Memoir on leprosy in Syria / by John Wortabet.

  • Wortabet, John, 1827-1908.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: Memoir on leprosy in Syria / by John Wortabet. 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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    the classification of the older nosologisls, E. Grcecorum^ 1 oey must, therefore, have embraced the disease known now as Ihn- badoes ” or “ Cochin ” leg and leprosy under one common name. The Arabs made a careful distinction between them, and called the former Da’el Eil {morbus elephantis)), from whence we have now its classical name E. Araborum. Nor did they adopt the equally objectionable name of “ leprosy,” a word derived from the lepra of the Greeks and indicating an innocuous cutaneous disease of a scaly character, with which the disease under consideration has hardly auything in common. They substituted for it an Arabic word, el Judham, derived from a root which indicates the mutilating effect ot the disease on the limbs. In the ordinary parlance of the people, it is often called ed Da’ el Kebir, the Great Disease. St/mploms and progress.—One of the earliest symptoms, and of which the patient takes special notice, is altered sensation, commonly in one or both of the extremities, sometimes on the face, and more rarely on the trunk. When the disease is situated in the extremities, the most distal parts are generally first affected, the circulation becoming feeble, the colour dusky, and general sensation diminished. The patient describes it as one of numbness, sometimes he calls it stinging or pricking pain (formication); probably in most cases, there is both objective auEesthesia and subjective hyperesthesia at the same time. The skin of the affected parts is at first puffy, and ultimately permanently thickened and somewhat scaly; and I have sometimes observed hard, corded, knotty lines running up the fore- arms, as if some of the superficial lymphatic vessels were enlarged. As the disease advances, the fingers and toes lose their usual sensibility, and the patient finds that his prehensile powers are con- siderably impaired, and that in walking he may cast off a loose slipper without his being aware of it. In trying the extremities with a pin, I have sometimes found that the extensor surfaces were some- what more anaesthetic than the flexor. About the same time, or very soon after, the face becomes similarly affected, the change of the complexion is more obvious, and the subsequent alterations produce that disfigured appearance of the features which is so peculiar to this disease. The colour becomes red, dusky and shining, and the skin thickened and knotted; the hair of the head and eyebrows, and the cilia drop gradually until they often disappear entirely; the eyes are red and watery with venules running across the conjunctiva;. When it attacks the trunk, the skin becomes affected in patches, though the hair is not so apt to drop off. I believe the face and trunk are rarely affected, unless the extremities are previously at- 1 the language of Arctams, however, when he says of it that “ it is most power- ful in dragging men to death, disgusting to the sight, and in all respects terrible, like the beast of the same name,” would seem to indicate other points besides the hypertrophied condition of the legs.