The India centre of JALMA (Japan Leprosy Mission for Asia) was established at Agra in 1965. At the beginning of 1966, it opened one out patient clinic at Ghatampur village near to Kanpur which is one of the famous industrial cities in India. Patients visited the clinic from neighbouring districts and states. Authers attended to the clinic for about eight years continuously and consulted several hundred to over a thousand patients per clinic day.
Ghatampur village is situated in the northern part of Ghatampur Block of Ghatampur Tahsil, which has another Block of Patara.
For eight years (Jan. of 1966 to Dec. of 1973) 1, 785 patients were registered for treatment who were living in Patara Block. Patara Block is situated between south part of Kanpur suburb and Ghatampur Block. It had 123 villages and 122, 500 population by the basic data for 1961 census of India. Many of the villagers were agricultural labours who worked in the field of a few land owners and some small scaled owners worked also in the lent field. Many villagers did not seem in good economical condition.
In the first year of the clinic, in 1966, about one third of the patients were registered from Patara Block. The yearey patient number was decreasing year by year with a little increasing for some years. The percentage of female patients to total cases was increasing yearly, and in 1973 it reached 35%. It seemed difficult for female patients to visit the clinic and it took fairly many years to pull out them from their own home. There must be some old traditions and customs in Indian rural society for female patients to visit the clinic.
The estimated population for the Block was about 155, 000 in 1973. The prevalence rate was 11.5‰ and it was lower than that of neighbouring Ghatampur Block in the same year. It was higher than the report of U.P. State Government for Kanpur District. The prevalence rate for male was higher than that for female and the same results were reported from other places of India. The child rate was 12.8% and it was lower than that of Ghatampur Block.
From the age distribution of the patients, the highest peak was noticed in the age group of 30-34 for both sexes and totally. The second peak was in 25-29 age group and the third peak was in 40-44 age group. In Patara Block, the age of the patients were rather higher compared to the patients from Ghatampur Block. There was one peak in 10-14 age group and a depression in 15-19 age group as in Ghatampur Block. The rate of male to female was 3.0:1 and in child group the rate was much low. In Patara Block, it might be said some female patients did not visit the clinic.
The rate of lepromatous was 11.9% and it was higher than that of Ghatampur Block, and still low compared to the results of many other places of India. The male-female rate in lepromatous cases was 5.4:1 and about 8.5 persons were male out of 10 lepromatous cases. The lepromatous rate was much low in child and it was about 4%. In child group, many cases were belonging to tuberculoid or indeterminate and some of them could get self-healing.
The prevalence rate from Patara Block was about a half of that of Ghatampur Block and it may be said that in U.P. State, near in Kanpur District, the prevalence rate will be lower in northern area than in southern area.

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JALMA (Japan Leprosy Mission for Asia) opened two clinics at Ghatampur and Etawah of U.P. State, India, in 1966 January. The number of newly registered patients has been increasing monthly and yearly. An analysis was done about the relation between chief complaints and clinical features of the registered patients in the period of April to August of 1971. The purpose of the attempt is to make clear the image about leprosy disease.
In this report, only lepromatous cases were selected. The number of lepromatous patients was 259 out of total 1796 cases registered in the period. The tudy for the patients of other types and groups will be reported in near future.
The chief complaints about the skin features were divided into four; nodule, infilt ration, hypopigmented macule and other. 43.4% of male cases complained skin symptom. Many male patients complained nodules and some cases showed the hypopigmented macules or infiltration as the chief complaints. About a half number of female casescomplained the skin features and 27.3% of them showed the nodules. Some of the patients complained hypopigmented macules more frequently than diffuse infiltration. Many patients seemed to accept that leprosy disease would have some skin changes, particula rly hypopigmented patches.
Clinically, the skin features were various from hypopigmented macules, slight infiltration to nodules. Usually the various stages of infiltration with nodules and/or hypopig mented macules were observed in one patient. In both sexes, nodules and macules were observed in young cases more frequently than in aged cases.
About one third of both sexes, 35% for male and 36% for female, complained the symptom of hypoesthesia, anaesthesia, neuralgia and the deformity of hands. These symptoms result from the peripheral nerve damage of the extremities. Clinically, the thickness of the ulnar and the common peroneal nerves was ommon in both sexes. The ulnar nerves were observed thickened bilaterally in most of male cases. In female, the percentage of the cases having thickness of hese nerves was lower than in male.
12.8% of male cases complained heat and dryness of the extremities. These symptoms will be a big trouble in hot and dry season for the agricultural labors in the field.
The complaints about the deformity and the disability of hands were done by a few. Loss of the eyebrow was observed in 76% of male and 70% of female ases. The deformity of nose was noticed in about 50% of both sexes and these symptoms did not appear as the chief complaints.
It will be concluded that most of the lepromatous cases registered in the period 152 1980 accepted the skin features and the sensory disturbance of the extremities as the important signs of leprosy disease. Usually, they do not have the correct knowledge about the early signs of leprosy, but most of them have a fairly good knowledge about the clinical features of the disease. Here, it may be said that their knowledge about the disease and their illiteracy do not have a parallel relationship.

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Conditions for maintaining in vitro growth ability of M. lepraemurium which should be inoculated to ND-5 medium were studied, and the results obtained were as follows; the growth ability of M. lepraemurium in cell-free medium was maintained for 2 and 6 weeks when the bacillary suspensions were preserved at 4°C and -20°C, respectively. However this relationship between preservation condition and growth ability was considered to depend upon the property of culture medium.

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Deteriorations of the potentiality of cell-free liquid medium, ND-5, ND-5+malate, and ND-5+succinate for the growth of M. lepraemurium during the incubation for 1, 2, 3, and 4 months at 30°C were tested. The results obtained indicated that no loss of growth capacity was observed during one month at 30°C, but fifty percent loss took place during two months' incubation, and finally the growth promoting capacity was almost deteriorated by four months' incubation.

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Subcultivations of M. lepraemurium in ND-15, ND-15+malate, and ND-15+succinate medium were attempted. The results obtained demonstrated that cessation of the growth of M. lepraemurium took place respectively after thrice, twice and twice passages when subcultivated with the intervals of every four, six, and eight weeks. This fact strongly suggested that no achievement of subcultivation of M. lepraemurium in ND culture system was not due to the natural deterioration of culture medium during cultivation at 30°C.

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When soluble starch was added to NC-5 and ND-5 medium, the growth of M. lepraemurium was not only significantly stimulated, but also maintained until 10 weeks' cultivation at 30°C. Optimal final concentration of soluble starch was 0.2 to 0.4 per cent. In the case of NC-5 medium, many bacterial clumps were observed by the addition effect of soluble starch.

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Susceptibility of M. lepraemurium against mycobacteriophage C3 and D29 strains was tested in NC-15 medium for quantitative multiplication of M. lepraemurium. Myco-bacteriophage infected bacilli were cultivated with the period of O, two and four weeks and propagation of phage was titered every two weeks after infection. The results obta-ined indicated that M. lepraemurium was insusceptible to the mycobacteriophages tested.Consequently, it was suggested that M. lepraemurium might belong to a sort of M.avium in some biological properties.

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The purpose of this experiment was to obtain a large number of bacilli that could be used for biochemical studies and also for subcultivation experiments. The results obtained are summerized.
1. Yields of M. lepraemurium depended upon the size and form of flask which contained the culture medium.
2. Morphology and other characters of M. lepraemurium were influenced by airspace of culture system.
3. Cultivation of M. lepraemurium in so-called 100ml-flask containing 42ml of complete medium was more efficient than in so-called 50ml-flask from viewpoints of the yieldsand cell-properties.

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