Tubercular leprosy in Madagascar / by Andrew Davidson.

  • Davidson, Andrew, 1836-1918.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Tubercular leprosy in Madagascar / by Andrew Davidson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the natives are also strongly impressed with the conviction that the disease is inoculaWe. Upon tliis point my cases cast no light. It is highly probable that the same originating causes, which at first gave rise to leprosy, are still in existence and endemic in cer- tain localities. It may spring up now and then under certain circumstances, de novo, without contagioji or hereditary taint. What the originating causes are is a profound mystery. In the island of Madagascar there are a number of different races—of all shades of colour, from the pure Negi-o to the Hovah, whose com- plexion is not darker than a native of Spain. These occupy widely varying climates. The central provinces, from tlieir great elevation, possess a temperate climate, similar to that of the south of France. The climate of the plains, on the other hand, is tropical, and towards the north excessively warm. The circumstances and modes of life of these races are as varied as their origins, and the natiu-e of the localities in which they reside. Yet leprosy affects all alike. The Hovah who lives in European fashion, and in a temperate climate, is no less exempt from this scourge than the African slave. It is found amongst the Betsemasarahas who eat pork, and amongst the Betanmenas who abhor it. It occurs where fish is an article of food ; but it is also to be seen where no fish is to be had, and where rice and vegetables satisfy the simple wants of the population. It exists in town and country,—at the elevation of 7000 feet above the level of the sea, along the coast line, and through all intermediate elevations. Eace, geographical situation, and diet,—all seem abso- lutely unimportant elements in relation to its presence or its spread. Probably the dirty habits so prevalent in many half-civilized nations must tend to aggravate it; eating from a common dish with the fingers; the custom, very common in Madagascar, of inter- changing garments, and of all lying huddled promiscuously together at night, cannot fail to render it more inveterate, even if they do nothing in the way of originating it. It has been a favourite theory with many that leprosy is related to syphilis or to yaws. But what proof is there to substantiate this theory ? Syphilis has suffered marked modification in different ages and amongst different races. Leprosy has remained unchanged through seventy generations and longer, even in the same country. We do not see leprosy result from syphilis in England. The spread of syphilis in the fif'teeutli and sixteenth centuries was not followed by an increase of leprosy, but the reverse. Leprosy seems to be a disease snt generis distinct altogether from syjihilis and yaws ; pro]iagating itself by hereditary transmission and jwssibly hy inoculation. It is probably seldom produced im- mediately and at once in any constitution from the causes originating it, hut (jradually by the persistence of the causes operating tln-ough successive generations. In the treatment of this most formidable disease we are still in the dark. Everything has been tried, and in vain. The utmost