NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
( 30 )
malady is due to a contagium or communicable germ, which takes root and
flourishes under favourable circumstances, and these favourable circumstances are
climate, soil and other hygienic conditions. These conditions alone cannot produce
the disease ; as under similar circumstances the disease does not originate. Again,
where the hygienic conditions are good, the disease, if introduced, will not spread
as it does not in some parts of the district, although so close to others infested with it.
Numbers of cases came to my notice in which the leprous individual re-
members having lived in close proximity to some one else affected or had distant
relationship with other lepers, but there were 33 cases in which the persons lived
in the same house with other lepers before getting it. In four of these 33 cases
there was sexual intercourse with leprous individuals before the attack. In one
village I found six individuals in different stages of the disease, more or less related
to each other. A woman got leprosy first from a leprous husband who lived in
another village. Her parents were not leprous. After her husband's death she
came to live with her brother, and before she was a year in the house he got the
disease. In the course of six years three other individuals in the neighbouring
houses were affected. The oldest individual in this village assured me that before
the woman returned home after her husband's death he had not seen a leper in
that village.
I beg to annex a skeleton map of the district showing the sites of prevalence,
the deepest colour indicating the parts of country most infested and then shading
off to places of comparative immunity, the places almost free from the disease
having been left altogether blank.
(31)
Phoorunbaree
Barobaree
Ulipur
...
...
...
...
Dimla
...
Bhowaneegunge
...
...
...
Chilmaree
...
...
...
Sadoollapur
...
...
...
Gobindgunge ...
Nageshuree ...
...
...
Nisbettgunge
Durwanee ...
Jaldhaka
...
...
...
Maheegunge
Kourgunge
...
...
...
Malanga
Peergunge ... .
... ...
POPULATION.
85,314
72,139
120,911
71,293
32,500
34,268
60,794
92,546
91,977
75,066
61,890
86,605
62,657
50,905
57,219
38,942
80,047
71,120
122,082
67,381
29,887
33,223
59,800
88,728
90,943
71,392
57,634
81,668
60,365
48,737
55,047
36,892
165,361
143,259
242,993
138,674
62,387
67,491
120,594
181,274
182,920
146,458
119,524
168,273
123,022
99,642
112,266
75,834
NUMBER OF CONFIRM-
ED LEPERS IN THE
CENSUS.
291
286
299
155
93
81
132
180
172
132
88
91
88
42
38
22
23
27
23
16
8
4
19
24
7
8
12
4
3
2
2
145
143
149
77
46
40
66
90
86
66
44
45
44
21
19
11
436
429
448
232
]39
121
198
270
258
198
132
136
132
63
57
33
3,744
1,716
1,792
928
556
484
792
1,080
1,032
792
528
544
528
252
228
132
10·5
11·9
7·3
6·6
8·9
7·1
6·5
5·9
5·6
5·4
4·4
3·2
4·2
2·5
2
1·7
5·9
Tract of the extreme
prevalence.
Tract in which the
prevalence is above
the average of the
district.
Tract in which the
prevalence is below
the average of the
district.
The tract of extreme
freedom
from lep-
rosy.
11·2
7·3
4·8
2·8
( 32 )
No. 30 E, dated Calcutta, the 8th June 1877.
Endorsed by the Deputy Surgeon General, Presidency Circle.
FORWARDED to the Secretary to the Surgeon General, Indian Medical Depart-
ment, in continuation of this Office memorandum No. 29 E, dated 7th instant.
No. 703, dated Dinagepur, the 4th June 1877.
From—J. W. W. WEBBER, Esq., Civil Surgeon of Dinagepur.
To—The Deputy Surgeon General, Presidency Circle.
WITH reference to your forwarding circular memorandum No. 311 of the 5th
January last, I have the honour to submit herewith a return showing the number
of lepers in each police station of this district for your information, and my remarks
on the disease.
Statement showing the number of lepers in the District of Dinagepur.
No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Names of stations.
Thakurgaon.
Ranigunge
Ranisunkail
Patiram
Beergunge
Garneah Out-post ...
Putnitola
Bungshihari
Habrah
Mohadebpur
Chintamon
Kotwali
Hemtabad
Rajarampur
Gangarampur
Atwari
Parsha
...
Nawabgunge
Kaliagunge
Peergunge
Total
Number of
lepers in each
station.
45
22
64
6
85
32
11
31
80
4
24
8
60
46
26
131
23
30
60
16
804
R Ε Κ Α Ε Κ S .
