Leper Hospitals in Medieval England (with particular reference to the County of Derbyshire).

by

Margaret Hughes, BA (Hons).

A Master's Dissertation, submitted in partial fulfilment of the requirements of the award of the Master of Arts (or Master of Science) degree of the Loughborough University of Technology

September 1994

© M. Hughes, 1994 ACKNOWLEDGEMENTS

[ would like to acknowledge the loving support and help given by my husband, Graham Hughes, during the writing of this dissertation. Also for the kind attention and consideration of my supervisor, Professor Michael Reed. [would also like to express thanks to the following for allowing me to reproduce maps from their publications: Eileen Bowlt of the Transactions of the London and Middlesex Archaeological Society; [an Mitchell of the Derbyshire Archaeological Society; and D Shaw, Town Clerk and Chief Executive of Chesterfield Borough Council. CONTENTS PAGE NO.

Chapter 1. Leprosy: A definition, an historical perspective, 1 and an outline of medical writings upon the subject.

Chapter 2. Civil and Ecclesiastical Laws Governing the Life of the 11 Leper.

Chapter 3. Leprosy Represented in Art, Literature, Superstition 23 and Folklore.

Chapter 4. The Leper Hospitals of Medieval England. 34

Chapter 5. Leper Hospitals in Medieval Derbyshire. 47 LIST OF MAPS

Figure 1. Leper Hospitals in the Middle Ages. British Medical Journal, 1890, p.466.

Figure 2. Leper Hospitals in Medieval London. Transactions ofthe London and Middlesex Archaeological Society, 1967,21, p.6.

Figure 3. Alkmonton, Derbyshire. G.T. Hughes, 1994.

Figure 4. Platt of Chesterfield Towne. William Senior, 1633-1637.

Figure 5. Derby - 1610. Sketches of Old Derby and Neighbourhood. J. Keys, 1895, p.20.

Figure 6. Derby - 1791. Derby: Its Rise and Progress. A. W. Davison, 1906, p.55.

Figure 7. Spondon, Derbyshire. G.T. Hughes, 1994.

Figure 8. Locko, Spondon. Derbyshire Archaeological Journal, 1991, 111, p.57. The dissertation begins with a modem definition of the disease of leprosy and is followed by an historical account of the development of the disease and ends with an outline of early writings on the subject with references to the sources employed by medieval scholars.

The biblical pronouncements of Leviticus conditioned the ecclesiastical laws and social attitudes concerning leprosy and the leper in society, and the civil laws curtailed his freedom of movement and mode of life. Many superstitions surrounded the disease, and the moral and religious overtones are to be found represented in art, church architecture, and literature.

The leper hospitals were not hospitals as we understand them today, but a place of refuge and general care. Many hospitals were run by monastic orders, others were by subscription. The number of leper hospitals in England has long been a point of speculation with numbers varying from fifty to over two hundred. They were situated on the outskirts of towns and cities and stringent laws were passed governing the movement and conduct of lepers, their social activities and their family life.

In Derbyshire, four leper hospitals are known to have existed, one each in Alkmonton, Chesterfield, Derby and Spondon. The leper hospitals themselves disappeared along with the disease at the end of the fifteenth century. The following is an account of these leper hospitals in Derbyshire which, like those in other parts of the country, either survived as alms houses or vanished without trace leaving only their names behind. For what is the impurity of Leprosy unless it is the sin of lust? s. N. Brody. The Disease of the Soul. Chapter One

Leprosy: A Definition. an Historical Perspective. and an Outline of Medical Writings upon the Subject.

To appreciate the problems in assessing the extent and severity of leprosy in medieval England and its effects on society, it is first necessary to understand its medical background. As a disease it provoked fear and loathing in society due to a large extent to a common misunderstanding of the nature of the disease and the moral connotations placed upon leprosy by the biblical pronouncements of Leviticus, Job and later the Church Councils.

