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SATURDAY PRESS SUPPLEMENT.
HONOLULU, H. I., APRIL 14, 1SS3.
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From thf bttimlpntitt of Itr, I'ttch.
. I wish to say in advance that tins U not In
tended as a medical paper j but is written for
general reading and to alliy public fear.
Fcrhaps on no one subject is the mind of
this community so greatly exercised as it is
about the disease known as "Leprosy." lleing
in constant attendance on several hundred
cases, and having for over two ears made it a
most earnest study, I desire to impress ujxm
the public mind what I believe to be the true
nature of the disease.
This I am anxious to do for man) reasons.
One reason is that a sensational newspaper in
San l'rancisco has raised a hue and cry calcu
lated to cause the public to believe that the
people of the l'aeific coast, perhaps of the en
tire world, arc in great danger of contracting
, thU disease, these Islands being regarded as
foci of contagion.
Friends in California arc writing to me in a
tone indicating a mortal dread of a disease no
one need contract by observing ordinary pru
dence and forethought. In my opinion this
disease is nothing more than s) phihs and there
arc thousands of cases of that all over the
world. To distinguish between thesjphilis so
called by other physicians and. the form of
syphilis called by others "leprosy," I continue
to use the latter term. That the disease is far
more severe here than in many other places is
true, but the reason is easily explained.
Johnathan Hutchinson a noted surgeon of
England says: "Now it is a matter of well
proven observation that any specific disease
will be especially severe when imported into a
community previously free from it. The ravages
of smallpox in a virgin race arc something far
beyond what is ever know n in a community
long accustomed to the disease. There arc also
good reasons for believing that s)philis has be
come during the list two centuries a milder
disease than it was when it first invaded Eu
rope." IJumslead, a noted author of New York,
quotes from an ancient writer as follows: "that
this French" disease characterized by enormous
prominent spots, by pustules giving the face
and body a hideous aspect, sometimes painless,
at other times causing the most excruciating
, suffering in the joints, and depriving the pa.
tient of rest and sleep at night, slowly con
sumes the body ; that it can be cured by no
remedy; that it was unknown to his ancestors;
that whatever others may name it, he desires
to call It rnorbum ftstifcrum Jilitunium ;
May this disease more destructive
than 'any pestilence, depart and return to the
gulf of hell whence it came."
Syphilis was introduced in these Islands by
the whites one hundred and four years ago.
When Captain Cook landed here it was un
known, but immediately after it swept the na
tives away as dust flies before the wind. At
first they died too quickly to develop leprosy.
The next generation bore it a little longer,
and succeeding ones have lived long enough
to carry the disease out to its fullest develop
ment. Now let me give the history of a Tew cases
that lead me to believe that leprosy is only a
form ot stage of syphilis.
A native, aged about sixty jcars, has been
under my care for some time. In January last
I removed a large section of his lower jaw, de
ttroyed by tertiary syphilis. He says he con
tracted the disease thirty )ears ago, and gives
me so clear a history of his symptoms that
there can be no doubt of the coirectncss of his
story. Shortly after taking the disease he mar
ried. Ills wife shows unmistakable signs of
the same trouble, but I cannot find out where
or when she contracted It. As a result of their
marriage six children were bom. The first
broke out with syphilis shortly after birth and
was umler ine care ui a ihijwuhii ..
years, tartly escaping with his life. The next
three died with svphilis, none of them living
to be over a jcar old. The last twosccnuillo
be quite healthy for some time, but whin they
were about seven or eight car old leprosy
appeared, and they were both sent to the leper
settlement. One is dead. The other still
lives, his nose sunken, his fingers nearly all
gone, his c) cs a red fungus mass. Neither of
the parents shows the least sign of leprosy,
although the) have long been residents ol the
leper settlement, taking care of their children.
Now we sec, in this case, the elder children
so thoroughl) poisoned by the disease con
tnclcd by their parents, that in three of the
cases death was the result. One lives only
with the greatest difficulty, l'inall), when
the syphilis has to a certain extent worn itself
out in the parents, two more children live long
enough for leprosy to develop. If leprosy
were a distinct disease, why lnvc the parents
not shown it? They both lived a long time at
the Leper Settlement, eating out of the same
dishes, sleeping on the same mats in daily,
hourly contact with it. Now I can cite num
erous cases, similar, or with only the usual
variations of daily life. There are iany cases
here where the oldest child in a family has
lepros), and the )ounger, syphilis, one or
other of the parents, or both, having syphilis.
One case illustrates as well as fifty.
