Memoir on leprosy in Syria / by John Wortabet.

  • Wortabet, John, 1827-1908.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: Memoir on leprosy in Syria / by John Wortabet. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    6/28 (page 4)
    tacked. These changes are attended by fetid perspiration, chiefly of the hands and feet. It is difficult to believe that these earlier symptoms of the disease1 can usher it in without a considerable degree of constitutional dis- turbance. In his great concern as to the fearful consequences of his malady, the patient rarely speaks of it • but there is always more or less of general malaise, febrile flushes, disturbed dreams, a peculiar heaviness affecting the whole body, and depression of spirits. This latter phenomenon becomes ultimately a settled state of the mind; all active cheerfulness is lost, and the leper assumes a sad subdued mien through life. This state of mind is produced probably by moral as well as physical causes. The victim of an incurable and loathsome disease, shunned by his nearest relations, disabled from work and reduced to dependence if not absolute privation, his life becomes a burden heavy to be borne. I have known a case where this state of feeling became intolerable, and the poor man (who was in good circumstances) was so affected by the bearing of his wife and children that he put an untimely end to his life. Soon after the invasion of the disease, an eruption appears on the skin, limited to the forearms and hands, the legs and feet, and the face; very rarely, if ever, appearing elsewhere. Of this eruption we have two distinct forms, viz. tubercules and bulla; the former appear- ing on the face, forearms, legs and back of hands and feet; the latter on the extremities, chiefly their palmar and plantar surfaces. The tubercules are generally numerous, and rarely smaller than a pea. They rise from the skin, and like it are red and dusky in colour, and shining. During the course of the disease they become inflamed, crack, and discharge a thin sanious fluid; after which they heal and contract, others taking their place in different spots. The bulla appear in the form of large vesicles or vesicular blebs, are generally ovoid in form, and measure from three quarters of an inch to one or two inches in their diameter. They resemble so closely the blister of a scald that the patient often describes them as burns from too near an exposure to the fire, while the anaesthesia of the parts failed to give him the needful warning. They soon break and discharge at first a thin lymphy fluid, and leave an ulcer which penetrates deeply into the integument, and often exposes the tendons of the muscles. The vesicle is thus converted into a deep, red ulcer which discharges fetid pus. When the ulcers are many, or the patient is not cleanly in his habits, the odour becomes intolerable. They generally heal, leaving often a well marked white cicatrix. The tubercules and O 1 The earliest symptoms of the disease are stated by El Kamory, an ancient Arabian author, as follows“ Congested appearance of the eyes, duskiness of the skin, huskiness of the voice, fetid perspiration, puffiness of the face, with ulcera- tion and increased redness, and gradual loss of the hair of the eyebrows.”