LEPROSY IN AUSTRALIA AND NEW ZEALAND.

Auckland Star, Volume XXXVII, Issue 146, 20 June 1906, Page 7

LEPROSY IN AUSTRALIA AND NEW ZEALAND.

r f(By E. H. BAKEWELL. M.D.)

I have just received by the kindness 0 f Dr. Ashburton Thompson, the Chief Medical Officer and President of the Board of Health of New South Wales, the 4nnual Report of the Board of Health of that- State. Tins report contains a full account of nil cases of leprosy that have been reported to the Board of Health during the year 1005 and statistics of cases that have wn noted in the other States of the Voramonwealth- From this report it would appear that nineteen (19) cases lave been reported in Queensland, nine (9) in New South Wales, one (1) each in Victoria and South Australia, nnd none in Western Australia and Tasmania. These statistics are further explained in the body of the report, which states that "Twelve persons were reported to the Board under the Public Health Act. 1902. Part lU., as being suspeoted lepers, and of these seven fl-ere ultimately admitted to the Lazaret 0 n warrants which were issued by the Board after careful inquiry into each case. Two others were suffering or had' suffered from leprosy, who were pot admitted lo the Lazaret; one was allowed to return to Queensland, where Je lived, while the other was considered to have recovered from nerve leprosy, and was dismissed. "The remaining three had not leprosy." Ir, is to he regretted that further particulars of the ease which was "considered" to have recovered from nerve leprosy arc not given. Was there any treatment, and if so, what? In my experience I have never seen a case recover spontaneously. The number remaining in the Xew (south Wales Lazaret on December 31st, 1!)05. was eighteen (IS). Two died durjnn- the year, both whites, and Europeans or of European extraction, the one an Englishman and the other a native of New South Wales. Three out of the nine cases recognised as leprosy last year were whites —one English, oue Irish, and the other a Queenslander. Sis were admitted from the Pac-itic Islands. There were two Chinese admitted, both of whom were "repatriated." It appears that the policy of sending back the Chinese is so rigorously practised that none were remaining in the Lazaret at the date of the report. I am sorry to say that the statistics are given in such a confused manner that it is most difficult to get at accurate results from them. For instance, on p. 3 there is a table which shows that in 1905 one Chinese, was admitted, one lemaining, and two were discharged. It it not stated at what time in 1905 the one was "remaining," whether at the 'beginning or end of the year. Since the year 18S3 the total number of admissions to the Lazaret is stated as 103, deaths 48, repatriations and discharges 37, remaining 18. These numbers may seem small as compared with the population of Australia, but it must be remembered that they only represent the cases that have teen discovered. It is impossible to say or even to guess the number that are ather wilfully concealed or not recognised in the earlier stages of the disease. All the cases narrated in the Report were in an advanced stage, and ihete cannot be any doubt, that if only Such cases are recognised and segregated, there must be a, large number of tthers living among the healthy population and spreading the contagion. There have been some curious Hhanges in medical opinion as to tbe ,«ommunicability of leprosy even in my life-time, but the public opinion in places where the disease is endemic has xever changed. It has always been considered contagious, ami there is no distase which causes so much horror. The hideous aspect of the face, called leoutine, in the tuberculosis forms of the disease, and the paralysis of the hands and arms, with the consequent dropping •off of the fingers joint by joint, until at last only the palms of the hands are left, with neither thumb nor fingers, are so repulsive that even those professionally attending on the cases require some seasoning before they can touch them. Having been physician to a Leper Asylum in the West Indies, and made a special study of the disease, although the sight of a leper does not produce that feeling of disgust it did at first, yet I candidly confess that nothing but a strong sense of duty would induce me to touch one. And yet lam 6ure that the mere touch would not communicate the disease. The way the disease is spread is no doubt by inoculation. Formerly, under the old system of vaccination from arm to arm, .the researches of Mr Wm. Tebb, as desfcribed in his work on "The Recrudescence of Leprosy," show conclusively that it was communicaled by vaccina(tion. In the later sixties of the last cenwry the Colonial Office consulted the Royal College of Physicians of England on the question whether leprosy was infectious or not. The College, who knew nothing at all about leprosy Wther individually or collectively, sent Tound a long list of queries to medical men in the colonies and India, and received in reply (lie kind of medley of "pinions that might have been expected. Of course wherever leprosy was endemic and known to be so. as in Ihe £ast and Wt<s( . j ndie , s 1(1 | the all thori»es, the business people, ami the doctors were, exceedingly anxious to *how- that leprosy is not 'infectious. The reason is obvious. Still there were a ley obstinate men. who brought forward dear instances of communication «" the disease by contagion and infecWW. The College of Hivsicians. summing up the replies, decided tlmt there JM not sufficient evidence to prove Hie "Usease communicable from ~ne human "™»g to another, and thai therefore were was no jnstilieation for the compulsory separation „f lepers from (he nm °* the community. The Colonial Office therefore senl a circular to the fiovernors 0 f all (he colonies where 3,7 ,? iSte<l di,w ' li Umm to proPose o the local legislatures the repeat an Acts authorising the secrregalior, Evir rS ', and «""*««« that the leper SC ould be , - ,ospa " — i,s Sf:° t Crown Colony, j be . 53a Z7V e more t,ia " Mr Seddon if leL ° P ro P°*e m New Zealand in rrnn 8y , W6re as eommon as it is Huuplv P r / oU,ltrie *' The governors tea? J R GU I\ an pffect the order aedical on d ' Until another chan S e in ■SSft pimon look p lace - and the S3con W6re qUitC SUre that ] °P™*V Cer T La f 10USj and mcfiical officers of Jonn if?"™* he S an thc hunt-for a bacillus TT CeS9fn[ - ior the lp Fosv i ** a^; a ; P o ;:* having dis<ovt, ' c ' d

