tortures are in his blood; he is cast out from the society of his fellow. men, and forbidden to touch, in friendship or affection, the hand of the untainted." And yet, life such as that, he thinks worth having, and struggles to perpetuate it.

Geo. K. Kendall, in his narrative of the Texan Santa Fe Expedition (Vol. II., p. 220), describes the lazarinos or lepers of the Hospital San Lazaro. He says it appears in many different aspects.

In 1844, the existence of leprosy in New-Brunswick attracted the attention of the provincial government, and a medical commission was appointed to investigate it. The report of the Committee clearly shows that the disease was the Greek leprosy, having no affinity with elephantiasis.

Causes.-Drs. Boeck and Danielssen have maintained that leprosy is a thoroughly hereditary disease, that it descends from generation to generation; they think it descends more by the collateral branches than by immediate succession; and that it frequently skips over one, two, or three generations, to reappear with fearful severity in the fourth. The belief in hereditary transmission was so general in Norway, that a proposition was laid before the Storthing, in 1754, to prohibit the marriage of all lepers, and of their immediate descendants; the bill was debated but was rejected.. Dr. Hjort thinks the disease not entirely propagated by contagion.

Contagion.-Denied by Hjort, Danielssen, and Boeck; but Hoegh, in his report, 1855, is inclined to admit a secondary infection through the acarus scabiei, so frequent on the skins of lepers. He says the crusts and horn-like elevations that, in many cases of spedalsked, cover the arms and face, are now found to be composed entirely of the remains of acari closely agglutinated together; and, on removing forcibly these crusts, living acari are to be found on the ulcerated surfaces beneath. In one family, residing at a height of 2,000 feet above the sca-level, a female, aged twenty-five, of a family not related on either side to any leprous subject, by associating with a leprous girl, became a year after affected with leprosy; she then communicated it to her sis ter, her brother; then her mother.

Other External Influences.-Dr. Hjort attributes the increase of leprosy in Norway to extension "of the great sea fisheries" on the coast of Norway, "exactly in those parts of the coast where the spedalsked is most prevalent." In the last century there existed large fisheries on the coast of Sweden, and leprosy was very common there. In 1807, the herring shoals left the coast, and immediately showed themselves on the coast of Bergen; leprosy declined on the Swedish coast, and in 1837, the hospital of Uddevalla had hardly a single leper, but since the transfer of herring fisheries to the coast of Norway, leprosy has gradually extended.

It is a disease of the sea-coast, but extending up along the fiords or inlets which descend towards the sea, and along which the fishermen are congregated. There the air is damp, loaded with sea-fog, though the winter cold is intense; swampy land, stagnant waters, the water intolerable. The houses are small, with small windows, little light; windows always nailed down, never opened, or the house aired or swept once a year. The dog and pig live in the hut with the family, who eat, cook and sleep in the same room. The children go without shoes to herd the cattle on the hills from which the snow is melting; they endure the storms of spring, the rains of summer, and the heavy mists of autumn; they sleep in their unchanged clothes, which are rarely if ever washed; face and hands may be washed twice a week, the feet once a year; the rest of the body, never.

From the first of January to the end of March, the hardest period of the northern winter, the men are engaged in the herring-fishery. They spend the night on the bare ground under an upturned boat or a sail spread as a tent. The men are packed together, lying side by side upon the floor in their wet clothes. The condensed vapor from the breath and that from the wet clothes drips upon them from above; and the air, filled with offensive exudations, is unfit for respiration; cleanliness is totally neglected. The greater part of the day is passed at sea, half frozen in an open boat.

From the first of February to the middle of April, the Norwegian peasants

Not less than 3,500 boats, each manned with six men, assemble at these fishing stations

"Around the shores where runic Odin

Sings his death-song to the gale."

