64^ International Journal of Leprosy^ 1981

questions are challenging, be it in immunol-ogy, in microbiology, in epidemiology, orin other branches of research. Serious con-sideration should be given to these pointsby members of the International LeprosyAssociation because to some extent, oneway or another, many of us are part ofacademia. We should ask ourselves if wehave done what we ought to do to promotethe teaching of leprosy in universities andto stimulate young physicians and scientiststo become interested in the disease.

National or regional leprosy associationsand appropriate teaching of leprosy in theuniversities are two points which need tohe discussed. The columns of the JOURNALare open for any suggestions, reporting of

actual experiences, news, and comments.More exchange regarding these points issought.

Fifty years ago a group of leprologistsfounded the International Leprosy Associ-ation, creating the conditions for great ad-vances in leprosy. Considerable successeshave been obtained. Old challenges havebeen met. New challenges have arisen. Letus hope that these new challenges will bemet with the same determination our pre-decessors have shown. If so, 50 years fromnow leprosy will be, if not eradicated, atleast widely controlled thoughout theworld.

—Michel F. Lechat

Report of the Leonard Wood Memorial Conference on Leprosy *Held in Manila, Philippine Islands, January 9 to 23, 1931

ForewordIt has long been evident to those engaged

in the study and control of leprosy, that theexisting terminology and classification ofthe subject permitted of widely divergentinterpretations. This defect had become ahandicap of such degree, in correlating theviews and results of different leprologists,that an opportunity for discussion and at-tempted correction of some of the difficul-ties seemed to be an imperative require-ment for progress.

During the past year both the LeonardWood Memorial for the Eradication of Lep-rosy and the Leprosy Commission of theLeague of Nations took cognizance of thesituation, and became interested in holdinga round-table conference, in the Far East,and the trustees of the Memorial subse-quently made a financial allotment to effectthis purpose in so far as it was practicable.It was decided that the Conference shouldtake place in Manila immediately after themeeting of the Leprosy Commission, whichwas held in Bangkok in December 1930.

These materials are reprinted from Int. J. Lepr.2 (1934) 329-331, which was in turn reprinted from thePhilippine Journal of Science 44 ( 1931) 449-480.

The number of leprologists invited to theConference was necessarily limited since itwas intended that the proceedings shouldbe of the nature of informal discussions. Itseemed especially desirable that those in-dividuals who are members of the LeprosyCommission of the League of Nations, ortheir representatives, should attend be-cause of their previous studies of the sub-ject, and of their broad knowledge of theconditions prevailing in the widely scat-tered areas which are affected. Invitationswere extended to a number of others whowere located in the Far East, and whoseexperience was known to include uniqueaspects.

The Conference convened at Manila,January 9, 1931, and was in session untilJanuary 23, 1931. Those who attended areas follows:

Dr. Et. Burnet, Secretary, Leprosy Com-mission, League of Nations

Dr. R. G. Cochrane, Secretary, British Em-pire Leprosy Relief Association

Dr. H. I. Cole, Chief Chemist, Culion Lep-er Colony

Dr. J. Fajardo, Director of Health, Philip-pine Health Service

49, 1^ Editorials^ 65

Maj.-Gen. J. D. Graham, I.M.S., PublicHealth Commissioner, Government ofIndia

Dr. G. Gushue-Taylor, Superintendent,Mackay Memorial Hospital, Taihoku,Formosa

Dr. V. G. Heiser, Director for the Far East,Rockefeller Foundation

Dr. Lee S. Huizenga, Superintendent, Mis-sion Hospital, Jukao, Ku, China

Dr. A. N. Kingsbury, Director, ResearchInstitute, Kuala Lumpur, Federated Ma-lay States

Capt. P. H. J. Lampe, Director of Health,Dutch Guiana

Dr. C. B. Lara, Chief Physician, CulionLeper Colony

Dr. J. Lowe, Medical Superintendent,Dichpalli Leprosy Hospital, India

Dr. J. L. Maxwell, Henry Lester Instituteof Medical Research, Shanghai

Dr. E. Muir, Leprosy Research Worker,Calcutta School of Tropical Medicine

Dr. E. E. Neff, Superintendent, MogokaiCentral Leper Hospital, Fiji

Prof. Dr. B. Nocht, President, LeprosyCommission, League of Nations

Dr. M. Ota, Tohoku Imperial University,Japan

Dr. J. N. Rodriguez, Supervisor of Lepro-sy-Treatment Stations, Philippine HealthService

Dr. J. C. Tull, Government Pathologist,Singapore

Dr. H. W. Wade, Chief Pathologist, CulionLeper Colony; and Medical Director,Leonard Wood Memorial

Dr. N. E. Wayson, Director, United StatesLeprosy Investigation Station, Hawaii

Drs. LeRoy-Desbarres and H. Joyeoux, ofFrench Indo-China, also participated inthe first sessions.

