Bontius informs us that this disease was observed on the banks of the
Ganges, where it was known by the name of _Cowrap_. Kaempfer noticed it in
Ceylon and Japan. In Sumatra, whole generations are infected with both
leprosy and elephantiasis; and those who are labouring under the latter
disease, although it is not contagious, are driven into the woods.
Christopher Columbus found lepers in the island of Buona Vista in 1498,
and frictions of turtle blood were used to relieve them.
In our days it is a disease of rare occurrence, at least in Europe; yet it
was observed at Vetrolles and Martignes, in France, in 1808, and at Pigua
and Castel Franco, in Italy, in 1807. The elephantiasis still prevails in
our West India colonies, more especially that species which is called
"elephant leg," and which is not uncommon at Barbadoes, St. Christopher,
and Nevis. Parsons, in his Travels in Asia and Africa, informs us that a
similar complaint exists on the coast of Malabar, where it is called the
"Cochin leg." The Hindoo physicians treat it with pills of arsenic and
black pepper.
A curious species of leprosy appeared in Rome under the reign of Tiberius,
which was brought thither from Asia. The eruption first broke out upon the
chin, whence it was called _Mentagra_, and is thus alluded to by Martial:
Non ulcus acre, pustulaeve lucentes;
Nec triste mentum, sordidive lichenes.
From the chin it extended over the entire body, and on its disappearance
left scars more unsightly, if possible, than the former disease. Its
virulence and difficulty of cure induced the Romans to send to Egypt for
attendance. The same disease prevailed in the second century, and Soranus,
a physician of Aquitania, was sent for to heal it. Crispus, a friend of
Galen, is said to have discovered the best method of cure. Pliny has given
an accurate account of the mentagra in his Natural History, lib. xxvii.
cap. 1. According to the same writer, elephantiasis was brought to Rome by
Pompey's troops. Plutarch fixes its apparition to the time when
Asclepiades of Bithynia flourished as one of his disciples. Themison wrote
a treatise on the disease, which is mentioned by Caelius Aurelianus, but
has not been preserved from the ravages of time. Lucilius called the
affection _odiosa Vitiligo_. The _Gemursa_ of Pliny appears to have been a
similar complaint; and Triller thinks that it was the _Gumretha_ of the
Talmud.
Formerly, in England, the causes of lepers were committed to the
ecclesiastical courts, as it was prohibited to prosecute a leper before a
lay judge, as they were under the protection of the church, which
separated them from the rest of the people by a ritual. At this period a
law existed, called _Leproso amovendo_, for the removal of lepers who
ventured to mix in society. Thus leprosy may be considered one of the most
terrific maladies inflicted on mankind. Holy Writ affords us abundant
proofs of its fatal character. It is probable that this disease was first
observed under the scorching sun of Egypt, whence it spread its ravages to
Greece and Asia; and when the East was obliged to submit to the Roman
legions, the conquerors carried the scourge of the vanquished to their own
country. From Italy the disorder extended to France; and in the reign of
Philip I. we find some members of the church militant, called
_hospitaliers_, who spent their arduous life in attending upon lepers, and
waging war against the infidels.
The Hebrew tribes, on quitting Egypt, were subject to three kinds of
leprosy; all of them were distinguished by the name of _Berat_ ([Hebrew]),
or "bright spot." One called _Boak_ ([Hebrew]), of a dull white; and two
named _Tsorat_ ([Hebrew]), or "venom or malignity:" the first variety of
the latter being the _Berat Lebena_, or bright white berat; and the next
the _Berat Cecha_, or the dark and dusky berat; both of which were highly
contagious, and rendered those who laboured under their attack unclean,
and dangerous to society.
Manetho, Justin, and several historians, pretend that the Hebrews were
expelled from Egypt in consequence of their being infected with this
formidable disease; a reproach from which Josephus attempted to exculpate
his countrymen. It appears, however, that, during their captivity of one
hundred and thirty-four years, the Israelites laboured under this awful
visitation; and, three thousand years after their migration we find
Prosper Alpinus describing the banks of the Nile as the principal seat of
the disease. Lucretius gives the same account of it:
Est Elephas morbus, qui, propter flumina Nili
Gignitur, Aegypto in media, neque praeterea usquam.
