. A practical treatise on medical diagnosis for students and physicians . destruction of tissue. The disease occurs especially from puberty tothe thirtieth year, and oftener in men than in women. It develops slowlyand insidiously. Sometimes the first skin-lesion is a crop of bullae,suggestive of pemphigus. More commonly there appear reddish orviolet-colored patches, varying in size from ^ inch to 2 or 3 inchesin diameter, and becoming of a darker hue later. The next step LEPROSY. 807 is the formation of nodules, Mhieli are characteristic of the may develop upon the patches alread


. A practical treatise on medical diagnosis for students and physicians . destruction of tissue. The disease occurs especially from puberty tothe thirtieth year, and oftener in men than in women. It develops slowlyand insidiously. Sometimes the first skin-lesion is a crop of bullae,suggestive of pemphigus. More commonly there appear reddish orviolet-colored patches, varying in size from ^ inch to 2 or 3 inchesin diameter, and becoming of a darker hue later. The next step LEPROSY. 807 is the formation of nodules, Mhieli are characteristic of the may develop upon the patches already described, or in other j^ vary in size from that of a pea to that of a birds egg or are most conmion upon the face and extensor surfaces of the arms,legs, lingers, and toes. The tubercles consist of an infiltration into thetrue skin ; they are raised, firm, relatively painless, and vary in colorfrom red to copper. The face is characteristically distorted into a fierceexpression (leontiasis). The tubercles may become absorbed and leave Fig. Leprosy. atrophic areas, but generally they break down into eroding ulcers, whichslowly burrow aud increase in extent, eating off a portion of the nose,fingers, hands, and feet, and exposing muscles, tendons, nerves, blood-vessels, and bone. Tubercles form also upon nerve-trunks, and ulcersupon the mucous membranes. (See the JSTose and Larynx.) In other cases, or in combination with the tubercles, especially u])outhe limbs and trunk, there are ancesthdic areas. Ulcers may follow with- 808 THE INFECTIONS. out the previous occurrence of tubercles. With the anaesthetic patchesare associated crops of bull(B and neuritis. The further peculiarities of the disease are : its long duration, its slowprogress interrupted by apparent healing of some of the ulcers ; its afebrilecourse (the temperature is generally subnormal); its comparative pain-lessness, and the slight impairment of the general health. Death results from gr


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