From all this we can only conclude that the cord is affected in some cases, in others not; _definite clinical symptoms_ are absent, and where they suggest a central cause, they may be equally well ascribed to a peripheral neuritis. The lymphatic glands related to the affected skin are swollen, but not nearly so much so as in nodular leprosy. After death one usually finds the glands but little swollen, and their appearance presents nothing characteristic. In only one case of maculo-anæsthetic leprosy have we found the inguinal glands distinctly leprous, and that two years after the disappearance of the macules. This indicates in the first place that the affection of the glands is due to the same cause in this as in the nodular form, and secondly, that the leprous affection of the glands may last longer than that of the skin. In the same case we found indefinite traces of leprous affection of the liver and spleen, unfortunately so indefinite that we cannot say with certainty whether the liver and spleen are affected with leprosy in this form of the disease. The case occurred in the pre-bacillary era. The _muscular affections_, paralysis and atrophy, play a prominent _rôle_ in the maculo-anæsthetic form of the disease, and the anatomical examination of the muscles is of great interest since some (Neisser)[5] regard it as a specific leprous process, while G. and E. Hoggan[6] had previously described it as secondary, and due to the neuritis. In our[7] examination of various stages of muscular atrophy, we have found that the changes begin with a multiplication of the nuclei of the _Perimysium intern._, which becomes thicker and thicker; at the same time the muscle fibres become thinner, they retain their transverse striation, and some break up into discs. The greater the thickening of the perimysium the thinner become the muscle fibres, so that one must regard the process as an atrophy due to pressure. The intra-muscular nerves showed interstitial neuritis. [5] Virchow’s Archiv, Bd. C. III. [6] Archive de Physiologie, Bern. 1882. [7] Zeitschrift, par D. C. Danielssen, Bergen, 1891. Where the atrophy was very pronounced, as in the small muscles of the hands and feet, the muscular fibres had completely disappeared, and only fat and connective tissue remained. We found no bacilli, not even in sections of very early stages of the process, where the larger nerve branches, relating to the part, contained numerous ones, either in so-called mixed or in true tuberous cases. We must therefore with Hoggan regard the muscular affection in leprosy as a secondary one, caused by neuritis. We have tabulated at the end of this work the results of thirty-six post-mortems on maculo-anæsthetic lepers (see TABLE II, page 138). In those thirty-six cases we find _simple meningitis_ twice, _tubercular meningitis_ once, _solitary tubercle in the cerebellum_ once, and _hydrocephalus internus_ twice. The protocol notes nothing further.