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LEPIDUS

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Originally appearing in Volume V16, Page 481 of the 1911 Encyclopedia Britannica.
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LEPIDUS, the name of a Roman patrician family in the Aemilian gens. 1. MARCUS AEMILIUS LEPIDUS, one of the three ambassadors sent to Egypt in 201 B. C. as guardians of the infant king Ptolemy V. He was consul in 187 and 175, censor 179, pontifex maximus from 18o onwards, and was six times chosen by the censors princeps senatus. He died in 152. He distinguished himself in the war with Antiochus III. of Syria, and against the Ligurians. He made the Via Aemilia from Ariminum to Placentia, and led colonies to Mutina and Parma. Livy xl. 42-46, epit. 48; Polybius xvi. 34. 2. MARCUS AEMILIUS LEPIDUS, surnamed PORCINA (probably from his personal appearance), consul 137 B.C. Being sent to Spain to conduct the Numantine war, he began against the will of the senate to attack the Vaccaei. This enterprise was so unsuccessful that he was deprived of his command in 136 and condemned to pay a fine. He was among the greatest of the earlier Roman orators, and Cicero praises him for having or hairy with a curiously forked tail-segment. A similar larva characterizes the South American Brassolinae or owl-butterflies 'e ~ After A. R. Grote, Nalu.ol Science, vol. 12 (J. M. Dent & Co.). 2, Sub-costal. 3, Radial. 4, Median. 5, Cubital. 7, 8, Anal nervures. Regions. robust insects (figs. 72, 73) with the areolets closed in both wings, which are adorned with large " eye-spots " beneath. The Satyrinae, introduced the well-constructed sentence and even flow of from the most diverse industries. The Academie des Sciences language from Greek into Roman oratory. conferred on him the Montyon prize. Napoleon III., who held Cicero, Brutus, 25, 27, 86, 97; Veil. Pat. ii. To; Appian, Hisp. him in high esteem, entrusted him with the organization of the 8o-83; Livy, epit. 56. Exhibition of 1855, and appointed him counsellor of state, 3. MARCUS AEMILIUS LEPIDUS, father of the triumvir. In commissioner general of the Exhibition of 1867, senator of the 81 B.C. he was praetor of Sicily, where he made himself detested empire and grand officer of the Legion of Honour. He died in by oppression and extortion. In the civil wars he sided with Paris on the 5th of April 1882. Sulla and bought much of the confiscated property of the Marian partisans. Afterwards he became leader of the popular party, In 1856 Le Play founded the Societe Internationale des etudes d with the help of Pompey elected consul for in site pratiques d'Economie sociale, which has devoted its energies princip- and was e 78, spite ally to forwarding social studies on the lines laid down by its founder. of the opposition of Sulla. When the dictator died, Lepidus The journal of the society, La Reforme sociale, founded in 1881, is tried in vain to prevent the burial of his body in the Campus published fortnightly. Other works of Le Play are La Reforme Martins, and to alter the constitution established by him. His sociale (2 vols., 1864; 7th ed., 3 vols., 1887); L'Organisation de la Lutatius Catulus found a tribune to his veto on famille (1871); La Constitution de l'Angleterre (in collaboration with colleague place M. Delaire, 1875). See article in Harvard Quarterly Journal of Lepidus's proposals; and the quarrel between the two parties Economics (June 1890), by H. Higgs. in the state became so acute that the senate made the consuls LEPROSY (Lepra Arabum, Elephantiasis Graecorum, Aussatz, swear not to take up arms. Lepidus was then ordered by the Spedalskhed), the greatest disease of medieval Christendom, senate to go to his province, Transalpine Gaul; but he stopped identified, on the one hand, with a disease endemic from the in Etruria on his way from the city and began to levy an army. earliest historical times (1500 B.C.) in the delta and valley of the He was declared a public enemy early in 77, and forthwith Nile, and, on the other hand, with a disease now common in Asia, marched against Rome. A battle took place in the Campus Africa, South America, the West Indies, and certain isolated Martius, Pompey and Catulus commanding the senatorial army, localities of Europe. An authentic representation of the leprosy and Lepidus was defeated. He sailed to Sardinia, in order to of the middle ages exists in a picture at Munich by Holbein, put himself into connexion with Sertorius in Spain, but here also painted at. Augsburg in 1516; St Elizabeth gives bread and wine suffered a repulse, and died shortly afterwards. to a prostrate group of lepers, including a bearded man whose face Plutarch, Sulla, 34, 38, Pompey, 15; Appian, B.C. i. 105, 107; Livy, epit. 90; Florus iii. 23; Cicero, Balbus, 15. is covered with large round reddish knobs, an old woman whose 4. MARCUS AEMILIUS LEPIDUS, the triumvir. He joined the arm is covered with brown blotches, the leg swathed in bandages party of Julius Caesar in the civil wars, and was by the dictator through which matter oozes, the bare knee also marked with thrice nominated magister equitum and raised to the consulship discoloured spots, and on the head a white rag or plaster, and, in 46 B.C. He was a man of great wealth and influence, and it was thirdly, a young man whose neck and face (especially round the probably more on this ground than on account of his ability somewhat hairless eyebrows) are