Vol. 60, 1909 - University of North Carolina at Chapel Hill

.!14 THE CHARLOTTE MEDIOAL JOURNAL
intended or included in the descriptions presents a white diseased surface, and these '\
given. It is, he believes, improper to ap- instances probablv related to psoriasis, as i
ply the term, "the leprosy of the Bible" to in the case of Moses' hand, Miriam, and l|
the disease under discussion, lepra, or Gehazi; also in many places the Bible '
elephantiasis Graecorum, as studied so thor- speaks of the skin tun ing while with white !
oughlyin Norway and observed abundantly hair on it, referring to leucoderma, etc. It :.'
in the East, and more or less over various is to be remembered that not long ago the i!
portions of the earth. word lepra, now exclusively applied to lep- j
It is to be remembered that the Levitical rosy, or elephantiasis Grsecorum, was a
law was given at Sinai, or soon after, when common designation for psoriasis, used thus j
there was an enormous, untrained horde of by Mr. Erasmus Wilson of London, and !(
Israelites, recently escaped from bondage,
who were being welded into a nation, during
forty years of a roving, nomad life. In
also as the title of quite a large book on ;
psoriasis, by George Gaskoin; while the i
word "lepra'' is used in the Greek New •
order rightly to shape this people the great Testament to indicate the leprosy of the li
law-giver Moses, by Divine direction, formu- Bible, and this word lepra means scales, •
i
i
lated many laws and rules, in regard to Finally, the word zara'ath, translated lep- ;
health as well as in regard to moral and rosy in the Old Testament, signifies a smitreligious
matters, which formed the basis ing or stroke, and in the German of the
for the national life of the Jews for many middle ages the same word was translated
centuries, and are operative in a measure aussasdig, indicating an outcast, or one uneven
to the present day. fit to live with others.
Now among the manv ordinances relat- , „
„
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^ 1,1.1 ... iiig to health it became necessary to treat
DRIC ACID rtND GOUT.
of diseases appearing on the skin, some of His and Freudweiler have not long since
which are contagious and which, if neg- produced evidence to account for the
lected, would readily spread among those Sodium Urate deposits in cases of gout,
living together in tents, unless some sanitary
precautions were taken. We must re-
They showed that an inflammatory process,
similar to the one observed in gout, can be
member, however, that there were no books produced by a crystalline deposition of
and no medical science in those days, but sodium biurate; and Kionka has shown by
that the priests were about the only ones animal experiments that a long-continued
who possessed knowledge of any kind, increase of the alimentary uric acid content
Consequently we find in Leviticus just about of the blood leads—at least in certain places
what we would expect, a layman (in medi- —to a precipitation of uric acid crystals,
cine) Moses, writing for lay priests, and The concurring views of numerous authors,
consequently it is by no means a scientific that a primary overloading of the blood
discussion of the subject of leprosy. with uric acid plays an important role in
It is, therefore, no wonder that the de- bringing about a condition favorable for
scription of the various conditions found on the urate deposit, meet with no serious
the skin should be more or less confused, controversy. The questions, however, still
so that only by the most careful study can remaining to be studied are: \. Why in
one make out what is intended. Several cases of leukemia, pneumonia, and of
who have investigated the matter state that chronic nephritis, in which there is like-'
undoubtedly a number of different diseases wise a noticeable overloading of the blood
appearing on the skin are included in the serum with uric acid, there seldom or never'
Biblical accounts, and one can discover in- results a condition similar to the one obdistinct
references sufficient to identify some served in gout; and 2. Why the deposits!
of them; thus, writers have found allusion are always formed in certain predetermined;
to syphilis, favus, ringworm, pinta, scabies, places in the body H. Strauss, in his re-,
psoriasis, eczema, morphcEa, leucoderma, cent excellent monograph, says in regard to!
and perhaps other affections on the skin, the first point, that the combination of goutl
but, as intimated, before, no one well ac- and leukemia has been described by Duckquainted
with true leprosy, as recognized worth, Pibram, and Ebstein, but that such'
today, would Ije able to find any descrip- cases are very rare; however, he refers to
tion at all fitting to any of its symptoms in the fact that gout and nephritis occur COthe
Bible. The cry of "unclean, unclean," incidently by no means infrequently, ."^cand
the eeparation of those afflicted, with cording to Strauss in gout the overloading
out the camp, related therefore to various of the blood serum and the tissue fluid witi
eruptions on the skin and not at all to uric acid is not a necessary condition fe
present-day leprosy, and affords not the the precipitation of the crystalline deporfi
slightest reason for such action today. of acid sodium urate. And, also, the fa
It is, however, now known that neither that this crystalline precipitation does n
the tubercular nor the macular leprosy ever take place in all tissues, but only in certait