NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
No. 3247, dated Lucknow, the 19th July 1876.
From—Major A. MURRAY, Offg. Personal Assistant to the Chief Com-
missioner of Oudh.
To—The Offg. Under Secretary to the Government of India.
WITH reference to previous correspondence ending with your
letter No. 2—75, dated 18th March 1875, I am directed to submit the
accompanying copy of the report of the Officiating Sanitary Com-
missioner on the prevalence of leprosy in this Province, with its
enclosures in original.
Report on Leprosy in Oudh by A. GARDEN, Esq., M. D., Officiating Sanitary
Commissioner, Oudh, dated Lucknow, the 14th July 1876.
THE information called for in para. 8, Government of India Resolution
No. 1—136, dated 5th March 1875, on the prevalence of leprosy in Oudh, embraces
the following points :
I.—The extent to which leprosy exists amongst the people in each
district.
II.—If localised, the localities in which it is chiefly found.
III.—The special peculiarities of the locality, if there be any,· and the special
conditions in other respects under which the people in this locality
exist.
IV.—Evidence derived from individual cases, of the origin, whether here-
ditary, by contagion or by other means.
2. A summary of the evidence obtained from the Civil Surgeons on these
points is herewith submitted.
3. I.—The extent to which leprosy exists in each district in Oudh.
To decide this point returns were called lor as follows :
(1) The number of lepers in poor-houses.
(2) The number of lepers in hospitals.
(3) The number of lepers in jails.
(4) The number of lepers ascertained by enquiry, either personally or
through district officers, to exist in certain areas of greater or less
extent amongst the population at large in each district.
4. The figures obtained from Nos. 1 and 2 may be dismissed at once as in no
way bearing on the subject under enquiry. The numbers in poor-houses and
hospitals are and must be the result of purely exceptional circumstances.
5. From jail returns possibly some approximate idea might be gained of the
relative prevalence of lepers in the Province at large, but for individual districts
la
( 2 )
nothing can be gained, as the populations dealt with are very small, and the absence
of lepers would not show immunity of a district any more than one or two or
many cases, as in the Central Prison, would indicate its exceptional prevalence.
6. In the first returns submitted the figures could not be totalled so as to
give a general summary, as in some the total population and number of lepers was
given, whilst in others the number of sick in hospital and of lepers was entered.
7. In the subjoined statement the jail population and number of lepers, as
they stood on 30th June 1876, is given for each jail.
Lucknow Central Prison
Ditto District Jail
Unao
...
Bara Banki
Fyzabad
Bahraich
Gonda
Rai Bareli
Partabgarh
Sultanpur
Sitapur
Kheri
...
...
Hardui
Total
On 30th June 1876.
1,716
637
229
580
609
265
465
588
450
428
506
208
365
7,046
20
2
...
...
5
...
...
...
...
2
1
2
32
11.65
3.14
...
...
8.2
...
...
...
...
...
3.9
4.8
5.5
4.5
...
...
...
...
2
...
...
...
...
...
...
...
...
2
20
2
...
...
3
...
...
...
...
...
2
1
2
30
8. The ratio 4.5 per mille is very high, and would give, if true, somewhat
about 50,000 lepers in the Province ; but the circumstances of jail must be looked
on as exceptional, especially those of the Central Prison, as will be evident if we
examine at the figures in the next table. Thus in Fyzabad the ratio for the
district is 1.3, whilst that for the jail is 8.2.
9. To arrive at an accurate idea of the prevalence of leprosy not only in
every district, but also of its greater or less prevalence in different portions of each,
would necessitate a lepers' census—a matter of great difficulty and likely in the end
to be very far from correct, as I think is very evident from the return obtained from
Unao, the only district in which it was tried.
10. The other alternative, that of guessing at the prevalence from the number
of lepers found within certain towns and villages, or areas of limited extent, was
tried in the remaining districts, from which returns have been submitted.
From Partabgarh and Hardui no information at all has been given.
( 3 )
District.
Lucknow
Bara Banki
Unao
Fyzabad
Bahraich
Gonda
Eai Bareli
Partabgarh
Sultanpur
Sitapur
Kheri
Hurdui
Area.
