NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
xvi
REPORT OF THE LEPROSY COMMISSION:
lepers between the ages of twenty-six and thirty, the next most
frequent time of onset was from twenty-one to twenty-five years
of age, then from sixteen to twenty. From such a table it
would appear that leprosy most commonly begins between the
ages of sixteen and thirty, in other words, in early adult life.
These figures again closely agree with those given by Van-
dyke Carter. 2 However a difference does exist. For accord-
ing to his table 4 . 7 per cent, acquired the disease before the
age of ten, whereas the Commissioners found that according
to the information they obtained, about double that percentage
were attacked before the age mentioned.
TABLE II.
Ages at which Leprosy appeared, arranged in Quinquennial Periods.
Asylum or
Locality.
Agra .
Aligarh .
Almora .
Bangalore
Belgaum .
Benares .
Bombay .
Burdwan.
Calcutta .
Calicut.
Cawnpore
Conjeeveram
Darjeeling
Dehra Dun
Delhi
Dharmsala
Fyzabad .
Gwalior .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
5 years or
under
1
1
2
1
...
7
...
3
...
..
..
... ... 1 ... ...
6-10.
12
3
1
1
13
...
5
...
...
...
1
2
3
11-15.
1
1
16
...
1
18
...
6
2
...
2
1
6
1
...
...
3
16-20.
5
...
23
2
...
3
33
4
12
6
1
2
...
14
1
...
6
1
21-25.
9
2
2O
6
2
4
41
3
3
3
2
1
1
7
2
1
3
2
26-30.
14
1
12
9
1
7
35
5
15
10
3
5
...
18
.
5
2
1
31-35.
2
2
10
7
1
2
40
3
11
1
1
2
1
13
1
3
3
1
35-40.
9
1
9
7
...
8
25
1
8
1
1
1
..
10
..
...
..
..
41-45.
3
1
3
3
..
2
16
4
3
2
.
..
8
3
1
.
3
46-50.
7
1
...
I
...
.2
11
1
4
...
...
...
...
7
.
...
..
1
51-55.
1
.
...
1
..
1
6
3
..
..
...
.
1
1
..
1
.
56-60.
2
1
5
1
..
...
...
...
... I
61-65.
I
2
I
66-70.
I
I
71-75.
I
•
76-80.
81-85. TOTAL.
51
10
108
4 6
6
32
258
21
10
25
10
13
3
88
11
12
17
1 2
Age not stated.
3
9
17
1
9
1
5
1
GRAND TOTAL.
54
10
108
55
23
3 2
259
21
89
26
10
18
3
88
11
12
17
13
( 2 ) Leprosy and Elephantiasis, page 152.
General Remarks.
xvii
Table II—continued.
Ages at which Leprosy appeared, arranged in Quinquennial Periods.
A s y l u m or
L o c a l i t y .
Gya
H y d e r a b a d
J u b u l p o r e
.
J u m m o o .
•
K a p u r t h a l l a
.
L a h o r e
.
,
L u c k n o w
M a d r a s
.
M a d u r a
.
M a n d a l a y
Mcernt
.
M o u l m e i n
,
N a g p u r
.
N a i n i a n d A l l a -
h a b a d ,
.
N a i r n T a l
Patiala
P e s h a w a r
P o o n a
P r o m e
,
P u r u l i a
.
R a n g o o n .
.
R a w a l p i n d i
S i a l k o t
.
S u b a t h u .
T a n j o r e
.
T a r n T a r a n
T h a y e t m y o
T r i c h i n o p o l y
.
U m b a l l a .
.
Y e r r o w d a P r i s o n
T O T A L
5 years or under
10
3
3
3
i
5
I
3
I
3
49
6-10.
2
I
21
13
17
4
12
I
2
7
3
4
3
3
2
6
S
1i
IS2
11-15.
2
2
2
25
1i8
38
2
1iS
4
4
2
3
4
10
S
7
4
3
12
II
I
4
1
2 4 4
16-20..
5
S
2
2
2 3
I5
3 8
5
1 8
3
2
1
5
4
9
7
2
4
I
1 7
5
1
3
3
2 9 S
21-25.
4
3
4
2
3
20
16
30
3
21
9
4
3
12
12
11
6
4
2 5
15
2
2
3
3 3 3
26-30.
7
1
1
2
2 6
1 7
16
6
2 5
1 5
7
I
14
8
7
9
S
7
25
6
5
S
3
3 5 8
31-35.
8
3
1
2
1
14
9
10
21
9
6
3
12
7
2
I
10
S
19
4
4
3
I
266
36-40.
7
1
3
I
2
7
10
2
22
8
4
3
1 8
6
4
4
8
1
13
5
3
I
330
41-45.
S
2
1
1
12
S
s
13
4
4
2
7
4
2
2
6
4
4
I
1 3 8
46-50.
2
1
4
7?
6
7
8
6
2
7
2
2
3
3
11
2
1
1
111
51-55.
2
9
1
1
1
2
2
1
3
1
3
1
I
4 5
56-60.
1
I
2
1
2
1
I
2
24
61-65.
1
I
8
66-70.
3
2
1
1
11
71-75.
j
T
3
76-80.
81-85.
2
2
ToTAL
42
1i8
15
2
10
2
12
182
112
175
9
35
164
65
2
9
1
45
30
83
62
47
39
45
14
140
61
14
31
13
2,272
Age not state.
3
1
2
1
2
10
1
1
16
1
1
2
6
1
2
I
2
9 9
GRAND TOTAL
42
21
15
2
10
2
13
184
"3
177
9
25
174
66
2
9
2
45
30
99
62
47
40
46
16
146
62
16
32
15
2,371
b
xviii
REPORT OF THE LEPROSY COMMISSION :
In Table III the actual ages of the lepers at the time they
were seen are given. This table does not materially differ
from the last one, for it was remarked by the Commission that
most of the lepers examined by them had been afflicted for
several years. If then all the figures in this table are put back
five or ten years, they will be found to approach closely those
in Table II.
TABLE III.
Cases observed according to Actual Ages in Quinquennial Periods.
Asylum or
Locality.
Agra
Aligarh .
.
Almora .
Bangalore
Belgaum
Benares .
Bombay
Burdwan
Calcutta.
Calicut .
Cawnpore
,
Conjeeveram .
Darjeeling
Delira Dun
Delhi
Dharmsala
Fyzabad
Gwalior.
Gya
Hyderabad
Jubbulpore
Jummoo.
Kapurthalla
Lahore .
Lucknow
Madras .
5 years or
under.
1
I
1
6-10.
I
4
1
11-15.
3
1
I
7
3
16-20.
1
1
8
27
5
1
1
1
2
1
1
2
1
7
21-25.
2
2
2
26-30.
8
2
3
37
3
13
4
I
3
10
4
5
4
5
2
I
2 5
31-35.
4
1
11
5
5
50
5
8
8
6
5
1
17
2
3
2
36-40.
8
3
21
3
7
44
5
17
6
11
3
4
13
41-45.
5
1
10
4
2
1
3
3
2
15
2
1
8
2 1 1 14
46-50.
2
2
9
9
4
3
4
1
11
2
1
3 6 2 4 3 13
51-55.
3
2
1
5
3
1
1
9
1
1
1
1
1
11
1
56-60.
1
1
61-65.
1
1
3
2
1
1
1
8
66-70.
2
2
...
71-75.
76-80.
1
...
1
81-85. 86-90.
91-95. 96-100. TOTAL
51
10
108
50
6
32
259
21
80
25
10
18
3
88
11
12
17
13
4 2
2
I
I3
I
184
Age not stated.
3
5
17
9
1
...
2
3 ...
4 ...
TOTAL.
54
10
108
55
23
32
259
21
89
26
10
18
3
88
11
12
17
13
4 2
21
15
2
10
2
13
184
General Remarks.
xix
Table III—continued.
Cases observed according to Actual Ages in Quinquennial Periods.
Asylum or
Locality.
Madura .
.
Mandalay
Meerut .
Moulmein
.
Nagpur .
,
Naini and Alla-
habad
Naini Tal
Patiala .
Peshawar
.
Poona .
Prome .
Purulia .
Rangoon
Rawalpindi .
Sialkot .
Subathu
.
Tanjore .
,
Tarn Taran .
