NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
REPORT
OF
THE LEPROSY COMMISSION.
CHAPTER I.
Diary of the Commission.
T HE English members of the Commission left London,
October 23rd, 1890, arrived at Bombay, November 17th,
and remained, here with the two Indian delegates until Novem-
ber 26th.
November 20th.—The Commissioners visited the Matoonga
Leper Asylum, accompanied by Surgeon-Major K. R. Kirtikar
and Dr. Choksy, the Medical Superintendent of the Asylum, to
both of whom they are greatly indebted for much valuable
assistance.
November 22nd.—The Trombay Leper Asylum, in the
neighbourhood of Bombay, was inspected, the above gentlemen
again kindly acting as guides.
November 25th.—A visit was paid to the Dharmsala, a
building in the city set apart for indigent lepers.
November 26th.—The Commission then left for Poona,
where, on November 28th, they examined the lepers at the
David Sassoon Infirm Asylum.
November 2gth.—Proceeding thence to Belgaum, the two
Asylums were visited, Surgeon-Major J. P. Greany assisting
the Commission.
2
REPORT OF THE LEPROSY COMMISSION:
November 30th.—Returning to Poona they went over the
leper ward at the Yerrowda Central Prison.
Accepting a most courteous invitation from the Govern-
ment of His Highness the Nizam, the Commissioners proceed-
ed to Hyderabad, where they stayed from the 4th to the 10th
December. Here they enjoyed the liberal hospitality of Sur-
geon-Major E. Lawrie, who spared no trouble in assisting them
in every possible manner. The Commissioners consider it their
pleasant duty once more to give expression to their deep
sense of gratitude for all the kindness received while guests at
Hyderabad.
Lepers were examined at the hospital and the house of
Abdul Gafur, a charitable native gentleman who offers alms
and food to the infirm on certain specified days of the week.
Lepers from the Central Gaol and from among the native
troops were also seen.
December 12th.—From the 12th to the 14th of December
the large Asylum at Madras occupied the entire attention
of the Commissioners. Surgeon-Major H. D. Cook, under
whose direction the Asylum is placed, rendered invaluable ser-
vices to the Commission not only during their stay at Madras,
but at all times.
December 15th.—Conjeeveram was next visited and a
certain number of lepers who had been collected at the dis-
pensary were examined.
December 16th.—Travelling through the Madras Presi-
dency, Trichinopoly was reached on December 16th, where,
assisted by Brigade-Surgeon W. S. Fox, the Commissioners
examined the lepers at the Municipal Leper Hospital.
December 19th.—Tanjore was visited on the 19th of
December where Surgeon-Major H.A. F. Nailer had brought
together a number of lepers, who-were seen and interrogated
at the Civil Hospital.
December 20th.—The Commission arrived at Madura and
were here met by Surgeon-Major W. B. Browning, from whom
Diary of the Commission.
3
they received great kindness and hospitality. As there was
no Asylum at Madura, Dr. Browning had collected a large
number of lepers from the town and outlying villages and did
everything in his power to facilitate the investigations of his
guests.
In accordance with a suggestion made by the Committee
in England, it was now considered advisable that the Com-
mission should form two parties, one to travel into Burma, the
other to remain in the Peninsula.
December 26th.—The latter—G. A. B., A. B., and A. A.
K.— proceeded to Calicut, where they examined the lepers at
the Asylum.
January 1st, 1891.—This part of the Commission arrived
at Bangalore, where, accompanied by Brigade-Surgeon T. J.
McGann, they saw the lepers at the Asylum. Surgeon C. M.
Thompson, by the aid of the local authorities, had assembled a
number of lepers at a convenient spot in front of the Bowring
Hospital, and these also were examined.
January 7th.—Nagpur was reached January 7th. Here
Surgeon-Major G. F. A. Harris had made all necessary
arrangements and with the aid of the civil authorities a large
number of lepers had been assembled at the hospital, and were
questioned by the three Commissioners, who take this oppor-
tunity of expressing their great obligation to Dr. Harris.
January 14th.—A small number of lepers were seen at
the Police Hospital of Jubbulpore. Unfortunately a Hindu
festival was in progress, and this prevented the collection of
many lepers. Surgeon-Major B. Franklin did everything in
his power to assist the Commissioners.
January 16th.—This section of the Commission visited
Naini and Allahabad, where they examined the leprous prison-
ers at the Central Gaol, and the inmates of the Naini Leper
Asylum. Thence they proceeded to Calcutta.
