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 L<■'wv^K- . 
 
 BUIEF REMARKS 
 
 On ''The Report" laid before the Government of Nexc-Brwisxvkk 
 by the Medical Commission appointed bij the Lieiitcna?it Governor 
 to i?ivestigate the nature , causes, S^c. of a disease termed Leprosy, 
 prevailing in certain French Settlements in that Province, border- 
 ing on the Gulf of Saint Lawrence. By Alexander Boyle, 
 M, D, 
 
 A REPRESENTATION haviiig been made to the Lieutenant C.overnor of New- 
 Brunswick, that a disease of a highly malignant and loathsome nature, receiv- 
 ing the name of Z,f/>/-osy,had been discovered among the inhabitants of certain 
 French settlements in the Counties of Gloucester and Northumberland, in 
 that Province ; a Commission, composed of four Medical Gentlemen and the 
 French Clergyman residing in that district, was appointed for the purpose 
 of investigating its nature and causes; and suggesting such measures as 
 might be judged necessary for its prevention— The Commission entered 
 on this enquiry in 3Iarch last, and the result is now before the public; 
 and a sum of £1000 has been granted by the Provincial Legislature, to 
 enable the Government to carry into effect the measures proposed. 
 
 As they have " unanimously recommended the erection of a Lazaretto, 
 «' the removal of the sick, and their strict seclusion in that establishment," 
 as means necessary to guard against the extension of this malady, which they 
 consider as not only hereditary, but contagious; I have been induced to exa- 
 mine some of the more prominent facts which they have brought forward in 
 support of this opinion ; with the view of determining how far it is expedient, 
 on this occasion, and on the grounds exhibited, to have recourse to mea- 
 sures involving extreme hardship on individuals, and not devoid of in- 
 jury to society, and which ought never to be adopted under the sanction 
 of causes which admit of doubt ;— and with what probability of success 
 those measures are calculated to accomplish the end proposed. 
 
 It may, in the first place, be observed, that much confusion has ueen 
 introduced into medical writings, inconsequence of doubts respecting the 
 disease to which the name of Lepromj, more properly belongs ; arising, as 
 is supposed, from the inaccuracies of the translations of the Greek and 
 Arabian authors who treat of this subject, and who have somrtimes de- 
 
 f~ 
 
 scribed, under the same title, three different aflectio 
 
 us, very 
 
 dist 
 
 met in 
 
r 1 
 
 2 
 
 !3 
 
 character, namely, the Hebrew Leprosy, a scalv disease ; the Elephant 
 or Barbadoes leg; and the "Tubercular" disease, now under conside- 
 ration. It is, however, at present unnecessary to enter farther upon this 
 subject, as the disease in question must be viewed under the aspect 
 presented to us by the cases given in the " Report," where it is classed 
 under this last denomination : and, as observations of modem date have 
 removed much of the perplexity by which it was obscured, there is less 
 difficulty in assigning to each its proper place in nosological nomencla- 
 ture. 
 
 The facts collected, and which form the subject of the official docu- 
 ment, are interesting ; and the cases are detailed with a degree of accu- 
 racy and clearness, leaving no doubt as to the existence of a disease 
 which has all the characteristic symptoms of the " Tubercular Elephan- 
 tiasis " of modern nosologists, the " Juzam " of the Arabians, and the 
 " Lepra Groecorum " of the middle ages, by which its identity is fully 
 established, and which, therefore, need not now be repeated. 
 
 It is stated in the «' Report," that » no positive conclusion could be 
 drawn as to its original appearance in this quarter ;" but, that, according 
 to the information that was received from the oldest settlers, the first case 
 occurred in the person of Ursule Laudre, about the year 1817, nineteen 
 years after her marriage with Joseph Benoit, of Tracadie, a small French 
 settlement situated in a part of this Province, bordering on the Gulf of 
 Saint Lawrence, and where she went to reside after her marriage. Her 
 father, mother, and their children, nineteen in number, appear, with the 
 exception of Ursule alone, to have been perfectly healthy. She was mar- 
 ried about the year 1798 or 1799, and having been affected ten years 
 before her husband, (for, it appears, he also became affected with it,) it 
 would be absurd to suppose that she possibly could have received the 
 infection from him; neither can we suppose that he could have contracted 
 It Irom her, for he continued free from it until three years before her 
 death, which happened in 1829; a period of twenty-six years after their 
 niarnage, and of his having lived with her about ten years after she had 
 shewn all its unequivocal symptoms. After the birth of her fifth child 
 Ursule ceased to bear children; and it is stated that, from that time, her 
 hea th continued to decline for six or eight years, when the disease was 
 no longer doubtful. 
 
