PART II,] 



Forms of Leprosy seen in India. 



441 



accurate information regarding the particular parts of the country where the disease 

 is most prevalent. This is, we believe, the first attempt that has been made, or could 

 have been made, with any prospect of accuracy, seeing that some of the most important 

 census papers have only very recently been issued, to map out the distribution of leprosy 

 over the Peninsula. Unfortunately, the large portion of the country which is not 

 directly under British control must remain still undescribed. It is known to prevail 

 in many of the districts under native rule to a very great extent, but that is all that 

 can be said.* 



The Forms of TiEPROSY encountered in India, and the Designations 



APPLIED TO it by THE PEOPLE. 



As regards the forms of leprosy that are met with in this country, they may, we 

 think, be classified very conveniently under the two headings generally adopted by 

 modern writers — a classification based on the two most characteristic features of the 

 disease. These features it will be more convenient to describe when the result of 

 clinical observations come to be recorded ; in the meantime it will be sufficient to 

 mention generally what these leading characteristics are. In one form the most pro- 

 minent feature consists in the diminished sensibility manifested over various parts of 

 the body, and it has consequently been designated the anaesthetic form — Le'pra 

 ancesthetica — induced, it is believed, by a peculiar alteration in the cutaneous nerves 

 of the part. The other leading form is commonly referred to as the tuberculated 

 variety — Le'pra tuberculosa — characterised by analogous changes in the skin and in 

 other tissues, so that the parts in question present more or less tuberculated nodular 

 projections of various sizes and outline. 



The existence of the two forms in one person forms the third, mixed variety of 

 some writers, but, as Virchow says, " no clear line of demarcation exists between the 

 nervous and cutaneous forms of leprosy." We hardly think it necessary, therefore to 

 adopt this term as distinctive of any particular form of the disease, seeing that at best 

 the terms " Anaesthetic " and " Tuberculated " are only used relatively according as the 

 one or other feature characterises the phase of the malady most prominently. At the 



* Whilst this Report was being printed, we had the opportunity of consulting the recently-published 

 "Report on the Census of British Burma," from which we extract the following data regarding the number 

 and distribution of lepers in that Province : — 



British Burma. 



DiviBioii. 



Arakan . . . 



Pegu 



Tenasserim 



Total 



Population. 



484,362 



1,662,058 



600,727 



2,747,148 



Number of 

 Lepers. 



185 

 2,072 



3,203 



Lepers per 10,000 

 of Population. 



3-8 

 12-4 

 15-7 



11-6 



