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ably very different and distinct from true leprosy a terrible 

 disease described by Aretaeus as so much greater than the 

 rest of diseases, as the elephant is bigger than all other 

 animals which is generally diffused through the body, 

 involving more or less its every tissue. Leprosy is endemic 

 and hereditary, and amongst the other predisposing causes 

 may be mentioned those which produce scrofula. As to 

 the exciting causes much difference of opinion still exists, 

 the late Sir Erasmus Wilson contending that miasma is the 

 causative agent, while Mr. Jonathan Hutchinson and others 

 believe that the real cause is a poison taken in connection 

 with fish. Certainly leprosy has been known to exist and 

 flourish where malaria is unknown. Mr. Hutchinson thus 

 summarises the evidence which leads him to place leprosy 

 amongst the diet-diatheses: "It is," he says, "the same in 

 all countries, and probably has been so in all ages. It is the 

 same in rich and poor, in hot climates, and in cold climates. 

 It is certainly neither infectious nor contagious ; yet it is 

 capable of origination in those who go to reside where it is rife. 

 It slowly gets well in those who leave its haunts and reside 

 elsewhere. It is not possible to mention any climatic 

 condition which is common to all the varied localities where 

 leprosy is found. Whenever it occurs in hot climates it 

 usually observes the same rule as it does when occurring in 

 a temperate climate, where it happens to those who are 

 engaged in the fishing trade, and who live, to a very large 

 extent, upon the poorer kinds of fish ; yet in hot climates it 

 now and then happens to those who eat but little fish. 

 But this is always under circumstances where fish is known 

 to be bad, and where it rapidly decomposes. Finally, in 

 all temperate climates leprosy disappears before advancing 

 civilisation, the introduction of agriculture and the increase 