Leprosy is scattered throughout the whole district.
The climate is bad, and there is only one mineral
product in it, viz., lime, which lies in the form of
kunkur in scattered beds in several localities at
various depths. The Southern portion of the district
is undulating : no mountains nor hills ; a great deal
of forest and barren land. The disease does not
appear at all hereditary, most of those that I exa-
mined did not get the disease till long after puberty,,
and they said that they contracted it either from the
wife or husband. As far as I could judge, most seemed
to have got it through poverty, exposure, bad food and
worse clothing — in fact, dirty habits. There are a good
many well off and even in independent circum-
stances suffering from the disease. Drinking water
does not seem to have anything whatever to do with
it. Scarcely anything has been done in the way of
carrying out general treatment. Those coming under
my own care have had the chalmoogra oil treatment
with very little benefit I am sorry to record.
Dinagepur
J. W. W. WEBBER,
The 4th June 1877.
Civil Surgeon.
No. 123, dated Bogra, the 14th March 1877.
From—R. SANDIFORD, Esq., Civil Medical Officer of Bogra.
To —The Deputy Surgeon General, Presidency Division.
WITH reference to your memorandum No. 111 of the 5th January last, I have
the honour to report that I have not seen a case of true tuberculated leprosy, nor
I have been able to get any information. It does not appear to exist in the district
to any great degree. I believe there are a few isolated cases to be met with here and
there. I may say I have seen a ease of what is called white leprosy, a few cases
of those are in the district.
( 35 )
No. 763, dated Jessore, the 30th June 1875.
From—W. H. GREGG, Esq., M. B., Civil Surgeon, Jessore.
To—The Deputy Surgeon General, Presidency Circle.
IN answer to your circular memorandum No. 11 of the 5th March last,
I have the honour to report that I have taken great trouble in order to collect
the information required. Leprosy is not confined to any particular part of Jessore.
It is most common in the Sub-Divisions of Jhenida, Magoora, Narail and Bagirhat,
which form the North and East of the district, and through which the Rivers
Modhumuti, Koomar, Nobogungee run. The Sadr Sub-Division and Khoolna which
form the central, West and South portion of the district, are more free from the
disease. This will be clearly seen from the accompanying statement. In March
the largest number of cases there; no evidence of hereditary taint. The number
of lepers which attend the dispensary is very small. They believe that the
disease is incurable. I have treated the lepers with gurjun oil, but with only partial
success.
Statement showing the number of lepers in the District of Jessore for year 1876.
Name of Sub-
Divisions.
Sadr
Jhenida
Magoora
Narail
Khoolna
Bagirhat
Total ...
Number of
lepers.
136
41
241
126
57
18
619
NUMBER OP LEPERS
Who inherited
leprosy.
1
14
24
9
2
4
54
Who know
nothing of its
cause.
135
27
217
117
55
14
565
Number of
lepers treated by
gurjun oil.
1
...
1
...
7
11
20
Result of treat-
ment.
Little improved.
...
Not known.
...
Not cured.
Ditto.
R. T. WRIGHT, M. D.,
Civil Surgeon, Jessore.
No. 335, dated Noakholly, the 29th June 1877.
From—T. LYONS, Esq., Civil Medical Officer, Noakholly.
To—The Deputy Surgeon General, Dacca Circle, Shillong.
IN reply to your circular memorandum No. 15 of the 11th June 1877, calling
for a report on leprosy in the district, I have the honour to inform you that the
disease appears to be very rare in the Noakholly District, two cases only having
been met with during the past eighteen months.
From the entries in the prescription and attendance book of the charitable
dispensary, as well as from information gathered from the Native Doctor in charge,
it is ascertained that Johar Ali, aged 40 years, and inhabitant of Sundeep, applied
for treatment on the 15th September, and taking a supply of gurjun oil returned
home the same day. He stated that he had been suffering from the disease for
three years, but could not give particulars of his health immediately preceding its
first appearance, but that there was no history of leprosy in his family.
The second case, that of a man from Begumgunge, named Sarafut Ali, aged
25 years, came to the charitable dispensary on the 12th October last. He stated
he had always enjoyed good health up to his eighteenth year, when he contracted
syphilis, and that during the following twelve months he was in the hands of the
Native physicians, who treated him largely with calomel, and that while suffering
from the effects of mercurialization he first noticed and complained of numbness
( 36 )
of the feet and hands which, ultimately ulcerating, led to the sloughing off of
several of his fingers and toes. In his family also there was no history of here-
ditary taint.
