Abstract
1 The author tried to lay stress on the pathogenesis of leprosy, and endeavored to presume the modus and course of the infection, intrusion into the body and development of the illness.
2 Then observed and followed up morphologic and functional changes in the R. E. S. concerning above mentioned cases. In particular, studied the tissue reaction in the reticuloendothelial system of lepromatous leprosy, especially, in visceral leprosy. The tissue changes chiefly of that group, undergo hyaline and fatty degeneration and atrophic change markedly.
3 In visceral leprosy, there are characteristic tissue changes occurring in the liver, spleen, lymph nodes, adrenals and in the others. The histologic changes in the R. E. S., in particular, decline in phagocytic cells and fibroblastic cells are recognized.
1) On the microscopic examination, sinuses in the spleen and lymph nodes, and in the sinusoids in the liver and adrenals, and others, have left widely opened but sinus endothels are not increased and atrophied and in particular, desquamative cells in their lumens not be grown, rather consumed and tend to decline.
2) Lymphatic follicles in the spleen and lymph nodes are small in size and number. In the follicles, reticulum cells and lymphatic cells are little germinated. In particular, in the follicles are generally wanting in germinal centers, moreover, some of them underwent hyaline degeneration.
3) In the spleen and lymph nodes, in the splenic pulp and lymphoid tissue vacuolar alteration, resolusion or hemorrhage could frequently be found. In the liver, number of leprous nodules and dissociation of the liver cells could be found.
4 In leprous inflammation occur granulomatous cells owing to endothelial or monocytic cells, but fibroblastic cells seldom be grown. By reason of above mentioning, scar healing in leprous lesion hardly be grown, therefore the lesion is very difficult to recover.
5 In the R. E. cells in leprosy, reactive cells production are very scarce, as well immune substances to the disease may be produced very feeble and scarce. The existence of immune bodies may proved by means of positivity of Lepromin Test.
6 In clinical and immunological study, and also histological, various kinds of exacerbation or relapse may occur. On account of leprous reaction, the most usual matter in fluctuation of the illness as follws. They are E. N. L. (nodular erythema), acute infiltration, reactional recurrence and so on.
7 In conclusion, the difficulties in recovery, especially in visceral leprosy, mostly depends upon histologic changes in the R. E. S. The tissue changes in the organs become incapable to function the proper activity owing to hyaline degeneration and fatty alteration and ultimately inactivity and atrophy of the R. E. S. may be arisen.
