British Journal of Dermatology
THE author has examined histologically the macules in eight cases of leprosy, and his researches have led him to the following conclusions :-1. The " taches " or macules of nervous, tuberculous, and mixed Leprosy, whatever their clinical appearance (erythematous, pigmentary, erythematopigmentary, infiltrated, or non-infiltrated), constitute a single nosographic species. 2. These macules have an uniform and sufficiently characteristic histological structure. 3. They contain demonstrable bacilli
... monstrable bacilli in the large majority of cases. 4. They approach, by a series of insensible gradations, the " lepromes en nappe." 5. They are of the same nature as the true lepromas-that is to say, of a leprousbacillary nature. 6. Their evolution is controlled by conditions of virulence of the germ, or of resistance of the soil, of which one has little real understanding. The fact that the bacillus is demonstrabIe in the macules; that the macules, whatever their clinical form, have the same histopathological structure ; that the macules may pass through gradual stages into fully-developed nodules, and that they are of the same nature as the nodules, these are the chief points upon which Darier insists. It is taught at the present time that the macules do not oontain the bacillus, or, at any rate, only in very small numbers, and at the moment of their appearance. I n eight cases examined by Darier during life, by removal of portions of macules, six showed the bacillus of leprosy in considerable numbers ; in one they were somewhat less numerous, and in one case only they were not present. H e attaches great importance to the technique in staining, using Ziehl's solution, and decolourizing with nitric-alcohol-the sections remaining in the warm Ziehl's solution for at least two hours. The possibility of demonstrating the bacillus in the macules is of great value for early diagnosis.