But it is a poor rule that docs not work both
wa)s. At the Leper Settlement, thcrearc now
two little girls, one born Nov. I, 1S73. A
few da) s before her birth, her grandmother
died a leper; a few weeks after, her father
died a leper ; before she was two)cars old,
her mother died a leper. Her grandmother,
father and mother, all three, had leprosy for
some) tars before the child w as born. The
record is complete ; )et this little girl shows
no sign of leprosy, but docs show unmistakable
inherited syphilis. In the same house lives
her Companion born Feb. 9, 1S74. In this
case both father and mother had leprosy for
years before the child was born, and good
Father Damicn says he saw this girl as a babe
nursing at her mother's breast when the mother
was a living mass of putridity.
Yet the little girl shows no sign of leprosy but
docs show unmistakable inherited syphilis. In
fact every single child born of leprous parents
shows syphilis first and only when they arc
more than sev en ) cars old, as a rule, docs leprosy
develop and in some cases leprosy never devel
ops at all. Do we not here see an illustration
of the lawof atavism; that is, leprosy frequently
skips one generation to reappear in the next ?
Now when we know that syphilis has a natural
tendency to wear itself out of the sv stem this
becomes plain.
lly Chinese law, a man contracting leprosy
pin only marry a woman who has contracted
it; the child of a leper can only marry the
child of a leper ; the grandchild of a leper can
only marry the grandchild of a leper ; but the
great grandchild is clean and can marry at
will.
In the Iliblc wc read, " For I the lord thy
God am a jealous God and visit the sins of the
fathers upon the children unto the third and
fourth generation."
Again, all the physicians here who have had
much experience with the disease, so far as I
know them, except one, admit the difficulty of
distinguishing accurately between the two dis
eases at certain stages. There arc the same copper-colored
sores thick crusted with scabs ; the
same aching bones ; the same swollen glands ;
the same pigment patches ; fhc same intense
feeling of coldness and the same "necrosis or
death of lwrtions of bone. In fact a large part
of the symptoms of the leprous are identical
with syphilis.
I will now drop this point and come to the
part the public is most interested in, its con'
tagious or infectious character. The leprosy
report of the College of Physicians (of London)
tells us that, " the all but unanimous convict
ion of the most experienced observers in differ
ent pans of the world is quite opposed to the
belief that leprosy is communicable by proxim
ity or contact." Kxpcriencc here amply cor
roborates this view ; and its infectious proper
ties are certainly small.
To instance this I know of one white man
here who married a native women seven
years ago. Three years after his mirriagc lep
rosy appeared on his wife. He still continues
to live with her and shows no signs of the dis
ease. A man at the leper settlement has bur
ied three wives, who all died with leprosy. He
is now married to his fo'itth and she h a leper.
In addition, he is a notorious consort of leprous
women. Yet he shows no sign of leprosy. A
man on Kauai, married to a leprous woman,
had syphilis badly, but continued to live with
his wife. Their grown daughters wore the
mother's clothes yet she alone shows leprosy,
being an inmate of tht leper hospital now. A
native member of the last legislature married
his wife thirteen years ago; oncycar after their
marriage, leprosy appeared on the wife and al
though they have maintained their marriage
relations he his no sign of leprosy about him.
I know of at least five other cases where white
men live with native women who arc lepers.
In some of these five these relations have been
maintained for as long a period as seven years.
Yet not oneof these white men shows any siyns
of leprosy.
Now while the records of the leper settle
ment arc not entirely correct they arc approxi
mately so. From them I gather that only
twenty-tight of those who have been permitted
to go there to nurse sick friends have after
wards been sent there as lepers. There have
been hundreds of these nurses allowed to reside
there at different times, Yet, so far as the
books show, only the small number of twenty
eight have contracted the disease. Syphilis is
only contagious for a certain period and lep
rosy is a stage of the disease which has passed
the contagious point in the majority of cases. .
Syphilis, like typhoid fever, smallpox and
similar diseases, has a stage of incubation, of
activity, and of decline. Its period of incuba
tion is usi-ally twenty-six days; its period of
greatest activity in a white man at the present
era is usually not much ov cr two years. Van
Uuren and Kcycs, two noted authors on syphi
lis say, " Practically what the physician wants
to know is this, during what time are symp
toms liable to recur before that long latent
period may be expected, which is to terminate
all manifestations of disease, and in which the
patient is certainly well, probably cured.
Roughly ami on the average this last question
maybe answered by saying after about two
and a half years, or, to be safe regarding
marriage, one y car after the disappearance of
the last syphilitic symptoms, treatment having
been continuously kept up and being continued
until after the birth of the first child."
Leprosy rarely appears before seven years
after contracting syphilis ; in some cases, how
ever, it docs appear earlier. In one white
man here, it appeared in four months after the
primary symptom of syphilis; and, in another,
in ten months, So, while in a vast majority of
coses, leprosy is neither contagious or infec
tious, these two cases might have been so.
And this partially explains why I fully believe
in segregation.
