The lepers were, as a rule, idle, insolent and insubordinate, and knowing the incurable nature of their disease reckless and desperate to a degree. Half-castes, Malays, especially those whose morality was below the average, or those whose diet was, as a rule, confined almost exclusively to fish, I was told were more susceptible to the disease than Europeans. On making inquiries I learned many horrible facts. Among others I found the bath-room and the kitchen to be identical, one place only being provided for them in which to live, eat, drink and sleep, the “wash” or refuse and almost certainly contaminated food actually being used to feed the pigs and poultry, and, “Horror on horror’s head” the miserable sufferers themselves could be seen rolling about in squalid filth, their clothes soaked and besmeared with the discharges from their festering sores. No one seemed to have power or inclination to manage them; neglected and forsaken, they were left to the charge of fellow lepers as helpless as themselves, Horace’s “Quis custodiet ipsos custodes?” never having a better exemplification.
Dr. Wynne, the assistant medical officer in charge, who has had considerable experience of this disease in Bulgaria and Constantinople, although not noticing among the common fowls the tender-footedness, bowing of the legs, incurvated claws, and the nodular articulations which are the earliest symptoms of the disease in animals, yet distinctly stated in evidence before a select committee of the house of assembly in 1883 that he had come across pigeons, mice, pheasants and turkeys unmistakably suffering from leprosy; and he further remarked at the time that “the communicableness of this disease to animals is a matter of great importance, for the reason that it may also be communicable to human beings through the agency of animals suffering from the disease being used as food.”
After seeing and conversing with these poor social outcasts, and at the same time having had convincing proofs afforded me every day, from outside sources, of the increase of leprosy among the lower and colored classes, I left the island with the conviction that nothing but complete segregation could ever stamp out this dreadful disease. The success which has since 1865 attended the complete isolation of affected persons in the Sandwich Islands, where leprosy was unknown before its introduction by the Chinese in 1848, as compared with the immense strides the disease was then making, should be an inducement to our legislators to adopt the most stringent measures here, the more especially seeing how widespread this terrible and loathsome disease is becoming. It may not be generally known, but it certainly bears out the generally received theory of the contagiousness of leprosy, that the apostle of the lepers of Molokai is beginning to pay the penalty of his heroism. Shut away from all civilized and healthy humanity, Father Damien has for years been a willing prisoner in the island in which are collected and confined the lepers of all the neighboring Sandwich group. For a long time, though cut off from the outward world, Father Damien continued in good health, though alone among the dead. But the stroke has fallen at last. In a letter written recently he says: “Impossible for me to go any more to Honolulu on account of the leprosy breaking out on me. The microbes have finally settled themselves in my left leg and my ear, and one eyebrow begins to fall. I expect soon to have my face disfigured. Having no doubt myself of the true character of my disease I feel calm, resigned and happier among my people. Almighty God knows what is best for my sanctification, and with that conviction I say daily a good ‘Fiat voluntas Tua.’” Where is the heroism which will vie with this? And does not Father Damien’s martyrdom tend to establish the contagious nature of the scourge?
The following extract from the “People’s Medical Adviser” (London), bearing upon the question, is interesting: “The following is a summary of an account in the New York Medical Record, of the first attempt to use a condemned criminal for the solution of an important and scientific question at the Sandwich Islands. It appears that more than two years ago the government procured the services of Dr. Edward Arning, for the purpose of having a thorough and scientific study made of leprosy. Attempts were made to cultivate the bacillus lepræ, which is uniformly found in the diseased parts, but not in the blood, by Kock’s method, using various media, but without success. Numerous inoculation experiments upon lower animals were made, but although the bacilli would grow at the points of inoculation for a long time, the animal never became infected. At last Dr. Arning obtained permission to make an inoculation upon a condemned criminal, whose sentence was commuted to imprisonment for life. With the convict’s written consent an inoculation of leprous matter was made in his arm, and bacilli were found in the sore or the scar up to fourteen months after the operation; no constitutional symptoms being observed. One further observation of importance was made by Dr. Arning; he found that in putrid leprous tissues, and even in the body of a leper who had been dead for three months, the bacilli were found in great numbers. This seems to bear against their specific pathogenetic function. Owing to difficulties with the health board, it is stated that it is highly probable Dr. Arning will be obliged to discontinue his work of research. With respect to the cultivation of bacillus, Dr. Neisser, of Breslau, appears to have been more successful than Dr. Arning, for he has recently stated that in a few cases he has observed an exceedingly slow growth, and he also claims to have recognized spores, which the Hawaiian observer has so far failed to do.”
