The leprosy contact children, non-contact children and leprosy children patients under 10 years old in Thailand were subjected to physical examinations, Dharmendra and Tuberculin test. The reading of Dharmendra and Tuberculin reaction was performed at 48 hours after injection. The results are as follows.
1) Fourteen out of 287 children showed some clinical signs. Twelve children showed only the enlargment of nerve. Two children showed hypochromic macule.
2) The percentage of pisitivity of Dharmendra early reaction in leprosy contact children is higher than that of non-contact children.
3) Among leprosy contact children, the percentage of Dharmendra positivity in Phraeng Kayang Colony, in where bacilli negative patients are admitted, is lower than that of other institutions.
4) All the babies under 1 year old showed negative early reaction against Dharmendra antigen, and the children 1 year old showed remarkable positive reaction already.
5) Among leprosy contact children, Dharmendra reactions of female children are generally somewhat stronger than those of male children.
6) Dharmendra positive and Tuberculin negative children, or Dharmendra negative and Tuberculin positive children could be considerably found, but the number of children positive against both antigens is small.
7) The early Dharmendra and Tuberculin reaction are not correlated with each other in children under 10 years old.
8) The natural infection of tubercle bacilli does not cause the positive conversion of early Dharmendra reaction in the children under 10 years old.
9) Dharmendra positivity of children who react negatively against Tuberculin is due to the infection of leprosy bacilli.
10) In the children, the infection of leprosy bacilli causes the positive conversion of Dharmendra reaction, but does not cause that of Tuberculin reaction.
11) The infection of leprosy bacilli does not always cause the positive conversion of Dharmendra reaction.
12) The early Dharmendra reaction can be used for the epidemiological investigation.
13) BCG inoculation should be done in age as young as possible.

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Detection of M. leprae in 168 skin samples removed by trepanation from 58 patients negative for bacilli in repeated examinations of 3 to 8 times in the periods ranging from 1/2 to 2 years was performed. In addition, 6 cases showing occasionally positive, and 17 cases showing 2+ to 3+ positive for bacilli were examined similarly. These skin pieces were smeared directly or after trituration and grinding (40 samples of 27 cases) on slides and examined. For the purpose of concentration of bacilli in the tissue, two techniques were employed, NaOH-(with and without acetic acid treatment) and chloroform-methods. The results obtained were summarized as follows :
1) The trepan-snip method seemed to be slightly superior to the routine slit method so far as the 168 samples concerned. However, 3 out of the skin samples showing positive for bacilli, very few in number, by slit method, gave negative results.
2) Smearing preparation after grinding the skin piece in a mortar did not work only unfavorably for search of M. leprae, but also made it difficult presumably because of increase in masking effect of tissue debris on bacillary bodies which would be gradually losing their acid-fastness.
3) Concentration procedure with NaOH chloroform was unlikely serviceable to the purpose of detecting M. leprae in the skin smaples of very small amount with scanty bacilli.
4) From these results, it can be safely stated that the routine snip or scraping method is a fairly good means for detection of M. leprae. The method is quite simple, practical and suitable for repeated examinations. In addition, the yield is not necessarily inferior in efficiency to snip method, if care is taken for selection of the site to be examined, and for preparation of films after rendering the site bloodless by pressure.
5) Varied changes in morphological and tinctorial properties of M. leprae were observed; viz., granular form (5 cases), shortening of bacillary body (1), purplish red (3) or pale bluish staining (1), etc. The meaning of these changes remains to be solved by further research.
6) The instruments to be used should be kept quite sanitary. Cleaning of the knife, and other instruments, mortar and pestle, etc. in a boiling NaHCO₃-solution is very simple and satisfiable for washing out adhering acid-fast germs to them.

