EEPROSY 2 
By JOHN A. JOHNSTON 
(From the Bacteriological Laboratory, Bureau of Science, Manila, P. I.) 
Leprosy may be defined as an extremely chronic, practically 
incurable disease, with a long incubation period of from two to 
ten years, according to various authorities. Prodromal symp- 
toms are stated to exist, but they can hardly be definitely stated 
to be peculiar to leprosy, as they are usually so indefinite, con- 
sisting of malaise, attacks of fever, sweating, and somnolence. 
Two well-defined types of the disease exist: namely, the 
nodular or tubercular and the anesthetic. A combination of 
these two may give rise to a third division—the tuberculo or 
maculoanesthetic or mixed. 
Leprosy existed throughout the world several thousand years 
before Christ. A disease is mentioned in the Hindu sacred 
writings and also in the Ebers papyrus which is similar to what 
we now call leprosy. Ancient writers undoubtedly confused 
other skin diseases with leprosy, but it has been well established 
that leprosy was introduced into Europe from Egypt in the 
first century before Christ by the returning troops of Pompey. 
The returning crusaders in the fourteenth century spread the 
disease generally over Europe. It is stated that in France alone 
there were over 2,000 leprosaria. Very drastic segregation 
seems to have been established, so that by the end of the fifteenth 
century the disease had practically disappeared. At the present 
day in Europe there are a few isolated cases in Norway, Sweden, 
Turkey, the Balkans, France, Germany, Spain, and the British 
Isles. Outside Europe leprosy is found in Africa, which is 
heavily infected, China, Japan, India, the Philippines, the 
United States, Hawaii, and in many of the islands of the Pacific 
Ocean. — 
In the Philippine Islands the records show that the disease 
was introduced from Japan. The early missionaries from the 
Philippines had made strenuous endeavors to obtain a foothold 
in that country. The Emperor finally advised the church 
*Read before the Manila Medical Society, July 12, 1915. Received for 
publication October 2, 1915. 
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