CHAPTER XIV.REMARKS ON LEPROSY.
By Surgeon-MajorG. 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 giveinformation 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 thesympathy 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 becomepermanentresidents 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.
Male Lepers
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 traceddirecttransmission 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 abacillusin 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 anddeforms 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 producinganæsthesia, 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 over25 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, triedmost 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 leastpermanentbenefit 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 ofinmates. 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.