REMARKS ON LEPROSY.
By Surgeon-Major G. G. MACLAREN, M.D.
Leprosy, as is well known, is a disease prevalent all over the world,
from Norway and Sweden in the north, to India and China in the east,
and to Australia and the Islands of the Southern Seas.
My own personal experience, however, has been limited only to India,
where I have had the disease under close observation for nearly
twenty years. It would be out of place to enter into any technical or
scientific description of its nature and progress in a work of this
kind. All are aware that a Commission, composed of five men, most
competent to undertake the investigation of the history of the disease
in all its bearings, is now sitting in India, and their report, which
will be made public at the end of the year, will doubtless give
information which will be of the utmost value in establishing means
for its amelioration and, probably, ultimate extinction. My service
in India has placed me in a district where, unfortunately, leprosy
is exceedingly prevalent amongst the native population, although not
entirely limited to those alone; for I have had cases of Europeans also
to deal with. This led me to take the matter up, more from the hope of
relieving suffering than from any other motive, the miserable victims
being allowed to wander about as simple beggars, outcasts from their
own friends and villages. They thus transform themselves, if not into
a danger to their fellow-creatures, at least into a most objectionable
nuisance and eye-sore to the whole community. To look upon the streets
and roads of an Indian Station on Sunday morning (and this was the
manner these wretched creatures adopted to enlist the sympathies of
their fellow beings in my own station), lined with rows of lepers,
exhibiting their disgusting sores and their maimed and deformed bodies
to the public gaze, was a sight that could not fail to touch the
hardest and most indifferent heart. To prevent the daily exhibition of
these harrowing scenes, I enlisted the sympathy of the general public,
and was able, as shown in the report of the Dehra Dun Leper Asylum,
mentioned elsewhere in this work, to establish and endow a retreat for
all who would take advantage of its comforts and benefits. I had no
difficulty whatever in inducing all the afflicted--old and young, men
and women--to take up their quarters therein. Before admission, all
agree to become _permanent_ residents and to live apart. I had studied
with care the beneficial effects of segregation which had been adopted
in the retreats in Norway and Sweden, with the marked diminution in the
number of cases imported during the decades succeeding the foundation
of these institutions, and, acting on this principle, the Dehra Dun
Leper Asylum was opened in 1879, and has been in existence ever since.
There the sexes are strictly segregated, and the inmates live and are
cared for under the most happy conditions. Throughout those years
I have had constant opportunity, there, of studying the nature and
progress of the disease.
[Illustration: MALE LEPERS.
_p. 123._]
Being a firm believer in the hereditary transmission of all
ailments--or the tendency to them, both mental and physical--I have
traced _direct_ transmission in at least thirty per cent. of the
cases coming under my observation. The disease is doubtless due, like
most others, to the presence of a _bacillus_ in the blood, and if there
be not direct transmission of this from parent to child, its effects
are undoubtedly hereditary. These, however, are points which I need
not discuss, for they will be specially considered by the Leprosy
Commissioners. Acting on the strength of my own convictions as to the
transmissibility and communicability of leprosy, I established the
Dehra Dun Asylum on the principle already noted, and it has answered
so far admirably; all its inmates living as happily as they can, under
their unfortunate conditions, and ending their existence contentedly!
I have had, of course, ample opportunity of studying the nature of the
disease, and its effects on the different organs of the body, and in
the many examinations I have made, _post mortem_, I can testify that
not a single organ in the whole body is exempt from the attacks and
inroads of this dire and loathsome malady. It invades the brain, spinal
nerves, the eyes, tongue and throat, the lungs, the liver, and other
digestive organs. In addition, as is generally known, it maims and
deforms the external parts of the body in a manner too revolting to
describe. It is painful to witness the amount of deplorable suffering
some of these creatures endure. True it is that many feel but little
pain--one of the forms of the disease producing _anæsthesia_, or
insensibility of the parts affected; but this is the case in a few
only. The majority suffer in variously painful degrees, according to
the organ or part implicated, and it is a mistake to think that their
sufferings are little. Many, in the earlier forms of the ailment, lose
their sense of sight, smell and taste, and when their lungs or throat
is attacked (a common form), their agonies are dreadfully distressing
and painful to behold. The inroads of the disease are slow and gradual,
which makes it all the more trying, and the painful and lingering death
to which most are doomed is a condition that one dreads to dwell on.
Added to all this there is a peculiarly penetrating odour common to
lepers, whether they be Europeans or natives of India, constantly
emanating from their bodies, which makes contact, or even close
conversation, with those afflicted, most objectionable. During my
medical experience of over 25 years, I have had, of course, to deal
with all sorts of ailments; but the odour evolved from the leper’s
body is one so peculiar and “sickening” that I fail to find words to
exactly describe it. The effects of a visit to a leper asylum, or to a
single individual leper with whom I have had to remain in conversation,
produces a sensation quite dissimilar to that resulting from personal
contact with any other disease. A peculiar sensation is produced in the
mouth, and an irresistible feeling that one has inhaled some disgusting
and noxious material, which clings to the tongue, the lining membrane
of the mouth and fauces. This feeling lasts for sometimes fifteen
minutes after my visit has ended, and is not entirely removed until
I have overcome it by smoking a pipe or cigar. This result is (it
certainly is not fancy) one that should be strongly impressed on the
general public, and be accepted as a powerful argument in favour of
secluding all lepers from contact, either directly or indirectly, with
any body or thing that is likely to prove a means of communicability.
It may not be out of place here to mention that since 1875 I have
given the most careful attention to the treatment of leprosy, tried
most conscientiously all the various drugs that have been from time to
time recommended, and used unsparingly and for prolonged periods all
outward applications that have been brought to notice, and must frankly
admit that I have not witnessed the least _permanent_ benefit from
any one of these. There are different forms of the disease described
in books, but my experience has been that these are simply external
or special manifestations, all resulting from the same single cause,
determined for the special locality in the system of the particular
organ attacked. _Once a leper, always a leper_, is the sad outcome of
my many years close observation, let the treatment be what it may. It
behoves us, therefore, as human beings, simply to do all in our power,
in whatever part of the world leprosy prevails, to establish retreats
in which its victims can be housed in seclusion, apart from intercourse
with the general public, where they can obtain proper shelter, be
provided with suitable food and clothing, and where medical comforts
can be placed at their disposal. All such institutions should be built
and conducted on the best sanitary hygienic principles; each being
suited to its own special locality and class of inmates. By these
means assuredly will the disease cease to extend, and thus, in all
probability, ultimately be exterminated. This happy result had been
accomplished in instances of other allied diseases, simply from the
adoption of improved sanitary surroundings, and it is not too far to
look forward to a like result in the case of even such a loathsome,
repulsive, and vile a malady as leprosy.
Transcriber’s Notes
Punctuation and spacing errors were corrected.
The spelling of Loretto and MacLaren were standardized.
Table of Contents: The starting page for chapter XIII was changed to
112.
Page 69: “Eurasian leper have” changed to “Eurasian lepers have”
Page 83: “during the the intense heat” changed to “during the intense
heat”
Page 98: “Whose going to get” changed to “Who’s going to get”