Pliny and Marcellus Empiricus refer the calamity to the same source. They
state, however, that it was more general in the lower classes, although it
sometimes attacked their sovereigns; an event which added to the horrors
of the infliction, since it appears that royalty had the privilege of
bathing in human blood as one of the most effectual curative means. Gaul
and Avicenna attribute its fatal prevalence in Alexandria to the influence
of the climate, and the quality of their food. The Persian writer thus
expresses himself: "Et quando aggregatur caliditas aeris cum malitia cibi,
et ejus essentia ex genere piscium, et carne salita, et carne grossa, et
carnibus asinorum, et lentibus, procul dubio est ut eveniat lepra, sicut
multiplicatur in Alexandria."
The _Boak_, or slighter berat, which is not considered to be contagious,
still bears the same denomination amongst the Arabs, and is the [Greek:
lepra alphos] or dull white leprosy of the Greeks. The bright white and
dusky berats of the Hebrews were distinguished on account of their
malignity, and with the _Tsorat_ ([Hebrew]) are still called among the
Arabians by the Hebrew generic term with a very slight alteration, for the
_Berat Lebena_ is their _Beras Bejas_, and the _Berat Cecha_, the _Beras
Asved_.
While the Arabians borrowed the Hebrew terms, the Greeks took their
denominations from the same source; and from _Tsorat_ they adopted the
word _Psora_. The _Tsorat_ is restrained by the Hebrews to the contagious
form of leprosy. Amongst the Greeks Lepra was a generic synonyme of
_Berat_ or _Beras_.
This confusion in the adaptation of the names given to the varieties of
leprosy has occasioned much perplexity in the study of the disease.
Actuarius, in endeavouring to rectify these errors, has produced a greater
confusion. According to him, they are different forms of a common genus.
However, the most important distinction was that which defined the
contagious and the non-contagious forms. The leprosy described by Moses
under the name of _Boak_ or _Bohak_ was the [Greek: alphos] of
Hippocrates; _Seeth_ the [Greek: phakos]; _Saphachath_ and _Misphachath_
the [Greek: leichen]; and _Bahereth_ the [Greek: leuke]; and according to
Carthenser and other writers, this leprosy was the _Leuce_ of the Greeks.
The elephantiasis was long confounded with leprosy; but the former is a
tubercular affection of the skin, widely different from the scaly leprosy,
and certainly not contagious. Its singular name was derived from the
condition of the surface of the huge misshapen limbs of those who were
affected with the malady, and which bore some resemblance to the leg of an
elephant. This morbid state is not uncommon in the island of Barbadoes,
and in England it has been called "the Barbadoes leg." The original Arabic
name for this affection was _Dal Fil_, or "the elephant's disease," which
is now the common denomination; although it is frequently abridged into
_Fil_ alone, literally _Elephas_. The elephantiasis is not even alluded to
by Moses in his descriptions of leprosy. However, the elephant leg of the
Arabians is a disease totally different from the specific elephantiasis,
which is a disorder of the skin, the roughness of which led to the name,
and which the Arabians called _Juzam_ or _Judam_.
These errors of description amongst medical writers have of course
occasioned much obscurity and perplexity in the productions of travellers
and historians, who have generally confounded all these diseases with the
Hebrew leprosy, or the leprosy which for so long a period desolated the
fairest portions of Europe, where every country was crowded with hospitals
established for the exclusive relief of the malady. The number of
leper-houses, as they were denominated, has been singularly exaggerated.
Paris has been made to assert that there were nineteen thousand of these
hospitals, whereas he merely stated that the Knights Hospitalers, under
various patron saints, but more particularly St. Lazarus, were endowed
with nineteen thousand manors to support their extensive establishments;
and he thus clearly expressed himself: "_Habent Hospitalarii novemdecim
millia maneriorum in Christianitate_." It appears that in the reign of
Louis VIII., France had no less than two thousand of these hospitals.
Leprosy was well known in the eighth century, and St. Ottomar and St.
