Reprinted from University Medical Magazine, January, 1896. 
INOCULATION OF LEPROSY. 
The following article has been translated and published in Nor- 
wegian with a note by Dr. Armauer Hansen, of Bergen, Norway: 
The leprous stigmata or quality are attracted to the neighborhood 
of light and free air, as all vegetables are, and therefore are located 
in such uncovered parts as the face, the hands, the forearms, legs, and 
feet, where they are nearest to light and air,-that is, to oxygen. 
Another proof that they tend to the most oxygenated parts is that 
the spots and tubercles appear first in greatest quantity in the convex 
and more vascular parts of the organs, where oxygen is most 
abundant. 
Professor Cope, discussing the question of consciousness in vari- 
ation and evolution of organic beings, says, " The causes of the move- 
ments of organic beings are various The best known are conscious 
states, as hunger, cold, heat, and various other sensations ; some of 
them of higher mental grade, as fear, anger, etc. Movements by the 
lowest animals, as that drop of jelly, the amoeba, appear to be the 
result of sensations. . . . The phenomenon of heliotropism, for 
instance, where these simple creatures leave the dark and crowd into 
light places, cannot be shown to be due to chemical or physical causes 
only. They seek oxygen, which is more abundant where sunlight 
penetrates, but they have to bq aware that they need it, and must 
have some knowledge of the fact, when they get it." 
Let us see if this last theory of Cope can be applied to the leper 
bacillus. The tubercle bacillus which is nearest in kind to, if not 
identical with, the leper bacillus (perhaps a variation of the same 
species), when drawn into the organism by respiration, inoculates 
most frequently the apex of the lung, probably because the motion 
there is least. In that place there is much oxygen. Lupus or skin 
tuberculosis is most frequent where insect life is very abundant. If 
the transmission, in the first case, has taken place by inoculation, as 
is demonstrated, we may easily presume that the inoculation, in the 
second case, may be effected in the same manner, probably by the 
intermediary of insects. I do not think that there is any choice 
given to the bacteria of leprosy, as to localization, just as there is 
none in the tubercle bacillus. They develop wherever chance has 
deposited them, and wherever they find favoring condition and no 
obstacles, for instance, the outside of forearm, where there is little 2 
Albert S. Ashmead. 
muscular movement. On the exposed portions of the body, oxygen 
retains and feeds them. The inoculation by insects can only be suc- 
cessful in these places, in others, circumstances are too much against 
them. 
An internal inoculation is also easily imaginable and even proba- 
ble. Salt fish is eaten all over the world ; raw fish is eaten only in 
some countries, like Japan. Fish, especially the carp, which is so 
general an element of alimentation in Japan, where it is eaten raw 
and even alive, feed on the larvae of mosquitoes, and may well be 
suspected of communicating the spores of diseases, extracted by the 
insects from the exposed parts of diseased bodies. If not spores, 
then the toxines of the bacilli. 
Considering these points, I should be disposed to conclude that 
external inoculation means tubercular leprosy, and internal inocula- 
tion, anesthetic leprosy. 
Note.-In lupus we have the same trophic loss of tissues as in leprosy, and 
the bacilli of the two diseases are not distinguishable except by this circumstance: 
that the leper bacillus is gregarious, while the other is more individual. The 
microbes presenting themselves so differently may differ in a similar way in 
their action; this would explain the resemblance which exists certainly between 
these two diseases and also the difference. I should think that leprosy and lupus 
are the same disease with a difference. Ashmead, " Peculiarities of Colombian 
Leprosy." 
(Extract of a letter to Hansen.) 
". . . In this article I try to bring out the following points: Non-volition of 
the bacilli in their localization: light and free air places; probability of the leper 
bacillus and the tubercle bacillus being variations of the same species; the seeming 
preference of the tubercle bacillus for the apex of the lung, and of the leper bacil- 
lus for the extensor-side of members, is due, perhaps, to the lack of disturbance in 
those places; the spectacular difference between lupus and leprosy in Colombia, 
South America, may be a result of the well known and admitted difference between 
the bacilli of both diseases, the tuberculous microbe being individual, while the 
leprous bacillus is gregarious. ..." 
(Extract of a letter from Hansen.) "Bergen, November io, 1895. 
". . . You will have nothing to object, I hope, to my translating your little 
paper and publishing it in our Journal. I must, however, add a little note, on my 
own account, as to the identification of leper and tubercle bacillus, in which I have 
no belief, as you will see from my book, which you, as I hope, have received now. 
The publishers tell me they have sent it. I am very glad to see that you have not 
found any precolombian leprosy; just as civilization leprosy has spread from 
Eastern countries. Yours very truly, G. Armauer Hansen." 
Albert S. Ashmead, M.D. (Univ, of Pa.), 
Late Foreign Medical Director, Tokio Hospital, Japan.