LEPROSY
sve
LEPROSY
gave the name of Da'L fil, wliich means literally mor- hus ekphas. The disease to which they applied this name is called by modern writers tlie tumid Barbadoes leg, and consists in a thickening of the skin and subcu- taneous tissues of the leg, but presents nothing resem- bling tlie tubercles of elephantiasis. Now the Latin translators from the Arabic, tinding that the same name existed both in the Greek and Arabic, translated DcCl fil by elephantiasis, and thus confounded the Barbadoes k'g with the Arabic Jndliuin, while this latter, which was in reality elephantiasis, they rendered by the Greek term lepra. See Kleyer, in Miscell. iwt. curios. 1G83, p. 8 ; Bartholin. Morb. J3ibl. c. 7 ; Michaelis, Einkit. iiis A . T. i, 58 sq. ; Eeinhard, Bibelkrank. iii, 52.
Elephantiasis first of all makes its appearance by spots of a reddish, yellowish, or livid hue, irregularly disseminated over the skin and slightly raised above its surface. These spots are glossy, and appear oily, or as if they were covered with varnish. After they have remained in this way for a longer or shorter time, they are succeeded by an eruption of tubercles. These are soft, roundish tumors, varying in size from that of a pea to that of an olive, and are of a reddish or livid color. They are principally developed on the face and ears, but in the course of years extend over the whole body. The ftice becomes frightfully deformed ; the forehead is traversed by deep lines and covered with numerous tu- bercles; the eyebrows become bald, sv/eUed, furrowed by oblique lines, and covered with nipple-like eleva- tions ; the eyelashes fall out, and the eyes assume a fixed and staring look ; the lips are enormously thickened and shining; the beard falls out; the chin and ears are en- larged and beset with tubercles; the lobe and alae of the nose are frightfully enlarged and deformed ; the nostrils irregidarly dilated, internally constricted, and excoria- ted ; the voice is hoarse and nasal, and the breath intol- erably fetid. After some time, generally after some years, many of the tubercles idcerate, and the matter which exudes from them dries to crusts of a brownish or blackish color; but this process seldom terminates in cicatrization. The extremities are affected in the same way as the face. The hollow of the foot is swelled out, so that the sole becomes fiat; the sensibility of the skm is greatly impaired, and, in the hands and feet, often entirely lost; the joints of the toes ulcerate and fall off one after the other; insupportable foetor exhales from the whole body. The patient's general health is not affected ftr a considerable time, and his sufferings are not always of the same intensity as his external defor- mity. Often, however, his nights are sleepless or dis- turl)P(l by frightful dreams; he becomes morose and melancholy; he shuns the sight of the healthy because he feels what an object of disgust he is to them, and life becomes a loathsome burden to him ; or he falls into a state of apathy, and, after many years of such an exist- ence, he sinks either from exhaustion or from the super- vention of internal disease.
About the period of the Crusades elephantiasis spread itself like an epidemic over all Europe, even as far north as the Faroe Islands; and henceforth, owing to the above-named mistakes, every one became familiar with leprosy under the form of tiic terrible disease that has just been described. Leper or lazar-houses abounded everywhere : as many as 2000 are said to have existed iu France alone. In the leper hospital in Edinburgh the imnates begged for the general community— sitting for the purpose at the door of the hospital. They were obliged to warn those approaching them of the presence of an infected fellow-mortal by using a wood rattle or clapper. The infected in European countries were obliged to enter leper hospitals, and were considered le- gfilly and politically dead. The Church, taking the same view of it. performed over them the solemn cere- monies for the burial of tlie dead — the priest closing the ceremony by throwing u|ion them a shovelful of earth. The disease was considered to be contagious possibly only on account of the belief that was enter-
tained respecting its identity with Jewish leprosy, and the strictest regulations were enacted for secluding the diseased from society'. Towards the commencement of the 17th century the disease gradually disapijearetl from Europe, and is now mostly confined to intertropical coimtries. It existed in Faroe as late as 1G7G, and in the Shetland Islands in 173G, long after it had ceased in the southern parts of Great Britain. This fearful dis- ease made its appearance in the island of Guadaloupe iu the year 1730, introduced by negroes from Africa, producing great consternation among the iidiabitants. In Europe it is now principally confined to Norway, where the last census gave 2000 cases. It visits occa- sionally some of the sea-port localities of Spain. It has made its appearance in the most different climates, from Iceland through the temperate regions to the arid plains of Arabia — in moist and drj^ localities. It still exists in Palestine and Egypt — the latter its most familiar home, although Dr. Kitto thinks not in such numerous instances as in former ages. The physical causes of the malady arc uncertain. The best authors of the present day who have had an opportmiity of observing the dis- ease do not consider it to be contagious. There seems, however, to be little doubt as to its being hereditarj'. See Good's Study of Medicine, iii, 421 ; Kayer, Mai. de la Peau, ii, 296; Simpson, On the Lepers and Leper- houses of Scotland and England, in Edinb. Medical and Surgiccd Journal, Jan. 1, 1842 ; J. Gieslesen, De elephan- tiasi Norvegica (Havn. 1785) ; Michael. U. orient Bibl. iv, 1G8 sq. ; B. Haubold, Vitiliginis leproseB rarioris his- ioria c. ejncrid (Lips. 1821) ; C. J. HiUe, Rai-ioris morbi elejihantiasi paiiicdi similis histor. (Lips. 1828) ; Kosen- baum, in the Hall. Encyklop. xxxiii, 254 sq.