Both these cases were of the non-tuberculated form, and they attended hospital
for one day only.
I regret that I am not able to furnish you with more detailed information re-
garding these cases ; hut keeping in view the points specified in the above circular,
I have directed the Native Doctor to detain all cases of leprosy in future until my
morning visit to the hospital, or, if that is inconvenient to the patient, to send
for me.
In conclusion, I beg to state that circular memorandum No. 84 of the 15th
January 1877 does not appear to have reached this Office.
Mo. 400, dated Mymensingh, the 30th June 1877.
From—E. BOVILL, Esq., M. B., F. R. c. s,, Civil Surgon, Mymensingh.
To —The Deputy Surgeon General, Dacca Circle, Shillong.
WITH reference to your circular No. 15, dated Shillong, the 11th June 1877, I
have the honour to report that leprosy appears to prevail in a slight degree in most
parts of the district. As I have only been here a few months, I am unable to speak
with any certainty on this point. I have made enquiries from Native Doctors and
persons long resident in the district, and none of them have been able to point out
particular seats of the disease.
With a view to obtaining fuller information on this point, I have sent a
circular to all the branch dispensaries on the subject, and will, on receipt of answers,
furnish you with any information they may convey.
As a matter of experience it is not uncommon to meet with lepers, but I have
no information of their real or comparative numbers.
In the charitable dispensary the following numbers were treated :
1874
1875
1876
Out-patients.
...5
...5
... 11
— 21
In-patients.
0
0
6
—
6
__
None of these are reported as cured.
There is at present one leper in the jail amongst 375 prisoners ; he is undergoing
a sentence of ten years. He is a Garo from Shusbung at the foot of the Garo Hills.
He says that his father suffered from leprosy, but none of the rest of his family
except himself. He was a leper on admission to the jail eight years since. He says
that leprosy exists, but it is not very common amongst the Garos.
On looking through 3,126 admissions to the jail, I find four cases of leprosy
recorded. They all occurred amongst Muhammadans. Two cases were from the
sadr station, one form Jamalpur, 36 miles to the North-West, and one from
Kendun, 32 miles to the East of Nasirabad. The register shews 1·21 cases per
mille.
The following has been received from the Magistrate's Office in answer to an
enquiry as to the location and prevalence of leprosy : " I regret that I am unable to
give you full information on the subject of leprosy. In this district it is neither
epidemic nor endemic, but sporadic cases are not uncommon though at the same
time not frequent. We have, however, no statistics on the subject. The disease is
not localised, and I have not studied it sufficiently to offer an opinion on the special
conditions under which it is usually found to occur."
( 37 )
Report on Leprosy in the Dacca District.
THE total number of lepers in the Dacca District, as shewn in the returns of
the census of 1872, amounted to 852, of whom 723 were males and 129 females.
The total population of the district was 906,238 males and 947,659 females, giving
an average of 7 977 male lepers in every 10,000 males and 1·361 female lepers in
every 10,000 females and 4·598 lepers in every 10,000 of the population. The
average for the Presidency of Bengal was 5·2 lepers in 10,000, so that Dacca
occupies a position somewhat below the average. It was unlikely therefore at first
sight that the Dacca District would offer any striking illustration of the causes of
leprosy taken as a whole.
2 On enquiring into the distribution of the disease, however, I found that
the different thannahs into which it is divided varied in the number of reported lepers
from 0·208 in Harirampur to 7·248 in Kapasia in 10,000; and the following table
has been drawn up to illustrate this point. Here the Sadr Station and Lalbagh are
taken together, as the figures furnished to me, do not enable me to distinguish
them.
I.
Table showing the distribution of lepers in the Dacca District,
Name of thannah.
Harirampur
...
...
...
Munshigunge
Naraingunge
...
...
Sabhar
Raipura
...
...
Rupgunge
...
...
Manikgunge
...
...
...
Nawabgunge
...
Dacca and Lalbagh ...
Srinagar
Jafurgunge
Kapasia
,,.
...
...
Total
Total number
affected.
2
51
23
57
55
46
65
56
97
137
72
62
723
4
18
7
14
8
12
10
12
18
11
15
129
2
55
41
64
69
54
77
66
109
155
83
77
852
Number affected in 10,000
of the total population.