23 villages ...
2 towns ...
...
Whole district
10 towns
2 do.
1 town
...
29 villages ...
...
Nil
4 towns
5 do.
8 villages ...
Nil
Population.
Not available.
20,011
944,792
35,726
6,680
11,600
61,913
Nil
10,020
29,271
32,981
Nil
Lepers.
I
34
27
650
49
18
14
144
Nil
5
51
44
Nil
Eatio per
mille of
lepers.
...
1.35
.7
1.3
2.7
1.2
2.33
Nil
.5
1.7
1.33
Nil
The list of individual towns and villages with population, lepers and ratio per
mille will be found in the appendix, as it is too long to be entered here.
11. If the figures are true, leprosy must be exceptionally common in Rai
Bareli, the ratio being 2.33 per mille and unusually rare in Sultanpur. In many
instances, however, there are grave reasons for setting aside the returns as untrue,
irrespective of the strong chance of mistakes, through the reticence of the lepers
themselves and the non-detection or concealment of incipient cases.
12. In Unao the returns must be rejected, as leucoderma, an affection of
the skin deemed leprous by Natives, but not really so, has been included. In
Bahraich are given only two towns with too small a population for the purpose.
13. In Bai Bareli only such towns and villages were taken as contained more
than three lepers each, and this gives some very startling results. Thus in one village
as many as 11.5 per mille were lepers, but then there were only three lepers and the
village contained but 263 people. It is not so stated, but these may have been relatives
and the disease hereditary ; and it seems to me that it is examples of this nature
that have raised the ratio so high. However the return possess no real value, since
by picking out all the villages or hamlets without lepers one might easily arrive at
the opposite result, i.e., that leprosy is unknown in Rai Bareli.
In Kheri a similar mistake was made. The question was most carefully
examined into by the Civil Surgeon, but he took no account of the population of
villages in which there were no lepers, and thus vitiated his returns.
14. The utmost then that can be stated from these tables is that over one and
under two per mille of the population of Oudh probably is leprous, but that data
are wanting to show its greater or less prevalence in any one district or parts of
districts.
15. II.—If localised, &c.
III.—Special peculiarities, &c.
The replies on these points are quite negative. The disease is spread over the
districts pretty uniformly and attacks all castes and all conditions of people having
a preference for the worst fed, worst clothed and worst housed.
( 4 )
16. IV.—Evidence derived from individual cases regarding origin by heredi-
tary descent, contagion or by other means.
That leprosy is hereditary there can be no doubt, but to what extent is by no
means easy to ascertain—
(1) on account of the reticence shewn by lepers or their healthy relatives
in allowing that the disease exists, or has existed in other members
of the family ;
(2) because few Natives know aught concerning the state of health of grand-
parents and of other relatives than their parents and brothers and
sisters; and
(3) because the disease may be concealed, and I believe often is in its earliest
stages and milder forms.
17. The evidence furnished on this point is as under :
Civil Surgeon,
Lucknow.
Central Prison
Ditto ...
Civil Surgeon,
Gonda.
Bahraich
Fyzabad
Jail
Rai Bareli
Hurdui
...
Total
9
21
19
62
17
7
...
2
137
8
18
18
5
11
3
...
1
64
Hereditary.
1
3
1
10
6
4
...
1
26
Eelative lepers.
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
• • •
1
2
Gran
fathe
1
d-
r.
1
1
Grand
moth
d-
er.
IP
1
2
1P
1P
1 relative
1 not
stated.
18. From this we find that out of 137 cases 26, or 18.9 per cent. had relatives
affected. I do not believe this represents the actual influence of hereditary in the
propagation of leprosy for the reasons given above.
19. In 43 cases (from my own note books) I found eight, or 18.1 per cent., had
relatives affected. In two the father and in one the mother, in four the uncles
( 6 )
father, whilst his mother and two other children deserted them. The boy became
leprous about a year after his father, whilst the two others who continued with the
mother remained healthy.
25. Hereditary, or exposure to the same conditions of life as the father, will
account for the son's leprosy quite as well as contagion.
