. A practical treatise on diseases of the skin, for the use of students and practitioners . tificial distinction betweencases of leprosy, by assigning them to three varieties, tubercu-lar, macular, and anaesthetic. It will be understood, then, inseparately considering these three forms, that the distinctionbetween them is useful simply for the purposes of classification;that mixed eases of the disease occur which it would be diffi-cult to assign to either variety exclusively; and that eachmerely represents a predominance of certain lesions at one path-ological epoch. It should be noted also th
. A practical treatise on diseases of the skin, for the use of students and practitioners . tificial distinction betweencases of leprosy, by assigning them to three varieties, tubercu-lar, macular, and anaesthetic. It will be understood, then, inseparately considering these three forms, that the distinctionbetween them is useful simply for the purposes of classification;that mixed eases of the disease occur which it would be diffi-cult to assign to either variety exclusively; and that eachmerely represents a predominance of certain lesions at one path-ological epoch. It should be noted also that the symptoms ofleprosy are particularly remarkable for their polymorphism, awide variation often existing between the character of two ormore lesions which at any given moment are apparent. This islargely owing to the fact that leprosy is a general and constitu-tional disorder, the cutaneous symptoms of which are simply itssurface markings. Lepra Tuberosa. Tubercular leprosy commonly begins in the skin with macu-lar lesions. These are bean to tomato-sized, reddish, brownish, Fig. %i>A i,,,, lss,.n and Boeck.) or bronze patches; roundish, ovalish, or irregular in contour;and occurring upon the face, trunk, or extremities. The skin LEPRA. 425 covering these is either smooth and shining as if oiled ; or mode-rately infiltrated and elevated. After a period ranging in duration from weeks to years,tubercles rise from these maculations, varying in size from apea to a nut, though they may be as large as a tomato. Theyare yellowish, reddish, brown, or bronzed in color, often shiningas if varnished or oiled, covered with a soft, natural, or slightlydesquamating epidermis, roundish, or quite irregular in contour,and either isolated or grouped. Numbers of very small and illdetermined nodules may often be recognized by careful exami-nation of the skin in the vicinity of those fully may be either cutaneous or subcutaneous in situation, andsoftish or quite firm to th
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