The Pacific commercial advertiser. [volume] (Honolulu, Hawaiian Islands) 1856-1888, 1865-09-16

lass exempt from this scourge than the African
slave. Ii is found amongst the Betsemasarahas
WIG eat pork, amongst the Betanmenas who abb
nor is. IL occurs where fish is an article of food
but is il also 10 be seen where no fish is 10 be had,
aid where rice and vegetables satisfy the simple
wants OF the population. 1t exists IN town and
country, at the elevation of 1000 feet above the
level Of the sea, along the coast line, and through
oil intermediate elevations. Race, geographical
situation, and diet,-all seem absolutely unim-
portant elements in relation 10 its presence or its
spread. Probably the dirty habits so prevalent
in many half-ciyilized nations must tend TO az
grayats 1t eating from u common dish with the
fingers the custom, very common In Madagascar,
Of interchanging garments, and of all lying hud-
died promiscuOusly together At night, cannot fail
10 render it more inyeterate, even if they do moth
ing in the way of originating it.
1t has been a favorite theory with many that
leprOsy is related to syphilis or 10 yaws But
what proof is there to substantiate this theory ?
Syphilis has suffered marked modification in diff
feTent ages and amongst different races. Leprosy
has remained unchanged through seventy genera
tiOns and longer, even III the same country. We
do not see leprosy result from syphilis in England.
The spread Of syphilis in the fifteenth and six
teenth centuries was not followed by al increase
of leprOsy, but the reverse.
LeprOsy seems to be a disease SUI generis distinct
altogether from syphilis and yaws propagatiDg
itself by hereditary transmission and POSSIBLY by
lROcuLatIOn. IL IL probably seldom produced nm
0IedI0tsiy and at once in any constitution from
the causes originating 1t, but gradually by the
persistence Of the causes operating through sue
eessiye generations.
In the treatment of this most formidable dis
Ease We are still in the dark, everything has been
tried and in vain. The utmost that can be &C
complished in the present state of our knowledge
is to ~palliate, not cure, the disease. In Il con-
siderable number Of the cay=s, iodide of potassium
in various combinations, according to the pecu-
lurities of the case, was given, and often with
---I.ar Ct - n1naT EnrnrI. AE rhn
tubereles. accompanied, however, by loss of aPpe-
tite and weakness in the patient. L will give two
cases.
Andriamanana, a blacksmith, seven years un-
sell. The whole skin is altered in texture,
thickened and glued. The nose and lips thick
curved forwards, the hair of the eyebrows and
eyelids fallen. Hands and feet livid, cold and
insensible. Voice rough and husky, with pain
in larynx. This patient was put upon iodide of
potassium in combination with warm tOnics.
After a ueek's treatment some of the tubercles
burst, others were being absorbed, and after 4
longer time the skin became much more natural,
o few tubercles only remaining.
Ravao, act. 40. Two years leprous tubercles
scattered over the greater part Of the body was
ordered iodide Of potassium in small doses three
times a-day, with tepid bath, and generous diet.
4 manifest improvement took place, most of the
tubercles having disappeared. The patients APP
petite, however, began To fail, and after three
months the lOulue lau 10 De SuSpenUeu. III LNcSe,
and in several other instances, the iodide of po-
tassium really seemed to produce absorption, TO
cause the tubercles to disappear, and TO render
the skin thinner and softer. The patient Ravao
was permanently improved, but i'll the case OF
Andrimanana, the weakness increased, liberation
of the cornea cnsued, and death speedily took
place. l cannot help thinking that the fatal
result in this instance was FASTENED by the treat
ment.
Arsenic, with attention to the general health,
was perseveringly tried for months in eleven cases.
The usual constitutional symptoms Of arsenic,
when administered in medicinal doses, were mani
Tested in several of the patients without any miti-
cation OF the disease. L noticed, also, IN more
than one case, an inflammatoIy condition of the
skin, especially in the face. to result.
Where liberation existed great temporary bene-
fit was obtained from the use of quassia in large,
frequently repeated doses. L am indebted TO DR..
Powell. of Mauritius. for Il knowledge of the
value Of this remedy in the liberation of leprosy.
Under its use ulcers heal for Il time more readily
than under any other treatment.
When Il venereal faint was known or suspect
ed, mercury was tried. The preparation used
wac the bichloride in small doses. No good was
observed 20 result.
\ treatment directed TO the improvement of
the general health, and the due performance of
the various functions. with the use of tOnics and
occasionally Of cholagogue purgatives, if the
liver is inactive, will be of service. Should the
liberation be troublesome, quassia, alone, or in
suitable combinations, will promote the healing
process. lodide of potassium given at intervals
and in small doses, will help to promote the alb
sorption of the effusion, care being taken to sus-
pend it if the appetite fail or the health suffer.
The tepid bath will always be useful in promot-
ing the action Of the skin and the comfort of the
patient. Experience is also in favor of ~inaction
As an adjunct to other treatment. 1t is probably
more serviceable than any single remedy. The
oil used by me was the best olive oil, and it was
thoroughly rubbed into the skin twice a-day,
after the patient came out of the warm hath.
BY the perseyering use of these simple means,
many of the patients experienced benefit, although
none were entirely cured. Yet, l am convinced
that in the present state of knowledge. more good
may be hoped from such general treatment than
from any single medicine used empirically.
Now that the attention of the profession has
been directed To this disease, may we not hope
that our knowledge of the therapeutics and pa
thology of this fearful scourge of our race may
be speedily advanced.