LEPROSY


Macular cases often develop into a tubercular or nodular type. The disease is hereditary or it may be communicated by contact of a sore or abrasion of the skin with leprous discharge. It is caused by Bacillus leprae. A thickening of the lobes of the ears and of the skin of the forehead is often the first manifestation of the disease. Bed bugs are often accused of transmitting the disease.


Forms: Leprosy appears in three forms: (1) the non-tubercular, macular, nerve, or anaesthetic, (2) tubercular or nodular, (3) mixed leprosy, showing both types.

Anaesthetic leprosy: In this form of leprosy the skin becomes red or brown, later thickened, and the maculae are either anaesthetic or less often hyperesthetic. The diseases appears in circular spots or blotches of irregular size and coppery hue on any part of body, which afterwards assume a whiter appearance with loss of sensation in the affected part. It may attack fingers, toes, face or entire body. It causes deformity of fingers.

Tubercular or nodular leprosy: It is characterised by a gradual growth of solid prominences or tubercles varying in size from that of a pins head to a walnut, causing the part to assume a curiously nodulated appearance. This process commonly attacks the face and there is considerable swelling in the part affected. In severe forms the ears are very much enlarged, the nose becomes big and the lips thickened.

The expression of the face changes entirely. Ultimately the affected parts ulcerate and the flesh and bones slough off. If it attacks the eyes the patient becomes blind. Ulcers usually occur first on the nodules and gradually eat away the flesh and bones.

Mixed leprosy: It may present the symptoms of both types just mentioned above.

Macular cases often develop into a tubercular or nodular type. The disease is hereditary or it may be communicated by contact of a sore or abrasion of the skin with leprous discharge. It is caused by Bacillus leprae. A thickening of the lobes of the ears and of the skin of the forehead is often the first manifestation of the disease. Bed bugs are often accused of transmitting the disease.

The virus may enter the body through mucous membrane. In most of the cases the skin becomes swollen and tumefied with long and deep cracks causing the bones to become visible through the fissures. Disturbances of sensibility are almost always present. Marked loss of weight, great weakness and drowsiness may precede the disease. Sepsis, gangrene, kidney affection, and tuberculosis are some of the end results of leprosy. Some cases are marked by rise of temperature and this fever may often be mistaken for Malaria.

Treatment.

Remedies: Anacardium orient. Alumina, Ant-t. Ars. A,.

Bad. Bar.c Calop. Calc-c. Carb-ac. Carb.a. Carb.s. Carb.veg. Carica papaya. Colocynth. Chaulmugra. Comocl. Cupr.ac. Cur. Caust. Con. Crot.h. Diphtero-carpus. Elaeis. Form. Grap. Guans. Gynocardia. Hoang-n. Hura. Hydrocotyle. Hell.

Iod. Iris-v. Jatropha-goss. Kali-c. Kali-Iod. Lach.

Mag.c. Mang. Meph. Merc-s. Madaru alb. (Indigo orient). Nat-c. Nat-m. Nit-ac. Nuph. OEnanthe.

Petr. Phos. Psor. Piper meth. Pyrara. Sec. Sep. Sil. Sulph. Tub. Thyr. Zinc.

Leprous tubercles: Nat.c. Phos. Sil.

Tubercular leprosy: Alumina. Ars-a. Calotropis. Carica Papaya. Madaru. Nat.c. Petr. Pip-m. Sep. Sil.

Anaesthesia-Anac. Elaeis. (Ars-a. Carb-ac. Carb.S. Merc. Petr. Phos. Sep. Zinc.).

Hyperaesthesia-Alumina. (Lach. Merc. Petr. Sep. Sil. Sulph).

Hyperaesthesia and anaesthesia alternating- Ars-a.

Coldness of affected part-Anac.

White spots; Silic (cheeks) Sep. (fingers) piper meth (Hands and feet) Ars-a. (Album. Am-c. Aur. Berb. Calc.c. Carb.a. Merc. Nat.c. Nit.ac. Phos.Sul.).

White spots which become bluish: Calc-c.

White spots with dark borders: Calc.c.

Discoloured borders around the white spots: Phos.

Yellow spots: Ant.t. Arn. Ars.a. Canth. Con. Ferr. Hydroc. Iod. Kali.c., Lach. Lyc. Nat.c. Petr. Phos. Psor. Sep. Sul. Thuj.

Yellow spots: On both extremities: Hydroc.

Yellow spots: Around navel, peeling off: Berb.v.

Yellow, scaly, on abdomen and around nipples: Kali-c.

Brown spots: Ars.a. Aur. Carb.s. Carb.v. Caust. Crot-h. Cur. Iod. Kali-c, Lach. Lyc. Merc. Nat.c. Nitr-ac. Petr. Phos. Sep. Sil. Sulph. Thuj. Tub.

Brown and white spots: Thuj.

Brown and yellow spots: Petr.

Brown and Yellow spots: On an even base: Phos.

Leprous spots: Alumina (lips) Graph. Madaru Alb.

Leprous spots (whole skin) without itching: Cupr.ac.

Circular spots with scaly edges: Hydroc.

Red spots: Alum. Am.c. Ars.a. Bar-c. Calc.c. Carb.a. Carb.v. Caust. Crot.h. Graph. Kali-c. Lach. Lycop, Merc-s. Nat.c. Nitr- ac. Petr. Phos. Sep.Sil. Sul.

Copper coloured spots: Carb.a. Lach. Sep. Sil. Graph. Alumina. (tubercles on face).

Thick patches on face and arms: Phos.

Patches of raised and hardened skin: Anac.

