FEBRUARY 25, 1904] 
INA TROLLS, 
395 
area approached, marked by east winds blowing from 
a continental region of high pressure in the south. 
The storms so characteristic of the south polar region 
were here experienced in their full force. 
the only land actually inspected was the solitary peals 
of the ‘‘ Gaussberg,”’ the whole character of the neigh- 
bourhood, with its vast sheet of ‘‘ inland-ice,’’ was 
such as to argue the existence of a continental mass 
stretching southward from the Antarctic circle. The 
ancient crystalline character of the rocks and the 
sudden fall towards a deep sea in the north point in 
the same direction. Valuable observations of the ice- 
conditions, both of the sea and land areas, were made, 
and the paper in the Zeitschrift is accompanied by 
excellent photographic representations, one showing 
the stratified formation of an iceberg being especially 
noteworthy. i 
THE “FISH HYPOTHESIS” AND THE 
TRANSMISSION OF LEPROSY. 
(eee SY is a disease that has been known from 
the earliest times, and in the British Isles was very 
prevalent in the twelfth and thirteenth centuries. At 
the present time, though unknown in many countries, 
it is impossible to traverse any large tract in any conti- 
nent without meeting with cases, Norway, the Medi- 
terranean littoral, India, China. certain of the Pacific 
islands and various parts of America and Africa 
being preeminently the seats of the disease. A bacillus 
having a strong resemblance to the tubercle bacillus is 
present in enormous numbers in the leprous tissues, and 
is regarded as the specific virus, though it is non- 
inoculable into animals, and, with doubtful exceptions, 
has never been cultivated. 
The transmission of the disease is generally regarded 
as being due to personal contagion, and there are 
many facts in support of this view. Segregation of the 
lepers is believed to be eradicating the disease in Nor- 
way; the introduction of a case of leprosy into a place 
previously free has been followed by a great spread of 
the disease, as in the Loyalty Islands, and many in- 
stances are on record of persons contracting the disease 
after associating in some way with the sick, whose 
secretions swarm with the bacilli. 
For some months past, Mr. Jonathan Hutchinson, 
F.R.S., has been strenuously maintaining his ‘ fish 
hypothesis ’’ of the origin and transmission of leprosy 
with an ardour and with a wealth of facts and figures 
that must strike all with admiration. Moreover, Mr. 
Hutchinson has recently undertaken two journeys, to 
India and to the Cape, in order to collect data in sup- 
port of his hypothesis, no light undertakings for a man 
of his years! 
fish hypothesis assumes that in all ages and in all 
countries, leprosy has been and still is due in the main 
to the consumption as food of decomposing or imper- 
fectly cured fish. 
receives modification in connection with some specific 
virus (toxin or bacillus) which is occasionally, but by 
no means frequently, developed in connection with such 
fish. It assumes that, if the virus be present, a very small | 2 
| states that in Iceland, during the five years after the 
quantity of fish may suffice to produce the disease in its 
full vigour, whilst, if it be absent, large quantities may | 
be habitually consumed without any result. It is a 
specific poisoning which occurs, and by no means 
merely a form of ill-health due to unwholesome diet. It 
has no degrees of less or more, and is either contracted 
in its totality or wholly escaped. Thus, all who eat 
fish in bad condition are supposed to run some risk; 
and those who eat it habitually and largely encounter 
that risk more frequently than others. 
NO. 1791, VOL. 69] 
Briefly stated in his own words, ‘‘ the | 
e 1 It is thought probable that the | 
disease is a modification of tuberculosis, and that it | 
Although | 
It is, however, | 
| cumstantial, not demonstrative. 
the quality and not the quantity with which chiefly we 
are concerned—the presence or absence of the specific 
virus. For the present the existence of such a virus is 
a matter of hypothesis, for it has never been isolated 
from any specimen of fish. Thus the evidence is cir- 
Mr. Hutchinson has directed attention to the inci- 
dence of leprosy among Roman Catholic communities ; 
this he attributes to the use of fish during the fasts 
ordained by that Church. Believing, as he does, that 
personal contagion plays little or no part in the spread 
of the disease, he advocates the abolition of leper 
asylums or at least a great mitigation in the severity 
of the laws as regards segregation, especially in Cape 
Colony. 
Mr. Hutchinson’s hypothesis is doubtless supported 
by many facts, and there is a remarkable coincidence 
between fish-eating and leprous districts. Thus in 
India generally the incidence of leprosy is about three or 
four cases per 10,000 of the population, but in the island 
of Minicoy, devoted to fishing, it rises to 150, and in 
Kaligoan, a fish-curing centre, to 500. The decline of 
leprosy in the British Isles he would attribute to the im- 
provement in the food of the people and to the intro- 
duction of the reformed faith, whereby fasting was 
abolished. There are, however, grave difficulties in the 
way of accepting the fish hypothesis as proved. It is 
almost certain that leprosy is met with among peoples 
who rarely or never touch fish, e.g. the Basutos, as 
pointed out by Dr. Turner. Mr. Hutchinson has con- 
troverted this statement, alleging that Dr. Turner’s 
witnesses were not to be believed, but surely the same 
argument may be applied to much of Mr. Hutchinson’s 
own evidence. Mr. Hutchinson states that on several 
occasions he has by cross-examination obtained an 
admission of fish-eating that had previously been 
denied. But the cross-examination of an ignorant and 
perhaps terror-stricken native by a casual visitor is 
hardly calculated to elicit the truth, and must be carried 
out with the greatest circumspection or the examinee 
will infallibly admit that which he believes is required 
of him. On this ground much of Mr. Hutchinson’s 
evidence must be regarded as untrustworthy. Then 
there is the difficulty as to why fish in bad condition 
conveys the disease, whereas good fish, fresh or dried, 
is innocuous. Why is the virus present in bad fish and 
not in fresh fish, where does it come from, and how does 
it get there? These are questions that require an answer, 
for it is admitted that the leprosy bacillus has never 
been met with apart from the leprous person; there is 
absolutely no proof, or even suspicion, that fish har- 
bour the leprosy bacillus. Orkney and Shetland for- 
merly suffered greatly from leprosy, but Mr. Traill 
Skae, in a letter to the British Medical Journal, entirely 
denies that the food of the people has rmucn improved 
and asserts that enormous quantities of bad fish are still 
consumed. It would seem much more likely that the 
civilisation of a people that will eat bad fish is low and 
that promiscuous intercourse of all kinds is, therefore, 
habitual, leading more readily to personal contagion ; 
this would explain the connection, if there be one, be- 
tween the consumption of bad fish and leprosy. 
As regards segregation being useless, Dr. Ehlers 
opening of the asylum in 1899, the number of lepers, 
which had previously been increasing, diminished by 
one-fourth. The statement that segregation is use- 
less is against all experience, though there is, doubt- 
less, much to be said for a modified form of segregation 
and for a revision of the leprosy enactments in Cape 
Colony. 
With regard to the remarkable waxing and waning 
of leprosy in many countries, this is seen in nearly every 
