HEALTH COLUMN,

Otago Witness, 14 December 1893, Page 49

HEALTH COLUMN,

Leprosy in India.

Ifc will be remembered that Father Damien, a Belgian priest, died in 18S0, in the Sandwich Islands. He had devoted himself for 1G years to the relief of the lepers of Hawaii, and had at last contracted the tame disease himself. A movement was at once set on foot in England to perpetuate his memory, and besides the erection of a memorial at the leper station at Hawaii, funds have been established for the relief of those suffering from the disease in Great Britain, and scholarships founded for the systematic study of leprosy. In addition a commission was appointed to report upon the disease in India. The Indian Government readily co-operated with the Ecglish committees and a laboratory was built at Simla, where the scientific part of the work has been carried out. The report of the commission has now been issued, and forms a valuable and interesting contribution to our knowledge of leprosy. Leprosy is a specific disease — that is to say, it has only one recognised cause. This cause is the bacillus lapise, a minute rodshaped micro-organism, about the one fivethousandth of an inch in length. These bacilli are found in enormous numbers in the affected tissues of persons suffering from the disease, especially in the deeper parts of the skin. In size and many other respects they closely resemble the bacillus tuberculosis, the cause of consumption ; in particular tbeir manner of staking with aniline dye 3is very similar, and serves to distinguish these two bacilli from aU other micro-organisms. When a soludon of one of these dyes is used with carbolic acid as a mordant, these bacilli will retain their colour after treatment with 25 per cent nitric or sulphuric acid, whereas all other micro-organisms are decolorised. By thi3 4 they are readily recognised under tho microscope. But while very abundant in the tissues, nothing is known of the bacillus outside the human body, and the investigations of the commission confirm the negative results of previous observers on this paint. Earth from the paths in the leprosy asylums was carefully searched without revealing any of the micro-organisms. A similar result was obtained from the water of the holy well at Tarn Taran, which is supposed to have remarkable healing properties, and in which lepers are constantly bathing in the hope of being cursd of their disease. Flies and moEquitoes were caught and examined, and articles of food, such as dried fish, which in many places is thought to have something to do with the disease, were subjec:ed to bacteriological investigation, and equally failed to reveal the spacific baci las.

The commissioners state that "although in a scientific classification of diseases leprosy must be regarded as contagious and also inoculable, yet the extent to which it is propagated by these means is exceedingly sinalJ." This paragraph will be read with surprise by most people, as the popular idea is that leprosy is an exceedingly contagious disease. Yst here again the commission merely confirms the results of many previous observers. In all probability leprosy is much less contagious than is consumption or other forms of tuberculosis. Still, that it is directly transmissible has been proved by a unique experiment. In 1884 a condemned criminal in Honolulu elected to be inoculated in place of being hanged, and has since died of the disease. There can be little doubt but that the bacilli are the true cause of the disease, but other conditions, such as insanitary surroundings, and insufficient and unwholesome food, act in a secondary way by increasiog the predisposition of the individual. Hereditary transmission seem 3to have little to do with its spread, and lepers themselves have fewer children than the average, and hence the disease has a natural tendency to die out. On the whole, therefore, the report is rea3sariDg. Leprosy is diminishing in India, where the latest statistics, the census of 1891, gives an average of one to every 2000 of the inhabitants. In the previous census, of 1881, the number was returned as slightly higher, or six par 10,000. Without placiag too great reliance upon these figures, the commissioners think that the disease is at all events stationary, and that the statements about its becoming an " Imperial danger " are exaggerated. The same is probably true for most parts of the world, and in civilised countries, at least, recent alarmist reports about its rapid increase are to be discounted. No doubt with f u'ler investigations and more skill ul diagnosis many case 3 are brought to light which were formerly overlooked, bat it is equally certain that it h^s disappeared from many regions in which ifc was onca rife. In Qreat Britain it was endemic for more than 1000 years, but the last case is supposed to have disappeared at the beginning of the present century. Again, a number of years ago 160 Norwegian lepers emigrated to North America to form a colony of their own. Of these only 17 are alive at the present dxy, bub not one of the descendants of the original emigrants ha 3 contracted leprosy. In view of these faots the CDmmisBioners do not recommend any drastic measures to be taken for the complete eradication of the di' eise.

The report of the commission h«s not been approved in full by the original committee of tha National Leprosy Fund, at whose instance the work was undertaken in the first place. Many of the medical men on the committee hold that the oieu in favour of the Blight degree of contagiousness is too strongly grated, and disagree wilh this p-i-oioQ of the report. We arc inclined to came to tho same conclusion; for ia view of the unloubtcd fact that leprosy can be inoculated direct, and the invariable presence of the specific bacillus, ifc is extremely probable that each freeh case arises from a pre-oxisticg case. The evidence in respect to the contagiousness of leprosy is in much the same position as that of the contagiousness of tubercle was a few years ago. Ab that time the tubercle bacillus had been cultivated artificially; but very little was known of its ocsurrence and life history in3ide the body And the lepra bacillus is in much the sacce condition to-day. Cultivation experime* ts have not been very succe-sful so far, bu*-, judging from the analogy of ell that we know of the other contagious diseases, there js little donbt but that some link in the ghain of evidence as to the causation oE

the disease is wanting, and that the discovery of this will explain the whole matter. Not only do the tubercle and l^pro^y bacilli closely resemble each other, but the two diseases have much in common. While it is easy to understand how people living in close rooms and overcrowded cities contract consumption from one another, it is not so easy to see how it spreads in country districts, or how animals living in the open air are invaded by the micro-organism. Recently it has been shown that the tubercle bacilli are able to live and thrive outside the body under conditions which were formerly thought impossible, and it is at least probable that the leprosy bac.lli may do so too. The evidence at present before us seems to point to the conclusion "that the presence of a leper in the community is not a source of greater danger than is a consumptive patient," and the practical suggestion seems to be, not that we shouli relax our precautions with regard to the spread of leprosy, but that we should learn to treat tubercle in all its forms as a CDntagious disease, and gradually educate the community to adopt measures which will check its increase. — " CE iipu?," in the Age.