Recently, we found that the intracutaneous coloration reaction with TTC is superior to the methylene blue test in examining the oxid.-red. function of the skin.
This method was tested in leprosy and the following results obtained.
1) A comparative study of the oxid.-red. ability (TRI) of the skin in leprosy shows that similar to normal subjects, it is stronger in the male than in the female, it decreases in strength in the order intrascapular region>intraciavicular region>flexor surface of the forearm>flexor surface of the lower leg. It is markedly higher in the L-form and in the N-form is between the L-form and the healthy subject. No significant difference was noted in age, duration of illness or time of year (January and April).
2) No significant difference was noted between the healthy skin and regions of sensitivity or perspiration disturbances but a marked rise in TRI was found in the acute stage of ENL. A high value was also found at the site of the lesion in tuberculoid macules, ENL and leprous leucodermia, but was low in acute infiltration and macularization.
3) There appears to be some relationship between TRI and blood sedimentation rate, capillary resistance and the Mitsuda reaction but there was no relationship between the TRI and the hyaluronidase spreading reaction or the tuberculin reaction.
From these indings, it is suggested that the irregularities in the TTC reaction (TRI) in leprosy are due to systemic changes resulting from tissue destruction and the autonomic nervous system and endocrine system are also involved.

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The author conducted studies on the pattern of body temperature in leprosy and from the findings attempted to correlate this with body metabolism.
The following results were obtained.
1. There is no significant difference in axillary temperature according to type of leprosy but the temperature is higher in the summer than in the winter, cases suggesting heat stagnation being observed at times. A difference was observed according to time of day and month and there was a marked climatic fluctuation.
2. A greater variation from the normal basal metabolism was found in lepromatous leprosy.
3. Analysis of the diet of the patients in the leprosarium showed that it was higher in total calories, protein, carbohydrate, riboflavin, iron and hosphorus and somewhat lower in fat, vitamin A, and calcium compared to the standard of the general population.
From these findings, it can be seen that the reactivity of the leprosy patient is extremely labile from the standpoint of body temperature and basal metabolism suggesting a general systemic dysfunction. It is believed that this will be influenced by diet.

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Experiments were carried out using the dd strain of mouse, Hawaii strain murine leprosy bacilli and heat killed vaccine, with and without an adjuvant (liquid paraffin, olive oil, propylene glycol), prepared by the Couland and Saenz method.
Murine leprosy bacilli were inoculated after a lapse of a set time following injection of vaccine, the animal sacrificed after 5 months and the leproma at the site of inoculation, and distribution of bacilli in the lymph nodes and organs examined. The efficacy was evaluated on the basis of the findings.
The results were as follows.
(1) There was some degree of inhibition of the local lesion with the vaccine containing oil but no preventative effect was noted in the organs.
(2) The olive oil vaccine and liquid paraffin vaccine had a moderately strong preventative effect. The olive oil vaccine especially, had an inhibitory effect on proliferation of bacilli in the lymph nodes and organs as well as an effect on the leproma. The propylene glycol vaccine was without effect.
(3) It is suggested that this characteristic granular inflammation is due to a disturbance in the communication of sensations to the central nervous system resulting from the anaesthesia and the occurrence of a disturbance in the anti-inflammatory nervous regulation.
(4) Leprosy bacilli cannot be isolated from the site of perforation and the arteritis obliterans is a secondary change arising from the inflammatory stimulation, so it can be said that neither pre essential causes of leprotic mal perforans pedis.

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Various methods for collecting marine leprosy bacilli in pure form and in high concentration were tried and evaluated by comparative tests in rats. The following methods were tested (a) centrifugation (b)pretreatment with trypsin and then centrifugation and (c) pretreatment with trypsin followed by the Hanks concentration method. The following results were obtained.
The yield was 13% with (a), 21% with (b) and 11% with (c). In other words, the method of pretreatment with 0.1% trypsin for 1 hour at 37°C (b method) gave the best results. It was found that the activity of the bacilli was not affected by this treatment.

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The histopathological picture and mechanism of leprotic mal perforans pedis was studied and the following observed.
(1) Leprotic mal perforans pedis occurs in the presence of anaesthesia (atrophy of the skin and intracorial arterial hypertrophy) and stimulation by an outside factor as a wound or burn. The added stimulation of the mechanical pressure of walking on the affected part is also required.
(2) The typical histopathological picture in this condition consists of hyperkeratosis, acanthosis, papillomatosis, parakeratosis, proliferation of connective tissue cells in the corium, slight lymphocytic infiltration, collagenous and elastic fiber degeneration and arteritis obliterans besides a characteristic granular tissue. This granular tissue is made up of 3 layers, necrotic layer (due to deposition of fibrinoid masses), necrobiotic layer and reaction layer. It is similar to ulcerative granulation and there is marked proliferation of connective tissue cells, a high degree of degeneration of vessels and edema with little infiltration of vascular cells.
(3) It is suggested that this characteristic granular inflammation is due to a disturbance in the communication of sensations to the central nervous system resulting from the anaesthesia and the occurrence of a disturbance in the anti-inflammatory nervous regulation.
(4) Leprosy bacilli cannot be isolated from the site of perforation and the arteritis obliterans is a secondary change arising from the inflammatory stimulation, so it can be said that neither are essential causes of leprotic mal perforans pedis.

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The serum protein and glycoprotein fractions was studied by paper electrophoresis in 41 cases of leprosy (lepromatous type......25, tuberculoid type......16) and in white rats inoculated with the Hawaiian strain of murine leprosy (3-10 months after inoculation). The glycoprotein was quantitatively measured by the periodic acid-Schiff method and the protein by the bromphenol blue staining method. Photoelectro-colorimetric determinations were also performed.
In the lepromatous type, the albumin is reduced compared to the normal subject or the tuberculoid type. The γ-globulin is increased but there is no significant difference in the albumin-bound carbohydrate compared to the control. The γ-globulin-bound carbohydrate, on the other hand, is decreased. Furthermore, there is no rise in β-globulin even though the β-globulin-bound carbohydrate is increased.
There was little significant difference in the serum protein fractions in the tuberculoid type compared to the control but the α₂-globulin-bound carbohydrate was somewhat decreased and the γ-globulin-bound carbohydrate was slightly increased.
In the experimentally infected rat, the serum protein fractions differed little from the normal except for a decrease in albumin and there was little significant difference from the control from the standpoint of serum glycoprotein fractions.

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