On leprosy (1987)

[Music] the purpose of this short video is to demonstrate the value of this type of presentation of a primary source for students of the history of medicine the work we've chosen is the Atlas published in 1847 by Danielson and Burke accompanying their book baled which is our first modern description of leprosy predating Hansen's account of the microbacterial nature of the Disease by a quarter of a century the superb plates show the appearances of patients in the leper Hospital in Bergen during the mid 19th century the atlas is extremely rare originally belong to Dr n an English surgeon interested in the disease it is now in the library of the welcome Institute for history of medicine the Rarity of this Atlas together with its fragile nature make it a suitable volume for representation by AI visual methods we include an abbreviated version of Dr L's abstract from Danielson and Burke's book he prefaces his remarks as follows these plates were colored in 1847 and some of the colors have since then changed and become blackish and not as they were at first with this exception the plates are exceedingly accurate leprosy is found in two forms the tubercular and the anesthetic the one affecting principally the skin and mucous membranes and in its morbid Anatomy reminding us of scrofula the other attacking in a more Insidious manner the nervous centers and producing various peripheral lesions as a consequence the first appearance of tubercular leprosy is an eruption of rounded blotches red or brownish slightly elevated above the skin these blotches are at first transient Vanishing and reappearing for some months or years at length they become permanent in more of a bluish tint after a Time the blotches become prominent new blotches appear and the hair falls off from the affected Parts the blotches become cubicles when the mouth throat and nostrils are affected the tubic soon soften and the parts are destroyed by ulceration wherever the tubic are whether within or without the body their tendency is to soften open discharge yellowish white substance and leave numerous discharging ulcers the eyes are often attacked in tubercular leprosy the anesthetic leprosy is more Insidious after some months or years bully like pagus appear leaving ulcerated surfaces when they burst this is repeated for some years the ulcers when healed leave white shining cuses a little sunk in the skin and slightly insensible and any hairs on them are turned white the eyes become affected and sight is slowly destroyed the cheeks become palid and slack the mouth is drawn to one side and the lower lip hangs open the nasal cavity dries up and the septum nesi is perforated by ulcers the anesthesia advances perie pursue with these changes and at length not only May the eyeball cheeks lips gums and inside of the nostrils be touched without the patients perceiving it but the limbs may be burnt or amputated without pain the skin is undermined an ulcer forms laying bare the muscles the anesthesia being fully developed necrosis sets in usually attacking the bones of the fingers or toes fingers and toes are lost one after another and the metatarsal bones are destroyed leaving a clubbed stump of hand or foot after death some part of the spinal cord is found to have an albuminous exudation in the sub aridian cellular tissue the same is found in the shields of nerves which are sometimes arfid and also in the brain especially about the base and at the origin of the fifth sixth sth and eighth pairs of nerves such are the two forms in which true leprosy or spit appears this brief sketch of leprosy is condensed from the full detailed account of it by Danielson and book a volume of 500 pages with ample bibliography done that de [Music]