Leuce is a change of the skin to a white colour, occasioned by a viscid and glutinous phlegm. Since all the kinds of leuce are not curable, you may form a diagnosis of it in this manner. Pierce the leuce superficially, not deeper than the skin, with a needle, and if blood flow, the complaint may be cured; but if a milky moisture be discharged, it is incurable. Or, rub it with a rough woollen rag, and if the part become red, the complaint may be cured; but if it remain of the same colour, it cannot be cured. And those kinds which attack a great part of the body are to be supposed more difficult to cure than those which are confined to a small space, and old cases than recent. Some, therefore, in leuce, have approved of burning by iron, consisting simply of the application of heat. Others, dreading the pain of burning, and the scar arising from it, as being no less unseemly than leuce itself, have had recourse to escharotic medicines, such as they say will produce a scar of the natural colour. Others rejecting all these things on account of the difficulty of their application, have used dyes (paying more consideration to the deception than the utility which they produce,) which are, of all others, the most to be rejected, owing to the speedy renewal of the affection. We must use, then, the under-mentioned remedial powers: Of adarce, of rosemary seed, of sulphur vivum, of each, equal parts; bruise and strain singly, and then, having triturated together for a sufficient number of days, anoint in the sun, but not in great quantity, lest the skin be ulcerated; and, after some time, a little hellebore and galls may be added in like manner.—Another: Macerate the tops of the black fig in vinegar, and having triturated, mix equal parts of aphronitrum, sulphur vivum, and the fruit of tamarisk, and having rubbed natron into the part, anoint and expose to the sun, taking care lest an ulcer be produced. But Archigenes having mixed a sufficiency of quicklime with fig-leaves, used them in like manner: or, he says, having rubbed the leuce with white hellebore until the part perspire and become of the same colour as the rest of the body, anoint with sinopis or melian earth; or, having perforated them with needles until they bleed, anoint with sinopis in vinegar; or, having first rubbed them as formerly said, anoint with the fresh juice of figs, or rub in so much with the leaves of it.
Commentary. In [the second Section] we have stated so fully the nature of the leuce, and the difference between it and its cognate affections, that it will be unnecessary for us now to resume the subject. It is there mentioned that leuce is Celsus’ third species of vitiligo, and the baras of all the Arabian translators, with the exception of Stephanus Antiochensis, the translator of Haly Abbas, who applies the term lepra to it. It was therefore the white species of leprosy. All the medical authorities represent it as an intractable disease, not only the cuticle being altered in structure, but also the flesh below, and even the hairs, having undergone a change of colour. All direct us to prick the skin with a needle, and, if it bleed, the cure is to be attempted; but if a slight colourless fluid issue from it, the case is to be abandoned as hopeless. They consider it as arising from debility of the assimilative faculty of the part which can no longer convert the nutritive juices into their proper consistence. All recommend nearly the same treatment. The diet is to be regulated with a strict abstinence from gross food; if there be plethora, venesection is to be premised; then drastic purgatives and emetics are to be given, and the parts affected are to be rubbed with stimulant and caustic applications, containing hellebore, nitre, sulphur, misy, red arsenic, &c., or even the actual cautery may be applied. In short, all treat the disease in nearly the same manner as our author. (See in particular Serapion and Avicenna.)
Aristotle, we believe, is the first Greek writer who makes mention of leuce. He calls it a disease in which all the hairs of the body turn white. (Hist. Nat. iii, 11.)
“The snow-white leprosy” of the ancient Jews was the leuce of the Greeks. Moses describes very correctly the method of distinguishing it from the alphos and melas; (Leviticus, c. xiii.) The symptoms of leuce are given in the 3d verse; of the alphos in the 4th; of the melas in the 6th. He calls it contagious, which might lead us to suspect that elephantiasis was mixed up with the leprosy of the Jews. This opinion is further confirmed from what is mentioned by Josephus of its being said that his countrymen were driven out of Egypt because they were affected with leprosy. (See also Justin. xxxvi, 20, and Tacit. Hist. v, 3.) Now we know that elephantiasis was endemial in that country. (See chap. i.) The English translation of this chapter is very inaccurate, the translators having evidently failed to recognize the nice distinction between cognate diseases, laid down by the Jewish legislator.
Leuce is still common in tropical climates. Negroes affected with it are called Albinos. It is merely an aggravated variety of the Lepra vulgaris.
