( 14 )
I think it probable that lepers living in an asylum, and, from experience, less
likely to fear or suspect the object of examination would be inclined to tell all they
know. The result here gives rather more than 50 per cent, of the whole as cases
connected with hereditary taint, and perhaps that may be accepted as near the truth
in regard to this matter, so far as it can be determined by the testimony of living
lepers.
36. But, viewed in any form, the testimony as disclosed in these histories is
sufficient to prove that hereditary taint, unlike contagion, must bo a potent cause of
the continuation or prevalence of leprosy amongst the people of this country, perhaps
the most potent of any cause in existence.
37. That there may be another cause, or other causes, cannot however be denied.
The testimony in this direction is plain, and often repeated in the histories and the
papers which accompanied them. And it seems certain that the cause or causes which
first originated this form of disease are still in existence, and may originate the com-
plaint in a man to whose history no suspicion of hereditary taint attaches.
It cannot, I think, be possible that all the 1,194 persons, who denied hereditary
influence, could have been mistaken : indeed, a few of them were very explicit in deny-
ing the existence of any such influence, sometimes to their knowledge for three genera-
tions back.
38. What these originating causes may be cannot in the present state of our
knowledge be more than guessed at. They appear to be first and principally such
climatic conditions, habits, or mode of life, as conduce to the formation of constitutions
in middle life prone to low forms of disease.
In a person thus predisposed, it seems probable that a previous attack of syphilitic
disease may result in the establishment of a condition of leprosy.
Thus of 63 lepers examined at Saháranpur, 18, who denied hereditary taint, attri-
buted their leprous condition to syphilis. And Doctor Jones records the opinion that
syphilis is an important initiating cause in the comparatively few cases of leprosy
generated anew.
At Muzaffarnagar four persons of those examined attributed their leprosy to the
results of venereal disease.
Doctor Fitzgerald of Sháhjahánpur is of opinion that syphilis may have some con-
nection with the occurrence of leprosy. Seven of the 30 persons examined there had
had syphilis before the leprosy made its appearance, and two had suffered from gonor-
rhea; and from enquiries made by Dr. Fitzgerald of intelligent natives, he found the
belief prevailing amongst them, that leprosy is sometimes developed where syphilis has
been injudiciously treated with mercury.
39. That leprosy may be developed "de novo" in persons against whom no sus-
picion of hereditary taint rests, seems to be most satisfactorily proved by the histories
of two cases recorded by Doctor Fitzgerald. The first, the case of an European lad
who had become a leper, although there was no trace or suspicion of taint on the father's
or mother's side, direct or remote. The young man was first seen at Agra in 1865 and
again seven years afterwards at Bombay, where he had gone to be treated by Dr. Bhau
Dhajee, who had acquired a widespread reputation for the cure of leprosy. But in this
case the treatment pursued had not been attended with benefit or promise of improve-
ment. The second, the case of an European lady, who left India in 1875 and suffered
with symptoms of leprosy after her arrival in England. No suspicion of hereditary
taint existed.
40. But the further consideration of this important point must bo postponed
until, as mentioned in para, 10, I have had opportunity for carefully recording the his-