December 31st.—B. N. R. and S. J. T. arrived in Rangoon
on the 31st of December, and were met by Surgeon-Major
4
REPORT OF THE LEPROSY COMMISSION:
O. Baker. During their stay at that town they were the
guests of Deputy Surgeon-General C. Sibthorpe, to whom
they are indebted for much kindness and assistance. At
Rangoon the General Hospital and the Central Gaol were
visited (January 1st and 2nd). On January 3rd Dr. Sutherland
had collected forty cases from the Shway Dagohn -Pagoda
and the town, and after these had been examined a visit was
paid to a leper village in the neighbourhood of Rangoon.
January 6th.—These Commissioners crossed the Bay to
Moulmein, where lepers were seen at the Gaol, the General
Hospital, and the Baptist -Mission House. The Commis-
sioners take this opportunity of recording their thanks to
Surgeons-Major D. Sinclair, S. H. Dantra, and G. T. Thomas
and to Surgeons R. E. S. Davis and T. T. W. Leslie.
January 11th.—They proceeded to Mandalay, and notes
were taken of patients seen in the Gaol and of others whom the
civil authorities had brought together at the General Hospital.
January 16th.—Thayetmyo was visited on the 16th and
17th. Here cases had been kindly collected by Surgeon E. P.
Frenchman.
January 18th.—The enquiries in Burma were concluded
by a journey to Prome. Dr. Naylor assembled some cases at
the hospital, and subsequently accompanied the Commissioners
through the town, where a number of lepers were interrogated
at their own houses. Returning to Rangoon these two mem-
bers crossed over to Calcutta.
January 22nd.—The five members met at Calcutta and
at once proceeded to investigate the cases at the Leper Asy-
lum. Surgeon-Major D. D. Cunningham, to whom the Com-
missioners are greatly indebted for much valuable assistance,
placed his laboratory at their disposal, and one of them—
A. A. K.—performed a series of animal experiments which
will be fully described in the laboratory report. Surgeon
J. R. Adie had been appointed by the Bengal Government
to assist the Commission during their stay at Calcutta, and his
Diary of the Commission.
5
services were highly appreciated by them. But the greatest
thanks are due to Dr. D. D. Cunningham, who freely gave
the Commission every information and subsequently assisted
them in every possible way. His services all through have
been so manifold, that it is quite impossible to enumerate them
or even adequately acknowledge them.
On leaving Calcutta the Commission once more divided.
Two of the members—A. B. and A. A. K.—left Calcutta
on February 3rd for Purulia, where, with Surgeon-Major
H. W. Hill and the Revd. H. Uffmann, of the German Evan-
gelical Lutheran Mission, they examined the lepers at the
Asylum and the children at the Orphanage.
February 10th.—They saw a number of lepers at the Poor
House in Lucknow and thence proceeded to Agra.
February 16th.—Accompanied by Surgeon-Major J.
Wilcocks, they took notes of the inmates of the Agra Leper
Asylum.
February 27th.—They then branched off into the Kangra
Valley, and after a short enquiry at Kangra, paid a visit to
the Asylum at Dharmsala on the 27th of February.
March 4th.—They reached Tarn Taran, and, with the
assistance of Surgeon T. R. Mulroney and Assistant Surgeon
Gulam Mustafa, in charge of the Asylum, they completed
their enquiries, and now proceeded to Simla to superintend
the construction of the laboratory and commenced bacterio-
logical work.
April 8th.—From Simla they visited the Asylum at Suba-
thu (April 8th to 12th). Here the lepers were examined and
microscopical specimens of blood, discharges, &c, prepared,
for a description of which reference must be made to the
laboratory report.
Febrtiary 3rd to 22nd.—In the meantime a third member
of the Commission—S. J. T.—visited Burdwan (February
3rd), Fyzabad (February 6th), and Ajodhya (February 12th),
and then met the other Commissioners at Agra on the 16th of
6.
REPORT OF THE LEPROSY COMMISSION:
February. Surgeon-Major G. Price of Burdwan and Surgeon
T. Sykes of Fyzabad gave him every assistance.
February 23rd to 25th.—Work was continued at Dehra
Dun, where Surgeon-Major G. G. Maclaren gave much valu-
able assistance.
February 1st.—A third section of the Commission—B. N.
R. and G. A. B.—left Calcutta on February 1st for Darjeeling,
and here Surgeon-Major J. O'Brien gave them every assist-
ance both in collecting lepers and in procuring samples of
food eaten by the mixed population of the place.
February 5th.—Returning to Calcutta they travelled to
Gya, which was reached on February 5th. Here a number of
lepers were examined at the Civil Hospital. The Commis-
sioners take this opportunity of thanking Surgeon-Major R. D.
Murray for his kind help and hospitality.
