LEPROSY AND LEPROSARIA. — Proper leprosy (lepra tubercolaris) is an infectious, transmissible disease with a chronic course, characterized by the formation of tubercles or growths on the skin, mucous membranes, peripheral nerves, bones, and internal organs, which produces deformities and mutilations, usually with a fatal outcome. It is caused by a specific bacillus (bacillus leprae), discovered in 1868 by A. Hansen.
I. LEPROSY IN HOLY SCRIPTURE
In the Bible no disease is mentioned so frequently or with such horror as leprosy, both in the Old and New Testaments. Not all the cases studied or recorded necessarily refer to true leprosy or the elephantiasis of the Greeks; this is also evident from the multiplicity of Hebrew terms used (gârâbh, neghabh, netheq, sâra'ath, sêhîn). Sometimes it may refer to simple psoriasis vulgaris.In Lev. 13:1-14:37 there is almost a brief treatise on this terrible disease. The priest, for whom the various signs are minutely described according to the semiotic methods of the time (ibid. 13:1-44), is to judge whether it is true leprosy or a sore or pustule. As long as there is any doubt, the sick person is isolated. After the observation period, if the examination confirms the suspicion, the unfortunate individual is declared unclean and expelled from the camp to avoid contagion. He must wear torn garments and go bareheaded, covering his face down to his mustache and crying out: “Unclean! Unclean!” Segregation was not strictly individual, as lepers were permitted to live together outside the camp or settlement (cf. 2 Kings 7:3; Luke 17:12).
If a sick person were healed, he was subjected to careful observation, and then the priest who had declared him clean would readmit him to the community with a complicated ritual (Lev. 14:1-32). The offering for such purification, reduced in cases of poverty, consisted of the sacrifice of two lambs and one ewe lamb, along with a certain quantity of flour and oil. The expiatory sacrifice implies the concept of leprosy as a punishment from God. In the Old Testament (cf. Ex. 4:6; Num. 5:2; 12:10; 2 Kings 5:1; 7:3; 2 Chron. 26:20 sq.) and in the New (cf. Matt. 8:2; 10:5; 11:5; 26:6) lepers are often mentioned, some of whom are said to have been miraculously healed. By analogy, based on external signs, the Bible also speaks of 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 molds or other germs that corrode wool and linen fabrics, while in the second one thinks first of all of saltpeter encrustations or similar stains often found on walls. From the norms established to determine the nature of the various phenomena, from the destruction of objects and houses, and from the ritual prescribed when it is clear that the danger is past, it is deduced that for the Hebrews such stains were considered as infections capable of spreading the disease.
II. THE HEALING OF LEPERS IN ICONOGRAPHY
In early 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, tavv. 68,3 and 74,2). The same author recognized it in sculpture on a polychrome slab in the National Museum of the Baths. The scene also appears on a ciborium diptych in Palermo (Venturi, I, p. 417, fig. 382). In later cycles, for example, in the mosaic cycle of Monreale and the frescoes of S. Angelo in Formis, it is accompanied by the distich: “Hunc maculis mundat, mundum qui crimine mundat,” Enrico Josi.III. THE SPREAD AND TREATMENT OF LEPROSY
This ancient disease, first described by Rufus of Ephesus, spread rapidly after the fall of the Roman Empire, then through Saracen invasions and the Crusades. In Italy, it was already raging in Lombardy in the 5th century A.D.; in 643 the Lombard king Rothari issued very severe laws prescribing the isolation of lepers and the deprivation of civil rights. In the 16th century leprosy began to decline in intensity, giving way to syphilis.Both in antiquity and in the Middle Ages, two forms of defense against leprosy were employed: prophylactic measures to contain and limit the disease, and medical treatments aimed at healing the leper. While the former, though cruel from a human standpoint, contributed to limiting the spread of the disease, the latter were nothing more than superstitious and often magical practices with no practical result. The anti-leprosy legislation included measures aimed at isolating the leper from the community, even separating him from spouse and children—a virtual civil death. Isolation had seemed the best prophylaxis since biblical times; in the Middle Ages, authority over the leper was entrusted to ecclesiastical authorities, since he was considered a “poor man of God,” and if he triumphed in this divine trial, a candidate for paradise.
The councils of the Catholic Church also addressed the issue; thus Pope Siricius at the end of the 4th century authorized the separation of spouses to avoid contaminated offspring; the Third Lateran Council also upheld the indissolubility of the marriage bond for lepers; according to the Councils of Orléans (549), Tours (561), and Lyon (583), the authority to pronounce isolation decrees belonged to the ecclesiastical authority. Later, this was replaced by civil authorities, resulting in royal and municipal laws and decrees, and the bishop’s tribunal was succeeded by a tribunal consisting of seven lepers, a physician, and a surgeon.