The Conference was organized at thefirst meeting, and the agenda for consider-ation was agreed upon promptly thereafter.The subject matter was prepared for themost part in comittee, presented to the ple-nary sessions, and final decisions reachedin these. January 14, the members em-barked on a journey of inspection of re-gional treatment stations and leprosaria atCebu, Zamboanga, and Iloilo, and of theCulion Leper Colony. The sessions werecontinued with but brief intermissions

throughout the tour, both on the steamerand at ports visited.

The discussions were frank and detailed,and were in most instances extended to apoint of reconciliation of viewpoints andcommon agreement. The following reportis that decided upon by the Conference inplenary session.

—H. H. WadeChairman of the Conference

—G. Geshue-TaylorSecretary

ContentsForewordDiscussions and Conclusions

I. International ViewpointStudy tours; transfer of workers;leprosy digest, or annuaire

II. Uniformity of Methods and TermsI. Designation of cases of leprosy

Suspected; clinical; incipient;infectious; burned-out; arrestedwith deformity; leper; case ofleprosyDesignation of lesionsMacular;^acroteric;^skinchanges; definitions; leprotic;leproma; ulcers; infiltration;nodule; papule; macule

3. The microorganismNomenclature; toxins

4. Clinical classification of casesPrimary classification; proposedclassification of types of lepro-sy; main types; subtypes

5. Administrative classification ofcasesOpen; closed

6. Lepra reactions7. Early diagnosis of leprosy8. Methods of examination

Clinical; bacteriological9. Treatment of leprosy

General measures; special mea-sures; standardization and ap-praisal of treatment; organiza-tion of treatment

10. Evaluation of progressActive cases; quiescent cases;arrested cases; cure; relativecure; negative

11. Follow-up of patients

66^ International Journal^Leprosy^ 1981

12. Study of contacts13. Standardization of records

III. ProphylaxisIV. Research

I. Epidemiology2. Clinical studies and therapeutic

experimentation3. Diet4. Etiology and pathogenesis5. Biochemistry6. Pharmacology

AppendicesI. Details of Examination

II. Method of Treatment by IntradermalInjection

III. Treatment of Lepra ReactionIV. Manufacture of Mixed Ethyl Esters

of Hydnocarpus-group OilsV. Epidemiological Surveys

The International Leprosy Association*It was realized that this Conference af-

forded an exceptional opportunity to con-sider the question of a permanent interna-tional organization of those engaged inactivities concerning leprosy and of othersinterested in such work. It has long beenfelt that such a body would serve a usefulpurpose in stimulating greater interest inthe problem and in efforts to obtain moreeffective results.

Accordingly, information was laid beforethe Conference concerning two movementsto this end. These were (1) a discussion be-gun in 1922-23 among certain leprologists,which resulted in a decision to organize asociety as soon as there should seem to bea possibility of obtaining funds to supporta periodical; and (2) a separate movementstarted in 1925-26 to form an organizationto be called "Societe, Internationale de Le-prologie." The latter has unfortunately notbecome active. The Conference was alsoadvised that the Leonard Wood Memorialfor the Eradication of Leprosy would con-skier sympathetically a request for a sub-sidy to aid such a plan as the Conferencemight indorse.

After a thorough discussion of the matterit was unanimously decided that the exist-

Reprinted from Int. J. Lepr. 2 (1934) 354-355.which was originally printed in the Philippine Journalof Science 44 (1931) 449-480.

ing circumstances made it advisable to in-augurate a movement in which due consid-eration should he given the plans of thosepreviously interested in the matter andevery effort made to secure their coopera-tion. A proposed constitution and by-laws,comprising features of the earlier plans,were studied by the Conference. Uponreaching agreement on these, the membersof the Conference joined unanimously informing the Association. A meeting of theAssociation was then held; the constitutionand by-laws, subject to modification whenorganization of the Association has beencompleted, were adopted, and temporaryofficers were elected.

The name of the organization is THE IN-TERNATIONAL LEPROSY ASSOCIATION (As-sociation Internationale de la Lepre).

