Report on leprosy by the Royal College of Physicians, prepared for Her Majesty's Secretary of State for the Colonies; with an appendix.
- Royal College of Physicians of London ; Great Britain. Colonial Office.
- Date:
- [1867]
Licence: Public Domain Mark
Credit: Report on leprosy by the Royal College of Physicians, prepared for Her Majesty's Secretary of State for the Colonies; with an appendix. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![cramped and bent; then the nails began to fall off, first from the hands then from the feet. Soon tubercles appeared on his face and on the lobes of his ears ; his features became changed from caries of the bones and consequent failing in of the nose; .distressing ozsena has existed for some time. Several of the end joints of his fingers and toes have fallen off, leaving open sores ; he has large sores on liis knuckles, also on his elbows and knees; he has no feeling in his arms from the elbows, nor in his legs from the knees ; he has felt no wish for sexual intercourse for two years ; ho had syphilis in 1847, out does not attribute the leprosy to it in any way; he can bear no heat of the sun, and during the day is continually pouring cold water over himself; his eyesight is very bad ; he does not sleep well, and has very little appetite. Meerut.—-'TliQ age for development of the disease varies greatly, but I have not myself seen any case in which it occurred before adolescence, say 16 years of age. The invariable symptom first complained of by patients labouring under this dis- ease is the loss of sensation in the skin. This condition they call sun (senseless). (Z?r. Wylie.') Dehra.—The patient’s chief complaint at the onset of the disease is of general uneasiness ; a feeling as of small insects creeping over his skin, and complete or partial anaesthesia of the parts affected ; and the skin wears a rough appearance, and is often shiny. Sreenuggur.—The disease generally manifests itself after puberty. The earliest symptons observable are a feeling of langour, lassitude, and indisposition by the patient to any exertion ; depression of spirits; a sensation that worms are creeping over the difierent parts of the body, and of burning in the palms of tlie hands and soles of the feet. Formication and burning of the palms of the hands and soles of the feet are the earliest symptoms, and in many cases harass the patients for a considerable time before the true nature of the disease becomes manifest. Tiiese latter two symptoms are very prominent in the anaesthetic form and slight in the tubercular. Numbness of the fingers and a sensation of coldness in the extremities, when the disease has made some progress, are often complained of. Blozufferuuggvr.—Tubercular leprosy commences with inflammatory or febrile sym])toms, and affects chiefly the face, hands, and feet. At first there is general swelling in the part, accompanied by spots of discolouration or dark shining patches, whicii are followed by more or less tubercular thickening of the shin. As the swelling subsides the part becomes studded with small permanent nodules, seen mostly in greatest number on the aim of the nose, the external ears, and the extreme phalanges of the fingers or toes ; after a time the cuticle dries or hardens, and cracks into scales, which in places fall off’, leaving the part tender or perhaps covered with excoriations. The nervous sensibility is heightened at the onset, but subsequently diminished. In the anassthetic form of the disease, the prevailing symptoms are often obscure, though there is sometimes noticed a degree of constitutional irritability, followed by a glossiness or redness of the surface and other indications of increased vascular action. In many instances, however, it appears difficult to fix on any precise time at which the. disease may be said to liave first made its appearance. No pustules or tubercles form on the }>art, l)ut as the irritability and redness subside the cuticle cracks into small bran-like scales, Avhich soon desquamate, and leave the skin hard, rough, and fissured. Interrogatory HI. Benares.—.This varies according to the form of leprosy. Tlie disease is developed in the first and second forms in from three to eight years, and proves fatal in from twelve to thirty years ; the third form, or whitening of the skin, is not a fatal disease. (Z?r. Bunbar.) Goruchpore.—The disease, usually commencing about middle age, goes on increasing, and I believe usually proves fatal towards the natural decline of life,—about the age of 50. In some cases it is much more rapid ; and in others I have known it has gone on for 20 years and more, making almost imperceptible progress. There is now a man in the Dispensary Hospital, about 50 years, who has had leprosy for 20 years; the greater part of both feet have fallen off, and his hands and fingers contracLed and more or less covered Vv^itli v/hite cicatrices. The disease has not advanced for five years ; and I have lately extracted cataract from one of his eyes, and the wound in the cornea healed rapidly and well. Caivnpore.—It is very seldom in itself attended by fatal results, but it commonly induces a predisposition to other diseases, such as dysentery, diarrhoea, low fevers,](https://iiif.wellcomecollection.org/image/b24992069_0240.jp2/full/800%2C/0/default.jpg)
