Leprosy / by Isadore Dyer.

  • Isadore Dyer
Date:
[date of publication not identified]
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Licence: Public Domain Mark

Credit: Leprosy / by Isadore Dyer. Source: Wellcome Collection.

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    nective tissue and in the muscles. In general the number of bacilli has no relation to the severity of the accompanying tissue changes. Scheube! gives a comprehensive summary of tissues where the bacilli have been observed: The skin and mucous membranes, earliest in the aneesthetic patches. In the peripheral nerves and lymph glands, especially in the sheaths and in the lymph gland secretions. The internal organs involved are the lungs, liver (especially the liver cells), the intestines, kidneys and lumen of the urinary tubules, the testicle, its tubules and ducts, and the ovary. In the tonsils, the eye, in the sweat glands, hair follicles and sebaceous glands between the epidermal cells, and in the arrectores pilorum the bacilli are found. te ES The connective tissue of the cutaneous nerves, in the Pacinian corpuscles, the salivary glands, pancreas, adrenals, spleen, larynx contain the organisms. They are also found in the substance of the brain and cord and in the Pur- kinje cells of the cerebellum; in the choroid, retina and ciliary body; in the muscles and tendons, and in the periosteum, bone and medulla. In the acute stages of leprosy, the bacilli are found as contents of the blood cells and in fluid lesions of the disease. The bacilli are very numerous in the infiltrative tissues, and in nodules and tubercles, but in the erythematous patches and nerves they are scanty. Outside the human body the bacilli have been found in the hab- itations of lepers and in the ground over lepers’ graves. Various fish have been examined for the bacilli but with negative results. The leprous nodules belong to the group of granulation tumors and are similar to those of syphilis and tuberculosis. Microscopically they consist of a small amount of fibrillar connective tissue with nu- merous cells of various forms, mostly small, round epithelial cells, spindle formed, and the leprosy cells. These are mostly large, round or oval cells, with many nuclei and vacuoles. They contain the lep- rosy bacilli. These cells are diag- nostic of the disease and are found most numerously in the tubercles and nodules of leprosv. Neisser ob- & thant: SF served the gradation in the devel- 777 UPS: eee pec te ‘ ; cells; C, chains of bacilli. (Leloir.) opment of the lepra cell in size and contained nuclei and bacilli, also the degenerative lesion showing numerous extra-cell bacilli. Virchow, Neisser, Gerlatz, and others argue the consistent type of the lepra cell as the container of the bacilli, the exception being ‘Die Krankheiten der Warmen Lander, IIer aufl., Jena, 1903, pp. 320-392. (With a very complete bibliography.)
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