Leprosy, or Hansen’s disease (so named because it was G.H. Armauer Hansen who discovered, in Norway in 1873, that the bacterium Mycobacterium leprae was the cause) has been known to man for over 4000 years. The word leprosy comes from ancient Greek meaning ‘scaly skin’ or ‘scaly back’. Most people are naturally immune to the disease and nowadays it mostly affects people in developing countries where resources are scarce. It is not highly infectious and is probably transmitted through airborn droplets. After infection symptoms can take up to 20 years to develop and begin by affecting the nerves that control feeling in the skin. If left untreated, further nerve damage occurs and ulcers may develop. Because of the loss of sensation, wounds and cuts go unnoticed and the consequent damage leads to the visible signs commonly associated with leprosy.
Leprosy appeared in Europe in the early 11th century and by the 15th century it had all but disappeared. It is thought that the disease may have been brought to Europe from Middle Eastern countries by those who had been on Crusade and it was regarded as being an upper-class disease rather than a disease of the poor. In fact early sufferers were pitied and treated well, but as the prevalence of the disease grew those with leprosy were reviled and seen as unclean and sinful. They were forced to carry a clapper, and later a bell, to warn of their coming so that people could avoid them and not come into close contact with them.
A person with leprosy from a 14th century manuscript. The bell may have been to attract charitable donations as well as warning that a diseased person was in the vicinity.
In the Middle Ages, many skin conditions were labelled as ‘leprosy’. These may have included such conditions as eczema, psoriasis and skin cancers and by the 12th century those with leprosy became regarded as unclean. Around this time many leper houses were built to keep sufferers separate from society as it was believed that the disease was very contagious. The Benedictine monk and chronicler, Matthew Paris, who lived from around 1200 to 1259, estimated that there were 19,000 leper houses in Europe, with 2000 being in France and over a hundred in England. These houses were run along similar lines to monasteries and convents and were for care as well as quarantine. In fact those with leprosy were sometimes viewed as experiencing purgatory whilst still on earth and their suffering was viewed as holy. The residents spent much time in prayer and, as it was also popularly thought to have been a sexually transmitted disease, the leper houses made the sufferers take a vow of chastity.
Those who did not enter leper houses took the vows that are listed in the Mass of Separation including vowing not to enter any church or marketplace and not to touch the rim or rope of a well except with gloved hands. They were also excluded from inheriting.
Famous sufferers include Baldwin IV, king of Jerusalem, who continued to rule despite his illness and Alice the Leper, a Cistercian nun who became a leprous martyr. There is also, of course, Richard FitzEustace, in my novel The de Lacy Inheritance, who is based on a real person.
Many wealthy people in the middle ages gave donations to the leper houses and Roger de Lacy (who was Richard’s brother) gave land for a leper hospital on the banks of the river Ribble near Clitheroe. The site is now the Edisford Hotel near the bridge that spans the river. The hospital was named St Nicholas’s.
Nowadays leprosy is curable with treatment by a multidrug therapy that combines dapsone, clofazimine and rifampicin. However the disease remains in parts of Africa, Asia and South America and there are still occasional cases of leprosy treated in the UK.
I have also been told by Sian Arulanantham, Head of Programmes at The Leprosy Mission, that legislation still exists that discriminates against people affected by leprosy. This is just one of the issues that The Leprosy Mission is trying to address. You can find out more about their work at: http://www.leprosymission.org.uk/