IS LEPROSY A TELLURIC DISEASE P 
783 
Thus, for instance, the prevalence cf leprosy in Europe in the 
Middle Ages is frequently— and, I venture to add, lightly— ascribed 
to the return of leprous crusaders from the East. But according to 
Haeser,* * quoted by Sir John Simon, notices of leprosy in Europe go 
back to the 4th century, and in the Oth and 7th centuries there 
were already leper-houses in France and Lombardy • and that makes 
it impossible to exclude the influence of locality, and to distinguish 
the alleged epidemic from recrudescence of a local infeetivity. Then, 
again, you are all aware, doubtless, that the present prevalence of 
lepra among the natives of the Hawaiian Group has frequently been, 
and indeed is usually, ascribed to the importation of Chinese lepers 
about 1855 or I860. But if you consult the papers on leprosy in 
Hawaii, collected by the Board" of Health, and the review thereof by 
the Hon. Walter M. Gibson, the Minister who presided over the 
board and over collection of the documents referred to, you will have 
no difficulty in perceiving, first of all, that the beginning of leprosy in 
that group is unknown, and, secondly, that there is strong reason to 
believe that the disease was present among the aboriginals as early as 
1822 — and how much earlier no one knows, nor ever will know now. 
With these opinions Hr. Arthur Mouritz, who, as well as Mr. Gibson, 
had taken great pains to learn the history of the endemic there as far 
as it could be learned, agreed in an appendix to the collection, the 
whole of which was issued in lSSG.f It is misleading to speak of such 
cases as those I have mentioned, and some others which vou will 
notice from time to time if you read with sufficient cautiousness, as 
though there were evidence to establish a fact, ancl especially a fact 
such as this, which really is of fundamental importance. The truth 
seems to he — and all who have critically considered writings on the 
course of leprosy cannot hut agree with me— that writers on this 
subject usually entertain the prepossession that lepra is maintained by 
communication with the sick, and forthwith cither unconsciously bend 
the facts to accommodate their prejudice, or, which comes to the same 
thing, take for granted a great many important points as to which 
there is in reality no evidence at all. 
Hitherto I have spoken only of a contagium, and of man, as 
though conjunction of the two were all that was necessary, and as 
though all men were equally susceptible. If it were thought that the 
contagium resided in localities, then very little could be said as to 
comparative susceptibility, for reasons which 1 shall give before con- 
cluding ; hut if it were assumed that the contagium was communicated 
by the sick, then it would be pretty clear that all men were not equally 
acquainted that leprosy can be maintained by communication with lepers ; and it is 
remarkable that writers who hold contagionist views should not have made extended 
and special use of a case which furnishes them with unique support to their opinion. 
By the side of this example Dr. Khler's account of Iceland (Da Semaine Medicale, 
Nov. 17, 1804) and that of Leprosy in New Caledonia, and its transmission to the 
lie des Pins, by Dr. F* Form* (Arch, de Medicine Navale, vol. 54, 1800, p. 185), have, 
in my opinion, but sliglffc evidential value. And so with others. But as regards the 
subject of the present paper it will suffice to remind the reader that disproof of the 
hypothesis now put forward requires that some isolated area should be pointed out on 
which a population had lived leprosy free for long before leprosy began to spread among 
them subsequent t.o a known importation of lepers. 
* “English Sanitary Institutions,” 1890, p. 30. But also several other writers 
besides Haeser. 
+ Report by the President of the Board of Health to the Legislative Assembly of 
1886, on Leprosy. Honolulu, H.I., 188G. 
