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 death,
or fall into a fever caused by swallowing the poison of their sores when
these attack the nose and throat.

Those diseased give out soon a very sickening odor, and I was much obliged
to a thoughtful man in the settlement, who commanded the lepers who had
gathered together to hear an address from the doctor to form to leeward
of us. I expected to be sickened by the hospitals; but these are so well
kept, and are so easily ventilated by the help of the constantly blowing
trade-wind, that the odor was scarcely perceptible in them.

You will, perhaps, ask how the disease is contracted. I doubt if any one
knows definitely. But from all I heard, I judge that there must be some