Leprosy

Generalized Sclerodermia.-H. D. HALDIN-DAVIS, F.R.C.S. This patient is a man, aged 68, who, two years ago, came to me suffering from sclerodermia which was nearly complete: the greater part of the arms, legs and abdomen was affected; the thorax was less involved but there was a very distinct central area over the sternum extending for some inches on either side over the pectoral muscle. There was, however, no interference with respiration. The face, hands and feet were unaffected. I thought that the prognosis was bad, but after I had taken him into hospital for a few weeks, during which the treatment consisted mainly of colonic irrigation, paraffin baths to the extremities and galvanic current-he also, of course, took the inevitable thyroid, but he has not had any of this for a good many months now-improvement set in and has continued ever since. Dr. Parkes Weber has shown a case of polydermatomyositis in which the patient recovered perfectly. My patient has not recovered perfectly although his improvement is undoubtedly remarkable. Two years ago the areas of sclerodermia which are still in evidence were much more extensive. The central plaque on the sternum then extended on to the pectoral muscles, the abdomen was much harder, and the limbs were more affected. At that time movement of his knees, which can now be bent easily, was so limited that he was unable to lace-up his boots. Since then his progress has been continued and every time I see him I note an improvement. I hope that in course of time he will be able to disprove Dr. Parkes Weber's dictum that the recovery of these cases is never complete.