SCARLET FEVER. Synonyms.—Scarlatina; Scarlet Rash. Definition ...

The specific cause, the bacillus lepræ, discovered by Hansen in 1874,
resembles the tubercle bacillus, though it may be distinguished from it
by “differential stains,” by their great number, and by their tendency to
form colonies, and to the fact that as yet it has failed to propagate in
inoculation tests.
Pathology.—The tubercles of leprosy are made up of granulomatous
tissue, and consist principally of round cells, in and between which are
found the bacilli in large numbers. These tubercular masses involve the
skin, and, pushing outward, form nodular masses, between which are
seen areas of ulceration and cicatrization, which, in the face, distort the
features, and give rise to the so-called facies leonina.
These tubercular masses caseate, soften, and discharge a thick purulent
material, or partial organization may take place, staying the further
progress of the disease.
The destruction of tissue proceeds gradually, years being occupied in
destroying the patient. The deep, ulcerative process may amputate
fingers and toes in its progressive march—lepra mutilans. When the
bacilli develop in the nerve fibers and their sheaths, a peripheral
neuritis results, with local anesthesia.
Symptoms.—This is a chronic disease, lasting from five to twenty
years before death finally ends what has been, for years, a living death.
Indefinite prodromal symptoms, such as malaise, general depression,
loss of appetite, gastro-intestinal disturbance, may appear months
before the outbreak. Two distinct forms are seen: 1. The nodular, or
tubercular; 2. The anesthetic.
Tubercular Form.—This is the most common form, embracing from sixty
to seventy per cent of all cases. The first suspicious or positive evidence
is the appearance of irregular spots or patches of erythema, more or less
clearly defined and slightly hyperesthetic. These always appear on the
face, though other portions of the body may be involved. After a time,
these may partially or wholly disappear for a season, but always
reappear, generally as circumscribed infiltrated spots. Gradually these
develop into leprous nodules. The nose and lips become thickened and
stiff.
These same tubercular masses appear in the nose, mouth, and throat;
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 235