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strain of the organism to a toxin, to a filter-passing or other form of the organism, or to trophic nerve disturbance. 5. The occurrence of acute and sub-acute inflammatory changes in leprous lesions of the tuberculoid type is described. These have frequently been attributed to " lepra reaction ". A contrast is made between these inflammatory changes which are usually followed by subsidence and often by arrest of the disease, and the inflammatory changes seen in " lepra reaction " in cases of nodular leprosy, which are often associated with a permanent increase in the leprous infection. It is considered inadvisable to describe both these conditions under the one term " lepra reaction " with no qualifying term to explain which type of reaction is meant. 6. The place of cases with tuberculoid macular lesions in the scheme of classification suggested by the Leonard Wood M'emorial Conference is discussed. The opinion is expressed that in spite of the occurrence in them of changes which are leprotic in the sense of the Conference's definition, tuberculoid lesions are essentially part of the type of leprosy which has been described as " neural " or " maculo­ ansthetic. " leprosy, and should therefore be classified as such. The clinical , pathological and bacteriological findings made in these lesions are different from those made in lesions of nodular or " cutaneous " type, and the prognosis of cases with macular lesions is very much better than the prognosis of cases with cutaneous lesions. Therefore the differentia­ tion of tuberculoid lesions from " cutaneous " lesions is a matter of considerable importance.

Purulia Leper Home and Kindred Efforts on the Bengal-Bihar Frontier