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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![■29 The earliest symptoms are the appearauces of “ yellow spots,” and insensibility of the skin to external stimuli. Thus melted loaf sugar accidentally dropped on the fingers without producing any sensation gave rise, in a young white female, to suspicion, which was shortly afterwards confirmed by leprosy manifesting itself more decidedly. The “ yellow spots ” alone do not necessarily constitute leprosy, or are followed by it. They must co-exist with a rough elevated or sv/ollen condition of the parts; and if anaesthesia be also j)resent, the diagnosis is the more certain. Generally the earliest indications are found in the elbows and knees; and I have always made it a point, when the facial signs admitted of a doubt, to examine those parts, and if the symptoms were present there at once to declare the nature of the disease. Dr. Goding. It occurs at any age between 10 and 40. I have known it as early as the seventh year. Spots of vitiligo on the arms and legs, and here and there on the body, first attract notice. They are of a dirty yellow or brown colour, scarcely sensible to the touch, but if j)inched are slightly painful and thicker than the surrounding skin. . . . The integuments of the ears, brows, and alte nasi, on careful manipulation, will also bo found slightly thickened. Then follow the tuberculated condition of the features, and the other changes already described. Joint evil does not, I believe, occur before pqberty, nor much after that j^eriod. The earliest symptoms are spots of ephelis on the face, arms, and legs, and hero and there about the body, insensible to the touch. There is a slight halt in the gait on one side, thinness of the hands from wasting of the muscles of the thumbs and little fingers, and of such as lie in the palms of the hands and between the metacarpal bones, and the thumb being forcibly drawn against the under finger ; there is no bulging up of the adductor pollicis between the metacarpal bone of the one and the other ; no power to comjiress the eyelids forcibly together, perhaps on one side only, with a slight opening between them; and on that side there is perhaps just a perceptible numbness of the skin, and weakness of action in the muscles. These synii)toms slowly and gradually increase, and then the third and second phalanges of the finger and the second of the thumbs become contracted, and ulcers appear around and under the nails, and the phalanges drop ofl', and the skin cicatrises. The progress of joint evil is slower than that of leprosy. Persons labouring under these disorders usually die of infiammatory or chronic affections of the lungs and air passages, or of diarrhoea and other abdominal diseases, attended always with typhoid symptoms. Dr. Youna. Early in life. The earliest symptoms in the tuberculous form are small disseminated tubercles in the face ; in the other form, white spots on the body, generally large, and caused by want of the usual pigmentary secretion. Of 42 inmates of the lazaretto, the disease commenced in 29 before 16 years of ao-e; in 7 between that age and 26, and in 6 between 31 and 54. Dr. Browne. About puberty. The earliest symptoms are those already mentioned. To these I may add an alteration in the voice, a sort of snuffling, and very frequently (particularly in the worst cases) a numbness along the course of the ulnar nerve, with a slight discolouration and swelling of one or two fingers. Dr. Stevenson. 3. When the disease is hereditary it usually manifests itself at an early age, and runs its course before the adult period ; but when it appears at a more advanced peri(;d, it usually terminates ill death about the age of 50; occasionally, but rarely, it commenres at a stiil later period of life. JJr. Carrington. It generally attains its full development about the age of puberty. Persons so adected usually die about 35 or 40 years of age. J/r. Rogers. It is not unfrequently very slow in its progress, and is often for a long time unrecoo-uized either by patient or friends. Gradually developing itself, the patient may live for inanv years, nay even to old age. ]Jr. Clarke. The periods of its full development, and also its duration, vary very much. A person may live for many years, for 10 or 15 or more years, with leprosy, before it [iroves fatal, ivlnfe others will succumb quickly. It is not, l.owever, a disease that generally kills (|uickly. Dr. Goding. If the disease appears before puberty, it will be a year or two before it is fully develo|>ed, and from six to ten years, or even longer, before it ]iroves fatal. Occurring after ])ubertv, its development and fatal termination will be shorter and shorter as the jiatients advance in years. In joint evil life is protracted longer than under le})rosy. Dr. Youwi. 3. Judging from the cases admitted into the lazaretto, the time of its full development appears to be at pubeitv or a little after. Of 17 deaths in the lazaret, five occurred bemre](https://iiif.wellcomecollection.org/image/b24992069_0113.jp2/full/800%2C/0/default.jpg)
