Buzz
The tolling of bells marking the presence of the ostracized, the decay of the body, the isolated colonies where people were abandoned... leprosy, the ancient affliction, carries with it a set of deeply ingrained images. However, many of these are misleading—like so many things in history, the reality is much more intricate than we’re often taught.
10. Leprosy is Still Widespread—And Affects Millions
Though we often associate leprosy with medieval times or ancient plagues, the disease is still very much present today. It's estimated that between two to three million people are living with leprosy right now.
Pinpointing an exact number is difficult because the majority of those affected by leprosy live in impoverished, underdeveloped regions. In India alone, over a million cases are reported, and the number of new diagnoses continues to rise. The World Health Organization declared that some areas of India had officially eradicated leprosy by 2005, yet several of these regions have since seen a sharp resurgence. Between 2010 and 2011, doctors recorded over 125,000 new cases.
And leprosy isn’t limited to remote regions of India. In the southern United States, 213 new leprosy cases were recorded in 2009, with approximately 6,500 cases across the entire country.
9. The Original Purpose of the Bells Was Different
One of the most enduring images tied to leprosy is the sound of bells ringing, signaling people to steer clear of the approaching threat. However, the bells were not initially used for this purpose; they weren’t intended to evoke fear.
Before the 14th century, lepers depended on the generosity of strangers. Many sufferers lost their ability to speak due to the disease, and the bells were used to draw attention, encouraging people to offer donations. These donations were often their only means of survival, though some towns banned the bells due to the disturbance they caused.
8. Lepers Were Not Always Shunned
Recent archaeological studies have revealed that our understanding of medieval lepers has been largely mistaken, particularly up until a certain period in history.
From 1000 to 1500, Europeans viewed leprosy as a catch-all term for almost any skin disease. Excavations of leper hospitals in France and England have unearthed evidence not just of what we now recognize as leprosy (or Hansen’s disease), but also signs of malnutrition and tuberculosis. Though these hospitals were often located on the outskirts of towns, this was more a result of available land than a deliberate attempt to isolate the patients.
The quality of early leper hospitals indicates that patients received care of a high standard. Most of these institutions were well-constructed, with expansions and renovations as necessary. They featured not only dormitories but also chapels, and the graveyards where patients were buried were carefully maintained, with individual markers and often adorned with religious symbols.
It wasn’t until the onset of the plague that the sick began to be avoided, rather than cared for.
7. Religion Helped Spread It, The Plague Nearly Eradicated It
Efforts to track the spread of leprosy have uncovered some surprising facts. Studies comparing the pathology of various strains of leprosy have shown that the form most common in the Middle East today first reached Europe over a thousand years ago. With 11 known types of leprosy, researchers can trace the spread of the disease through these variations.
Leprosy spread most widely during the Crusades. At the time, a quarter of Europe's population was affected, aided by the introduction of new diseases to which isolated populations had no immunity.
While religion may have played a role in spreading leprosy, the plague all but halted it. The Black Death that swept across Europe coincided with a significant drop in leprosy cases. One theory suggests that the population was beginning to develop immunity to the disease (today, around 95 percent of people are immune). Another theory posits that the plague wiped out those who would have been most susceptible to leprosy—namely, the poor, malnourished, and those with weakened immune systems.
6. Royal Compassion for Lepers
Not every leper in the Middle Ages faced a grim fate. Some monarchs took it upon themselves to care for the afflicted. Queen Matilda of Scotland, renowned for her charitable works, made it a point to extend her compassion to the lepers among her people. She even invited them into her private chambers, touching their open sores in public to challenge the fear and superstition surrounding the disease.
Matilda followed the example set by her mother, Margaret, who would later be canonized in 1250 for her charitable deeds. Alongside her father, Malcolm, Matilda would wash the feet of the poor every Lent. She also founded St. Giles, a hospital devoted to the long-term care of lepers, and contributed funds to other similar institutions, such as a hospital in Chichester and a women’s facility in Westminster.
England’s King John also passed laws to aid lepers. He established the Stourbridge Fair in Cambridge, an event that became a great success in providing the leper community with opportunities to earn extra income.
5. Leprosy Can Be Spread by Armadillos
Most diseases tend to remain confined to a specific species, while others, such as rabies and the flu, can cross between animals and humans. For a long time, leprosy was believed to affect only humans, but it has recently been discovered that armadillos can also carry the leprosy bacteria.
Around 20 percent of wild armadillos are infected with leprosy. In the southern United States, these creatures are hunted for their meat, and consuming it can lead to contracting leprosy. Symptoms are often misdiagnosed, as leprosy is rare in the region, which means cases that might otherwise be treatable progress unchecked.
On the bright side, the leprosy bacteria cannot survive without a host, making it very difficult to study. Lab samples typically perish within days. However, researchers can now investigate the effects of the disease in a non-human host, opening up new opportunities for study.
