The history of leprosy in Ethiopia to 1935.

ETHIOPIA has suffered since time immemorial from a high incidence of leprosy, and is indeed said to have been one of the countries most seriously affected by the disease.' Its existence there is well documented in the rich travel literature of the area.2 The Portuguese priest, Francisco Alvares, the first foreign observer to write a comprehensive account of the realm, testified in the sixteenth century that it was inhabited by "*many lepers".3 The more numerous observers of the nineteenth and early twentieth centuries indicated that little had changed in the intervening years. Nathaniel Pearce, a British resident in the north of the country, declared in 1831 that infection was "very common among the lower class", and that there were "thousands who had lost their fingers and toes", and whose bodies were "covered all over with large white spots".4 A decade or so later, the French Scientific Mission reported that the disease was "very common" in the north, while the German explorer Eduard R(uppell, also writing of that area, described persons with bad sores on their feet, the bones of which gradually degenerated so that their toes fell off.5 Travellers to the southern provinces told similar tales. Rochet d'Hericourt, a French visitor to Shoa, referred to leprosy in the 1840s as one of the most common complaints (though he admitted that he had not himself seen many lepers).6In Ankobar, the British diplomatic mission of 1841-2, which treated 717 patients, found that twenty-six were suffering from the disease.7 Numerous cases were also reported later in the century by other observers, who noted significant regional variations: the French traveller Borelli, the Italian missionary Massaia, and an Italian physician De Castro all stated that leprosy was most widespread in Gojam, a province