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heredity, the conditions of its latency or manifestation have still to
be worked out. Cases of the leprous or predisposed emigrating to non-
leprous places, as in the well known instances of the Norwegian
Colony in Western America, afford the best opportunity for investigat-
ing the subject of transmission ; and, on the other hand, cases
arising de novo in which no family history exists offer the best
material for investigating causation apart from transmission. The
whole question of heredity is thus a complicated and difficult one, and
requires very delicate handling, and the evidence recorded in these
reports simply amount to a support protanto of a conclusion gained
by more discriminating inquiry elsewhere, notably in Norway.
Contagion.
11. The subject of contagion is a still more difficult one, because
it is necessary to eliminate, in order
to establish it, so many other condi-
tions—most of them obscure, and more especially heredity and common
local influences. It is certain, however, that there exists in India a
firm popular belief that the disease is capable of communication by
contact more particularly by sexual intercourse. None of the in-
stances of apparent contagion given in these reports—and they are
pretty numerous—will bear criticism, because other possible causes of
manifestation have not been considered and eliminated. The most
striking cases are those related by Surgeon Z. A. Ahmed in the report
on the Sonthal Pergunnahs ; Dr. Picachy in the Purneah report ;
Surgeon W. Duncan, Jalpaiguri ; Surgeon R. D. Murray, Chittagong ;
Surgeon C. H. Joubert, Burdwan ; Dr. Green, Serampore ; Dr. Ghose,
Burdwan ; and Dr. Gregg, Hooghly. They are, however, too indefinite
to bear critical discussion.
Sex.
12. The preponderance of males affected with leprosy in India is a
very remarkable circumstance; but
this may, for reasons already given,
be more apparent than real. In Norway where the careful and syste-
matic registration of lepers is carried out under the orders of Govern-
ment by a strong special agency, the proportions are reported to be
1.29 males to 1· female. Dr. Vandyke Carter, who has specially in-
vestigated the subject in the Bombay Presidency, gives the proportion
as 4.38 to 1. Drs. Lewis and Cunningham found the proportion of
admissions into the asylum at Almorah to be males 1.5 to 1· female.
The statistics given in these reports support the general conclusion
that the disease is more frequently seen among men than women.
Thus of 59 cases seen by Surgeon Z. A. Ahmed in twelve villages 45
were males and 14 females, or 3.2 to 1·, and of 378 seen by Dr. Ghose
in Rungpur 253 were males and 125 females, or 2. to 1·. The figures
given by other reporters have been obtained from the census returns
and show even higher ratios.
Age.
13. That leprosy is a disease of adult life has been fully demon-
strated, and the evidence contained
in these reports goes to support the
conclusion. The youngest subject mentioned is a female child of
seven seen at Jalpaiguri by Surgeon W. Duncan. There are no
facts to show whether the disease appears earlier, or later, in males, or
females.
Varieties.
14. Some of the reporters describe the forms of leprosy seen by
them ; but there is noting new or
noteworthy in these details. All
who notice the matter agree in affirming that the anæsthetic variety
of the disease is more commonly prevalent than the tuberculated.
Drs. Lewis and Cunningham found in the Almorah Asylum 49 cases of