Recorded at the department of Dr. Muir at the College for Tropical Medicine
and the Alberth Victoria Hospital in Calcutta.
The outpatient material is examined at the research facility, sorted by stages and forms
and the patients are either treated as outpatients or admitted to one of the leprosy hospitals.
Here follows first the initial stages.
Nerve case (category A1). The anesthetic area is outlined with a skin marker.
Nerve case (category A2). Displays the leprous thickening of the nerves, plaques and early nodules.
Moving on to skin affections.
Nerve-skin case (category A2-B1). Numerous lesions in the face, upper body and
the extremities.
The thickened nerve is indicated by a finger. Occasionally, in the middle of the nodules,
you will observe visibly dark areas which result from the excising of specimens. One sees that large areas of the skin are
depigmented with plaques and growing early nodules. The cases described so far,
were preliminarily described as negative. The exact diagnosis could only be established
based on sensitivity tests and bacteriological examination of nasal secretion
and small excised skin samples.
The following case clearly shows the process of infection. A barber working at the bazaar in
the countryside typically shaves the healthy and the infected indiscriminately, and in this way is infected with leprosy.
You can observe how a heavily infected leprosy patient (category B3-B2) is shaved by the barber.
In the place on the forearm where he rubs off the soap, the barber has developed an anesthetic plaque (category A1).
Skin case (category B1).
Skin case (category B2). Ear and knee affected.
Skin case (category B2). Both earlobes affected.
Skin case (category B2). The nasal secretion showed a strong positive reaction--the skin lesions were also positive.
Skin case (category B2). Only the smear tests were positive, not the epithelial tissue.
The Albert-Victoria Hospital. The facilities.
The patients move about completely freely, so far as their health allows,
and keep themselves busy.
Severe skin case (category B3-B2-A2). The most severe changes are found in the face and the upper extremities.
The anesthetic lesions are expressions of category A2.
Nerve case (category A1-A2). Characterized by anesthesia--in the shape of a glove--and tropical disorders of
the skin, along with nodules artificially created by the treatment.
This is a skin case (category B3) that has improved to category B2-A2. The treatment has shrunk the
previously inflamed skin and has produced the so-called "shrunken elephant skin."
Skin case (category B3-A2). Leonine facies (lion face) with severe tropical damage in the
extremities. Toes have been lost.
Both the following two cases (category B3 to A2) show swellings and tuberous changes in the
skin that is of particular interest. The first shows ulcers in the eyelids, while
the second has expressed nodular changes in the eyeball.
The following two cases show a variety of skin and nerve conditions (category B3-A2), with profound tropical
ulcers, tropical skin changes, mutilations, clawed hand, Facies Leonidas (lion face) and tuberous lesions.
The treatment of leprosy with chaulmoogra oil obtained from trees planted in the hospital garden itself.
The oil is recovered from Hydnocarpus Whightiana, and the treatment is administered as a combination of injections and
inunctions of the patients. The injections take place using a specially designed short and thick
injection needle intracutaneously. Both the oil and esters of the fruit are used.
The intracutaneous injections are administered once or twice a week, in doses of one to five cubic centimeters, which is injected
under the skin to create nodules measuring between a half and three quarters of a cubic centimeter. The dosage must be carefully
made, and controlled by determining the sedimentation rate of the blood, in order to avoid severe
local and general reactions.