Many cases of vascular spider have been observed in the leprosy patients in Oshima Seishoen. Up to now, no report was published on the relation of leprosy and this disease. This paper presents the results of the statistical observations and many kind of clinical exminations and refers to the etiology of this phenomenon.
1) Vascular spider was observed in 82, 20.7%, of 396 cases examined. The frequency is by far larger in leprosy than in other skin disease, and is conspicuously larger in the male than in the female (Fig. 1).
2) The manifestation of vascular spider is disposed to appear more frequently in tuberous leprosy (Tab. 4), in the ages ranging from 31 to 51 years old (Tab. 2), and in those who have the progress of disease from 11 to 20 years (Tab. 3).
3) Vascular spider predilects the upper half of the body, but it seems to have no correlation with the sensory disturbances (Tab. 5).
4) In all 38 cases of leprosy patients manifesting vascular spider, the disturbance of liver function was recognized, and the disturbance of interstitium is more intense than that of the parenchym (Tab. 4).
5) The double glucose tolerance test produced an anormal result in all 7 examined cases combined with vascular spider (Tab. 11).
6) The unbalance of autonomic nerve function is presented in nearly all of 10 cases (Tab. 12).
7) Thorn's epinephrin-test showed an anormal value in every case (Fig. 2).
8) The results of skin function tests were anormal (Tab. 6, 7, 8), and the difference caused by the existence of vascular spider was not clearly demonstrated.
9) Gynecomastia was found out in 6, 2.6%, of 228 male leprosy patients and in 2, 2.9%, of 69 patients combined with vascular spider.
10) The frequency of vascular spider in leprosy patients can be attributed to the superfluous circulating estrogen, which is caused by a decline of estrogen inactivating power due to the disturbances of liver function and the destruction of the inner genital and other endocrine organs.

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The statistical examination was carried out upon the macroscopical findings of the liver and portal lymph nodes of autopsy material of 300 leprous cases. The results obtained are as follows :
1) In most of lepromatous patients the development of lepromata in liver keeps a proportion to the degree of diseases judged by inspection.
2) The number of macrospically recognizable lepromata in liver has a tendency to be smaller in the patients whose skin lepromata have remarkably improved than in those whose skin lepromata have not yet been resorbed. Lepromata can not be observed by naked eye in the liver of the secondary neural cases.
3) It takes more than five years since the first growth of leproma in the skin that the individual lepromata in the liver become noticeable macroscopically and increase in number.
4) The other combined diseases which could give rise to the proliferation of interstitium were excluded as strictly as possible. The proliferation of the liver interstitium can not be observed in neural and macular cases. The degree of the interstitial proliferation in the little improved lepromatous cases keeps a proportion to the degree of disease and the development of lepromata in the liver, while, in the remarkably improved lepromatous cases, the interstitial proliferation shows a tendency to be relatively conspicuous, though the number of lepromata is small.
5) After the combined diseases which could produce fatty degeneration were eliminated, it has been recognized that this finding is seen frequently in the serious cases. Therefore, there exists fatty degeneration resulting from leprosy.
6) When the cases due to the other diseases are omitted, the capsule of liver is smooth and the typical granulate liver originating in leprosy is scarce.
7) The degree of lepromata in the portal nodes is in proportion to that of diseases and of lepromata in the liver.
8) The lepromatous change of the portal nodes progresses more rapidly in development than that of the liver, and within 5 years from the initial appearance of cutaneous leproma, the change in the portal nodes is more conspicuous than that in the liver. While, in the improving lepromatous leprosy, the absorption of lesion tends to be more prolonged in the potarl nodes than in the liver.

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The following results were obtained from the macro- and microscopical examinations on the liver of autopsy material of 20 leprous cases (lepromatous 19 and neural 1).
1) The degree of histological and bacteriological improvement of lepromata in the liver is proportionate to that of lepromata in the skin.
In the relapse after temporary improvement, the course of lepromata in the liver is in proportion to that of skin lesion, but the liver change is not always subordinate to the skin lesions. Sometimes, the local relapse of lesion takes place in the liver, which can be the sourse of aggravation of skin and general disease.
2) In some cases the progresses of development of change in the lobule differ from that in the interstitium.
3) There exist macroscopically yellowish and whitish lepromata. This difference of the color tone is originating in the quantity of lipid in lepra cells of the lepromata.
4) The distribution of hematogenously disseminated leprosy bacilli is not always equable, but various in each loubule or in part of the lobule itself.
5) Though many factors except leprosy can influence upon the liver cells, atrophy, necrosis and disappearance of liver cells may be attributed directly or indirectly to leprosy, for example the pressure of numerous lepromata in the lobule, or the local congestion due to stenosis or obliteration of the central veins caused by the leprous changes.
6) The fatty degeneration caused by leprosy takes the type of peripheral fatty degeneration.
7) Leprosy shows a stronger tendency than tuberculosis to affect the central veins.
8) The proliferation of the interstitium is generally in proportion to the degree of changes in liver, and is also influenced by the ratio occupied by the improving lepromata. And there seems to exisit the disparity in the intensity of connective tissue reaction between tie individuals.
9) The elastic fiber is weaker in resistense than the reticular and collagenic fibers, and easily broken and disappear and difficult to regenerate. Besides such remarkable breaking and disppearence, new growth of the elastic fibers, though in a slight degree, can be observed in some cases.
10) The vessels, regarding the tunica intima of the arteries, in the interstitium undergo leprous changes often, and sometimes the veins are invaded.
11) The individual differences of the intensity of connective tissue reaction participate in the thickning of the liver capsule as well as the proliferation of interstitium.

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We examined therapy and inhibition of the appearance and development of murine leprosy with isonicotinic acid hydrazid and its combination with Streptomycin.
Its results were as follows:
1. INAH inhibits the appearance and development of murine leprosy in some degree.
2. The inhibitory effect of INAH against murine leprosy is increased by the conbination with SM.
3. The medicine is more effective in the case in which it is applied from the day of inoculation of murine leprobacilli than in the case where it is applied after a month from the day of inoculation.

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