 Upon the whole, other facts stated in the "Report" are not more 
 favorable to the existence of contagion as a cause of this disease, than 
 those already mentioned ; for, it is not shewn from whom Ursule received 
 
 \^ 
 
 ^ 
 
7514 
 
 ^ 
 
 ^ 
 
 the infection, nor is it proved that she communicated the disease to any 
 one, either by direct contact or through the medium of substances im- 
 bued with a contagious principle. There is, indeed, no sort of analogy, 
 as far as those facts go, between this disease and those of a contagious 
 nature; in most of which, we can, almost, as it were, detect the contagion 
 m Its passage ; and it is only by analogy we can reason on the subject. 
 The latent period in contagious diseases is never long— being only two 
 or three days, sometimes less, and seldom exceeding three weeks ; whereas, 
 in the present instance, several years of continued intercourse intervened 
 from the firsi communication with the infected person to the time of its 
 appearance in the individual exposed. 
 
 As it is admitted by all that " Tubercular Elephantiasis," or the Greek 
 Leprosy, as it is sometimes called, is an hereditary disease, and, like Scro- 
 fula, may pass one generation and appear in the next, when concurring 
 causes favour its development ; the taint in one of the nineteen children of 
 Laudre pere (Ursule) may have been derived from a source to which, at this 
 distance of time, it cannot, perhaps, be traced ; and the case of the only one 
 of her five children who was affected, must be referred to the same category- 
 while the exemption of the other four, though living in continual intercourse! 
 completely overturns the doctrine of contagion, and is in perfect analogy 
 with the facts observed in Scrofula and other diseases which are transmitted 
 from parents to their posterity, affecting some and sparing others, according 
 to circumstances not often very evident or easily explained. The case of 
 Frances Savoy is not less decisive. She has a family of six children, and 
 only one, a boy of eight years of age, is affected. She herself has had the 
 disease four years and a half, in a severe form ; " her husband sleeps 
 with her every night, and is in perfect health." P. Savoy's case is a se- 
 vere one. He has a wife and four children, but all of them are apparently 
 healthy. The case of T. Robicheau bears equally on the same point. 
 He IS about fifteen years of age, and has been affected six years ; and 
 his uncle was recently carried off by it ; marking, decidedly, hertditarv 
 transmission in that family. 
 
 It must, indeed, attract particular notice, as a singular feature in the 
 •* Report," that, as regards Contagion, so many of the facts related mili- 
 tate strongly against the conclusion which has been deduced from them, 
 on this important question. 
 
 The affected district is situated between the Bay of Chaleur and Mi- 
 ramichi River, and the intercourse between it and Canada, Prince Ed- 
 ward Island, IVova Scotia, and the adjoining Coiiniits uf New Bntnswlck 
 
7515 
 
 anterior ,„ .u7; 1" !f " -'"T ^T "'""^ "'" ""'^ ''""" "' ° •'■'«= 
 poar, boon pmpar.? t an" ' .h': ''""•'' ',' '?'' "°'' '■ """W "P" 
 sidorcd or.,at impolL 1° 'f namcl place,, nor been co„. 
 
 ticular notice or Tche "' ''"T"' " ""•■ '""«• »» '" ""'"» Par- 
 
 had prevailed iCcief^' °" ' T "Z""'"" '''' *^ " "''Po"." after i. 
 
 <en.i™ of .1,0 Lef slam e ZV ,f r"".^-'"^™ ''"'•'• "■=" "'^ »'• 
 
 .an«er, and re^rln^irLt^rrpr:^^^^^^^^^ -'■ -'"= 
 
 1 hat the original source of the disease is to be detectedin nnv ^«.i • i 
 
 u..,;. St dLr- ;^r-:St:J:tdr iJi^t^ 
 
 cu uva tion of the soiJ. if „ot n.uch improved, certain y are no d r brated 
 
 ? V. r e^rN^lT '^ ""'"'r' ""'"''f ^^^"^^ '"^^^"-'« '" thai ;r f , e 
 n^uch 1 ' °^^^«'-«"'"«" Jfl^. 't 'nay also be remarked, have always been pretty 
 
 North A ''"" "' ^'^^ settlement, with those in other parts of BrS 
 
 ttle of 7ood"' '"?' ''T '''' '^' "'"^^ ^^"^^''"'- ^''"-^ their sol at 
 ticle of food. IS not, perhaps, of the same wholesome quality as amonL- 
 
 h ": t:^z::''''T' °^^^"^ ^° ^^^^^ p^^^^^^- -^-^ on^n Preve^:? 
 
