THE NEW ZEALAND GAZETTE. 161

Dr. Milroy to the Honorable R. H. Meade.
Richmond, S.W., 8th September, 1874.

SIR, In reply to your letter of the 29th ultimo, I
have the honor to state that as it is very desirable
that public attention continue to be drawn to the
subject of leprosy in the colonies where that disease
prevails, it would be advantageous, I think, to have
Dr. Carter's report communicated to them, and I
take leave to suggest that the following observations
accompany its transmission.

1. Dr. Carter states "That leprosy may be per-
   sonally communicated and received amongst human
   beings has not been strictly demonstrated, and the
   force of negative facts being awarded paramount
   influence, it has been held that this disease is, in fact,
   not so communicable, and the opinion has been
   superadded, that there is no need of Leper Asylums
   in countries infested with the malady. It was
   recently affirmed by high British authority, viz., a
   Committee appointed by the London College of
   Physicians in June, 1862, that, as a measure for
   checking the progress of leprosy, the compulsory
   segregation of lepers was not to be recommended,
   and inter alia it was advanced that the decline of
   leprosy in Europe (during the middle ages) is
   attributable chiefly to improvement in diet, as well as
   of general hygiene, identical results being predicted
   for India on similar grounds. Apparently the
   assumption that leprosy is not contagious led to this
   discountenance of Leper Asylums, and the necessity
   for consistently explaining its extinction in Europe
   probably led to this result being referred to improved
   hygiene."

(a.) I am not aware where or when the opinion
"that there is no need of Leper Asylums" has been
expressed. All who have seen the disease must
recognize, I should think, the necessity for destitute
lepers of such institutions when well placed and well
conducted.

(6.) The declarations by the College of Physi-
cians in 1863, to the effect that the documentary
statements then before them "contain no evidence
which in their opinion justifies any measures for the
compulsory segregation of lepers," in other words,
for their forcible detention and seclusion, were made
in answer to communications from the Colonial Office,
requesting the opinion of the College on the subject
referred to, and intimating that the Secretary of
State, then the Duke of Newcastle, "contemplates
sending out a circular to the Governors of all Her
Majesty's colonies, expressing an opinion that any
laws affecting the personal liberty of lepers ought to
be repealed, and that in the meantime, or if they shall
not be repealed, any action of the Executive authority
in enforcement of them, which is merely authorized
and not enjoined by the law, ought to cease."

The Norwegian Government has, it appears,
acted in the same manner, avoiding all compulsory
measures.

"Of the ascertained number (of lepers throughout
the Kingdom) nearly two-thirds remain in their
homes. The remainder are induced to enter an
asylum. To this end, however, no active coercion is
employed: it may be made a condition of relief in the
instance of pauper lepers, but this is no greater con-
straint than our own poor are subjected to. The
advantages of thus placing their sick, as regards both
themselves and the patient, are at last, I am informed,
becoming apparent to the peasant and fisherman.
Government has been solicited to interfere more
actively with the movements and actions of the leper,
and that more than once, but the propositions have
not been acceptable.

"As there is no compulsion either to give informa-
tion or to enter an asylum, so likewise is there none
to remain there."

(c.) On the important question as to the con-
tagion or communicability, by personal intercourse, of
leprosy from the sick to the healthy, Dr. Carter has
not stated what conclusions he came to himself from
what he saw and heard in Norway, but he has given
a recent instructive paper by Professor Boeck, of
Christiania, who has been long one of the leading
authorities in Europe on the disease. This paper
declares, -

"We both (Dr. Boeck and his colleague Dr.
Danielssen) pronounce ourselves decidedly against
its being contagious.

"In our Christiania Hospital we have always got
some lepers under treatment, but have never thought
of separating them from the other cases of skin dis-
ease, and have never observed any infection being
caused."

2. With reference to the propriety of strict
   separation of the sexes in Leper Asylums, Dr. Carter
   quotes the following passage from the circular
   despatch of Lord Kimberley, of 4th September, 1873,
   (which has been inserted in an article in a medical
   journal, and a copy of which article is hereto annexed),
   to the Governors of West India Colonies.

"The fact that leprosy is transmitted by parent to
child is indisputable, and as leprosy by descent is
often, through a natural error, mistaken for leprosy
by contagion, the members of one family being
naturally in contact, it is important that this fact
should be borne in mind. It is a fact which points
also to the expediency of placing asylums for females
at a distance from asylums for males when circum-
stances permit, and when the numbers are such as to
justify separate establishments."

Dr. Carter adds, "In quoting the above remarks,
I do not necessarily indorse all that they contain;
but I am glad to find the views, which are not above
advocated for the first time or the second, seem at
length likely to be adopted by Her Majesty's Govern-
ment, and also by the Royal College of Physicians of
London."

The College distinctly stated that "there is an
almost unanimous concurrence of opinion that leprosy
is often hereditary." The practical inference is ob-
vious, viz., that, as with insanity, all means short of
compulsion should be used to bar the propagation of
the malady by heredity. Acting on this belief, I
strongly urge the point on the local authorities in
the case of the several asylums in the West Indies,
which I visited in 1871-72.

Already in the Trinidad Asylum a distinct ward
for female lepers has been erected at a distance from
the main building, where the men and boys are
accommodated; and the same thing is about to be
done in Demerara.

In a communication from the College of Physicians
to the Colonial Office, 10th August, 1873, special
reference was made to this subject:-

"The College thinks it very desirable that on all
occasions the hereditary character of the disease
should be kept steadily in view. In the majority of
cases, leprosy is an hereditary transmission. How
far, however, it may be possible or right, politically
and socially, to prevent the transmission of leprosy
from parent to child, is a question that should not be
lost sight of."

3. The general evidence contained in Dr. Carter's
   report relating to the medical history of leprosy in
   Norway, corroborates the leading conclusions adopted
   by the College of Physicians from the mass of docu-
   ments submitted to their consideration, and the
   soundness of which conclusions was confirmed by the
   result of my personal experience in the West Indies a
   few years afterwards. The information he gives re-
   specting the condition and management of the asylums
   in that country, to the operation of which he mainly