Report on the parangi disease of Ceylon / prepared by W.R. Kinsey ; ordered by His Excellency the Governor to be printed.

  • Kynsey, William Raymond.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Report on the parangi disease of Ceylon / prepared by W.R. Kinsey ; ordered by His Excellency the Governor to be printed. 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.

    12/88 (page 12)
    PARANGI DISEASE. Introduction to Report. Dada parangi (qqzd&SS) Geta paraugi (<&lQz>6s3(8) Aramana-wana parangi (^pt3Ss30s3C3 Give the past and present history of the case. Mode of onset and period of incuba- tion. Constitutional symptoms. Investigate the subjective symp- toms. Examine all parts of the body where any eruption is pre- sent. Observe the ex- act locality affected, and distribution of eruption. Separate the erup- tion into its compo- nent parts, distin- guish the essential from the superadd- ed. Termination of eruption. Description of the ulcers General conditio Of skin. Determine the '.issues involved. The varieties are,— Alu parangi (efb^desiS) Odi parangi («)e3o(5ed<S) Goni parangi (s*e>J*S j<5&3&) Kushta parangi (agtsdodeiS) Besides these there are several terms in use amongst the people and vedaralas, such as Dumas (g®~), a disease of the feet, Pinasroge (Saadtetftecsf), Etapalaroge (^iS^^a^dJ^cd), and Panukewilla often us^d for the after-effects of Parangi, which it is very desirable to have accurately defined and described. It is evident from the descriptions given of the disease, especially by the native vedaralas, that several probably distinct affections have been included under the term, and, as regards its nature, that it is supposed to be either syphilitic, a form of Leprosy or Lupus, or a disease sui generis. In paragraph V. will be found a few remarks on the three named diseases which may be useful in arriving at an opinion, but it is to be distinctly understood that the object specially aimed at by this enquiry is a collection of facts from the different districts of the Island where the disease prevails. III.—Instructions for the Systematic Investigation of the Disease. 1. Obtain a history of the case, and note the present condition of the patient as regards general health, diathesis, temperament, age, sex, race, occupation or mode of life, past history of patient, and of eruption. 2. Ascertain the mode of onset of the disease, the duration of the latent or incubative stage, if there is any, the early constitutional symptoms, and if they precede, accompany, or follow the eruption. Can the symptoms of the disease be divided into distinct stages ? If so, the duration of each, and total duration of the disease. 3. Subjective symptoms. Note if there is any itching, burning or tingling sensation com- plained of, and observe any marks of scratching which may be present, and if it is auto-inoculable. 4. Carefully examine every part of the body where there is any eruption; note the order in which the several parts became affected, and if pievious to the appearance of the eruption there was any scratch, sore or abrasion, or if the skin was unbroken. The condition of each patch of eruption should be noted at the time of making the examination. Observe if the eruptions follow the course of any particular nerve, if the area of the disease is diffused or circumscribed, and if there is any marked difference in the t.ize of the patches of eruption. Describe the shape or form of the patches. Ascertain the earliest appearance of the eruption as described by the patient or actually observed by yourself, its progress, and if there is only one single evolution, or if it comes out in successive crops. For minute examination select those portions of the skin where the disease is least complicated, and compare the sound portions of the skin with the diseased. Distinguish what is essential in the eruption from that which is non-essential or accidental; whatbelongs to the original affection from what has been superadded.* Did the eruption originate from contagion or spontaneously ? 5. Describe the ulcers which form after the appearance of the eruption. Their most frequent situation, and number, size, consistence, colour, shape, secretion or discharge (if any), crust, and the surface after its removal, and whether the exposed part is sensitive or not, if elevated or depressed in relation to the surrounding parts, its edges, areola if any, and the progress of the sore from the first'to its healed condition. If the crust falls off, is it replaced ? If you find ulcers upon any part of the body originating independently of the eruption, describe them. 6. Describe the general condition of the skin. Is the eruption preceded, accompanied, or followed by any peculiar state of the cuticular surface of the body ? Is it unusually dry or moist? Examine the mucous membrane of the mouth and throat. 7. Determine as early as possible the original anatomical seat of the disease and then the extent to which the neighbouring tissues are involved; note, if possible, the exact extent to which each element of the skin is affected, and whether the disease is confined to the cuticle, true skin, hairs, sebaceous glands, follicles, or to alterations in the pigmentary layer only, or if all are involved in the disease— t (a) Condition of epidermis, (d) Beard and hair. (b) Follicles. (e) Colour—any divergence from the (c) True skin. normal. * Modifications in skin diseases are brought about by remedies, diathesis, chronicity, scratching, abortive development, aud by the intermingling or co-existence of two or more different diseases (Fox), to which may be added food and climate. t (a) The epidermis may be rough, dry, scaly or thickened by the accumulation of ephithelium as in Psoriasis, abnormally thin or transparent, or the outer layer may be raised by the formation of vesicles or pustules. (b) The orifices of the follicles may be plugged with sebum as in comedones, or may pour out an abnormal quantity of oily matter ; papules may be present formed from the hair follicles or by enlargement of papillas of skin. (c) The true skin may be infiltrated, which is ascertained better by sense of touch than by sight. (d) The beard and hair may be either removed too easily or too brittle; force required for removal should be note I, and an examination under microscope made of shaft and root with and without Liq. Potassa;. (e) Colour. Any divergence from the normal may be due to altered degree of vascularity, hemor- rhage, irregular pigmentation, jaundice. [56]