 AmLr flct the 7 """ -"""^^^ ^-^ P^*^^^^'^^ '' ^- "- Some 
 P 1 V cauL nf f '"' "'" ^'""^"^^ ^° ^•^"'^^^' ""»• conclusions as to the 
 b regfett d ha h '' T"'' " k^' '°^""'^ satisfactory; and it is to 
 
 horn those Frenchmen who visited North America at a very early period of 
 us settlement; and by whom, it can scarcely be doubted, th disease was 
 brought to this part of the world ; and the superb structure erected l^Henry 
 II. Duke of Normandy, at Caen, in 1160. for the reception of Lepers (bm 
 ong since appropriated to another use.) attests to this day the prevalence of 
 he disease m former times, in that country, where it had'been.'in a manner 
 naturalized since the time of the Crusades. It is of no small importance, there 
 
 fw'lT 7^Tu" '^'■°" ' ''^ "^ "^^^ '^'^ '^'« P^r^ «^^'^- ^"q»iry, to know 
 that Ursule's father was an » Acadian." that her mother was of Caraquette " 
 in the Bay of Chaleur, and her husband from « Tracadie " on the Gulf Shore • 
 for ,t IS also known that, the Bale de CA«W and the north-east shores of 
 Acculie were places where those adventurous navigators first encountered 
 
 •\ 
 
 1* 
 
r 
 
 \ 
 
 'f.' 
 
 ^"ilS 
 
 4 3 I 
 
 of cfs"'7l'"".'! T''l'Jr ""'r"--'-'"' h- boon .1,0 ,o.al „„,„„or 
 
 asccrliiined f-,, iTl ,? f "'''"'• »"'' '' "'»'"• P"*"-!'". bo also 
 
 twelve. "-"Presy. "hich, as far as »o arc lufornied, amount to 
 
 ReBoJrt*'rf"l"' '"I.^ru""' ■•"•'"o'""'^ P""'^iP'-l -lata f„n,isl,od l,v the 
 cnlT' i "■".'■ *' Commissioners found their opinion as to I ! 
 . SLfthrarf f 'rr- T"'"- ^">- -■" -rram reeourse to 
 strVc ^n^ i, 1,1 f T'' "'1 '"""P''"" of Lazaretto regulations and re- 
 sinctions it may not ho deemed nnprolllahle or uninloreslinK in a Question 
 whtch so deeply mvolvos the eomfon and safety of a large porU,^n oVsoc "v 
 
 ion in Zn?:*;",""'""''" °'"'' '"«'"^'' ""«•" "' '"^ -nedieal , f •' 
 s.o„ ,n support of he opposite doetriue, or n.„.eo„tagious nature of this 
 
 I anTrttl""',"'""';" """"'""^ aeknowlodgod .o\e .W„ 2. 
 Bo llaud vt '.? "";;?','='"'"='''■'' ''« «"'-'"» « Chirurgie pratiques", l,y 
 anteu sdJ, u.^ L^', ""'• " Iir""""*'™ » *'» admise par eor. in' 
 rr,w7. 1 . ''''' "' O" '"^ "''"'^"^ reelment pas. Quel e,t le 
 
 X omp le t:i:T: "•" tr 'r ""'""^""" * ""■ - 1" » «» <! "•> -"p r 
 exemple, sur la contagion de la Lepre, &c." And acc.i. vol '; r. Jir V 
 
 r:' "L°: atf "■"'^ r ^''^ "- "'-'-'-^ clrrhre, .^s i;,; :,- 
 
 thus . Les attaques dont cette mesure sanitaire k H^ I'objer dans ces A J 
 mors temps, paraissent bien fonde^s, et le moment n'est peutitre pas eloln ' 
 ou el,e sera completement abandonne.." To this e/ct Is "r : a f * 
 
 bis relaTi^^To Q:: a't- '' f '' ^'^ ^""'^' ^^'^^» ^''^'-'^ ^f the in" 
 
 rrat^me 1 L P n ' ' T^'' " "^^ '^"P^" ^'•"^^' ^«"« ^" instructions, 
 
 en quatneme 1 gne ; ma,s parmi les gens qui ont bien observe cette miladir 
 
 o::sX"est:t"^"f '^" ' " ^''-^^"^^^ ^°-^^'--^ iesdl: : ions: 
 atroces pnses con re les lepreux. sont tombees en desuetude, et ces mahdcs 
 
 sont adm.s parmi les autres dans nos hfipitaux sans onpT.mnJ? 
 
 aper?u de la transmission de leur a/Tcction " ^ "^ '" "" '' '"'' 
 
 bv D^ ""^7 n ''" ^>^-'«f ''-- of Practical Medicine, on "Contngion " 
 by Di. Joseph Brov, n, ,ve find the rullon ing rcnark :-'. Thae afc," o 
 
