The N.Z. Times SATURDAY, APRIL 6, 1907. LEPROSY

New Zealand Times, Volume XXIX, Issue 6176, 6 April 1907, Page 6

The N.Z. Times

SATURDAY, APRIL 6, 1907. LEPROSY

OT 17XUCH IB IKOOXPOJU7ZD TUB " TOLU KG TO I nrEBpawDZ.TT,” kbtasuhszd IC-40.

The question how to dispose of our lepers has lately brought into prominence a disease which had almost coiscd to possess for English-speaking com. ir.unitics any other than an antiquarian and academic interest. AVe remember from our childhood Naaman the Syrian and tho lepc-rs who were cleansed by our Lord, but we remember them as something outside our cu n personal world, -remote as tho age cf miracles. Our four lepers, however, small as the number is, arc sufficient to remind us that this disease, v> ith its maleficent power, is still with ns, if not in process of active piopagation, yet in ambush, waiting for its opportunity. It is a mistake to suppose that leprosy is a disease of peoples or climates, that it loves rho black any more than the white, or thrives in a

tropical country any moic than in tho Umpcrnto or arctic zones- As a matter of fact the string fortress of this disease, tho citadel to which it has retreated before tho advance of science, is tho oold region of Northern Europe—more particularly Scandinavia and Iceland. Sixty years ago there a ere as many as three-thousand lepers in Norway alone, though medical science has non’ succeeded in reducing the number to less than two hundred. But Iceland is perhaps the country whero leprosy at tho present moment is most rampant, tho ratio of lepers in that island being put down by a French authority in 1901 as three per cent, of the population. There is no good ground, therefore, for supposing that leprosy is fastidious in its choice of victims, that it is difficult to jilcase in the matter of latitude, complexion, or {emperature. If in our own Arcadian islands it has fastened upon Maoris rather than upon Europeans, this must bo because those victims havo lived the life which supplies the suitable nidus for tho disease. WHAT LEPROSY IS. And what exactly is it, this fell disease, tho very name of which makes those who arc clean shudder with horror, creates a loathing dread often too strong for humanity and pity? , As a matter of fact, there arc many diseases more rapidly fatal in their progress than leprosy, and much more painful to tho victim. Nor must it bo supposed that lepers are always unhappy. Were it not for tho ban under which the general well-being of the community makes it imperative ho should bo placed, the leper would be much less of a sufferer than many of the inmates of our -hospitals -and lazarettos. What makes leprosy, so terrible to the human imagination is not even its hopelessness of cure, which it shares with diseases not half so much abhorred, but its loathsome liideousness. There is no disguising leprosy. It is an affection of the skin and of tho neighbouring tissues, which places itself in evidence from tho earliest stages, and, as the process of deterioration goes on, assumes morbid and monstrous forms, which in many cases rob tho victim of all human expression: wounds, ulcerations, disfigurement of tho face, the features of which sometimes become enlarged so as to resemble tho muzzle of a wild beast (the leonine face, in what is called leontiasis); thickening of tho members so as to resemble those of an elephant (in elephantiasis); mutilation and necrosis-of the extremities, so that sometimes the fingers and toes drop off, sometimes tho nose, sometimes the cars—there is no end to tho degrees and forms of hideous disfigurement which this most ancient of human scourges may induce: most ancient and most human, too, in a sense, for it reserves itself exclusively for man, do. dining to establish itself, to breed, or to multiply in dog, rabbit, guinea-pig, or even in the anthropoid ape. . HOAV LEPROSY ORIGINATES.

To breed or to multiply—for that is precisely what it does. , No need to say that leprosy is one of tho bacterial discuses. A prioro one would have been led to that conclusion. The grand discovery of the parasitic microbe was made not quite forty years ago by tho Norwegian Hr. Hansen, who studied tho disease during an epidemic which broke out at Bergen. Not long afterwards a German professor, Dr. Neisser, of Breslau, discovered a means of colouring the microbe, in this way placing it under more accurate observation; and so the bacillus is now known on tho continent of Europe as the HansenNoisaer bacillus. It is not safe, apparently, to diagnose leprosy purely by external appearances, since other diseases, syphilis, for instance, may present the same symptoms. Tho only true diagnosis of leprosy is the discovery of tho bacillus, which affects sometimes tho skin, sometimes the nerves, producing two forma of tho disease, leprosy of tho nerves called anesthetic leprosy, and that of the skin, styled nodular or leonine leprosy. Tho bacillus exists wherever there are leprous lesions, whether of the nodular or anesthetic form, and

