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Sutliff says he has every reason to believe that there are at least four lepers not reported for every one that is. Most of them hide themselves in the mountains, and do not like to move about in public.

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Orme, President of the State Board of Health, California, in his instructive treatise on Leprosy, says, "I have no doubt that the practice of secreting lepers is general throughout the world, wherever the disease prevails; and it is not difficult, in an early stage, for lepers to evade the authorities and go about their usual business. The destructive re sults of this misguided policy are everywhere manifest for those who are not too prejudiced to see what is plainly before them.

Leprosy is reported to be increasing in Russia with startling rapidity. Petersburg correspondent of the London Standard, January 18,says: Bergmann discovered thirty-seven cases in the town, and twenty-one in the environs. There are now over one hundred. In and around Dorpat, where the disease has attained alarming proportions, the late Professor Von Wahl strongly urged the necessity of leper colonies, such a system of compulsory isolation being in conformity with the provisions of the existing, but unenforced, law of Livonia.

Petersen and Professor Munch have collected eight hundred and seventeen cases, which, however, must be considered far below the actual number. The former observer has noted forty-three cases from the records of the St. Petersburg hospitals in the last sixteen years. Archdeacon Wright in his instructive work, "Leprosy an Imperial Danger," says that leprosy has increased so much of late in the Russian provinces of the Baltic that last year a "Society for Combating Leprosy" was founded at Dorpat, under the presidency of Professor Wahl, but otherwise composed entirely of lay members.

Hellat, of Dorpat, travelled through the district, and showed that the reports made to the Government were very imperfect. In Livonia, where official statistics reported cases, he found In Courland he discovered 76 cases, and in Esthonia, From other sources I hear that in the neighbourhood of Dorpat the lepers number as many as 17 perand another report says that in certain districts 10 per cent of the population are affected.

From more recent reports May, I learn that the Town Council of Riga, alarmed by the ever-increasing proportions attained by the fearful malady, have just erected a leper hospital, at a cost of 6o,ooo roubles, which already contains 98 authenticated cases. The British Consul at Riga, in his report forsays: Petersburg, Mochovaia, 44, the writer says: The number of lepers in certain districts is as much as 2 per cent, of the population. Furthermore, the investigation showed that the disease was steadily on the increase.

The lepers are allowed to lead an independent life in this quarter; they are allowed to contract marriages, and no supervision, whether medical or otherwise, is exercised over them. It has resulted from the advice tendered him at these consultations that the Emir has decided upon the foundation of a special hospital for the lepers, at which they will be treated by specialists in their disease.

The present writer has been under the impression that leprosy had diminished in Norway, the diminution being generally admitted to be due to the segregation of lepers in the hospitals at Troudhjem, Molde, and Bergen; but Dr. Vandyke Carter, who has closely investigated the subject, considers that: Patterson, the British Consul, to whom Archdeacon Wright had written for information when publishing his book on this disease, and also Dr.

I learned here that in the year there were cases out of a population of 50, but that now, out of a population of 72, the numbers had decreased to I must state, however, that on further inquiries from an older and more experienced doctor near Laugardalir Gudmunson, I think, was the name I was told that the disease was increasing, and that one in every thousand was a sufferer from this hideous complaint.

There are no hospitals for leprosy in Iceland, though Dr. Henderson, who travelled through the island instates that there were four then in existence. During my visits to the Virgin Islands, the Leeward and Windward Islands, and British Guiana,I had opportunity of conversing with intelligent residents, including governors, medical practitioners, superintendents of leper hospitals, magistrates, prison chaplains, editors of newspapers; and the general opinion was that leprosy was largely on the increase.

In some islands, such as Jamaica, St. Kitts, and Trinidad, there are leper communities, which are gradually increasing; and appeals are frequently made in the Colonial Press for their segregation in hospitals. In a dispatch to the Colonial Secretary, Dr. Hall Bakewell, Vaccinator-General, Trinidad, said: On the 22nd January,I visited the lazaretto at Barbados, a crowded institution. A new ward was then in course of construction, to accommodate 32 more patients; but the applications from the single parish of St.

Michael were greater than the extra beds to be provided. I may mention that the island of Barbados comprises thirteen parishes, with a total population of aboutof which St. If the segregation, which includes only the leprous poor and pauper class, were compulsory, as some now demand, the alarming spread of the disease, which is endemic in all the islands, would be yet more fully exhibited.

