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The present study incorporates a study of 42 cases of lepromatous leprosy for hepatic involvement and role of indigenous herbal preparation in protecting the liver in leprosy. Liver was enlarged in 32 cases which was tender in 8 patients. Alteration in liver function irrespective of extent and duration of the illness (3 months to 10 years with mean duration of illness = 2 years 5 months) was mainly seen as uniform elevation of serum proteins (6.2-9.2 gms%, mean = 7.5 gms%) with hypoalbuminaemia (2.0-4.4 gms%, mean = 2.9 gms%). Highest level of serum bilirubin of 1.6 mg% was detected in 6 cases, emphasising the presence of leprous hepatitis. Raised level of serum transaminases (SGOT = 65.2 IU, SGPT = 78.7 IU) were proportionate to the liver and muscle involvement. Presence of characteristic granulomata in the liver around the central vein, periportal area and even distribution at various locations in the liver lobules were the most significant changes in 12 out of 15 liver tissues. Acid fast M. leprae were demonstrated in 12 patients. The present work emphasises the detection of hepatic involvement in the early stage of the disease and hepato-protective role of indigenous drug Liv-52 in lepromatous leprosy which usually lead to dreaded mutilated complications in the body.

The diabetic status of the local Jhansi patients (120 cases) was established before and after antileprosy treatment. Control studies were performed in normal healthy subjects (50 persons) without family history of diabetes mellitus. Random normals showed an incidence of diabetes only 2%, while leprosy patients (94 males and 26 females) had incidence of diabetic status of 14.2%. The highest incidence (19.3 %) of diabetes was in lepromatous leprosy and lowest incidence (6.4%) in tuberculoid leprosy patients. Repeated studies in leprosy after treatment showed not only clinical improvement for leprosy but also disappearance of the chemical and latent diabetes mellitus and lowering of blood sugar levels in manifest diabetes mellitus. Incidently it was noted that `diabetic status' was worse among males (82.3%) and with advancing age. Association and improvement of diabetic status with specific treatment would tentatively suggest that Mycobacterium leprae lesions are not confined to skin alone but somehow also related to carbohydrate metabolism. A careful management of the chemical and latent diabetes may help in clinical management of leprosy too.

Sixty male patients of leprosy (mean age = 27.2+5.04 years) selected at random, were studied for gonadal involvement and therapeutic efficacy of two indigenous drugs. Of these 34 were married, with the mean duration of illness 4.17+3.27 years. Only those with lepromatous and dimorphous leprosy developed testicular and epididymal changes. Testicular pain and/or swelling (lepromatous =62.5%, dimorphous 30%) was the commonest presenting feature. Altered sexual function was observed in 34 (56.6%) cases, while 11 patients revealed altered sexual hair pattern and nine gynaeco-mastia. Reduced testicular size associated with soft feel was present in 25% of cases with no testicular sensation in 8 (13.3%) and impaired testicular sensation in 9 (15%) patients. Spermogram revealed azoospermia in 19 (35%) and oligospermia in 16 (26.6%) patients. Histopathological findings of testicle biopsy revealed evidence of leprous pathology irrespective of testicular size, semen picture and clinical manifestations. Histopatho-logical changes had shown marked variation and so did not enable categorising them into vascular, interstitial and obliterative phases. These changes were believed to be due to the altered gonadal state in leprosy. The therapeutic efficacy of the indigenous preparations, Speman and Tentex forte (Himalaya) was evaluated subjectively as well as objectively in 34 patients. 823% of cases showed subjective improvement while objective improvement in spermogram was noted in 87.5% cases with oligospermia. The drugs have no side effect and were well tolerated.