Thayetmyo
Trichinopoly .
Umballa
Yerro w da
Prison
,
TOTAL
.
5 years or under.
3
6-10.
1
1
I
2
3
1
1
1
11-15.
13
9
l
7
1
2
2
1
2
2
I
1
6
75
16-20.
11
35
6
16
1
3
3
3
6
1
6
3
7
1
2
180
21-25.
18
34
1
3
21
10
3
I
6
3
11
8
5
1
7
5
1
2
5
2 57
26-30.
17
3 1
1
170
1
27
8
3
3
11
10
6
7
8
1
19
13
345
31-35.
9
13
3
13
7
2
6
2
13
10
9
2
5
2
8
6
5
1
297
36-40.
13
19
2
37
12
9
2
18
10
13
5
7
4
37
6
4
4
4
39
41-45.
11
15
3
1
12
5
1
2
16
16
5
8
15
7
2
1
1
206
46-50.
10
10
1
20
8
7
4
12
6
5
9
5
25
5
5
1
51-55.
6
6
1
5
3
1
3
1
1
1
4
2
1
1
1
82
56-60.
4
1
4
8
5
2
8
2
2
5
21
1
127
61-65.
I
I
I
2
I
2
23
66-70.
I
4
2
I
5
22
71-75.
1
2
1
5
76-80.
1
1
1
9
81-85.
1
86- 90. 91-95.
1
96-100.
1
1
TOTAL.
113
177
9
25
167
65
2
9
1
45
30
87
62
47
39
46
143
61
16
31
13
2,305
Age not stated.
7
1
1
12
1
3
1
2
65
GRAND TOTAL.
113
177
9
25
174
66
2
9
2
45
30
99
62
47
40
46
16
146
62
16
33
15
2,371
In the foregoing tables the sexes have not been separated,
as in consequence of the conditions of life in India few adult
women were seen, and it seemed hardly fair to calculate any-
relative percentage of sexes.
It was thought, however, that some conclusions might be
drawn from those cases in which the disease began before the
age of ten, for up to this time females are not secluded.
b2
xx
REPORT OF THE LEPROSY COMMISSION :
These have been therefore arranged in Table IV, and it
will be seen that up to five years of age the sexes were nearly
equal, there being 28 males and 21 females. From five to
ten, however, the proportion of males attacked increased, and
there are" shown to be 95 males to 56 females.
TABLE IV.
Cases in which the Disease commenced before the Age of Ten Years,
arranged according to Sex.
ASYLUM OR
LOCALITY.
Aligarh .
Aim ora
Bangalore
Belgaum
Benares .
Bombay .
Calcutta .
Dehra Dan
D h arm sala
Fyzabad
Gya
Hyderabad
Madras .
Madura .
Mandalay
Meerut .
Mouhnein
Nagpur .
Naini and Alla-
habad .
Poona
Pro me
FIVE YEA
Cases.
1
1
2
1
7
3
1
10
3
3
3
1
5
RS OK U
Male.
1
1
6
1
4
3
3
1
1
3
NDER.
Female.
1
1
1
I
2
1
6
2
2
s
Cases.
12
3
1
1
13
5*
3
1
2
2
1
21
13
17
1
4
12
1
2
7
IX TO TEL
Male.
5
3
6
3
1
1
2
2
1
15
10
10
1
3
9
1
2
6
Female.
7
1
1
7
1
2
6
3
7
1
3
1
REMARKS.
* In one case
sex not stated.
General Remarks.
xxi
Table IV—continued.
Cases in which the Disease commenced before the Age of Ten Years,
arranged according to Sex.
ASYLUM OR
LOCALITY.
Rangoon
Rawalpindi
Sialkot .
Subathu .
Tanjore .
Tarn Taran
Thayetmyo
Umballa
TOTAL
FIVE YEARS
Cases.
1
3
1
3
49
OR
Male.
1
1
1
1
28
UNDER.
Female
2
2
21
SIX
Cases.
3
4
3
3
2
6
8
1
152
X TO TEM.
Male.
2
2
2
3
5
Female.
1
2
1
2
6
3
1
56
REMARKS.
