PART II.] Analyses of Statistics of Leprosy. 445 



Writing in 1874 to the India Office, the Army Sanitary Commission, in reiterating 

 its suggestion that the whole subject of leprosy should be examined in India, says : — 

 " The first step towards this examination is to obtain accurate statistics of the disease, 

 such as can show not only the usual numerical data, but the precise localities where 

 leprosy exists in India." And Dr. Gravin Milroy, who probably has a more extensive 

 and accurate knowledge of the malady and its literature than any other writer in 

 England, remarks, in a communication regarding the manner in which, in his opinion, 

 the present inquiry should be conducted, as follows: "Commencing, therefore, as if 

 the subject were a tabula rasa, Drs. Lewis and Cunningham will first make themselves 

 acquainted with the natural history of the disease as it occurs in Hindustan ; its essential 

 and pathognomonic outward and physical symptoms ; the circumstances and conditions 

 which influence its origination and spread ; the factors which seem to affect or modify 

 its progress, whether beneficially or otherwise, apart from direct medication or the 

 action of drugs, internal or external — in short, all its characteristic features and attri- 

 butes. They will thus determine the general nosological nature of the malady, and 

 whether Cullen has rightly classed it as a ' cachexia totius vet magnce partis corporis 

 habitus depravatus, sine pyrexia primaria vet neurosis ; ' and the College of Physicians 

 ranged it among the 'General Diseases' between Lupus and Scrofula." 



We have on the present occasion endeavoured to follow out the preliminary stages 

 of these suggestions so far as was compatible with the circumstance that, owing to the 

 advent of the rains in July and the consequent difficulty in getting about among the 

 hills, it was not deemed advisable to undertake any systematic personal investigation 

 of the special localities in which the disease prevails, during the current year. This 

 part of the inquiry we hope to be in a position to be able to report upon on a future 

 occasion. At present we purpose restricting our remarks to such portions of the 

 inquiry as may be comprised under the following heads : — 



A— Analysis of the Statistics of the District. 



1. To what extent does leprosy prevail in Kumaon ? 



2. Is the disease exceptionally prevalent in this district ? 



3. The geographical distribution of the disease in the district. 



4. What are the main features in connection with the localities in which it most 



prevails ? 



B -Analysis of the Statistics of the Almora Leper Asylum, and of the results of 



Clinical Observations. 



1. Number of lepers admitted since the Asylum was founded, and the more 



prominent facts concerning them generally. 



2. Clinical observations regarding the persons affected with anaesthetic leprosy ; 



3. Tuberculated leprosy ; 4. Mixed varieties of leprosy ; and 5. The so-called 

 eruptive varieties of leprosy. 

 6. Analysis of all the cases and deductions regarding the influence of age, sex, 

 predisposition, etc., in the etiology of the disease. 