Nicholas, were considered the first founders of establishments for its
treatment in France and in Germany. The Crusaders, however, by their
connexions with the East, materially increased its inroads in Europe, and
the disgusting malady appears to have been considered as a proof of
holiness. Moehser, in his work "_De medicis equestri dignitate
ornatis_," informs us that the Knights of the order of St. Lazarus were
not only intrusted with the care of lepers, but admitted them into their
noble order: their Grand Master was himself a leper. The Crusaders,
returning from their useless wars, eaten up with the disease, received the
honourable distinction of being _pauperes Christi, morbi beati Lazari
languentes_. The most distinguished individuals in the land attended upon
them with the utmost humility; and Robert, King of France, used to wash
and kiss their filthy feet to keep himself in odour of sanctity. All these
attentions, however, did not always prevent the lepers from complaining of
their complicated sufferings, but they were exhorted by holy men (who of
course had never experienced the miseries of the malady) to be of good
comfort, as their illness was a blessed favour conferred upon them as the
elect of the land. St. Louis thought the Sire de Joinville an unbeliever;
for having once asked him which he would prefer, being a _mezieu_ or
_laide_ (a leper), or having to reproach his conscience with any mortal
sin, his favourite replied to the singular question, that he would rather
be guilty of thirty deadly sins; whereupon the sanctified monarch severely
rebuked him by telling him in the quaint language of the times, "Nulle si
laide mezeuerie n'est, comme de estre en peche mortel."
Notwithstanding the sanctity of their disease, lepers were by various laws
separated from the healthy portion of the community. The ceremonies used
on these occasions were curious; and we find the following description of
them in the History of Bretagne: A priest in his sacerdotal robes went to
the leper's dwelling, bearing a crucifix. He was then exhorted to submit
with resignation to the affliction: he afterwards threw holy water upon
him, and conducted him to church. There he was stripped of his ordinary
vestments, and clothed in a black garment; he then knelt down to hear
mass, and was again sprinkled with holy water. During these ceremonies,
the office for the dead was duly sung, and the leper was finally led to
his destined future residence. Here he again knelt, received salutary
exhortations to be patient, while a shovelful of earth was thrown on his
feet. His dwelling was most diminutive: his furniture consisted of a bed,
a water-jug, a chest, a table, a chair, a lamp, and a towel. He further
received a cowl, a gown, a leathern girdle, a small cag with a funnel, a
knife, a spoon, a wand, and a pair of _cliquettes_, (a sort of castanets,)
to announce his approach. Before leaving him, the priest added another
blessing to these gifts, and departed, after commanding him under the
severest penalties never to appear without his distinctive apparel, and
barefooted; never to enter a church, a mill, or a baker's shop; to perform
all his ablutions in streams and running waters; never to touch any
article he wanted to purchase, except with his wand; never to enter
drinking-houses, but to buy his liquor at their doors, having it poured
into his barrel by means of the funnel graciously given him for that
purpose; never to answer any question unless he was to windward of his
interlocutor; never to presume to take a walk in a narrow lane; never to
touch or go near children, or look at a good-looking wench; and only to
eat, drink, and junket with his brother lepers; and invariably to announce
his unwelcome approach by rattling his castanets.
The offsprings of these sequestrated creatures were seldom baptized; and
when this rite was performed, the water was thrown away. After this
oration his ghostly adviser took his final leave, and the patient's former
dwelling was burnt to the ground. The sepulchre of St. Mein, in Britanny,
was frequently visited by these poor creatures; and on such occasions they
were obliged to have both their hands covered with woollen bags, as a
distinguishing mark amongst the other pilgrims. Lepers were only allowed
to intermarry with fellow-sufferers; yet we find in one of the Decretals
of St. Gregory, that any woman who chose to run the chances of contagion
could please her fancy. St. Gregory perhaps thought this the most
effectual method of preventing the dreaded intercourse, as most probably,
had it been prohibited, lepers would have been in great request, they
having always been notorious for their amorous propensities. Muratori
informs us that these unfortunate persons did not always submit quietly to
these severe regulations, but several times joined the Jews in a revolt
against the authorities.
This affliction has been observed in various countries. In Iceland it is
called _Likraa_; in Norway, _Radesyge_ or _Spedalskhed_. It is to be
apprehended that many of these cases of leprosy belong more particularly
to the elephantiasis: such is the red disease of Cayenne, and the _Boasi_
of Surinam.
It is especially in the East, its probable original seat, that leprosy is
observed. In Damascus there are two hospitals for its treatment. The
waters of the Jordan are still considered efficacious in its cure, and the
waters of Abraham's well are looked upon as a specific. In Candia the
disease was common, and lepers were noted for their obscene profligacy.
From Crimea it has also been carried to Astracan, whence it infected the
Cossacks of Jaick. Pallas and Gmelin have given an accurate account of its
invasion.