Leprosy in the Middle Ages - Essay Example

? Leprosy in the Middle Ages. Leprosy, or Hansen’s disease, is an extremely debilitating disease which has been prevalent since ancient times. In the Middle Ages, leprosy was a serious problem which elicited unique social and medical responses. The most common attitude toward leprosy was ostracism, rising from the fear that leprosy was a highly contagious disease. In addition to the physical stigma attached to leprosy, the disease was considered to be the outward manifestation of inner moral degeneration. The social stigma attached to leprosy in the Middle Ages was so strong that the very word continues to connote ostracism even in contemporary times. Leprosy in the Middle Ages. Leprosy, or Hansen’s disease, is an extremely debilitating disease which has been prevalent for over 4,000 years, right from the ancient civilizations of China, India and Egypt. The earliest documented case of leprosy, supported by DNA evidence, is that of a man whose remains were discovered in a tomb next to the Old City of Jerusalem. The first recorded instance of leprosy is found in the Bible, in Leviticus 13:2 (Creativecommons.org, n.d.). It is probable that the disease spread to Europe from Egypt through Phoenician sailors in the eighth century (Souvay and Donovan, 1910). The word leprosy has its roots in the Greek lepra, meaning ‘a disease which makes the skin scaly,’ and the Arab lepo, or ‘to peel of scale off.’ The primary external symptom is pronounced skin lesions. It is caused by the bacteria Mycobacterium leprae discovered by Gerhard Armauer Hansen in 1873. If unchecked, this chronic bacterial infection can progressively attack the skin, nerves, limbs and eyes, causing permanent damage, deformation, blindness, loss of neural sensation, and local paralysis. The mode of transmission of the disease is still not certain. Approximately 99% of men are naturally immune to the disease. Poor living conditions, diet and genetic factors may predispose an individual to contact leprosy. Treatment for leprosy began with the introduction of dapsone in the 1930s and complete cures were made possible by multidrug therapy in the 1980s (Creativecommons.org, n.d.). It is acknowledged that leprosy was a familiar disease in medieval Europe, and probably reached its peak during the twelfth and thirteenth centuries (Covey, 2001). In the Middle Ages, leprosy was a serious problem which elicited unique social and medical responses. Leprosy was a feared condition throughout the Middle Ages. This may be largely attributed to ignorance of its causes and medical implications, and the absence of any recognized treatment or cure. The Medieval diagnosis of leprosy, “was a prediction of disfigurement and death, and what is perhaps more terrifying, it separated a man from society because of the infection he carried outwardly and the moral corruption that lay within him” (Covey, 2001, 316). Biblical references supported this reaction to the disease. The numerous references to leprosy in the Bible largely give leprosy a connotation of being a disease of the unclean. This is evident in the passage from Leviticus 13: 44–46 which states, “Now whosoever shall be defiled with the leprosy, and is separated by the judgment of the priest, shall have his clothes hanging loose, his head bare, his mouth covered with a cloth, and he shall cry out that he is defiled and unclean. All the time that he is infected and unclean, he shall dwell alone without the camp” (Covey, 2001, 316). In effect, the Bible condemned leprosy as a ‘defilement’ and sanctioned the banishment of lepers from society. The most common attitude toward leprosy was ostracism, rising from the fear that leprosy was a highly contagious disease. In the light of this fear of contacting leprosy through association with lepers, medieval laws enforced segregation of lepers in various manners in different places. The 1276 assizes of London restricted the freedom of movement of lepers by banning them from residing in the city. This was followed by the edict issued by King Edward I in 1346, which expelled people with leprosy from the city limits of London. Further laws enacted between 1346 –1375 attempted to restrict begging by people with the disease. Medieval English officials also issued writs of separation to people with the disease. Medieval French communities often denied lepers ownership privileges. French officials, in a parody of the burial service, sprinkled earth on the heads of lepers signifying they were buried from the world. An extreme reaction to leprosy was seen in some Scottish communities in which victims of the disease were hung or transported out of town. In a rare exhibition of compassion and charity towards lepers in twelfth century England, Queen Matilda was the benefactress of lepers, King John (1204) allotted a portion of all flour sold at market to people with leprosy and the Bishop of Exeter allowed them to enter the markets to collect food or alms in 1163 (Covey, 2001, 319). In general, lepers were forced to