234 The Philippine Journal of Science 1922 
were sent away from Culion, 3 of whom were returned later 
to the colony. There were residing at the end of 1921, 308 
children born in the colony (both parents of practically all of 
them being lepers) the majority of whom were living among 
lepers; a limited number were isolated in the Negative Children’s 
House after having been in intimate contact with lepers for 
varying lengths of time. 
The children now living in the Culion Leper Colony, born of 
leper parents and raised among lepers—that is, in an ideal 
environment for infection—offer favorable material for the study 
of the early lesions and the development of leprosy. This paper 
is the result of the study of the records in the colony, and repeated 
clinical and bacteriological examinations made during the period 
between June, 1921, and March, 1922, of all children born up 
to December 31, 1921, inclusive, and now residing in the colony. 
MORBIDITY AND MORTALITY 
As a rule the healthy children of lepers show the same phys- 
ical and mental development as do the children of healthy 
parents. 
No records were kept in the colony of minor ailments among 
the children, but the general observation is that they are subject 
to the diseases of childhood that occur among children of the 
same age in healthy communities, and that they are not partic- 
ularly susceptible to any childhood disease. 
On examination of the children we were struck by the fre- 
quency of diseases of the skin other than leprosy. Over one- 
third of the number examined showed active or recent lesions 
of an itch of some kind, which in many cases persists for years 
and becomes generalized all over the body and is eczematous in 
nature. There are also a few others suffering from tinea, yaws, 
and other skin diseases. 
No comparison can be made with the incidence and nature 
’ of skin diseases in nonleper communities, as no data are avail- 
able; but it seems that the “itc ” among the children of lepers 
is rather rebellious to treatment. 
The mortality among children of lepers during the first years 
of the establishment of the colony was very high; none of the 
children born in 1906 and 1907 survived. The mortality stead- 
ily decreased in subsequent years on account of better care and 
accommodation of the population. In the City of Manila from 
1905 to 1918, inclusive, deaths among children under 1 year of 
age averaged 41.3 per cent of the total number of births. (still- 
births excluded).(6) In the Culion Leper Colony, up to De- 