4. Flesh Doesn’t Actually Rot
A leper’s flesh doesn’t decompose or fall off in chunks as is often depicted. This image likely stems from one of the actual symptoms—the sores. However, these hallmark skin lesions can be very subtle, often resembling slight discoloration rather than the decaying flesh we usually associate with the disease. In some cases, the skin can also develop thick patches or unusual growths, while large areas may become numb.
The numbness, along with swollen nerves, leads to a loss of sensation, which causes a range of other issues. We rely on sensation—especially pain—to alert us when we’re injuring ourselves. This may seem obvious, but without the ability to feel, those affected can sustain cuts or burns without realizing there’s a problem. Injuries that would typically be mild, with warning signs, can become much worse.
If left untreated, this numbness can lead to permanent paralysis. Since leprosy develops slowly in the body, it may take up to 10 years for symptoms to manifest after infection, making it difficult to diagnose in the early stages.
3. The Leper Knights
While lepers are often associated with being cast out from society, including by Christians, the Order of Saint Lazarus of Jerusalem emerged from the very presence of leprosy and welcomed leper knights into its fold.
Following the capture of Jerusalem at the close of the First Crusade in 1099, European knights seized control of a leper hospital. The first leader of this hospital was Blessed Gerard, and within a few decades, it began receiving support from the Order of Malta. As leprosy surged during the Crusades, the hospital saw an influx of leprous knights, eventually transforming into a military order itself.
Knights who contracted the debilitating disease became members of the Order of Saint Lazarus, with the Templars providing them with a stipend. A few of them returned to France and then England as envoys, setting up branches of the order in Europe. The original site in Jerusalem grew to include a convent for the wives of the leper knights, several chapels, a mill, and additional hospitals. While Saladin's invasion halted the expansion, the Papacy continued to offer protection. As most of the order perished, the survivors began recruiting non-lepers.
The Order of Saint Lazarus of Jerusalem still exists today. Its branches around the world continue to serve with the same humility and dedication demonstrated by the leper knights centuries ago.
2. Preventative Burials
Leprosy reached well into Asia and into the Americas, in addition to Europe. People across the globe shared many European concerns over leprosy, which might explain a bizarre burial method in Japan.
Nabe-kaburi involved people being buried with pots over their heads. The 105 Nabe-kaburi burials that have been excavated include both men and women spanning a variety of ages. The pots could be iron, earthenware, or mortar covering. The earliest remains date to the 15th century, and the latest are from the 19th.
According to Japanese folklore, a pot on a person’s head stops the disease that killed them from spreading. We’ve long considered that the buried pots tied in to this, but until recent advances, it’s all been speculation. Now, however, we’ve confirmed that many Nabe-kaburi individuals suffered from leprosy.
1. Biblical Leprosy Wasn’t Leprosy
One reason lepers were increasingly ostracized during the later Middle Ages was due to the biblical stigma associated with them. However, a deeper examination of the biblical description of leprosy reveals that it refers to something quite different from what we know today as Hansen's disease, or modern leprosy.
In biblical terms, leprosy was referred to as sara’at, a term used for various types of skin conditions. While this might seem similar to modern leprosy, biblical leprosy encompassed a wide range of symptoms, from rashes and red patches to swollen spots. Priests were responsible for diagnosing it, and contrary to the nature of modern leprosy, it was considered highly contagious.
Archaeological evidence from biblical times does not support the existence of the modern disease. Furthermore, many hallmark characteristics of modern leprosy, such as deformities and loss of sensation, are absent from biblical accounts.
Perhaps most notably, the Bible also speaks of leprosy affecting inanimate objects. Mildew on a person’s home, belongings, or clothing was seen as a sign of impurity and divine displeasure. A priest would assess the situation to determine whether the 'leprosy' was caused by the wrath of an angry God. If deemed so, the house would be quarantined and cleansed, and if the mold persisted, it would be destroyed.
+The Leper Saints
In the 1800s, when leprosy reached Hawaii, those afflicted were forced to relocate to the isolated island of Moloka’i. Belgian immigrant Joseph De Veuster selflessly volunteered to care for over 700 individuals confined there. While he wasn’t the first to offer aid, his efforts left the most lasting impact on the people of Hawaii.
Father Damien, as he was later known, was far more than just a caregiver. He offered not only medical assistance but also emotional support, connecting with the lepers in their native tongue. He helped build schools, created running water systems, and advocated for their rights. After dedicating 12 years to the community, Father Damien was himself diagnosed with leprosy and passed away in 1889, at the age of 49.
At his deathbed was Mother Marianne, a devoted woman who had given her life to serving the leper population of Hawaii. A Franciscan Sister, she arrived on Moloka’i in 1883 at the age of 45, and continued her mission until her passing in 1918 at 80 years old.
Father Damien was elevated to sainthood by Pope Benedict XVI on October 11, 2009, and Mother Marianne was canonized in October 2012, both honored for their unwavering commitment to serving the most marginalized individuals.