Leprosy is a slow-developing, chronic and infectious disease which rarely kills as a result of the infection itself, but does severely cripple and disfigure the victim. It is a disease which thrives on poor living conditions and deficient diet, in particular low quality salted meat and fish, badly cured meat, and bread made from mouldy or contaminated rye and barley. The disease is caused by the bacteria mycobacterium leprae, a single species with no bacterial variations. The bacteria itself was identified in 1874 by the Norwegian biologist, Gerhard Hanson and often Leprosy is referred to as Hanson's Disease. l The differing types of leprosy are assessed entirely by the victim's degree of immunity to the bacteria. There are two clearly defined forms of leprosy and two less well defined. Lepromatous and Tuberculoid Leprosy are the most severe forms of the disease and reflect both ends of the immunity spectrum. Those with a low resistance to the disease contract the Lepromatous form and those with a high degree of immunity develop Tuberculoid Leprosy. Between these are the less serious forms of Intermediate, which, depending upon the patient's immune system, will develop into either tubercular or lepromatous leprosy at a later stage, or Dimorphous, which shows symptoms of both forms, finally emerging as lepromatous leprosy.

The disease has a long incubation period of between two and seven years and occasionally even longer. Communication of leprosy is through nasal and laryngeal droplets, but the disease is not communicable through fomites such as clothing, bedding, commodities or food. It is not hereditary, nor is it transmitted through sexual intercourse. The most severe and infectious form of the disease and the most disfiguring is the lepromatous form. The bacteria causes extensive cell destruction which results in the swelling and yellowing of the face giving a

1 typical "lion face" appearance to the victim. The latter was know to the Greeks as Leprosy Leontiasis. Blindness, destruction of the nose, virtual loss of the voice, nodules erupting over all of the body surface, are further manifestations of this variation of the disease. Tuberculoid Leprosy, although also severe, is the least damaging and infectious form of this disease. Here the severity lies in the damage to the nervous system resulting in loss of sensation to both hands and feet. Persistent and horrifying injuries can be caused through this loss of feeling.

Many people are infected by the disease without developing any of the symptoms, or the variation is so mild that the victims recover without knowing they had ever contracted the disease. The latter would have been one of the most common means of unknowingly infecting others and the sufferers would not have been segregated from society. It also illustrates the fact that mycobacterium leprae has a low level of manifestation.2 The fact that leprosy is not a mass disease, coupled with either a very high or very low resistance to the bacteria, suggests that the incidence of leprosy may not have been as high as was previously believed.

Identification of the disease has also prevented a true assessment of the extent of the disease in this country. Leprosy as a term was used indiscriminately to describe a variety of skin diseases, complicated by the use of the Greek term Leprae meaning "scaly" and referring to the ulcerous and tubercular skin disease, Lepra. Leprosy had been diagnosed by the Greeks around the turn of the third century BC. Straton, a disciple of Erasistratos, an Alexandrian physician (300- 250 BC), called the disease elephantiasis. Later this was called Graecorum Elephantiasis to distinguish it from Elephantiasis Arabum the disease we know today as elephantiasis which results, among other symptoms, in the grotesque swelling of the legs. 3 Other diseases also known as leprosy were psoriasis, eczema, scrofula, cancer of the skin, and lues, a venereal disease now known as syphilis or lues venerea, characterised by pustules on the skin, scarring and madness. Pellagra and morphea were also often mistakenly diagnosed as leprosy. The former caused redness, cracking and eventual peeling away of the skin, while the latter brought about severe discoloration of the skin, forming yellow, white, brown and even black patches. Since all these conditions were covered by the portmanteau term "leprosy" it is difficult to estimate the true extent of the disease.

The earliest known descriptions of leprosy appear in the Indian vedic writings

2 dating from 600-400 BC, but as these were compilations of past masters, the presence of the disease is almost certain to predate this period. Further references to leprosy were to be found in China in 250 BC, in the medical classic, Huang di nei su wen (The Yellow Emperor's Classic of Internal Medicine}.4 The disease is believed to have left China and travelled the trade routes to India, Persia and the Mediterranean. It is also considered possible that Xerxes' armies, when invading Greece in the fifth century BC, brought the disease to Europe. Another source of infection was considered to be Alexander's army returning to Greece in 327-326 BC from its six year campaign in Persia, Afghanistan and India. With the returning army were some 10,000 Asian mistresses who, by order of Alexander, married his soldiers on arrival at Susa, in Persia. Many of the soldiers settled in Palestine in the ten cities known as Decopolis. Others returned to Macedonia, and from there the disease was spread to Italy by Pompey's army, as later described by Pliny the Elder. Further mentions of the disease were made by Lucretius (98-55 BC), Celsus (25 AD), Galen (150 AD) and Arataeus also in the second century AD. Galen gave an accurate description of the disease which was not to be challenged for hundreds of years.

