There are two kinds of skin diseases occurring recently in regions on the southwest coast of Taiwan. As the people effected are in groups, so the question has aroused the attention of the public. The main pathogenic factor accountable for both kinds of diseases is defective underground water, particularly when containing an excessive quantity of arsenic.
The first kind can be taken as Arsenical Keratosis, while the other as Arsenical Gangrene.
This report is a presentation of the facts on the distribution as to how the diseases have become a problem of the community; what are the causes of the diseases and what preventive have been adopted; with special emphasis being laid on the seriousness and complexity of Black Foot Disease, the possible conditions which are accountable for the development of this disease, and the reason for having taken this name.
Discussions are here made with a view of clarifying the question why the disease in two different localities having the same causes of the diseases which may be attributable to the production of the disease are accompanied by evidently different symptoms.
In the same village where people drink water from the same shallow wells, and people of the same family having the same living conditions, why is it some people are affected by diseases but some are not? And it carries a report on different incubation period of the two kinds of different rare diseases which have drawn so much attention of the public.

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The influence afforded by the animal age at the moment of inoculation upon the rate of evolution of the murine leprosy was studied in rats and hamsters, peritoneally inoculated with M. lepraemurium.
The results based on the evolution of the leprosy lesions and on the rate of evolution of the disease show, as a concequence of the animal age at the moment of inoculation: 1) In rats the length of the resting phase of the lesion evolution becomes altered; It is longer in suckling than in adult rats; 2) The initial phase of the disease evolution is shorter in suckling than adults hamsters.
The rate of evolution of the murine leprosy is similar both in suckling and in young adult rats, showing that it is not influenced by the age at the moment of inoculation.
In suckling rats, in opposite to what happens to young adult ones, there is no correlation between the size of inoculum and the mean of survival.

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The evaluation of enzymatic activities in the patients serum has been enphasized a good deal clinically on the diagnosis and prognosis of the disease.
It has been known these various enzymes in serum are produced from tissue cells.
They are said to be restored in the cells and metabolize themselves and are excreated via endocrine organs and degenerated or destructed cells.
We have discussed about K and urinary creative as well as serum phosphatase under the disease and the normal condition.
1) Alkaline phosphatase, P and Ca remain unchanged in the serum of leprosy patients.
This means that general bone pathological changes in leprosy are due to rather the abnormal conditions belonging to nutritional and functional disturbances from secondary infection that abnormal phosphorous metabolism.
2) Acid phosphatase and ATP ase remain the normal levels.
3) Alkaline ATP ase in the serum of the leprosy is activated by Mg.
Alkaline ATP ase increases somewhat in leprosy than normal. It can be said that unstability of alkaline ATP ase in leprosy depends on rather leprous tissue and its destruction than secondary muscule atrophy.

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The plasma lipoprotein lipase has been studied in 4 normal individuals and 26 leprosy patients, of whom 10 were of tuberculoid type, 14 were lepromatous type and 2 were borderline group, by the Stork-Kucerova's method. Ten ml of the control (pre-heparin) and 10 minute post-heparin blood samples were obtained from all subjects after an overnight fast respectively. Heparin sodium, 50mg in 5ml injected intravenously, was used as a clearing factor stimulus. The plasma was separated by centrifugation in a refrigerated centrifuge as soon as possible after withdrawal. The activity of plasma lipoprotein lipase was determined by the reduction in turbidity-measured as a fall in optical density-of the mixture of pre-or post-heparin plasma and diluted milk emulsion contained 0.03 per cent of fat. Turbidity was measured in a spectrophotometer at 610mμ after inoculation of the mixture for 2 hours at 37°C.
In tuberculoid leprosy, the degree of clearing activity extend from 12 to 34 per cent, and the average was 21.5 per cent. No difference was found in the enzyme activity of tuberculoid cases compared to that of the healthy persons. Although the activities were considerably lower in lepromatous and borderline leprosy than those of tuberculoid leprosy. Namely, the enzyme activity of lepromatous type was from 3.5 to 29.5 per cent, and the mean was 13 per cent, and that of borderline group was around 9.5 per cent. In 3 cases who had had recurrent attacks of erythema nodosum leprosum there was a moderate decrease of the enzyme activity. Electrophoretically, in most of the cases, the slight decrease in the mobility of plasma albumin was observed after intravenous administration of heparin irrespectively of age, sex or leprosy types.

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