The Hawaiian gazette. [volume] (Honolulu [Oahu, Hawaii]) 1865-1918, 1873-07-09


ton lWilson.l This poison primarily affects
either the skin. BY depositing in it peculiar al
buminous substance or the nerves and nervous
centres. at last destroying them so as to take
away sensation. In this way. two forms Of ele-
phantiasis are distinguished the tu5eczl1fed ele-
plaafiasis. and The dR9Stlsic, or noR-fHbsTcHlai-
ed eleplGn;iGsiS Some Of the most obvious
external effects Of these forms. in welLmarked
cases bear such different aspects that they might
easily be taken TO belong to two entirely distinct
maladies But the identity Of their origin ap-
pesrs to be clearly proved by several facts. In
many cases the Characteristic features Of the two
I forms are combined O; instances occur in which
one form charges entirely into the other h and
in hereditary transmission. the parent is some
times afflicted with one form and the child with
I the other.
The numbers in brackets prefxed to the par.
ticuars described in the two following paragraphs
are referred to in the notes on those expressions
in Lev XIII which the particulars appear to illus
trate
" 1l The tubercuIated elsphHniiasis is the
more common form. II generally frs: shows IL
self BY in famed patches in the skin. on the face,
ears. or hands Of doll red or purplsh hue. from
half an inch to two inches in diameter C2) These
soon change to q brovnish or bronzs color. with
metallic or oily lustre. and clearly defined edge.
and IN this state they often remain for several
weeks or months. ~ In some cases these ex-
ternsl symptoms disappear altogethe-. and after
while again show themselves. az By degrees
the discolored surface becomes hard. and rises
here and there into inbercles at first reddish but
afterwards either brunzed or white. The scarf
skin often scales of. The hardness and rising
result from ihickening Of the true skin BY the
injection of albumirous matter. % Afer an
other period. Of weeks. or months or even Of
years. many Of the iubercles subside, and leave q
kind Of cicairix. thinner than the surrounding
skin. which may remain either bronEed or white.
'6) The iubercles which do not subside or which
break out again. may vary from the size Of 3 pea
to that Of pigeons egg and after continuing,
it msy be for years. with no external change ihey
uicerate. discharging q Ehitish matter. The ul-
GERS often eat into the muscle till they expose the
bone. or. occasionally. heal over and leave hard
white cicatrices- ca Should there be any hair
on The tubercles It either falls of or turns white.
and the hair Of the lead and eyebrows mostly
disappears From the gradual swelling Of the
features the face assumes sort Of lion-hke or
satyr-like aspect. which suggested the names
which have been sometimes applied to the dis
ease. leoRfidsis and sdfyridsis The change on
the surface Of the skin has given rise to other
names in more modern times. such ns the black
leprosy. and the humid leprosy. When the dis
ease is fully formed the distorted face the lvid.
encrusted and liberated tubercles the deformed
pering voice, the foetid breath and cu,aneous ex-
creiion. the contoried joints which are often
buried iu or absolutely dislocated by tuhercles.
the fvid patches on those psrts of the body not
vet t0herculous. all form picture which is not
exceeded 10 the horror Of its features by any
other disease. tDr. A. T. Thompson.l lsl The
disease for the most part creeps on with irresisi
ible progress until it attacks some vital organ
and occasions death.
Y. ~ The anesthetic elepbaniiasis often COM
mences in the forehead Csee enron. XVI 10, I
2ol with shining white or copper-colored patches /
and vesicles. technically called bu11s. which are
developed suddenly without pain. soon burst. and |
discharge a miTk-Iike matter. ~ An inaamed 4
liberated surface is left which is very tender but
heals after a time. and leaves 8 smooth white.
insensible ciestrix without hair. The hair in
some cases returns. but i. is always white and
fine. For a period sometimes of years. fresh
crops of buiIae arise. ~ The disease soon at
lacks the joints Of the fingers and toes and Of.
forwards those Of the larger limbs. which drop of
bone by bone. In some cases the homes appear
to be absorbed. The ulcers heal with wonderful
celebrity and completeness. It is said that am
puiaiion BY elephantissis will often bear CON-
parisou with the mos; finished performance of the
surgeon a. The limbs which are affected but
do not ulcerste become at last so completely de-
roid of sensation that portions of them may he
burned, cut or nibbed of by mice. without the
person being conscious of it. C5) The face never
becomes so utterly deformed as in differentiated
but the skin is. for the mos: part
tightly strained over the features with mummy.
Ike aspect. the eyelids droop. tears continually
flow. and the lower lip hangs down and exposes
the teeth and gums. The taste. sight and smell
fail. but the voice is not affected. l6) The eye
broWs and lsshes. and the other hair, generally
fall or become white. "a The progress of the
disease is even much slower than that Of tuber-
cuated elephaniiasis, and its fatal termination is
not so nearly certain. The average duration Of
life after The first appearance of the disease iu
the one is ten years, in the other nearly twenty,
or in India above thirty yesrsk In each Of
the two forms death is mostly preceded
BY an attack of dyseutery. See IL. Isl An
sslheiic elephantiasis is sometimes called The
oint evil. and sometimes the dry leprosy but it
IS still more frequently known as the white lepro-
y. and under that name is COMPOUNDED with what
Is more properly called The leprosy (lspra 1uE
garisl TO which it bears, in its early stages.
superficial resemblance. See I'll. and notes on
Lev. xiii u. IS.
VI. Both these forms of eIepbantiasis were
well known to the ancient physicians, and were
accurately desclibed by them, but they we're
treated as separate diseases. Areiaus and CELSIUS
al ~ - IL