It is a well known fact that the disturbance of the sensation and perspiration often extend still after the subsidence of the skinlesion in leprosy. The effect for the recovery of such disturbance by hitherto available anti-leprosy drugs were not expected.
We examined following five points for the measurement of their recovery, for we confirmed the good effect of this vaccine on their recovery during vaccine treatment of leprosy in the past:
1) Research for the patients' complaint.
2) Measurement of the electrical skin resistance by ohmmeter on several fixed sites of the skin at intervals.
3) Objective observation of the tactile and pain sensation of patients in vaccine treatment and controlled groups at intervals.
4) Utilization of Minor's test for the measurement of recovery on the patients with advanced disturbance of perspiration.
5) We compared the results in both groups with advanced loss of sensation by a definite criteria, on the evolution of the loss of sensation, worse or improved.

View full abstract

Among the inhabitants of Amami-Islands, mass-survey of leprosy was carried out in peoples of 77, 500, who lived in Kikai-Island, Setouchi-Town, Tokunoshima-Town and Okierabu-Island (Wadomari-and China-Town). This survey was put into practice at each hamlet in conjunction with the survey of tuberculosis in order to investigate all inhabitants as many as possible. The rate of examination was different in examined areas, as shown in 89.3 to 98.6%. Many unexamined cases were found in Setouchi-Town, where the communication each other had to be due to sea-route, but this rate was more than 96% in the other towns. Therefore, it seems to be better that this examination puts into practice in conjunction with the mass-survey of tuber-culosis on all inhabitants, as well as the author's method.
In these examined areas, total numbers of leprosy patients were 343(4.64 per 1, 000 of population), and hospitalized cases were 257 and unhospitalized cases were 86 in these patients. The incidence of leprosy in examined areas was highest in Setouchi-Town, secondarily in Tokunoshima-Town or Kikai-Town, and this prevalence was lowest in Okierabu-Island, and many unhospitalized patients were found in town where there were many hospitalized patients.
Unhospitalized patients of 86 cases corresponded to 1.16 per 1, 000 of population and this rate was 46 times higher than the average in Japan. However, 72% of these unhospitalized patients was TN-type of leprosy and the other cases were L-type or TM-type of leprosy who would become the infectious sources. Unhospitalized patients who were found newly by these examinations were three times higher than those who were registered already. This fact suggests that mass-survey of leprosy will be very important in areas where many hospitalized patients were found already. However, leprosy patients with the age of less than 19 years were found in 3% to all patients and these cases were already hospitalized. This phenomenon may show the tendency that the prevalence of leprosy will be decreasing gradually in Amami-Islands.

View full abstract

One year and 2 months after the inoculation with human leprous material, one mouse out of ten died suffering from acid-fast bacilli, It has been verified by the au-thors that the acid-fast bacilli is a strain of Murine Leprosy Bacilli. Therefore, it is certain that mice are carriers of murine leprosy bacillus.
Experimental research on acid-fast bacilli in normal mice was then performed as follows. One group of normal mice was fed with the ordinary diet and the other group was fed with disinfected foods and kept in disinfected cages and room. The mice sacrificed after such feeding ranged in age from 3 days to 6 months. The sacri-ficed mice were examined for subcutaneous tissue, liver, spleen and lymph nodes, and the acid-fast bacilli were discovered not only in the mice fed with the ordinary diet, but also in those fed with the disinfected foods. In addition, in one mouse (N7) of 3 days age the bacilli were found. Next, examinations of normal pregnant mice together with their fetus were made in search of acid-fast bacilli. The results of the investigation showed the following facts:
Acid-fast bacilli were found in 5 of the 20 pregnant mice and in 14 of the 149 fetus. The bacilli were always scattered, and sometimes they were in the packet arrangement, but never found in globi. The bacilli did not grow on the egg medium nor on the nutrient agar; however, the bacilli were able to be transferred from mouse to mouse.

