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January 22, 1944


Author Affiliations

Kalaupapa, Molokai, T. H. Medical Director.

JAMA. 1944;124(4):256. doi:10.1001/jama.1944.02850040056024

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To the Editor:—  Careful reading of a recent article by Frazier (Leprosy, Epidemiology and Natural History, The Journal, Oct. 23, 1943, p. 466) leaves me a bit bewildered. Why was it written? For the worker in leprosy who is familiar with the literature it contains nothing new, although some points are controversial, such as his statements regarding transmission. If it is for the general practitioner or dermatologist who may see an occasional case of leprosy, it is dangerous. Here are my reasons:The section on natural history is true for the most part but ignores the accepted classification which is the basis for diagnosis, study and prognosis (The Cairo Congress, Report of the Subcommittee on Classification, Internat. J. Lep.6:389 [July-Sept.] 1938). One might think from Frazier's discussion that lesions may shift from tuberculoid to lepromatous and back to simple neural. This simply does not happen or, if it

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