Therefore the _fate of the patient is very different_. If the eruptions are frequent the growth of the nodules is usually luxuriant, and those nodules with diminished epithelial covering, and therefore moist, are very frequent. If then, the whole countenance and part of the extremities are covered with such nodules; if the eyes are blinded by the formation of nodules in the cornea; if the tongue and the pharynx are, through formation of nodules and infiltration, half ulcerated and sore; if respiration is made more difficult by the narrowing of the rima, and the voice inaudible; then the condition is as miserable as is possible to conceive. If there is added to this, amyloid degeneration of the kidneys, liver, spleen and intestine, with diarrhœa, it can only be desired that death shall put an end to such a condition, and that usually takes place soon, although occasionally the patient may linger for months. Whether leprosy alone is responsible for the end is, we think, doubtful; as remarked above, the affections of the liver and spleen appear to be without much significance. The biliary secretion is never influenced, and there is according to our observations no special leprous anæmia. The patients are indeed often anæmic, or become so during the disease, but we have not been able to convince ourselves that this is a direct result of the leprosy. In many examinations of the blood, which were indeed undertaken for other purposes, we have never noticed anything remarkable in relation to the number or form of the blood corpuscles. As in almost all cases of nodular leprosy nephritis is present, we are inclined to regard this nephritis as a frequent cause of the marasmus which ensues. Tuberculosis was formerly a frequent occurrence in our hospitals, where our observations have chiefly been made. The relationship between this and leprosy we will discuss later.