Contrary to common belief, leprosy was not introduced into this country by returning crusaders. Geoffrey De Vinsauf, a chronicler to Richard I, made no mention of leprosy other than identifying one victim, Baldwin IV, a prince who defeated Saladin and became the seventh king of Jerusalem.5 The first introduction of the disease is considered by some to be as early as 60 AD, being brought into this country by Roman Legionnaires or Phoenician sailors, although the evidence for this is unsubstantiated.6 Some of the first English cases are believed to date from the early Anglo-Saxon period. Calvin Wells7 excavated a sixth century Saxon burial ground in Beckford, Gloucestershire, where he found a male leprous skeleton of 30-35 years. The evidence of diseased and missing digits indicated advanced lepromatous leprosy. (It is interesting to note that during this period lepers were not buried in separate cemeteries as occurred in the medieval period, but were interred in a general burial ground.) Other leprous skeletons have been found at Poundbury Camp, Dorchester, dating from the middle of the fourth century AD; at Burwell, Cambridgeshire, a skeleton was discovered in a Christian Anglo-Saxon cemetery of the fifth century AD. Others were excavated at Tean, in the Isles of Scilly, Castle Hill at Scarborough, and at South Acre in Norfolk, where seven of the eight skeletons excavated were found to be leprous.8

3 Many of the problems in identifying the true extent of the disease are caused to a large degree by misinterpretations of the disease in the Bible. Later church authorities were to base their moral judgements on a mis-translation of the Hebrew term for "unclean". The Hebrew "sa ra'ath", means "unclean, defiled or accursed" and covers a large range of skin conditions, especially those described in Leviticus Chapter 13. Seven conditions were listed by which a person was found to be unclean, but this was a ritual uncleanliness, and they were removed from society to prevent moral, not physical contamination. The seven conditions included a depigmented skin and hair, thin yellow hair present in hardened skin, and a bald area that swells or becomes raw and inflamed. The Old Testament was written between 587-538 BC, and D. Kaplan9 maintains that as leprosy was not introduced into that area until 325-324 BC by Alexander's army, then - - sa ra'ath could not have been leprosy. In describing sa ra'ath, two further terms must also be taken into consideration, "tahor" meaning clean and "tameh" meaning unclean. These two terms also refer to the states of purity and impurity, of holiness and unhappiness. If a person was defiled or unclean he had displeased God and if clean or pure he was pleasing to God. This strengthens the supposition that sa ra'ath was the moral manifestation of a skin complaint that gave a physical and therefore morally impure appearance, which was unacceptable to society.10 This is further substantiated in the Mosiac law, given to Moses by God, where sa ra'ath is given as a punishment for a supposed sin and the penalties were purely ritual.

It is believed that the lepers who met Christ as described in Luke Chapters 5 and 17, Mark Chapter 1 and Matthew Chapter 8, were in fact suffering from sa ra'ath and being touched by Christ gave them their "moral" c1eansing. ll Leviticus gives the following detailed account of the disease:

When a man shall have in the skin of his Desh a rising, a scab, or bring spot and it be in the skin of his Desh like the plague of leprosy; then shall he be brought unto Aaron the priest, or unto one of his sons the priests: And the priest shall look upon the plague in the skin of the Desh: and when the hair in the plague is tumed white, and the plague in sight be deeper than the skin of his Desh, it is a plague of leprosy: and the priest shall look on him, and pronounce him unclean. Leviticus 13: 1-3 Authorised Version

4 In Numbers Chapter 12, Miriam was diagnosed as having leprosy, a sin visited upon her by God for criticising Moses. Through the intervention of Moses Miriam was restored to society "clean" and "pure". Miriam was described as "white as snow", although white was not mentioned in the Hebrew text and the "as snow" refers not to a white skin but the flaky and scaly skin that was rubbed off the flesh.