The Official Gazette, Barbados, May 5th,p.

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The Poor Law Inspector, Mr. The report forTrinidad Royal Gazette, p. Bevan Rakewho are admirably cared for by the French Dominican Sisters. Every bed is occupied. In his report to the Surgeon-General forDr. Since then it has been constantly full. There were then, she said, fourteen lepers in the Colonial Port of Spain Hospital awaiting vacancies for admission to the asylum.

In the last report on leprosy in Trinidad, dated March 1st,by Dr. Koch, acting Medical Superintendent, it is stated p. There was a rush of patients to fill it. The Trinidad Leprosy Report for p. The asylum contains inmates, "every bed being occupied. Twelve years later, when an attempt was made to segregate them upon a small adjacent island, it was found that these afflicted persons had increased so rapidly that the scheme had to be abandoned. In there were out of a population of , and later statistics show that the number of lepers was increasing four times as rapidly as the population.

In a leading article in the St. Christopher Gazette of St. Kittsthe 17th May,entitled, "The most pressing question in the Colony," the writer quotes Dr.

I am satisfied that the disease is increasing rapidly in this island St. Kitts and Nevis contain more lepers per thousand of the population than any other British possession. He also considers that the disease has increased in Antigua, and there are no fewer than lepers in the Leeward Islands. Kitts and Nevis at Munro discovered, by a personal census, that there were 72 lepers at St. Kitts, a number which has now increased toor at the rate of 90 per cent. Kitts, which already contains eighty inmates.

Haynes-Smith, with the request that it might be sent to the Queen. Amongst other things it states that leprosy is most prevalent in these islands, and that the number of persons afflicted with it is rapidly increasing. The London Daily Graphic for August 15th,publishes the following: Munro, formerly medical officer of St. Kitts, West Indies, which shows conclusively that leprosy is extending in that colony.

Boon, referred to by Sir Morell, runs as follows: Kitts; at present there are known lepers, and I think there are a good many more that are kept hidden from the medical men. I am at present getting as complete a list as possible of the lepers here. One thing is very noticeable in Nevis, namely, the way in which the leprosy spreads in each neighbourhood from single cases. It is not easily traced in St. Kitts, as the people there do not own land like the Nevis people, and are consequently more nomadic.

One thing has struck me very much, and that is the number of shop-keepers that have contracted the disease. Leprosy has attacked people of all conditions in the West Indies. Through the action of the then President of the Island, the inspector was forbidden by the Governor to interfere in any way with these lepers.

We count among our lepers other than mendicants bakers, butchers, salesmen in groceries and provision shops, fishermen, printers, editors, circulating - library keepers, shopkeepers, planters, agricultural labourers, and carpenters. In a lodging-house kept by a leper, members of the Bar lodged when on circuit, and slept on the same bed used by the leper when he had no lodgers. Another leper kept a creche, and tended about twenty infants at a tithe in his room for over ten years.

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Our administrator of the islands, Mr. Maling, reports to the Colonial Office that the disease, though perhaps slowly, is surely on the increase; and though the average of patients treated at the Leper Asylum is only 15, there are many more at large. No law exists to compel those afflicted with the disease to go to the asylum and receive proper medical attention, but the subject is one which will receive the early attention of the Local Government.

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Haynes Smith, of the Leeward Islands, who informed me in that leprosy was seriously on the increase in the West Indies, issued an address to the Federal Council in April,in which he quotes the opinion of the medical profession that the disease has greatly increased, and that the only satisfactory explanation of the spread of the disease is that under certain conditions it is communicable and contagious.

In the report of the superintending medical officer of Jamaica, dated July,it is stated that cases of leprosy in the island are known to the district medical officers, but it is conjectured that a good many living in unfrequented districts are not reported, and that some cases in families of the better classes are not to be found in these returns. The actual number is estimated ator one in of the present population of the island, reckoned atThis is a decidedly low estimate.

A new ward, capable of accommodating forty beds, has just been made ready for the reception of these unfortunate patients. A communication from Dr. Lacary, physician to the lepers in the French Antilles, dated Basse-Terre, Guadaloupe, January 16th,and sent by request of the chief of the Sanitary Department at Guadaloupe, in reply to an inquiry for the statistics in respect to leprosy, states that it is impossible to report with accuracy the number of persons known to be more or less subject to leprosy throughout the various districts.

