THE INDIAN MEDICAL GAZETTE.
210
the conditions under which
SCty Jmltrnt Jftffipl
are
THE COMMISSION ON LEPROSY.
of
We do not know what discoveries may be in store for medical science and research, but it is well to recognise the fact
day,
medical skill is
to face with the
medy
has
as
that,
helpless
treatment
at the
changes so
vital
cause
nature that
they
a
the death of the
matter of 7 or 8 years,
so
great
sooner
patient.
are
or
of
later
It may be
a
in the tuberculated
form; or it may be more than double that period in the anassthetic or non-tuberculated kind: but
those
conditions
for them.
It is doubtful whether the method of
liable data.
will
as
opportunities to discover only diligent search is made
brought face of leprosy. No rewhen
and
practical
causes
adopted by
arrest the progress, or cure the ravages, of the disease. Once a leper, always a leper. The are
if
the
present
yet been discovered which will
in the tissues
exists and
leprosy
for all
which,
purposes of the disease, are within the bounds of scientific research, and we have plenty
JULY, 1889.
as
and
spreads,
1889.
[July,
was
the best
enquiry
Physicians in 1867 calculated to gather together reCollective investigations are rarely
the
of
College
It is very seldom that information to which much real weight attaches can be
a
success.
throughout
the medical world.
Valuable
opin-
but it is difficult to elimi-
ions will be nate the
broadcast
by distributing circulars
obtained
given, opiuions of those
and have
studied the
those who
are
who
experienced subject thoroughly from
inexperienced;
are
and
as
the inex-
to be in the
likely majority, as perienced whether the leprosy is of the tuberculated, regards a disease such as leprosy, there is very tuberculated, or mixed variety, the result is the great danger of the collators being led astray. We think that the College of Physicians did same, and death alone is here the great physician who brings the sufferer's misery to an end aud not collect facts so much as they did opinions, gives freedom from a disorder which renders and, on those opinions, they came to the conare
non-
the victim the
an
healthy.
object
We hear
of horror and
occasionally
of
disgust
to
some won-
derful remedy having been discovered, but these discoveries have hitherto had but an ephemeral reputation, and have shared the same fate as the so-called antidotes for
cobra-bite,
and the
leprosy ia, in the main, hereditary and non-contagious. This conclusion is distinctly opposed to what was held in former days, though
clusion that
that would in
way militate against its accuracy ; but it is also curiously opposed to the views of nearly all those who have had much no
specifics for cholera. experience in countries in which leprosy preThe recognition of the incurability of leprosy vails, and who hold that leprosy, though herediis important, for it permits of greater atteution tary, is, in the main, contagious. Twenty-two years is a long period in modern being directed to the prevention of the disease, which necessarily involves an intimate acquaint- times. Scientific medicine has made many in that time. Bacteriology and if strides not with its origin, at least with the con- rapid ance, ditions under which it is propagated. This is a its prac tical bearings on disease were almost consummation, which, though devoutly to be wish- unknown twenty-two years ago. Then, the much-vaunted
for, it must be confessed, we are far from having reached, and it is, therefore, with much satised
faction that we receive the news that a Scientific Commission is to be sent to India to enquire into leprosy. Concerning the origin of the disease
nothing
is
known,
but
we are
in the
same
degree
regards the origin of other diseases, such as small-pox, cholera and phthisis. To discuss such recondite problems, is as unprofitable as to discuss the origin of life. But of darkness
as
of
theories
Pasteur,
Koch and
Lister
were
impatience. Physicians discusswhether typhus and typhoid fever were the
listened to with ed
same
and
diseases,
to urge
that
none
phthisis
would have ventured
contagious. The years certainly fur-
was
advances made in recent nish abundant reasons for the reconsideration of the
question
doubt that many
of
leprosy,
more
tant character have
for there
facts of been
a
can
most
brought
to
be
no
impor-
light
re-
THE COMMISSION ON LEPROSY.
July, 1889.]
which may have modifying the views
considerable
gardiug leprosy,
a
influence in
as
in 1867
the Committee of
by
the
time of vaccination in the child from
forward
put College
211
vaccine
of
lymph
was
There is also
recorded by Dr.
case
a
whom the
taken. in which
Physicians.
of New
Brunswick, Canada,
The presence of bacteria in leprous tubercles* discovered by Dr. Gr. A. Hansen, of Bergen;
man was
accidentally inoculated from a woman whom he helped to
the further ser, of
of
cases
world
working
who found the
Leipsig, ;
laborious
the
of Dr.
experiments
successfully he
hogs, pigeons
rats,
to inoculate
permitted
was
a
lasted sion as
servitude.
penal
the 30th of
ou
1889 Keanu is
periment
monkey,
condemned
the
the
might
been
always
In
a
proces-
service,
robust
man
whose
began
to feel
short
time the symptoms of letheir appearance, and he died of
whose ancestral
genealogy
generations back;
sease
not
was
yet known in the
people.
