an accident, a foreigner saying
to a native that he had a disease such as they had in China. There are but
six Chinese in the Molokai leper settlement, and there are three white men
there.

The leprosy of the Islands is a disease of the blood, and not a skin
disease. It can be caught only, I am told, by contact of an abraded
surface with the matter of the leprous sore; and doubtless the familiar
habit of the people, of many smoking the same pipe, has done much to
disseminate it.

Its first noticeable signs are a slight puffiness under the eyes, and a
swelling of the lobes of the ears. To the practiced eyes of Dr. Trousseau
these signs were apparent where I could not perceive them until he laid
his finger on them. Next follow symptoms which vary greatly in different
individuals; but a marked sign is the retraction of the fingers, so that
the hand comes to resemble a bird's claw. In some cases the face swells
in ridges, leaving deep furrows between; and these ridges are shiny and
without feeling, so that a pin may be stuck into one without giving pain
to the person. The features are thus horribly deformed in many instances;
I saw two or three young boys of twelve who looked like old men of sixty.
In some older men and women, the face was at first sight revolting and
baboon-like; I say at first sight, for on a second look the mild sad eye
redeemed the distorted features; it was as though the man were looking out
of a horrible mask.

At a later stage of the disease these rugous swellings break open into
festering sores; the nose and even the eyes are blotted out, and the body
becomes putrid.

In other cases the extremities are most severely attacked. The fingers,
after being drawn in like claws, begin to fester. They do not drop off,
but seem rather to be absorbed, the nails following the stumps down; and I
actually saw finger-nails on a hand that had no fingers. The nails were on
the knuckles; the fingers had all rotted away.

The same process of decay goes on with the toes; in some cases the whole
foot had dropped away; and in many the hands and feet were healed over,
the fingers and toes having first dropped off. But the healing of the sore
is but temporary, for the disease presently breaks out again.

Emaciation does not seem to follow. I saw very few wasted forms, and those
only in the hospitals and among the worst cases. There appears to be an
astonishing tenacity of life, and I was told they mostly choke to dea