0·439
5·459
4·032
7·797
6·998
7·583
7·859
8·575
9·119
11·366
10·921
11·184
7·977
0·395
3·434
0·877
1·829
1·328
1·409
1·375
1·149
1·237
1·578
2·951
1·361
Total. 0-208
2·828
3·746
4·215
4·448
4·467
4·586
4·782
5·184
5·827
6·120
7·248
4·595
3. Kapasia which is thus shown to be the most leprous thannah is situated at
the extreme North of the district, and is the highest and hilliest part of it. It has
a red laterite soil, with great fluctuations in the level of the subsoil water, and is
eminently malarious. It is covered with a sâl jungle. The people get their
water from wells without any protecting parapet to keep out surface flushings.
The District Superintendent of Police, who is well acquainted with both districts,
assures me that -in these respects, as well as in the coarse food of the people, this
part of the district resembles very closely the country round Bancoorah (where the
number of lepers is 41 in 10,000). In both there is a hilly sâl jungle, and the
people indulge freely in " kachu" (a kind of caladium) and other jungle roots.
He asserts that he can distinguish an inhabitant of either of these districts by the
configuration of the body which their habits lead to. Hearty meals of rice with
jack and "kachu" give rise to a dyspepsia with protuberance of the upper part of
K
( 46 )
Orissa it is to be met with more among the Mussalmans than any other class
of population. The use of beef by them is generally supposed to account for the
difference. However untenable the theory may be upon other grounds, I think
that this particular kind of meat being
very much heating, as I believe it to
be, is unsuited to the climate, and has
combined with the unclean habits of the
Mussalmans as a class to produce this
result.
The Babu is a strict Hindu, hence these views.
There can be no doubt, however, that the
article called beef sold in bazaars is of very
inferior quality.
W. D. S.
In the generality of cases, especially among the Hindus, venereal diseases,
and perhaps administration of mercury for their cure, have, I believe, been the
cause of lepra. At least, in most of the instances that have come under my notice,
the leprosy was clearly venereal. My view is further supported by the fact that
the malady is to be met with more among people inhabiting and frequenting the
towns than those living in the interior of the country, where the usual sources of the
venereal diseases do not exist, at least to tht extent they do in the towns.
That the malady, as a rule, descends from father to children does not, I think,
admit of a doubt, for I have seen several instances in which it has done so. I also
know of a case in which the husband has communicated the disease to the wife.
The 17th March 1877.
JUGGOO MOHUN ROY.
D. N. M., R. D'R, & N. C, P.—Home, Rev. & Agri. Dept. Press—No. 456—20-8-79—100.
No. 1674, dated. Fort William, the 12th February 1878.
From—J. F. BEATSON, Esq., M. D., Surgeon General, Indian Medical Dept.
To—The Offg. Secretary to the Govt. of India, Home Department.
* No. 598, dated 27th July 1876.
I HAVE the honour to acknowledge receipt of your letter No. 71,
dated 28th ultimo, and in reply to submit the following observations
on the reports on leprosy in Bengal therewith forwarded for my
remarks. In a previous letter*
addressed to the Government of
Bengal I commented on 12 reports on the same subject then sub-
mitted. A few more reports have been received since those now
† Herewith returned.
under notice† were forwarded.
There is but one remaining to com-
plete the provincial list, and on its receipt it will be submitted with
any additional remarks which may appear necessary.
Number of reports and districts to which they
refer.
2. The reports now submitted are 31 in number—29 from medical
officers m charge or districts, and
two from medical officers in charge
of sub-divisions. They may be arranged as follows :
WESTERN BENGAL
(mainly laterite).
Burdwan (L. and A).
Beerbhoom (L).
Hooghly (A).
Serampore (A).
Howrah (A).
Baucoorah (L).
Midnapore (L and A).
CENTRAI BENGAL·
(mainly alluvial
Gauge tic).
Moorshedabad.
Southal
Pergun-
nahs.
Nuddea.
Rajshahye.
Pubna.
NORTHERN BENGAL
(mainly alluvial).
Darjeeling.
Jalpaiguri.
Purneah.
Rungpur.
Dinagepur.
Bogra.
Chumparun.
Buxar Sub-Division.
SOUTHERN BENGAL
(deltaic).
Backergunge.
Jessore.
Noakholly.
EASTERN BRNGAL
(mainly alluvial).
Mymensing.
Dacca,
Tipperah.
Chittagong.
Chittagong Hill
Tracts.
ORISSA (littoral).
Balasore.
Poor e e.
Cuttack.
Value of the reports.
3. None of them are of much special value. In no case has the
reporting officer made a prolonged
special study of the subject.
