Leprosy

the sulphonamides can be responsible in the way he has suggested. It is also erroneous to draw conclusions from what happens to the liver in animals, because animals respond in a different way. Skin irritants have been shown to have an effect more on the stomach than on the liver. Finally, liver extract is not of much value in the treatment of hepatitis, except by way of vitamin supplement. Dr. Brian Russell: In reply to Dr. Moynahan, in my opinion tests of liver function are so insensitive as to be of little value. A liver puncture would give the information required but I do not consider the risk is justified, particularly as flavine and sulphonamides are known to be absorbed, for example, from burns, and have been reported to cause liver damage and even necrosis. Regarding penicillin sensitivity, I would suggest that there is an increasing number of individuals who have been sensitized by the use of sulphonamides and flavine, so that they suffer from a subclinical hepatic insufficiency and react unfavourably to relatively milder agents.