is found in largo numbers, forming characteristic colonics or masses. It has an elongated form, and so. closely resembles the germ of tuberculosis tbat some authorities have been disposed to regard the two as identical; but the life Habit of the leprosy bacillus differs entirely from that of ilio bacillus of Koch, the first being a social bactcrion living in crowded communities, whilst Koch's tuberculosis germ prefers an isolated existence. Fortunately tho leprosy bacillus is fastidious as to the conditions under which it consents to exist, a fact which, whilst it makes the virulent snread of tho disease less possible, makes its study, on the other hand, extremely difficult. In defiance of all attempts to create nfirserios for tho study of tho bacillus, it absolutely diclir.es to lend itself to any form of art'ficial culture, or bo exist on any other hoot than man. Nor does artificial inoculation always succeed oven with tho human subject. Desperate as such an attempt may seem, it has been attempted more than once. AVhot, however, will not the devotee of science attempt ? The Swedish doctor, Danielsseii, inoculated himself in Egypt four times with tho blood of a leper; but tho blood, seemingly, docs not, except very abnormally, carry the contagious germ. Another doctor, Pvofita, made tho same experiment, but again with tho blood, and therefore unsuccessfully. In the caso of the convict Keanu, of Hawaii, who was reprieved on condition that he submitted to tho necessary experiments, tho disease took three years to declare itself; an ambiguous case, from which

it is x>ossiblo to deduce either the comforting inference that the disease does, not easily communicate itself, or the equally disquieting conclusion that the germ, like a mummy pea, can remain a long time dormant, waiting for its opportunity. IS LEPROSY" CONTAGIOUS? It is a much vexed question whether leprosy is or is not contagious; an important point, however, since on the decision arrived at depends altogether the treatment accorded to lepers. Great authorities like Danicissen and Virchow have hold anti-contagion opinions, founding their contentions on the numerous cases where the clean, after liming been brought into intimate and prolonged contact with infected persons, have yet remained clean. Those negatives do not, however, appear convincing beside rho numerous well-auth-enticated cases where missionaries, Sisters of Charity, and others, brought into close association with the infected, hare themselves sooner or later contracted tile disease. In the meantime, improved knowledge can be obtained only by closer study of the bacillus. As far as its nature and. lifo history are already known, leprosy is a disease which should easily be stamped out of existence, since the conditions under which the germ can retain ils vitality stem to be somewhat difficult of fulfilment. As soon as it is separated from its host it perishes. “Dead the leper, dead the poison,” it has been said; whereas the tubercular bacillus, resembling tho leprosy bacillus so closely as to seem identical, is well nigh immortal. It may be imprisoned in the viewless winds. And blown with restless violence round about Tho pendant world, . and oven after such an ordeal, lighting on a fruitful soil, may breed and multiply, and replenish the earth with enough tuberculosis to destroy armies. THE OUTLOOK HOPEFUL. Not so with tho seeds of leprosy. They do not appear to havo tho same vitality; so that there is every hopo that, if tho disease, by careful segregation, were once stumped out, and careful measures were taken to prevent reimportation, tho country taking these precautions would ho forever free from this dreadful scourge. Those familiar with tho story of St. Francis d’Assisi will remember how in his time lepers with hideous sores swarmed over Southern Europe, tho disease having been brought, it is supposed, from the East by returning crusaders. Since then, however, and particularly of late years, improved hygienic conditions have reduced the number of lepers, until at tho present time the disease has practically ceased to bo endemic in most civilised countries, though all countries of Europe, not excepting Groat Britain, have always a certain number of imported oases. In some of tho colonial dependencies of these countries, however, where, with native races, it is impossible to insist on tho necessary hygienic conditions, there still remains an appalling amount of leprosy. Thus in Cano Colony, according to a recent statement of Dr. Sutherland Black, there are at present 600 lepers in the Robben Island asylum, and probably as many nforo at largo, for whom there is no adequate accommodation. Those interested in this’subject will find a document of supremo interest in the report presented recently by Dr. Pomare on tho Health of the Cook Islands, to which group ho last year paid an official visit. Wo hardly Enow which most to commend in this report, its wealth of interesting scientific detail or the tone of enlightened humanity which pervades it. As far as leprosy is concerned the report is reassuring. Two diseases are rampant in tnese islands, however, which, Dr. Pomare says, “are ten times more to be dreaded than consumption, and a hundred times more than ietmosy.” One deeply pathetic paragraph of this report we cannot help citing in extenso and in conclusion: —

“Tho question of looking after tho lepers at Penrhyn is one to be inquired into. Tho poor unfortunates do not get enough to cat. i here, will be no need to ask for a volunteer as a keeper, as wc have alreadv -an unrecognised Father Damien in Aleka and his young wife, who volunteered to live on the island in order to be near their adopted son. I rcallv do not know what would have hannonod to these poor unfortunate British subjects if Meka had not volunteered to go amongst them. He docs all tho .fishins. and looking-after

or the sufferers, and for this lie receives no recognition from the civilised world in cither funds or praise. Perhaps when the great Master will call His own Ho will say unto him: ‘Good and faithful servant, enter into the rest of thy Lord.’ ‘For no greater love lias man than this; that he lay down his life for his friend.’ ”