February 10th and 11th.—Benares: Brigade-Surgeon
W. R. Hooper had a number of lepers assembled for examina-
tion at the Secrole Dispensary.
February 13th.—Fyzabad : Here work was done at the
Civil Hospital.
February 15th.—Cawnpore : About a dozen vagrant lepers
had been collected for the two Commissioners by Brigade-
Surgeon J. H. Condon.
February 17th and 18th.—The two Commissioners reach-
ed Gwalior, where they were the guests of the Maharaja Scindia.
Surgeon-Major A. M. Crofts assisted them in their enquiries.
February 19th.—Agra was reached.
February 23rd.—Aligarh was visited.
Surgeon-Major
W. H. Cadge kindly collected lepers for examination.
February 25th.—The Commissioners proceeded to Delhi,
where they were most hospitably entertained by Surgeon-
Major B. Doyle, who assisted them in examining lepers in
the city during their stay.
March 2nd.—Peshawar: Surgeon H. Hendley had assem-
bled a few lepers at the Civil Hospital.
Diary of the Commission.
7
March 5th.—The Asylum at Rawalpindi was visited.
March 7th.—The Commissioners saw lepers at the Baba
Lakhan Asylum (Sialkot), accompanied by Dr. Dhuni Mehta
Chand, who grave them every assistance.
March 8th.—They reached Jummoo, being during their
stay the guests of the Maharaja of Kashmir.
With Dr. Jag-
gan Nath, the Civil Surgeon, cases were examined at the
hospital.
March 9th.—They arrived at Lahore and conducted their
enquiries at the Civil Hospital with the assistance of Brigade-
Surgeon W. Center.
March nth and 12th.—They visited Mooltan, and with
Surgeon J. A. Cunningham collected information at the Civil
Hospital.
March 15th and 16th.—Accepting an invitation from the
Maharaja, a stay of two days was made at Patiala, and by the
courtesy of Brigade-Surgeon G. Thomson a number of lepers
was examined.
March 17th and 18th.—The Commissioners, through the
kindness of the Maharaja, visited Kapurthalla, and with the aid
of Surgeon-Major W. P. Warburton, the leper colony in this
place was seen and interrogated.
March 19th.—Accompanied by Surgeon G. W. P. Dennys,
the Leper Asylum of Umballa was visited.
March 22nd.— These two members reached Almora and
here were met by the other Commissioner—S. J. T.—who had
returned from Dehra Dun and commenced enquiries. From
this date until April 16th, the Asylum was daily visited and
notes were taken of the inmates both of the Asylum and the
Orphanage.
A large number of lepers was vaccinated and the lymph
examined microscopically ; specimens of blood, discharges from
ulcers, and various excretions and secretions of the body were
studied in order to ascertain the distribution of the leprosy
bacillus. These and other investigations will be detailed in the
8
REPORT OF THE LEPROSY COMMISSION:
laboratory report. Dr. Carmichael and the Revd. G. H. Bul-
loch gave every assistance.
April 16th.—Leaving Almora B. N. R. and G. A. B.
travelled back to the plains through Naini Tal, where a few
lepers were seen at the dispensary. They here take the oppor-
tunity of recording the great kindness shown them by Surgeon
J. F. Tuohy.
April 27th.—Simla was reached on April 27th, S. J. T.
having preceded the other two Commissioners by a few days.
Here the united Commission stayed until the completion of
their enquiry, engaged chiefly in microscopical and bacteriolo-
gical work.
Loeal Notes:—Bengal.
9
CHAPTER
II.
Local Notes:—Bengal.
BURDWAN.
N O Asylum exists here. Twenty-three cases were col-
lected and examined at the Civil Hospital and the
Gaol. Among this number was one Brahmin. Eighteen lepers
were married and had thirty-three children, or 18 to each
marriage. Five cases had been vaccinated. Two cases that
were seen, were not leprosy. Former censuses show that
Burdwan is a district where leprosy is exceptionally prevalent,
about twenty-five lepers to every ten thousand of the popula-
tion. According to the census of 1881 the population of this
district is 1,391,823, and the number of lepers is stated to be
four thousand one hundred and eighteen or 29 5 to ten
thousand of the population. The arrival of the Commission
at any place frequently caused many lepers to leave the
locality. The small number collected here is possibly to be
explained in this way.
CALCUTTA.