Naaman, in Kings, II Chapter 5, was also considered a leper and his bathing in the river Jordan can be viewed as either the healing of the actual disease or a spiritual cleaning as in sa ra'ath. Although Job was not specifically described as being a leper, it was accepted as such by medieval writers, and for some time Job was the patron saint of lepers. Reference was often made to his own description of himself as an outcast:

My brothers stand aloof from me, and my relations take care to avoid me. My kindred and my friends have all gone away, and the guests in my house have forgotten me. The serving maids look on me as a foreigner, a stranger, never seen before. My servant does not answer when I call him. I am reduced to entreating him. To my wife my breath is unbearable, for my brothers I am a thing corrupt Even the children look down on me, ever ready with jibe when I appear. All my dearest friends recoil from me in horror,' those I loved best have tumed against me. Pity me, pity me, you, my friends, for the hand of God has struck me. Job 19: 13-21 Jerusalem Version.

The Greeks had translated the Old Testament some 300 years before Christ and sa ra'ath was translated as "lepros", the Greek for scaly. St Jerome also translated the Old Testament into Latin about 40 AD, but used the Greek term 'lepros' for sa ra'ath and Latinised it into Lepra. Further complications arose when John of Damascus (777-857 AD), an Arabic physician, used the term 'lepra' to mean leprosy. The Arabs also used the term Lepra Graecorum to mean leprosy and not the usual Elephantiasis Graecorum. From the misuse of the terms Lepra Graecorum and Lepra, later medieval writers would translate these terms to leprosy, further perpetuating the myth of "biblical leprosy". When the Bible was translated by Wyclif in 1382, leprosy (or leprosie) was incorporated into the Bible.12

Many of the medieval writers on leprosy, its diagnosis and treatment, were clerics, some of whom had also studied medicine or had first had experience of studying

5 and treating lepers. There is a degree of consensus among the writers that diet was an important factor in contracting leprosy. As noted earlier, poorly preserved meat and more importantly fish, that were eaten over a long period of time, were felt to be the main source of infection. Bartolomeus Anglicus wrote that it was dangerous to eat corrupted food whilst John Gaddesden speaks of "errors of diet': 13

Their writings were influential, but perpetuated the sexual myths of leprosy, with many indicating a confusion of diagnosis between leprosy and syphilis. Both Jewish and Christian faiths agreed on the sexual connotations of leprosy. Each Rabbi was of the opinion that if a woman had sexual intercourse during her menstrual period, she would give birth to a leprous child. 14 Adamus Scotus (1180) wrote that Naaman the leper, fell from pride to lust "For what is the impurity of leprosy unless it is the sin of lust': 15 Although not all writers agreed that the sexual act itself was a source of infection, most agreed that lepers were a threat to society through their evil and corrupt behaviour and their desire for sexual intercourse.16 The theory that leprosy could be caught either by sexual intercourse or through the womb was developed by Bemard of Gordon, a professor of medicine at Montpellier, who wrote his Lilium Medicinae in 1303, stating:

Leprosy is either introduced from within the uterus, or after birth. If from within the uterus, it is because of conception at the time of menstruation, or because it is the child of a leper, or because a leper had intercourse with a pregnant woman and thus the baby will be leprous, for leprosy is generated out of those great corruptions that befall the conception17

An anonymous treatise on De Lepra from the fifteenth century continued the sexual link with leprosy when it stated that:

These days leprous children are especially generated in the conception by a menstruating woman, because at the time she enjoys sex more as her blood tingles and she is tickled; and thus, as the child is conceived in the Bow of menstrua, he will undoubtedly incur leprosy or scabies:18

John Gaddesden who wrote his Rosa Anglica in 1314, may have encouraged this belief when describing how a man may suffer penile sores and eruptions following

6 intercourse with a leprous woman.19 However, the association could well have been made from the fact that as a leper was considered an outcast from society, they would become the object of sexual fascination and fantasy not unlike those attributed to the blacks in the southern states of America, or the Jews in the Third Reich.2o