Of the expectation of life in leprosy the Commission are
unable to speak from actual experience in India. Statistics of
the total duration of a leper's life can only be obtained from
asylums where accurate records are kept of the dates of onset
of the disease, and of death. It may, however, be mentioned
that Danielssen and Boeck have worked out the mean duration
of tuberculated leprosy as nine and a half years, and that of'
anaesthetic leprosy as eighteen and a half years. An analysis
of the figures of the Trinidad Asylum, extending over some
eighteen years, showed the average duration of tuberculated
leprosy to be a little under nine years, while that of anaesthetic
leprosy was about twelve years. It is only fair to state that all
the deaths in the Asylum were reckoned, whereas Danielssen
and Boeck excluded certain cases in which they considered that
death was due to some intercurrent disease.
In estimating the value of census and other returns, it was
thought that some information would be gained, if the Com-
mission were able to form an idea of the percentage of errors
xxii
REPORT OF THE LEPROSY COMMISSION:
in diagnosis made by native enumerators and others entrusted
with reporting or collecting cases of leprosy. In each place
visited a record was therefore kept of all negative and doubtful
cases appearing amongst the patients collected for examination
as lepers. Table V gives the number of negative cases, with
short notes of their nature. All doubtful cases have been
omitted, for nothing can be argued from them. Two percen-
tages of errors have been worked out, one for all the places
visited, and the other for those places only where no leper asy-
lum existed. It is at once evident that the latter is the fairer
percentage to adopt, for in these places the diagnostic powers
of native police, hospital assistants and others of the class
from which the census enumerators would be taken, are chiefly
relied on, while in places with a leper asylum the inmates
come under the notice of the Civil Surgeon, or at any rate of
some qualified medical man, so that spurious cases are more
likely to be detected. The difference in the figures is suffi-
ciently obvious, the percentage of errors being 5 for all the
places visited, against 9*5 for localities with no leper asylum.
These probably are the most reliable figures obtainable from
the data at hand, and it will readily be seen that if a deduction
be made, say, of a tenth of all the lepers returned for India, a
not inappreciable diminution in the estimated leper population
will result.
TABLE V.
Erro?'s in Diagnosis.
ASYLUM OR LOCALITY.
Agra
AHgarh
Almora
No. of
persons
produced
as lepers.
54
(12)
108
No. of
Negative
Cases.
2
Form of Disease.
Syphilis.
NOTE.—Figures shown in brackets are the cases which were collected by the local authoiity.
General Remarks.
xxiii
Table V—continued.
Errors in Diagnosis.
ASYLUM OR LOCALITY.
Bangalore
.
Bel gaum .
Benares
Bombay .
Burdwan .
Calcutta .
Calicut
Cawnpore
Conjeeveram
Darjeeling
Dehra Dun
Delhi
Dharmsala
Fyzabad .
Gwalior
Gya
Hyderabad
Jubbulpore
Jummoo .
Kapurthalla
Lahore
Lucknow .
Madras
Madura .
No. of
persons
produced
as lepers.
63
(33)
23
36
2 59
(23)
89
27
(10)
(20)
(7)
88
(12)
12
(18)
(13)
(44)
(30)
(38)
(2)
(10)
(2)
14
189
(123)
No. of
Negative
Cases.
8
(7)
4
2
1
2
4
1
1
2
23
1
5
10
Form of Disease.
(3) Syphilis, (1) Sycosis of the beard,
(1) Leukoderma, (1) Chronic
Rheumatism.
(1) Psoriasis, (1) Old Age.
(3) Leukoderma, (1) Pityriasis Versicolor,
(1) Psoriasis, (1) Syphilis.
Syphilis.
(1) Syphilis, (1) Leukoderma.
(2) Syphilis, (1) Seborrhcea Sicca,
(1) Eczema of foot.
Syphilis.
Whitlow on thumb.
(1) Syphilis, (1) Ringworm,
(3) Leukoderma, (1) Perforating Ulcer,
(1) Neuritis of Ulnar Nerve.
(1) Nil, (1) Phthisis, (2) Nerve lesions.
(22) Leukoderma, (1) Syphilis.
Epilepsy.
(1) Tabes with perforating ulcer, (i)
Acne, (1) Syphilis, (2) Nil.
(1) Acne, (1) Scaly condition of skin,(i)
Syphilis, (1) Numbness in thigh.
