?98	REPORT OF THE LEPROSY COMMISSION:
of a district, may have a definite influence. Cholera has been
used as a test of unhealthiness and bad hygiene, and it has
been suggested that in a district, the permanent home of cho-
lera, the surroundings may be such as to favour the diffusion
of leprosy.
Still greater difficulties make themselves felt while discus-
sing the relation between the material prosperity of the people
and leprosy. The Commissioners incline greatly to the belief
that the greater the poverty of a district, the more prone the
latter is towards leprosy. Considering India as an unit the
masses are poor and live in defective hygienic conditions, far
below the level of the western European nations, and appa-
rently have lived in such surroundings for centuries. An
absolute comparison between the individual provinces and dis-
tricts is impossible, but the Commissioners express their
strong belief that it can be shown that the numerical diffusion
of leprosy depends, among other factors, greatly on the well-
being of the population, and that with the furtherance of pro-
sperity, education, and hygiene, and in fact with a substitution
of a standard of maintenance for that of subsistence, leprosy
will materially decrease in India as it has done in Europe.
Such progress has been going on actively in India for the last
twenty years, and it is hoped that under the British Govern-
ment the native standard of health and wealth will more and
more approach that of the masses in the mother country.
Leprosy an Endemic Disease.
In a subsequent chapter it will be more fully explained that
in leprosy, as in tuberculosis, a special individual disposition is
necessary for the acquisition of the disease. Here an attempt
has been made to show that it is by no means improbable that
the general susceptibility to leprosy of a district and its inhabi-
tants depends on certain conditions: in other words, there
seem to be certain factors, partly connected with the climatic,
economic, social, or hygienic conditions which establish the