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Dr. Fitzgerald, of Sháhjahánpur, is of opinion that syphilis may have some
connection 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
gonorrhœa ; 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
suspicion of hereditary taint rests, seems to be most satisfactorily proved by the his-
tories of two cases recorded by Dr. Fitzgerald. The first, the case of an Euro-
pean 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 improvement. 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 be postponed
until, as mentioned in paragraph 10, I have had opportunity for carefully recording
the history 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 population thus notorious.
The results of this local investigation will form the subject of a second com-
munication 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, Banda, and probably
Gorakhpur.
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
influence as a cause of the disease. This point, however, remains for further consi-
deration.
It is a disease specially of men as distinguished from women. A disease not
peculiar 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 debarred, by public opinion concerning them, from earning a liveli-
hood as before their attack. This reduction to beggary being much helped by the
fact that the anæsthetic variety, which leads most surely to mutilations of the hands
and feet, is most prevalent.
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 cir-
cumstances of these " de 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 compas-
sionate 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 them, therefore they suffer, yet linger in life. For this
reason they are worthy objects of charity, and are properly cared for in good.