444 Leprosy in India. [part ii. 



LEPROSY, AS OBSEEVED IN KUMAON. 



In accordance with, instructions which we received from the Government of India, we 

 proceeded to Almora, the headquarters of the Kumaon and Garhwal Division, early in 

 May last, for the purpose of commencing a series of systematic observations regarding 

 leprosy. The Commissioner, General Sir Henry Ramsay, had specially addressed the 

 Lieutenant-Governor of the North-Western Provinces, pointing out the urgency of 

 such an investigation, and strongly recommending the Kumaon district as peculiarly 

 adapted for its prosecution. General Ramsay writes in May 1875 : " It would be 

 impossible to find anywhere in India so suitable a locality as Kumaon for pursuing a 

 thorough and complete investigation into the whole subject of leprosy. At Almora we 

 have an asylum containing on an average 1 00 lepers, labouring under every form and 

 stage of the disease, whose family history can be ascertained to the minutest detail. 

 In the district there are many hundreds either wandering alone as beggars, or residing 

 at their homes, whose history could be gathered with perfect accuracy. Such a record 

 would give a mass of statistics which would admit of some reliable deductions being 

 drawn, as to whether it is possible to deal with this loathsome disease. In my opinion 

 it is necessary that something should be attempted. If, on inquiry, it is found that 

 nothing can be done, then it will be so far satisfactory to have ascertained that as a 

 fact; but in the absence of that knowledge it appears to me wrong that this fearful 

 disease should be allowed to continue to spread itself amongst the population if any 

 measures can be taken to prevent it." In this the Lieutenant-Governor, Sir John 

 Strachey, coincides, and adds that "the field of inquiry, while sufficiently large, will 

 not be unmanageable in extent." 



inflammation and burning, and produce worms, are also caused l)y wind. They appear like the ripe fig, and 

 are hence called Audumhara (fig-like). 



" Some are cold to the touch, raised, hard, reddish-white, clammy, itching and infested with worms. 

 These, too, are caused by wind ; they are called Mandala (circular). 



" Those which are rough, red, white, yellow, blue, or coppery, producing itching pain, worms, burning 

 sensation, and insensibility, are also caused by wind. They have the appearance of the tongue of an antelope, 

 and 'are hence called Rishayjih'va. 



" Those which are white or red, spreading and elevated ; which discharge blood, pus, and sanies, and pro- 

 duce itching, are also caused by wind. They appear like the leaves of the white lotus, and hence are called 

 Paundarilta. 



" Those that are rough, red, thin, internally cold, sometimes reddish- white, which cause slight pain, 

 itching, burning, and discharge of pus and sanies, are also caused by wind. They appear like the flowers 

 of the pumpkin, and are called Sidhma. 



" Xdhmka and others have all the symptoms of Jiushtha. They are incurable, while the others are 

 curable. That which is incurable can never be cured, and those which are curable sometimes l:iecorae 

 incurable. 



"The wind causes coppery -red roughness, pain, inflammation, shrinking, horri{)ilation, and insensibility 

 of the skin. The bile produces burning, perspiration, pain, discharge of blood, and suppuration. The phlegm 

 causes whiteness, coldness, itching and confluent pimples. 



" The worms that form in leprous eruption destroy the flesh, skin, veins, muscles and bones. When 

 affected by them, the patient suffers from spontaneous discharges of blood, insensibility, loss of sensibility 

 of the skin, mortification, thirst, fever, dysentery, burning, weakness, disrelish, and indigestion. Then liushtlui 

 becomes incurable. The man who neglects the disease at its commencement is sure to die. He, who at the 

 first breaking out of the disease tries to get rid of it, may be sure of its being cured." •'• 



