[Chronic inflammatory diseases of the skin / Extracted from his "Commentaries on Diseases of the Skin."].

  • Thomson, Anthony Todd, 1778-1849
Date:
[1839-1840]
Catalogue details

Licence: Public Domain Mark

Credit: [Chronic inflammatory diseases of the skin / Extracted from his "Commentaries on Diseases of the Skin."]. Source: Wellcome Collection.

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    reliance is to be placed upon internal remedies, in conjunction with repeated, moderate bleedings. It must be admitted, however, that no eruptive disease requires the treatment to be so much varied, according to circumstances, as Lepra. The duration of the disease is undetermined ; it is always more or less tedious. It is most difficult of cure in old people; and in cases which depend upon hereditary pre-disposition: it is most easily removed when the eruption occupies only the ex¬ tremities. If the view of the proximate cause of the disease which I have ventured to give be correct, the remedial measures should be those which will relieve capillary congestion when it exists ; and those which, whether topical or general, are calculated to excite moderately the minute vessels of the skin, and change the morbid action, under which they are labouring, to that of health. But to confine our attention solely to the state of the skin would be to proceed upon grounds neither warranted by true pathology nor correct observation. It is no argument against regarding the eruption merely as a symptom, that no febrile condition can generally be detected. Some functional derangement must exist, however obscure ; and if its nature cannot be detected, we must be guided by the extent and severity of the eruption, in determining the treatment. In every case, the age, the constitution, and the occupation or habits of the patient, must be considered. Bleeding was, long since, recommended by Willis*, as an important part of the treatment of lepra ; and the practice has been followed by later physiciansf: but it is supposed to be necessary only when the patients are young, strong, and plethoric; when the pulse is full and hard; and the margins of the patches are much inflamed. I have, however, seen no case of Lepra vulgaris, nor indeed of L. alphoides, which has not required, and been benefited by, blood-letting: but, at the same time, I must mention that I have found more ad¬ vantage arise from small repeated bleedings of from six to eight ounces, than from the abstraction of larger quantities of blood. By moderately unloading the vessels, a fresh im- * lie Impetigine sive Lepra Grsecorum, sect. viii. e. 7. f Willan, Bateman,, Biett, Bayer.