The island of La Disirade, in which the Lazar-house is situated, may afford some. The lepers frequently secrete themselves, and it is impossible to give the exact figures of those who are at large. It is recognised throughout the islands that leprosy is on the increase. As my communications to the Authorities in Japan requesting information remain unanswered, I have but few details to report.

Leprosy has existed from time Immemorial in this country, and there is an old established leper settlement at the hot springs at Kusatsu, to the north of Tokio. Leprosy is reported to be increasing considerably, and according to a communication in the Liverpool Mercury, September 22nd,three leper hospital asylums have been established in Tokio during the past ten years.

One of these hospitals, treated in 6 years cases, of which were those of Japanese patients. The Pioneer Allahabad of September 9th,reports that leprosy has spread in the Japanese villages to an alarming extent during the past few years.

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In one village near Toimachi, in the Gifu Ken province, every inhabitant is a leper. The Japanese Government is taking steps to look after their afflicted people. Mr Hamilton Cartwright, in The Lancet for May 25th,states that vaccination was made compulsory in the seventh year of Meiji It will be noted therefore that the rapid diffusion of leprosy took place shortly after the introduction of the compulsory law, and has kept pace with the progress of vaccination in this community.

Tamanoto, of the Imperial Japanese Navy, says that when leprosy occurs in a family it is the custom to conceal it.

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Father Vigroux, Missionary Apostolic, in an article in the Catholic Review, which also appears in the Tablet, May 14th,says that 44 patients have already been admitted to the Leper Hospital at Gotemba, Japan, founded by the late Father Testevuide. There is accommodation for as many as eighty. In the Island of Samos, with a population of 42, there are 43 registered lepers, and many others unregistered; to segregate whom the Prince of Samos has built an asylum. Dujardin Beaumetz estimates that there are three thousand, some of them at large, and others in the hospitals.

In Syria lepers abound, and the most repulsive examples I ever saw were in the lazaretto at Damascus, where the supervision and accommodation was of the most wretched description. For their comforts they depended on the alms given by casual visitors. In Palestine I noticed many lepers, in the most hideous state of deformity, begging. This was in The Constantinople correspondent of the Times writes July 31st, Like some others, Dr. Zambaco has come to the conviction that leprosy is non-contagious.

He offers practical arguments and proofs in support of his opinion. There are in Constantinople alone upwards of lepers, all of whom Dr. Zambaco has personally attended. In the Islands of the Archipelago there are at Crete lepers; and at Rhodes, Cyprus, Mytilene, Tenedos, and other smaller islands, they are also numerous, and excepting in the larger ones, free in their movements.

Zambaco has prepared to lay before the congress, and for publication, a most interesting work upon the subject of leprosy in the Levant, containing numerous illustrations, portraits, and biographies of patients living and dead, with accounts of curious cases of cure, non-contagion, and remarkable facts observed by him, which cannot fail to attract attention of scientific men with respect to the disease which has come so prominently before the public.

I called at several hospitals, and conferred with a number of officials connected with Government, but without obtaining much information.

Selim Zeidan, the medical director of the General Hospital at Luxor, informed me that during the past few months five lepers had presented themselves for admission, but he was obliged to refuse them. This was due not to want of space, but to lack of funds In a communication to Dr Abraham, dated 4th Nov, and published in the Journal of the Leprosy Investigation Committee, Dr Greene, of Cairo, director of the Sanitary Department, Egypt, states that the total number of cases reported is"but this does not by any means represent the whole of the lepers in Egypt, for many districts, where I have reason to suppose some exist, sent in blank returns.

In a report to Louisiana Board of Health, May,he refers to 42 known cases of leprosy at New Orleans, twelve cases at La Fourcho, and six cases these doubtfulat St. Martinsville; and in only a very small number could he discover the causation in heredity. Other authorities give similar reports of the New York hospitals. Morrow, "is leprosy gaining ground in this country, and the disease prevails over more than a fourth of the habitable globe.

Its rapid increase is by far the most urgent and anxious question of the hour, and successive Medical Officers of Health seem powerless to cope with it.