PART il] Hereditary Predisposition to Leprosy. 475 



isolated instance cannot be regarded as affording any trustworthy evidence, as in 

 an endemic area the possibility of the occasional occurrence of marriages between 

 predisposed parties must always exist. 



The history of the Asylum furnishes no other evidence in favour of contagion ; 

 there is no evidence of attendants or others employed about the institution or of 

 those in any way connected with it having suffered from the discharge of their duties 

 in any way. * 



8. — The evidence which the histories of the inmates afford on the influence 



of heredity. 



"We next come to the question of heredity of the disease. The inmates of this 

 Asylum belonging to more or less localised hill communities offer greater facilities 

 for the elucidation of this subject than the inmates of similar asylums in the plains, 

 seeing that the former have usually more definite information than the latter 

 concerning their present and ancestral relatives. On this account, therefore, the 

 information which we have obtained from these people regarding the influence of 

 heredity in the propagation of leprosy may, we think, be considered as of more than 

 ordinary trustworthiness. 



Table XIX shows the number of lepers with leprous relatives, with the degree 

 of relationship in each instance. 



"We thus obtain unequivocal information that of the eighty lepers in the Asylum 

 at present, 28; or 35 per cent., had one or more leprous relatives. This per- 

 centage gives a proportion 140 times greater than the percentage of lepers to 

 the total population of the district, and allowing the fullest play to the possible 

 influence of similarity of external conditions, points to the distribution of the disease 

 by families and therefore to hereditary predisposition. The circumstance that in 

 2 of the 4 cases in which both parents were leprous, the total number of leprous 

 relatives was greater than in any of the others, and in fact furnished nearly a fourth 

 of the total of leprous relatives for the 28 cases, also supports this con- 

 clusion. 



It should be borne in mind, moreover, that many of the inmates had not for 

 years past learnt anything of the individual histories of the various members of their 

 families, so that this circumstance (in addition to the paucity of precise information 

 regarding the particular ailments of distant relatives, common to all families) tends 

 to show that even this high ratio under-states the actual proportion of leprous kindred. 



* Among the cases reported to the College of Physicians in support of the contagious nature of the disease 

 there is one quoted on the authority of a Native Sub-Assistant Surgeon, in which it is stated that two men, who 

 acted as durwans, i.e., gate-keepers, at the Almora Asylum, were attacked by leprosy whilst so employed. 

 [" Report on Leprosy by the Royal College of Physicians ; " London, 1867, page 141.] 



On referring to the Superintendent of the Institution, the Rev. Mr. Budden, for information on the point, 

 we have been informed that the Sub-Assistant Surgeon in question " knew nothing about the Asylum ; and the 

 statement," writes Mr. Budden, "has no foundation whatever. Nothing of th. kind reported has ever occurred 

 in the Asylum since I took charge of it in 185] ." 



