CHAPTER XVII
LEPROSY
DEFINITION AND SYNONYMS
=Definition.=—Leprosy is a very chronic, almost incurable disease, with a protracted period of incubation (two to ten years), which sets in with indefinite prodromata of malaise, and irregular febrile attacks associated with sweating and somnolence. In nerve leprosy there may be vague manifestations of neuritis as prodromata. There are two well-recognized types of the disease. The type characterized by granulomatous proliferations in corium and subcutaneous tissues, as well as lymphatic glands, is known as nodular or skin leprosy. It shows spots and nodular infiltrations, chiefly about lobes of ears, alae of nose and region of eyebrows, with falling out of hairs of eyebrows and bearded region, and also involves extensor surfaces of forearms, dorsal surfaces of hands and feet. The palms of hands and soles of feet are almost never invaded. The other type is known as nerve or maculo-anaesthetic leprosy and is characterized by nerve thickenings, flat anaesthetic spots, chiefly of the covered region of the body, muscular palsies and atrophies, with trophic changes leading to contractures and mutilations. When the two types are associated we have mixed leprosy.
The disease is caused by an acid-fast bacillus, which has not surely been cultivated or inoculated into animals with pathogenic result, and which is found in extraordinary abundance in the granulomatous subepithelial tissues of nodular leprosy and in scanty numbers or not at all in the perineurium and endoneurium of the ulnar, facial or perineal nerves.
=Synonyms.=—Lepra. Elephantiasis Graecorum. Leontiasis. Satyriasis. French: La Lèpre. German: Aussatz.
HISTORY AND GEOGRAPHICAL DISTRIBUTION
=History.=—There are those who consider India as the home of leprosy, a condition corresponding to the disease having been described in the Rig Veda, of date of 1400, B. C.
Others regard Egypt as the original focus, a disease similar to leprosy having been described in the “Ebers papyrus” of date of about 1300, B. C.
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