Leprosy : $b in its clinical & pathological aspectsHansen, G. Armauer (Gerhard Armauer)
Science
Leprosy : $b in its clinical & pathological aspects
Hansen, G. Armauer (Gerhard Armauer)
Leprosy
The spinal cord twice showed macroscopic changes (thin and atrophic
once, thickening and hyperæmia of the lumbar cord once).
The most of these brains and cords, which are entered as normal, were
unfortunately only examined macroscopically.
Two cords thoroughly examined by Weigert’s method showed degeneration
of the posterior columns.
The peripheral nerves were probably examined in all cases, but only the
results of a few of the examinations are noted.
The lungs were found tubercular thirteen times, the intestine four
times, once without the presence of pulmonary tuberculosis being noted,
this making fourteen cases of tuberculosis out of thirty-six--almost
exactly 39 per cent. In the nodular form we had thirty-six undoubted
tubercular cases out of eighty-nine--rather over 40 per cent. Possibly,
and indeed probably, some insufficiently described cases in this form
were also tubercular, but the frequency of tuberculosis is so nearly
equal in both forms, that there is no ground for supposing that the
particular form of leprosy has any relation to the development of
tuberculosis. Under precisely similar conditions, in our institution,
the nodular and maculo-anæsthetic cases were pretty equally attacked by
tubercle. If Leloir means to say that tuberculosis is much rarer in
the maculo-anæsthetic form, than in the nodular, it is certainly not
the case in our leper hospitals.
So far as concerns the _necrosis of the bones_, the panaritii and
periostitides, we have found in them nothing specific; we have often
sought for bacilli, but always in vain. Pyogenic cocci, usually the
staphylococcus aureus, we have found both microscopically and in
cultivations.
The mutilation of the bones may occur from concentric atrophy alone,
as demonstrated by Prof. Hjalmar Heiberg (_Klinisk arbog_, III). The
phalanges of the hands and feet, the bones of the metacarpus and
metatarsus, and even the carpal and tarsal bones, diminish in all their
dimensions, evidently from trophic changes, the result of the neuritis.
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