To these dreary isles, beyond the Arctic Circle, they make their voyages' and return in the course of two weeks, having neither changed nor dried their clothes in the time, having slept on "the soft side of boards" for beds, twenty men in a lodge that had no chimney to favor the escape of smoke; the floor is never swept, and the accumulating filth is never removed.

The food of these people, among whom leprosy is increasing in the midst of the advancing light of the nineteenth century, consists chiefly of fish.-Salt fish, imperfectly preserved, having lain too long on the shore waiting for a purchaser. When no purchaser comes, the halfputrid fish are partially salted, and after a lapse of some weeks they are "pickled," that is, soured by becoming half-rotten. A vitiated taste acquired by long use, leads the peasant to prefer the tainted fish to

those fresh from the sea; and they seldom eat any until the process of decay is far advanced. Other meats, if used in Norway, are hung up in a salted state for years.

LEPRA GRÆCORUM. (ELEPHANTIASIS OF THE GREEKS.)

DEFINITION.-Dusky-red or livid tubercles of various sizes on the face, ears, and extremities; thickened or rugous state of the skin; diminution of its sensibility, and falling off of the hair, excepting that of the scalp; hoarse nasal or lost voice; ozona,-ulcers of the sur face, and extreme fœtor.

Tubercular Lepra of the Middle Ages.-This is the true lepra anaesthetica; lepra tuberculeuse of the French; lepra græcorum of the middle ages. Dr. Valentine Mott says he examined this disease at Athens, in 1842, and found it to resemble syphilis, though it is a "more formidable and apparently more chronic affection than syphilis." He thinks the ancient leprosy of the Jews, "the progenitor of them all;" and that on more thorough investigation, the ancient leprosy and the modern syphilis will be found to be more nearly related than has yet been supposed. Mercury and Arsenic were found the best reme dies for both.-(Travels in the East, 1842.)

The Greek leprosy is a hereditary and contagious disease.* It was introduced into Western Europe at the time of the crusades. It has gradually disappeared in the lapse of centuries, though it is still endemic in Egypt, Java, some parts of Norway, and Sweden. It is characterized by, "hard, insensible tubercles, which appear upon the skin, and are accompanied by a progresive insensibility, and the loss of the voice. The tubercles appear on different parts of the skin; they are hard, rough, and numerous, and cause the loss of the hair at the places where they appear. They finally terminate in ulcers, which penetrate even to the bone, producing a caries. They also cause the separation of parts of the body,-the toes and fingers, for example, dropping off. There is also languor in the motions, a dullness in the senses, a change in the voice, offensive breath, and lethargy. It appears in three forms: 1. The squamous or scaly. 2. The crustaceous, in which the skin is cov ered with crusts. 3. The tuberculous.

LEPRA ANESTHETICA.

It commences in spots or patches, which are of a somewhat lighter shade or color than that of the adjoining surface in blacks, and a tawny color in whites. These patches appear first in the feet, hands. legs, and arms, and seldom on the face and trunk, till a more advanced period. They sometimes seem slightly prominent, from the thickening

* See "Good's Study of Medicine." Doane's Edition, 1840.

of the several tissues of the skin; and they are rough, and apparently wrinkled, from minute indented lines; but the wrinkles do not run into the surrounding skin. The hairs, if any have previously existed in the seats of these patches, fall out or cease to grow in them. The patches are insensible, and extend slowly over the legs and arms to the trunk, until the extremities, and sometimes also the greater part of the surface of the body, are more or less affected and deprived of feeling. The affected surface is unperspirable, and neither itchy nor painful, nor swollen. As the disease advances, the pulse becomes slow and -soft, and the bowels constipated; the toes and fingers are benumbed, as if with cold,-shining, slightly swollen, and stiff.

