The influences of antileprotic agents, such as Promin, KOHA, chaulmoogra oil, and of inoculation with human, murine and pseudomurine leprosy bacilli upon the blood sedimentation ratio were studied.
1) The intravenous injection of Promin for 111-178 days (30-32cc) accelerated B. S. R..
2) Intramuscularly injected chaulmoogra oil for 111-178 days (47-76cc) produced no change upon B. S. R..
3) The injection of KOHA for 133-145 days showed no change in B. S. R..
4) Among 10 rabbits which had received the human bacillus suspension 20-119cc subcutaneously for 35-221 days, 3 showed no change, 3 slight, 3 moderate and the remain- ing 1 striking acceleration in B. S. R..
5) Every animal which had been inoculated with murine leprosy bacilli presented acceleration of B. S. R..
6) In the rabbits inoculated with 9mg of pseudomurine bacilli for 45 days, 3 showed slight change and the rest 2 moderate acceleration in the B. S. R..
7) The skin emulsion injected 28cc for 45 hours into the control 5 animals produced almost no change upon B. S. R..

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In this part of paper, the correlation between serum proteins and B. S. R. of leprosy patients and experimental rabbits was researched. Comparison of B. S. R. and serum protein fractions of the 10 animals with those of leprosy patients was made. Moreover, the same experiment was carried out with 14 untreated and 50 rabbits which had received various thrapeutic agents, human, murine and pseudomurine bacilli suspensions. The results are summarized below:
1) In the serum protein fractions the decrease of albumin and increase of globulin, especially that of γ-globulin, are remarkable in accordance with the seriousness of the disease. These facts appear to have a relation to the results of B. S. R..
2) In the experiment with. rabbits, the injection of antileprotic agents does not provoke any increase of globulin, while the injection of human and other bacilli gave a rise to an increase of γ-globulin in most of animals. These results are in accordance with those of B. S. R., and the control group which had received skin emulsion presents no marked change in the serum protein fractions.

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In the course of leprosy there have been developed acute manifestations of fever, exanthema and joint pains, which may give rise to a frequent occurence of the face-swelling as seen in a case of the rose-disease.
Such acute symptoms appear in all the types of leprosy: maculo-anaesthetic type, lepromatous type and also erythema nodosum leprosum (E. N. L.), and they have been named clinically"akuter Schi b" (acute relapse), " lepra reaction ", or" reaction fever" by some leprologists or others.
This reaction appearing in a case of the maculo-anesthetic type bears a close resemblance in its origin and symptom to that occurs in the lepromatous type, excepting in the E. N. L..
However, when developed in a course of the lepromatous type, it is of the writer's opinion that another nomenclature should be selected in accordance with reasons as follows:
(1) The acute relapse presents itself on the one hand in the maclo-anesthetic type, while on the other hand, though very similar in its condition, it comes out on the lepromatous type which is great different from the formers.
(2) More fundamental difference exists in serology, pathology and clinic between the two types.
(3) The acute relapse in course of the lepromatous type resumes its original symptoms in some cases or, instead, takes a course of the secondary neural leprosy.
(4) Histo-pathologically in acute infiltration more lepra bacilli exist in the eruptive regions than in maculo-anesthetic type, and also less lepra bacilli than in lepromatous infiltration.
(5) Mitsuda's reaction, although negative before an appearance of the acute infiltration, becomes positive at the time of its occurence. (Tab. II)
Moreover, this relapse is not nodules or infiltrations in lepromatous type which abruptly augmented and aggravated.
Again in leprosy, "infiltration" is what has been unequivocally applied to lepra cells infiltration. Neverthless the acute infiltration, inspite of the symptoms appeared in the lepromatous type, does not show histo-pathologically such a structure or somewhat near it.
With the reason thus far, it should be distinguished also in the meaning of its own from acute lepromatous infiltration.
(6) It seems that the acute infiltration belongs to border-line group under the leprosy classification which is determined on the 6th International Leprosy Comference at Madrid (1953), but it is either different from acute symptoms of neural-macular type by histopathological figures or negative result of Mitsuda's reaction before attack of acute infiltration. And also it is different from acute lepromatous infiltaation or lepromatous type with changing into positive reaction of Mitsuda's test and turning good prognosis.
So, the author thinks that the acute infiltration does not belong to neural-macular type but special case of lepromatous type.
(7) Acute infiltration comes out after long duration of resorption stadium of lepromatous type, or early stadium of transition to lepromatous type from neural or macular types. (Tab. I)
Brief description of the acute infiltration:
(1) The acute infiltration is to be applied to a group of abrupt symptoms of acute eruption of the skin and infiltration as temporary as seen in the case of the rose-disease. It takes place in the early stage of the lepromatous type or in a prolonged period of absorption, with a fever 37°-39°C at the early stage of its appearance, and being often accompanied by the joint pains.
(2) Histo-pathologically it shows a structure like the tuberculoid type and more concentration of bacilli is found than in tissue of "akuter Schub" of the neural-macular type, and it is a certain fact that acute infiltration belongs to lepromatous type.
(3) With the acute infiltration as a turning point, Mitsuda's reaction becomes positive which remains for a fairly long period (about two years at least).