spotted with brown patches that Caesar raised him to such honours. In the beginning of of various size. It is conjectured by Virchow that the painter 44 B.0 he was sent to Gallia Narbonensis, but before he had left had made studies of lepers from the leper houses then existing the city with his army Caesar was murdered. Lepidus, as at Augsburg. These external characters of medieval leprosy commander of the only army near Rome, became a man of great agree with the descriptions of it by the ancients, and with the importance in the troubles which followed. Taking part with pictures of modern leprosy given by Danielssen and Boeck for Marcus Antonius (Mark Antony), he joined in the reconciliation Norway, by various authors for sporadic European cases, by which the latter effected with the senatorial party, and afterwards Anderson for Malacca, by Carter for India, by Wolff for Madeira sided with him when open war broke out. Antony, after his and by Hillis for British Guiana. There has been some confusion defeat at Mutina, joined Lepidus in Gaul, and in August 43 in the technical naming of the disease; it is called Elephantiasis Octavian (afterwards the emperor Augustus), who had forced (Leontiasis, Satyriasis) by the Greek writers, and Lepra by the the senate to make him consul, effected an arrangement with Arabians. Antony and Lepidus, and their triumvirate was organized at Leprosy is now included among the parasitic diseases (see Bononia. Antony and Octavian soon reduced Lepidus to an PARASITIC DISEASES). The cause is believed to be infection inferior position. His province of Gaul and Spain was taken from by the bacillus leprae, a specific microbe discovered by Armauer him; and, though he was included in the triumvirate when it Hansen in 1871. It is worthy of note that tuberculosis is very was renewed in 37, his power was only nominal. He made an effort in the following year to regain some reality of power, conquered part of Sicily, and claimed the whole island as his province, but Octavian found means to sap the fidelity of his soldiers, and he was obliged to supplicate for his life. He was allowed to retain his fortune and the office of pontifex maximus to which he had been appointed in 44, but had to retire into private life. According to Suetonius (Augustus, 16) he died at Circeii in the year 13. See ROME : History ii., " The Republic," Period C, ad fen. ; Appian, Bell. Civ. ii.-v.; Dio Cassius xli.-xlix.; Veil. Pat. ii. 64, 8o; Orelli's Onomaslicon to Cicero. LE PLAY, PIERRE GUILLAUME FREDERIC (1806-1882), French engineer and economist, was born at La Riviere-Saint-Sauveur (Calvados) on the Ilth of April 18o6, the son of a custom-house official. He was educated at the Ecole Poly-technique, and from there passed into the State Department of Mines. In 1834 he was appointed head of the permanent committee of mining statistics, and in 184o engineer-in-chief and professor of metallurgy at the school of mines, where he became inspector in 1848. For nearly a quarter of a century Le Play spent his vacations travelling in the various countries of Europe, and collected a vast quantity of material bearing upon the social condition of the working classes. In 1855 he published Les Ouvriers europeens, which comprised a series of thirty-six monographs on the budgets of typical families selected common among lepers, and especially attacks the serous membranes. The essential character of leprosy is a great multiplication of cells, resembling the " granulation cells " of lupus and syphilis, in the tissues affected, which become infiltrated and thickened, with degeneration and destruction of their normal elements. The new cells vary in size from ordinary leucocytes to giant cells three or four times larger. The bacilli are found in these cells, sometimes in small numbers, sometimes in masses. The structures most affected are the skin, nerves, mucous membranes and lymphatic glands. The symptoms arise from the anatomical changes indicated, and they vary according to the parts attacked. Three types of disease are usually described—(1) nodular, (2) smooth or anaesthetic, (3) mixed. In the first the skin is chiefly affected, in the second the nerves; the third combines the features of both. It should be understood that this classification is purely a matter of convenience, and is based on the relative prominence of symptoms, which may be combined in all degrees. The incubation period of leprosy—assuming it to be due to infection—is unknown, but cases are on record which can only be explained on the hypothesis that it may be many years. The invasion is usually slow and intermittent. There are occasional feverish attacks, with the usual constitutional disturbance and other slight premonitory signs, such as changes in the colour of the skin and in its sensibility. Sometimes, but rarely, the onset is acute and the characteristic symptoms develop rapidly. These begin with an eruption which differs markedly according to the type of disease. In the nodular form dark red or coppery patches appear on the face, backs of the hands, and feet or on the body; they are generally symmetrical, and vary from the size of a shilling upwards. They come with one of the feverish attacks and fade away when it has gone, but only to return. After a time in-filtration and thickening of the skin become noticeable, and the nodules appear. They are lumpy excrescences, at first pink but changing to brown. Thickening of the skin of the face produces