In knotted leprosy, red spots and sores break out upon the body, especially on the face, which becomes much swollen. These are not accompanied with pain, and often disappear again; but with a new attack of fever they re-appear, and at last become permanent. They now grow larger and larger—some of the knots attain the size of a hazel nut—and are generally of a yellow-brown colour, with occasionally a tint of blue. They are most frequent on the arms, hands, and face, but most of all about the eyebrows, which fall off in consequence. After a period of time—which is shorter or longer as the case may be—pain is felt in these knots, and they then either turn into regular sores, or become covered with a brown crust. The eyes, mouth, and throat are next attacked, and the eye-sight, breathing and swallowing are affected.
In smooth leprosy, the symptoms are large blisters and white spots, together with great pain and tenderness in various parts of the body. These vesicles are from the bigness of a hazel-nut to that of a hen’s egg, and are filled with a watery fluid. They are situated about the elbows and knees, occasionally under the sole of the foot, and elsewhere, and soon burst. The spots, which in the smooth leprosy occur on the body, are not brown, as in the knotted leprosy, but white, and of a larger size, sometimes being as big as a man’s hand; they are covered with white scales. The pain and tenderness which occur in this kind of leprosy gradually disappear, and are followed by utter absence of feeling. At this stage fire or the knife can be applied to the parts diseased without the patient feeling it in the least. A large portion of the body can be thus affected. The patient now begins to get thin, his skin is dry, and his countenance distorted. He can’t shut his eyes, and he is not able to bring his lips together, so as to cover the teeth; besides this, the toes and fingers become contracted and rot off.
Curiously enough symptoms of both these horrible phases of a most loathsome disorder occur in one and the same person; in that case the knotted leprosy occurs first, and the knots gradually vanishing, the smooth leprosy supervenes.
This frightful malady has been ascertained to be hereditary, that is to say, it can be transmitted by either parent to their offspring. At first the children seem to be quite healthy, but they conceal within their system the hidden germs of the complaint, which may at any time break out. Sometimes such children never do betray the presence of the poison, certain defective sanitary conditions being necessary for its development. But, notwithstanding, the disease may come out in the third generation. The most favourable circumstances for its development are an irregular way of life, defective clothing, bad lodging or diet, want of personal cleanliness, and mental anxiety. Under such circumstances, persons who have no hereditary tinge may take the complaint. It is not contagious in the strict sense of the word, but experience seems to show that persons who live in intercourse with leprous persons are very prone to become so themselves. A remarkable illustration of this occurred in Nord-Fjord. The owners of a gaard took the leprosy, and died. The farm was inherited by another family, who became infected with the disease, and died of it. A third family, who succeeded to the dwelling, also perished of the malady. On this, the owner of the house burnt it down.
The Government authorities finally recommend, as a means of getting rid of this dreadful disease, personal and household cleanliness, proper apparel and lodging, wholesome diet (especially abstinence from half-rotten fish), moderation, particularly in the consumption of spirituous liquors; and, above all, they deprecate intermarriage among those so affected. The present number of lepers in Norway is two thousand and fifty odd, or about one in every seven thousand.
But to proceed with our walk through the hospital. In another ward set apart for males, I addressed a lump of what did not look like humanity, and asked how old he was. The answer was sixteen. He looked sixty. His voice—oh heavens! to think that the human voice divine could have become degraded to that hoarse grating, snuffling sound, the dry husk of what it ought to be!
Close by this case was a man whose face was swollen immensely, and over the brows huge knots and folds of a dark tint congregated together. His face looked more like a knotted clump in the bole of a tree than a human countenance. Sitting on a bed in another room was a boy whose face was literally eaten through and through, and honeycombed as if by malignant cancer. Nobody can witness all this without realizing to himself more completely the power of Him who could cure it with a mere touch.
Crossing the passage, I saw a nice, pretty little girl playing about.
“She is all right at present,” said the doctor, “but both her sisters showed it at her age, and her parents died of it. She is here to be taken care of.”
On the women’s side, one of the first cases that caught my attention was an old woman with the septum of the nose gone, and groaning with intense agony. Near her was a woman whose toes and fingers had disappeared, and for the present the complaint was quiescent. Indeed, one of the not least frightful symptoms of the disease is, that after a toe or finger is gone the sore heals up, but suddenly breaks out afresh higher up the limb. Unlike a person in an adjoining bed, who shrieked out for fear she should be touched—so sensitive was her flesh—this poor thing had lost all sense of feeling. When I touched her, at the doctor’s request, she could feel nothing.