Report on the depopulation of the Vanni District, Northern Province / by James Loos ; ordered by His Honor the Officer Administering the Government to the printed.

  • Loos, James.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: Report on the depopulation of the Vanni District, Northern Province / by James Loos ; ordered by His Honor the Officer Administering the Government to the printed. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    and there were many cases of excoriations at the angles of the mouth, sometimes with DEPOPUL ^TTON Avhite discoloration. In one village (Eraperiacolam) a child had a large ulcer on the ^^p^s'nucx'^'^ right nates, excavated, with yellow sloughs; and another child was in a wretched state of emaciation, with several ulcers on the body and ulceration of the nostrils. The eruptions Report, on the children were pustules or tubercles,- the summits of which appeared to have a thin mucous lining from which serum exuded, and some had decidedly mucous tubercles {condy lomata) near the anus. In older children and adults, nodes and affections of the bones were common, and obviously connected Avith the progress'oTlihe disease. T met with several young people who had become crippled from this cause, and from contraction of the cicatrices of ulcers about the joints. Many also complained of pafns in the joints, and it was'Stated that such pains are often the precursors of the eruptions. Pustular eruptions were found in all parts of the body, including the face. The most common seats of ulceration were the hips, knees and elbow joints; but the dorsum of the foot, the back of the wrist and fingers, fore-arms and legs, were also in many cases ulcerated. Such are the characteristics of the disease in its aggravated form—a form which, unfor- tunately, is not rare in the places I visited. Milder cases exist, in which there are few scattered eruptions or circumscribed patches of ulceration. The general health is remark- ably unaffected, and there are no signs of constitutional disturbance or great suffering, except in very severe cases. The disease is not viewed as fatal in itself, and from what I have observed, it is troublesome and offensive, but does not materially shorten life, except perhaps in the case of very young children. As many of the already mentioned features of the disease are those of constitutional or tertiary Syphilis, a careful consideration of the whole subject has impressed me with the conviction that the disease itself is of a syphilitic character. The appearance of the r pustular eruptions, the affection of the bones (in three cases portions of the palate had been destroyed), the mucous tubercles observed in children, and the syphilitic ulceration, / increasing by one side while the process of healing is slowly taking place on the other, have all served to impress me with this opinion. I have seen several members of the same family affected, and in cases where the parents looked healthy, their past history revealed that they had been formei'ly affected with the complaint, plainly proving a hfixeditarYc- tendency. There are so few free from it in the Vanni, that it is extremely probable intermarriage has served, not only to disseminate, but to aggravate the disease. In the Mullaittivu district, the worst villages I visited were inhabited by the lower castes, and the Moors were said to be remarkably exempt from the complaint. In the Mannar Vanni it is said to be most prevalent in the Sinhalese villages bordering on Anuradhapura ; but I have seen it equally prevalent, in the Mannar Vanni, in villages inhabited by Moors and Tamuls. The people of one Moorish village (Salampan) traced the introduction of the disease among; them to intermarriao;e with the inhabitants of another Moorish villao;e, ' 1 . . . ^ 'ViJiff — -t. (Suduventapulo.) I have not been able to find the marks of Syphilis in new-born J- ' C/U^ infants; but it is not improbable that the taint is gradually imparted to the system of the (rA, ^ ^ child by the milk of the mother, and it is said that the disease often makes its first appear- ance about the third month of infancy. Paraiigi appears to me a variety of Lepra. Some of the severe cases of Parangi appeared to me to correspond closely to descriptions of lepra (or -psoriasis) iitveteratu. I am confirmed in this opinion by what one of our most eminent authorities on diseases of the skin, Erasmus Wilson, says with regard to the origin of lepra. The cause of lepra, says this writer, is a special poison. I have stated my belief, and I see no reason to change the opiuion, that leprous poison is in its essence and origin Syphilitic, that lepra is in fact a manifestation of the syphilitic poison, after transmission through at least one, and probably through several generations. Another affection of the skin, also said to originate in syphilis and allied to lepra, exists in the interior of Cejdon, Marshall ( Medical Topography of the Interior of Ceylon) says, I have seen a number of Kandyans suffering under a wide spreading ulceration of the skin. In the Sinhalese language this complaint is Aramana IVana. The disease occurs on all parts of the body, except perhaps the hairy scalp. The outer circle of ulcerous surface extends, while not unfrequently the central area is healing. Occasionally while some of the ulcers are healing, other parts of the skin become affected, and eventually ' ulcerate.' And agam,—This disease occasionally commits great ravages on the face. The forehead, cheeks and lips are much liable to it. The nose and eyelids, however, suffer more from an extension of the ulceration than perhaps any other parts of the body. Sometimes the alse of the nose become tubercular and ulcerated ; more frequently they are destroyed by the progressive ulceration, which extends along the floor of the nostrils and destroys the velum pendulum palati. I have met with cases of this kind, although not many; but an intelligent Headman at Anuradhapura informed me that cases of aramana wana are frequently seen in the interior of that district. This disease is certainly lupvs, which Wilson classes with lepra, remarking: Numerous observations led me to the conclusion that lepra originates in the syphilitic poison, the poison being modified by transmission, through one or more generations. Lupus in some instances is clearly referrible to the poison of syphilis; in others it seems to appertain to an affection equally mysterious, namely, scrofula; and scrofula, I believe to derive one of its sources from syphilis. ~ - ^[165] L