a highly characteristic appearance, recalling the aspect of a lion. The tissues of the eye undergo degenerative changes; the mucous membrane of the nose and throat is thickened, impairing the breathing and the voice; the eyebrows fall off; the ears and nose become thickened and enlarged. As the disease progresses the nodules tend to break down and ulcerate, leaving open sores. The patient, whose condition is extremely wretched, gradually becomes weaker, and eventually succumbs to exhaustion or is carried off by some intercurrent disease, usually inflammation of the kidneys or tuberculosis. A severe case may end fatally in two years, but, as a rule, when patients are well cared for the illness lasts several years. There is often temporary improvement, but complete recovery from this form of leprosy rarely or never occurs. The smooth type is less severe and more chronic. The eruption consists of patches of dry, slightly discoloured skin, not elevated. above the surface. These patches are the result of morbid changes affecting the cutaneous nerves, and are accompanied by ,diminished sensibility over the areas of skin affected. At the same time certain nerve trunks in the arm and leg, and particularly the ulnar nerve, are found to be thickened. In the further stages the symptoms are those of increasing degeneration of the nerves. Bullae form on the skin, and the discoloured patches become enlarged; sensation is lost, muscular power diminished, with wasting, contraction of tendons, and all the signs of impaired nutrition. The nails become hard and clawed; perforating ulcers of the feet are common; portions of the extremities, including whole fingers and toes, die and drop off. Later, paralysis becomes more marked, affecting the muscles of the face and limbs. The disease runs a very chronic course, and may last twenty or thirty years. Recovery occasion-ally occurs. In the mixed form, which is probably the most common, the symptoms described are combined in varying degrees. Leprosy may be mistaken for syphilis, tuberculosis, ainhum (an obscure disease affecting negroes, in which the little toe drops off), and several affections of the skin. Diagnosis is established by the presence of the bacillus leprae in the nodules or bullae, and by the signs of nerve degeneration exhibited in the anaesthetic patches of skin and the thickened nerve trunks. In former times leprosy was often confounded with other skin diseases, especially psoriasis and leucoderma; the white leprosy of the Old Testament was probably a form of the latter. But there is no doubt that true leprosy has existed from time immemorial. Prescriptions for treating it have been found in Egypt, to which a date of about 4600 B.C. is assigned. The disease is described by Aristotle and by later Greek writers, but not by Hippocrates, though leprosy derives its name from his " lepra " or " scaly " disease, which was no doubt psoriasis. In ancient times it was widely prevalent throughout Asia as well as in Egypt, and among the Greeks and Romans. In the middle ages it became extensively diffused in Europe, and in some countries—France, England, Germany and Spain—every considerable town had its leper-house, in which the patients were segregated. The total number of such houses has been reckoned at 19,000. The earliest one in England was established at Canterbury in 1096, and the latest at Highgate in 1472. At one time there were at least 95 religious hospitals for lepers in Great Britain and 14 in Ireland (Sir James Simpson). During the 15th century the disease underwent a remarkable diminution. It practically disappeared in the civilized parts of Europe, and the leper-houses were given up. It is a singular fact that this diminution was coincident with the great extension of syphilis (see PROSTITUTION). The general disappearance of leprosy at this time is the more unintelligible because it did not takeeffect everywhere. In Scotland the disease lingered until the 19th century, and in some other parts it has never died out at all. At the present time it still exists in Norway, Iceland, along the shores of the Baltic, in South Russia, Greece, Turkey, several Mediterranean islands, the Riviera, Spain and Portugal. Isolated cases occasionally occur elsewhere, but they are usually imported. The Teutonic races seem to be especially free from the' taint. Leper asylums are maintained in Norway and at two or three places in the Baltic, San Remo, Cyprus, Constantinople, Alicante and Lisbon. Except in Spain, where some increase has taken place, the disease is dying out. The number of lepers in Norway was 3000 in 1856, but has now dwindled to a few hundreds. They are no longer numerous in any part of Europe. On the other hand, leprosy prevails extensively throughout Asia, from the Mediterranean to Japan, and from Arabia to Siberia. It is also found in nearly all parts of Africa, particularly on the east and west coasts near the equator. In South Africa it has greatly increased, and attacks the Dutch as well as natives. Leper asylums have been established at Robben Island near Cape Town, and in Tembuland. In_7lustralia, where it was introduced by Chinese, it has also spread to Europeans. In New Zealand the Maoris are affected; but the amount of leprosy is not large in either country. A much more remarkable case is that of the Hawaiian Islands, where the disease is believed to have been imported by Chinese. It was unknown before 1848, but in 1866 the number of lepers