26. Another suggested cause is syphilis, but there is just the same amount
of evidence in favour of it as of contagion. It may be put aside, I think, as not
being a cause of leprosy,
27. One reporter considers malaria to be a chief factor in the production of
leprosy. It may or it may not be. There is no evidence to the fore on this
point as yet.
28. The general opinion or feeling is that, whilst hereditary, it may arise as
a disease de novo under general insanitary conditions, defective hygiene, want
of clothing, and want of proper nutritious food; in fact that, when it shows itself
de novo many men, it can be ascribed to no one conbination of circumstances suffi-
ciently peculiar and succinct to be denominated the cause.
29. There is no doubt that it has a predilection for the male sex. Not one
of the leper prisoners is a female, and the same thing is to be noticed in all the
reports when everything is said of sex. Thus in Gonda, out of fourteen, ten were
male and four female.
30. To sum up, in conclusion, the results of the enquiries amount to this—
(1) That the prevalence of leprosy in most districts is still unknown, either
from faulty methods in obtaining information, or from the number
being too small to justify general deductions therefrom.
(2) There is no evidence at command of its being more prevalent in one
district than in another, or in one part of a district than in
another, and in consequence there is no evidence as to peculiarities
of locality, habits of life and surroundings which may or do act
in the production of leprosy. To show the difficulty of finding
evidence on this subject, I may mention that in the Lucknow
Central Prison there are six prisoners lepers who did not show
the disease until, in some instances, long after they had been inmates
of the jail, where food, clothing and hygiene leave little to be
desired. They all deny hereditary, but probably they were all
descendants of leprous progenitors, or had acquired the disease
before entering jail ; otherwise we must ascribe it to conditions met
with in jails. I have myself in former years seen similar cases.
(3) That, whilst it is undoubtly hereditary, probably it is far more so than
18 per cent. or 19 per cent. represents.
(4) That it does not spread by contagion and is not connected with
syphilis.
31. If it is desirable to try and obtain more accurate information on the
prevalence in Oudh of leprosy, the enquiry must be carried on with painstaking
and care on some settled definite plan, so that the data supplied may have some
chance of being alike for every district.
The reports received from the civil medical officers are forwarded herewith.
( 7 )
District.
Bara Banki ...
...
Unao
Fyzabad
Akberpur
Shahganj
Bahraich
Gonda
Eai Bareli ...
Name of village or town
Radauli
...
Futtehpur ...
,,.
...
Total
Whole district
Tandah
Ilifatganj ,.,
...
,..
Mobaricpur ...
...
Akberpur
.,,
...
...
Shazadpur ...
...
Moradabad ,,,
Mirzapur ...
...
Shahganj ,,,
Paharpur ...
...
...
Dobbyara ,,.
Total
Bhinga
,..
...
...
Ikauua
...
...
...
Total
Gonda
...
...
...
Behta
...
...
...
Salone Kkas ...
...
...
Koonsa
...
...
...
Sultanpur Khas
Pahoo
...
...
»•.
Khero
...
...
...
Bhatargaon ...
...
Koripur
...
...
Satawan
..
...
..
12,517
7,494
20,011
944,792
16,971
1,922
4,306
1,745
5,069
387
240
4,086
489
511
35,726
4,491
2,189
6,680
11,600
3,798
5,190
5,864
2,678
2,944
3,480
4,297
3,293
2,952
13
14
27
650
26
...
6
2
2
2
...
8
1
2
49
12
6
18
14
4
3
16
10
8
5
7
7
10
1.
1.86
1.35
.7
1.55
...
1.4
1.1
.4
5.2
...
2.
2.1
1.3
2.67
2.74
2.7
1.2
1.05
.57
2.72
3.72
2.72
1.43
1.62
2.12
3.38
( 8 )
District.
Rai Bareli, — concluded
.
\
i
Sultanpur
..
Sitapur
r
Kheri
Name of village or town.
Jamrawan ...
...
...
Osali
Koosaro Sagarpur
Kuriba
...
...
...
Sidhomea ...
...
...
Morainee
...
...
Thana Teopin
...
...
Maro Suklin...
Halar
...
...
Nurthooah ...
...
Acci
Kotawali
Raipur Jekeria
Snwam
...
