therefore, that, with the exception of a few insignificant islands, leprosy is an element, and often an important element, in the pathology of nearly all warm countries.
The only tropical country of any magnitude about which .we have anything like accurate leprosy statistics is India; and even in this instance the figures for many reasons— principally errors in diagnosis and concealment— are untrustworthy. According to the census of 1891, after making allowance for error, it is estimated that in British India there were 105,000 lepers in a population of 210,000,000— a ratio of about 5 in 10,000. Respecting China, of all countries probably the one in which there is the largest number of lepers, we have no figures to go by; but, judging from what is seen in the coast towns and treaty ports, the number of lepers is probably sensibly greater than in India. In Japan, in the Philippines, in Cochin China, in the Malay Peninsula, in the islands of the Eastern Archipelago and of the South Pacific, in Persia, Arabia, and Africa, the disease is common enough. The same may be said of- the West Indies and of the tropical regions of America.
As regards more temperate countries, we know that there are a considerable number of lepers at the Cape, a few in Australia (principally Chinese, but also a few Europeans), a few in San Francisco (Chinese). In Canada and in the United States there are also a few lepers of European blood, but their number is quite insignificant. In New Zealand, where leprosy used to be common among the Maoris, it has died out. There are a good many lepers in Iceland. Leprosy is also reported as existing among the aborigines of the Aleutian peninsula and Kamtchatka. In Great Britain and other European countries, particularly in the capital cities, lepers are not infrequently exhibited at medical societies; but, with rare exceptions, these cases are not of indigenous origin, most of them having contracted the disease abroad.
Though thus extensively diffused, leprosy is by no means equally prevalent throughout the wide area
