Chapter II: Introduction: And Nomenclature 1

_CHAPTER II._

NODULAR LEPROSY 5

Seat, 5; Localisation, 5; Affection of the Eyes, 8; Affection of the Extremities, 10; Affection of the Mucous Membrane, 11; Affection of the Lymphatic Glands, 13; Subcutaneous Nodules, 13; Affection of Nerves in this Form, 14; Fate of the Nodules, 15; Commencement of the Disease, 16; Duration of the Eruptions, 19; Fate of the Patient, 19; Combination with Tuberculosis, 22; Comparison with that Disease, 23; Affection of the Lungs, 26; Cultivation of the Bacilli, 27, Miliary Leprosy, 28; Mental Symptoms, 29.

_CHAPTER III._

STRUCTURE OF THE LEPROMA 31

Movement of the Bacilli, 31; Nature of the Cells, 32; Nature of the Blood Vessels, 32; Softening of the Nodule, 34; “Brown Elements,” 34; “Globi,” 35; Position of the Bacilli in the Cells, 37; Position of the Bacilli in the Blood Vessels, 38; Effect of Measles, 40; Digestion of the Bacilli by the Cells, 41; Structure of the Bacilli, 41; Bacilli in the Sweat Glands, 43; Affection of the Testicle, 45; Affection of the Liver, 47; Affection of the Spleen, 47; Affection of the Glands, 48; Affection of the Nerves, 50.

_CHAPTER IV._

LEPRA MACULO-ANÆSTHETICA 52

Prodromal Stage, 53; Development of Bullæ, 53; The Macular Eruption, 54; Symmetry, 55; Neuritis, 56; Trophic Disturbances, 57; Affections of the Joints, 59; Motor Weakness, 60; Atrophy of the Interossei, 61; Paralysis of the Orbicularis oris et palpebrarum, 61; Trophic Affections of the Bones and Skin, 62; Sensation, 64; Loss of Smell and Taste, 66; Duration, 66; Cause of Death, 66; Recovery, 67.

_CHAPTER V._

PATHOLOGICAL ANATOMY OF THE MACULO-ANÆSTHETIC FORM 68

Comparison of Recent and Old Macuoles, 68; Alterations in the Nerves, 70; Bacilli in the Nerves, 70; The Spinal Cord, 71; Lymphatic Glands, 72; Muscular Affections, 72; Association with Tuberculosis, 73; Necrosis of Bones, 75; Joint Affection, 76; Difference between the two Forms of the Disease, 77; Influence of Climate, 79.

_CHAPTER VI._

DIAGNOSIS AND PROGNOSIS 82

Diagnosis from Psoriasis, 82; Diagnosis from Syphilis, 83; Diagnosis from Syringo-myelia, 83; Leprosy in France, 83; Morven’s Disease, 83; Prognosis, 84.

_CHAPTER VII._

ETIOLOGY 86

Humoral Pathology, 86; Heredity, 87; Miasma, 87; Contagion, 88; Baumgarten’s Dormant Heredity, 89; Nature of Heredity, 90; Father Damien’s Case, 93; Leprosy among Norwegians in North America, 94; Inoculation, 95; Hutchinson’s Fish Theory, 96; Direct Proofs of Contagion, 97; Hospital Experience in Norway, 99; Communication of the Disease, 102; Greater Danger of Nodular Form, 102; Leprosy and Vaccination, 103.

_CHAPTER VIII._

TREATMENT 105

Ancient Treatment, 105; Treatment in the Eighteenth Century, 105; Specific Remedies--Madar 107, Cashew Oil 107, Gurjun Oil 109, Chaul Moogra 111, Hoang-nan 113, Ussacou 113; Carbolic Acid, 114; Creasote, 114; Phosphorus, 115; Arsenic, 115; Ichthyol, 115; Kreuznach, 115; Mercury, 116; Iodine, 116; Tuberculin, 117; Chlorate of Potassium, 118; Hydroxylamin, 118; Europhen, 119; Aristol, 120; Naphthol and Salol, 120; Methyl Blue, 120; Nerve Stretching, 120; Electricity, 121; Salicylate of Soda, 122; Importance of Isolation, 124; Results in Norway, 125.

TABLES.

PAGE

_TABLE I._ 128

The Frequent Complication of Nodular Leprosy with Tuberculosis.

_TABLE II._ 138

The Proportion of Tuberculosis in Maculo-Anæsthetic Leprosy.

_TABLE III._ 144

The Proportions of the Two Forms of the Disease in Different Districts.

_TABLE IV._ 145

The Results of Isolation in Norway.

LIST OF PLATES.

PAGE

PLATE I.--Tuberous Leprosy (the so-called Facies
Leonina) of two years’ duration 8

” II.--Tuberous Leprosy of six years’ duration 10

” III.--Tuberous Leprosy after breaking down of
the Nodules 12

” IV.--Maculo-Anæsthetic Leprosy of two years’
duration 55

” V.--Case of Maculo-Anæsthetic Leprosy after
Recovery 61

PLATES VI. to XIII.--Chromo-Lithographs 148

LEPROSY:

IN ITS _CLINICAL AND PATHOLOGICAL ASPECTS_.