View full abstract

Cultivation of the leprosy bacillus and the murine leprosy bacillus is difficult and the attempt is being made for find a way to overcome this problem by clarification of the metabolic system. We have been conducting studies on the respiratory enzyme system in the murine leprosy bacillus for the past several years. It has been found that the inability of the murine leprosy bacillus to oxidize most substrates is due to the absence of the cytochrome system and lack of the electron transport system. In the present study, the various enzyme systems of the TCA cycle were examined at each step. It was found that in the ground extract of murine leprosy bacillus, hydratase and condensing enzyme are present in considerable amount while addition of an artificial electron acceptor is necessary for dehydrogenase and the activity of decarboxylase and the enzyme for oxidative decarboxylation are very weak.
As may be seen in Fig. 2, the murine leprosy bacillus possesses fumarate hydratase (fumarase) activity and forms radio active malic acid from radio active fumaric acid. As no cytochromes are present in the crude extract, malic dehydrogenase is unable to act and malic acid accumulates.
Fig. 3, shows that the murine leprosy bacillus has succinic dehydrogenase activity and produces radio active fumaric acid and malic acid from radio active succinate. Auto-oxidisable phenazine methosulfate was added as an electron transpost system of succinic dehydrogenase. This dye, at the same time, becomes an electron acceptor for the malic dehydrogenase system but as the decarboxylation of pyruvate are inhibited, condensing enzyme is not able to act and as a result malic acid and fumaric acid accumulate.
As may be seen in Table 2 and 3, the murine leprosy bacillus has citrate synthase (condensing enzyme) activity but citrate is not formed from the oxaloacetate alone or oxaloacetate plus pyruvate systems. This suggests that the formation of acetyl CoA from oxaloacetate and pyruvate is inhibited in the cell free system.
The aconitate hydratase (aconitase) activity of the murine leprosy bacillus is quite strong as shown in Table 2 and citrats is formed from cis-aconitate and isocitrate.
Quantitative determination of the dehydrogenase activity of crude extract using triphenyl tetrazolium chloride as the electron acceptor gives the results indicated in Table 1. and a characteristic finding is apparent. With oxaloacetate as the substrate, formation of formazan, equivalent to the substrate used, is not observed. Oxalosuccinate, which is said to be spontaneously decarboxylated by animal tissue, is utilized with difficulty by the murine leprosy bacillus and formation of α-ketoglutarate appears to be difficult.
Examination of the quantitative relationship of the formazan which is formed to the substrate shows that with citrate, cis-aconitate or iso-citrate as substrate, the formation is strongest with citrate followed in descending order by cis-aconitate and isocitrate.
The dehydrogenase step in the TCA cycle is the state of iso-citrate dehydrogenase so the order of formazan formation should be iso-citrate, cis-aconitate, citrate. On the other hand, formazan is not formed when only oxaloacetate is used so that malic acid is not formed by reverse action of condensing enzyme.
As inactivation of some enzyme system may take place at the stage of preparation of the ground extract of the murine leprosy bacillus a definite conclusion cannot be made regarding the metabolic system of the live organism on the basis of the present study alone but the findings suggest the presence of a metabolic system for citrate which does not pass through the TCA cycle. When α-ketoglutarate is used as the substrate fomrazan formation is observed but succinate is not formed and as shown is Fig. 4, almost all of the substrate is converted to glutamic acid.

View full abstract

The results of field investigation on the leprosy in Thailand for 50 days since the 5th of February in 1966 are reported.
Some differences could be seen between the symptoms of leprosy patients in Thailand and those in Japan except Okinawa. Those characteristics of leprous symptoms in Thailand compared with the symptoms in the mainland of Japan are very similer to those in Okinawa. But some symptoms are different from those in Okinawa also.
The characteristics which are common with those in Okinawa are as follows.
1) Hypochromic macules could be seen in patients of every types more fre-quently than in the mainland of Japan. Also the hypochromic patches combinated with other findings could be seen frequently.
2) Generally speaking, the lepromatous infiltrations in Thailand are thinner than those in the mainland of Japan.
3) ENL complicated with high fever and other general symptoms are less. The frequency of occurence of acute iridocyclitis and arthralgia in cases with ENL is less than in the mainland of Japan. On the other hand, the ulceration and necrosis of ENL which were more remarkable then those in the mainland of Japan could be observed.
4) Alopecia, depilation of eyebrows or cilia are less.
5) Lepromatous changes of sclera and cornea, and acute iridocyclitis are less than in the mainland of Japan. Then the blind patients are less.
6) Claw hand, foot drop, wrist drop and facial paralysis are less than in the mainland of Japan. The difference is remarkable especially in wrist drop and facial paralysis.
7) Perforating ulcers could be seen more frequently than in the mainland of Japan.
The symptoms which are somewhat different from those in Okinawa also are as follows.
1) The grade of lepromatous changes of nose compared with those of other parts is more remarkable than in Japan.
2) The lepromatous infiltration of palms could be more frequently seen in the cases who were not so severe than in Japan.

View full abstract