PART II,] Leprosy in its Relation to Sex and Age. 463 



two old cases in which the disease had lasted for many years unaccompanied by 

 much distortion or destruction of the hands. 



The voice was more or less altered and husky in 7 cases. In 5 of these 

 the nose was sunken, and in several it was difficult to determine whether the condition 

 was not due rather to syphilitic than to leprous disease. In 2 at all events there 

 could be little doubt in referring it to syphilis ; in 1 of these there was most 

 offensive ozaena, and in the other the depression of the nose was affirmed to have 

 preceded the leprous symptoms. 



The blood of the patients was microscopically examined in 28 cases. In 17 

 of these it was to all appearance perfectly normal, in the remaining 11 it was 

 characterised in 5 instances by a greater or less excess of normal white corpuscles 

 and bioplastic fragments of small size, in 3 by such excess combined with a 

 softened gelatinous condition of the red corpuscles causing them to adhere in 

 irregular masses, and in 3 by the latter phenomenon alone. In 2, specimens of 

 blood could only be with difficulty obtained from the hands. One of these was a 

 case in which the characters of the specimen were normal ; the other, one in which 

 the red corpuscles were softened. In both cases the difficulty seemed to arise from 

 the presence of imuch condensation of the tissues at the site of puncture due to 

 absorptive and cicatricial changes there. In most cases the blood was obtained 

 with ease, and in some there was an excessive tendency to haemorrhage on the 

 slightest provocation. 



These are the principal phenomena noted in regard to the condition of the 

 subjects of anaesthetic leprosy in the Asylum, and it now remains to consider one or 

 two more general points in their history. 



Sex. — Of the 49 cases of the anaesthetic variety of the disease, 25 were males 

 and 24 females, giving respectively a percentage of 54-3 and 70-5 on the total 

 male and female leprous population of the Asylum. * 



Age. — The ages of the patients ranged from 17 to 63, the average of all being 

 40-9. In regard to this as well as in regard to the age of attack, and consequently 

 of the duration of disease, the data are avowedly imperfect and to be taken as only 

 relatively correct, as the natives of India are habitually so ignorant of their actual 

 age and so incorrect in their estimates of time, that no reliance can be placed on 

 the accuracy of their statements on such subjects. Taking the figures as they are 

 the earliest date of attack is 8 years, and the latest 60. Of the 40 cases 5 are 

 said to have commenced under 10 years of age, 12 between 10 and 20, 12 between 

 20 and 30, 13 between 30 and 40, 3 between 40 and 50, 3 between 50 and 60, 

 and 1 at 60. 



The average age of attack for the 49 cases is 26-18, The duration of disease 

 from the date of attack until the period of examination ranged from 1 to 40 

 years. That of 16 was under 10 years, of 15 between 10 and 20 years, of 16 



These percentages refer to the distinctly leprous inmates only. 



