Smith and Rivas add 10 vols. of 2% acetic acid to 1 vol. blood, centrifuge and make smears. Gland puncture has recently been considered as an important diagnostic procedure in leprosy. It must not be forgotten that while the finding of leprosy bacilli is usually very easy in the nodules of nodular leprosy it is a painstaking and discouraging procedure with the spots of nerve leprosy. Even the affected nerves, at autopsy, often fail to show bacilli. For nerve leprosy the examination of nasal mucus is of prime importance. The _Roentgen ray_ has been utilized in the recognition of the very early, trophic changes in bone, showing the commencing absorption of phalanges. Neve has reported a case in which there were no satisfactory indications of leprosy other than slight deformity of toes and fingers but showing marked changes in the phalanges, even to disappearance of terminal phalanx of some toes when examined with X-ray. PROGNOSIS The progress of the disease is so slow that it is difficult to estimate improvement or cure. At present the possibility of a cure, with the new methods of treatment, is encouraging. There is no doubt but that many of the reported cures have simply been instances of remissions in the course of the disease for periods covering months or even three or four years. It would seem that the earlier treatment is instituted the greater the possibility of cure. There were 38 cases officially reported as cured, in Norway, from 1881 to 1885. Nodular leprosy runs its course much more quickly than does nerve leprosy. It is in nodular leprosy particularly that intercurrent affections carry off the patients. Tuberculosis carries off about 23% of cases and nephritis almost 30%, while a combination of tuberculosis and renal disease about 10%. In the remainder, the cachexia or accidents of leprosy itself are responsible for a large portion of the deaths. Cases of nodular leprosy are more often carried off by kidney disease than those with nerve or mixed leprosy. It must not be forgotten that lepers, especially those with the nerve form, may live for twenty to forty years. PROPHYLAXIS AND TREATMENT