Scheme for obtaining a better knowledge of the endemic skin diseases of India / prepared by Tilbury Fox and T. Farquhar.

  • William Tilbury Fox
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Scheme for obtaining a better knowledge of the endemic skin diseases of India / prepared by Tilbury Fox and T. Farquhar. 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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    LEPROSY, OR ELEPHANTIASIS GR^CORUM. /-I The Report on Leprosy issued by the Royal College of Physicians, and compiled from answers received from all parts of the world, has made us more perfectly acquainted than we hitherto were with the characters, the course, and the varieties of leprosy; and it has confirmed the prevailing opinion that leprosy exists in two principal forms, the tubercular and the ansesthetic, and that these are the same all over the world, with the exception that the one prevails more plentifully in one than another district. The pathology of the disease is fairly understood. The accompanying figures, Plate VI., illustrate the features of leprosy. Fig. 1 is an eastern picture of a leper. Fig. 2 represents the face of a native of Jamaica, with well-marked tubercular leprosy. The illustration was sent to me by Dr. Izett Anderson of that place. In the disease a granulation tissue is found deposited in the integuments and in the fibrous textures, and about the nerves and at times the nervous centres : more plentifully, and particularly in the nerve structures of the body in the anaesthetic, and in the skin and mucous surfaces in the tubercular form, a circumstance that sufficiently explains the peculiarities of the two forms. Neumann has given an excellent illustration of the minute characters of a leprous papule. We give his figure, for the use of which we have to thank Dr. Puller. Neumann found the papillary body elevated, the cutis thickened, the normal tissue replaced by minute cells, slightly expanded by acetic acid; so that in some parts there only remained a slight amount of normal tissue. The fat goes. At first it seems there are colloid cells in the corium., then aggregated colloid globules, and then the small cells infiltrate the whole cutis. Many ob- servers believe the new growth begins about the hair follicles, and take the form of strands. There is a con- tinual production of small rounded cells, between which the intercellular substance becomes gradually more scanty, so that between the cells (arranged in groups and rows) are seen only narrow strands, of some- what striped substance, the nuclei of which are rendered opaque by acetic acid. In fact the cell growths in- vade the fibrous textures gradually to more or less defacement of them. But the cause of leprosy is as obscure as ever, and upon this particular matter the Leprosy Report gives us very little satisfactory explanation, beyond illustrations of the general statement that leprosy disappears pari passu with an improvement in the hygienic condition and diet of a people, and the cultivation of land in districts where it has abounded. It is especially with a view of seeking information and promoting the collection of facts, touching the immediate cause of leprosy, that the following observations are offered. We have enjoyed unusual opportunities of seeing leprosy in its native haunts, and also have had many cases under our care in this country, and have paid no little special attention to the disease, so that we speak from a practical acquaintance with the disease and its surroundings. Now in estimating the cause of leprosy we must be very careful to distinguish between its production and its propagation. This distinction is a vitally important one, for we may have leprosy merely propagated, and that extensively, in certain districts and under conditions, whilst we attempt to seek for its origination in the action of some malarial poison, or some peculiarity in the food of the people, or something outside the individual, and are so led completely astray and to wrong inferences. We might, in discussing for example the explanation of the cause of V c' 1 I a. is the epidermis and rete. b. cutis with cell infiltration, c. groups of colliod granules, c'. colloid globules, cl. disorganised and dilated sebaceous glands with accumulated contents, e. coiled hair follicle with atrophic hair. /. g. sinuous connective tissue strains, formerly hair follicles (?).
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