AUTHORS’ PREFACE.
As it is evident in the numerous recent publications on Leprosy that our first work on the disease, which was published in Norwegian, is unknown to many investigators, and as there appear in their publications many statements, to our thinking, premature and founded on insufficient knowledge, we think it desirable to present a comprehensive statement of the result of our studies of this disease, so interesting in itself and so instructive in other directions.
Since one of us has been for more than twenty years occupied in dealing with the disease, we hope to be able to lay before experts a thorough, complete and instructive demonstration, the more, as we do not base our views, as has been frequently and unfortunately done, on any single or scattered observations.
TRANSLATOR’S PREFACE.
In the translation of this little work I have, of course, made absolute accuracy of meaning my first aim. It presents the views of one who in his knowledge and experience of the disease is probably second to none. There are, of course, certain points on which there is much difference of opinion. For example, Hansen’s view, which is very widely held, of the position of the bacilli in the cells, is very strongly opposed by Unna. Then as to the occurrence of nodules on the palms and soles which Hansen denies, Unna remarks that it is quite exceptional, while Hillis seems to consider it by no means rare. The chapter on Treatment has been wholly re-written for this edition, and is practically a summary of the late Dr. Danielssen’s views. The photographs are a further addition to the original German edition. It has been pointed out to me that Dr. Hansen does not refer to the recent Indian Commission. His views on it may be found in the Lancet, of October, 1893.
In conclusion, I have to thank my friends, Dr. Colcott Fox for a general reading of the proofs, and Drs. George Mackay and Stockman for their revision of those parts relating to the affections of the eye and to the drugs used in treatment.
Norman Walker.
Edinburgh, May, 1895.
CONTENTS.
| [CHAPTER I.] | |
| PAGE | |
| Introduction and Nomenclature | [1] |
| [CHAPTER II.] | |
| Nodular Leprosy | [5] |
| Seat, [5]; Localisation, [5]; Affection of the Eyes, [8]; Affection of the Extremities, [10]; Affection of the Mucous Membrane, [11]; Affection of the Lymphatic Glands, [13]; Subcutaneous Nodules, [13]; Affection of Nerves in this Form, [14]; Fate of the Nodules, [15]; Commencement of the Disease, [16]; Duration of the Eruptions, [19]; Fate of the Patient, [19]; Combination with Tuberculosis, [22]; Comparison with that Disease, [23]; Affection of the Lungs, [26]; Cultivation of the Bacilli, [27], Miliary Leprosy, [28]; Mental Symptoms, [29]. | |
| [CHAPTER III.] | |
| Structure of the Leproma | [31] |
| Movement of the Bacilli, [31]; Nature of the Cells, [32]; Nature of the Blood Vessels, [32]; Softening of the Nodule, [34]; “Brown Elements,” [34]; “Globi,” [35]; Position of the Bacilli in the Cells, [37]; Position of the Bacilli in the Blood Vessels, [38]; Effect of Measles, [40]; Digestion of the Bacilli by the Cells, [41]; Structure of the Bacilli, [41]; Bacilli in the Sweat Glands, [43]; Affection of the Testicle, [45]; Affection of the Liver, [47]; Affection of the Spleen, [47]; Affection of the Glands, [48]; Affection of the Nerves, [50]. | |
| [CHAPTER IV.] | |
| Lepra Maculo-Anæsthetica | [52] |
| Prodromal Stage, [53]; Development of Bullæ, [53]; The Macular Eruption, [54]; Symmetry, [55]; Neuritis, [56]; Trophic Disturbances, [57]; Affections of the Joints, [59]; Motor Weakness, [60]; Atrophy of the Interossei, [61]; Paralysis of the Orbicularis oris et palpebrarum, [61]; Trophic Affections of the Bones and Skin, [62]; Sensation, [64]; Loss of Smell and Taste, [66]; Duration, [66]; Cause of Death, [66]; Recovery, [67]. | |
| [CHAPTER V.] | |
| Pathological Anatomy of the Maculo-Anæsthetic Form | [68] |
| Comparison of Recent and Old Macuoles, [68]; Alterations in the Nerves, [70]; Bacilli in the Nerves, [70]; The Spinal Cord, [71]; Lymphatic Glands, [72]; Muscular Affections, [72]; Association with Tuberculosis, [73]; Necrosis of Bones, [75]; Joint Affection, [76]; Difference between the two Forms of the Disease, [77]; Influence of Climate, [79]. | |
| [CHAPTER VI.] | |
| Diagnosis and Prognosis | [82] |
| Diagnosis from Psoriasis, [82]; Diagnosis from Syphilis, [83]; Diagnosis from Syringo-myelia, [83]; Leprosy in France, [83]; Morven’s Disease, [83]; Prognosis, [84]. | |
| [CHAPTER VII.] | |
| Etiology | [86] |
| Humoral Pathology, [86]; Heredity, [87]; Miasma, [87]; Contagion, [88]; Baumgarten’s Dormant Heredity, [89]; Nature of Heredity, [90]; Father Damien’s Case, [93]; Leprosy among Norwegians in North America, [94]; Inoculation, [95]; Hutchinson’s Fish Theory, [96]; Direct Proofs of Contagion, [97]; Hospital Experience in Norway, [99]; Communication of the Disease, [102]; Greater Danger of Nodular Form, [102]; Leprosy and Vaccination, [103]. | |
| [CHAPTER VIII.] | |
| Treatment | [105] |
| Ancient Treatment, [105]; Treatment in the Eighteenth Century, [105]; Specific Remedies—Madar [107], Cashew Oil [107], Gurjun Oil [109], Chaul Moogra [111], Hoang-nan [113], Ussacou [113]; Carbolic Acid, [114]; Creasote, [114]; Phosphorus, [115]; Arsenic, [115]; Ichthyol, [115]; Kreuznach, [115]; Mercury, [116]; Iodine, [116]; Tuberculin, [117]; Chlorate of Potassium, [118]; Hydroxylamin, [118]; Europhen, [119]; Aristol, [120]; Naphthol and Salol, [120]; Methyl Blue, [120]; Nerve Stretching, [120]; Electricity, [121]; Salicylate of Soda, [122]; Importance of Isolation, [124]; Results in Norway, [125]. | |