?(8)
2. Leprosy is a common affection in this district. It is generally limited to
the poorer classes, and is infrequently seen in the well-fed and the rich. The Bow-
rees and Sonthal castes suffer most, and the dark-skinned are more prone to the
disease than the fair-skinned, but this may be due to the greater preponderance of
the former over the latter. The pure Aryan, as represented by the high caste
Brahmin, is least susceptible to the disease-a fact borne out by my limited observations
in the Burdwan Leper Hospital and Pooree District. The pure or somewhat mixed
aboriginal as the Sonthal or the Bowree caste is, on the other hand, most susceptible
as hereinbefore observed, and the intermediate castes appear to be more or less
liable to the disease in proportion to the aboriginal blood in them. This, if proved
by an extensive number of accurate observations, will establish an important fact.
Out of 800 admissions into the Bankoora Jail in 1876 two were lepers, or 2·50
per 1,000.
3. Anęsthetic form of the disease is the most common, tubercular is rarely
seen, but the mixed form is more frequent. Eruption is observed in most cases,
attended often with considerable anęsthesia or diminished sensation. Atrophic
changes, distortion, and finally ulceration and loss of substance of the hands and
feet were not absent in a single case I observed in this district.
4. Syphilis, venery, poverty and bad living are great exciting causes of the
disease.
5. The treatment adopted in the Bankoora Dispensary was liberal diet, clean-
liness, and the continual administration of tonics. Under this plan two of the
cases improved, and the progress of the disease rendered slow; but as soon as the
treatment was left off, or the patient was reduced in health by febrile attacks
or other causes, the disease broke out afresh with renewed vigour. Gurjun oil
was tried in 1875 in some of the cases, but the result was not recorded, nor the
manner of its administration.
6. Nine cases of leprosy were treated in the in-door hospital in 1876. The
details of the cases are kept badly to allow me to determine accurately to what form
of the disease each belonged. Eight of them appear to be of the anęsthetic variety;
they were admitted with ulcerated hands and feet, and more or less diminution of
sensation. One died after one year's residence in hospital, one slightly improved
and left the hospital after twenty-two days, one is still undergoing treatment and is
improving, and the remaining five ceased to attend. No improvements in these
cases is recorded. The ninth case appears to be of the tubercular variety, as it is
stated that the patient had sores all over the body. He was six days only in
hospital.
7. Two lepers were admitted into the Bankoora Jail in 1876: One was re-
leased very shortly after, and his case is not recorded; the second was soon trans-
ferred to Burdwan; his case was noted in the Burdwan records as one of anęsthe-
tic leprosy.
8. Twenty-five cases treated in the out-door dispensary, but no record is kept
of their varieties.
No. 270, dated Midnapur, the 26th March 1877.
From-R. L. MATHEW, Esq., Civil Surgeon of Midnapur.
To-The Deputy Surgeon General, Presidency Circle.
I HAVE the honour to forward the following brief remarks regarding leprosy
in this district:
I have now before me nine reports from the medical subordinates serving in
this district, and from their perusal I regret to say hardly any information of a
definite character can be procured.
The Assistant Surgeon in charge of the Midnapur Dispensary considers
leprosy a rare disease amongst the inhabitants of the town and district.
There were some 56 cases of leprosy treated in the Charitable Dispensary from
the 1st of March 1876 to the end of February 1877.
The patients were for the most part pilgrims from the North-West, who only
remained for a few days until their strength was recruited, and then proceeded on
their way.
The Assistant Surgeon does not mention the type of the disease that he most
frequently observed, nor does he seem to have made any enquiry as to what cause
the disease was attributed, or what part hereditary taint or contagion played in
producing it.