Reflections
Emergency medicine History and humanities
Volume 195 - Issue 11

Register of reported cases of leprosy

Author:  Peter Christopher

Med J Aust 2011; 195 (11): 717. || doi: 10.5694/mja11.10416
Published online: 12 December 2011
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Many years ago, I rescued from destruction a unique 120-year-old leprosy register of the colony of New South Wales (Box 1). This register commenced in 1891 and continued after federation under NSW legislation.1,2 With 101 double pages, patient details were entered into 12 columns, in clearly legible copperplate handwriting (Box 2). As leprosy notification was compulsory, entries were a provisional diagnosis. Patients were subsequently examined by specialists, sometimes chaperoned by police. The diagnosis was entered into the register. If the patient had leprosy, warrants were issued for their detention at the Coast Hospital lazaret at Little Bay in Sydney.

For many, this was a sentence of life imprisonment as there was no effective treatment. Some absconded only to be returned by the constabulary. Patients were treated compassionately, being allowed to keep pets, grow vegetables, and to fish. Chinese patients were even given a liberal allowance of opium.3

In the first four decades, to 1931, 290 patients were entered in the register; 224 of these (77.2%) had leprosy (other diagnoses included beri-beri, “cretinism”, eczema, gangrene, hemiplegia, psoriasis and, frequently, syphilis). Of those with leprosy, 203 were men and 21 were women, one of whom was a nun.

“Nationality”, where recorded, showed the highest prevalences of leprosy among Australian or European patients (79 [35%]), Chinese patients (66 [30%]) and Pacific Islanders (22 [10%]). Only three (1%) were Aboriginal, corroborating the fact that leprosy was not endemic before European settlement. Other patients were from Ceylon, Egypt, India, Syria, the United States and Zanzibar.

In the fifth decade (1934), the hospital was renamed the Prince Henry Hospital of Sydney. Subsequently, with the advent of sulfones, patients could be rendered non-infectious within 12 months and be discharged on treatment (with regular reviews) rather than remain incarcerated. Many were readmitted, probably because their compliance with treatment lapsed. The last entry in the register was made in 1950, 59 years after its commencement.

There was no confidentiality coding as there is now with HIV-AIDS registers. Nowadays, leprosy is rare in Australia and immigrants are screened;4 globally, there is a decreasing trend in new cases, with the World Health Organization reporting about half a million in 2003 falling to about a quarter of a million in 2009.5

Author

  • Peter Christopher1
  • 1. Sydney, NSW.

Competing interests

No relevant disclosures.

References

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