The purposes are: "To encourage and fa-cilitate mutual acquaintance and collabo-ration between persons of all nationalitiesconcerned in leprosy work and the coordi-nation of their efforts; to facilitate the dis-semination of knowledge of leprosy and itscontrol; and in any other practicable man-ner to aid in the antileprosy campaignthroughout the world; and to this end topublish a scientific journal of leprosy. Itshall endeavor to cooperate with any otherinstitution or organization dealing with lep-rosy work. —

For purposes of expediency provision ismade for a Western Section and an EasternSection; a General Council to be in chargeof the general affaris of the association, andSection Councils to be in charge of section-al affairs.

Membership may be of two classes."Regular membership" is open to all per-sons with recognized medical or other sci-entific qualifications, who are actively en-gaged in connection with the study,treatment, or control of leprosy, or whohave been so engaged. "Associate mem-bership — is open to all other persons con-nected with or especially interested in lep-rosy.

The chief activities anticipated are thoseof the holding of meetings and the publish-ing of a scientific periodical on leprosy.When found desirable and practicable, it isintended that general leprosy congressesshall be convened. It is believed that thesections can hold meetings more frequent-

49, I^ Editorials^ 67

ly, possibly in connection with other med-ical gatherings.

The proposed periodical, to be calledTHE INTERNATIONAL JOURNAL OF LEPRO-SY, will contain, besides suitable originalarticles, reprintings of important papersthat have appeared elsewhere, abstracts,news items, and possibly correspondenceand other appropriate material. The edito-rial control of the Journal will be carriedout by a board consisting of an Editor andtwo Associate Editors, to be chosen by theGeneral Council.

It was agreed that, for some time, itwould probably be impossible to finance asatisfactory journal solely from member-ship fees and subscriptions. Since therewas reason to believe that the LeonardWood Memorial would consider sympa-thetically a request for a subsidy for this

purpose, a resolution was passed request-ing such aid for a period of five years. Ifthis is granted, it is intended that publica-tion will commence early in 1932.

The temporary general council elected is:President, Dr. Victor G. Heiser; Vice Pres-ident, Western Section, Prof. Carlos Cha-gas; Vice President, Eastern Section, Dr.E. Muir; Secretary, Dr. R. G. Cochrane;Treasurer, Dr. Wm. H. Brown; GeneralCouncillors, Prof. Nagayo, Sir LeonardRogers, Dr. Etienne Burnet, and Prof. deLangen. The council made the followingappointments: Editor (and general council-lor cx officio), Dr. H. W. Wade; AssociateEditors, Dr. H. P. Lie and Dr. James L.Maxwell. Elections and appointments ofpersons not at the meeting are subject totheir acceptance.

Notes Concerning the Formation of theInternational Leprosy Association

The following comments have been solic-ited because I have been informed that I amone of the last survivors among the foundersof the International Leprosy Association.This makes me feel rather old. The eventsoccurred half a century and more in the past.We hope they will be of interest and haverelevance to our readers. Reviewing themhas freshened in my mind the privileges andfriendships of past years.

The proposal to form the ILA was initi-ated by Dr. H. W. Wade, who had beenfor some years working toward the formu-lation of such an organization. A number ofus realized that the subject of leprosy waspassing from a state of ignorance to a po-sition of greater knowledge. With the in-creasing popularity of the subject, a newera was dawning. If I am permitted somepersonal remarks and reminiscences, I shallshare with you some of my part in the be-ginnings of the ILA.

In 1924, I graduated from Glasgow Uni-versity and finished my degree course at St.Bartholomew's Hospital in London. Mycareer commenced in India, working as a

medical missionary under the Mission toLepers, now The Leprosy Mission. It is apoint of interest that when in medicalschool I had a vivid dream that I discovereda cure for leprosy. This probably influencedmy choice of leprosy as a lifetime work.When my father, Dr. Thomas Cochrane, amissionary to China with the London Mis-sion and founder of the Peking Union Med-ical College, mentioned to me that the thenMission to Lepers wanted a doctor, I un-hesitatingly offered myself. My first stationwas Purulia, Bihar, now West Bengal, innorth India. I received preliminary trainingby one who became the doyen of leprosyworkers, Dr. Ernest Muir, at the School ofTropical Medicine, Calcutta.

Returning to England in 1927, I obtainedthe Membership of the Royal College ofPhysicians, London, and proceeded to aDoctorate of Medicine in 1928 from Glas-gow. The year 1927 also marked the begin-ning of my connection with the British Em-pire Leprosy Relief Association (BELRA,now LEPRA). For the next approximatelyten years I travelled extensively on their