A sanatorium for lepers should, in the light of our present knowledge, be con ducted much on the same lines as one for consumptives: scrupulous cleanli ness, pure air and sunlight, strict atten tion to the destruction by fire or antisep tics of all substances containing bacilli, especially the secretions of the mouth and nose and the discharges originating from tuberculous nodules. With abun dant wholesome food, comfortable sur roundings, distraction, ancl constant pro fessi onal care, the lives of these victims could be made bearable; the fetters which sanitary rulings impose upon them would hardly be felt, and many would be returned to their homes.
[At the Leper Hospital of Maracaibo (Venezuela), in charge of Dr. Flores, a very laudable effort, sustained by the government and private initiative, to render the life of these unfortunates bearable, has been made. The success met N% ith is thus described by our faith ful consul in that city, Hon. E. H. l'Innmeher, Ito has repeatedly visited the sufferers and inquired into their general welfare:— '"I'he interior arrangements of the island are excellent. Capacious cisterns insure a supply of fresh water, and the diet is wholesome and abundant, the cost of the maintenance and treatment of each person amounting monthly to about thirteen dollars in American money. comfortable building has been erected for the use of the employees, while for the patients a large edifice, built of concrete, forming, a parallelogram with a court yard in the centre, is divided into sepa rate apartments., plainly, but sufficiently furnished. A neat chapel has been re cently built, where religious service is held every Sunday. A pleasant feature is the establishment of cottages with grounds, in which reside those patients whose means permit of it. Land is given free to anyone who is able to erect a dwelling, and, as there are many who possess an income, little homesteads are soon formed.
"It was at first a mooted point as to whether marriages should be permitted among patients, but the question was de cided affirmatively, and several weddings took place. For years the theory of sterility was not contradicted by experi ence, and seemed about to be definitely settled, N% hen two births occurred on the island, the parents in each case being lepers. I would be inclined to ask whether a mistake had not been made in the diagnosis of one or the other of the parents, confounding with true leprosy some other physical taint.
"With the establishment of matri monial relations and the system of sepa rate cottages for those who desire them, the island is beginning to assume the as pect of a rural municipality. Its extent
is little more than a mile square, with good soil, of which advantage has been taken by the well-to-do patients for the cultivation of various products and the breeding of goats. The territory has been artificially stocked with game, which is now becoming abundant, and nothing seems to have been omitted to secure the comfort and welfare of the unfortunates. A library is at their constant disposal, and occasional musical entertainments are furnished by the Junta, whose efforts seem directed to the establishment of a veritable home for the patients, where they may, as far as possible, forget their afflictions and pass their lives in cheer fulness. Weekly visits of relatives and friends are allowed, which are looked for ward to with eager anticipation, and the discipline generally is mild and judi cious." C. E. DE M. SAJOUS.] As to the immigration of lepers into the country, Dr. Bracken, of Minne apolis, basing his opinion upon a study of the Minnesota colony, suggests that the family history of all immigrants from a country where leprosy prevails should be secured before they are allowed to embark for America, no member of a leprous family being permitted to land upon our shores. This procedure would doubtless prove effective were it properly carried out; but, as recently shown by Hansen, in answer to Ashmead, who recommends the same measure, the symp tomatology of the disease in its early stages and the necessity of examining the entire body of each passenger would de feat any attempt in this direction from the start.
The conditions antagonistic to the spread of leprosy in Minnesota are also opposed to sterility, as borne out by the families of several of the Minnesota ers. Dr. Bracken believes it quite sible for leprosy to die out in certain favored sections of the country, such as Minnesota, without segregation, provided the importation of lepers is discontinued; but he contends that segregation should, nevertheless, be insisted upon in all cases. Attempts to cultivate the bacillus on leprous material made during the four years under review have always failed. In inoculation of animals the bacillus was found in the lymphatic glands uated at a distance from the seat of inoculation. Ninety-seven cases of lep rosy which left the hospital apparently cured followed up. ln some a cure ap peared to have been effected, but the number of these estimated at 30 at the most. Lie (Brit. Med. Jour., Jan. 26, 1901, from Lepra, vol. i, Fase. 1 and 2).