Four years in Upper Burma

by W. R. Winston

It is not amiss for barbarous people like these, who have been accustomed to set all law and order at defiance, and raided upon Burmese territory just as they liked, to have the opportunity of seeing for themselves some marks of a superior civilisation. It may be expected to induce in them a wholesome dread of the British power, and a more orderly and peaceful mode of life.

They begged us to stay over the next day, stating that they wished to bring their people from far and near to see this strange sight, but the risk of fever, through sleeping out in the jungle, was too great to justify us in remaining longer, and next day we left Pinloak, and returned the way we came. And we live in hopes that, when the funds will allow of it, the information we gleaned on this tour may be turned to good account.

CHAPTER XX.
THE HOME FOR LEPERS AT MANDALAY.

One of the painful sights which specially attracts the notice of the European in Burma is the large number of lepers to be seen in all the public places. As you walk along the streets you see them, sitting in the dust, holding out their mutilated limbs, from which sometimes all traces of hands and feet have ulcerated away. If you go into the great bazaar, they are seen mingling with the crowds of buyers and sellers. If you go to the great pagodas, where hundreds of people congregate daily, there are lepers sitting on the steps, and appealing to the generosity of the worshippers. At the gates of the royal city, and in the public zayats or resting places, they are to be found; and when the leper has dragged about his poor diseased body as long as he is able, he lies down to die, a friendless, homeless outcast. In Burma, until we took the matter up, there was no organised relief for them beyond chance coppers, no place of refuge where they could be housed and provided for.

Seeing the lepers were so numerous, I began to investigate the matter, and as a preliminary measure looked up the statistics of the leper population of Burma. There had then been no census in Upper Burma, but according to the census of 1881, there were upwards of 2,500 returned as lepers in Lower Burma. Large as that number is, it is to be feared that it does not fully represent the evil, for the people naturally object to being called lepers even if they are, as though by avoiding the name they could hope to avoid the awful thing. I have known a leper, so far advanced as to have lost the whole of both his hands, and quite emaciated in body, declare in answer to my question, that it was not leprosy, only “Koh-ma-koung-bu,” a bad state of body. To form a fair estimate of the actual number of lepers in Burma, we should have to make a considerable addition to the 2,500 returned for Lower Burma, and multiply that by two, to take in both Upper and Lower Burma. It is probably not too much to say that there will be about one leper to every thousand of the population.

I have often been asked what is the cause of leprosy. That is not a question that can be answered in a word. The native of India makes short work of it. He scarcely recognises any laws in nature but the one law of his fate.

“I saw a leper,” writes Mr. Bailey,[3] “in a shop, sitting in the midst of his goods. He sells betel nut, tobacco, oil, cakes, etc. He has a leprous brother living with him, also a brother not leprous, and a niece who already shows signs of the disease. We asked the healthy brother if he were not afraid to live in the house, and he said that if it were not God’s will he could not take the disease.” So far as science has yet ascertained, three causes may be specified: (1) Insanitary conditions of life generally, as predisposing to it. (2) Heredity, to some extent. (3) Contagion resulting from lengthened residence in close company with leprous and insanitary surroundings. It is not yet determined to what extent these causes respectively operate. It is the business of the Leprosy Commissioners, sent out at the expense of the National Leprosy Fund, of which the Prince of Wales is the President, to try and ascertain more on these points, by the careful and exhaustive inquiries they have been pursuing; and their report is now awaited.

In India there are medical men who have studied this disease for many years, for there are hundreds of thousands of lepers scattered over India. Dr. Munro, an acknowledged authority, and a man of deep research, says: “Summing up, therefore, leprosy is not always, but only very rarely, transmitted from generation to generation, has never been proved to be transmitted without contact, is not constantly transmitted even when both parents are diseased, seldom affects more than one child in a family, and those only successively, independently of age, sometimes the youngest first, after contact, and goes back from child to parent when in contact. From all I have learned of the disease, I can find no proof of even the hereditary predisposition allowed to exist by Virchow, but feel much inclined to believe with Landré, that contagion is the only cause of its propagation.”