by His Lordship Friar Thomas Bacon (David Moreno)
Orignally published in the October 2005, A.S. XL issue of the Dragonflyre, a publication of the Barony of Vatavia.

During the Middle Ages leprosy was the AIDS of its time. It was as much a moral contagion as it was a physical one. Those unfortunate enough to catch it were cast out of society as unfit and impure. The most notable leper was Baldwin IV of Jerusalem, the Leper King. As a result many myths have arose over leprosy, both of the disease itself and its effects on medieval society. This essay will explore those myths.

Medically, leprosy is the result of infection by the bacterium Mycobacterium leprae. And there ends the simplicity of leprosy. How contagious leprosy is depends on such things as whether there are open sores on the leper, skin breaks on the would be host, and the genetics of that host. A person infected by leprosy need not show symptoms for years. And those symptoms can range from very mild to extremely disfiguring. One of the most notorious symptoms is the lost of extremities. While the myth has these body parts falling off, what is really happening is that the bone is being reabsorbed by the body. The other major symptom is skin lesions. These can range from patches of skin which change appearance to disfiguring nodules which can be inflamed, ulcerate, and scar. However the primary tissue attacked by leprosy is the nerves which can leave skin either insensitive or extremely sensitive.

There are several difficulties assessing leprosy during the Middle Ages. The first is one even today’s doctors face, and that is that many skin conditions mimic the symptoms of leprosy. The second is that though by law the diagnosis of leprosy was to be pronounced by a medical doctor, is most cases it was done by a village elder, usually the priest. And finally it is not clear that the leprosy of the Middle Ages is the leprosy of today. During the Renaissance, the apparent incidence of leprosy dropped for reasons unknown. It can not be ruled out the bacterium mutated into a less virulent form.

Just how prevalent leprosy was during the Middle Ages is another one of those demographic questions that can only be vaguely answered because of lack of data. The number of leper house is a poor guide. They did not exist prior to 1179 when the Third Lateran Council decreed that a separate accommodation should be made for lepers. Towards the end of the period many were being established, not for need to house growing numbers of lepers, but as acts of charity to ease the souls of the benefactors into heaven. Many of these houses held few to none actual lepers. At their most numerous, lepers numbered only one or two per thousand population. Lepers were more feared then encountered.

The cause of this fear goes beyond the disfigurements of the disease. Leprosy was also seen as a sign of moral corruption. The reason has its roots in the Biblical book Leviticus. One of the principle purposes of Leviticus is to delineate what was ritually clean or unclean, that is what was permissible to be in the presence of holy items. In general there is no judgment involved, merely presentably. Among the unclean things is a vague skin condition denoted by the Hebrew world tsara’ath. This was translated into Greek as lepra, a generic term for skin diseases. The Greek word for leprosy is elephantiasis. Greek medical knowledge reached Europe through the Arabs. The Arab term that best fit Elephantiasis was das fil, which was a different disease. The best known victim of that disease was the Victorian “Elephant Man”. So the Arabs used a different word, juzam, for leprosy. It was this word that was translated into lepra. Thus transforming the vague condition of Leviticus into a specific disease.

Elsewhere in the Bible, various individuals are inflicted with leprosy as the result of some sin. This is not unique to the Bible, and other cultures have similar viewpoints. This was sufficient to cause various commentators to connect leprosy with sinning, and thus invoking the Levitical strictures of casting out the unclean. Once the connection was made, it then became a question of which sins would cause leprosy. Various lists have been drawn up based on various texts within the Bible.

One commentator or another has connected leprosy with just about every sin possible. And leprosy as a sign of sinfulness in general is a common theme. But the two most common sins associated with leprosy are heresy and lust. Heresy here goes beyond any specific doctrinal dispute, but to a general failure to acknowledge God or divine law. In lust, leprosy represented a double whammy. A common idea was that leprosy was a venereal disease. Not only could you get leprosy from sex, but lepers were often said to have unsatiable sex drive.

The theme was not only found in ecclesiastical texts, but also in secular literature. A common motif was that the outside reflected the inside. The story “The Picture of Doren Gray” is an echo of this motif. Thus authors would have their characters struck with leprosy after they had committed some moral outrage, or turned away from God. To be cured when they repented and accepted God. A common disguise for doing immoral acts was that of a leper. To hit bottom was to be force to live among lepers.

Once someone was diagnosed as a leper, the Levitical command to cast them out was invoked. They were banned from living within the village or town. They were stripped of all property, titles, and inheritance. They were to wear distinctive clothes, and to announce their presence with some form of noisemaker. Charity was the only source of substance. The ceremony by which this was done was adapted from the ritual of the dead, for all intents and purposes, they were dead. It is this social ostracism as much as the physical disfigurement that generated the horror of leprosy.

Leprosy today is not the scourge it once was. Improved sanitation, drugs, prompt treatment, and the mysterious changes in the disease itself has reduced it to an unfortunate malady suffered by only a few. To truly understand the medieval response to leprosy, one must turn to the current response to AIDS. First identified in s sub-population that many considered morally degenerate, AIDS has acquired a sense of moral judgment that was once attached to leprosy. Whether either is the result of divine judgment is a question that will only be answered on Judgment Day.



Brody, Saul Nathaniel. The Disease of the Soul: Leprosy in Medieval Literature. Ithaca: Cornell University Press, 1974.

McCall, Andrew. The Medieval Underworld. London: Hamish Hamilton, 1979.

Rawcliffe, Carole. Medicine & Society in Later Medieval England. Stroud: Alan Sutton Publishing Ltd., 1995.

Richards, Peter. The Medieval Leper and His Northern Heirs. Cambridge: D.S. Brewer Ltd., 1977.


Copyright © 1997 - present His Lordship Friar Thomas Bacon (David Moreno). All rights reserved.

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