354 PATHO 
lie is almoft lingular in his opinion. On Plate VII. fig. 
2. we have given a delineation of this variety ; the let¬ 
ters A, B, C, See. Ihowing the progreflive ftages of the 
malady, 
( 3 . L. albida, white leprofy: feales whitifh ; fize of a 
fflver penny; deprefi'ed in the middle; chiefly confined 
to the extremities. See fig. 3 of the fame Plate. 
Th is difeafe is milder than the firft variety, from which 
it is diftinguilhed by the indolence of the eruption, the 
fmallnefs of the feales, and their little difpofition to be¬ 
come confluent. Both varieties pf Lepriafis are difficult 
of cure, and have acquired characters for being more ob- 
ftinate than they really are, in confequence of the empiri¬ 
cal praftice which has been commonly applied to them. 
Tire practice, to be effectual, mud depend entirely on 
the ftate of the vafcular fyftem of the fkin ; for, as Dr. 
Bateman has clearly fhown, if we give the fame medi¬ 
cines to an inflammatory variety or ftage of Lepriafis that 
are found ufeful in one of tardy progrefs, we fliall of 
courfe do mifehief. Therefore, whenever much rednefs 
furrounds the fcale, when pain, forenefs, or ftiffnefs of 
the joints, is prefent, our firfl: care fhould be to mitigate 
the feverity of the cutaneous phlogofis which accompa¬ 
nies the eruption. Ablution with tepid water, or with 
thin gruel, is the only application that it is allowable to 
life. Gentle purgatives, a fo.mewhat low diet, with the 
occafional exhibition of nitre, or fmall dofes of fulphur, 
a few drops of the liquor potnffae, in conjunClion with 
equally fparing quantities of tinClure of hellebore, are 
meafures generally fufficient to remove the irritable ftate 
of the fkin. But, when this ftate has degenerated into 
the indolent form fo remarkable in the fecond variety, 
and in the advanced ftages of the firft, ftimulating medi¬ 
cines and applications may be tried. The warm Talt-wa¬ 
ter bath, with a moderate degree offridion to loofen the 
feales, may be firft ufed as the raoll proper local means; 
and, if not found fuccefsful, may be fucceeded by the 
ufe of more aCtive ftimuli, gradually increasing their 
ftrength. A variety of thefe will be fucceflively required. 
Spirituous lotions, or thofe containing thecauftic potafs, 
the muriatic acid, or the oxymuriate of mercury, the 
unguentum picis, ortheung. hydrargyri nitratis, are the 
moft approved local ftimuli we know of. The internal fti- 
muli which muft be reforted to when dietetic regulations 
do not operate on the malady, are the arfenical folution, 
pitch, and fteel. Of thefe the firft is the moft powerful. 
They are all given in the ufuai dofes. Dr. Bateman re¬ 
commends alfo a decoftion of the Solanum dulcamara 
in gradnally-increafing proportions, both as an internal 
and an external application. 
7. L. nigricans, or black leprofy, is a more rare variety 
of the difeafe, differing externally from the L. vulgaris 
chiefly in the dark and livid hue of its patches, w'hich is 
moft obvious in the margin, but even appears through 
the thin feales in the area of each patch. See fig. 4. 
The feales are more eafily detached in this form of lepra, 
and the furface remains longer tender, and is often ex¬ 
coriated, difeharging bloody ferum, till a new incrufta- 
tion is formed. This variety of lepriafis occurs in per- 
fons whofe occupations expofe them to the viciffitudes of 
the weather, and to a precarious diet, with fatigue and 
watching, and feems of a cachectic nature. It is cured 
by nutritive food, with moderate exercife, followed by 
the ufe of the bark, mineral acids, and fea-bathing. 
£. L. canefcens, the leprofy of the Jews : feales white ; 
hairs on the patches white or hoary ; central depreffion 
deep ; difeafe more inveterate. See Leprosy, vol. xiv. 
“ Several of the varieties are found alfo occafionally, 
as a fymptom or fequel, in lues ; but diftinguilhed by a 
livid or chocolate hue.” Good, 473. 
3. Lepidofis pforialis, fcaly tetter, or dry fcale: patches 
of rough amorphous feales ; continuous, or of indeter¬ 
minate outline ; fkin often chappy. 