Rampur
...
Kurrthee
...
...
Busuntpur ...
Kokarampur
...
Balla Bawan
Laleythoo
Total
Haliapur
Hassunpur ...
•
Baronsa
...
,,,
,..
Tirsooli
...
Total
Lahurpur ...
...
...
Biswan
...
...
...
Bari
Mahowli
...
...
...
Sitapur
...
...
Total
Singhai
Dhaurahra ...
Kheri
Lakhimpur ...
..
Miltawli
Aurangabad ...
Barwar
Muhanimadi..,
,,
Total
1,870
1,134
unknown,
less than
500.
Do.
1,406
1,383
990
2,660
1,577
2,322
659
853
263
1,060
616
Dot known,
but loss
than 500.
1,095
1,617
4,607
1,795
61,903
3,026
4.399
1,333
1,262
10,020
10,989
5,749
4,018
1,338
7,177
29,271
1,360
3,000
5,639
2,482
3,000
5,000
4,500
8,000
32,981
3
3
3
3
3
8
3
4
5
3
4
3
3
3
4
3
3
5
4
4
144
4
1
Nil,
...
5
5
4
4
4
34
51
1
3
11
3
6
11
2
7
44
1.60
2.63
6.
6.
2.13
5.78
3.
1.5
3.6
1.29
6.07
3.51
11.40
2.83
6.49
6.
2.74
3.09
.88
2.23
2.33
1.32
.22
...
...
.5
.45
.69
.94
3.
4.73
1.7
.73
1.
1.95
1.2
2.
2.5
.44
.87
1.33
( 9 )
No. 45, dated Kheri, the 19th April 1875.
From—F. W. HIGGINSON, Esq., Civil Surgeon of Kheri.
To—The Sanitary Commissioner of Oudh.
IN connexion with your No. 899 of 1S75, I have the honour to supply the
numerical data as to the prevalence of leprosy in this district you ask for.
2. I know of no locality in this district in which the disease is specially
prevalent.
Institution.
District Jail
Sadr Dispensary
Poor-house
Number of inmates on
the 17th April 1875.
214
6 in-patients; 36 out-patients
Nil.
Number of lepers among
them.
None.
None.
Nil.
No. 37, dated Rheri, the 23rd March 1876.
From—F. W. HIGGINSON, Esq., Civil Surgeon of Kheri.
To—The Sanitary Commissioner of Oudh.
IN reference to your No. 2814 of 1875, I have the honour to submit the follow-
ing remarks concerning leprosy in this district.
2. While in camp in November and December last I took the opportunity of
enquiring in all large villages I came across as to the number of lepers in each, and
of examining the persons affected; the results are here given :
Name of town.
Sinjhai
Dhaurahra
Kheri
Lakhimpur
Mitauli
Aurangabad
Barwar
Muhammadi
Direction.
North
East
South
Ditto
South-West ...
Ditto
West
Ditto
Aggregates
Population
1,360
3,000
5,639
2,482
3,000
5,000
4,500
8,000
32,981
No. of lepers.
1
3
11
3
6
11
2
7
44
or 1.36 per mille.
As these towns are situated at all points of the compass, the proportion of lepers to
their population may fairly be taken as a representation of the proportion of lepers
to the total population of the district; indeed the latter is less, probably, for in many
small villages I found no lepers.
3. Excepting one at Muhammadi and the one at Sinjhai, none of these lepers
were so ill as to be unable to follow their usual employments; they did not seem
to be shunned by their fellow-townsmen and did not live alone; they were all of
adult age.
4. There is no poor-house or leper asylum in this district. I have had no
opportunity of trying the gurjun oil treatment at the dispensary or jail.
3a
( 11 )
in the first case ; and that the children of leprous parents do not necessarily in every
instance inherit the dreadful disease, although their parents may have been living
and cohabiting together after the first appearance of the disease in either of them.
