?(7)
The disease as seen here does not differ in any respect from the description
found in books. I have seen it in the early stages in two forms: First, circular raised
copper-coloured spots; when these spots are pinched, the skin feels thick; these spots
are numb at first, and gradually become insensible. Second variety consists of mot-
tling of the skin of the face, hands and feet, gradually extending to the trunk; the
patches are lighter in colour than the surrounding skin and are generally circular,
often edged with a red border; the skin of face becomes coarse, thick and granular
like the rind of an orange; the lips, nose and ears appear thick and larger than
natural; eyebrows look heavy. As the disease advances the voice gets husky, hair
thins and falls off; the patches gradually become quite insensible. Ulcers form with
thick cartilaginous edges, and pale shining surface, discharge water. These ulcers
often heal, leaving white shining contracted cicatrices. When these ulcers are
situated on the hands and feet the fingers and toes drop off. Flexors of extremi-
ties often contract, causing fingers and toes to be permanently bent. The whole
skin of body becomes scaly, and the sufferers look older than they usually are.
Death generally takes place from diarrhœa and exhaustion. The muscles are found
wasted and pale with the cellular tissue converted into a gelatinous substance in
various parts of the body.
Causes.-I have no doubt that leprosy is propagated by sexual intercourse,
as I have seen several instances at the Serampore Hospital, when the disease was
acquired in this way and mistaken at first for venereal. Diet has also a great deal
to do with its production; most of the sufferers are from the homeless classes,
beggars, &c., who live by begging, and it is well known that these people are sup-
plied with grain of the cheapest and worst kind. Grain dealers, as a rule, set aside
damaged and worm-eaten grain for distribution to this class; they seldom get
animal food, living principally on diseased grain and vegetables with a taste of
rotten fish occasionally. As far as my observation extends, climate does not seem
to have any great influence in the production of the disease, though there is no
doubt that the disease is one of tropical origin.
JAMES GREENE, M. D.
Civil Medical Officer, Serampore.
No. 67, dated Howrah, the 5th May 1877.
From-Surgeon Major J. G. PILCHER, M. D., Civil Surgeon of Howrah.
To-The Deputy Surgeon General, Presidency Circle.
I HAVE the honour to acknowledge the receipt of your circular memorandum
No. 111 of the 5th January, and annexures, calling for a report on the prevalence
of leprosy in this district, and the circumstances attending its occurrence, also for a
clinical history of the disease as observed in this part of the Province.
I have only been three months in charge of the district, and I have been
unable to make myself acquainted with the subject of leprosy. From personal
observation, therefore, I can record few facts regarding the special forms or charac-
teristics of the disease as seen in Howrah.
In the municipality very few cases of the disease are seen at the dispensary
partly owing to the nearness of the larger city and the greater ease with which the
destitute leper can obtain support from the charitable, partly also from the fewer
number of cases of real leprosy, if I am correctly informed, in this district in com-
parison with others.
No. 32 E, dated Calcutta, the 11th June 1877.
Endorsed by the Deputy Surgeon General, Presidency Circle.
FORWARDED to the Secretary to the Surgeon General, Indian Medical Depart-
ment, with reference to Surgeon General's Office circular memorandum No. 134,
dated 20th December last, and in continuation of this Office memorandum No. 29 E,
dated the 7th instant.
No. 162, dated Bankoora, the 9th June 1877.
From-Babu B. L. DUTT, M. D., Civil Surgeon of Bankoora.
To-The Deputy Surgeon General, Presidency Circle.
IN compliance with your circular memorandum No. 111 of the 5th January
1877, I have the honour to submit a report on the leprosy prevailing in this district.
My short experience of the district and the want of satisfactory notes of the
disease enable me only to give a short and imperfect account.