charities of New York, Philadelphia, Boston, etc.  The estimated number of lepers a few years ago in the United States varied between two hundred and five hundred.  It is represented as diminishing in frequency in the Hawaiian Islands, Porto Rico and the Philippines.  In the Hawaiian Islands it spread rapidly after 1860, and strenuous attempts have been made to stamp it out by segregating all lepers on the island of Molokai.  There were 1,152 lepers in that settlement in 1894.  In British India, according to the leprosy commission, there were 100,000 lepers in 1900.

Cause.—­The bacillus, discovered by Hansen, of Bergen, in 1874, is universally recognized as the cause of leprosy.  It has many points of resemblance to the tubercle bacillus.  These bacilli have been found in the dwellings and clothing of lepers as well as in the dust of apartments occupied by the victims.

[238 Mothers’ remedies]

The usual vehicle by which the disease is transmitted is the secretions of a leprous patient containing bacilli or spores.  The question of inheritance of leprosy is regarded now as standing in the same position as that relating to the inheritance of tuberculosis; no foetus, no new-born living child, has been known to exhibit the symptoms of either disease.  Several cases have been cited where infants but a few weeks old exhibited symptoms of leprosy.  It affects men more than women.  Infection is more common after the second decade, though children are occasionally among its victims.  When it occurs in countries where it had not previously existed, its appearance is invariably due to the infection of sound individuals by lepers first exhibiting symptoms where the disease is prevalent.

Neisser states this:  “The number of lepers in any country bears an inverse ratio to the laws executed for the care and isolation of infected persons.  The disease appears to spread more rapidly in damp and cold, or warm and moist, climates than in temperate countries.  It is not now regarded as contagious.  The leprosy of the book of Leviticus not only includes lepra, as that term is understood today, but also psoriasis, scabies and other skin affections,” The leper, in the eye of the Mosaic law, was ceremoniously unclean, and capable of communicating a ceremonial uncleanness.  Several of the narratives contained in the Bible bear witness to the fact that the Oriental leper was seen occasionally doing service in the courts of kings, and even in personal communication and contact with officers of high rank.

Symptoms.—­Previous symptoms:  Want of appetite, headache, chills, alternating with mild or severe feverish attacks, depression, nosebleed, stomach and bowel disturbances, sleeplessness.  The durations of these symptoms is variable.  Some patients will remember that these symptoms preceded for years the earliest outbreak of lepra (leprosy).  In other cases only a few weeks elapsed.  These earlier skin lesions are tubercular, macular (patches), or bullous elevations of the horny layer of the skin.  It may then be divided into three varieties tuberculous, macular and anaesthetic.