But many writers chose not, as the above had done, to emphasise the link between sexual intercourse and leprosy. One of these earliest writers on leprosy was Galen (130-203 AD), a Greek physician, who became a respected and revered source for later medieval scholars. Arataeus, who wrote in the second century AD, gave an accurate description of leprosy mixed with folklore and superstition. He also equated leprosy with sexual intercourse, and was known to call the disease satyriasis, from "From the redness ofthe cheeks, and the irresistible and shameless impulses of ad coitum':21 His writings reflected contemporary society's attitude to the leper:

Who would not tum aside from a leper, even though he were a son, or a father, or a brother since there is a fear lest the disease be communicated? Hence many have been banished, those that were nearest to them into solitudes and mountains.22

In the fourth century Sextus Placitus translated an Anglo-Saxon text into Latin, entitled The Medicinae de Quadrupedibus, which included a cure for leprosy. It was suggested that goat's urine should be mixed with honey and salt with the mixture then being rubbed over the patient's body.23 Theodoric of Cerva (1205- 1298},24 a bishop and a surgeon, in his Surgerv described four kinds of leprosy: Elephantia, Leonine, Alopecia and Tyria. Later writers such as Gilbertus Anglicus and Bemard of Gordon were also to describe those same forms of leprosy. Gilbertus Anglicus who died in 1250, wrote a Compendium Medicinae, which included a chapter on "De Lepra". Both Gilbertus and Bemard gave accurate descriptions of leprosy, emphasising loss of sensation or anaesthesia of the hands and feet resulting in physical damage to these areas as well as sores and ulcerations. They both described the loss of eyebrows, change in skin pigmentation, erosion of the nose, and Gilbertus also described a "pins and needles" sensation not unlike the "creeping of ants".2S

Bemard of Gordon like Theodoric of Cerva believed leprosy to be linked to the four humours of melancholy, choler, phlegm and blood. He wrote that yellow bile

7 or choler changes to black bile and becomes Leonine Leprosy, burned blood leads to Alopecia, black bile or melancholy becomes Elephantia and phlegm is the basis of Tyria.26 John of Gaddesden, a physician to Edward 11 and Professor of Medicine at Merton College, Oxford, believed that:

No one is to be adjudged a leper, and separated from intercourse of mankind, until the figure and form of the face is actually changed.27

Gaddesden also noted that the blood of lepers was different to others and suggested two tests that could be undertaken to establish leprosy. The first was to take some leper's blood and place it in clear water, if the blood stayed on top then he was infected, if it sank he was not a leper. The second test was to mix blood with three grains of salt and if the patient was leprous the salt would dissolve. 28

Guy de Chauliac was a celebrated fourteenth century surgeon, whose works became the standard reference for the diagnosis of leprosy. He wrote his Inventarium sive Colledium Artis Chirurgicalis Medicinae in 1363. He was one of the first writers to suggest that lepers should be segregated from society:

Let them not freely mix with the people, because they are sinking into leprosy ... they must be separated with kind and consoling words, from the people and committed to the leper hospitals.29

Unlike other authors he did not link leprosy with the sexual act, but he did regard the disease as a sign of inner decay, a "Disease of the sou/,:30 He, like Gaddesden, observed the difference in leper's blood, noting that it will clot easily in a pottery bowl and would also feel gritty when rubbed between thumb and index finger. These observations proved to be symptomatic of advanced Lepromatous Leprosy where the blood has increased amounts of platelets that adhere to one another, causing a grainy texture.

Through observation and reference to earlier works, medieval writers had accurately described and diagnosed the disease of leprosy. They frequently failed, however, to differentiate the disease from syphilis which was also prevalent at that time and this led to the erroneous belief that leprosy was a contagious venereal disease. The very nature of leprosy and its disfiguring symptoms would naturally lead to an aversion and fear of the leper. However, this natural reaction was further compounded by the misrepresentation of the disease in the Bible, together

8 with the strictures and condemnation to be found in Leviticus. In early church history, leprosy was irretrievably linked with sin, heresy and sex. The latter was in some part responsible for the civil laws enacted against the leper, due to the belief that leprosy was a sexually transmitted disease.

REFERENCES

1. McGrew, R. Encyclopaedia ofMedical History. 1985, p.161.

2. ibid., p.162.

