?Sanitation, Diet, Disease, etc. 299
CHAPTER VI.
Sanitation, Diet, and Diseases in relation to Leprosy.
Sanitation.
IT has been seen that heredity and contagion are altogether
insufficient to explain the spread of leprosy, and other
ætiological factors must be sought for. In diseases like le-
prosy and tuberculosis, it is always difficult to find the ex-
citing cause. For, with the recognition that a specific bacillus
enters the body, the matter is but little advanced. The en-
quirer must always ask, why a widely diffused microbe, such as
that of tuberculosis or leprosy, should cause a particular dis-
ease in some people and not in others. What is it that estab-
lishes the necessary specific predisposition ?
This question is as obscure for leprosy as it is for tubercu-
losis. In this chapter the more important causes, supposed to
bring about such specific predisposition, will be discussed.
When a disease, as is the case with leprosy, is so generally
distributed over a vast country, attention must be directed
to the general life and hygienic surroundings of the people.
Does defective sanitation cause a specific predisposition to
leprosy?
Since all classes of the community and all races appear
to be subject to leprosy, remarks upon the sanitary environ-
ment of the inhabitants of India must be necessarily gene-
ral in character. In the cities and larger centres of population
considerable progress has of late years been made in sanitary
improvement, though very much yet remains to be done. In
the smaller towns and villages, however, little has been ac-
complished, or, indeed, is practicable in the present state of
native opinion. Fortunately the nature of the employment
of the great mass of the population necessitates an outdoor