45° Leprosy in India. [part ii. 



388 individuals, does this indicate that Kumaon is exceptionally unfortunate in this 

 respect? We have already commented on the distribution of the malady over India 

 generally in the opening chapter, and have found that it was only in comparatively 

 a very few parts of the empire that the disease attained to the magnitude implied 

 by a ratio of 2 per 1,000 ; and when the entire divisions were taken, it was 

 found that only in the division of Kumaon was this ratio exceeded. There are, 

 however, a few districts in India in which the proportion is larger, especially some 

 of the Districts (notably Beerbhoom) which go to form the Burdwan Division in 

 Lower Bengal — a division in Bengal which alone contains nearly as many lepers 

 as the whole of the Bombay Presidency,* so that Kumaon has the unenviable 

 privilege of occupying a place at least in the front rank among the leprosy affected 

 districts of British India. 



With regard to the prevalence of leprosy in other countries, even the very complete 

 Leprosy Eeport of the Koyal College of Physicians published in 1867 contains but very 

 few statistics, and so it is with other documents which we have examined : the writers, 

 owing to paucity of information, have been compelled to restrict themselves " to general 

 impressions." As is well known, the disease is in the present century less prevalent 

 on the continent of Europe than on the other continents ; nevertheless it is still 

 endemic in many parts of Southern Europe, f and in some of the islands in the 

 Mediterranean. 



With regard to Sicily, for example, we have very recent information, X and the 

 figures which have been published are of interest in connection with the relation 

 of leprosy to the sea-coast. It has been seen that in Madras the disease is more 

 prevalent along the coast than in the interior ; the reverse, however, holds good for 

 Sicily, for whereas the returns gave 2 lepers to every 9,000 persons living along 

 the coast, there were 5 persons to a similar number in the interior. Many parts 

 of India may be cited as testifying to a similar condition. . 



Leprosy is also endemic to a serious extent in one at least of the countries of 



j 



Northern Europe, viz., Norway. Fortunately we have a mass of information regarding 

 the disease as found in that country also, of the greatest value, thanks to the labours 

 of the numerous Norwegian physicians who have investigated the subject, and to 

 others not belonging to that country — notably Virchow, Vandyke Carter and Neumann. 



* As an example of the want of definite information regarding these matters, the following remarks from 

 a published oificial letter of comparatively recent date referring to the CoUectorate (Division) of Ratnagherry 

 in Bombay, may be cited : — " I cannot tell what the number of lepers may be in other collectorates, . . . but 

 ii the statements of a report I lately read be reliable, the whole province of Bengal does not contain so many 

 oi tnis class of unfortunates as this single district." According to the Bombay Census Returns, Ratnagherry 

 contains 1,237 lepers, — two per mille of population, — and the Province- of Lower Bengal alone 28,403. 



f There are at the present time four most characteristic cases of leprosy in the wards of the Presidency 

 General Hospital under Dr. Coull Mackenzie who have come from Greece for the express purpose of submitting 

 themselves to medical treatment in Calcutta . 



X Profeta "Sulla Lepra in Sicilia," September 1875. Vide '^ Jahresberieht uber die gcsammten Medioin" 

 (Virchow und Hirsch), fur 1875; Band I. Seite 431. 



