( 3 )
embraces also portions of the adjoining districts of Moorshedabad and
Sonthal Pergunnahs. Dr. Joubert, in his report on the Burdwan
District, gives a list of specially leprous villages. The peculiarities
of these leprous localities have not as yet been studied, though such
a study would probably (if properly conducted) throw more light on
the causation of the disease than any other species of inquiry.
Physical peculiarities of leprous areas.
6. The evidence on this point is very unsatisfactory. In the
case of Burdwan and Moorsheda-
bad the specially affected localities
are said to possess a laterite soil and the exempted localities an alluvial.
In Rungpur the laterite tracts are reported to be least affected,
and the alluvial and marshy most ; while in Dacca, of the two worst
thannahs, one is said to belong to the laterite formation, and the other
to the alluvial and water-logged tract. The Civil Surgeon of Balasore
mentions that leprosy is more prevalent among the inhabitants of
villages on the sea-coast than in the interior ; but it is quite certain
that the disease is worse in other districts for inland than in any part
of Balasore. The relations of the disease to geology and physical
geography, soil, water, elevation and drainage are, as far as these
reports are concerned, as obscure as ever.
Sanitary and domestic condition.
7. Nor does the evidence adduced throw much light on its
relations to sanitary and domestic
conditions. Filth, overcrowding',
defective ventilation, &c., are mentioned by several reporters as causes ;
but it is not shown anywhere that these conditions are peculiar to, or
specially aggravated in, the localities in question. The same remark
applies to poverty and impoverished diet. Nor do the papers contain
any proof that any special kind of diet causes the disease. On the
contrary, Dr. Crombie shows that the leprous and non-leprous partake
of similar food. Fish, whether fresh or salted or putrid, has evidently
no influence ; for it is nowhere shewn that the leprous are consumers
of these articles, and the non-leprous not so. There is indeed some
evidence to the opposite effect. Some reporters remark that it is a
disease of poverty and the poorer classes ; but it is quite certain that
the rich are not exempt, and the immense preponderance in the
community of the poorer classes is not taken into account, nor the fact
that the disease itself impoverishes its victims. Dr. Ghose, in his report
on the Rungpur District, makes an attempt to establish a causative
relation between this disease and malarious diseases and parasitic skin
diseases ; but the most malarious districts and tracts in the Province
are certainly not the most leprous. Dr. Crombie shews the same
thing with regard to the District of Dacca.
Syhpilis and salivation.
8. Syphilis and mercurial salivation have acquired the popular
reputation or being causes or
leprosy, and this current belief
crops out frequently in these reports, but that these influences are not
necessarily or specially causative of leprosy is certain from the
circumstance that syphilis and salivation have been and are very
common where leprosy is rare or unknown both in and out of India.
Nor even in cases where it is shewn that a certain number of the
leprous have been the subjects of syphilis is it proved that the pro-
portion is larger than among the non-leprous. It is possible that, as
surmised by Dr. Stewart, syphilis may determine the manifestation
of the outer signs of leprosy in one predisposed hereditarily or other-
wise to the disease, and this may be the real history of such cases as
that related by Mr. Lyons in his report on Noakholly.