SECT. VI.—ON WHITE AND BLACK ALPHI.
The formation of alphos is similar to that of leuce, but the latter produces a deep change of the skin, so that the hairs grow of a similar colour, whilst the alphi affect the skin superficially, except that when continued, they extend more deeply, so that the hairs grow white, owing to the humour which causes it. From the pituitous humour then they are produced white, but black from the melancholic. Wherefore, a common application for both is washed lime dissolved in water, or, the root of dracunculus applied with vinegar; in like manner, either species of hellebore, the decoction of bitter lupines poured on the part, and their flour when applied as a cataplasm with vinegar or oxymel, the bark of the root of capers with vinegar, the root of lily with honey, onions with vinegar rubbed into the part in the sun, the dung of the land crocodile, and in like manner, that of starlings, when they are fed solely upon rice, and the burnt shells of the cuttle-fish. The following is a compound application: of alcyonium, of natron, of each, oz. ij; of white hellebore, of sulphur vivum, of each, oz. j; and some also add the burnt lees of wine.—Another: Of sulphur vivum, of the spuma nitri, of each, dr. iv; rosemary seeds, vij; triturate with vinegar. But rub only the part affected with alphos, not touching the unaffected parts, and when dry, wash with cold water.—Another: Of the flour of lupines, of buccina, and natron, of each, a chænix; of white hellebore, dr. viij; rub with it in a dry state.—Another: Of the flour of bitter vetches, lb. ij; of the seeds of rocket, of bitter almonds, of the root of the wild cucumber, of each, lb. j; triturate with wine and honey and anoint, and after an interval of an hour wipe it away with a sponge. It applies also for freckles, warts, and other spots on the skin.
A tried remedy for white alphos: of sulphur vivum, ii sextarii, of quicklime whitened, oz. iv; five whites of eggs, of nard-oil and vinegar, a small quantity. The sulphur is first pounded, then we add to it the oil of nard, and again triturate; then the vinegar is poured in, and the mixture is again triturated. But the quicklime is to be washed separately, once, twice, and thrice, and then we add it to the sulphur with the white of the eggs and triturate; and we pour out the collected fluid; but leaving a small quantity so that the ointment may admit of anointing, we use it thus.—Another tried remedy: Take sulphur vivum, dried fig leaves, aphronitrum, alcyonium, Cimolian earth, and myrtle, use with vinegar.—Another of Archigenes: Rub in equal parts of fig leaves dried in the shade, of sulphur, and of alum with vinegar, or of fig leaves, dr. iv; of nitre, dr. ij; of burnt alcyonium, dr. ij; anoint with vinegar in the bath. But red arsenic with one half of sulphur is excellent for removing the black alphos; thus having cleansed the part with natron, anoint with it in the sun. For white alphos: of copperas, of verdigris equal parts, of natron the double, rub without fat: or, of rosemary seeds, of sulphur vivum, of adarce, equal parts; triturate with vinegar, rub, and anoint; but when it is dry, bathe by rubbing. This applies also to the white species.
Commentary. We have again to refer the reader to the second chapter for an account of these complaints, and an exposition of the differences between them and the affections to which they are allied. It will be seen that they are varieties of the genus vitiligo of Celsus, and that they bear a near resemblance to leuce, from which they are chiefly distinguished as being mere superficial affections of the skin. The Arabians treat of them under the names of morphea alba and nigra. Dr. Willan makes them to be varieties of lepra, in which opinion we fully coincide with him.
The description of the two diseases by Actuarius is so precise that we shall give it in lieu of all the others. The alphi, he says, are superficial, but sometimes extend in depth, so that the hairs appear of the same colour. The white species is tried as to the depth it has spread, by being pricked moderately with a needle; when blood flows though the needle has only penetrated the skin, the disease is curable, but if the discharge be milky it is incurable, inasmuch as the flesh is converted into the disease. Others, he adds, rub the part with rough towels, and if it become red they have good hopes, but if it remain of the same colour they abandon all hopes of recovery. They are of a more aggravated nature when they affect different parts of the body and are inveterate. The alphi, he says, are generally milder than leuce, and can be cured by gentler means, but when they become inveterate they require similar treatment. The difference between the white and the black alphos is produced by the colour of the prevailing humour.