Dr. Aixslie's Observations on the Lepra Arabum. liS9 



which I have above described. Some of the tubercles occasionally disappear 

 suddenly, and return again, without evident cause ; others generate a small 

 quantity of ichorous matter, which drying, occasions a trifling scurfy desqua- 

 mation. At this stage of the malady I have met with one or two cases in 

 which glandular swellings at the upper and inner part of the thigh made 

 their appearance, similar to those mentioned by Dr. Adams ;* but, as far as 

 I can learn, this is by no means so constant a symptom of the disease in 

 India as it seems to be in Madeira. The leprosy advancing, the tubercles 

 increase in size and number, and seizing on the face, render the infected 

 person a most unsightly object. It must here be remarked, that up to 

 this period the breast, abdomen, and back either remain tolerably smooth, 

 or the tubercles are comparatively much fewer upon them ; they are 

 moreover smaller in size, nor ever on those parts do they occasion much 

 white desquamation, the natural consequence of their greater vitality. 

 About the end of the first year every symptom is much aggravated : the 

 dryness and rigidity of skin becomes universal, is distressing in the 

 greatest degree ; the numbness has extended to above the knee, and is so 

 great, that the poor sufferer may, through inadvertency, burn his hands 

 or feet to the bone without perceiving it : the surface of the whole frame 

 assumes a bright yet unctuous appearance ; when narrowly examined, it 

 looks wrinkled longitudinally, and not unfrequently feels, in those parts 

 where feeling remains, as if stung with nettles, rising up into wide spreading 

 irregular bumps, which come and go. The skin about the wrists and 

 ancles, where the tubercles have scaled off, has a scurfy appearance, and 

 here and there a raw excoriation may be perceived, the consequence, per- 

 haps, rather of chafing than ulceration. The countenance alters still more ; 

 the cheeks grow bloated and puffy, and are studded, if I may so say, with 

 irregular dark protuberances ; the muscles of the forehead enlarged, seem 

 as if pushed downwards ; the eyebrows, thickened and swollen, hang over 

 the eyes, which being in every instance inflamed and rheumy, and having 

 been made to look rounder by the pressure from the neighbouring parts, 

 resemble those of some wild animal ; the lobes of the ears are rough, 

 knotty, and misshapen ; tlie tongue is foul, and is in some cases blistered 

 with tubercles, which bleed ; the breath is foetid ; the voice sounds un- 

 pleasant ; the urine is plentiful, and generally turbid, having a most 



• Sec Adams on Morbid Poisons, page 273. 



