4^4 Leprosy 2n India. [part ii. 



of misinterpretation than a detailed report where all the qualifying circumstances of 

 any set of deductions can be produced. 



It will have been seen that although leprosy was known to prevail in Hindostan 

 many centuries before the Christian era, comparatively little was known regarding its 

 precise localisation in the different provinces until the general census of 1872 was taken. 

 Not only was the comparative prevalence of the disease in various districts all over 

 British India ascertained at that period, but the possibility of attaining to something 

 approaching to a fair estimate of the aggregate leprous population of the country 

 also became practicable. According to these census returns, there are some 99,000 

 lepers in the territories under British rule, yielding a proportion of 54 lepers to every 

 100,000 of the entire population, or (taking the actual figures in the first Table) 1 leper 

 to every 1,845 persons. Of the aggregate number about one-eighth is contributed by 

 certain districts, each of not less than 100,000 in population, furnishing a ratio nearly 

 five times higher than the average ratio for the whole of India. In these districts 

 there is a leper to every 384 persons instead of to 1,845. Should these latter data be 

 verified on more close observation, an important step will have been made tow^ards 

 solving the difficulty of dealing with the question in a practical manner, as such a 

 phenomenon must depend either on peculiar local or hereditary conditions. 



One of these abnormally affected localities forms the subject of a special report 

 on this occasion, m^., the district of Kumaon. Koughly speaking, it contains 1,000 

 lepers. This yields a proportion equivalent to something over 250 per 100,000 of the 

 population, or, calculating on the actual figures of the estimate, 1 leper to about every 

 388 individuals (vide Table V, page 449). With the object of mitigating the sufferings 

 of at least a portion of this unfortunate class, the Commissioner, Sir Henry Eamsay, 

 has founded an asylum at Almora with accommodation for over a hundred lepers. 



The inmates of this Asylum formed the subject of a series of clinical observations, 

 the details of which are recorded in the foregoing pages. 



Eighty lepers were subjected to the closest scrutiny ; 49 proved to be cases in 

 which anaesthesia presented the most prominent feature; 12 in which the presence 

 of tubercles in the skin was the most marked peculiarity; in 15 cases the two former 

 conditions were so equally evident that they were classified as " mixed ; " and in 4 

 cases an eruption formed the most pronounced symptom. The ratios which these 

 yield agree generally with the proportion in which the different varieties of the disease 

 have been observed to occur in other countries . 



The average age at which the onset of the disease was observed was found to 

 be between 23 and 24 years; even the decimals obtained by calculating averages in 

 the case of male and female lepers were found to be almost identical. There was, 

 however, a range of from 3 years to 60. The average duration of the disease was nearly 

 14 years. The form in which anaesthesia was the prevailing feature was the most 

 chronic, the average duration of the " tuberculated " cases being shorter by nearly 

 six years. 