had risen to 230 and in 1882 to 4000 (Liveing),. All attempts to stop it by segregating lepers.in the settlement of Molokai appear to have been fruit-less. In the West Indies and on the American continent, again, leprosy has a wide distribution. It is found in nearly all parts of South and Central America, and in certain parts of North America—namely, Louisiana, California (among Chinese), Minnesota, Wisconsin and North and South Dakota (Norwegians), New Brunswick (French Canadians). It is difficult to find any explanation of the geographical distribution and behaviour of leprosy. It seems to affect islands and the sea-coast more than the interior, and to some extent this gives colour to the old belief that it is caused or fostered by a fish diet, which has been revived by Mr Jonathan Hutchinson, but is not generally accepted. Leprosy is found in interiors where fish is not an article of diet. Climate, again, has obviously little, if any, influence. The theory of heredity is equally at fault, whether it be applied to account for the spread of the disease by transmission or for its disappearance by the elimination of susceptible persons. The latter is the manner in which heredity might be expected to act, if at all, for lepers are remarkably sterile. But we see the disease persisting among the Eastern races, who have been continuously exposed to its selective influence from the earliest times, while it has disappeared among the Europeans, who were affected very much later. The opposite theory of hereditary transmission from parents to offspring is also at variance with many observed facts. Leprosy is very rarely congenital, and no cases have occurred among the descendants to the third generation of 16o Norwegian lepers settled in the United States. Again, if hereditary transmission were an effective influence, the disease could hardly have died down so. rapidly as it did in Europe in the 15th century. Then we have the theory of contagion. There is no doubt that human beings are inoculable with leprosy, and that the disease may be communicated by close contact. Cases have been recorded which prove it conclusively; for instance, that of a man who had never been out of the British islands, but developed leprosy after sharing for a time the bed and clothes of his brother, who had contracted the disease in the West Indies. Some of the facts noted, such as the extensive dissemination of the disease in Europe during the middle ages, and its subsequent rapid decline, suggest the existence of some unknown epidemic factor. Poverty and insanitation are said to go with the prevalence of leprosy, but they go with every malady, and there is nothing to show that they have any special influence. Vaccination has been blamed for spreading it, and a few cases of communication by arm-to-arm inoculation are recorded. The influence of this factor, however, can only be trifling. Vaccination is a new thing, leprosy a very old one; where there is most vaccination there is no leprosy, and where there is most leprosy there is little or no vaccination. In India 78% of the lepers are unvaccinated, and in Canton since vaccination was introduced leprosy has declined (Cantlie). On the whole we must conclude that there is still much to be learnt about the conditions which govern the prevalence of leprosy. With regard to prevention, the isolation of patients is obviously desirable, especially in the later stages, when open sores may disseminate the bacilli; but complete segregation, which has been urged, is regarded as impracticable by those who have had most experience in leprous districts. Scrupulous cleanliness should be exercised by persons attending on lepers or brought into close contact with them. In treatment the most essential thing is general care of the health, with good food and clothing. The tendency of modern therapeutics to attach increasing importance to nutrition in various morbid states, and notably in diseases of degeneration, such as tuberculosis and affections of the nervous system, is borne out by experience in leprosy, which has affinities to both; and this suggests the application to it of modern methods for improving local as well as general nutrition by physical means. A large number of internal remedies have been tried with varying results; those most recommended are chaulmoogra oil, arsenic, salicylate of soda, salol and chlorate of potash. Vergueira uses Collargol intravenously and sub-cutaneously, and states that in all the cases treated there was marked improvement, and hair that had been lost grew again. Calmette's Anterenene injected subcutaneously has been followed by good results. Deycke together with R. Bey isolated from a non-ulcerated leprous nodule a streptothrix which they call S. leproides. Its relation to the bacillus is uncertain. They found that injections of this organism had marked curative effects, due to a neutral fat which they named " Nastin." Injections of Nastin together with Benzoyl Chloride directly act on the lepra bacilli. Some cases were unaffected by this treatment, but with others the effect was marvellous. Dr W. A. Pusey of Chicago uses applications of carbon dioxide snow with good effect. In the later stages of the disease there is a wide field for surgery, which is able to give much relief to sufferers.
End of Article: LEPIDUS
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KARL RICHARD LEPSIUS (1810–1884)

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