The Leper Asylum was originally established in 1811. It
was situated at Ballygunge, and the buildings accommodated
forty persons. After thirteen years, during which time the
governors of the Institution attempted by meetings, subscrip-
tions, and applications to Government to enlarge the Institu-
tion, but without definite results, the Asylum was moved from
Ballygunge to Balliaghatta,and eighty persons could be received
into the dwellings. Finally, in 1840, the present Asylum, which
is situated in Amherst Street, and stands upon a site given by
Government, was erected, the whole Institution being trans-
ferred into the city in 1848, and the huts which had been
10
REPORT OF THE LEPROSY COMMISSION:
moved from Balliaghatta were replaced by what are practically
the present buildings.
There are at present eighty-nine inmates, the majority of
whom are Hindus. Sixty-four are married and have seventy-
eight children, giving 1 2 to each marriage. Forty-seven
cases had been vaccinated.
Leper Inmates of the Asylum.
Males .
Females
TOTAL
•
Europeans.
3
2
5
Eurasians.
3
3
6
Native
Christians.
5
3
8
Muhamma-
dans.
26
I
27
Hindus.
30
13
43
TOTAL.
67
22
89
Among the Hindus there were two Brahmins. Twelve of
the cases seen were also suffering from syphilis, and three
patients, among whom was one European, were suffering from
diseases other than leprosy.
DARJEELING.
Seven cases were examined here, but among these three
only were undoubted lepers. Two were married, with three
children to each. One case had been vaccinated and one in-
oculated. 1 It does not appear that leprosy is very prevalent
in Sikkim. The consumption of dried fish among the in-
habitants as a flavouring is almost universal. Such fish is
(1) Inoculation for small-pox is still practised to some extent as a protective
measure in India, for, as is well known, the mortality from the inoculated disease
is much less than from the infective disease, and the form of the disease is milder
in the former, than in the latter, case. Material from a small-pox pustule is taken
mixed with water and introduced under the skin with a lancet. The site for in-
oculation is the flexor surface of the forearm (Punjab) or the wrist. This practice
is of great antiquity in the East. It was introduced into England from Turkey
by Lady Marv Wortley Montague in 1763. During the first quarter of this cen-
tury it was practised in preference to vaccination. Inoculation for small-pox in
England was made illegal by Act of Parliament in 1840.
Local Notes-.—Bengal.
11
imported to these hills from Calcutta, and in the bazaar of
Darjeeling it is a common article for sale.
GYA.
This is the chief town in the district of Behar. It is a city
of pilgrimages, and both here and at Buddh Gya, eight miles
distant numbers of lepers were seen in the streets.
Number of lepers per ten thousand of population was 9.8
for 1872 and 9/5 for I 88 I .
Forty-four cases were examined here, and of this number
two were free from leprosy. There is no Asylum, but the
Civil Surgeon arranged with the local authorities that lepers
should be collected in the compound of the Civil Hospital.
A very large.proportion of those who were examined were
Beharis, and came from the district.
Thirty-three were Hindus, among these two Brahmins.
Nine were Muhammadans, or 2 I. 4 per cent.
Forty-one were married.
Total number of children born to these was seventy-eight,
giving. 1. 9 to each marriage.
Twenty-six had been inoculated for small-pox.
None had been vaccinated.
Thirteen had suffered from small-pox.
Of twenty-eight cases where enquiries were made, ten had
suffered from syphilis.
Diet.—Both Brahmins denied eating fish or meat ; butter,
milk, dâl, and rice being the chief food.
In nineteen cases enquiries about diet were made, and it
was ascertained that—
Five had never eaten fish.
Seven had sparingly eaten fish.
Seven had frequently eaten fish.
Two cases produced were not leprosy.
Enquiries made at Gya showed that the following customs
12
REPORT OF THE LEPROSY COMMISSION:
were followed among the people of this district. Children eat
out of the same dish with their father, but the wife never does
she only eats after the dish has been washed.
Hindu women do not eat flesh or fish after the death of
their husbands.
Many Hindus never eat fish or flesh from childhood.
In lower castes, if the husband leaves any food, the wife
will eat it. In higher castes, if the husband leaves food, no
person will eat it, but it will be given to the children, or, in the
absence of children, to poorer people.
PURULIA.
There is both an Asylum and an Orphanage here. The
Revd. H. Uffmann, of the German Evangelical Lutheran Mis-
sion, opened the former in February 1888, and the latter in
the summer of the same year. There are ninety-nine leper
inmates, sixty-one males and thirty-eight females. The sexes
are separated. Up to the present time no child has been born
in the Asylum. The lepers are attended by a resident native
doctor.
Twenty-three children are maintained in a separate com-
pound, which is adjacent to the Asylum. They are all healthy.
Three patients who had suspicious symptoms at the time of
admission, subsequently became lepers, and were removed to
the Asylum. No child, which was originally healthy, has yet
become a leper.
Madras.
CALICUT.
