PART II.] Dr. Profetd s Inquiries regarding Leprosy in Sicily. 483 



stances of giving origin to the development of disease. How, then, is the absence 

 or disappearance of predisposition to be determined? 



That Asylums, properly so called, are very useful and desirable institutions in 

 districts where chronic diseases like leprosy prevail, is just as true as that prisons 

 ought not to be substituted for them. By their means a shelter is secured for the 

 patients where they may be benefited by treatment, and where they, in many cases, 

 are certainly saved from much suffering; where the phenomena of disease may be 

 studied, and the effects of curative means tested. By their means, moreover, the 

 existence of a large amount of miserable beggary in a district may be avoided. 

 Such institutions are, beyond doubt, calculated to do very great good, and deserve 

 all support and encouragement so long as such support does not relieve the relatives 

 of the diseased from the performance of their duties to the sick — so long as their 

 existence does not afford an encouragement tp people to profit by the misfortune of 

 their relatives at the expense of the community. 



Such have been the results of our investigation during the present year. They 

 have, at all events, served to clear the way for further work, and to point out the 

 direction to be followed in more detailed local inquiry.* 



SUMMARY. 



A BRIEF recapitulation of the principal points to which reference has been made in 

 this our first report regarding leprosy may be of use to such readers as have not 

 sufficient time to study the question in detail. It must, however, be premised that 

 any digest relating to such an obscure subject is necessarily attended with more risk 



* The results of our inquiries hitherto regarding leprosy correspond closely with a similar inquiry very 

 recently carried out in Sicily by Dr. Profeta. We have already, in an earlier part of this Report, referred to this 

 investigation, but as we have not seen any account of these researches in any English journal, we subjoin a short 

 translated abstract of Dr. Prof eta's paper. Since the year 1867, the author has collected information regarding 

 114 cases of leprosy in Sicily — 80 men and 34 women. In three-fourths of the cases he was able to trace the 

 disease to inheritance — in a few instances he had to trace the malady in relatives four times removed. In no 

 instance was there any evidence of contagion, although 22 of the lepers had lived with their families for 

 many years. 



Children who had been suckled by leprous women had not, apparently, been infected thereby, nor had 

 re-vaccination with lymph obtained from leprous persons been shown to transmit the disease. (It is not 

 mentioned how long a period has since elapsed.) The inference that leprosy may be dependent in some way on a 

 fish diet is not (as mentioned in a previous page) supported by experience in Sicily, seeing that the disease 

 prevails among the inland population to a greater extent than along the coast ; nor do poverty, want and filth 

 seem to exercise important influence as factors, for the disease is even more prevalent among the well-to-do 

 classes : and, least of all, could the disease be attributed to malarial influences. So that the author has come to 

 the conclusion that heredity is the only ascertained etiological agent in its propagation — " So dass in der That nur 

 die Erblichkeit als atiologisches Moment iibrig bleibt." 



Of the 114 persons, 9 were affected at ages ranging from 7 to 10 years ; 26, at 11 to 20 years ; 39, at 21 to 30 

 years ; 22, at 31 to 40 years ; 11, at 41 to 50 years ; and in 7 cases the disease was not manifested until the 

 persons had reached ages ranging from 51 to 65 years. The duration of the disease, taking the average of all the 

 cases, was 13 years, the minimum being 3 years and the maximum 40. Both the tuberculated and anaesthetic 

 forms of leprosy occur in Sicily, the latter form being somewhat more common than the former. — Virchow and 

 Hirsch's Jahresbcricht uher die gesammten Medicin. — X. Jahrgang, Band I. Abth. 2. S. 431 : Berlin, 1876. 



