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

To difficulty Of breathing and ozena, in the larynx
| and trachae to labOure1 respiration, husky voice,
and occasionally to aphonia. The lining mem-
brance of the external ear is rarely affected. The
cutaneOus and pulmonary exhalatlons become
fetid in the last degree. So peculiarly p~enetrat-
ing indeed is the smell Of leprosy, that there is
no difficulty in detecting, by the sene of smell
alone, the presence Of 4 leper in a large company.
As these changes are going on, liberation be-
gins 10 take place, commencing generally on the
hands or feet. These become livid as if half
frozen the temperature is really lower than that
of health. The nails grow dry, shrivelled, and
fall without pain. Tubercles burst in succession,
discharge q thin watery matter, and after a time
dry up. Other ulcers form on the fingers close to
the joints, and deepen until the joints already in
fltrated by leprous effusion, their vitality ali but
e~xtinguished, drop off. After the part falls away
the ulcer heals over for a time thus, member
after member dies as ii were ON the yet living
body, leaving the sufferer as helpless u himself a.
he IL loathsOme to those who have 10 minister u
this wants
SO much for the outward signs of leprosy in its
various stages. Its effects upon the functions,
vital and natural, are at first by no means 50 evil
dent or uniform. The earlier stages Of the dis
ease may be accompanied by nothing abnormal
in the function oi any Of the organs. Experience
alone informs us Of the serious nature Of the com
plant. Ia sUme patients there Is even from the
beginning a remarkable torpidity. physical and
mental, and this Is observable in the later stages
in every case. The patient is untitled for active
work he is rarely irritable, but sluggish. The
appetite is seldom impaired at the commence
mcnt, and even towards the end it is rather per-
verted than lost. The patient eats almost any
thing set before him, but without a relish. Loss
of appetite is a most fatal symptom, and fire.
quently Indicates approaching dissolution. The
tongue becomes large, fabby, and foul, the gums
blush and spongy, and the bowels irregular or
cOstive. Sooner or later in the malady indiges-
rIpn ruanItgGta lfsaif tho ftnprIOp nf the Eypr
being imperfectly or inactively performed. The
urine, az regards quantity, specific gravity, con-
stituents and their proportions, does not differ
from the healthy standard MenstruatiOn in the
female is seldom affected, for / found in twenty
two patients, between the ages of fifteen and
forty, only one in which the menstruation was
irregular.
The function of reproduction in the male and
female continues unimpaired for u long series of
years. The facts bearing upon this point were
not recorded in many instances but | find that L
have notes of nine persons In the second stage of
leprosy and sick from three to six years, who had
young children. This shows that even after the
disease has existed several years, and advanced
considerably, the function of reproduction may
not be affected. 1t is, however, equally certain
that it falls during the last stage of the malady.
1 believe that the - H5ido inerpLebihs,' mentioned
by some authors, is "A mere lancy,-when the
POlCer ceases, the desire is ex;inguished.
Respiration is impeded in two ways,-by thick
enIng OF the laryngeal and tracheal mucous MEM
branes from efusiOn, and from a similar etfusIon
into the substance of the lung itself and into the
minute bronchi. The pulmonary capillaries lose
their tone and become congested. The changes
which the blood undergoes in the lung are i'm
perfectly carried on the action of the heart be-
comes increasingly feeble with the progress of the
disease the pulse is invariably weak and slow.
The fatal termination in leprosy is often owing
to some affection of the respiratory organs.
In q few instances the blood was examined dur
ing The first and second stages of the disease.
The coagulum was found occasionally to be loose;
but the sensible qualities of the fluid were normal.
1t is probable that there is some materieS mOr6i in
the blood, which may hereafter be detected, of
which we are yet entirely ignorant.
As blood-letting is evidently contra-indicated
when the patient is reduced by the disease, the
blood has seldom been examined during the last
Organic disease Of the heart was not detected
in any of the cases observed. DR.. Copeland men
tions q case in which that organ was found soft
ened further investigation is required to settle
whether this is a coincidence or a result of leprOsy.
That the nervous systems, both organic and ccre-
bro-spinal, are involved, is evident from what
has already been said. The itching and flying
pains. the heightened sensibility and succeeding
anesthesia, the depressed vital power, enfeebled
action of the heart. inactive secretion, depraved
appetite-all evidence the extent to which the
nervous system is implicated. These symptoms
become more prominent as the disease advances.
In conducting my inquiries, | had special
to the causes, predisposing and exciting.
Several points of great interest and Importance
were clearly and conclusively established while
others Were left where | found them.
To be concluded next week.