. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. ensi-bility, such as have been described;second, of perversions of sensation,which consist of dyssesthesias, formi-cation, numbness, and delayed sensa-tion; and third, abolition of sensation, which is more or less trophic changes involve the conjunctiva? and the mucous membranesof the nose, mouth, and throat, which may become dry and red and theseat of areas of superficial ulceration. The ulcers which form in the anes-thetic patches developing jn the hands and feet may
. Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index. ensi-bility, such as have been described;second, of perversions of sensation,which consist of dyssesthesias, formi-cation, numbness, and delayed sensa-tion; and third, abolition of sensation, which is more or less trophic changes involve the conjunctiva? and the mucous membranesof the nose, mouth, and throat, which may become dry and red and theseat of areas of superficial ulceration. The ulcers which form in the anes-thetic patches developing jn the hands and feet may be very destructive,giving rise to contracture and necrosis, which produce distressing deformi-ties, the loss of fingers and toes, and the development of perforating resorption of bone may take place. In favorable cases the disease may last for a long periotl withoutthe development of marked trophoneurotic changes. The average dura-tion of life in this form of leprosy is about tw^enty years. In someinstances the progress of the disease is arrested and the patient mayreach an advanced Fi<;. 2712.—An 180 MEDICAL DIAGNOSIS. (c) ]\IiXED OR Complete Leprosy.—The lesions peculiar to the tuber-cular and the anoBsthetic forms develop simultaneously, or in succession. Whilethe distinction between the two main forms is in well-marked cases sharplydefined, there are many cases which must be referred to the mixed form. Diagnosis.—The direct diagnosis of leprosy in the early stage ma} bedifficult. The erythematous macules with hypersesthesia, pain, and pig-mentation, and the subsequent development of tuberculous nodules arecharacteristic. In the nervous form the areas of persistent anaesthesia,with bullae, ulceration, deformities, and necrosis of the hands and feet, areimportant. A history of residence in a country in which leprosy prevails,even without actual association with known lepers, justifies the suspicionof contagion. The bacteriological examinatio
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectmedicine, bookyear192