4. In conclusion, I would beg to remark that the three cases are residents of
villages widely separated from each other, the village in which the first case lived
is nearly surrounded by a large swamp. I have not seen the village myself in which
the second case lived, but I know that Pergunnah Kutyaree, in which it is situated,
is the most malarious part of the district in which fevers are very prevalent for
nearly six months of the year. The last case lived in a large village, the remains of
an old town, in which there is a good deal of fever every year, which I witnessed
myself when I went through it last month, and distributed an ounce of quinine
among the sufferers.
Dated Sitapur, the 17th July 1875.
From—The Civil Surgeon of Sitapur.
To—The Sanitary Commissioner of Oudh.
I HAVE the honour to forward the following informati on regarding the prevalence
of leprosy in this district.
Tabular Statement No. I. given below represents state of the disease existing,
on the 8th June last in the institutions mentioned.
Tabular Statement No. II. has only been recently received from the Police
Office.
Tabular Statement No. I.
Institution.
Jail
Poor-house
Native hospital
Number of inmates on
8th June.
710
31
56
Number of lepers among
them.
0
6
1
Of the six lepers in poor-house three are from the Punjab and one from
North-Western Provinces, and only two are residents of this district.
Prevalence of the disease in different towns of the district.
Tabular Statement No. II.
Names of towns.
Lahurpur
Biswan
Bari
Mahowli
Sitapur, Thompsonganj and
Alumuaggar.
Population.
10,989
5,749
4,018
1,338
7,177
Number of lepers in
each.
5
4
4
4
34
The proportion of lepers in population, judging from the first four towns
above given, is only about 0.8 to 1,000. Judging from Sitapur and Thompsonganj
it is nearly 5 per 1,000, but many of the lepers at present in Sitapur come from
( 14 )
Objective symptoms at beginning of treatment.·—No. deposit or loss of pigment
anywhere; general appearance of skin rough and dry, especially in hands and feet;
nails thickened and ragged ; no tubercules.
Subjective symptoms.—Sight affected, myopic; loss of sensation in hands and
feet ; palms and soles as well as dorsi affected ; has burning and tingling sensations
in hands and feet.
Is under treatment from 13th February 1875.
Condition of patient on I5th November 1875.—Sensation has returned in the
right hand, which has assumed a natural appearance ; the nails of this hand are
no longer thickened and ragged; general appearance of skin more natural.
CASE No. 5.
Prisoner Gungapershad, No. 1985, aged 45 years, Brahmin, duration of disease
eight months, said not to be inherited.
Objective symptoms at beginning of treatment.—Skin somewhat rough in right
thigh and leg and right arm and forearm ; nails of right hand atrophied ; no
tubercles.
Subjective symptoms.—Loss of sensation in whole of right upper limb, in front
and sides of right thigh, in right leg (except calf) and in dorsum of right foot ;
sense of burning and tingling in right upper and lower limbs.
Is under treatment from 21st April 1875.
Condition of patient on 15th November 1875.—Sensation is returning to right
arm ; sensation has returned to right thigh and leg ; no sensation as yet in dorsum
of foot.
CASE No. 6.
Prisoner Joogah, No. 1031, aged 37 years, Lodh, duration of disease nine
mouths, said not to be inherited.
Objective symptoms of beginning of treatment.—Skin rough over whole body;
slightly tuberculated appearance on eyebrows and nose.
Subjective symptoms.—Loss of sensation as follows : In cheeks and forehead ;
in whole surface of back and front of chest ; in right forearm and hand ; in right leg,
from three inches below knee ; in right foot ; in lower half of left thigh ; in left
leg and foot. Sense of burning and cramps in limbs.
Is under treatment from 18th May 1875.
Condition of patient on 15th November 1875.—Sensation has returned in chest
and back, in right forearm and left thumb, and in right leg to nine inches below
knee ; general appearance of skin not improved.
Memorandum No. 991, dated Lucknow, the 29th June 1876.
IN compliance with, his docket No. 1509, dated 21st instant, begs to submit a
statement of particulars of cases of leprosy in the Central Prison in which the
disease showed itself on prisoners while in jail.
G. D. McREDDIE,
Supdt. of Oudh Central Prison.
To the Inspector General of Prisons.
Particulars of cases of leprosy in the Central Prison in which the disease showed itself on prisoners while in jail.
1
Name of prisoner.
