ANA TOMOPATHO-LOGICAL STUDY OF COMPLICATION OF TUBERCULOSIS SEEN IN HUMAN LEPROSY (REPORT II)

Abstract

The state of complication of tuberculosis in leprosy and the relation between leprosy and tuberculosis according to the disease types was further examined by histo-patho-anatomical examination as in Report I, of all the 450 autopsy cases of the National Oshima Seisho-en Leprosarium from 1924 to 1959.
Further, the process of the disease was examined by dividing into 3 stages, taking into consideration the influence of the period and of chemotherapy ; that is, 1) before the introduction of chemo-therapy (stage of hydnocarpus oil therapy) (1924-1942) … before World War II ; 2 after introduction of chemo-therapy (1943-1950) … during and directly after the War ;
3) after chemo-therapy (1951-1959) … after the War. Conclusion :-
1) Out of the 450 cases, there were 313 cases of the L-type (64.3%) and 137 cases of the T-type (30.6%), the L-type being over 2.3 times that of the T-type.
2) The percentage of combined tuberculosis was 77.2% (347 cases out of 450), 80.5% in the L-type (252/313), and 69.6% (95/137) in the T-type. Further, of the 252 cases of combined tuberculosis in the L-type, 84.3% was found in those before the war, 56.4% during the war, and 80% in those after the war; and of the 95 cases of combined tuberculosis in the T-type, the percentage was 70.8%, 76.6%, and 53% respectively, tube- rculosis being found in more than half in both types.
3) As for the foci of secondary tuberculosis, similar to Report I, they were found in all the L-type cases. Moreover, in the T-type, 24% were healed in the stage of primary foci ofthe lungs, while 16/74, 21.3% … before the War ; 13/45, 30% … during the war ; and 3/8, 37.5% … after the War, i.e. over one-third were healed in the stage of primary foci of the lungs.
4) As for the frequency of tuberculosis, there were about 70% of severe cases in both L-, and T-types in the period before the War, but with the passage of years the absolute number of patients is decreasing conspicuously. In the L-type, severe cases of tuberculosis were found in 76.7% before the War, 81.8% during the War, and 56.3% after the War; while in the T-type it was found in 63.8%, 30.8%, and 12.5% respectively during the above periods, showing a marked decrease, being only 500 of the L-type in the latter half period. Many severe cases could be seen in both types, but with the progress of chemotherapy, the spread of BCG vaccination, and the improvement of nutrition, the mortality of both leprosy and tuberculosis patients have shown a marked decrease.
The same tendency as seen in Report I was also confirmed, that is to say, the L-type which has a weak resistance towards leprosy has also a weak resistance towards tubercu-losis, while the T-type more resistant towards leprosy, possesses a strong resistance towa-rds tuberculosis.