A practical and theoretical treatise on the diagnosis, pathology, & treatment of diseases of the skin : arranged according to a natural system of classification, and preceded by an outline of the anatomy and physiology of the skin / by Erasmus Wilson.

  • Wilson, Erasmus, Sir, 1809-1884.
Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: A practical and theoretical treatise on the diagnosis, pathology, & treatment of diseases of the skin : arranged according to a natural system of classification, and preceded by an outline of the anatomy and physiology of the skin / by Erasmus Wilson. Source: Wellcome Collection.

    210/404 (page 212)
    run into each other by their periphery, and form a continuous patch of large size. These large irregular patches are also produced occasionally in other situations. The scales of lepra are remarkable for their grayish white and silvery hue, being sometimes almost metallic in appearance. They are composed of thin lamellae, which gradually increase in size from the centre to the circumference, so as to project beyond each other in an imbricated manner, a disposition which is marked on the surface of the scale by a series of concentric lines. When rubbed off by the attrition of dress, or thrown off spontaneously, they leave upon the skin a surface which is of a dull red colour and smooth in recent cases, and rough and furrowed when the disease has already existed for some time. After their fall, the thin crusts are speedily reproduced. Lepra is rarely accompanied by constitutional symptoms, and is attended with very little local inconvenience, the latter not exceeding a slight degree of itching on getting warm in bed, or on exposure of the body to changes of temperature. When the patches are so extensive as almost or com¬ pletely to surround a joint, they are productive of some degree of stiffness. The disease is slow in its march, and usually continues for years, some¬ times for life, rarely getting well when left to itself The first patches of lepra appear about the knee or elbow joint, and often symmetrically on the two limbs at the same time. Willan signalizes a point immediately below the patella as the most frequent site of commence¬ ment of the disease. Extending from the knee, the patches appear in va¬ rious points upon the leg as far as the ankle. Willan has remarked, as a peculiarity of lepra, that it invariably occurs in the situation of a superficial bone, as in the course of the tibia, of the crests of the iliac bones, &c., and rarely on the muscular parts, as upon the calves of the legs. The patches also proceed upwards towards the trunk, invading in their turn the upper parts of the limbs and the trunk of the body. Sometimes the disease attacks the scalp, and occasionally the pubic region. When lepra affects the scalp it confines itself to the limit of the hair, ex¬ tending for a short distance only upon the neighbouring skin. In this situation the disease is highly inconvenient, exciting such pruritus, and producing an irritation, which is increased by scratching, and followed by a morbid secretion. Nearly the same inconveniences attend the affection when it invades the pubic region, where, in the female, it is frequently ac¬ companied by a distressing pruritus pudendi. When the ends of the fingers are the seat of lepra, the formation of the nails is disturbed; they are thick¬ ened and irregular in appearance, and a yellowish curdy matter is depo¬ sited beneath them. As the patches of lepra decline, the central portion of the area resumes its healthy state, and ceases to produce scales. By degrees the scales upon the circumference of the patch become smaller and thinner, the prominence of the skin subsides, and the ring breaks at one or several points, the re¬ mains of the patches returning very slowly to the state of the neighbouring skin. / LEPRA ALPHOIDES. Syn. Weisse Aussatz. Germ. 379. Lepra alphoides is a modified form of the typical lepra, charac¬ terized by an inferior degree of energy in the development of the eruption.