Observations on Leprosy in Great Britain at the Present Time

IN I909 the Second International Congress on Leprosy was held at Bergen and passed the following resolution: "Leprosy is a disease which is contagious from person to person, whatevel may be the method by which this contagion is effected. Every country, in whatever latitude it may be situated, is within the range of possible infection by leprosy, and may, therefore, usefully undertake measures to protect itself." The lapse of more than twenty years has only borne out the wisdom of this resolution. Up to that time there was a feeling in this country that leprosy was not contagious and that any method of enforced segregationi was as unnecessary as it was cruel. This fallacious doctrine of non-contagiosity has died a slow death in the medical mind, and now all of us who have had occasion to deal with leprosy must know how erroneous and misleading it was. Many of us must be cognizant with cases where men have gone from this country to live abroad in some district where leprosy was rife, and through close association with it, become infected. In I925 I reported a series of four contact cases of leprosy contracted in this country, three of them in persons born here anid who had never been abroad. In these cases there was a histoly of prolonged intimate association and actual contact with some other member of the familywho suffered from the disease but had contracted it abroad (Brit. At the present time we have an indefinite number of cases of leprosy in Great Britain. With the exceptioni of the above-mentioned contact cases, they are usually in British subjects, who have come from abroad to settle here either with the knowledge and obvious signs of their afflictioni or in the incubation period without evidences of it and with the symptoms appearing later. The exact number of the cases it is impossible to estimate, and such numbers as from 75 to ioo, which are usually given, though possibly not far out, are simply guesswork. Several reasons are responsible for our want of precise knowledge with regard to the number of cases. First they are liable to be hidden away and the existence of the disease carefully concealed both by the patient and the relatives; then they are apt to go unrecognized, as the disease is fortunately so comparatively rare in this country, that only the few medical men who have …