But while admitting, and, indeed, always having believed, that leprosy is communicable, I have not only my own personal experience, but that of numerous attendants of leper hospitals, to show that it is only communicable with difficulty, and to persons whose blood must be in certain conditions that fit it for the reception, nutrition, and reproduction of the gerais of the disease. And that it originates without any contagion J have had positive proof. I saw in Venezuela a young girl who had come from Martinique for treatment by Dr. Beauperthuy. Her face was frightfully disfigured by tubercular leprosy, as were /ber hands and arms. She had spots in every part of the body. Her mother showed us a photograph of the girl taken only two or three years before, and a more beautiful young woman it would have been difficult to find. And bow had this fearful change been brought about? Well, she bad gone to a ball, and returned home at four iu the morning, very hot from dancing. Before going to bed ■she plunged into a cold bath, but did not stop in it long, as it gave her the sensation of thousands of pin-pricks over sill the skin. She could not sleep, and iii the morning found an eruption (an erythema) all over her. This did not go away, but in a short time developed into leprosy. There was no possibility of contagion in this case, besides that the history was so clear. I saw another case myself, when tbe disease had fully developed in three weeks. The history of scores of cases attributed to bathing while hot, I have among my papers. When 1 took charge of the Leper Asylum in Trinidad it was in an awful state, and the patients had to dress their sores themselves. The stench was horrible, and my first care was to apply antiseptic and deodorizing dressings. As all the staff, except the dispenser, had been dismissed for neglect of duty. I had to dress the sores myself. This I used to do every morning, until I bad taught the nurses and wardsmen what to do. Even then I made post-mortems on every case, performed amputations of fingers, and dressed any specially bad cases. Inever had a sign of the disease. When I gave over charge of the nursing to the Dominican Sisters, who have had the asylum under their charge ever since IS6B, they did all the dressing, nursing, and attendance on the lepers. I saw a report from tbe Rev. Mother Superior a lew years ago, in which she stated that during tbe thirty odd years her order had had charge, no one of them had been infected by the disease. Of course, there have been a few cases of medical men, and there is the case of Father Da-mien, who have contracted leprosy from their patients, but there must have been special conditions in the victims, or the neglect of common precautions in such cases. But the public generally require that they shall not be subject to the least danger of catching this or any other infectious disorder. Hence the mania of the present day for special hospitals for leprosy, small-pox, diphtheria, etc. We have occasionally cases of leprosy here in New Zealand. I have seen two myself—one in a Chinaman and one in an Englishman. One was reported a few weeks ago. down in Canterbury. Now, I should like to know what is done with such cases. We never heard any more of them. M} r Chinaman disappeared ■ very quietly a Sew weeks after I saw him! The Englishman I never paw again. There ought to be some place of detention for even the few cases we have. And there ought to be systematic efforts made to cure such cases. I bave tried, until I am wearied out. and too old and feeble to contend any longer, to get Beauperthuy's method fairly tried, but I cannot beat doxvn the mean jealousies of the profession, who, rather than see another medical man obtain the glory of having discovered a cure, would allow tens of thousands to die of this horrible disease. No place in tbe world could be found more favourable for the trial of any method of cure than New Zealand,* and for my part, having curftl cases by Beauperthuy's treatment in tbe unhealthiest island in the West Indies, I make no doubt that it would succeed here. But I have tried* in vain to get a chance of trying it. Onehunga. June, 1906.