PART II.] Causation of Leprosy. 443 



paratively little was definitely known regarding its localisation in the various parts of 

 the country until the results of the censuses of 1872 had been published. Very 

 important advances have within the last few years been made in the acquisition of 

 knowledge regarding the pathology of leprosy, and it will be our duty in a future 

 report to describe these very fully ; but with regard to our definite knowledge of its 

 actual causation, it is to be feared that we have not, except phraseologically, advanced 

 very much on the etiological views recorded by Atreya many centuries B.C., which 

 were to the following effect : " When the seven elements of the body become vitiated 

 through the irritation of the wind, the bile, and the phlegm, they affect the skin, the 

 flesh, the spittle, and the other humours of the body. These seven are the causes 

 respectively of the seven varieties of Kushtha " (leprosy). 



Leipzig) with the enclosed from Charaka, which I have got prepared for him. In Sus'ruta's time Charaka 

 was an old authority of great weight, and an interval of two centuries between the two is by no means an 

 extravagant guess. Now Charaka quotes Atreya, who was a son of Atri, a sage of great renown, who is 

 named in the Vedas, and was the author of one of our text-books on Law. The name of Atreya occurs in Panini, 

 whose date Goldstiicker takes to be the 9th century B.C. It is also met with in the Rig Veda Sailhita, which 

 dates from the 14th century B.C. Charaka also quotes Bagbhata, who, likewise, has a chapter on leprosy. 

 Bagbhata, again, quotes Agnivesa, who was a great grammarian, and is named in the Madhukanda of the 

 S'atapatha Brdhmana of the White Yajur Veda, and Jdtukarna, who is named in the Yajnavalkya Kanda of 

 the .same Veda. The works of the last two are lost, but on the authority of Bagbhata we may fairly accept 

 them to have been professors of medicine, though it is impossible to say whether they wrote on leprosy or 

 not. Manu mentions leprosy, but the recension of Manu we now have is supposed to be not older than the 

 6th century B.C. In Sus'ruta's work the word XusJitha, the Sanskrit name for leprosy, has been used in a 

 generic sense, and includes several cutaneous diseases which are not leprous, but from Atreya's descriptions 

 quoted by Charaka, it is evident that the word primarily meant leprosy. It does not occur in the Rig Veda 

 Sailhita, which dates from the 15th century B.C., and if we could accept this negative evidence to be of any 

 weight, we could say that the disease was not known in the loth century ; but as there is no reason why 

 the name of a disease should occur in a book of hymns, it is of no value ; while the name of Atreya, which 

 occurs in that Veda, and has been cited as that of an authority on the subject, would carry us much beyond 

 the 13th century B.C., to which Dr. Munroe limits the inquiry." 



" Extract from the Charaka Sdnhitd on the Pathology of Leprosy. 



" Atreya says : — ' When the seven elements of the body become vitiated through the irritation of the wind, 

 the bile, and the phlegm, they afEect the skin, the flesh, the spittle, and the other humours of the body. 

 These seven are the causes respectively of the seven varieties of Kushtha. The Kushthas thus produced cause 

 much pain and suffering. None of these varieties result, however, from the vitiation of a single humour. 

 Kushthas are of seven, of eleven, or of a larger number of kinds ; and these, constantly irritating the system, 

 become incurable.' We shall give a brief account of these as they are produced by the vitiation of the 

 different humours. The wind, the bile, and the phlegm, being vitiated, re-act on the skin, etc. When the 

 wind is most vitiated it produces the hapala Imshtha, the bile the aibchinihara, the phlegm the mandala, 

 the wind and the bile the rishyajihvd, the bile and the phlegm the paundarika, the phlegm and the wind 

 the sidhma, and the thi-ee together the hahanaha. 



" Excessive physical exercise after exposure to too much heat or too much cold ; taking food after sur- 

 feit ; eating of fish with milk ; using barley and several other grains, such as hayanaha, dalakd, karodusa, 

 etc., along with venison, milk, curdled milk, and buttermilk; excessive sexual intercourse; long-protracted 

 excessive fear or labour; fatigue, interruption of catarrh, etc., — vitiate the phlegm, the bile and the wind; 

 hence the skin and the three others become slackened. Thus irritated, the three elements corrupt the skin 

 and others, and produce kushtha. 



" The premonitory symptoms of kushtha are as follow : Want or excess of perspiration, roughness, dis- 

 colouration, itching and insensibility of the skin, pain, honipilation, eruptions and excessive pain on the 

 parts that are about to fall off. 



*' Some kushtha eruptions are red, rough, spreading and small ; they cause horripilation, slight itching, 

 pain, and discharge of matter and sanies. These are caused by wind, and are called kapdla-kxishtha (scaly). 



** Those that arc of a coppery colour, which discharge matter, blood and sanies, cause itching {)ain. 



