Leprosy

(lep' -rose). Lepra vera; Elephantiasis gracorum; Black Leprosy; Leontiasis; an endemic, chronic, constitutional disease analogous to syphilis, and varying in its morbid manifestations according as the brunt of the disease falls on the skin, the nerves, or other ti ues. It occurs in three forms, the tuberculated, non-tuberculated or anesthetic, and the mixed tuberculated. The tuberculated or nodular leprosy is attended at the onset with debility, depre ion, dyspepsia, diarrhea, drowsine , chilline and profuse perspiration, marked vertigo, recurrent epistaxis, fever up to 1040 F.; after a variable period of days or even months, coming first with edema of the eyelids, the leprous spots appear on the face and ears, and then on the anterior and external surfaces of the limbs. The exanthem is an erythema, varying from a bright-red to a purplish-red or mahogany red tint, a ociated with the leprous deposit of well-defined, shiny, slightly raised patches of from one to several inches in diameter. Papules then form in crops, gradually reaching the size of a hen's egg and of a yellowish to a dark-brown color. Tuberculation does not develop until from three to six months after the commencement of the disease. Nodules are most common on the face, limbs, breast, scrotum, and penis. There is also an involvement of the mucous membranes. When the disease is fully developed, the face a umes the characteristic leonine appearance, from thickening of the skin. Ulceration eventually sets in, and the patient dies of exhaustion or complications. Non tuberculated leprosy is the most common tropical form. The prodromal symptoms are marked, and are a ociated at first with hyperesthesia of the skin. At the end of a year the special eruption breaks out, usually on the back, shoulders, posterior aspect of the arms, nails, thighs, and sometimes in the course of nerves. The spots are one or two inches in diameter, well defined, not raised, and of a pale-yellow color. They spread peripherally, clearing in the center, which becomes dry, scaly, and anesthetic. Paralysis is usually a late symptom, and ulceration is common. Death results from ulceration, gangrene, marasmus, or general debility. Mixed tuberculated leprosy is the least common form, and its symptoms are a combination of those of the other two varieties. Destruction of the cartilages of the nose and of the soft palate is common.