« 7517 
 
 ••".e iHUer e,„all, devoid of , ha, "St '■^ """ "'°"°" "' """'' 
 
 Numerous aulhorilies might be nuoie'd i„ .h 
 
 fish and vicini.y ,o ,he sea shore. There is holv. ''' "'""'"' '»""'' 
 greatest difficul.j, and uncenaimy in aloum^rr ' '" '"""^ '""°"«'. "■« 
 above, lilte those of a moral naluil "'"""""Kf'"^ •" appearanee; and the 
 
 corded by the celebrated Ilber as colr„,' '. T""'"'"'' '"'"»" » " 
 Precis, &c. vol. 2 n Sli i,7. . ^^ ""''" '"«°™ immediate car. 
 
 hereditary Predispos'^ti^Vandrm^lfLrr f ^"^"^ """"'"■"S ' '-n'.' 
 CO., ecture. The testimony of SMirind Pall ''r """f "'" ''»«'» «" 
 
 ■».hor, as opposed to the d'l.ctrine ^Xt "'""'' '° "^^ "■« ""•» 
 
 »Hchi::;f.:rc:;:-:.:;^;-a.o^^^^ 
 
 eminent men, I may be pertLufed i^thi I T* "" "P'"'"" "f ""ose 
 
 occurred in a perso'L abr„™h 1 "" s „f' rf' '° '""'^j' ""''" »°""- " 
 laboured under itfor a conside abrienlff .Lrr?'^"'*"'"- «» "■»<< 
 for the benefit of bis health, where h.l.T '''"'"" ""''"'"•Scotia 
 about two year, before I saw Wm lft,T.hL h°" '"'""'"■"' ^"""S '"'y 
 "as under the care of Dr Bold and f'r' ?'""° ®»'"' ■'°''". a«d 
 
 breath was extremely offensive and hf. T!, ?" °''°"' '"■" •"■>"""• »' 
 "ilh blotches and lubercles of a ,lvid h '^' u . '"'' ''«' ""« "^""red 
 "ere in a state ofulceraTion He Ifi ' V""''' '"''""■■ "•"' """o of them 
 «..e than when heTr 'left the wri""' ? f r^*""' '» » ""^^^^^^ 
 long after his arrival. During the who/; pSd'„°fh 1°' """ '"»^''° "<« 
 of his marriage, his -vif,. w.f Jl . ! "^ ." °' *"* '""ess, from the time 
 occupied ^^eLeV,^:^^^^^^^^^ V^ »-. aud 
 
 ing-house where they lodged for nearlv 1 i ^ ? '"'"^*^' °^»^'« board, 
 had daily intercourse, ever sheweTthtl ' . T'^ '"^ ^"^ ^^om they 
 children; and after hi« L7.!\- -r ^'^ ™^'^'' °^*^'^ ^'^^ase. Hehadna 
 
 has^nued to tjoy ^t'ct ht:Str'' "'""' '' '^°^'^-^-^'«' ^'-e «he 
 
 * R^y^r, Bat,ma„, Al.bert. Kobm.o«. T. Heb.vdcD, Ain.ley. 
 
7bl8 
 
 In the course of the ahove remarks, I have purposely abstained from all 
 opinions respecting the operation of contagious miasmata, or the manner of 
 their introduction into the blood, as foreign to the object of the present en- 
 quiry ; and as chemistry has, hitherto, thrown but feeble light on the nature 
 of their elementary constituents, or the changes they eflect on the circulat- 
 ing fluids. 
 
 Several important organs undergo a morbid alteration of structure dur- 
 ing the progress of this disease ; but, as its pathology is unconnected with 
 the question at issue, it need not now engage our attention. 
 
 It is generally admitted that Pulmonary Consumption is, according to 
 the common acceptation of the term, an hereditary disease, usually developed 
 by the action of exciting causes. In some countries, it is also deemed con- 
 tagious ; and the houses which have been occupied by persons who die of 
 this coniplauit, are always left deserted. In New-Brunswick, its occurrence 
 18 very frequent; and, though not deemed contagious, it may certainly be 
 pronounced incurable. So far, the parallel between it and Leprosy is strictly 
 correct ; but surely, it would not be recommended that those persons labour- 
 ing under Pulmonary Consumption throughout the Province should be torn 
 from their families, and left to die in a Lazaretto ; nor can it be imagined 
 that any such measure would be proposed to prevent the continuance of so 
 great a scourge of the human race; as it is sufficiently evident, how fruit- 
 less the attempt must be, by the removal of a (ew, to arrest the progress of a 
 disease whose germ, unhappily, is but too widely spread among mankind, 
 and whose extinction is beyond the reach of legislative power. 
 
