( 11 )
affecting the intermediate generation. If this is so, it may not be unlikely that
many of the 1,194 persons who stated their want of knowledge in regard to heredi-
tary taint, or absolutely denied its existence as part of the history of their own cases,
may have had leprous grandfathers or other relations of previous generations of
whom they knew nothing. Some I think were likely to deny the fact of such
taint, if they knew of it, from shame or disinclination to record any words of me-
mory disrespectful to their departed forefathers.
34. This idea of, in reality, a larger average of cases of hereditary taint than
the histories disclose, is upheld by the statements of some of the Civil Surgeons who
recorded the facts on which this investigation rests.
The Civil Assistant Surgeon of Tarái District states, with regard to nineteen cases
in which lepers examined there answered " No" to the question of hereditary taintj
that he should be inclined to put down " unknown " as more nearly expressing their
meaning.
Dr. Wood, Civil Surgeon of Bijnor, is of opinion that many of the lepers
examined by him, who denied any hereditary taint, were none the less subject to it.
Dr. Jones, of Saháranpur, is of opinion that leprosy is as much hereditary as
tuberculosis, and he has no doubt that the families of a much larger number of lepers
than those who acknowledged it in his histories (18 out of 60) have been afflicted
with leprosy, for there exists a great unwillingness on the part of lepers to confess
that their families have been affected.
Dr. Fitzgerald, of Sháhjahánpur, is of opinion that leper parents will
almost always beget leper children.
Dr. Thomas, of Banda, records the opinion of the Tahsildar of Sehondá, to
the effect that leprosy is invariably hereditary (confined to certain families) in that
pergunnah.
Dr. Hatchell, of Jaunpur, where of 30 lepers, 28 denied all knowledge of
hereditary taint, is of opinion that no reliance can be placed on the information given
under the head " family history".
35. In further proof of the probability that in these 1,531 histories the num-
ber of cases connected with hereditary taint is under-stated, I should mention that
of 60 cases reported by Dr. Hooper, from the Benares Leper Asylum, 33 of the
persons examined acknowledged hereditary taint in the following relationships : 6,
the grandfather or grandmother ; 9, the father or mother ; 11, the uncle or aunt ;
4, the brother or sister ; 3, the cousin.
I think it probable that lepers living in an asylum, and, from experience, less
likely to fear or suspect the object of examination, would be inclined to tell all they
know. The result here gives rather more than 50 per cent, of the whole as cases
connected with hereditary taint, and perhaps that may be accepted as near the truth
in reward to this matter, so far as it can be determined by the testimony of living
lepers.
36. But, viewed in any form, the testimony as disclosed in these histories is
sufficient to prove that hereditary taint, unlike contagion, must be a potent cause of
the continuation or prevalence of leprosy amongst the people of this country, perhaps
the most potent of any cause in existence.
37. That there may be another cause, or other causes, cannot, however, be de-
nied.
The testimony in this direction is plain, and often repeated in the histories and
the papers which accompanied them. And it seems certain that the cause or causes
which first originated this form of disease are still in existence, and may originate
the complaint in a man to whose history no suspicion of hereditary taint attaches.
It cannot, I think, be possible that all the 1,194 persons, who denied hereditary
influence, could have been mistaken : indeed, a few of them were very explicit in
denying the existence of any such influence, sometimes to their knowledge for three
generations back.
38. What these originating causes may be cannot, in the present state of our
knowledge, be more than guessed at. They appear to be first and principally such
climatic conditious, habits, or mode of life as conduce to the formation of constitu-
tions in middle life prone to low forms of disease.
In a person thus predisposed it seems probable that a previous attack of syphi-
litic disease may result in the establishment of a condition of leprosy.
Thus of 63 lepers examined at Saháranpur, ]8, who denied hereditary taint,
attributed their leprous condition to syphilis. And Dr. Jones records the opinion
that syphilis is an important initiating cause in the comparatively few cases of
leprosy generated anew.
At Muzaffarnagar four persons of those examined attributed their leprosy to
the results of venereal disease.