He
was
the three others
in
is traced
fact,
the di-
leprosy, being of locality and among as
the fourth
being
the
case
in that
woman
spoken
the husband and sister of the woman, iu the ancestry of whom there had never been any
the fifth case in that the young man." of sister the locality The parasitic theory of the disease opens out trace
of the disease; was
other
avenues
of
the Commission of that
length
the
of the
of,
The conclusion is
adverse criticism
of
Some months after that
family
place,
have been carried out under
to bear on the
time
for several
these
obvious.
only
the abraided surface
on
recent appearance
rigid precautions. Keanu's family history good one, aud there appears to be little doubt that his leprosy was due to inTo dwell ou the importance of oculation.
The
sudden,
prosy made the disease eleven years after the occurrence There had never been any case of leprosy in
was
result is needless.
hot,
carry to
on a
his way home that the young washed his sore shoulder and chauged his
unwell.
was a
a
with
whole
only
was
health had
the most
such
the
clothing.
operation performed September 1884, and now in a well-marked leper. The ex-
seems to
it
liquid
part of
a
and
man
criminal, named Keanu, who agreed to Dr. Arning's trial of the experiment, in consideration of having his sentence to death commuted to The
and
The wet combined with the heat
contact of the
further than would
a
day
was
and the pressure of the sharp edge, produced an abrasion of the skin of the young man. The
be allowed to others, and his results are in favor of contagion. After his failures to inoculate aud
The
the carriers.
Vandyke Carter, of Bombay, have shed a new light on an obscure subject, and have given a to the investiganew test and new departure tion of leprosy, the results of which have already thrown considerable doubts on the correctness of the views expressed by the College of Physicians. Among recent investigators, Dr. Edward Arning has been able to carry his researches and
"
young the dead
liquid matter began to ooze out through a joint of the coffin wetting the shoulders of one of
parts of the
researches
of
her grave.
bacilli in
same
different
from
leprosy
and
body
subject by Neis-
out of the
Tache, a
research,
enquiry
lepra bacilli have putrefaction and to live for
be
tion. The
is that Keanu
to which no
will
give their
doubt atten-
been found to resist
experiment brought livingin a country where leprosy,having been
have been discovered in dead bodies three months
into it from China in 1848, had become was possible that Keanu
after interment, and it is an important matter for enquiry whether they do not contaminate
was
imported endemic, was
not
and hence it
affected
unknown
causes.
only instance There
being
are
of
by
the
leprosy
recorded
attacked
inoculation, but by
Keanu's
case
other
of
by leprosy
by inoculation. healthy children
They
Is it not
possible
that the
endemicity of leprosy in a large measure
in certain localities is due
after vaccination
lymph from children of leprous families, though the disease was not apparent at the
long time.
the soil and the sub-soil water, and thus indirectly gain entrance into the wells of a district.
however is uot the
caused
cases
a
pollutions of the patients as much as
to
with
i
Typhoid
soil and water the
by leprous endemicity Cholera, of
Fever and Phthisis is due in
a
great
THE INDIAN MEDICAL GAZETTE.
212
many cases to certain conditions of the soil anil water? Possibly this is one of the numerous
channels by which introduced among
precautious account
to
for
leprosy is spread when once a community who take no
segregate the
cases
that
without any contact leper. Here may be
or
are
sick. It may also said to have arisen
communication with
a common
ground
a
to which
contagionists and non-contagionists their views converging. The tendency
may find of modern
medical research is to show that there
are
channels and
we
many which diseases may be propagated, may assume that leprosy is not an
by
exception. There are recorded instances of leprosy having been caused by sexual intercourse with leprous individuals, by dressing the ulcers of leprous patients, by sleeping in the same bed, by attendance in a leper hospital, by residing near a leper hospital, by associating in games with lepers, and by washing the clothes of lepers. are many and it should be decided
These modes of communication but
various, assuming leprosy is chiefly spread by contagion, there is an equally important problem for the Commission to inquire into, viz., whether it is equally communicable at all stages of that
its
course.
is evident
It
that
the
whole
to be
of
re-opened, leprosy requires cannot be re-opened in a better manner than by sending a Commission of scientific medical men to Iudia to enquire into the
question
and
think it
we
subject. no
hurry
We to
will be
no
during
one
trust the
give
attempt cold
Commission will be in
in its to
report,
complete
season.
and that there
the
investigation
[July,
1889.