(1) Pale patch on knee, (i) wasting of
interossei of right hand.
(1) Mottling of skin, (1) Ichthyosis, (1)
Œdema of feet and legs.
(1) Eczema of toes.
NOTE.—Figures shown in brackets are the cases which were collected by the local authority.
xxiv
REPORT OF THE LEPROSY COMMISSION:
Table V—concluded.
Errors in Diagnosis.
ASYLUM OR LOCALITY.
Mandalay
M oulmein
Nagpur
Naini and Allahabad .
Naini Tal.
Patiala
Peshawar .
Poona
Prome
Purulia .
.
:
Rangoon .
Rawalpindi
Sialkot
Subathu .
Tanjore .
Tarn Taran
Thayetmyo
Trichinopoly
Umballa .
Yerrowda Prison
TOTAL
Total, reckoning only
places with no Leper
Asylums .
No. of
persons
produced
as lepers.
(180)
(26)
(188)
79
(2)
(9)
(2)
45
(32)
101
(66)
48
40
46
(20)
146
(65)
32
15
2,487
987
No. of
Negative
Cases.
3
1
14
13
2
2
4
1
3
125
94
Form of Disease.
(1) Elephantiasis, (1) Syphilis, (1) Leu-
koderma.
Lupus Erythematosus.
(3) Syphilis, (3) Leukoderma, (1) Caries
of spine, (7) Nil.
(1) Leukoderma, (3) Syphilis, (1) Malin-
gering, (1) Lupus of face, (7) Nil.
(1) Ringworm, (1) Leukoderma.
(1) Syphilis, (1)Nil.
(2) Syphilis, (2) Leukoderma.
Syphilis.
(1) Ringworm, (1) Leukoderma, (1) Want
ot Co-ordination in extremities, His-
tory of Syphilis, (1) Tertiary Sy-
philis.
(1) Acne of face, (1) Ringworm, (1) Ulcer
and Swelling of Foot.
(1) Scrofulous Ulcer and Cancrum oris
(1) Molluscum fibrosum.
(1) Spinal curvature and wasting of in-
terossei.
= 5 per cent.
= 9.5 per cent.
NOTE.—Figures shown in brackets are the cases which were collected by the local authority.
General Remarks.
xxv
The condition known as ainhum was more or less marked
in several cases examined in India. The pathology of this
obscure disease is not yet known. There is no doubt that it
may occur either in lepers or in otherwise healthy subjects.
When in the latter, however, it nearly always attacks the little
toe of one or other foot. In lepers, on the contrary, it may
attack any toe or even finger. The following case seen by the
Commission at the Matoonga Leper Asylum, Bombay, is typi-
cal. A Hindu boy, aged ten years, had suffered from mixed
leprosy for three and a half years. On examination the little
toe of the left foot was found to be enlarged, the outline convex
and the skin thickened and completely anaesthetic. There was
a furrow all round the base of the toe. On the plantar, inner
and outer aspects, this extended nearly half through the toe,
but was shallower on the dorsum. There was a small ulcer on
the plantar surface. The toe could be freely moved about,
the bone having been absorbed. The skin beyond the furrow
was thickened and somewhat painful.
Many of the symptoms of this condition suggest a trophic
nerve lesion, but the lesions of ainhum are so comparatively
mild that little opportunity occurs for post mortem dissection
of the nerves supplying the affected toe or finger. The occur-
rence of ainhum in any individual should, however, always
suggest a most careful examination for anæsthesia and other
leprous symptoms.
Probably few diseases have been so profitable to charlatans
as leprosy. While travelling the Commission met with several
instances of the credulity of patients in this respect. The
acknowledged incurability of the disease, in spite of the atten-
tion it has attracted for so many centuries, is no obstacle to the
unfortunate leper, who will often spend all his substance on
some hakim or other pretender who has promised to restore
him to health. The subject of palliative treatment will be
considered in another place.
TABLE OF CONTENTS.
INTRODUCTORY.
Method of Working
........
GENERAL REMARKS.
Forms of Leprosy—Percentages of different forms observed, with
tables—Ages of patients when attacked, and duration of disease,
with tables—Proportion of sexes—Expectation of life—Errors
in diagnosis—observed percentage, with table—Ainhum—Gene-
ral remarks
.........