Thickening of the whole skin: Madaru. Alb.

Skin covered with large scales: Pim.m.

Great thickening of skin: Hydroc. Elaeis.

Exfoliation of scales: Hydroc.

Circular spots: Hydroc.

Leprosy when there is no ulceration: Hydroc.

Ulcers on toes: Graph. Ars.a. Sep.

Ulcers at tips of fingers: Sil. Sep. Ars.a. Petr.

Ulcers on heels: Nat.c.

Excoriation at tip of tongue: Sep.

Muscles fall off in shreds from bone: Lach.

Shortening of hamstrings: Sil.

Later stages of the disease: Phos.

Hard and pale swelling: Lach.

Gangrenous tubercles: Madaru Alb.

Hoarseness: Petr.

Husky-voice: Alumina.

Feeling of pins and needles in affected parts: Anac.

Desquamation: Colocynth.

Itching of whole body: Calotrop.

Extremities numb: Petr.

Unhealthy nails: Sep.

When lumps threaten to turn into abscess. Pip-m.

Palsied hands: Sil.

When skin feels as if it were hide bound: Hura. B.

With swelling and cracks: Graph.

With swelling and fever: Calc.c.

Cracks long and deep showing bones: Graph.

Cracks: Graph. Comocl. Petr.

Alumina.

Leprous pimples. Renewal of cutaneous symptoms at every new or full moon. Brittle nails. Hairs fall out all over body. The skin of face feels as if covered with dried white of egg or as if a cobweb was on it. Fissures. Even small and soft stools are passed with great difficulty. Trembling of whole body. Vertigo on closing eyes. Craving for dry rice and dry food. Pulsations. Symptoms worse on alternate days, in the afternoons, in cold air, in dry weather, better by cold washing. Copper-coloured Tubercles on face. Lips swollen with leprous spots. Skin sensitive.

Anacardium Orient.

Pressive pains as from a plug in several places. Great fatigue. Weary on walking or ascending a height. Sensitive to cold air with chilliness. Diminution of senses. Skin devoid of feeling. Sensation of a hoop or band around parts. Soles of feet burn. Hands and fingers feel dry. Clammy sweat in palms. Leprosy when the affected parts are cold and numb. Hardened skin. Headache better lying down. Cough better by eating. Loss of memory. Smell of burning wood in nose. Tendency to suicide by shooting.

Arsenic Alb.

Burning relieved by heat. Blackness of parts. Blackish stools. Restlessness. Thirst but drinks little at a time. Fever worse in the noon or at midnight. Profound weakness. Offensive discharges. Yellow or white spots on body. Affected parts at times feel numb and at times very sensitive to touch. Ulceration with burning pain. Fear of death. Says it is useless to take medicine. Hopeless of recovery. Dryness of mouth and throat. Cannot digest meat.

Calcarea carb.

Great plumpness and excessive obesity. Takes cold easily. Dread of open air. Dread of bathing and water. Feels better when constipated. Diarrhoea in the afternoon. Hoarseness in morning. Chill at 2 p.m. Symptoms at full moon and at new moon. Feels week on ascending. Seeks warmth. Cold, clammy feet. Sweat on single parts especially on head. Hands inclined to chap. Bloody sweats. Offensive urine. Slow in movements. Chews and swallows in sleep.

Graphites.

Swelling and cracks of the affected parts. The cracks are long and deep, the bones are visible. Stout patients of fair complexion. Fat, chilly and costive. Takes cold easily. Menses too late and scanty. Aversion to meat. Sweets cause nausea. Hot drinks disagree. Stools united by mucus threads. Ulcers discharging a glutinous fluid, thin and sticky. Leprous spots, coppery and annular.

Lachesis.

Dark or bluish discolouration. Very Sensitive to touch. Begins on the left side and then moves to the right side. Symptoms worse after sleep. Melancholic disposition. Sensation of tension in various parts. Cannot bear anything tight anywhere. Headache with pale face. Symptoms relieved by discharges. Warm applications ameliorate.

Natrum carb.

Tubercular form. Ulceration of tubercles. Hands swollen every morning. Drowsy after meals. Ulcers with swelling and redness of affected part. Tingling. Worse during a storm. It hurts to lie on the left side. Avoids open air. Coldness of feet. Black ulcer on heel.

Petroleum.

Worse during winter. Nostrils ulcerated, cracked, burn. Face feels as if covered with albumen. Hunger after stool. Hungry at night. Diarrhoea in day time and after cabbage. Tips of fingers rough and cracked. Cracks bleed easily. Hoarseness. Suffocating cough. Tubercles on face.

Phosphorus.

Symptoms worse lying on left side and in the twilight. Washing with cold water relieves, cold knees at night. Small wounds bleed much. Drowsy after meals. Dreams of fire, of haemorrhage. Burning in back. Heat between the shoulder-blades. Great weakness after stool. Polypi bleeding easily. Thirst for very cold water.

Sepia.

Face thick, covered with tubercles. Tubercles and spots all over body. Ulcers on fingers and toes. Swelling of affected parts. Discharging ulcers. Copper coloured tubercles. White spots. Redness of eyes. Forehead swollen. Leonine face, pendant ears. Nasal discharge purulent. Feels cold even in a warm room. Indifferent to those loved best. Averse to family. Sadness. Cannot remain alone. Weeps when telling symptoms. Coldness of vertex. Yellow colour about mouth. Longing for acids and pickles. Cannot digest milk. Liver relieved by lying on right side. Coldness of legs and feet. Feet cold and wet. Offensive odor of skin.

N C Das