Leprosy historical perspective
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Mycobacterium leprae, the causative agent of leprosy, was discovered by G. H. Armauer Hansen in Norway in 1873, making it the first bacterium to be identified as causing disease in man.[1][2] Historically, individuals with leprosy have been known as lepers, however, this term is falling into disuse due the pejorative connotation of the term.
Etymology
The word "leprosy" derives from the ancient Greek words lepros, a scale, and lepein, to peel.[3] The word came into the English language via Latin and Old French. The first attested English use is in the Ancrene Wisse, a 13th-century manual for nuns ("Moyseses hond..bisemde o þe spitel uuel & þuhte lepruse." The Middle English Dictionary, s.v., "leprous"). A roughly contemporaneous use is attested in the Anglo-Norman Dialogues of Saint Gregory, "Esmondez i sont li lieprous" (Anglo-Norman Dictionary, s.v., "leprus").
Leper Hospitals
Numerous leprosaria, or leper hospitals, sprang up in the Middle Ages, particularly in England, and numbered 250 by A.D. 1230. The first recorded leprosarium was in Harbledown. (See Leper colony.) These institutions were run along monastic lines and, while lepers were encouraged to live in these monastic-type establishments, this was for their own health as well as quarantine.
Misdiagnosis Through History
Historically, the term Tzaraath from the Hebrew Bible was, erroneously, commonly translated as leprosy, although the symptoms of Tzaraath were not entirely consistent with leprosy and rather referred to a variety of disorders other than Hansen's disease.[4] In particular tinea capitis (fungal scalp infection) and related infections on other body parts caused by the dermatophyte fungus Trichophyton violaceum are abundant throughout the Middle East and North Africa today and might also have been common in biblical times. Similarly, the related agent of the disfiguring skin disease favus, Trichophyton schoenleinii, appears to have been common throughout Eurasia and Africa before the advent of modern medicine. Persons with severe favus and similar fungal diseases (and potentially also with severe psoriasis and other diseases not caused by microorganisms) tended to be classed as having leprosy as late as the 17th century in Europe.[5] This is clearly shown in the painting Governors of the Home for Lepers at Haarlem 1667 by Jan de Bray (Frans Hals Museum, Haarlem, the Netherlands), where a young Dutch man with a vivid scalp infection, almost certainly caused by a fungus, is shown being cared for by three officials of a charitable home intended for leprosy sufferers. The use of the word "leprosy" before the mid-19th century, when microscopic examination of skin for medical diagnosis was first developed, can seldom be correlated reliably with Hansen's disease as we understand it today.
Cultural Impact
Some medieval people believed that those suffering from leprosy were considered to be going through Purgatory on Earth, and for this reason their suffering was considered more holy than the ordinary person's. More frequently, lepers were seen to exist in a place between life and death: they were still alive, yet many chose or were forced to completely separate themselves from mundane existence. Radegund was noted for washing the feet of lepers. Orderic Vitalis writes of a monk, Ralf, who was so overcome by the plight of lepers that he prayed to catch leprosy himself (which he eventually did). The leper would carry a clapper and bell to warn of his approach, and this was as much to attract attention for charity as to warn people that a diseased person was near.
References
- ↑ Hansen GHA (1874). "Undersøgelser Angående Spedalskhedens Årsager (Investigations concerning the etiology of leprosy)". Norsk Mag. Laegervidenskaben (in Norwegian). 4: pp. 1–88.
- ↑ Irgens L (2002). "The discovery of the leprosy bacillus". Tidsskr Nor Laegeforen. 122 (7): 708–9. PMID 11998735.
- ↑ Barnhart RK (1995). Barnhart Concise Dictionary of Etymology. New York: Harper Collins. ISBN 0062700847.
- ↑ Artscroll Tanakh, Leviticus 13:59, 1996
- ↑ Kane J, Summerbell RC, Sigler L, Krajden S, Land G (1997). Laboratory Handbook of Dermatophytes: A clinical guide and laboratory manual of dermatophytes and other filamentous fungi from skin, hair and nails. Star Publishers (Belmont, CA). ISBN 0898631572.