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tory and circumstances of all the lepers of a village in which the disease is unusually
prevalent. And for this purpose I have it in mind to reside for some days, during the
approaching cold season, in the immediate neighbourhood of certain centres of popula-
tion thus notorious.
The results of this local investigation will form the subject of a second communi-
cation to Government on this important matter.
41. The conclusions which may I think be fairly arrived at, as the results of this
present investigation, can be stated as follows :—
Leprosy in the North-Western Provinces is a disease so widely spread as to be
known in all parts, but best known in Kumaun, Garhwál, Bánda, and probably Gorakh-
pur.
Yet, everywhere, the places where first attacks occur are so scattered over the
face of the country, as to almost preclude the idea that local conditions have any in-
fluence as a cause of the disease. This point however remain for further considera-
tion.
It is a disease specially of men as distinguished from women. A disease not pecu-
liar to persons of any employment or religion, with the possible exception that persons
of sedentary habits are prone to suffer. Leprosy affects in about equal proportions
the well-to-do and the poor. It results, however, in reducing to beggary at least
one-third of those attacked, though so long as labour is possible lepers are not debar-
red, by public opinion concerning them, from earning a livelihood as before their
attack. This reduction to beggary being much helped by the fact that the anfesthe-
tic variety, which leads most surely to mutilations of the hands and feet, is most pre-
valent.
As a rule leprosy assumes outward and hurtful appearance at the ages from 20
to 50 years, or after children have been born to those afflicted,—lepers, or those who
are to suffer leprosy, being as prolific as mankind in general, and living as long.
Its attack results so little from contagion, that only about 1 per cent, of 855 cases
of cohabitation between a leprous husband and healthy wife, or leprous wife and
healthy husband, resulted in showing leprosy of both husband and wife. This low
average even being possibly reducible, upon the well-founded supposition that the
cases of leprosy of both husband and wife may in some instances have arisen from
intermarriage of a man and woman in both of whom leprosy was hereditary.
Leprosy is essentially a hereditary disease, as shown by the testimony of about
20 per cent, of persons examined, and probably in far greater proportion of all those
afflicted in the Province, if the truth could be arrived at.
But in addition to the few cases which may result from contagion, and the many
which result from hereditary influence, there seem undoubtedly to be cases which arise
in persons remote from contagion and of healthy families, the circumstances of these
"do novo" cases requiring further study and consideration.
41. I think the practical value of this investigation may be summed up in the
statements,—1st, that lepers of all suffering mankind are most worthy of compassionate
consideration, at least such of them as, by mutilation, are reduced to beggary. For it is
certain that a large proportion of these suffering men (and men have less expectation of
help from relations than women) have fallen into misery and poverty, without shadow
of self-fault or misbehaviour.]
The evil was born with then, therefore they suffer yet linger in life. For this reason
they are worthy objects of charity, and are properly cared for in good numbers in the
Leper Asylums which exist in several places in the Province. Yet, from the number