LEPROSY 



187 



Paralyses of interossei of hands (main-en-griffe), thenar and liypo- 

 thenar eminences, also of forearm causing " drop wrist." 



Plantar muscles of toes, peronei, extensors — "drop foot " with an 

 internal twist. 



Reflexes increased, later diminished, muscles waste, R.D. distinct. 



Trophic lesions, whitlows on fingers occur, necrosis of phalanges, 

 or simple absorption of bone, the nail persisting. 



Maculae in anaesthetic leprosy. 



Also on lower extremities there are bullae varying in size from a 

 pea to that of an Ggg. Perforating ulcers. 



Fissures in digits of hands, toes, dry gangrene, or bones of fingers 

 may soften and become osteomalacic. 



Eye is more often damaged by secondary infection, the result of the 

 absence of lachrymal secretion and lagophthalmus. 



Secretion of tears is diminished, xerophthalmia with posterior or 

 total symblepharon, while desiccation and destruction of cornea may 