This irregularity of figure diftinguilhes Pforiafis from 
the round feales of Lepriafis; and the five different varie- 
L O G Y. 
ties of this irregularity are the fubjeft of Plate VIII. 
Moreover it is without the elevated border, the inflamed 
margin, and the oval or circular outline, of the leprous 
patches; the furface under the feales is likewife much 
more tender and irritable in general than in lepriafis ; 
and the fkin is often divided by rhagades, or deep fiffures. 
It is commonly accompanied by fome conftitutional dis¬ 
order, and is liable to ceafe and return at certain feafons. 
Thecaufes of pforiafis are nearly as obfeure as thofe 
of lepriafis. It is not contagious; with the exception 
perhaps of the firft variety; and this exception is doubt¬ 
ful. Of the following varieties, the firft two are fome- 
times the fequel of lichen. 
a. P. guttata, (fee fig. t. Plate VIII.) “is a fort of 
connecting link between this fpecies and lepra, the little 
patches being diftinCt, and fmall, (feldom exceeding two 
or three lines in diameter,) but with an irregular cir¬ 
cumference, and the other peculiar characters juft de- 
fcribed. They appear on almoft every part of the body, 
and even on the face ; but in the latter fituation they ex¬ 
hibit only a rednefs and roughnefs, without feales. This 
eruption is moft common in the fpring, at which feafon 
it is liable to recur for feveral years. It is preceded by 
general pains, and flight feverilhnefs. In children it of¬ 
ten fpreads rapidly over the body in two or three days ; 
but in adults its progrefs is gradual and flow.” Bate¬ 
man, 39. 
/ 3 . P. gyrata, (fig. 5.) fcaly patches in ferper.tine or 
tortuous ltripes; found chiefly on the back, fometimes 
on the face. 
7. P. diffufa, (fig. 2 and 3.) patches diffufe, with a 
rugged, chapped, irritable, furface ; fenfe of burning and 
intenfe itching, increafed by warmth and mitigated by 
cold ; fkin gradually thickened and furrowed, with a 
powdery feurf in the fiffures; moft common over the 
face, ears, and fealp. Sometimes thefe extenfive erup¬ 
tions appear at once; but, in other inftances, they are the 
refult of numerous minute elevations of the cuticle, 
upon which fmall diftindt feales, adhering by a central 
point, are foon formed, and which become gradually 
united by the inflammation of the intervening cuticle. 
In either cafe, as the diforder proceeds, a powdery fnb- 
ftance, or very minute feurf, is ieen. The heat and pain¬ 
ful fenfations are much aggravated by the leaft fridlion, 
which alfo produces excoriation, and multiplies the fore 
and painful rhagades. This form of the difeafe is moft: 
frequent about the face and ears, and the back of the 
hands ; the fingers are fometimes nearly furrounded with 
a loofe fcaly incruftation, and the nails crack and exfo¬ 
liate : but it occafionally occurs in other parts ot the 
body, either at the fame time or in fucceffion. It com¬ 
monly begins with fome general indifpofition; and a de¬ 
gree of erethifm, with occafional Iharp pains in the fto- 
mach, is fometimes kept up, during feveral weeks, by 
the conftant irritation which it excites. Its duration is 
from one to four.months, and fometimes much longer; 
and it is liable to return, in fucceffive years, in the fpring 
or autumn, and fometimes in both feafons. 
When limited to the back of the hand, it forms what 
is vulgarly called the baker's itch. On the hands and 
arms, fometimes on the face and neck, it is peculiarly 
troublefome to walherwomen ; probably from the irrita¬ 
tion of the foap they are continually making ufe of. 
P. inveterata, (fig. 4.) is the moft fevere modifica¬ 
tion of the complaint, beginning in feparate irregular 
patches, which extend and become confluent, until at 
length they cover the whole furface of the body, except 
apart of the face, or fometimes the palms of the hands 
and foies of the feet, with an univerfal fealinefs, inter- 
fperfed with deep furrows, andaharfh, ftiff, and thick¬ 
ened, ftate of the Ikin. The production of feales is fo 
rapid, that large quantities are found every morning in 
the patient’s bed. The nails become convex, thickened, 
and opake, and are frequently renewed; and, at an ad¬ 
vanced period, efpecially in old people, extenfive excori¬ 
ations 
