?( 4 )
All Muhammadan lepers were of the tubercular type, and none of long stand-
ing. Of the Hindu cases, 1 was of 30 years' standing, 1 of 25, 1 of 20, 9 of between
10 and 20, and the rest below 10. The first case was that of a Koolwadi beggar,
the second of a Mahar beggar, and the third of Mahar cultivator.
Only 1 case is reported to have had syphilis 5 years before his admission into
the hospital.
KOLABA, BOMBAY CITY, AND TANNA.
No reports received.
SURAT.
History available of only 2 cases treated in 1875. Commencement of the
disease in the case of the first about 5 and in that of the second 3 years ago. Both
are married; the first having three children, of whom the youngest is 1 year old,
and the second having a daughter aged 20 years. Both are coolie labourers.
Both, though not particularly well nourished, had yet a sufficiency of food. Their
usual diet is fish, rice (respectively nagli and jowari), bread, dall, and vegetables.
The first smokes and drinks but takes no opium. The disease of both has no
hereditary history. The lungs, heart, liver and spleen of both, and the kidneys
of the second, are healthy. The urine in the first case is normal. The second has
a deficiency of tone at both apices, notwithstanding his quiet and equal respiration.
The first man suffers from a complete anęsthesia of the arms and hands up to the
shoulders, and is insensible to touch only in the legs, the feet and the ears. He has
perfect taste, hearing, sight and smell. The veins of the lower limbs are swollen;
in fact almost varicose. The veins of the fore-arms and hands are also swollen a
little, and the skin of the anęsthetic parts is more or less wrinkled. There is an
ulcer partially healed on the left hip. The original size of the ulcer is about 3
inches in circumference, and the unhealed portion is about as large as a pea.
Another partially healed ulcer exists on the outer front of the left knee about 1/2
inch in circumference. The left foot from about 2 inches above the malleolus is a
good deal swollen. There is a small ulcer below the inner ankle and scar just in
front of the ankle. The big toe is swollen and much ulcerated. The bone of the
last phalanx is destroyed, but the nail remains. There is a larger ulcer in the cleft
between the first and second toes. The little toe is gone, but the ulceration is
healed. The three other toes are swollen. The toes of the other foot are some-
what swollen, and there is a small partially healed ulcer on the outer ankle. Sexual
capacity and inclination are apparently lessened, and the right testicle is shrunken.
The second man has no anęsthetic disease, but has a depression at the bridge
of the nose, with a hole in its centre, caused, as the sufferer asserts, by an insect
getting into his nose while asleep, and afterwards giving birth to maggots.
There are no signs of syphilitic affection unless the ulceration of the nose is one.
The five fingers of the left hand has been ulcerated but are now healed, leaving
considerable deformity. The skin of the right extremity from elbow to wrist is
black and shrivelled, and the muscles wasted. The wrist is almost destroyed by
ulceration, and the hand is separated by ulceration from the wrist, being merely
attached by pieces of diseased skin and the remains of tendons. There is an
ulcer on the palm of the hand, and the little finger is quite gone. There is an
ulcer on each hip about the size of a crown piece; of the last mentioned two
ulcers, the first is partially healed and the second supperating. The second toe of
the left foot is ulcerated, and the big toe entirely destroyed. There are other
ulcerated places on both legs. Sexual inclination is impaired.
The first patient was for about seventeen days after his admission treated with
chalmogra oil with ordinary diet, milk and mutton. Under this treatment
some improvement was soon observable. In the left lower extremity over a
limited space on the inner aspect of the thigh and from the lower part of the gluteal
region downwards, some sensation was felt. It was also felt on some portions of
the inner side of the leg. The right leg felt lighter and was somewhat more sensi-
ble to touch. The upper extremities of the fingers except the palms and palmar
surface were, however, entirely insensible. The chalmogra oil was then discon-
tinued, and gurjun oil given instead. Under this treatment, sensation returned
partially in the right upper extremity. The inner part of the arm was sensitive
to touch, while a great part of the back of the arm and only a limited space in
front of the deltoid still remained devoid of sensation. A limited portion of the
right fore-arm (palmar aspect) from the elbow joint to within three inches of the
wrist was sensitive. This treatment continued for about a week, and sensation
became apparent in the left upper extremity above the elbow generally. There was
no sensation below the elbow except on the palm and palmar aspect of the fingers.