Tanegashima is a small island, south from Kagoshima proper, 60 km. length and 20 km. wide, with 39.467 inhabitants.
Since 1935, leprosy survey had been taken place twice by doctors in Keiaien, and in 1939 September, the author surveyed there, numbering 51 lepers.
The sex ratio was 2.3:1.0 and average age was 47, older than that of all japanese lepers. Lepromatous form were 18 in 46 lepers.
As seen on the plate, leprosy is prevalent in north and south parts in the island. But the people in north have some understanding to leprosy and send patients to leprosarium, resulting reduce in number, while the condition in south is just the oposite and leprosy is wider spreading now.

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Bei Lepra haben wir die Nomura'sche Reaktion, die bisher fur die Diagnose der Tuberculose probiert wird, untersucet. Die Methode lautet: 0.2 cc.aktives Krankenserum and 1 N. Salzsaurelosung 0.1 cc. beimischt, genung geschuttelt, and dann im Wasserbad von 38°C. neunzig Minuten Lang erhaltenand danach sofort urteilt (R1).
Aber wir haben noch weiter zehn bis zwanzig Stunden lang bei Zimmertemperatur beobachtet (R2).
Im folgenden gehen wir die Resultate bekannt, die wir damit erzielthaben.

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The histo-pathological researches referring to the teeth of the lepers are little either in our country or abroad, there are many unsolved points still need be cleared.
I, therefore, have engaged in this field of study since several years and made the report of the things what I have learned from the same.
1. Since May 1933 to June 1939, totally 400 teeth from the 48 lepers in Rakuseien in Leprosarium were used for the study. These teeth werehistopathologically studied chiefly on leprous changes in the pulp-tissue by the method of decalciflcation (usual method) together with my newly originated pulp extraction method (special method). With these methods of examination, although the teeth were macroscopically no abnormal appearance, I frequently observed microscopically a marked leprous affection and numerous leprous bacilli within the dental pulp.
2. The teeth with leprous affection in the pulp were 65.52% of the cases or 31.35 % of the total number of the teeth examined. The affection were, as a rule, most predominant in severe cases of tubercular type (72.73%). And those were frequently found in the region of anterior teeth of the superior maxilla (49.12%) especially in central incisor region, nextly frequent in the anterior teeth region of the inferior maxilla (43.72%) and in the premolar regions of the superior maxilla (41.03 %), but less frequent in the molar regions of both superior and inferior maxillae.
3. The invading course of leprous bacilli into the dental pulp was the secondary transmission through the dental canal haematogenically from other organs of the body.
4. Leprous bacilli thus invaded were, I think, usually stagnate and multiply in small blood vessels or capillaries of the pulps in the crown region and it gradually diffused into the pulp tissue. The bacilli were taken by histiocyts and there were found a leprous change with so-called lepra cells or lepra globules.
5. Leprous lesions in the pulps were usually intensive around the crown region, so that the infection seemed to occur firstly in this region and infiltrate diffusedly towards the root.
6. Leprous affection in the pulp also appeared as an inflammatory enlarged tissue from the wall of hyperaemic flood vessels as well as, infiltration of lepra cells, plasma cells and tissue globular cells were mostly found, but polynuclear leucocytes very rarely.
7. Though lepra cells of the dental pulp had a few leprous bacilli in an early stage, a marked lipoid deposition occurred after gradual increase of the bacilli. The cells also enlarged and congregate in mass of large number. Furthermore, when those lepra cells grew old, vacuoles in the cell appeared more distinct and nuclei of the cells became atrophic and finally disappeared. Sometimes they metamorphosed into polynuclear cells.
8. The condition of the fasciculus of nerve fibers in the pulp of the leprous teeth were in general normally distributed, but in severe affected regions, they swelled up in verrucous or spindle shape or at times, on the contrary, anemaciaiton take place and it splited or atrophied granulately. And on the apertures of the nerve fiber fascicles a sign of lepra cell infiltration and lipoid granular cells were observed.
9. The petrifaction of the pulp (dentikel) were observed distinct in the leprous pulp and proportional to the degree of the affection.
10. The progress of leprous dental pulp, in my opinion, likely took following two course :
a) When the leprous lesion grew very old, the dental pulp and odontoblasts accordingly turn to reticulate atrophy or fibroid degeneration and finaly embrace the leprous tissues which terminated an active stage, and then gradually induce to the degeneration.
b) I n an active stage of leprous lesion numerous affected blood vessels in the dental pulp were easily ruptured even by a slight disturbance of the tissue and consequently freed hemoglobin which occasionally penetrate into dentinal tubules,