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In this paper, nucleic acid, gram substances and volutin of the leprosy bacillus were stained with the Feulgen reaction, Newton's gentian violet, its modified method, Brachet's methyl green-pyronin method, thionin method, gram staining and our diluted gentian violet method, and the mechanism of these staining methods were discussed.
Leprosy bacilli are stainable with the Yoshida's staining for mitochondria, and with Baker's phospholipid method to the same degree with Ziehl-Neelsen's staining. From these and other histochemical findings, the acid-fastness of leprosy bacillus is attributed to phospholipid or unsaturated lipid in the bacilli. And it is imaginable that the center of metabolism of the leprosy bacillus is in the nucleus.

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In this paper, the suppuration, which takes place in the course of Erythema nodosum leprosum, was studied, whether this lesion is caused by suppurative germs, excluding the leprosy bacillus.
The pus was collected aseptically 42 from the lesions of E. N. L. of which the overlying epidermis had not yet destructed, and cultured on goat-blood agar, aerobically in bouillon, anaerobically in Tarozzi's liver-liver bouillon, Kirchner's and Oka-Katakura's media for acid-fast bacilli.
The results of cultures on various media are as follows :
The results of culture upon various media are showed negative, except three cases. Two cases Corynebacterium (not inoculated in Tarozzi's boillon) in bouillon, and Staphylococcus albus in bouillon and Tarozzi's bouillon. But these two cases produced no growth of organism upon blood-agar, therefore, these organism should be taken for nonpathogenic saprophytes which had mixed by chance in the management of culture. The last case supplied us Staphylococcus albus in bouillon and Tarozzi's bouillon and Staphylococcus albus and Staphylococcus aures upon blood-agar. In this case the very pus contained these organisms, but the significance of their existence in it is question.
Seeing from our experiments, no organism was found in the pus collected from the lesions, except those which were mixed in the management of culture or exist there by chance. The suppuration of the lesions of erythema nodosum leprosum is independent upon the suppurative and other organisms which can be recognized by the above various media, but attributed to the other mechanism.

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Pharmacological actions of p-aminosalicylic acid hydrazide have been tested and the following results were recognized.
1) LD₅₀ against mouse was found to be 1.5mg./10g. by subcutaneous injection, LD against dog 40-50mg./Kg. by intravenous injection. It is a little more toxic than those of isonicotinic acid hydrazide. It acted excitedly on respiration, blood pressure and heart action of rabbit by intravenous injection of 200mg./Kg., while blood pressure fell and respiratory stoppage was recognized by intravenous injection of 400mg./Kg. ; the same phenomena were recognized on dog by intravenous injection of 40mg./Kg.
2) Except the actions on blood sugar and skeletal muscles, the other actions against other organs coincide qualitatively quite with those of isoticotinic acid hydrazide.

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To research for the effective radical of INAH upon the murine leprosy bacillus, aromatic aldehyde derivatives of INAH shown in Table 1 and hydrazines combined with thiazol or pyrimidin nuclei presented in Table 2, have strong inhibitory effect upon the tubercle bacillus in vitro, were examined. The results are summarized in Fig. 1. The compounds which were recognized to have more inhibitory effect are No. 1 and No. 9. The other derivatives have no effect, and No. 2 and No. 3 appear to accelerate the development of murine lepromas.
From these results, the drugs which are effective upon the tubercle bacillus can not be always expected to be efpieient upon the murine bacillus. The validity of INAH upon the murine bacillus can not be attributed only to the hydrazine radical, because the derivatieves consisting of H₂N-NH₂ can not always have the inhibitory effect, while some of the compounds combined with besides INAH have this effect. Therefore, isonicotinic acid can not be expected to research for the effective radical upon the murine leprosy.

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The effects of various following experimental methods to the affections of leprosy on mice and developing chick embryos have been tested.
1. Subcutaneous or intraperitoneal injections of glandular mucin and Ota's solution containing trypan blue, diatom, and Kali Jodi, into mice before or after the inoculation of Myc. Leprae.
2. Intraperitoneal injection of cobra venom before the inoculation of lepra bacilli.
3. Intracerebral inoculation of Myc. leprae into suckling or very young mice.
4. Inoculation of Myc. leprae into yolk sacs of developing chick embryos.
No results which promoted the propagation of lepra bacilli was obtained in all experiments.

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(1) Intradermal reaction with Iepromin reagent of Dharmendra was applied to 229 Leprosy patients (tuberous 174, nervous 54, and macular 10), comparing with Mitsuda's reaction carried out at the same time.
(2) Dharmendra's lepromin test presents the following results, in tuberous type 171 shows (-) 2 (±) and 1 (++), innervous type 8 (-), 4 (±) and 33 (+)-(++), in macular type all shows (+)-(++).
(3) Mitsuda's and Dharmandra's reactions coincide with each other 100% in positivity with the macular leprosy, and 90% in negativity with the tuberous. In the nervous type Mitsuda's reaction was positive in 91%, while Dharmendra's in 70%.

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A neural-leprosy patient, male, 48-year-old, swallowed by mistake an artificial tooth which was not found by X-ray examination and considered to have been excreted out of the body. But the patient began to complain of severe cough and sputum. The second X-ray examination revealed it in the left bronchial tube, which was picked out by bronchoscopy about 100 days after the accident.

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