How I Found Cure For World’s Most Dread Disease-Leprosy.

Star (Christchurch), Issue 18874, 26 September 1929, Page 8

How I Found Cure For World’s Most Dread Disease-Leprosy.

TO-DAY’S SIGNED ARTICLE.

(Written for the “ Star ” by

SIR LEONARD ROGERS.

M.D., F.R.S.

The World-famous Specialist in Tropical Medicine Reveals Inner Story of Thirty Years’ Effort to Find a Cure for Leprosy, and How Over a Million Lives Can Now Be Saved by New Discovery.

Only through the inspiration given me by my wonderful wife could I have dared to attempt the cure of a disease that has baffled doctors through all the ages—the dread disease that has broken hearts and homes by the hundreds of thousand and turned life into tragedy for millions—leprosy! And now at last—leprosy can be cured!

Few women would have had the courage to bid their husbands to work among lepers as my wife me, when we first went out to India together, expecting romance and colour and beauty, and finding always under it the undercurrent of disease, of suffering. Swarming with humanity is India, but swarming, too, with insect life; and the two are not always so far apart as one would desire. The glamour of the East was everywhere, but beneath its glitter and tinsel and reedy music was always a hidden festering wound, a subdued moan. A rajah, beneath the most gorgeous robes of state, and bejewelled from head to foot, might be a leper. . . . One of my patients was a rajah, as a matter of fact. ... A woman, gorgeously decked in the marvellous gems of the Orient, might aiv pear a picture of exquisite beauty until one saw a disfiguring patch her* sari did not hide . . . and then among the lower castes, the untouchables . .

the poverty, the vicious filth that in a hot climate comds alive almost before it has been out of sight, and which is fiever too far Away to taint the air one breathes. And among all these people, from the highest to the lowest, always the disease creeping secretly fipon them, reducing them all to the level of well-nigh inhuman monsters.

It was about thirty years ago, when I was in the Indian Medical Service, that I became interested in leprosy. Dr Hansen, the Scandinavian scientist, had proved ifft. germ disease, years previously; but, since it was impossible to cultivate the bacillus—how I tried! there seemed to be no starting point from which to begin an investigation. A Glimmer of Light. Perplexed and harrowed by the number of cases I saw and could not aid, I began to irfquire among the natives whether there was nothing that they had found useful. Then came the first glimmer of light. I learned that they had been using chaulmoogra oil for about 200 years, and that it gave them a little relief while they did so, but they could not take it for a sufficiently long time to be of any real help. The effect upon the digestion was too bad. I felt that here, at least, was a jumping off place for me. I a hundred different combinations—chaulmoogra oil blended with *his, chaulmoogra oil mixed with that, small doses, large doses, doses given rarely* doses given often. All these experiments failed. There were no two ways about it, they failed. That was a bitter realisation for me. My patients suffered and died as lepers had suffered and died for thousands of years. My wife had been a nurse. Naturally I used to diScuss the medical side with her; and when I was shattered by the thought that I was beaten, she came to my rescue by ceasing to be just my, wife and becoming once again. Sister Worth, the competent young nurse who ■must cure* her patient, if not by one means, then by another. Together we' arrived at the idea of injection.

“If the poor creatures can’t take the oil by mouth,” she agreed, “then all I can see is that you will have to inject it.” It certainly was an idea. My whole mind was directed to this new effort, and I got the chaulmoogra ready in what I thought was the proper form for injection. I never felt more thrilled than when I gave the first injection. The next thing I knew was that it had blocked the vein and could not be given to the patient again. It could do the patient no harm, but neither could it do him any possible good. “I think I might have given up then had it not been for the splendid American* scientist, Dr Heiser, who advised me to continue research along these lines. It is a queer thing, but actually it was some United States doctors, with true American resourcefulness, who discovered how to inject my preparation in a way that could benefit the patient, and that would not block the veins. Drs Perkins, Dean and Holmann, who have done so much valuable work for the lepers of the Philippines, found out a method of intravenous injection which I had not succeeded in discovering.

Of course, we have journeyed a long way since then. Dr Muir, probably the greatest authority in India to-day upon leprosy, and who is carrying on for me at the Calcutta School of Tropical Medicine, had discovered that by drawing a few drops of the patient’s blood into the syringe and mixing it with the new preparation, now known as “Alepol,” before injecting, he can avert even local irritation.

Perhaps I am forgetting that only those who are interested in leprosy may know what chaulmoogra oil is. It is a substance taken from the pips of the fruit of the hydnocarpus tree. By my method, the sodium is extracted from the oil, and in powder form is mixed with some suitable preparation for injection. In this state it is “Alepol,” and one of the most important things in regard to it is that for just a fraction under half a crown a leper can be treated for a whole year. That means a good deal when you are dealing with hundreds of thousands of cases at a time, and when most of the patients are too poor to pay any expenses.

