File:Medical diagnosis for the student and practitioner (1922) (14804599183).jpg

Identifier: medicaldiagnosi00gree (find matches)
Title: Medical diagnosis for the student and practitioner
Year: 1922 (1920s)
Authors: Greene, Charles Lyman, 1862-
Subjects: Diagnosis
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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the fetus, and that in nearly all cases it is acquired, the young children of
leprous parents being especially exposed to the bacilli which may be found
in nearly all of the excretions and secretions of affected cases.* Most

*Statistics show that 93 per cent, of the children of lepers escape infection.

1120 MEDICAL DIAGNOSIS

intimate contact seems indispensable to infection, inasmuch as nurses and
doctors in leprous settlements are rarely attacked, and it is probable that
the nasal passages represent the usual channels of infection though it is said
to occur even through the skin and to be conveyed through clothing as in the
case of washerwomen especially. Inoculation experiments as applied to man
have proved unsuccessful save in one case of Arnings who inoculated an
Hawaiian criminal who later developed the disease.
The solitary instance is not sufficient to establish the communicability
of the disease by artificial means.
Text Appearing After Image:

Fig. 539.—Tumor-like leprosy nodules. (Deycke.)

The anesthetic form is but slightly communicable, the tubercular type most
dangerous, although the necessity for some intermediate change in the
virus antecedent to transfer of infection is suggested strongly by its vagaries
of transmission. No intermediary host is known.
Incubation Period.—From two to ten or even twenty years may elapse
between known exposure and the development of recognizable symptoms.
Sex.—The incidence in the male is double that in the female.
Development of Leprosy.—The close resemblance of leprosy to tubercu-
losis in many particulars is no less remarkable than the likeness of its stages
to the development of syphilis. The initial lesion is believed, by some author-
ities, to be represented by an ulcer or excoriation on the nasal septum.
There is a prodromal stage resembling the second stage of syphilis in that it is
associated with transient fever, headache, joint pains, and commonly with
epistaxis, possibly due to the septal ulceration, and after several months or

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