Another fact, well known to physicians Is,
that after syphilis has lost its contagious or in
fectious character It may still be transmitted to
posterity ; and this is certainly reason enough
for the strictest kind of segregation. Again,
in quite a number of cases of leprosy among
the natives, I have seen well-marked mucous
patches and tuberclcsat the corners of the mouth;
and both these last symptoms, are recognized as
contagious. Right here I am met with the
objection : " Why docs not leprosy abound in
other places, where syphilis is prevalent?"
Perhaps I can make this clear. Pasteur lias
discovered that by taking a drop of blood from
an animal affected by splenic fever and putting
it into a plate uf bouillon, that in a few hours
the bouillon will be swarming with the pecu
liar gcims which produces this disease. Now
take a drop from the first plate and put it into
a fresh plate of bouillon. Again it will swarm
with the same germs. Hut the germs are much
less active than In the first plate. Continue
this experiment and, by a number of fresh
transplantations, the germs come to have a very
ow grade of vitality, and after a time a period
arrives when, by inoculiting animals from a
portion of this worn out product of the original
disease, the animals so inoculated run no risk ;
but on the contrary arc thereby completely
protected from the original disease. This pro
cess is known as the culture experiment.
To prov c this, Pasteur took fifty sheep from
the eamc band and inocuhted hilfofthcm
from his prepared Iwuillon. They vv ere all
made sick by the inoculation, but only slightly
so, and soon recovered ; then he inocuhted the
entire fifty with splenic fever ; those previously
inoculated with the prepared liouillon suffered
no harm, while in a few hours all the balance
were dead. Now in my opinion, this is just
what is taking place here. The native is now
going through the culture process. In other
words, it is "the survival of the fittest" and
the weak go to the wall. In the few cases
where white men have contracted .syphilis
here, and it has run on into leprosy , the dis
ease from defect of constitution has reverted
back to its original type. Hut, in the vast
majority of cases, the white man escapes much
more easily than the nativ c.
This idea Is fully borne out by experience.
I hav e labored most earnestly to get the true
history of cases of leprosy as they hive ap
peared here among whites. In every case, ex
cept one, that I hav e seen so far, the disease
has only appeared among adult males ; and in
everyone of these cases the disease has been a
just reward of the patient's licentiousness ; in
the one exception, if common report be true, a
parent's sin has Iwrnc its legitimate fruit. In
other cases here where white children have
contracted it, v accination has been the cause.
How then has leprosy become so widespread ?
A young native woman came to me n year ago,
suffering with primary syphilis in its most con
tagious stage. Shortly after she left for one of
the other Islands, a walking magazine of dis
ease. Now, in from sev en to ten y cars, n case
of leprosy is likely to appear in the neighlior
hood of her home and then another and an
other; according to superficial obscrv cis, they
will all have been contracted from the first case
which appears ; neglecting to account for the
appearance of the first. My belief is the girl
who left here was the initial point of contagion
in that place.
Another objection frequently made by phy
sicians to my position is 1 " Why cannot we
cure this as wc can syphilis?" Gross, the great
surgeon of America, says: "The prognosis
of tertiary syphilis Is always grave, whatever
form it may assume It is extremely difficult to
dislodge it effectually from the system or to
effect a radical cure. Relapses arc of constant
occurence from the most trivial exposure or the
least disorder of the digestive organs and few
patients however skillfully they may have been
treated arc afterwards ever entirety free from
rheumatic pains, pronencss to cold and stiffness
of the joints; in fact, although recovery un
doubtedly does occasionally take place yet in
most cases the constitution remains in an en
feebled and crippled condition remarkably
subject to attacks of other diseases." In this
connection may be mentioned the case of the
great French surgeon Guersant, who accident
ally Inoculated himself In the hand while doing
some operation on a child suffering from In
herited syphilis. In spite of his bwn skill and
that of all his colleagues, the disease was
shortly the occasion of his death. Following
these statements of the incurability of syphilis,
the following extract from a report of statistics
of leprosy in Norway, copied from an article
In the Hawaiian Gauttt of March M, 188,
will show what are the results In leprosy,
" The number of cured in the same period of
twenty-five vcars is 107, while the number of
deaths by leprosy during the same time Is
4,891."
In conclusion, I have only to say ; no man
whq has led a virtuous life has, as far as my
knowledge extends, ever been a sufferer from
leprosy in Hawaii. I have never positively
known of a white woman having it. Decency
is the only true and necessary jmlicy.
GEORGE U VITCII, 11.11.,
rhytkUn toihc Govtmmcnl Frc DUncnury, Hono
lulu; I'hvtieUn to lliinch Lrpcr IIoilul, Hono
lulu, uut 10 ihc LriJcr Sclllcmcnl of Moblud.
uLi
TiSF'tS'SB'WSm X'CffT
