?326 REPORT OF THE LEPROSY COMMISSION:
syphilis. There can be no doubt that syphilis pathologically is
nearer related to leprosy than any other affection.24 This,
however, is no justification for the more modern theory. In
fact, as far as local changes are concerned, an almost greater
resemblance exists between lupus and leprosy.25 Yet no one has
ever ventured to identify these two affections with one another.
Sir W. J. Moore's name is closely associated with what
might be called the syphilis-hypothesis. He considers leprosy
a phase of inherited syphilis.26 In the opinion of the Commis-
sioners this view cannot be supported for the following reasons:
(a) the history of this hypothesis, as briefly alluded to above,
is entirely against it; (b) there is at most only a resemblance
or analogy traceable between the two diseases; (c) certain
clinical facts absolutely disprove the theory, unless the present
views on syphilis be entirely modified or in part given up. The
fact that people contract syphilis after having become affected
with leprosy, is quite irreconcilable with the theory under con-
sideration that leprosy is a phase of syphilis: and it matters
little whether it be congenital or acquired. Of 154 individuals
who confessed to having suffered from syphilis, 12 had been
thus affected after the appearance of leprosy. At a few
asylums every leper was consistently interrogated with a view
to obtaining a more or less reliable ratio of syphilis amongst
lepers. Out of 458 lepers examined 88, or 19·2 per cent., were
found at one time or another to have suffered from this disease.
This percentage may appear high, but too much importance
must not be attached to the figures as they stand. In the first
place, the ignorance of the informants rendered it impossible
to be sure that the disease they described was truly syphilis,
and undoubtedly a certain number of cases must be deducted.
Yet many of these lepers had the unequivocal marks of tertiary
(24) R. Virchow: op. cit., pages 500 and 501.
(25) Ibidem.
(26) Journal of the Leprosy Investigation Committee, No. 1, August 1890,
page 27, and "Lancet," May 17, 1890.