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In the previous paper the authors reported that acid-fast bacilli were discovered in normal mice, even as young as 3 days, in addition, acid-fast bacilli were found occasionally in the fetus of pregnant mice. These bacilli were scattered or in packet arrangement and did not grow on the ordinary culture media. This paper reports on following experiments carried out by the authors. Two different groups (A and B) of mice were kept together in the breeding cages. The first group, (A) was composed of murine leprous females and normal males; the second group, (B) was composed of normal females and murine leprous males. Pregnant mice were picked up from both group A and group B, and autopsied, and carefully examined. When the female mice of group A and B were delivered of off-spring, they were also examined. In the second experiment normal females (in group B) and normal males (in group A) which had been kept together with leprous mice for a few months were examined. Both the fetus and also the off-sprig of these females were investigated for the presence of acid-fast bacilli. The results were as follows:
1. Twelve of the 41 leprous females (group A) became pregnant and acid-fast bacilli were found in 15 of their 77 fetus. In some fetus globi were discovered.
2. Only 4 of the 19 normal females (group B) which were kept together with murine lerpous males became pregnant, and in a total of 22 fetus, no acid-fast bacilli were found.
3. Only in one of the 41 total off-spring were a few scattered acid-fast bacilli found.
4. Acid-fast bacilli were found in 2 of the 13 normal males and in 2 of the 12 normal females which were kept together with the leprous mice. In one of the normal females globi were found in the liver.

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Facial plastic surgery in leprosy has two points of important significances, one of which is to eliminate the inferiority consciousness against facial deformity from the patient, who is returning to the society. However, an administration structure of leprosy in our country is almost brought to perfection, and early discovery and therapy are carried out smoothly, so that no impossibility for the patient, who returns to the society without causing deformity. Actually since administering with D.D.S., Thiourea, and Kanamycin for leprosy therapy, facial plastic surgery may be not directly taken part in the patient, who returns to the society. The another point has to correct a social prejudice for leprosy. A big factor formed such prejudice is an unnecessary terror mind for the infection and feeling of dislike for the ugly deformity. The former can be corrected by the right social education about leprosy, but the latter is only for endeavouring how to avoid the eye of social people by means of technics of plastic or orthopedic surgeries. Even for the patients in the leprosarium, who have no possibility to be returned to the society, the facial plastic surgery holds as one of important reasons.
The facial plastic surgery carried out in the leprosarium at the present time is as the following.
1. Loss of the eyebrows.
It is said that a single hair or a few hairs transplantation is the best method. Strip of the scalp, direct scalp pedicle flap and artery island flap are widely carried out, especially for the strip of the scalp, there are several reports for clinical study, in order to obtain a good condition of hair growing. Also for loss of eyelashes, narrow strips of the scalp are carried out, and for leprous alopecia, artificial hairing is also considered.
2. Nasal deformities.
For rhinoplastic operation of leprous saddle nose, several technics including preserved homocostal cartilage and prosthesis as materials of acrylic resin and Dimethylpolysiloxane are tried, especially for the method as U-type prosthesis is placed on the maxilla surface arounded foramen piriforme, and then combined with L-type prosthesis, in order to elevate a dorsum of the nose is noticed as much easier than Gillies' post-nasal epitherial inlay method. For the cases in defect or high atrophy of the whole nose, besides partial rhinoplasty, total rhinoplasty is carried out positively, especially transferring the acromiothracic tubed pedicle flap is applied willingly.
3. Facial paralysis.
For lagophthalmis, static sling using fascia lata and tendon or Sheehan's pedicle flap was chiefly applied, but lately temporalis muscle sling operation is also popular-ized. For lip paralysis, static sling of paralyzed lower lip with fascia lata and tendon, and also dynamic method of utilized masseter muscle are well carried out, but for the cases paralyzed strongly on the both sides, the static method is mostly selected, expecially a method of tendon through the lower lip being tied up to the masseter muscle at the both sides is superior for a point of simplicity.
4. Abnormal winkling of the face.
Usual rhytidectomy (or face lifting) is carried out. Naso-labial, perioral and submandibular region are removed with the skin incision.
5. Deformty of the ear.
Ear lobe at the state so called dangle or partial defect of the auricle (this is mostly found at the helix and so called as the rat-eaten ear) is the objects of plastic surgery.
6. Other deformities.
Besides, the operation (skin abrasion and Z-plasty etc.) for scar or pigmentation is also tried some for lesions of nose inside or mouth.

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