Sôbre o mecanismo da ação terapêutica dos derivados sulfonicos na lepra lepromatosa / On the mechanism of therapeutic action of sulphonated in lepromatous leprosy

The AA. build upon experience acquired by histopathologic and bacterioscopic examinations of a few thousand cases of lepromatous leprosy taken and after leprosy treatament by sulfone derivatives was first tried in S„o Paulo. The AA. do not pretend to deny those drugs a direct action upon the Hansen bacillus; they are m howewer, more ready to believe that the drugs, in spite of acting with a clearly benefic effect, do not go further than to start off, speed up and intensify some mechanism that seems to be present in the economy of the Virchow's cell/Hansen bacillus complex. It is their opinion that the action is directed principally toward the component Virchow's cell, altering its metabolism by some manner or other, and turning the cell into a medium improper for the multiplication and survical of the leprosy bacillus. An identical mechanism also occurs, even if not so regularly and efficiently, as a sequel to other types of treatment or bound to natural conditions, that is to say, with no treatment at all. The AA. arrived at this hypothesis based upon the following facts: 1) The receding lepromatous lesions obtained by sulphonic treatment superpose them-selves axactly to those receding lepromatous lesions observed, if not so frequently, before this treatment was instituted, presenting no new findings. This type of lesion's characteristics are the following: a) swollen Virchow's cell; b) pycnotic nucleus; c) cytoplasm full of vacuoles, with a foamy appearance; d) vacuoles containinglipids in a quantity inversely proportional to the number of bacilli - signs of cellular suffering; e) rare Hansen bacilli, with a granular aspect - signs of bacillar suffering. The AA. think the celular degeneration to be previous to the bacillar disintegration. 2) For the sulphonic treatment to be efficient in leprosy, the drug is required in large doses for a long time...

Sobre a presença de lipidios nas lesões cutaneas de lepra / On the presence of lipids in the skin lesions of leprosy

The authors researchd fat substancies in 231 cutaneous lesions of lepers, of various forms and stages, using frozen sections stained with the Scharlach R-hematein. Is was established that in leprosy of lepromatous form fat is found in a large percentage (63,5 per cente); in the tuberculoid form fat was found only in the reactionary from, and among these only in 16,6 per cente, and with special characteristics. Furthermore, in 33 per cente of the incharacteristic leprosy cases fat could be disclosed; for this reason and for other motives of cytological, bacteriological and clinical order, the authors believe that such lesions ought to be considered as regressive lepromatous lesions. It is the authors opinion that the research of the may be helpful, in some cases, in the differential diagnosis between certain types of lepromatous lesions.