Hope for Lepers

Fear fell upon the lads, as cold as death.

"A leper!" said Dick, hoarsely.

"His touch is death," said Matcham. "Let us run."

. . . He had been a tall man before he was bowed by his disgusting sickness, and even now he walked with a vigorous step. The dismal beating oj his bell, the pattering of the stick, the eyeless screen before his countenance, and the knowledge that he was not only doomed to death and suffering, but shut out forever from the touch of his fellowmen, filled the lads' bosoms with dismay; and at every step that brought him nearer, their courage and strength seemed to desert them.

The Black Arrow, Robert Louis Stevenson

For lepers, who are still, in effect, belled over all the earth, Christmas 1946 had special meaning. At the only U.S. leprosarium, in Carville, La., the 378 patients (whites, Negroes, Orientals) raised their first community Christmas tree. Major Hans G. Hornbostel, whose wife entered six months ago, played Santa Claus. In Washington, leprologists, gathered at a special conference, made the celebration official. They were ready to announce the first real hope of a leprosy cure.*

Carville has had excellent results with three sulfa drugs: Promin, Diasone and Promizole (streptomycin, now under test, also looks promising). Last year the leprosarium discharged 37 patients, this year it will discharge 40 or more. Said its medical chief, Dr. Guy H. Faget: "The sulfones have stopped even the most hopeless cases in their tracks."

Man's Fear. Modern research has disproved many of mankind's ancient notions about leprosy. The disease is only slightly contagious (much less so than tuberculosis); in 52 years,, no Carville nurse or doctor has caught it. Yet every state but New York requires segregation of lepers.

Carville, isolated in an unhealthy swamp on the Mississippi, 75 miles north of New Orleans, was founded by the Sisters of Charity in 1894 as a lepers' retreat. The Federal Government took it over in 1921. Patients are still called "inmates." Most use fictitious, names, to protect their families. Their outgoing letters are sterilized before mailing. They occupy their time with bicycling, movies, reading, dances, golfing on a small links. They are allowed visitors and two weeks' leave at home each year, but visits home are difficult because lepers may not travel on trains, buses or other common carriers. Carville patients sometimes marry each other, but their children (susceptible to the disease) are removed as soon as they are born.

U.S. health officers estimate that there are at least 2,000 lepers at large in the nation, either unaware that they have the disease or concealing it because of the stigma. Most of Carville's patients (17 of them World War II veterans) are from Texas, Louisiana, California and Florida, the only states where leprosy is endemic. Leprosy, in early stages, is hard to diagnose, is often confused with syphilis. Research is handicapped by the fact that leprae bacilli cannot be cultured artificially and the disease cannot be reproduced in animals.

Man's Hope. The leaders in developing the new sulfa treatment were Dr. Faget and world-famed Leprologist George H. McCoy, head of Louisiana State University's preventive medicine department. (They long ago dropped the traditional chaulmoogra oil as worthless.) Because leprae bacilli are tough, and most of Carville's patients are in advanced stages of the disease, recovery is slow. But heavy daily injections of Promin (or doses of Diasone or Promizole pills) gradually clear out the bacilli, reduce swellings, heal lesions.

Time required for suppressing the disease: 18 months to five years.

On the strength of the hopeful new treatments, the newly created National Advisory Council on Leprosy decided last week that it was high time for a more humane attitude toward lepers. Their recommendations (to Surgeon General Thomas Parran): 1) new diagnostic centers and clinics for treatment in the four states where leprosy is endemic; 2) segregation only as a last resort (in contagious stages); 3) pleasanter surroundings and more freedom for Carville's lepers, including a month's vacation every six months.

* Leprosy, caused by a germ (Mycobacteria. leprae) resembling that of tuberculosis, attacks the skin and peripheral nerves. The first symptom is loss of sensation in the skin. Reddish spots develop, then nodules (lumps), particularly on the face. In late stages the disease may rot away the nose, ears, hands, feet.

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