Many of them are extremely brief and devoid of information ; others
are a mere comment on census figures, and hearsay evidence collected
hastily from subordinates or civil officials. In a few instances per-
sonal inquiries were made, but not of a character or extent to render
much information of value. The truth is that questions connected
with the causation of leprosy demand very careful research and
discriminating analysis. Few medical officers are competent for the
task, and no Civil Surgeon has the time necessary for it without
neglecting the proper duties of his office. Such information as the
reports do contain is summarily shown in what follows.
The value of the census returns.
4s. Some evidence is given affecting the value of the census
returns (of 1872). These are said
to be subject to the following
fallacies :
(A) A strong tendency to conceal leprosy more especially
among women leading to understatement of the
number of lepers generally and of female lepers
especially. Only severe and advanced cases which
can't be concealed are said to be returned.
( 2 )
(Β) Inability to distinguish leprosy from some other diseases—
more especially leucoderma and some forms of
syphilis—tending to overstatement of the number of
lepers generally. These causes of inaccuracy are
held by some reporters to balance each other ; but in
order to do so, they would require to be equal as
regards both force and distribution, which is probably
not the case.
On the other hand, the testimony contained in these reports
broadly sustains the general accuracy of the census figures, except in
the case of the Darjeeling District, to which the census figures give
a prominent position in the scale of leprosy, while the Civil Surgeon
(Dr. Purves) asserts that the disease is very rare.
Localization of leprosy.
5. The reports contain some evidence on the important subject
of the localization of the disease, or
the excessive prevalence of it in
some localities as compared with others. The census figures of 1872
rendered this fact apparent, when divisions and districts were com-
pared. The Burdwan Division was found to present, as compared with
other divisions and with the whole Province, a remarkable excess of
lepers (16.5 per 10,000 of popu-
lation against 5.4), and the three
districts of this division marginally
indicated presented still higher
figures and attained the notoriety of being among the most leprous
localities of equal extent in British India. The reports now submitted
indicate that the same truth obtains when sub-divisions of districts
are compared. The instances in which this circumstance is most
clearly brought out are these—
Beerbhmn
Bancoorak
Burdwan
Lepers per 10,000
of population.
... 41.2
... 30.0
... 22.6
(a.) Sonthal Pergunnahs.—Of 515 lepers registered in the
census returns 314 belonged to the Dumka and
Jamtara Sub-Divisions bordering on Beerbhum.
(δ.) Burdwan.—The proportion of lepers in different thannahs
varied from 2 to 58 per 10,000.
(c.) Beerbhum.—Numbers in different thannahs vary from
145 to 754 (proportion to population not given).
(d.) Moorshedabad.—Larger proportion of lepers in the
thannahs adjoining Beerbhum (West of the River
Bagiruttee).
(e.) Dacca.—Thannah ratios vary from 0.2 to 7.2 per 10,000.
(f.) Backergunge.—Chiefly found in certain (specified)
villages.
(g.) Rungpur.—Thannah ratios vary from 1.7 to 11.9 per
1,000 of population.
(h.) Nuddea.—More common in the town of Santipur.
(i.) Rajshahye.—An excess of lepers in Nattore and Lallpur.
In other districts the disease is said to be equally diffused or the
point is not mentioned.
Reasons are assigned in some cases for an excess of lepers.
Large towns and religious shrines are said to attract them for obvious
reasons ; but this does not explain the matter to any material extent.
The fact may be accepted as established that the disease prevails exces-
sively in certain localities capable of geographical definition, and
there undoubtedly appears to be a well-marked leprosy area not
very accurately defined as yet in the Burdwan Division, which
( 6 )
the former against twelve of the latter, fifteen presenting character-
istics of the "mixed" and four of the eruptive variety. Of Surgeon
Ahmed's 59 cases 27 were anæsthetic and 13 tuberculated. Dr.
Joubert gives a still higher proportion—28 out of 30 treated in the
Burdwan Leper Asylum. It is curious to contrast these figures with
the results in Norway, where the tuberculated and anæsthetic varieties
of leprosy hold the relative proportions of 70 and 30 per cent., and
in Sicily where the anæsthetic variety is said to be "somewhat" more
common than the tuberculated.
Treatment.
15. The reports contain very little information of value on the
subject of treatment.
Patients
were treated by several of the
reporters with gurjun oil, but a difficulty was experienced in getting
them to persevere in the treatment. Some benefit was obtained in
most instances from its use ; but the relief was neither radical nor
permanent in any case.
D. N. M.—Home, Rev & Agri. Dept. Press—No. 457—15-8-79—100.