Office of the Supervising Surgeon-General, M.H.S.
Washington, D.C., March 28th, 1895
To the Supervising Surgeon-General,
U.S. Marine Hospital Service,
I have the honor to make the following report on a specimen from a supposed case of leprosy, submitted for examination by Dr. C.O. Probst, Secretary of the Ohio State Board of Health.
The specimen presented for examination is a portion of the left hand, including the little and ring fingers. The entire member is thickened to about twice its natural size.
On the dorsum of the hand is an extensive superficial ulcer with sharply defined edge and irregular margin. At the wrist the ulceration has extended deeply through the tissues, amputating the hand at this point. A similar process seems to have affected the tip of the ring finger.
Sections were made and studied from seven different places. Four were taken from the edge of the ulcer, two from its center, and one through the skin and thickened subcutaneous tissue, including the nerve going to the little finger.
All the sections disclosed a general hypertrophy of the parts and a larger overgrowth of connective tissue. Some of the specimens from the edge of the ulcer showed the histology of the specific granulomata. A thickening of the blood vessel walls was noticed in the subcutaneous tissue.
All the sections were stained for lepra bacilli, with negative results. Those sections containing giant cells were also stained for tubercle bacilli, none were found.
The disease, therefore, in my opinion in neither leprosy nor tuberculosis, which, by exclusion, throws some weight upon the suspicion of syphilis.
(signed) M. J. Rosenau,
Passed Assistant Surgeon, M.H.S.