live outside medieval community boundaries. It was believed that the contagion was spread through infected breath and authorities mandated that lepers could only “communicate when they were downwind” (Covey, 2001, 317). Victims were often forbidden access to public roads, taverns, churches, local streams and marketplaces and could not touch babies or use communal drinking cups. Prohibitions extended to the property ownership of lepers. Some medieval communities mandated the wearing of special clothing by lepers as a warning sign. Such clothing included long robes, ankle-length tunics of russet, cowls and capes of black cloth, gray or white wool robes with masks over the mouths, gloves and horns thrown over the shoulder. Yellow crosses, red signs in the shape of a goose or duck foot, or the letter “L” were sewn to the capes or vestments of lepers to mark them as social outcasts. Some medieval communities required lepers to carry long poles to use as pointers for purchases and to pull alms cups placed at a distance. Another medieval practice was the use of clappers, bells, rattles and castanets to warn people of their approach. Lepers were often made the scapegoats for social and economic catastrophes. This is best exemplified by King Philip V (1316 –1322) of France, who accused lepers of poisoning wells during a famine and ordered, “Let us collect in one place all of the people with leprosy and burn them, and so often as more appear, let us burn them also until the disease is eradicated” (Covey, 2001, 319). In addition to the physical stigma attached to leprosy, the disease was considered to be the outward manifestation of inner moral degeneration. This attitude was sanctioned by the Medieval Church. Under Pope Alexander III, the Third Lateran Council (1179) issued a decree that urged the segregation of lepers by building separate chapels for them and burying them in separate cemeteries. The statutes of St. Julian’s ruled that people with leprosy ought “in their conduct as in their garb, to bear themselves as more despised and as more humble than the rest of their fellow men . . .” On the whole, Medieval society, particularly Christians, considered leprosy to be a moral disease and “a warning to all living that their sinful lives might result in God’s punishment” (Covey, 2001, 320). Pope Gregory the Great (540–604), the scholar Isidore of Seville (560–636) and the medieval monk Bede condemned people with leprosy as heretics. Lepers were often perceived to be moral perverts with strong sexual appetites. The treatment of leprosy in the Middle Ages was arbitrary and not founded on sound medical knowledge. Leprosy was variously attributed to sexual transmission, simple association, bites of venomous worms, eating rotten fish and meat, drinking unclean wine, conception during menstruation, imbalances of bodily fluids and leprous wet nurses. The monk Angelicus held in 1246 that leprosy was hereditary. Medieval physicians adopted a variety of treatments, including bleeding, purging, bathing, herbal and chemical cures (such as Chaulmoogra oil), and the use of fresh food and ‘medicinal waters.’ The famous abbess, Hildegard of Bingen (1098 –1179), advocated the use of the white lily and the soil of ant-hills as cures. Most medieval treatment coupled physical and spiritual interventions. Christians viewed religious relics as effective treatments for leprosy, such as the bones of Saint Milburga (Covey, 2001, 319). As leprosy was largely acknowledged to be incurable, treatment focused on the philanthropic care of lepers and their isolation. This was done through the establishment of large numbers of leper houses outside town limits, with walls and private chapels. These were prevalent in France, Germany, the Netherlands, Spain, Britain, Scotland and Ireland. These hospices were called Lazar, as they were often run by the Knights of St. Lazarus. They were founded and endowed by Papal Bull as religious establishments, and were under monastic control (Souvay and Donovan, 1910).  The segregation of lepers from mainstream society prevailed for about eight centuries. By the middle of the thirteenth century leprosy started to decline and almost disappeared in Europe during the sixteenth century. This decline is attributed to various causes, such as improved sanitation, diet and living conditions. Other reasons may be acquired immunities, social segregation, cold weather, the onset of the more virulent tuberculosis and the Black Death and improved medical diagnosis (Covey, 2001, 319). However, the social stigma attached to leprosy in the Middle Ages was so strong that the very word continues to connote ostracism even in contemporary times. References. Covey, Herbert C. (2001). People with leprosy (Hansen’s disease) during the Middle Ages. The Social Science Journal. 38 (2001) 315–321. Leprosy. Creativecommons.org. Souvay, C., & Donovan, J. (1910). Leprosy. The Catholic Encyclopedia. New York: Robert Appleton Company. Retrieved April 22, 2013 from  http://www.newadvent.org/cathen/09182a.htm Read More