?Sanitation, Diet, Disease, etc. 309
more frequently ground, and the flour made into unleavened
cakes known as "chupatties." Rice is boiled and either eaten
alone or in the form of curries. As already stated, cooked
vegetables, salt, oil, and condiments form portions of almost
every dietary. Sugar, sweetmeats and fruits are also largely
consumed.
Of all articles of diet none has been held more responsible
for the causation of leprosy than fish. This view has of late
years gained considerable importance through the weight of the
authority of Mr. Jonathan Hutchinson who stated the fish
hypothesis with great force at the Tenth International Medical
Congress at Berlin.9 As Virchow and Dr. Liveing have pointed
out, the theory is very old and has reappeared from time to
time. Virchow's views on the subject have not infrequently
been misrepresented, and it may, therefore, not be out of place
here to quote his own words:10 "The more general use of
bad fish very (ungewöhnlich) frequently coincides with endemic
leprosy. This statement, however, is subject to exceptions,
but then, as a rule, another noxious dietetic article is accused,
and comparative observations might be made as to whether or
no the same deleterious substance exists in fish and these
other articles of food." It will not be necessary to say more
about the history of the fish hypothesis, as this has been done
so concisely by Dr. Liveing in his Goulstonian lectures. One
passage, however, of special interest with regard to leprosy in
India is worthy of notice. Dr. Liveing says 11: "The com-
bination, however, of milk and fish seems to have been consid-
ered especially favourable to the disease. Bernhard Gordon
says: 'Comedere lac et pisces in eadem mensa inducit Lepram.'
And it is not a little remarkable that the same opinion obtains
in the present day in India." There is no doubt that in certain
(9) Journal of the Leprosy Investigation Committee, No. 1, August 1890,
pages 77-87.
(10) R. Virchow: op. cit., page 507.
(11) R. Liveing: op. cit., page 33 and footnote, page 34.