1. Ouseree, No. 3466
2. Dhoom Singh, No. 2238
3. Koorkoot, No. 3217
...
4. Gungapersaud, No. 1985
5. Joogah, No. 1031
6. Bam Singh, No. 1973 ...
2
Caste.
Passee ...
Thakoor...
Ahir ...
Brahmin
Lodh ...
Thakoor
3
Sex.
Male
Do.
Do.
Do.
Do.
Do.
4
Age.
40
21
25
45
37
50
5
When admitted
into jail.
3rd Feb. 1874
4th Nov. 1871...
25th Aug. 1873
26th April 1871
24th June 1869
16th Fe. 1871
6
Resident of
Village. Pergunnah. District.
Marshy or not.
L oha r ee,
Purwa.
Kukrabad
Tanda ...
Musapur
Gowra ...
(marshy)
Surajmhow
(marshy)
Bara Banki
Lucknow
Tanda ...
Shahabad
Unao ...
Tendua...
Bara Banki
Lucknow
Fyzabad
Hardui ...
Unao ...
Hardui,..
7
Date of
first appear-
ance.
July 1874
Sept. 1873
April 1874
Sept. 1874
Sept. 1874
Oct. 1875
8
Hereditary
direct or
collative ;
any evi-
dence.
9
Good
Do.
Do.
Do.
Do.
Do.
10
Form of
leprosy.
Mixed, tuber-
cular and
anæsthetic.
Anæsthetic...
Do.
Do.
Mixed form
Anæsthetic...
11
Treatment.
Gurjun oil
Do.
Do.
Do.
Do.
Do.
12
Result — whole progress.
Benefited on the whole.
Not benefited.
Do.
Do.
Do.
Benefited on the whole.
The most marshy district is Hardui.
The other districts are not noted as usually marshy in character.
LUCKNOW
G. D. McREDDIE,
The
June 1876.
Supdt. of Oudh Central Prison.
(15)
( 16 )
No, 164, dated Unao, the 1st June 1875.
From—The Civil Medical Officer, Unao.
To—The Sanitary Commissioner of Oudh.
WITH reference to letter No. 1734, T beg- to state that the delay in submitting
the report on leprosy is owing to the absence of any record on the subject in this
Office.
The police was asked to make enquiries in the different thannahs about the
disease. They have sent in a report only a day ago. I hope to submit the report
in course of the week.
Dated Unao, the 18th July 1875.
From—The Health Officer, Unao.
T—The Sanitary Commissioner of Oudh.
WITH reference to No. 895, dated 15th April, I beg to submit the following
report :
1. The prevalence of the disease in this district, as could be judged from the
number of lepers present on any one date in the jail and Native hospital, is the
following :
Institution.
Jail
Poor Hospital
Native Hospital
Number of inmates on 17th
April 1875 (strength of
prisoners 334).
10 (sick)
70
Number of lepers among
them.
1
4
2. I also append here a list of lepers as distributed in the different thannahs
of the district furnished by the police. I think the cases of leucoderma as included
in the list.
The largest number is 125 in the thannah of Achulgunge to a population of
75,899, while the smallest number is 17 in the thannah of Barra to a population
of 98,364. The total number in the whole district is 650 to a population of
944,793, that is '06 per hundred of the population : according to sex, 555 male to
95 female.
The ratio of male to female pepulation is 1 male to 2'08 female.
The largest number of cases in the whole district is between the ages of
20 to 40.
3. I am unable to state the peculiarity of the thannah of Achulgunge as I
had not an opportunity of visiting it.
4. It would appear from the information given in the accompanying list
that the largest number, i. e., 262 out of 650, has an ostensible means of living; and
as the class of cultivators are not every badly off, I think that they are not in want
of food and small comforts of life. Out of 650, 262 is employed in cultivation, while
the rest are unfit for work and are either dependent on their families or life by
begging. Out of 650 given in the list only 27 are beggars. Their present cir-
cumstance is rather due to the disease.
5. I cannot give my opinion as to the propagation of the disease from my
experience of the district.
6. I beg to state the facts which I have come to know from my own obser-
vation in other places. I know instances in which the disease is decidedly hereditary,