Dr. Danielssen (Norse Magazin, Christiana, 1852) reports seventy cases of "spedalsked," or lepra græcorum, of whom eleven had it in the anesthetic form. Of the anesthesia of the extremities, he says: "It is the result of inflammation of the sheaths of the nerves, indicated by excessive sensibility of the skin; and this is followed by the deposit of the whitish-yellow albuminous matter between the fibrils of the nerves, compressing them, and at length producing total loss of feeling in the parts to which the nerves are distributed." When the cutaneous nerves are inflamed in this manner, they can be felt as hardened cords beneath the skin; and where there is hyperesthesia of the hands, the ulnar nerve at the elbow is so extremely sensible that the patient almost faints with pain if it is slightly compressed." These symptoms show that the disease is an inflammatory affection; but it is a dyscrasic inflammation, having a constitutional cause, over which antiphlogistic measures and local treatment have no control. Dr. Danielssen says, there is an excess of albumen and fibrin in the blood, and to this point his treatment is chiefly directed. He restricts the patient to a vegetable diet and steam baths. Other measures have been tried with little result, as it seems that out of seventy cases hardly one was cured. Iodide of Iron was his principal dependence in the anesthetic form of the disease.

Oxalic-acid has been extensively tried since 1851, but it had no perceptible effect, though continued for many months. One girl, aged fifteen, took 2 to 24 drachms daily of the pure acid with perceptible effects. When seven or eight grains were given every two hours, the pulse in some cases suddenly dropped to seventy beats per minute. Leprosy, says Dr. Danielssen, "is a disease which, left to itself, never dies out; it follows its prey through successive generations, even to the last scion of the race."

Some cases of this disease, generally from the tropical parts of America, have been treated by physicians of New-York. One of these is described by Dr. H. M. Smith, in the American Homeopathic Review, Nov., 1862:

W. T. aged twenty-four, born in Demarara, of English parents, was one of twenty children. Was vaccinated when a few months old; instead of the true vaccine pustule, small black sores appeared, which discharged thick black pus. From this beginning the leprous affection extended throughout the system; resisted all treatment at home, in Barbadoes, and England. He now presents the following appearance: "Thumb and fingers of the right hand are gone from the metacarpophalangeal articulation, and all the phalanges of the fifth finger are gone. All that remains is about half of the first phalanx of the index finger, one-third of the first phalanx of the fourth finger, and the first phalanx of the third finger. He has lost the toes of both feet, from the metatarsal phalangeal articulation, with the exception of the first phalanx of the left fifth toe, which was then denuded and coming off. On the hands are a number of hard red pustules, from one-eighth to three-eighths of an inch in diameter. With this exception the skin appears smooth and dry, and over the three remaining joints of the left hand are deep fissures; where the fingers have been the skin has healed, as over a stump after amputation. There is no sensibility of the arms below the elbow, nor has there been for years; the legs are likewise insensible from the knees down. The feet differ in appear ance from the hands: instead of the skin being dry and cracked, it is soft and moist, and has disappeared on the soles-leaving ulcers on each foot its entire breadth. Otherwise than this disease of the hands and feet, he says his health is good. In cold damp weather he is troubled with a cough, but this is always relieved by homoeopathic medicine. The patient is intelligent, and has received a common education."

The concentration of the constitutional affection upon the extremi ties seemed to be effected by a bruise in the palm of the right hand; a swelling was observed the next morning, which was lanced, and discharged freely. From this time he had no use of his hand; the fin gers became flexed, and he was unable to open them except by taking the fingers of the other hand. After coming to this country, "a fissure in the skin was observed on the distal end of the index finger of the right hand; the nail came out, and the fissure spread, making 'four slits,' as far as the last joint. The phalanx became circumscribed with dry skin, which was poulticed with bread and water, and peeled off until the bone was denuded, and was knocked or fell off. In this way the third phalanges of all the fingers of the right hand were lost. The fifth finger of the left hand was not affected, the disease extending no further than the second joint. The disease then returned to the right hand, this time extending only half the length of the second pha langes;-next the thumb of the left hand became affected, and healed The right foot was attacked next; what was supposed to be a corn