This report described the distribution of the patients who had been treated by psychiatrist in the National Tamazenshouen Sanatorium, a major leprosarium in Japan. We also investigated the characteristics of patients who had suffered a depressive episode during the last 5 years. Somatic symptoms were the predominant symptoms and were not limited to clinical signs unique to leprosy. The period of isolation was not significantly correlated with the geriatric depression scale. Forty-two residents had committed suicide since the leprosarium was established in 1909. The findings of this study emphasize the importance of psychosocial intervention to the residents.

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Moxifloxacin (MFLX) and garenoxacin (GRNX), new synthetic antibacterial agents, were assessed for in vitro anti-M. leprae activities. The anti-bacterial activities of these two drugs were compared to those of sparfloxacin (SPFX), gatifloxacin (GFLX), levofloxacin (LVFX) and rifampicin (RFP). The anti-M. leprae activity obtained by Buddemeyer system was stronger in order of RFP, MFLX, SPFX, GFLX and GRNX and LUFX.
The anti-M. leprae activity of MFLX or GRNX was also examined by the nude mouse footpad method. MFLX completely inhibited the growth of M. leprae inoculated into nude mouse footpads, when given orally at a daily dose of 10mg/kg, while GRNX completely inhibited at a daily dose of 60mg/kg. Both in vitro and in vivo tests indicated that MFLX was equal or superior to SPFX, but GRNX was equipotent to LUFX, in terms of anti-M. leprae activities.

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The epidemiological situation of leprosy is reported by the health division of each country to WHO. The reported data is collected by WHO and is immediately run on the Weekly Epidemiological Record. On this latest edition, data from the beginning of 2006 was reported. Early case detection and treatment with multidrug therapy (MDT) remains the cornerstone of leprosy control. The challenge will be to establish these facilities as part of an integrated system that provides referral services for other diseases in the area.

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The leprosy policy of Japan began from when the government enacted “law No. 11 (The leprosy prevention act)” in 1907 (Meiji 40) and several leprosy sanatoriums were built to receive previously homeless patients. Then, with the rise of totalitarianism, the isolation policy of Japan gained national support under the slogan “Patient Relief”, which would become a major factor behind the enactment of “Leprosy Prevention Law” in 1931 (Showa 6) by which the leprosy policy was changed to one of absolute isolation aimed at the internment of all leprosy patients.
From recent research on the leprosy policy of Japan, the internment of all leprosy patients, isolation for life, social defense, and neglect of patients' human-rights had tragic results in many cases. However, there is little research which can reply clearly to the question of whether the leprosy policy of Japan was really original and what factors led to the formation of the absolute isolation policy.
This paper focuses on the relation between leprosy policy and treatment, and from this, I make clear the similarities, or peculiarities, of the isolation policy between Japan and the rest of the world, while clarifying the factors associated with the progress of the absolute isolation policy.
The processes involved were historical and medical historical in that the relation between the formation of a national health system and the progress of the isolation policy of Meiji Era, the proposal of the isolation policy by Dr. Keizo Dohi, Dr. Shibasaburo Kitasato, and Dr. Masatsugu Yamane; the practical application of this policy by Dr. Kensuke Mitsuda, and the decision to enact this policy and its support by the Health and Medical Bureau and the Department of the Interior, as well as many other factors, all contributed to the final implementation of the absolute isolation policy.

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[in Japanese]

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