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.

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    3rd Case.—Illustration No. 3 a & b. Mihintalai. Reported by A. Appavuplllal. Thalia; a male sucking infant of the Sinhalese dhoby class, aged two years. The child is a native of Thariapkulam village in Kananthara-korale. He was attacked on February last, and he looks robust and sound in health. This is the first attack. This is of the primary form, and is tubercular in character. He is the only offspring of the parents, who have had the disease in their infancy, but who were entirely free from any trace of it at the time ; the child became affected during conception. The child had simple itch ( hori, as the Sinhalese call it), which was treated in the ordinary way and cured. But two of the eruptions, one on the left toe, and the other at the inner aspect of the knee-joint, did not heal. Three weeks or so after these eruptions, and particularly the one in the toe, were observed, two eruptions came in the cheek and then others in other situations. There are none in the village affected with a similar disease. [Although the parents say that there were none in the village with a similar disease, I know of a certainty there were several in the village at the time the child was affected, whom I treated for Parangi.] They are unable to trace how the disease came in ; the child never suffered from any form of venereal disease, was never vaccinated ; the child lives entirely on its mother's milk (breast) ; rice is the principal fond of the people. No treatment in the way of medicines ' either internally or locally. History of the case :—The child is, as already noted, very healthy-looking and of bilious temperament. The mode of onset of the disease was as follows : - The child had pustular eruptions identical with itch all over the body, which healed under appropriate local treatment. Two of the eruptions, one in the left toe and the other in the right knee-joint, did not heal. The one in the toe enlarged more than the other, which was in the inner aspect of the knee-joint. The relatives of the child are unable to say which of the two preceded the other, since .they observed them (the eruptions) at about the same time, but could only guess that the sore in the left toe preceded. About twenty days after, two eruptions made their appearance in the cheek, one on either side ; no constitutional symptoms preceded, attended, or followed the progress of the eruptions. (a). The first stage varied greatly as the others did and do ; but taking the majority of eruptions, the first stage lasted a few days (from four to fifteen). (bj. The duration of the second stage is also indefinite. The earliest eruptions, including the original sores, have stood over three months and have not as yet healed, while those that birke out subsequently have some of them healed, and many more are in the course of healing. The disease is likely to stand some five or six months. The tubercles are attended with itching, and marks of scratch are to be found. Every part of the body is thickly covered with the eruptions except the head, part of the hands aud soles of the feet, where they are scanty ; the eruptions were observed first in the left toe and knee, as already noted, then in the face, then in the buttocks, scrotum, and about the arms. The patches are of various size and shape, formed by the coalescence of two or more papules or tubercles. Those in the nates and legs are much larger than those in the other localities. Some of them, as in the nates, are oval and elongated, a few circumscribed, while a good many are irregular-shaped. There are papules and tubercles of every size and stage, varying in size from that of a millet seed to that of a tubercle over half an inch in diameter. They commenced in small, round, solitary papules which were white, dry, smooth and glossy. In four or five days they began to enlarge and were attended with itching. There are more evolutions than one. The papules in the buttocks and back are of very recent date and belong to the sixth or the fifth crop, if it may be called so. Iu fact there is no order iu the succession of these crops of papules, and the eruptions heal at every stage of the disease. The earliest eruptions are much more enlarged than the succeeding crops, and stand much longer without healing. Those of the last crop fade off in the papular stage and seldom run to maturity. It is not easy to say how the eruptions originated, but, viewing the history of the case as it is, it may not be unlikely that the disease might have been brought by con- tagion either directly or through some medium. The existence of a mother sore previous to the appearance of the eruptions is evident. The eruptious are all alike in character and are decidedly tubercular. There are no ulcers in the literal sense of the word, but there are only tubercles of every shape and size. The largest of the tubercles have, as above noted, a long diameter of over half an inch. The clean surfaces of the tubercles are pale yellowish in colour, hard and indurated in consistence, much raised above the surrounding skin, and attended with a scanty lymphy exudation. They are covered with a very thin scale or crust which takes a long time to peel off. The removal of the scale does not materially diminish or alter [81 ] PARANGI DISEASE. Histories of Cases.