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The medieval leper and his northern heirs

by Peter Richards

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291648,956 (2.67)1
Medieval history is rich in rules and regulations for lepers, but reveals little of who they were or what became of them. This book searches for the reality of the individuals themselves, people who through their disease - or suspicion of it - contributed a unique chapter to social and medical history. Their hopes, fears, frustrations, and sufferings are explored partly through English medieval sources but mainly through the record of the remarkable survival of both leprosy and many medieval attitudes to it in the Aland islands between Sweden and Finland in the seventeenth century, where the struggle of a poor community both to contain the disease and to provide for those suffering from it were recorded for over a quarter of a century by the rural dean. The medical identity of medieval leprosy is confirmed from descriptions, from portraits (many previously unpublished or forgotten), and from the characteristic mutilations of bones; an appendix of original documents forms a unique collection of source material for social and medical historians. The late PETER RICHARDS was a former Professor of Medicine and Dean of St Mary's Hospital Medical School in London, and President of Hughes Hall, Cambridge.… (more)
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Just the thing for a cheerful dinner discussion. I recently read a book on The Black Death in which I discovered that there was a controversy over whether the Black Death was the same disease that’s now known as bubonic plague. There’s a similar controversy over leprosy, and it goes in both directions timewise: is the disease known as leprosy in biblical times the same as the disease known as leprosy in medieval times, and the same as the modern Hansen’s disease? The ancient Greeks distinguished two kinds of leprosy; one was almost certainly the filarial disease now known as elephantiasis, and the other was skin disease that might or might not have included Hansen’s disease. The geographic pattern appears to have changed with time; it was first a warm climate disease, and this book suggests that returning Crusaders may have brought it back to Europe. However, by latter medieval times the endemic areas were in colder climates - England and Scandinavia. It was never an epidemic in sense that plague or smallpox was, but the incidence got up to two or three cases per thousand - maybe.


The “maybe” part is there because it’s not clear that all the people diagnosed with leprosy in medieval times had it. Leprosy was diagnosed by a priest and members of the congregation, so if there was somebody in the parish who was annoying or unlikeable or just plain odd, they could be sent off to a leprosarium. The accused could get a doctor’s certificate stating that they were “clean”, but they had to do this at their own expense; this might mean a journey from Cornwall to London or the Aland Islands to Stockholm which would probably be beyond the means of your average leper.


In England, leprosaria were typically religious institutions and the lepers were lay brothers and sisters. The lepers were generally put to work chanting prayers (sometimes up to 250 a day) for the soul of the founder, and could be punished if they failed to keep up the prayer quota. As the incidence of the disease diminished, some of these places experienced a leper shortage, with the staff outnumbering the lepers two or three to one.


The last third of the book discusses disease identification and concludes that medieval leprosy was the same as modern Hansen’s disease. Archeological investigations of leper cemeteries show a large fraction of the skeletons have bone changes identical with those seen in modern patients. (Interestingly, the facial bone changes were discovered in the leper cemetery first, which then led doctors to find them in X-rays of modern patients).


This is an older (1977) book, so there’s probably more recent information. It’s still pretty interesting. ( )
  setnahkt | Dec 26, 2017 |
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Medieval history is rich in rules and regulations for lepers, but reveals little of who they were or what became of them. This book searches for the reality of the individuals themselves, people who through their disease - or suspicion of it - contributed a unique chapter to social and medical history. Their hopes, fears, frustrations, and sufferings are explored partly through English medieval sources but mainly through the record of the remarkable survival of both leprosy and many medieval attitudes to it in the Aland islands between Sweden and Finland in the seventeenth century, where the struggle of a poor community both to contain the disease and to provide for those suffering from it were recorded for over a quarter of a century by the rural dean. The medical identity of medieval leprosy is confirmed from descriptions, from portraits (many previously unpublished or forgotten), and from the characteristic mutilations of bones; an appendix of original documents forms a unique collection of source material for social and medical historians. The late PETER RICHARDS was a former Professor of Medicine and Dean of St Mary's Hospital Medical School in London, and President of Hughes Hall, Cambridge.

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