Some Notes on Leprosy and its Control

Many fallacies have existed about this disease for centuries, and it was not until a concentrated scientific study was started by Maj. Gen. Sir Leonard Rogers, K.C.S.I., F.R.S., in 1923, that the real facts became known, or any real hopes of cure for the sufferers could be given.

Ignorance and supposed incurability, combined with the idea that it was highly contagious, led to compulsory segregation into leper colonies ; the main result of this being, that early cases hid their disease until it was in an advanced stage, when treatment of any kind was out of the question. The most infectious period had already passed, and the advantages of segregation were lost.

It is commonly believed that the limbs drop off in leprosy. This is a fallacy. What actually happens is, that the nutrition of the bones of the limbs suffers in a peculiar way, owing to the formation of leprous nodules in the nerves which supply the limb, with the result that the bones become ab­sorbed, and the limb shrunken, so that the remains of the fingers and the palm of the hand may be found on the end of a stump at the level of the elbow joint, all the intervening bone having been absorbed.

Another fallacy is the “diet” theory. Poor dietetic and hygienic conditions favour the spread of leprosy, but that fish diet can cause leprosy as suggested by so great an authority on leprosy as Hutchinson, is now known to be quite wrong.

Neither is the disease hereditary. Dr. E. Muir, in reporting to the British Empire Leprosy Relief Association, states that there is now unanimous opinion, that with one or two possible exceptions, children who are separated from their leprous parents at birth and are thereafter kept free from all chance of infection, do not develop leprosy.

Casual momentary contact with a leper practically never produces the disease. It requires lowered vitality and prolonged or intimate contact in all but exceptional cases. The wearing of leper-infected clothes, or sleeping in a leper’s bed is the most fruitful source of infection. Hence Europeans rarely contract the disease from natives. The disease is most common and most severe amongst “depressed” classes of natives, and has died out in most European countries, where living conditions are good. In England, all that we now see of it are the leper windows in old abbeys and churches.

Up till a few years ago, no satis­factory survey of the leprosy problem was possible. The fear of segregation in leper colonies deterred all but ad­vanced cases from declaring themselves Infected, and the absence of any satis­factory treatment removed all incen­tive from the native to immure him­self for life, for the sake of others.

The position is now entirely changed. Sir Leonard Rogers says that it is a remarkable fact that Nature has pro­vided specific remedies for some of the greatest scourges of humanity ; e.g., quinine, the active alkaloid of cin­chona bark, for malaria ; that of ipe­cacuanha root for amoebic dysentery, both vegetable substances discovered ages ago by ancient South American races. Similarly, the ancient Indian remedy for leprosy is Chaulmoogra oil, obtained from the seeds of several species of Indian trees. Recent researches have shown how this oil can be made so efficacious in treatment that early cases of leprosy amongst the natives are curable.

For a long time there was some scepticism, but the results were un­deniable, and treatment clinics set up soon led the early cases to divulge their disease, and come pouring in for treatment instead of waiting hopelessly for a lingering death.

Lord Reading succeeded in raising a fund of about £150,000 to endow the work. In India and in Africa and Oceania active steps are being taken to discover and treat all early and curable cases, with most encouraging results.

Much remains to be done, because it has been found, that now it is no longer kept secret in its early stages, enormous numbers of natives come forward with the disease. Some idea of the immense amount of work done, may be gathered from the following examples, taken from much similar information given by Sir Leonard Rogers in the January number of Discovery.

In India, 50,000 lepers are attending clinics in Madras and the Central Provinces alone, or seven times as many as were in the various leper asy­lums in the whole of India ten years ago. In Southern India, of 110,000 persons examined, 6,500 were found to be leprous, and 4,800 have been settled on a large area of land, 30 square miles in extent, where they are largely self-supporting.

After three years, intensive campaign in Nauru Island in the Pacific, where 30 per cent. of the natives were infected, the number of active cases has been reduced by 40 per cent., and no single case has gone to the infective stage. Arrangements have been made to apply a similar plan to another island of 200,000 inhabitants.