It is a common observation that cohabitation or close contact of healthy people with lepra patients do not induce apparent infection of the disease. Induction of infection or onset of the disease appears that predispositional constitution is necessary. The author studied many families in the lepra colony at Kusatsu and found that inspite of the fact that these families lived under poor sanitary conditions for many years, some people over twenty or more years together with lepra patients, yet no infection had taken place.
The author further studied the terminal diseases by which the immediate members of the families had died. The diseases of the 206 cases studied may be classified as follows:
1. 124 cases of the cerebro-spinal diseases distributed 90 paralysis, 27 apoplexy, 6 spinal dieseases, 1 brain disease.
2. 50 cases of she digestive diseases distributed, 33 gastro-intestinal diseases, 17 gastric carcinoma.
3. 3 cases of the respiratory diseases distributed 1 plumonary tuberculosis, 1 pleurosis, 1 asthma.
4. 1 case of periostitis.
5. 27 rheumatism and 1 neuritis.

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Autoro publikas unu malofta "kazo" de leprulo de makulo tuberkuloida, kungita de Recklinghausen'a malsano.
En la makulo estas tre malmulta nombro de leprbaciloj en nervbrancetoj, dum en nervfibromo nenio. Nervfibromo generigas de Schwann'a ingo, kie ordinare trovas sin neniam leprbaciloj je lepruloj.
Post cio, intereso de autoro ekzistas en futuro de la kazo, kiam makulo aperus sur fibromo au la malsanulo farigus nodulo.
Figuroj:
1) Pigmentmakulo de kruroj kai leprmakulo ce maldekstra maleolo eksterna.
2) Pigmentmakulo kaj leprmakuloj ce dorso.
3) Mikroskopa figuro de makulo ce maldekstra maleolo eksterna.
4) Mikroskopa figuro de nervfibromo, deprenita de brusto.

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Wir haben die statistischen Beobachtungen über die in Japan mitgeteilte Kinderlepra (unter 15 Lebensjahren) gemacht, die sich unter 7976 auf 21, 1759%±0.4574% belief. Krankheitstypus der 393 Kinderlepra (258 Knaben u. 135 Mädchen) sind wie unten.
L. maculosa 41.4757%±2.4852%
L. nervosa 24.4274%±2.1673%
L. tuberosa 23.1551%±2.1284% (Niemand unter 5 Lebensjahren).
In unsserer Klinik war der jüngste Patient ein 35 monatiges Kind, welches an L. maculosa gelitten war, bei der die Lepra-Bazillen gefunden wurden. Seine Mutter starb an Lepra tuberosa und es war während 2 Jahre von seiner erkrankten Mutter mastiert. Die mütterseitige Grossmutter des Patienten litt an Lepra nach dem Tod seiner Mutter und die leprösen Flecke des Patienten traten zuerst 35 Monate nach der Geburt an beiden Unterschenkeln, Voderarmen u. Knie auf.
Die Leprabazillen wurden im Nasensekret nicht, aber in der Macula nachgewiesen.
Ueber die Infektionsquelle des Patienten glauben wir also, dass der Dauerkontakt mit der Mutter eine grosse Rolle spielen soll.
Nach unsserer Foschung fanden wir unter 21 Leprakindern bei 13 direkte oder indirekte Kontaktinfektion mit anderen Leprakranken, die unter denen bei 9 in ihren Familien stattgefunden war; das Verhaltnis der Quelle mit den Patienten war wie unten:
Negiert den Kontakt mit Lepra. 8
Kontakt mit Lepra des Nachbars. 3
Kontakt mit Lepra des Vaters 5
Kontakt mit Lepra der Mutter 2
Kontakt mit Lepra des Grossvaters 1
Kontakt mit Lepra des Bruders 1
Kontakt mit Lepra des Onkels 1
21
Als die Infektionquelle des Kinderlepra ist der Kontakt im Säuglingsalter mit der Lepra der Famillie eine grosse Rolle zu spielen.

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1) In the Kyûshû Leper house the patients who were treated by tracheotomy were 43 cases during ca. 8, 5 years from 1915 to 1925. The percentage to all of the present inpatients (850) is 2, 7%. A half among them are still living.
2) The durstion from the onset of the disease to the tracheotomy was 5 to 31 years and 15 years and 5 months in average. The operation was clone most frequently (67, 2%) in 10 to 20 years.
3) According to the season the operation was done in winter a little more in number than in summer.
4) The prognosis of the operation: among 23 death cases, 3 cases died within only one month and 2 cases survived for 4 years. On the average they survived one year and seven months. Among 23 cases who have been still living 2 cases survive more than 7 years after the operation. These 2 cases and other 2 relative long surviving cases are all female.
5) The causes of death; leprous asthenia 56%, pneumonia 34, 0, other diseases 10-0.
6) As the care in the performance of the operation and after the operation, the incision of the skin should be possibly small and silver canule is employd better than brass one. In winter an inhalation is recommended. If expectoration is difficult, a piece of feather pained with glycerin is effective.
7) There is only one case in which the opening of tracheotomy has closed again. The tracheotomy at the earliest stage might causes healing of laryngeal diseases and the closing of tracheotomy to a relative higher rate.
8) Generally speaking, the author believes that the tracheotomy in lepers is not dispensable and relieves leprous patients from pain. It also makes their life longer and lightens morbid changes of the larynx.

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