LEPROSY AND LEPER HOSPITALS. - Leprosy properly so called (lepra tuberculare) is an infectious, transmissible disease with a chronic course, characterized by the formation of tubercles or growths in the skin, mucous membranes, peripheral nerves, bones, and internal viscera, which produces deformities and mutilations, generally with a fatal outcome. It is caused by a particular bacillus (bacillus leprae) discovered in 1868 by A. Hansen.
I. LEPROSY IN SACRED SCRIPTURE
In the Bible no disease is mentioned so frequently and with such horror as leprosy, both in the Old and in the New Testament. Certainly not all the cases studied or remembered refer to true leprosy or the elephantiasis of the Greeks; this seems to follow also from the multiplicity of Hebrew terms (gārāb, neghabh, netheq, sārā'ath, sēbīn). Sometimes it is perhaps a matter of simple psoriasis vulgaris.
In Lev. 13, 1-14, 37 there is almost a brief treatise on this terrible disease. It is for the priest, for whom the various signs are described in minute detail according to the semiotics of the time (ibid. 13, 1-44), to judge whether it is a case of true leprosy or of a sore or pustule. As long as some uncertainty remains, the sick person is isolated. Once the period of observation is over, if the examination confirms the doubt, the unfortunate one is declared unclean and expelled from the camp to avoid contagion. He shall wear torn garments and go bareheaded, cover himself up to the moustache and go about crying: "Unclean! unclean!". The segregation was not strictly individual, since lepers were allowed to live together outside the camp or the settlement (cf. II Kings 7:3; Lk. 17:12).
If a sick person recovered, he was subjected to a minute observation and then the priest, who had declared him healthy, readmitted him into the community with a complicated ceremonial (Lev. 14:1-32). The offering for such purification, reduced in cases of poverty, consisted in the sacrifice of two lambs and a ewe lamb, besides a certain quantity of flour and oil. The expiatory sacrifice implies the concept of leprosy regarded as a punishment from God. In the Old Testament (cf. Ex. 4:6; Num. 5:2; 12:10; II Kings 5:1; 7:3; II Chron. 26:20 ff.) and in the New (cf. Mt. 8:2; 10:5; 11:5; 26:6) lepers are often spoken of, and the miraculous healing of some of them is narrated. By analogy, based on external signs, the Bible also speaks of a leprosy of garments (Lev. 13:47-59) and of houses or walls (ibid. 14:33-57). In the first case it is evidently a matter of moulds or other germs that corrode the tissues of wool and linen; in the second, one thinks first of all of incrustations of saltpetre or similar stains often found on walls. From the norms established to determine the character of the various phenomena, from the destruction of the objects and the houses, and from the rite prescribed when it becomes evident that the danger has been averted, it is deduced that for the Hebrews such stains were considered as infections capable of spreading the disease.
Bibliography3 works
Angelo Penna
II. THE HEALING OF THE LEPERS IN ICONOGRAPHY
In ancient Christian art G. Wilpert identified two examples of this miracle, according to the narrative of the three Synoptics, in Roman catacomb frescoes, one at ad duas lauros and the other at the Nunziatella (Pitture, pp. 205-206, pls. 68, 3 and 74, 2). In sculpture the same author recognized it on a polychrome slab in the Museo Nazionale delle Terme. The scene is also found in an ivory diptych in Palermo (Venturi, I, p. 417, fig. 382). In later cycles, for example in the mosaic cycle of Monreale and in the frescoes of S. Angelo in Formis, it appears accompanied by the couplet: "Hunc maculis mundat, mundum qui crimine mundat".
Enrico Josi
III. SPREAD AND CARE OF LEPROSY AND LEPER HOSPITALS
The disease, very ancient, first described by Rufus of Ephesus, spread at first rapidly with the fall of the Roman Empire, then through the invasions of the Saracens and through the Crusades. In Italy, already in the 5th century A.D. it raged in Lombardy; in 643 the Lombard king Rothari issued very severe laws on the matter, prescribing the isolation of lepers and the deprivation of their civil rights. In the 16th century leprosy began to diminish in intensity, yielding ground to syphilis.
Both in antiquity and in the Middle Ages there were two forms of defense against leprosy: prophylactic measures to circumscribe and limit the disease, and medicinal treatments aimed at the cure of the leper. While the former, albeit cruel from the human standpoint, contributed to the limitation of the disease, the latter were nothing but superstitious and often magical practices, without any practical result. To the anti-leprosy legislation are to be ascribed the prophylactic measures aimed at isolating the leper from the community by separating him, a veritable civil death, even from his spouse and children. Isolation had seemed the best prophylaxis since biblical times; in the Middle Ages, authority over the leper was devolved to the ecclesiastical authorities, inasmuch as he was considered a "poor little one of God" and, in this divine trial, if victorious, a candidate for paradise.
The councils of the Catholic Church also dealt with the subject; thus one sees Pope Siricius, at the end of the 4th century, authorizing the separation of spouses to avoid contaminated offspring; the Third Lateran Council also sanctions for lepers the indissolubility of the marriage bond; according to the Councils of Orléans (549), Tours (561), and Lyon (583), the pronouncing of decrees of isolation was the prerogative of the ecclesiastical authority. At a later time it was replaced by the civil authorities, whereby there came about royal and municipal laws and decrees, and in place of the bishop's tribunal there came a tribunal of seven lepers, a physician, and a surgeon.
in the early Middle Ages to a veritable civil death; the leper was escorted to the hospice, no different from an ordinary prison, with the ceremonies for the dead and, once segregated there for life, he lost his legal personality and civil rights.
