らいの病因論についての考察ならびに論評

1. The tissue changes in the reticulo-endothelial system in leprosy are characteristic, in particular intensity of phagocytic activity to the pathogenesis markedly feeble and insignificant, and the production of immune substances may be little or none, that would be demonstrable by Lopromin Test on the patient.<br>2. Essentially, the most important function in the R. E. S. is phagocytosis, which are carried out by histiocytes and phagocytes in blood and interstitial tissue. The phagocytes are derived from wandering and resting histiocytes in the connective tissue and sinus endothel cells in the viscera.<br>According to the study of Maximow and Sabin they are classified as follows:<br>1. Clasmatocyte type, <br>2. Vascular endothelium type.<br>Sinus endothel cells are most important on phagocytic activity. They belong to clasmatocyte type, and act strongly on phagocytosis and production of immune substance. The phagocytes are mostly derived from the endothels in the sinuses and sinusoids in the spleen, lymph nodes, liver and so on. The other kind of phagocytes, endothelial cells, are derived from the lining cells of blood and lymphatic vessels. And they may be proved milder than that of the former type at the time of phagocytosis.<br>3. Macrophages or phagocytes originally make a defense action against pathogens or foreign materials.<br>In leprosy, particularly, the function is awfully feeble and scanty, and the tissue of that system are liable to be broken or undergo hyaline degeneration and fatty alteration. The R. E. S. in viscera, at last may be consumed and reduced to atrophy. The defensive power in the R. E. S., consequently may be prostrated or are exhausted.<br>4. Some times, on the occasion of the illness may carry out phagocytic activity owing to some other kinds of cells saving for the RE. cells. We can often may meet with an unusual phagocytosis in epithels or endothels, also in tuberculosis or rickettsial diseases and so on.<br>In leprosy these fact could be found, especially, in the endothel cells of blood vessels and in the epithel of sweat glands and in the liver cells. It is uncertain that such matter may be due to whether infectious intrusion or phagocytosis, and or symbiotic liviug to the cells.<br>5. Generally speaking, lepra bacilli are said to be non virulent to the human body, notwithstanding, really act upon the allergic reaction severely and bring about damage considerably in the tissue.<br>6. The most important factor that decides difficulties in healing in the illness lies in the nature of lepra bacilli itself, and exhaustion in the faculty of the R. E. S., on that occasion, the reactive power of that tissue is severely decreased.<br>7. Finally, the most important factors of pathogenesis of leprosy, come to consider as consumption and atrophy in the R. E. S.<br>The author, in conclusion, will emphasize the exhaustion (encroachment) and damage in the R. E. S. have to the most important thing to decide on the healing in the illness.