3. Browne, S.G. Some Aspects of History of Leprosy: The Leprosie of Yesterday. Proceedings ofthe Royal Society ofMedicine, 1975,68,486.

4. McGrew, R. ref.l, p.162.

5. Clay, R.M. The Medieval Hospitals ofEngland. 1909, p.36.

6. Browne, S.G. ref.3, p.486.

7. Wells, C. A Possible Case of Leprosy from a Saxon Cemetery at Beckford. Medical History, 1962, 6,384.

8. M0l1er-Christensen, V. & Hughes, D.R. Two Early Cases of Leprosy in Great Britain. Man, 1962, 287, 178.

9. Kaplan, D.L. Biblical Leprosy: An Anachronism Whose Time Has Come. Journal ofthe American Academy ofDermatology, 1993,28 (3), 508.

10. Beckett, D.W. The Stricken Hand of God: Leprosy in England. New Zealand Medical Journal, 1987, 100, 494.

11. L10yd Davies, M. & L10yd Davies, T.A. Biblical Leprosy: A Comedy of Errors. Journal ofthe Royal Society ofMedicine, 1989, 82, 623.

12. Hulse, E.V. The Nature of Biblical 'Leprosy' and the Use of Alternative Terms of Modem Translations of the Bible. Palestine Exploration Quarler~, 1975, 107,88.

13. Rubin, S. Medieval English Medicine. 1974, p.153.

9 14. Brody, S.N. The Disease ofthe Soul- Leprosy in Medieval Literature. 1974, p.119.

15. ibid, p.129.

16. Demaitre, L. The Description and Diagnosis of Leprosy by the Fourteenth Century Physicians. Bulletin ofthe History ofMedicine, 1985, 59,338.

17. ibid, pp.329-330.

18. ibid, p.334.

19. Browne, S.G. ref.3, p.491.

20. Ell, S.R. Three Times, Three Places, Three Authors, and One Perspective on Leprosy in Medieval and Early Modem Europe. International Journal ofLeprosy and other Mycobacterial Diseases, 1989, 57, 831.

21. Brody, S.N. ref.14, p.53.

22. Bayliss, J.H. Domus Leprosae - Community Care in Medieval England. Nursing Times, 11 January, 1979,63.

23. Rubin, S. ref.13, p.53.

24. Ell, S.R. ref.20, p.827.

25. Creighton, C. A History ofEpidemics in Britain. Volume 1. 1965, p.71.

26. Demaitre, L. ref.16, p.331.

27. Clay, R.M. ref.5, pp.60-61.

28. Rubin, S. ref.13, p.156.

29. Simpson, J.Y. Antiquarian Notices of Leprosy and Leper Hospitals in Scotland and England. Edinburgh Medical and Surgical Journal, 1842, 57,134.

30. Brody, S.N. ref.14, p.103.

10 Leprosy is the Disease of Poverty.

A. Weymouth. Through the Leper-Squint. Chapter Two

Civil and Ecclesiastical Laws Governing the Life of the Leper.

To fully appreciate the social restrictions and moral strictures put upon the leper, it is necessary to explain both the civil and ecclesiastical laws that governed the life of the victim. Throughout the Middle Ages there grew up a tradition of prejudice against the Leper. He became an outcast, not just from a fear of contagion, or because of the disease's sexual connotations, but also for the "terribilis aspecius"l of the leper himself, though the law was never so severe in the British Isles as it was in the rest of Europe, and was rarely used against a leper unless he proved himself a nuisance. In thirteenth century Scotland a canon was written that typified the attitude generally adopted by the British with regard to the leper (with particular reference to a possible non-performance of their parochial duties):

If they cannot be induced to do so, let no coercion be employed, seeing that amiciion should not be accumulated upon the amicted, but rather their misfortune commiserated.2

The church's attitude to the leper was based upon writings about the supposed Disease of Leprosy in The Book of Leviticus and further exemplified by the biblical stories of Miriam, Naaman, and Gehazi, all of whom were erroneously described as lepers. In 1988 Jacques Le Goff described the medieval church's ambiguous attitude to the leper as "fear mixed with a sense of fascination ':3 Le Goff further believed that although the church viewed lepers as being dangerous to society, nevertheless, they were required to be visible in order to ease the conscience of the church; they were to be "outcast but within reach':4