Whereas in ancient times lepers, cut off from human society, wandered through the countryside, they soon felt the need to gather into communities, living in clusters of huts. Thus true leprosaria arose, the first of which is recorded as that built by a certain Zodeco or Zoticus, a Roman nobleman who had followed Constantine to Byzantium. Although the primitive groups of huts remained, especially near springs of sulfurous mineral waters, if any one of them acquired particular importance, it was provided with an enclosing wall, a chapel, a cemetery, and masonry buildings.
Subsequently the type of leprosarium consisting of a single building was reached, such as that of St. Lazarus at the foot of Monte Mario in Rome. St. Lazarus, raised from the dead by Christ, was taken as the protector of such patients; thus was constituted, founded by Pope Damasus II (1047-48), the Order of St. Lazarus under the Rule of St. Augustine, whose members, dressed in black and marked with a green cross, had as their purpose to provide for the establishment of leprosaria and, as far as possible, for their maintenance supplemented by offerings.
With the decline of the disease in the 16th century, the spread of leprosaria became ever more modest, surviving, ever more organized in the form of true hospital cities, wherever leprosy still persisted in the form of endemic foci.
Though by now far from the spread it reached in the Middle Ages, leprosy still cannot be said to be fully eradicated and, beyond isolated cases, numerous endemic foci are scattered throughout almost every part of the world, with a total of over 3 million people afflicted by the terrible disease.
The geographical distribution is marked in Europe by certain countries bathed by the Mediterranean, certain regions of France and Italy (Sardinia, Sicily, Apulia), certain areas south of the course of the Danube, of Sweden, of Norway, of Ireland. Eastern Siberia is largely affected; likewise Asia, between the equator and the 40th parallel north, particularly British India, French Indochina, Japan, the Indo-Malay Archipelago. Leprosy is likewise largely endemic in Australia and in the islands and archipelagos of the Pacific; in North America along the Pacific coasts, California, Mexico; in Central and South America, the Antilles, the tropical zone, Brazil, Argentina; in particular southern Africa, the south-western coast (from Senegal to Cameroon), the South African Union, less so Algeria, Morocco, Tunisia, Egypt, the eastern coast (Mozambique, Zanzibar, Madagascar).
Within this vast territory the modern leprosaria are currently distributed, for the most part true hospital towns, where the care of science is interwoven with the loving assistance of charity, carried out in particular by religious and sisters of various congregations.
In such institutions the leper can lead a life quite similar to that of any other healthy individual, even respecting family ties and contracting new marriages, on the sole condition that newborn children be removed from their parents, since it has been demonstrated that leprosy is not transmitted by germinal contagion or during gestation, but only, after birth, through repeated external contacts. Apart from this, the new medical treatments deprive leprosy of much of its former terrifying character of invincible chronicity.
Bibliography3 works
Gustavo M. Apolloni-Giuseppe de Ninno
IV. LEPROSY AND LEPER HOSPITALS IN THE MISSIONS
Even in the missions of recent times the Church has not forgotten the lepers. Already in the 16th century we find leprosaria distinct from other hospitals, such as St. Lazarus in Manila (Philippines), founded in 1570 by the Franciscan Juand Clemente. In the hospitals of St. Joseph and St. Anne in Miyako (Japan), directed by the Franciscans from 1594 to 1597, between 100 and 130 lepers were received. In China there still exist today leprosaria erected in the 17th century by Jesuit missionaries, and Macao has had its asylum for more than 200 years, transferred in 1874 to a single nearby island.
In a special way the care of lepers was developed by the Catholic mission of the 19th century, beginning with the leprosarium of Acarouany in French Guiana, erected by Bl. Anne Marie Javouhey personally in 1832. Wherever the missionaries encountered lepers, with Christian charity they took special care of them, erecting leprosaria or at least special sections in hospitals, where priests, brothers and sisters devoted themselves to their care to the point of sacrificing their own lives. The most celebrated of the apostles of the lepers is Fr. Damien Deveuster SS. CC. (1840-89), who from 1873 cared for the lepers interned on the island of Molokai (Oceania), himself dying of leprosy. Like him, Fr. Giovanni Beyzym of the Society of Jesus (1850-1912), who from 1898 devoted himself to the care of the lepers of Madagascar, was also a victim of the terrible disease. Likewise the Capuchin Daniele da Samarate (1876-1924) died of leprosy in the leprosarium of Tocundula in Brazil. Alongside these heroic apostles of the lepers there is a large host of priests, brothers and sisters, dedicated to the service of these sick, whether in mission asylums or in government asylums, despite the danger of contagion.
According to the latest statistics of 1949, there exist in the Catholic missions, under the S. Congr. of Propaganda Fide, 174 leprosaria with 31,452 lepers, of whom in Africa 130 with 21,820 sick, in America 7 with 928, in Asia 21 with 4,229, in Oceania 16 with 4,475 inmates. - See plate LXIV.
