Distribution of Leprosy. 103
the last quarter of a century? If such decrease, however, be
not accepted, may it not be expected that by means of such
improvement the leper population, instead of remaining station-
ary, will gradually diminish? It must be the chief aim of the
reformer to counteract the agents which are responsible for
the fact that leprosy is endemic in India. It is impossible to
attack the virus itself, but it seems not only possible to battle
against the predisposing causes, but to do so with fair hope of
eventual success. There is in India a tendency towards a
decrease of the disease, and this is assuredly due to the rapid
progress of the social, economic, and hygienic conditions all
over the empire. With a further and continued improvement
of these, it may be hoped that in India leprosy will cease to be
an endemic disease.
Density of Population in Relation to the Diffusion of
Leprosy.
The health and wealth of a population is closely con-
nected with the density of the population, and for any other
country it might fairly be assumed that the masses would
always crowd to the richest areas. However, when it is
remembered that the Indian ideas of the standard of life and
comfort are very low, and that the people aim simply at
subsistence in contradistinction to maintenance, it is neces-
sary to exercise great care in forming an opinion as to the
wealth and well-being of the population. The fixity of occu-
pation and of condition, the great rigidity of domestic relations,
necessitate a keen indisposition in man to disperse, and thus in
some parts of the country there is no organised emigration as
yet, while in other parts the people have gradually accustomed
themselves to abandon their homes. A local congestion is
thus easily established, all the more as the requirements of the
masses are so moderate and the desire to increase them so
weak. Now as a population tends to increase faster within a
fixed area than the land yields food for it, and as according to