■i()2 SANITARY COXDITIOXS 



scope and has seen it teeming with myriads of bacteria, must admit it possible 

 that leprosy is transmitted by contact. And this possibility becomes well nigh 

 a certainty when it is considered that this tissue on ulcerating and sloughing 

 liberates these bacteria in countless millions to attach themselves to whatever 

 objects come within their reach. Vast quantities of bacilli are unquestionably 

 eliminated from the skin and from the nasal and buccal mucous membrane of 

 lepers. It is therefore very probable that every leper is a danger to his sur- 

 roundings, the amount of danger varying with the nature and the extent of 

 his relations therewith, and also with the sanitary conditions under whicli he 

 lives. 



Surgeon D. A. Carmichael in his report on leprosy in the Hawaiian Is- 

 lands " speaks of kissing, nose rubbing, cohabitation, and reception of the secre- 

 tion on abrasions of the surface of the skin or by inhalation, deglutition, or 

 transmission by insects as possible methods of communication. Probably one 

 of the most common sources of contagion is through improper vaccination and 

 uncleanly shaving. The common house-fly, mosquito and bed-bug in all prob- 

 ability also transmit leprosy, for Dr. Alvarez, leprologist of the Hawaiian 

 government, found leprous bacilli in the bodies of mosquitoes which had 

 alighted on the open sores of lepers.' 



Treatment of Leprosy. 



In regard to the treatment of leprosy in India, Dr. Hitt ' says that chaul- 

 nioogra and gurgan oils seem to be favorites, especially when the chaul- 

 moogra oil is used as an inunction. Arsenic, in early stages, is sometimes of 

 service. Iodide of potassium is also good in some cases. General and surgical 

 cleanliness is, of course, absolutely essential, but if the ulcers are healed too 

 quickly, unless an alterative is given, the temperature of the patient is likely 

 to go up to 102 or 104 degrees and his general condition suffers. He prefers 

 the iodide of calcium given in combination with bromide of calcium and 

 syrup of sarsaparilla. He also gives ichthyol internally in tubercular cases 

 beginning with 10 drops and increasing gradually until a drachm is taken at 

 a dose. Bathing is considered very necessary and in some cases the water is 

 slightly acidulated with sulphuric acid. Patients suffering from the anesthetic 

 type should not bathe in the same baths with those suffering with the tubercular 



" Loc. cit., p. 95. 

 ' Loc. cit., p. 106. 

 ^Loc. cit., p. 89. 