Leprosy, of course, is # what doctors call a “household" or “social" disease, like tuberculosis, for example, and unlike sleeping sickness. But its hideousness, and the suffering that goes with it, have impressed the world with a sense of almost melodramatic horror, and sheer terror has given rise to some serious misapprehension about it. Leper Not “ Unclean.’* From Biblical times we have been taught to think of the lepfer as “unclean" and “impure”! To the average person of the Middle Ages this conveyed the idea of a moral stigma. We have inherited that concept among many other wrong ones. In the times of the ancient Hebrew, “unclean” and “impure” meant merely “unfit for the Temple.” It dealt solely with ritualistic purposes. In evidence of this it was especially commanded that on festivals, when great throngs gathered together, no one was to be examined for leprosy lest the leper’s joy in the Holy Day be spoiled. That the mediaeval peoples did not understand the point of view of the ancient Hebrews has been the cause of untold sufferings and agonies of

the leper. He has been an outcast, a wanderer on the face of the earth, shunned and despised as well as feared, for countless generations. How let me explain how foolish, how unenlightened, and how cruel is this, the popular attitude toward leprosy. It is a disease in which segregation —unless the sufferer has reached the infectious stage—is not necessary. Hygiene, however, is imperative. The leper should sleep alone. He should not permit others to use the linen he wears, or to eat and drink from the same vessels as himself. But that is equally true of tubercular patients, bu£ we don’t dramatise it and send the tubercular invalid from us in shame with loathing. But—and this is the most important message I have to give, and so I want to make it as impressive as I can since it affects the destiny of millions —the infective stage never should be reached and never need be reached now! If we are to prevent the terrible disaster involved in the spread of leprosy, we shall have to change our attitude both toward the treatment and the sufferer. We shall have to forget the spectacular side of the illness, the awful sensations we endure at seeing our best beloved turned into a monster, repellent and scarcely human to the normal beholder, and treat it as we do other human ills. We must not take the tremendous risk of making life so terrible to the recognised leper that for years he conceals his ill, spreading disease and suffering instead of alleviating his own. Before a cure was found, compulsory segregation was the only makeshift that seemed feasible. Now what did this mean? Terrible Fate. Picture the man who awakens one morning discover a bronze patch on his arm. An insect sting? An abrasion? He touches it. His heart gives a leap and then misses a beat . . . for he has felt nothing. Those who live in the tropics know what that anaesthetic path may symptomise. Still he hopes against hope. Slowly the bronze tint fades, leaving the place a peculiarly dead white. Then he knows for certain. He understands the terrible fate that awaits him. He visualises the day when his features are unrecognisable, when his toes, his fingers, perhaps his arms and legs are gone . . . But he knows, too, that there is worse than that. Loneliness! Ignominy! The complete severance of all family ties: in short, being dead when one is still alive. This, actually, is what must happen to him should he consult a doctor in a *4and where compulsory segregation is still the law. To put it in a nut-shell—-by asking for medical aid, he precipitates the most disastrous consequences of the disease at once—years earlier than need be. On the other hand, should he hide his afflictions—as he can, sometimes for as long as eight years and seldom for less than four or five,, so long as the face Itself is not attacked—he postpones the final period of despair. Surely now that a cure has been found, the world need not drive the leper to the course of concealment, which means that when the infection has reached the acute stage, he spreads the germs among those with whom his lot is cast.

On the other hand, what right have we to give indiscriminate lifesentences, now that we have scientific tests by which we can determine whether or no the leper is a menace to the community? From South Africa, which arranged her own laws, comes the news, cabled by Sir Lister Spencer, that my treatment is valueless, and that it does not cure. Controversy rages round the subject now. All England asks why the “Alepol’* treatment succeeds in India, where we have, in two years, many hundreds of cures, a very high percentage indeed, to our credit, when it fails in Africa. The answer is very simple. Sheer Terror. South Africa, in her sheer terror of leprosy, has made incarceration in a leper asylum a law for all lepers, no matter at what stage they are detected. The result: concealment. Only cases of the advanced type enter the leper institutions, and it is then too late for my treatment, save in a few instances, here and there. By “Alepol” sixty lepers can be treated for the same money as it cost to incarcerate one for a single year before. Surely that means something when one deals with thousands, even millions. Children, sometimes, are cured in six months. There is a popular error to the effect that leprosy does not exist outside of the tropics. While it has its origin in hot, damp and unhygienic countries, this is not so. There are cases in England, and. many in the United States. In peaceful Essex, not far from London, there is a leper colony, housing at present about a hundred people: while in Carville, Louisiana, there is an institution with about five hundred patients. And now I think I have said almost everything I have to say. I might add that the hydnocarpus tree, from which “Alepol” is obtained, is being planted all over the affected areas of the British Empire. I might also say that wherever we find it necessary to isolate cases, I mean those cases that come to us late, we try # to run our institutes as much like sanatoriums for the tubercular as possible—good food, fresh air, mental occupation, and so on. We have men and women doctors who devote themselves heart and soul to these leper colonies and are real heroes and heroines in their selfsacrifice. Also, we take care, whenever we can, of the children of the sufferers, so that they have no anxiety for their families, a factor that plays a serious part. What I advocate is very simple. It amounts to a clinic for outpatients suffering from the disease, whenever possible—by that I mean when it is not too late for him to remain an outpatient—and examination of the members of his household at intervals of six months for five years after he has been discovered to be a leper. I do not hesitate to say that if this system is adopted all oyer the world, leprosy, in ten years’ time, will have been reduced, roughly, to about five per cent of its present strength, and that in twenty there will be only a sporadic outbreak here and there. Although I am too old now for the Indian Medical Service, my wife tells me that my job is not completed until I have altered the public viewpoint and I daresay she is right in this instance, as she is in most. And that is why I am now working at the Indian Office and at the London School of Tropical Medicine. Though my heart is in India.

which I achieved my life’s ambition, perhaps I can be of more use. there, teaching people that the leper is not the fearful and horrible being that they have always supposed. ( Anglo-American X .S. Copyright).