Tubercle 64 (1983) 43-56

0 Longman Group Ltd.

LEPROSY REVIEW

THE BACTERIOLOGY OF MYCOBACTERIUM LEPRAE

Philip Draper
National Institute for Medical Research, Mill Hill, London NW7 IAA. England.

Introduction
The study of the bacteriology of Mycobacterium leprae, ‘Hansen’s Bacillus’, made an auspicious
start. The discovery of the bacterium in about 1873 [I ] (the exact date is uncertain since the
report was not published at once[2]) by Armauer Hansen preceded the discovery of the
tubercle bacillus by a decade; indeed M. leprae appears to have been the first human patho-
genic bacterium to be identified. The discovery was made in a country with a developed
medical service, and was part of a general investigation of a serious epidemic which led to a
full description of the clinical and pathological aspects of leprosy and to the recognition that
it is an infectious disease.
Unfortunately, apart from descriptions of the bacteria found in leprosy lesions as observed
under the light microscope, knowledge of the putative cause of the disease made little further
progress until the middle of the present century and is even now absurdly inadequate. The
reason is that no organism bearing a close pathological, immunological or chemical resem-
blance to Hansen’s Bacillus has ever been cultivated on an artificial medium. M. leprae seems
to survive but not to multiply significantly in tissue culture (see below) ; no animal infection
was convincingly demonstrated until 1965 and no infection capable of producing enough
bacteria for biochemical study was available until a century after the original discovery of the
organism.
Since human inventiveness is not inhibited by lack of facts, various alternative theories
to the simple one, that Hansen’s bacillus causes leprosy, have been devised. Of these the only
theories that concern the present review are those that claim that types of micro-organism
with properties different from those of Hansen’s bacillus are the cause of leprosy. There
have been many reports of successful cultivation of organisms from leprosy tissues. The bac-
teria isolated may be classified into two main categories : mycobacteria related to M. scrofula-
ceum and ‘coryneform’ bacteria for which the name ‘leprosy-derived cotynebacteria’ (LDC)
is commonly used. These two groups will be discussed below. The convention is here adopted
that the formal name Mycobacterium leprae refers to Hansen’s bacillus as originally described
by Hansen and as characterized in the 8th edition of Bergey’s Manual of Determinative
Bacteriology [3], and it specifically excludes the cultivable organisms referred to above.
The bulk of the review will be concerned with the bacteriological properties of M, leprae.

Morphology
Size and shape
The description of the bacterium in ‘Bergey’ forms a convenient starting point for a discussion
of M. leprae. It is a strongly acid-fast rod, 1 to 8 urn long and 0.3 urn in diameter, with parallel
sides and rounded ends. These dimensions are based on light microscopic measurements;