GENERAL DEPARTMENT.
Bombay Castle, 29th June 1887.
No. 1843.—The following observations on the
prevention of leprosy by segregation, by Brigade-
Surgeon H. V. Carter, M.I),, are published for
general information in continuation of Govern-
ment Notification No. 756, dated ôth March
1884 :—
" Further observation on the Prevention of Leprosy
by Segregation of the affected. (For preceding
Articles see the Bombay Government Gazette of
6th March 1884, Part III).
Having, in anticipation of the next quinquen-
nial report, received from Bergen a short sum-
mary of the latest results of the segregation
of lepers as carried out under the Norwegian
Government, I think it not inopportune, with
reference to recently awakened public interest
concerning leprosy in India and elsewhere, to
submit the following information. Dr. G. A.
Hansen's position as Director of the Norse Leper
Department, serves for ample guarantee of the
authenticity and accuracy of the statistics sub-
joined; and my friend of 1872 has added to
his obliging communication some data of colla-
teral interest bearing on the etiology of this
national pest.
First, as to the progressive decline of leprosy
in Norway, my previous India Office Reports and
the Bombay Memorandum of 1884 will be found
to contain all the needful evidence establishing
the fact that the total number of lepers officially
registered had, between the years 1856 and 1880
inclusive, diminished from 2,863 to 1,382—see,
for example, column 9 of the table given in
the local Gazette. Of that later total, 617
were lodged in the Government Asylum, and 965
were living at their homes.
The three chief asylums are recruited from
the country-districts, under conditions already
detailed; and the number of lepers they lodge
at present is, I learn, ' about 500.' Owing it is
understood to economic measures, the asylum-
population has of late years been somewhat re-
duced : otherwise, had the previous annual mean
of about 650 (for the decennium 1871-1880) been
equably maintained until now, this sum would
exaetly equal the total of lepers at large, as shown
below ; and so would have been realised the san-
guine hope expressed five years ago in the
words ' by the year 1885 it is anticipated that
50 per cent, or one-half the entire leper-commu-
nity will be isolated '—see my preceding Article,
page 3, heading C, column 7. A detailed
statement of the incarcerated sufferers for
the quinquennium 1881-1885, is promised so
soon as the official reports are complete ; and
since the greatest pains are taken to reach ac-
curacy of every detail, some time longer may
lapse before they are issued : meantime, the
above comment may be regarded as noteworthy,
by way of both encouragement and warning.
As regards ' home-dwelling ' lepers—hygieni-
cally, perhaps, the more interesting and impor-
tant section to notice, Dr. Hansen has furnished
me in advance with the following datum, which
concisely shows the diminution outside the
asylums that has occurred of late and is still
going on, as he remarks 'steadily and tolerably
fast.'
B 374
Tabular Statement of all the Lepers known to be living at their
homes, at the end of the years 1880 and 1885, arranged for
comparison, and according to sex.
District of Norway,
Finmarken andTromso.
Nordland
Nordve Trondhiem ..
Söndre
do.
Ronisdal
..
..
Nordre Bergenhñs ..
Söndre
do.
Stavanger
Lister and Mandai
Jarlsberg and Laurvik.
Kristian ..
Hedemarken ..
Akerhüs
Totals ..
In
1885..Increase Decrease..
Decrease in percentages
Men.
13
77
49
64
81
115
72
48
4
1
3
3
520
..
1880.
Women.
14
48
85
41
51
99
86
37
1
m
2
3
1
418
••
Total.
27
125
84
05
132
214
158
85
5
1
5
6
1
938
••
Men.
9
61
31
37
55
74
49
34
1
2
1
354
Nil.
166
31.92
1885.
Women.
8
43
20
20
37
67
68
22
1
3
1
1
291
Nil.
127
30.33
Total.
17
104
51
57
92
141
117
66
2
6
2
1
645
Nil.
293
31.24
Reserving any comment on the highly localised
distribution of disease as indicated above, and
also on the ratio of the affected to the whole
population of separate districts, I remark that
this table, as it stands, shows a notable bene-
ficial change in the amount of suffering, as evi-
denced by decline in number of lepers from 938
to 645—being a diminution of 293, which is equi-
valent to a fall of 31 "24 per cent, on the higher
number at starting ; or, in other words, at the
close not far short of one-third less than at the
beginning of the five years under review. And
even supposing, as is likely, there be hereafter
found some ' overlooked ' cases (see the preceding
Article), still the above considerable abatement
of disease within so brief a period of time cannot
but be deemed both impressive and significant.
Adverting now to the whole series of data
from 1856 to 1885, it appears that the number
of home-dwelling lepers in Norway has declined
from 2,628 to 645, or to the extent of 75 per cent.,
in the course of 29 years. Again, upon closer
analysis of the two tables in hand, I find that
the ratios of decline at successive quinquennial
periods have been as follows :—15 per cent., 13
per cent., 4 per cent-, 14 per cent., 20 per cent.,
31 per cent., and 31.2 per cent.; so that during
the last 20 years, at least, there has occurred a
tolerably regular progressive improvement in the
rate of abatement ; and this datum would tend
to encourage the hopes of an early practical
extinction of the pest. The contrast of such
a prospect as this, of the effective eradica-
tion of leprosy within the course of 2 or 3
generations, with the past experience recorded
of other European countries in which the national
plague persisted with infinite aggravations for at
least as many centuries, seems to me most strik-
ing. I am aware that fallacies lurk especially
amongst vital statistics, but I also know that the
data under review have been particularly tested ;
and in the small and defined kingdom to which
they relate, the Government is such as to permit
of a far more rigid scrutiny than usual.
These facts, then, may speak for themselves ;
and as to their application, it may suffice to re-
mind that there are in India minor provinces and
even single districts, which individually could
represent the kingdom of Norway as regards the