A report on leprosy of the air-passages in Europe / by Sir Morell Mackenzie.

  • Mackenzie, Sir Morell, 1837-1892.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: A report on leprosy of the air-passages in Europe / by Sir Morell Mackenzie. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the principal changes observed in these parts, and the present account will be little more than an amplification of the details there given. I am not aware that the throat is ever affected in the macular variety of the disease, nor does this complication occur, as a rule, in the purely anaesthetic form. Hansen has, however, described a case in which there were redness and swelling of the whole throat and upper air-passages coinciding with an acute eruptive affection of the skin; the attack was of a merely temporary nature, but some roughness of voice remained.1 In tubercular leprosy, on the other hand, it is probable that the throat is attacked, sooner or later, in nearly all cases. As already said, the throat affection is invariably secondary to the skin complaint. It usually occurs at a compara- tively advanced stage of the disease, though occasionally it may come on, as in a case observed by myself in Seville, almost at the beginning. The voice becomes hoarse or nasal, then shrill, gradually losing resonance, till it is altogether lost, and the patient can only speak in a faint whisper. Breathing through the nose becomes diffi- cult, and as the laryngeal orifice becomes more and more obstructed a certain degree of dyspncea is felt, but the narrowing process is so gradual that the symptom rarely becomes urgent. It is in com- paratively few instances that tracheotomy is required, though the breath-passage may be found after death reduced so much as hardly to admit a straw.2 I was informed by Dr. Kaurin, of Molde, however, that in his experience rapid oedema of the glottis is not very uncommon, the patient dying of suffocation if help be not imme- diately at hand. The progress of the disease within the throat is rather less chronic than that of the cutaneous affection, ulceration occur- ring more readily, and the tuberculous infiltration taking place some- what less slowly. In the throat, however, as in the skin, the com- plaint progresses by fits and starts, as it were, the exacerbations 1 Nordiskt Medicinskt Arkiv., vol. ii., No. 16, 1870. - One of the specimens shown to me by Dr. Danielssen literally answered the above description. See also his work already referred to, p. 400. D
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