CHAPTER I.
Diary of Commission
........
CHAPTER II.
Local notes—Names of asylums and localities visited, with details
connected with the management of public and private institu-
tions receiving lepers
........
CHAPTER III.
Distribution of leprosy—Geographical distribution of leprosy—In-
crease or decrease of disease—The difficulties connected with
such investigation—Imperfections in census returns—Neces-
sity of caution in drawing conclusions from the figures—Figures
nevertheless possess a high value
.....
Leprosy found in all parts of India—Varies however in different
presidencies and provinces —Maps illustrating this—The returns
of the three censuses compared—Census of I89I shows general
decrease of leprosy in India—Returns for Central Provinces
and a few other localities not- yet received—Explanation of
delay in submission of report—Localities of greatest prevalence
—Tables illustrating changes in the number of lepers in British
Territory and Feudatory States as shown by three censuses.
Evidence against the belief that the disease particularly affects the
seaboard and vicinity of large rivers.
Hill districts suffer severely—Some localities in the plains, however,
show very high ratios of leper population—No particular tract
affected—No connection traceable between leprosy and geolo-
gical formaton.
PAGE
vii to xi
xiii to xxv
I to 8
9 to 35
36 to 203
xxviii
Table of Contents.
CHAPTER III—contd.
Difficulties in comparing census returns—Figures however suggest
decrease rather than increase of leprosy—Probably safest to
assume that the disease is at a standstill—Map illustrating same
— Calculations based on impressions untrustworthy—Tables.
Climate in India varies immensely even in same province—General
sketch—No connection between leprosy and heat—Map and ta-
bles suggest connection between dampness of climate and disease.
Influences affecting the health and well-being of people of India—
No connection between increase and decrease of population and
leper ratios—Tables.
Cholera as a test of the healthiness of an area—Endemic areas—
Speaking generally, such areas show highest leper ratios—
Possibly same noxia injuriously affect vital powers,, and indirectly
predispose to both diseases—No causal connection suggested.
Famines in India—Pauper lepers likely to succumb early—Leper
ratios in famine districts considered—Illustrated by maps—
Conclusions.
Leprosy attacks the poor more frequently than the rich—The latter
do not, however, altogether escape—Economic conditions of
different localities considered —Poverty predisposes to leprosy—
No connection between leprosy and density of population—Ne-
cessity of considering all concomitant conditions affecting a po-
pulation in comparing two areas as regards diffusion of leprosy
—No conclusions in this chapter to be regarded as absolute—
Evidence collected points to the fact that leprosy is greatly
affected as regards increase or decrease by the well-being, or
the reverse, of the community.
Leprosy an endemic disease —Special individual disposition requi- .
site for its acquisition—Factors establishing the endumic nature
of the affection—Bacillus leprse—Acquisition of leprosy de novo
— Explanation of the term as employed by the authors—Con-
tagiousness a relative term—What constitutes an endemic area
as regards leprosy—Comparison of leprosy with tuberculosis-
Probable explanation of the fact of the disease being at a
standstill.
Leper diffusion and density of population—No law exists between
the two—Tables.
Influence of race in leprosy considered—No race spared—Differ-
ence to be explained by inequality of social, rather than racial,
conditions—Returns of armies, European and Native.
Caste has no influence on disease, except that poorer castes suffer
more than richer—Difficult to obtain accurate details—Tables,
Asylums not a cause of diffusion of leprosy—Fallacious arguments
of alarmists—Increased popularity of such refuges.
Table of Contents,
xxix
CHAPTER III—concld.
Leprosy not maintained by vaccination —Lepers never assign this as
the cause of their disease—Animal lymph now largely used in
India—Improbability of disease being transmitted by vaccina-
tion—Vaccination returns—Vaccination becoming" more popular
and leprosy not increasing—Surgeon-Major Pringle's paper on
the subject—Conclusions.
Probable leper population in India at present—Disease, if not de-
creasing, at least at a standstill —Not to be regarded as an
Imperial Danger—Appendix
......
CHAPTER IV.