The Asylum at Calicut consists of one large well-built
bungalow,- on the seashore. It has been in existence for more
Loeal Notes'.—Madras.
13
than thirty years. The Civil Surgeon attends to the inmates.
Patients do not receive fish, simply because the diet table of
the Asylum was a copy of one used in the Municipal Hospital,
where fish is excluded.
A peculiar macular discoloration of the skin is common in
the Malabar district. These patches were exceedingly like
leprosy, but there was no anaesthesia. Indeed this skin disease
has nothing to do with leprosy. Ten or twelve cases seen at
the prison simply showed this skin discoloration. Elephantiasis
is very common in Calicut. Twenty-seven patients, lepers,
were examined here, and among these one case was not leprosy.
Of these, twenty-one were married and had forty-eight children,
or 2.2 to each marriage. Seven lepers had been vaccinated.
One of the servants at the Asylum had contracted leprosy.
Fish is a common article of diet in Calicut.
CONJEEVERAM.
The population of Conjeeveram is 37,275, and it is believed
that there are about a hundred lepers here. There is no Asy-
lum. Eighteen lepers, all of whom were Hindus, were ex-
amined. Among these were many silk weavers. Of this num-
ber, thirteen were married. The number of children was forty-
two, or 3'2 to each marriage.
As Conjeeveram is one of the seven sacred Hindu cities, a
great number of Brahmins live here, some of whom suffer from
leprosy. According to enquiries which were made here no fish
is eaten by Brahmins, whether they be rich or poor ; indeed
this rule is rigidly followed. Only in rare cases, where from
contact with Europeans a certain degree of education has
arisen, is this rule broken.
MADRAS.
The Asylum of Madras consists of a number of bungalows
built in a compound situated in Black Town. The garden is
14
REPORT OF THE LEPROSY COMMISSION :
planted with trees and flowers, and the comfort of the inmates
is considered in every way. The sanitation of the Asylum
and ventilation of the wards is thoroughly well arranged. The
diet is liberal, and the marked effect of this on the health of the
patients is at once evident. The most varied attempts at
palliative treatment, some of which have met with distinct
success in the hands of the Civil Surgeon, have been carried
out in this Asylum. The sexes are separated. There are
numerous Eurasian inmates. A separate ward also is occupied
by convict lepers.
At the present time the inmates number one hundred and
eighty-four. Twenty-five are Eurasians, and the majority of
the remainder are Hindus. Eighty-seven are married. The
number of children born to these marriages was two hundred
and fifty-one, giving 2.8 to each marriage. Elephantiasis,
which is exceedingly common in Madras, was not seen among
those lepers who were examined.
MADURA.
There is no Asylum at Madura. One hundred and twenty-
three patients were collected by the municipal authorities in
the compound of the Civil Hospital. Among this number ten
were not lepers. Seventy-four lepers were married, with a
total number of one hundred and ninety-three children, giving
2 .6 for each marriage.
Thirty-six lepers had been vaccinated.
Mycetoma (Madura foot) was not seen among the lepers
who were examined.
TANJORE.
There is no Asylum in this city. Among twenty patients
examined at the Civil Hospital sixteen were lepers, and one of
these was an Eurasian. Ten were married, with a total of
fifteen children, or 1.5 to each marriage. Six patients had
been vaccinated.
Local Notes-.—Bombay.
15
TRICHINOPOLY.
The Municipal Leper Hospital can accommodate sixteen
patients. Nineteen patients were seen here, and all were in an
advanced stage of the disease. Three of those examined were
not lepers. Less severe cases, estimated at about one hundred
and sixty, are vagrants in the city and immediate neighbour-
hood. Of the cases examined nine were Hindus. Eight
lepers were married, with a total of eight children, or ro to
each marriage.
Bombay.
BELGAUM.
There are two Asylums in Belgaum : one founded in 1863
for male, the other erected in 1872 for female, lepers. These
are distant about half a mile from each other, not in secluded
parts of the city but surrounded with dwellings. The buildings
each consist of a long hut built of latérite with a verandah ;
partitions divide this into about a dozen compartments. Behind
the female asylum is a street, about 12 feet wide, with houses
full of people on the opposite side. The inhabitants do not
seem to fear the disease spreading, for during the past seven
years no case of leprosy has occurred in proximity to the
asylum. Father Gonsalvo, a Portuguese priest, charitably
looks after the lepers. There is no compulsory detention, but
begging is prohibited. The attendant of the female asylum
during the last eleven years has lived next door to the build
ing, and is perfectly healthy.
BOMBAY.
Three colonies of lepers were examined in Bombay and
the immediate neighbourhood, at Trombay, in the Dharmsala,