1888 - 89 .] Dr R. W. Felkin on Tropical Diseases. 
299 
Geographical Distribution .— Leprosy is endemic at the present 
time in Egypt, and throughout the whole of the basin of the Nile, 
as well as on the shores of the Mediterranean and Red Seas. It is 
very prevalent in Abyssinia, on the coast, on the plains, and in 
the hill districts. It is also endemic at Zanzibar, Mozambique, 
Madagascar, St Marie, Mauritius, Reunion, St Helena, in the Canary 
Islands, and on the west side of the island of Madeira. It is met 
w T ith in Algiers and Morocco, but is rarely seen in the Azores, and 
Tripoli and Tunis are said to be free from it. On the west coast of 
Africa leprosy is endemic in a very extensive area, extending from 
Senegambia to Cape Lopez. In this region it exists all over Sene- 
gambia and Sierra Leone; it overspreads the districts watered by the 
Niger and the Binue, as well as the whole of the Cameroons district. 
Leprosy is not met with on the Loango coast, and Angola as well as 
the Congo are free from it, as also is the province of Natal, but it is 
endemic to a considerable extent at the Cape and in Zululand. 
Passing on to the endemic area of leprosy in Asia and the Archi- 
pelagos adjoining it, it is to be noticed that India and the eastern 
parts of Asia are the most affected. In Nearer Asia the disease is 
endemic in a few limited areas; e.g ., on the southern coast of Arabia, 
especially at Muscat, as well as in the centre of the country. The 
mountainous districts of Persia, Syria, and Cyprus are affected, as 
are also some parts of Turkestan, especially Samaracand, Miankal, 
and Hissar. In Asia Minor it is now only endemic in isolated spots 
— at Smyrna, in the neighbourhood of Sinope, and on the shores of 
the Black Sea. It is met with all over India, but is least prevalent 
in the Madras Presidency. The disease is fairly common in Ceylon, 
but chiefly on the south and south-western coasts, and endemic areas 
are found in British Burmah, in the peninsula of Malacca, in Siam, 
and Cochin-China. In the East Indian Archipelago the most import- 
ant areas of endemic leprosy are on the west coast of Java and in its 
mountainous regions, the disease being more rarely met with on the 
southern and eastern coasts. Leprosy is also endemic in the Anda- 
mans and Nicobars, in the elevated and inland regions of Sumatra, on 
the west coast of Borneo, in Celebes (province of Menehasse), in 
Elores, in the interior of Timor, in Banda, and in the Philippines. In 
the Chinese Empire the areas of endemic leprosy are chiefly confined 
to the southern and eastern coasts ; it is rarely met with in the 
