Reprinted from University Medical Magazine, September, 1895. 
NOTES ON AMERICAN LEPROSY. 
Leprosy in Colombia. 
The fact that there are 24,000 to 30,000 lepers in Colombia-that 
is, as many lepers as there are in the rest of South America, the Sand- 
wich Islands, North America, and Europe together-should give that 
country a pre-eminent importance in the eyes of leprologists. There 
is no proof that the disease existed in Colombia before the invasion. 
Why should it prosper there and not in Peru? The only essential 
difference between the two countries seems to be one of climate. But 
there is one circumstance which might throw some light on this singu- 
lar difference. Colombia, New Granada, Venezuela, etc., are coun- 
tries where insect life is extremely abundant, and very probably pes- 
tilential, carrying poisons to the human organism with which they come 
into contact. 
Cases of leprosy are more numerous in the river valleys, where the 
air is loaded with moisture, and becomes an enormous stimulant to the 
production and development of insect life. Such valleys are more fre- 
quently found and more densely populated in Colombia than in Peru. 
They are occupied by a low class mixed race of Spaniards, negroes, 
and Indians. The better class, the agricultural part of the nation, 
occupy the templados, 6000 to 8000 feet above the sea-level; the 
wealthiest part live still higher up above the templados, on the pomu- 
ros. The disease develops in climates which vary 140 to 20°, generally 
humid, and very sparely lashed by winds. 
An Extremely Interesting Particularity about Leprosy in 
Costa Rica. 
Dr. Emilio Echeverria, of San Jose, writes me that all cases of 
leprosy in that country, which came to his knowledge, were of the 
anesthetic variety, with one exception, that of an old negro, who 
brought the disease from his native Jamaica; he had lepra tuberosa. 
He adds that, to his knowledge, there is no physician in Costa Rica 
who has seen original tubercular leprosy in that republic. Dr. Eche- 
verria adds that he is pretty sure that this case of tuberosa was the 
only tubercular case ever observed in Costa Rica. 
This anesthetic leprosy, considered by Dr. Echeverria as post- 
Columbian, is gaining ground rapidly in that part of the world, 
although it would be too much, so far, to call it widespread. 2 
Albert S. Ashmead. 
History of Leprosy in Cuba. 
Dr. D. Enrique: Robeein writes: "In all America leprosy has 
been imported ; the Indians never knew this scourge until the first con- 
querors reached its shores. We may extend this assertion to all the 
Antilles, including Cuba. Not having existed ab ovo, we cannot well 
assert that leprosy has always existed in Cuba. 
" The disease begins to be known at the time of the colonizations 
which proves that lepra is inherent to men, and that it always follow, 
human currents. 
" Are there statistics on which we can found the relations between 
the number of lepers existing in the divers epochs up to our own days ? 
Unfortunately they do not exist: nothing has been done in Cuba to 
obtain such information. The director of the leper hospital of Havana 
could not give me these statistics. And if for one asylum there are no 
data, what can we expect from the province of Havana and the whole 
island ? In a country eminently leprous like ours, in which the two 
leper races, Africans and Asiatics, are largely represented, this negli- 
gence is incomprehensible. It is more than probable that in Cuba 
leprosy has spread as it has in other countries. To-day, even in our 
own capital, the lepers are numerous. We speak of those we see ; and 
those who hide, how many are they ?" 
Albert S. Ashmead, M.D. 
New York.