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
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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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    one who has beeu thoroughly cured in whom the treatment, has removed every vestige of the eruption. Although the eruption is loathsome, extensive, and troublesome, it has very little effect upon the general health ; except of course in those cases in which it is exceptionally severe or where it has existed for a considerable period. There are a great many who in their childhood or youth, suffered from the disease, and still lived to a ripe old age. The disease certainly does not interfere with the ordinary course of pregnancy. Miscarriages and still-births are rare among the people. 1 have had under treatment some women gone as far as seven months pregnant, who were literally covered with the eruption, bat 1 have never seen a miscarriage among them. In two cases of Parangi I practised vaccination with the result of inducing genuine cow-pox in both instances, and in one case a slightly marked amelioration of the symptoms. The vesicles ran the usual course, yielded clear lymph and healed perfectly. I did not feel justified in using the lymph so obtained, or the question whether vaccination can com- municate the disease or no, might have been settled. Parangi does not appear to me to be in any way related to Syphilis. It is peculiarly a primary disease, and in all cases there has been an absence of the usual symptoms pointing to syphilitic infection. The appearance of the Parangi eruption is so like syphilitic rupia that the superficial observer would at once consider both diseases similar. Parangi is also in no way connected with Leprosy or Lupus. The two diseases Parangi most resembles are Ecthyma and Framboesia. It appears to differ from Ecthyma in its chronicity, in the eruption being tubercular rather than pustular, in the scab not being reproduced, in the resulting ulcer being generally healthy and quickly healed, and in the comparatively slight extent to which the system is affected. Parangi resembles Framboesia to a very great extent. I have never seen the latter disease, but the excellent descriptions of it in Drs. Tilbury Fox and Farquharson's book seem to me to give a fair idea of Parangi disease too. The eruption of Parangi is not exactly like that of Framboesia, but resembles it to a great extent, particularly the moist form de- scribed above. It appears to me that Parangi and Yaws are identical, and that the differences observed iu the two diseases may be the result of the differences in the climate and in the surroundings of the people. ' The treatment seems to be the same in both diseases. It has been the custom among the native doctors or vedaralas, for ages, to treat Parangi with mercury and with China root (Sm'dax china.) They use fumigation with vermillion very extensively for the drying up of the scabs, and after that they combine arsenic with vermillion in the fumigation. Mercury is always an important ingredient of the thousand and one specifics for this disease used by the natives. The treatment which has yielded the best result in hospital practice is calomel and opium given till the gums are touched, then suspended temporarily and resumed, and equal parts of citrine ointment and oil well rubbed in after a bath and after the removal of the scabs. I think iodide of potassium given with mercury lessens to a great extent the efficacy of the latter, proba- bly by causing its elimination before it has had time to exert its beneficial effects. I have used sulphur and cream of tartar in some instances, but I have not been able to trace any good effects of them. The combination seems to do children some good by acting as a slight laxative and alterative. As a local application I have frequently used solid nitrate of silver, particularly in those obstinate aud painful eruptions occurring on the sole of the foot. When the ulcers resulting from the eruptions are slow to heal, I have obtained good results from the local application of cod-liver oil. As I have stated elsewhere, the disease is perfectly amenable to treatment. The dura- tion varies to a great extent—from two months to as many years. It usually runs a chronic eourse. The moist form or the coudyloma-like form of eruption takes longer to cure than the rupia-like form. Regarding prophylactic measures, I am of opiuion, considering the highly contagious nature of the disease, that nothing short of perfect isolation of the sick can be effectual. The principle is recognised by the natives themselves, and they invariably make an attempt at enforcing it, but, as a rule, unsuccessfully, as the spread—uninterrupted spread—of the disease testifies I am not in a position to state the causation of the disease, but I have little doubt that the insanitary state of the dwellings, the miserable food, and the execrable water, do largely influence its prevalence and extension. The etiological significance of these circumstances must be my excuse for the somewhat lengthy introduction of this paper. There are some interesting and important points in connection with this disease, such as the communicability of the disease to the lower animals, and by vaccination, &c, which I have not been able to study as yet, but which I hope to make the subject of a future paper. PARANGI DISEASE. Appendix C. Report' of Mr. Garvin. [ 109 ]