210
the conditions under which
SCty Jmltrnt Jftffipl
are
THE COMMISSION ON LEPROSY.
of
We do not know what discoveries may be in store for medical science and research, but it is well to recognise the fact
day,
medical skill is
to face with the
medy
has
as
that,
helpless
treatment
at the
changes so
vital
cause
nature that
they
a
the death of the
matter of 7 or 8 years,
so
great
sooner
patient.
are
or
of
later
It may be
a
in the tuberculated
form; or it may be more than double that period in the anassthetic or non-tuberculated kind: but
those
conditions
for them.
It is doubtful whether the method of
liable data.
will
as
opportunities to discover only diligent search is made
brought face of leprosy. No rewhen
and
practical
causes
adopted by
arrest the progress, or cure the ravages, of the disease. Once a leper, always a leper. The are
if
the
present
yet been discovered which will
in the tissues
exists and
leprosy
for all
which,
purposes of the disease, are within the bounds of scientific research, and we have plenty
JULY, 1889.
as
and
spreads,
1889.
[July,
was
the best
enquiry
Physicians in 1867 calculated to gather together reCollective investigations are rarely
the
of
College
It is very seldom that information to which much real weight attaches can be
a
success.
throughout
the medical world.
Valuable
opin-
but it is difficult to elimi-
ions will be nate the
broadcast
by distributing circulars
obtained
given, opiuions of those
and have
studied the
those who
are
who
experienced subject thoroughly from
inexperienced;
are
and
as
the inex-
to be in the
likely majority, as perienced whether the leprosy is of the tuberculated, regards a disease such as leprosy, there is very tuberculated, or mixed variety, the result is the great danger of the collators being led astray. We think that the College of Physicians did same, and death alone is here the great physician who brings the sufferer's misery to an end aud not collect facts so much as they did opinions, gives freedom from a disorder which renders and, on those opinions, they came to the conare
non-
the victim the
an
healthy.
object
We hear
of horror and
occasionally
of
disgust
to
some won-
derful remedy having been discovered, but these discoveries have hitherto had but an ephemeral reputation, and have shared the same fate as the so-called antidotes for
cobra-bite,
and the
leprosy ia, in the main, hereditary and non-contagious. This conclusion is distinctly opposed to what was held in former days, though
clusion that
that would in
way militate against its accuracy ; but it is also curiously opposed to the views of nearly all those who have had much no
specifics for cholera. experience in countries in which leprosy preThe recognition of the incurability of leprosy vails, and who hold that leprosy, though herediis important, for it permits of greater atteution tary, is, in the main, contagious. Twenty-two years is a long period in modern being directed to the prevention of the disease, which necessarily involves an intimate acquaint- times. Scientific medicine has made many in that time. Bacteriology and if strides not with its origin, at least with the con- rapid ance, ditions under which it is propagated. This is a its prac tical bearings on disease were almost consummation, which, though devoutly to be wish- unknown twenty-two years ago. Then, the much-vaunted
for, it must be confessed, we are far from having reached, and it is, therefore, with much satised
faction that we receive the news that a Scientific Commission is to be sent to India to enquire into leprosy. Concerning the origin of the disease
nothing
is
known,
but
we are
in the
same
degree
regards the origin of other diseases, such as small-pox, cholera and phthisis. To discuss such recondite problems, is as unprofitable as to discuss the origin of life. But of darkness
as
of
theories
Pasteur,
Koch and
Lister
were
impatience. Physicians discusswhether typhus and typhoid fever were the
listened to with ed
same
and
diseases,
to urge
that
none
phthisis
would have ventured
contagious. The years certainly fur-
was
advances made in recent nish abundant reasons for the reconsideration of the
question
doubt that many
of
leprosy,
more
tant character have
for there
facts of been
a
can
most
brought
to
be
no
impor-
light
re-
THE COMMISSION ON LEPROSY.
July, 1889.]
which may have modifying the views
considerable
gardiug leprosy,
a
influence in
as
in 1867
the Committee of
by
the
time of vaccination in the child from
forward
put College
211
vaccine
of
lymph
was
There is also
recorded by Dr.
case
a
whom the
taken. in which
Physicians.
of New
Brunswick, Canada,
The presence of bacteria in leprous tubercles* discovered by Dr. Gr. A. Hansen, of Bergen;
man was
accidentally inoculated from a woman whom he helped to
the further ser, of
of
cases
world
working
who found the
Leipsig, ;
laborious
the
of Dr.
experiments
successfully he
hogs, pigeons
rats,
to inoculate
permitted
was
a
lasted sion as
servitude.
penal
the 30th of
ou
1889 Keanu is
periment
monkey,
condemned
the
the
might
been
always
In
a
proces-
service,
robust
man
whose
began
to feel
short
time the symptoms of letheir appearance, and he died of
whose ancestral
genealogy
generations back;
sease
not
was
yet known in the
people.
