PATHOLOGY OF LEPROSY WITH SPECIAL REFERENCE TO ALLERGIC DIATHESIS

In 1943, it was found by the author that many rheumatic nodules were existed in the heart of the leprous patient; thenceforth, the author performed many researches about the study of this field to find out the rheumatic nodule in the heart of the patients suffering from myoma, malnutrition, beriberi, scarlatina, Graves's disease, typhoid fever and so on. It was of great interest especially that the beriberi heart and the malnutritional heart had rheumatic or rheumatoid nodules, that is, they were considered to be caused by some allergic factors. The author then intended to consider such avitaminous or malnutritional states must be a cause of allergic changes in the body, that is, the so-called allergic diathesis should be formed by avitaminosis or malnutrition, at least. Then, using 191 disected leprous cases, the author tried to confirm such consideration.<br>The materials were arranged in the following manner:- (a) The materials collect ed during the period without the knowledge of vitamines, that is, the patient did not treated with drugs including vitamines. (b) The materials collected during the period with insufficient supply of diet, such as the wartime, etc. (c) The materials collected during the period with sufficient supply of diet and the patient was treated completely with rich drugs including vitamines, of course.<br>1. About cardiac changes:-<br>If it was arranged about several cardiac changes from the standpoint of such classifying method as above-mentioned, the findings of 84 hearts were observed to be as follows:- Rheumatic and rheumatoid nodules appeared in 79.3% (no vitamine period), 77.1% (malnutritive period) and 57.9% (vitamine period). Periarteriitis and endoarteriitis nodosa, thrombosis were also found.<br>Such allergic changes of the heart must be considered to be derived not only from leprosy itself but also from avitaminosis ₁ and malnutrition in the meaning of metallergy or parallergy.<br>2. About hepatic changes.<br>About the liver, 116 cases were examined in this report. The appearance of leprous knot was observed to be accelerated by malnutritive or B₁ deficient condition, that is, it was observed in malnutritional period at 78.5%, in no vitamine period at 76% and in vitamine period at 55.5%. Allergic changes were observed to be accelerated in leprosy in the cases of avitaminosis B₁, malnutrition and nutritive deficiency.<br>3. About splenic changes.<br>Using 111 leprous cases, it was examined about the spleen. Leproma was observed at 52.9% in the malnutritional period, at 39.1% in the no vitamine period and at 33.0% in the vitamine period, so that, it must be said that malnutrition or vitamine deficiency accelerated the leprous changes in the spleen at 70.3% (78 cases among 111), which must be considered to be derived from leprosy itself as a sort of marantic suffering. Sago spleen was observed at 9.0% (10 cases among 111) which was considered to have no intimate connection with the complications such as tuberculosis, etc and this amyloidosis must be derived from leprosy itself and malnutrition in such case. Hyalinosis of small asteries was observed in the spleen abundantly in the cases of dystrophy and avitaminosis B₁.<br>4. About the nephrotic changes.<br>About 101 cases, the nephrotic changes were examined. Diffuse glomerulonephritis was counted at 27.3%, in the no vitamine period, at 26.0% in the vitamine period and 12.1% in the malnutritional period and exudative lymphocytic nephritis was counted at 33.3%, 29.8% and 39.4 % consequently. Amyloidosis of the kidney was found in 8 cases among 101 (7.9%). Leproma was found very rarely, that is, only 1 case among 101.