 During the prevalence of the Asiatic Cholera in Europe, erroneous 
 opinions regarding its contagious character led to the adoption of similar 
 measures of prevention ; hut experience has since taught us how useless and 
 unnecessary they were, ; u : how injurious to the interests of society ; and 
 the novelty of the disease among us, and its still inexplicable nature, afford 
 the only vindication of the course pursued during that period of gene- 
 ral consternation. In no part of Europe was Leprosy so prevalent at one 
 time as m France, from the eleventh to the sixteenth century. It is now 
 chiefly confined to the tropical and equatorial regions, being rarely met with 
 in Europe since the seventeenth century; and the advanced and more 
 refined state of society accounts for its gradual disappearance ; while great- 
 er experience has banished all dread of its supposed contagion, and opened 
 their noble hospitals to the admission of Lepers, without distinction, among 
 other patients; and numerous Lazarettos of great extent have long been 
 converted into retreats for the aged and infirm, or like purposes of general 
 puilantnrupy and benevolence. 
 
s 
 
 I nnsi it Hill appo.-.r, from ulinf f |,avp vnM ^..,1 .1 ... 
 
 .-r.T.e<l t,., that anv .....«,„•.« of pn-v,' , n v 'Vl """'?'"""' ' ''^'^'^ 
 
 Nick, Mu.cl. less tl.o s.veritv of I ,1 . t ^'""■' •'^''^•'"■^'"'» ««" «»'f 
 
 •Lis occasio... by the fuc s on whi I^ 7- ''"'^ «anan,.nl. o„ 
 
 tf...ir usd.vssucss unJi . policWi V ,'"" "'"'"" ''^ ^^'•"""''^•<' 5 and as 
 
 civili,..l nations ^ ^ '"'' "•"^"'•''^ ''^''""t'^^'' '''«^'" ^O'" 'I'e code of 
 
 .i^nr;: ":.^!sirrti^^^^^ --uon onep... p. 
 
 o..t the remotest njt.rto m .ei^nn ' Tr '^''' '"'^^ '^^ '•'^^^--' " 'th- 
 
 finishes ample p Z The d r , ' ' ""' "^ "'''''^''' ^'"' " «^''"'' " ''-•"• 
 peced fron. hos ,i "/n-e t o ^^^^ ''"'^^ ^-'' - '« be ex- 
 
 Mueh.however/maybe ot" 'bvi .^^ ?'.' ""''' ""''^ ''^ P'^'"^^'^'^- 
 
 iH'man body liable fo va IVdi '"'•' °'^''" '"''''' "'''''^'' ''•^"'J^r the 
 
 well as from' atn.o pheri • i"m. -0""', 7""?'^ ^"'" """"""^ emanations, as 
 eating the necessity of Vn 7" ''^''•'^'''^^'•-V P'-^'li^Position, by ineul- 
 
 tion of that d St c . b1- ^h hTl '^'"" /'"-'^''-"t the Freneh popula- 
 in/luenee of extennlllen I '''T'''T '"^^ ''^' ^"^'^'^'' '" '•^''^ the 
 
 ease wiil finall " e ^ 7;^;,. ,:i:"'7."' "^-^'; '? '« ^« ^e feared, the dis- 
 Wi.l. .1.;. ^.^^ °"? ''"'» '''e extinction of the race. 
 
 •Loir cl„,l,i„;, I i o'd :: Zr "TT"'"'' care,-,l,eh- occpa.io,,., 
 .■.cc„,-<li„g,„ ..ra^,. „,- T'""' "'"/'"'^"f 'I'"'- l.abi.a,i„„„ and 
 
 evil »a, no, aU„ge.,.ort7o::,te" a 'i ^^H 7° Thr'' """ "■•" f'''^"" 
 money from the public nurse f,»r th!. I,. fl' appropriations of 
 
 for obvious reasons, be'en . ed fo t ^ "r ^'"r"^"^' '^"•'^^^^^ «^-''d. 
 of Ne,v-Br«nswlck ;nd the Cor^oHI ^ , ""' '^"'"'" ^«'''«'^^ B'«hop 
 discretion and respo b^^it^ 'Xrf "'' '" "^^ ^''^tributed at their 
 
 the Executive Goven me of he P n ' '" "TT f'''' '''"'^•-"•-ments to 
 to controul them '' ' '°''"''' "'"^'^ ''''^"^ «5^«"''' I'^ve power 
 
 Saint John, (Netv-Brunswick;) May loth, 1844.