Leprosy is a disease that has been known from the earliest ages, and has prevailed among all races and in all climes. At present it is most widespread in countries lying both to the north and to the south of the temperate zone and the among the less enlightened people of the earth.
To a limited extent, however, it is met with in Europe and the United States.
The disease manifests itself in three chief forms or phases of development, known as the macular, tubercular, anaesthetic. The first is characterized by the development of brownish discolorations of varying size and number. These, after an existence of months or years, may lose their heightened color and become pigmentless, and the cutaneous nerves in the affected parts lose their sensibility. The tubercular form is characterized by the development of tubercles upon various parts of the body. These exhibit a slightly heightened color, becoming later somewhat copper-colored, and affect a preference for the face, especially just above the eyebrows and upon the nose and ears, but may, and usually do, appear upon the extremities. In the anaesthetic form, bullae, usually solitary, develop upon various parts of the integument. They persist for a short time only and leave behind them discolorations, which in time may become whitened and anaesthetic. In this form of the disease there is grave implication of the principal nerve-trunks of the extremities. This is notably the case with the ulnar nerve, which, in cases moderately advanced, may be readily perceived as a thickened cord just above the head of the bone whose name it bears. In this form, especially, pain in the extremities is a more or less prominent feature. Connected with the development of the disease, anaesthesia of theintegument, chiefly of the extremities, becomes a prominent feature. The gradual destruction of the ulnar nerve leads to impairment of its functions and atrophy of the more distant parts to which it is distributed. This atrophic action is most distinctly manifested in the fingers and toes. Fissures occur in the integument and absorption of the phalanges takes place and leads to loss of these parts. The separation usually occurs at some point between the joints rather than at the joints themselves. A continuance of the morbid action may result in loss of all the phalanges, and even of some of the metacarpal and metatarsal bones. Leprosy is essentially a chronic disease. Before the appearance of cutaneous or nervous lesions there usually exists a prodromal period of several years" duration, without definite symptoms other than impairment of the general vigor. During this period it is hardly possible to make a diagnosis of the impending trouble. After the disease, however, is fully developed, ten, fifteen, or twenty years may pass before the fatal termination. leprosy is a chronic disease, caused by Mycobacterium leprae, that affects the skin, mucous membrane and nerves. It is contagious disease, endemic (recurring in a locality) in warmer climates and is transmitted by direct contact. After an incubation period of 1-30 years, symptoms develop gradually and mainly involve the skin and nerves. Granuloma is formed in the nerves; this is called lepra reaction, with thickening of the skin and nerve. In some serious cases, there is numbness of the affected skin, weakness of the muscles and paralysis leading to disfigurement and deformity of various joints. In leprosy, the affected skin becomes scaly and does not show any sensation of needle pricking.
Treatment : Good food and good hygienic surroundings are of the first importance in the treatment of leprosy. Strychnine and chaulmoogra-oil are highly recommended by the old school.
They claim that with these four means at command the majority of cases of leprosy can be greatly benefited. They give the drugs in full doses, the oil being applied externally as well as internally.
Surgeon-major Peters gives as the result of two years' experience at a leper asylum in India, with twenty-nine cases, improvement in all the cases by the following plan : The patients had to rub the body for two hours early in the morning with Carbolic oil, 1 to 40; then bathe in warm soap and water. Afterwards an emulsion composed of Gurgium oil and lime water was rubbed into the affected parts only, any ulcerations being filled with cotton smeared with the same. Under this treatment the ulcers healed rapidly, while the anaesthetic parts and nodules remained unimproved.Use hydrocotyle Q
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