1. I have studied the leprosy changes of nails about 35 cases of nodular type, 11 cases of neural type, 4 cases of macular type, totaly 50 cases of leprosy.
2. In mild cases of nodular type, there appear only few leprosy changes of nails. In those severe cases of whose skin around nail suffer remarkable leprosy changes, we can recognize very distinctly the leprosy change of nails.
3. Macroscopic changes take from in the ruggedness, dryness and losing of luster of nails resulting from the infiltration of nail-beds. The other changes are the unevenness, appearence of vertical and lateral lines, and turbidity of the nail surfaces.
4. From the microscopic point of view, there appear quite distinctly the leprosy changes of nail-beds, nail-walls, nail-folds and the other epitherium and corium. The infiltration of leprotic cell and the appearance of lymphocytes, plasma cells, mast cells, and sometimes of leprotic gigant-cells are also recognizable.
Medullary sheath and Schwann's sheath of nerves, and artery and vein tubes undergo changes by leprotic infiltration.
The leprosy changes of sweat gland, adipose tissue, nail phalanx, bone marrow, and elastic fibre are also recognizable. It was recognized in severe cases that a few leprosy bacilli infiltrate into the parenchym of nails, but of course it is not the cause that makes the changes of nails.
5. In nodular type, from the fact that nails do not always suffer remar- cable changes, while leprosy changes appear on nerves, veins and arteries of all the cases (though they may differ in degree), it can, I believe, be said that the malnutrition resulting from the morbid changes of nerves, veins and arteries may be a cause that produces the leprosy changes of nails, but the 2 effects are very small, so the real cause lies in the leprosy changes of nail-beds and the adjoining parts of them, because the changes of nails run parallel to the morbid changes of nail-beds.
6. Burns and wounds because of the sensory anaethesia or the inadequate treatment for them, are apt to cause panaritium, and osteoclasten appear on nail-phalanx which set up the absorption of bones. This is the chief cause of lepra mutilans. But if the treatment for burn or wound is adequate, mutilans is not so severe.
7. In neural and macular types, nails are often atrophied, and some forms of them resemble to onychogryphosis.
8. Although the nails of neural type appear to be stiff, they are generally frail and mango liber are apt to split.
9. From the microscopic point of view, we can find leprosy bacilli in nerve-fibre of neural type, but in blood-vessel and skin they can never be found.
10. If nerves suffer changes, the affected parts are led to malnutrition, and are liable to suffer damages of burn and wound because of the sensory anaethesia. This is one of the chief causes that bring about the atrophy of nails and deformity of fingers of neural type.
11. In neural type, as in nodural type, Howship's lacunae appear on finger-phalanx and bones are absorbed and atrophied.
At the same time, the forms of nail-beds and nails suffer changes.

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Die Tanaka-Reaktion wurde von Dr Takata also Liquorreaktion sowie als Differentialdiagnostik zwischen katarrhalischer und cruppöser Pneumonie angegeben, und von Jezler u. Staub als spezilische Diagnostik der Leberzirrhose empfohlen. Seitdem wird diese Reaktion für die Leberfunktionsprüfung angewandt. Jaffe machte darauf aufinerksam, lass Ürobilin- und Urobilinogen-Reichtum des Harns zu den Symptomen der Leberf unktionsstörung gehoört.
Bei Leprakranken stellt sick häufig Leherschädigung em, insbesondere Leherzirrhose. Daraufhin bediente sich Verf. der Takata-Reaktion and der Ürobilinogenurieprobe bei 275 Fällen von Aussatz.
Die Takata-Reaktion zeigt in 195 von 275 Aussatz-Fällen, also zu 70.9%, ein positives Resultat; ebenso bei 90 von 111 Lepra tuberosa, also 81.089; bei 52 von 81 Lepra mixta, also 64.20%; hei 50 von 72 Lepra nervosa, also 66.67% and bei 3 von 8 Lepra maculosa, also 37, 50%. Bei 50 Leprakranken konnte der Verf. eine gewisse Schwankung der Takata-Reaktion mehr oder weniger parallel mit dem klinischen Verlauf beobachten.
Die Urobilinogenurieprobe fiel bei 129 von 233 Leprakranken, d. h. 55.41% positiv aus.
Diese Ergebnisse können wohl als schlagender Beweis gelten fur eine einwandfreie Diagnose der Leberschädigung insbesondere der Leberzirrhose hbei Leprakranken

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