The alleged sick person underwent empirical tests on blood and urine, which at that time, as is clear, had no real value, and more significant tests based on the search for areas of anesthesia and muscular atrophy, particularly of the thenar eminence; later, examination of the nostrils, recommended by Arnald of Villanova. Once declared sick, the individual was forced into confinement in a leprosarium. In the early Middle Ages this amounted to a virtual civil death; the leper was taken to the hospice, not unlike an ordinary prison, with funeral-like ceremonies, and once segregated for life, lost his personhood and civil rights.
While in ancient times lepers, cut off from human society, wandered through the countryside, they soon felt the need to form communities, living in clusters of huts. Thus true leprosaria arose, the first of which mentioned was built by a certain Zodocus or Zoticus, a Roman nobleman who had followed Constantine to Byzantium. While the primitive groups of huts remained, especially near sources of sulfur springs, if any of them acquired particular importance, it was enclosed by a wall, with a chapel, cemetery, and masonry buildings.
Later, the type of leprosarium consisting of a single building came into being, such as that of St. Lazarus at the foot of Monte Mario in Rome. St. Lazarus, raised from the dead by Christ, was chosen as the patron of such sufferers; thus was founded, under Pope Damasus II (1047-48), the Order of St. Lazarus under the Rule of St. Augustine, whose members, dressed in black and marked by a green cross, had the purpose of establishing leprosaria and, as far as possible, maintaining them with alms.
With the decline of the disease in the 16th century, the spread of leprosaria became increasingly modest, remaining in existence, increasingly organized as true hospital-cities, where leprosy still persisted in endemic foci.
Although now far removed from the prevalence it reached in the Middle Ages, leprosy cannot yet be said to have been fully eradicated. In addition to isolated cases, numerous endemic foci are still spread almost throughout the world, with a total of over three million people afflicted by the terrible disease.
Geographical distribution in Europe is marked by certain countries bordering the Mediterranean, some regions of France and Italy (Sardinia, Sicily, Apulia), areas south of the Danube, Sweden, Norway, and Ireland. Eastern Siberia is widely affected; so too is Asia, between the equator and the 40th parallel north, particularly British India, French Indochina, Japan, and the Indo-Malay Archipelago. Leprosy is also largely endemic in Australia and the islands and archipelagos of the Pacific; in North America along the Pacific coasts, California, and Mexico; in Central and South America, the Antilles, the tropical zone, Brazil, and Argentina; and especially in southern Africa, the southwestern coast (from Senegal to Cameroon), the Union of South Africa, to a lesser extent Algeria, Morocco, Tunisia, Egypt, and the eastern coast (Mozambique, Zanzibar, Madagascar).
Within this vast territory are now distributed the modern leper hospitals, most of which are true hospitable towns where the care of science is intertwined with the loving assistance of charity, particularly carried out by religious and nuns of various congregations.
In such institutions, the leper can lead a life very similar to that of any other healthy individual, even maintaining family ties and contracting new marriages, provided only that the newborn are kept away from their parents, since it has been demonstrated that leprosy is not transmitted through germinal contagion or during pregnancy, but only after birth through repeated external contact. Apart from this, new medical treatments have stripped leprosy of much of its former terrifying character of invincible chronicity.
Gustavo M. Apolloni – Giuseppe de Ninno
IV. LEPROSY IN THE MISSIONS
Even in recent missionary times, the Church has not forgotten the lepers. As early as the 16th century, distinct leper hospitals are found alongside 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), run by the Franciscans from 1594 to 1597, between 100 and 130 lepers were cared for. In China, leper hospitals built in the 17th century by Jesuit missionaries still exist today, and Macao has had its asylum for more than 200 years, moved to a nearby island in 1874.The care of lepers was especially developed by the Catholic missions of the 19th century, beginning with the leper hospital of Acarouany in French Guinea, personally established by Blessed Anne Marie Javouhey in 1832. Wherever missionaries encountered lepers, they took special care of them with Christian charity, building leper hospitals or at least dedicated sections in hospitals, where priests, brothers, and sisters devoted themselves to their care even to the point of sacrificing their own lives. The most famous of the apostles of lepers is Fr. Damien Deveuster, SS. CC. (1840-89), who from 1873 cared for lepers interned on the island of Molokai (Oceania) and himself died of leprosy. Like him, Fr. Giovanni Beyzym of the Society of Jesus (1850-1912), who from 1898 dedicated himself to caring for lepers in Madagascar, also fell victim to the terrible disease. Similarly, the Capuchin Daniele da Samarate (1876-1924) died of leprosy in the leper hospital of Tocundula in Brazil. Alongside these heroic apostles of lepers, a large host of priests, brothers, and sisters have devoted themselves to serving these patients, both in mission asylums and in government-run institutions, despite the risk of contagion.
According to the latest statistics from 1949, there are 174 leper hospitals under the Holy Congregation of Propaganda Fide in Catholic missions, housing 31,452 lepers, of whom 21,820 are in Africa, 928 in America, 4,229 in Asia, and 4,475 in Oceania. – See plate LXIV.