288 Db. Ainslie's Observations on the Lepra Arabian. 



lepers are poor in spirit, drooping and listless : they are rarely seen to smile, 

 and have not unfrequently a weakness of intellect approacliing to idiotism. 

 But the malady commonly begins its depredations about the age of twenty- 

 three or twenty-four, seldom later than forty ; and the following are the 

 symptoms, so far as I have been able to observe, which mark its first 

 approach, progress, and termination. 



The unhappy person fated to perish by this slow but relentless affliction, 

 first perceives an unusual dryness and slight roughness of skin in his hands, 

 feet, arms, and legs, which, even after violent exercise, do not transmit the 

 perspiration readily; he begins to fall off a little in his appetite, and to be 

 much troubled with flatulence and other signs of indigestion, but he is as 

 yet not ill enough to be alarmed, and pursues his customary occupation ; 

 his sleep, soon after tiiis, in place of being refreshing to him as it used to 

 be, is disturbed by wild dreams, and he frequently during the night starts 

 up in a fright, with a palpitating heart and sense of suffocation. About six 

 weeks or two months from tlie time of his first being taken ill, his colour 

 ^ begins to change ; if he was a rather fair man, he grows at least two shades 

 darker, and his features lose much of their natural aspect, becoming some- 

 how tumid and less agreeable than formerly. The dryness and roughness of 

 skin increase, and about the end of the tiiird month he complains of a 

 strange numbness in his hands and feet, which he can allow to be pinched 

 without feeling pain ; his pulse, which was most likely always feeble, will, 

 if felt, be found to be extremely languid, small, nay at times scarcely to be 

 perceived. The aridity and unevenness of skin now extend further, reach- 

 ing as high as the middle of the arm and leg ; indeed, the cuticle over the 

 whole body seems rigid, harsh, and to have entirely lost that smooth and 

 healthy look which it had before the lepra made its primary attack. About 

 this period many dark coloured spots and purple tubercles usually appear 

 on the ancles and wrists, and partially on the legs and arms ; they are in 

 shape not unlike segments of ripe currants, but flatter at top, and of a 

 singular shining and oily aspect ; they are not attended however with any 

 pain, neither are they particularly itchy,* which in truth they could not 

 well be, when we consider that they are subsequent to the want of feeling 



* Dr. Thomas Heberden, in his paper on this leprosy, says, I think erroneously, that the 

 tubercles are attended with great heat and itching. — See Medical Transactions of the College 

 of London, vol. i. 



I 