I do not consider, however, that these experiments in any way prove the non-communicability of the disease, when we take into consideration the length of time (ten to fifty years) that leprosy takes to destroy the general run of its victims.
Not only can it be seen here and there over the whole Cape Colony, at Fort Beaufort, Malmesbury, Saldahna Bay, Caledon, Fraserburg, Calvenia, Clanwilliam, Hopetown, in Fingoland and Namaqualand, but even at Weeren and Alexandra County, especially in the Amapapeta location. In Natal its ravages are attracting attention among the members of my profession and philanthropists generally. In the latter colony a commission was appointed on January 27th, 1885, by Sir Henry Bulwer to inquire into the extent of leprosy then existing. The report of that commission was published in the Natal Government Gazette of September 23d, 1886, and conclusively demonstrated that leprosy was widely spread and was slowly increasing among the native population, and recommended as a means of checking the disease the enforcement of strict segregation. Surely some method for its arrest or eradication might be taken from the lessons taught by other countries and from experience of the past! After the crusades in the fifteenth century leprosy played sad havoc in Europe, but taking alarm in time the lepers were sought out and separated from their fellows, Norway being the only country in Europe where this system was not adopted, and while the disease has disappeared in other lands, in the last named, after the lapse of more than three hundred years, it still lives.[[75]] This disease is also found in Greenland, Iceland, where it is termed “likthra,” in Lapland and the Faroes, but in these more northern regions, as leprosy is not considered to be contagious, its victims are objects more of pity than disgust. I believe that many local, lay and professional men think it a far-off disease, entombed in biblical lore; if so let them at once disabuse their minds of this idea and learn that this awful malady is a rapidly increasing scourge of to-day, extending from the North Pole to the South, from Iceland to Australia, India and America; Africa and Arabia supplying their quota of victims. “It distorts and scars and hacks and maims and destroys its victims inch by inch, feature by feature, member by member, joint by joint, sense by sense, leaving him to cumber the earth and tell the horrid tale of a living death, till there is nothing human left of him. Eyes, voice, nose, toes, fingers, feet, hands, one after the other, are slowly deformed and rot away, until at the end of ten, fifteen or twenty years it may be, the wretched leper, afflicted,, in every sense, himself, and hateful to the sight, smell, hearing and touch of others, dies despised and the most abject of men.”
Dr. Keith Guild, M.D., district surgeon of East Griqualand, in a pamphlet published this year on leprosy, arrives at the conclusion that “leprosy is a blood poison arising from the combination of two other blood poisons, tubercular and syphilitic,” and goes on to assert that “leprosy among the natives of South Africa is neither more nor less than a form of tertiary syphilis.” There is a manifest inconsistency between these two statements, but if the latter be a correct one it must also apply to leprosy in general, which I myself would be very sorry for one moment to admit, for obvious reasons.
Looking upon this frightful picture, is it not time, I will ask, we were “up and doing” before it be too late?
To come down to figures: the cost of each leper on Robben Island is £63 per annum: while the total expenditure of the island annually, including lunatics in 1885, was £15,482, of which £5,000 was expended in salaries.
The following is a return of the leper patients admitted in the general infirmary, Robben Island, from the year 1845 to July 31, 1883, inclusive, the number remaining about the same, as fresh cases were only admitted as old ones died off: