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History.
except lower part of back, which is slightly raised and discoloured. The lower
halves of legs are patched and discoloured bluish-black with slight whitish scaly
eruption, Toes are shortened and knobby, tubercled at ends, nails broken, thin and
raised, slight exudation from them. Lobes of ears are thickened and tubercled,
especially left. Appetite impaired. Bow-
els regular. Her father had the disease,
Heredity.
and died of it when 40 years of age. She had only one child which died alter
birth ten years ago. There was one brother whe died years ago of some other
complaint. There are four sisters. She is the eldest, the two next are at present
free from the disease ; the third one s
daughter has the complaint ; the fourth
sister is also ill.
TREATMENT.—September 27.— Commenced with oil.
October 19.—The tubercles and raised patches on arm and face are less promi-
nent, the itchy feeling she had is now stopped, so also the exudation from the toes
and leg.
November.—The oil continued to do good so long as it was taken, the scaly
eruption on legs disappeared, the skin of legs became smooth, and swelling of face,
nose and hands considerably diminished.
Occupation.
III. RAHAMAN KHAN (September 28), aged 40 , formerly a maker of leather
vessels ; inhabitant of Cuttack.
No
member of his family have had the disease ;
his sister is alive and has a daughter ; these have no marks. Has eight children,
the eldest 20 years, none of them is affected. Disease commenced ten years ago
by tingling of the left hand, which afterwards got swollen and red ; there was con-
traction of flexor tendors, weakness of musles and inability to raise anything.
The right hand began to be affected three years after the left, there was anæsthesia at
the very commencement; fire falling on any part could not be felt. Anæsthesia com-
menced first in the left hand, and then in the right side of chest and right hand, then
in right leg. None in left leg. There are patches of discolouration in small
of back ; on anterior and outer aspect of thighs with slight thickening ; at present
pinching over the part cannot be felt. The flexors of left arm firmly contracted,
bending two phalanges over the first row; the palm of left hand is wasted and
hollowed; the same condition, but in minor degree, exists in right hand ; the two
last fingers more so than others ; the hollowing in palm is not so marked. There is
bluish discolouration over right foot with shortening by fth inch of great toe,
thickening and glistening of ends of smaller toes. No tubureles anywhere. Face
clean and smooth ; ear lobes, nose, &c., healthy.
No treatment.
TREATMENT to commence from to-day with two drachms of emulsion ointment
bis. ; attended only one day ; he gains his
livelihood by begging, and does not find it
convenient to attend.
Heredity.
IV. BHEEMA, aged 13, a young lad, looking younger than thirteen; father
and mother alive ; occupation fisherman ; parents have not got the disease according
to his account ; his uncle has it. It is
well marked on him. There are several
patches on tace, trunk, buttocks and lower extremities (an æsthesia). The insen-
sibility is not much marked. There are no tubercles. The ears are smooth; small
patches about face are reddish, distinctly raised and spreading. There is wasting
of the upper and anterior half of right foot ; underneath ball of big toes there is
loss of the thick integument, fissures, and tendency to ulceration. The little toes
are knobby, shortened, spreading out and becoming irregular. There is contrac-
tion (flexing) of two last fingers of right hand; thickening and ulceration of middle
finger (originating from burn). There are patches of scabious eruption with
exudation on left hand; he can flex and extend its fingers easily ; says he has had
the disease three years. Has a brother twenty years, another eight years, and a sister
three years,—all healthy.
TREATMENT.—October.—Commenced.
November.·— Did not persevere with the oil.
V. NARAIN NAIK (September 28), prisoner in the jail, aged 30, is suffering
from anæsthetic leprosy. Since last January, first an anæsthetic spot appeared on the
abdomen, commenced to spread and thicken ; one large anæsthetic discolouration on
the dorsum of the left hand ; several small spots on the back, chest, upper and lower
extremities ; the spots are thick, whitish and anæsthetic ; eyebrows little swollen :