He
was
the three others
in
is traced
fact,
the di-
leprosy, being of locality and among as
the fourth
being
the
case
in that
woman
spoken
the husband and sister of the woman, iu the ancestry of whom there had never been any
the fifth case in that the young man." of sister the locality The parasitic theory of the disease opens out trace
of the disease; was
other
avenues
of
the Commission of that
length
the
of the
of,
The conclusion is
adverse criticism
of
Some months after that
family
place,
have been carried out under
to bear on the
time
for several
these
obvious.
only
the abraided surface
on
recent appearance
rigid precautions. Keanu's family history good one, aud there appears to be little doubt that his leprosy was due to inTo dwell ou the importance of oculation.
The
sudden,
prosy made the disease eleven years after the occurrence There had never been any case of leprosy in
was
result is needless.
hot,
carry to
on a
his way home that the young washed his sore shoulder and chauged his
unwell.
was a
a
with
whole
only
was
health had
the most
such
the
clothing.
operation performed September 1884, and now in a well-marked leper. The ex-
seems to
it
liquid
part of
a
and
man
criminal, named Keanu, who agreed to Dr. Arning's trial of the experiment, in consideration of having his sentence to death commuted to The
and
The wet combined with the heat
contact of the
further than would
a
day
was
and the pressure of the sharp edge, produced an abrasion of the skin of the young man. The
be allowed to others, and his results are in favor of contagion. After his failures to inoculate aud
The
the carriers.
Vandyke Carter, of Bombay, have shed a new light on an obscure subject, and have given a to the investiganew test and new departure tion of leprosy, the results of which have already thrown considerable doubts on the correctness of the views expressed by the College of Physicians. Among recent investigators, Dr. Edward Arning has been able to carry his researches and
"
young the dead
liquid matter began to ooze out through a joint of the coffin wetting the shoulders of one of
parts of the
researches
of
her grave.
bacilli in
same
different
from
leprosy
and
body
subject by Neis-
out of the
Tache, a
research,
enquiry
lepra bacilli have putrefaction and to live for
be
tion. The
is that Keanu
to which no
will
give their
doubt atten-
been found to resist
experiment brought livingin a country where leprosy,having been
have been discovered in dead bodies three months
into it from China in 1848, had become was possible that Keanu
after interment, and it is an important matter for enquiry whether they do not contaminate
was
imported endemic, was
not
and hence it
affected
unknown
causes.
only instance There
being
are
of
by
the
leprosy
recorded
attacked
inoculation, but by
Keanu's
case
other
of
by leprosy
by inoculation. healthy children
They
Is it not
possible
that the
endemicity of leprosy in a large measure
in certain localities is due
after vaccination
lymph from children of leprous families, though the disease was not apparent at the
long time.
the soil and the sub-soil water, and thus indirectly gain entrance into the wells of a district.
however is uot the
caused
cases
a
pollutions of the patients as much as
to
with
i
Typhoid
soil and water the
by leprous endemicity Cholera, of
Fever and Phthisis is due in
a
great
THE INDIAN MEDICAL GAZETTE.
212
many cases to certain conditions of the soil anil water? Possibly this is one of the numerous
channels by which introduced among
precautious account
to
for
leprosy is spread when once a community who take no
segregate the
cases
that
without any contact leper. Here may be
or
are
sick. It may also said to have arisen
communication with
a common
ground
a
to which
contagionists and non-contagionists their views converging. The tendency
may find of modern
medical research is to show that there
are
channels and
we
many which diseases may be propagated, may assume that leprosy is not an
by
exception. There are recorded instances of leprosy having been caused by sexual intercourse with leprous individuals, by dressing the ulcers of leprous patients, by sleeping in the same bed, by attendance in a leper hospital, by residing near a leper hospital, by associating in games with lepers, and by washing the clothes of lepers. are many and it should be decided
These modes of communication but
various, assuming leprosy is chiefly spread by contagion, there is an equally important problem for the Commission to inquire into, viz., whether it is equally communicable at all stages of that
its
course.
is evident
It
that
the
whole
to be
of
re-opened, leprosy requires cannot be re-opened in a better manner than by sending a Commission of scientific medical men to Iudia to enquire into the
question
and
think it
we
subject. no
hurry
We to
will be
no
during
one
trust the
give
attempt cold
Commission will be in
in its to
report,
complete
season.
and that there
the
investigation
[July,
1889.