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Diool ist eine elektrische Kolloidallosung der zwei Metalle des Platinums und Palladiums. Durch die Injektion dieser Losung durchdringt und bleibt sinkend das Partikelchen der Metallen in Gewebe, und lasst die Oxydation im Gewebe so lebhaft, dass dies krankhaften Prozess zur Heilung fuhrt. Namlich wird die Peroxydasenwirkung dieser beiden Metalle zur Behandlung angewendet. Dr. Yamanouchi hat einen gewissen Erfolg dieser beiden metallen Losung gegen die Tuberkulose festgestellt. Im Vertrauen auf die Wirksamkeit gegen die Lepra benutzte ich dieses Mittel versuchungsweise bei vielen Leprakranken von April 1938 bis Juli 1939. 26 Falle davon sind wenigstens uber 4 Monate behandert, dessen Erfolg will ich aussern wie folgt:
Unter diesen 26 Fallen waren 6 Kranken von Lepra maculosa und 20 von L. tuberosa. Alle 6 Maculosen waren relativ neulich Erkrankte, die zahlreich frische Macula besassen, und unter Tuberosen waren verschiedene Stufe von Veranderungen, leicht oder schwer, frisch oder veraltet, nachgewiesen.
Ich injezierte anfangs einigemal alle zwei Tage 1.0 cc. von Diool subcutan oder intravenos bei Erwachsenen und 0.5 cc, bei Kindern, dann vermehrte ich die Dosis bis 2.0 cc, bei Erwachsenen und 1.0 cc. bei Kindern. Die Ergebnisse der Behandelung sind :
Die Maculosen reagiert darauf so gunstig, dass die Macula in kurzer Zeit resorviert wurde und seine Lahmungssymptome auch sick sehr gebesserthaben. Man kann aber dies nicht lediglich auf die Wirkung dieses Mittels zuruckfuhren, denn die Macula pflegt haufig van selbst sick resorbieren und verloschen. Hier aber habe ich noch schnellere und gunstigere Besserung gesehen als von selbst oder durch Hydnocarpusol-Behandlung. Die Wirksamkeit fur die L. tuberosa war verschieden. Unter 20 Fallen besserten sich 8 Falle, 8 Falle zeigten keine Verandrung und 4 Falle verschlimmerten sich mehr oder weniger.
Obwohl nach oben genannten Ergebnissen dieses Mittel nicht als das bestegelten kann, so ware doch ein solches Mittel auch jedenfalls zu versuchen, da es heute noch kein vollkommenes Heilmittel gibt. Diese Forschung will ich noch weiter fortsetzen.

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Patient: H. M._??_9 years old, nodular type. Family anamnesisMaterial grand mother died from leprosy, father is healthy, mother leprous, and a sister of his mother is also leprous.
1) As leprous changes of the patient appeared in his early age taken ina children's home under care of doctors and nurse, we were able to observeclosely an early stage of the disease.
2) The macule appeared in the age of 5 years and 10 months, andchanged into a nodular type after a period of 2 years and half.
3) And first nodule has broken out at his left lower jaw at 8 years and4 months old.
4) Mitsuda's skin test (leprolin test) was negative before changing tonodular type.
i) Early stadium (5 years 11 months old) was positive.
ii) When many macules appeared (6 years and 2 months old) negative, and then changed to nodular type after about two years.

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