Tubercular leprosy in Madagascar / by Andrew Davidson.

  • Davidson, Andrew, 1836-1918.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Tubercular leprosy in Madagascar / by Andrew Davidson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ithat can be accomplished in the present state of our knowledge is rto palliate, not cure, the disease. In a considerable number of the i cases, iodide of potassium in various combinations^ according to the : peculiarities of the case, was given, and often with marked effect in ; producing absorption of the tubercles, accompanied, however, by iloss of appetite and weakness in the patient. I will give two Vcases. Andriamanana, a blacksmith, seven jears unwell. The whole jskin is altered in texture, thickened and glazed. The nose and ! lips thickened and tuberculated, the ears irregular and curved for- ' wards. The hair of the eyebrows and eyelids fallen. Hands and I feet livid, cold, and insensible. Voice rough and husky, with pain i in larjux. This patient was put upon iodide of potassium in com- bination with warm tonics. After a week^s treatment some of the 'tubercles burst, others were being absorbed, and after a longer ;time the skin became much more natural, a few tubercles only remaining. Kavao, £et. 40. Two years leprous ; tubercles scattered over the . greater part of the body ; was ordered iodide of potassium in small ' doses three times a-day, with tepid bath, and generous diet. A manifest improvement took place, most of the tubercles having dis- appeared. The patient's appetite, however, began to fail, and after three months the iodide had to be suspended. In these, and in several other instances, the iodide of potassium really seemed to produce absorption, to cause the tubercles to disappear, and to render the skin thinner and softer. The patient Ravao was permanently improved, but in the case of Andriamanana, the weakness increased, ulceration of the cornea ensued, and death speedily took place. I cannot help thinking that the fatal result in this instance was hastened by the treatment. Arsenic, with attention to the general health, was perseveringly tried for months in eleven cases. The usual constitutional symp- toms of arsenic, when administered in medicinal doses, were mani- fested in several of the patients without any mitigation of the disease. I noticed, also, in more than one case, an inflammatory condition of the skin, especially in the face, to result. Where ulceration existed gi-eat temporary benefit was obtained from the use of quassia in large, frequently repeated, doses. I am indebted to Dr Powell, of ]\Iauritius, for a knowledge of the value of this remedy in the ulceration of leprosy. Under its use ulcers heal for a time more readily than under any other treatment. When a venereal taint was known or suspected, mercury was Iried. The preparation used was the bichloride in small doses. No good was obsei-ved to result. A treatment directed to the improvement of the general health, and the due performance of the various functions, with the use of tonics and occasionally of cholagogue purgatives, if the liver is inactive, will be of service. Should the ulceration be troublesome.