly constant 
in the nasal passage, where an ulcer appears at the junction of the 
bony and cartilaginous septum. This has given rise to the belief 
that the nasal passages are the chief portals of entry of the organism 
and that infection takes place through dust or droplets. A case has 
been described which shows extensive involvement of the liver and 
spleen, in which the intestinal tract was considered the atrium of 
infection. Cases also are on record in which the primary lesions appear 
to have occurred on the feet, indicating that abrasions of the skin may 
also be portals of entry. 
Diagnosis. Scrapings from the nasal ulcer may give an early 
diagnosis. It should be remembered, however, that an acid-fast 
organism described by Karlinski (nasal secretion bacillus) is fairly 
1 Semaine nipd., 1905, p. 110. 
