A large building with a long colonnaded porch in a tropical setting.

Leprosy in India, ca. 1931

Circulating Now welcomes guest blogger Magnus Vollset. Dr. Vollset is a researcher at the University of Bergen, Norway, and holds a PhD in medical history from the same institution.

Film showing the disfiguring effect of leprosy on the feet of a patient.
Still frame, Leprosy in India, ca. 1931
NLM Unique ID 100965364

Leprosy in India [Lepra in India in the original German] is a hard film to watch. In the course of its 12 minutes, it puts before the camera patients who suffer from a variety of symptoms, ranging from mild discoloration of the skin to terrible facial and bodily disfigurement, and loss of fingers and toes. Leprosy is a devastating illness, with a long history. In the early decades of the 20th century, doctors were starting to understand it as a bacterial disease, but there was still no very effective treatment (today it is usually called “Hansen’s Disease” and can be cured with antibiotics). People who were afflicted were designated as “lepers” and stigmatized. In some places they were reduced to the most degraded conditions of beggary and homelessness. In other places they were segregated, remanded to “leper colonies” where they would live out their lives isolated from the general population.

A bar graph shows the estimated number of lepers in India in 1920 as 150,000 and an increase of lepers in asylums between 1920 and 1921 as only 40 for a total of 8890.
Frontispiece, titlepage, The Leper Problem in India, 1922
NLM Unique ID 101606763

Leprosy in India is also a document of medical attention and treatment (and even a bit of hope), in the setting of British colonial India. Some of the treatment is rough—patients are displayed with varying degrees of callousness—but they do receive care. We may be shocked to see the patients exhibited so starkly. That wouldn’t fly nowadays, but back then there were no standards of informed consent. The patients were positioned before the camera and they complied. Viewers will be uncomfortable with that, and should be. Some of us will not want to watch, will feel that we don’t have the right to watch. But if everyone averts their gaze, or worse if we are not permitted to see, then the people who suffered so grievously are erased from history, theirs and ours. Because Leprosy in India is most of all a document of the human condition, and human suffering, which is a shared history: We are, at some time in life, every one of us prey to pain and disability and, potentially, disfigurement and separation.

Leprosy in India has two parts. Part one, a film clinic, shows a grand rounds of patients at the School of Tropical Medicine and Albert Victoria Hospital in Calcutta (now Kolkata), matched to intertitles that label the patient’s condition. Part two shows the layout of the hospital and the therapies it has to offer, including (at the very end of the film) a bit of physical fitness exercise.

The print that resides in the collection of the National Library of Medicine is a bit of a mystery: no other copies are known to exist; we don’t know of any documents that relate to its production or screening history. It was probably made in 1931, just after the scheme for classifying cases was decided upon at an extended international meeting in Manila. Its creator is probably Bernhard Nocht (1857–1945), director of the Hochschule für Tropenmedizin (Institute for Tropical Diseases) in Hamburg, Germany. Nocht had been the president at the second meeting of the League of Nations Leprosy Commission in Bangkok in December 1930, and after attending the meeting in Manila he was sent to Calcutta on a fact-finding mission.

Leprosy in India would have been screened at medical schools, especially schools of tropical medicine, and meetings and congresses convened by medical associations, governmental health authorities, and medical missionary organizations. A silent film, it undoubtedly would have been accompanied by voice-over commentary from a speaker. (A 1938 article reports that “Dr. Muir showed a cinematograph illustrating the activities of a leper settlement” at an “ordinary meeting” of the Royal Society of Tropical Medicine and Hygiene in London.) Although the details of the making of the film, and the intentions of the filmmaker, are unknown, it was probably designed to demonstrate the “Manila-classification.” The classification distinguished cases by type and severity of clinical signs: The letters A or B were used to signify whether the disease affected the nerves or the skin, and the numbers 1 to 3 stated how far the disease had progressed.

To read the full essay, including a discussion of contemporary attempts at finding a cure and the politics surrounding the issue, and to see the film go to NLM’s Medical Movies on the Web, a curated portal including original research on selected films from NLM’s collection.

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