Treatment.—­Absolute rest.  Lying down treatment if begun early arrests this disease often.  Build up the system.  Splints and brace are needed sometimes.

Knee joint disease. (White Swelling).—­This is simply a tuberculous knee.

Treatment.—­Rest.  Stop motion of the joint by some form of splint or plaster of Paris cast.  Get a good physician at the beginning in these cases and you will save lots of after worry and blame for yourself.  It does not pay to wait.  These joint diseases will progress, and often treatment is begun months after trouble is seated.  It ought to be criminal negligence and dealt with accordingly to neglect such diseases.  Parents should never forget that they have endowed their children with such a constitution, and they should be glad and willing to correct it as far as they can.

[Infectious diseases 237]

Leprosy.  Definition.—­Leprosy is a chronic infectious disease, caused by what is called the “Bacillus Leprae,” and is characterized by the presence of tubercular nodules in the skin and mucous membranes (tubercular leprosy), or by changes in the nerves (anaesthetic leprosy).  These forms are separate at first, but ultimately they are combined and there are disturbances of sensation in the characteristic tubercular form.

History.—­Leprosy is supposed to have originated in the Orient, and to be as old as the records of history.  It appears to have prevailed in Egypt even so far back as three or four thousand years before Christ.  The Hebrew writers make many references to it, and it is no doubt described in Leviticus.  The affection was also known both in India and China many centuries before the Christian era.  The old Greek and Roman physicians were familiar with its manifestations, ancient Peruvian pottery represent on their pieces deformities suggestive of this disease.  The disease prevailed extensively in Europe throughout the middle ages and the number of leper asylums has been estimated at, at least, 20,000.  Its prevalence is now restricted in the lands where it still occurs while once it was prominent in the list of scourges of the old world.

It is now found in Norway and to a less extent in Sweden, in Bulgaria, Greece, Russia, Austro-Hungary and Italy, with much reduced percentage in middle Europe; it is the rarest of diseases in England where once it existed.  In India, Java, and China, in Egypt, Algiers, and Southern Africa, in Australia and in both North and South America, including particularly Central America, Cuba, and the Antilles, it exists to a less extent.  It has been recognized in the United States chiefly in New Orleans, San Francisco, (predominantly among the Chinese population of that city).  The disease has steadily decreased among the latter colonists in Minnesota, Wisconsin and Iowa.  Isolated cases have been recognized in almost every state, and leprous cases are presented at the public