Hereditary transmission and predisposition in leprosy—Diverse
opinions on the subject—Distinction between hereditary trans-
mission and inherited predisposition—Leprosy not hereditary
and inherited specific predisposition hardly established—Views
on the subject—" Skipping a generation "—No congenital case
seen—Little to be argued from collateral relationship—Atavism
—Tables—Ratio of specific family taint in direct line—In-
fluence of external conditions on leprosy—Lepers born of healthy
parents—Born of leprous parents—Tables—The Almora Or-
phanage—Brothers and sisters of lepers—" True" and " false "
heredity—Tables—Deductions from tables—No risk of spread
of disease through hereditary transmission and predisposition—
Norwegian emigrants—Diminished procreative power of lepers
—No risk of diffusion by marriages among lepers—Tables—
Summary
.........
CHAPTER V.
Contagiousness of leprosy—Leprosy an infective disease and caused
by the bacillus leprae—Disease due to pathogenic germs not
necessarily contagious—Views of certain authors on thesubject—
Scientific and practical meaning of the terms " contagion " and
"infection"—Tuberculosis—Leprosy contagious and infective—
Not sufficient evidence that it is maintained or diffused by con-
tagion—Amount of contagion too small to demand legislative
action —Evidence of natives of India and others—Evidence in
favour of contagion very defective—Diffusion of disease through
eating and drinking with lepers—Contagion in families—Table
—Between man and wife—Tables—Vaccination—Experiments
by Commission—Spread from a leprous community—Bacillus
leprae in dust and earth—Healthy people living in asylums
with lepers—Tables—Leprosy and tuberculosis—Summary —
Appendix
..........
36 to 203
204 to 25S
259 to 298
xxx
Table of Contents.
CHAPTER VI.
Sanitation, diet, and diseases in relation to leprosy—General sketch
of sanitary measures in India—Mosquitoes—Flies—Personal
cleanliness—Scabies—Influence of defective hygiene—Diet—
Influence of, on constitution—Diets of inhabitants of India-
Fish—Mr. J. Hutchinson's views—Habits of inhabitants as re-
gards fish-eating—Hill people—No proof that fish-eating
causes leprosy—Salt—Statistics concerning consumption of—
Deficiency of salt not responsible for origin or maintenance of
leprosy—Maps—Water cannot be held responsible for propaga-
tion of this disease—Injurious habits—Syphilis—Views of Sir
W. J. Moore—Evidence against his theory—Tables—No real
or specific influence on production of leprosy—Summary
CHAPTER VII.
Treatment of leprosy—Time spent by Commission in India too
short to observe effects of treatment—No cure of disease known
—Hygienic treatment—Medicinal—Effects of certain remedies
considered—Surgical—Results of treatment by, and opinions
of, medical officers and others in India—Appendices I and II—
Treatment by salol and tuberculin, with results .
Conclusions and practical suggestions
.....
APPENDIX I.
Laboratory work done at Almora and Simla by Drs. Rake and
Buckmaster, and Surgeon-Major Thomson (with plates)
APPENDIX II.
Laboratory work done at Simla by Mr. A. A. Kanthack and Sur-
geon-Major A. Barclay
.......
299 to 330
331 to 383
384 to 390
391 to 439
440 to 452
LIST OF MAPS AND PLATES.
Map showing Asylums and Localities visited by Commission
Map illustrating Distribution of Leprosy in India at Census of 1872
Map illustrating Distribution of Leprosy in India at Census of 1881
Map illustrating Distribution of Leprosy in India at Census of 1891
Map illustrating Changes in the Ratios of Leprosy in India since the
Census of 1881
Temperature Chart of India
........
Weather Chart of India
.
Cholera Map of India
.........
Map showing Areas affected by Famines in India since 1850 .
.
Maps showing Distribution of Leprosy, with reference to Consumption of
Salt
Plates illustrating Cultivation Experiments of Drs. Rake and Buckmaster
and Surgeon-Major Thomson
.......
PAGE
1
41
41
41
53
59
61
73
81
320
392
Reg. No. 458, Leprosy Com.—Sept. 91.—315.
Reg. No. 458 R., Leprosy Com.—Mar. 92.—1,004. Oct. 92.-1,000.
Photo litho., S. I. O., Calcutta.