One of the first examples of legislation against the leper can be found around the year 1100, during the reign of Henry I. The writ of De Leproso Amovendo stated that:

Where a man is a Lazar or a Leper, and is dwelling in any town, and he will come into the church, or amongst his neighbours where they are assembled, to talk with them, to their annoyance and disturbance then he or they may sue forth that writ for to remove him from their company. But it seemeth, if a man be a Leper or a Lazar, and will keep himself in his house, and will not converse with his neighbours, then he shall not be moved out ofhis house.5

11 It was from this writ too that lepers lost the right to bequeath or inherit property, neither could they sue nor stand for surety.

In 1276 during the reign of Edward I, the Assizes of London proclaimed that:

No leper shall be in the city, nor come there, nor make any stay there by night or day. 6

Edward also instigated enquiries into all the wards of London to see if any lepers were resident. This ordinance was repeated by Edward 11, and in 1346 Edward III issued a proclamation (Ordinance 21), expelling lepers from the city:

All persons who have blemish ofleprosy shall within fifteen days from the date of these present quit the city and suburbs aforesaid ... No persons shall permit such leprous persons to dwell in their house on pain of forfeiture ofhouse and property. 7

The link between leprosy and venereal disease is made quite explicit in the edict when it states that lepers who have:

Camal intercourse with women in stews or other secret places, detestably frequents the same, do so taint persons who are sound, both male and female to be the greater injury of the people dwelling in the city ... 8

It was also believed that lepers could infect others through polluted breath, in fact a characteristic - not of leprosy - but of lues venera or syphilis. In 1348 a further decree was proclaimed by Edward Ill, which stated that the Sheriff of Middlesex was to remove all lepers begging by the highway and fields between the City of London and the vill of Westminster, as it was the main thoroughfare of the Royal Servants, Judges, Clerks and Magnates. However, the king also declared that people should continue to give alms to lepers. By 1367, the fear of lepers spreading infection was such that they were forbidden to beg for alms. Further, in 1372 any leper found walking the street was liable to irnprisonrnent.9

The city of London was so concerned about the possible spread of leprosy that in 1375 Edward III further decreed that the porters of the City Gates were to swear to prevent lepers from entering the city. The porters of:

12 A1gate ... Bisshopsgate, Crepulgate, Aldrichesgate, Newgate, Ludgate, Bridge Gate and the postern ... were not to ... allow lepers to enter the City, or to stay in the same, or in the suburbs thereoflO but if they were to enter, then they would forfeit their clothes. Foremen or masters of the hospitals were also sworn to protect the city from the leper, with Edward's original edict being reinforced in 1378 and again in 1381. Marjorie Honeybourne believes that the above were the first health regulations in England.ll Although by the fifteenth century leprosy had generally declined in England, a Westminster Ordinance of 1472 showed that there was an apparent increase in the disease in London. It stated that all lepers on horseback or on foot should be taken to special hospitals as:

The disease being infectious from the air the leper breathes and the sight oftheir eyes.12

If any mayor or sheriff ignored this decree they could be fined £500, which led these officials in turn to charge constables and beadles of the various wards with also guarding against lepers. The fear of contagion only left the city during the reign of Edward VI (1547-1553) - a possible indication of a reduction in the incidence of the disease - since he no longer compelled lepers to leave the city:

All leprous and bedrid creatures whatsoever, may at their own liberty be allowed to continue in such houses appointed for lepers or bedrid people, and shall not be compelled to repair into other counties or places appointed by this Act13

Not all cities throughout the country adopted the same attitude to lepers, some being more severe, whilst others displayed more leniency. The laws of Berwick­ on-Tweed stated that any leper who forced his way into the town would have all his clothes stripped from him and burnt and that he would be turned out naked from the town. In 1163 the Bishop of Exeter confirmed that lepers could come into the market twice a week to collect alms, although by 1244 this was no longer allowed. In 1204 King John allowed lepers to collect corn and flour from Shrewsbury market. In Chester they could claim a portion of cheese, corn and fish, whilst in Southampton they could receive a penny from a fixed amount of wine imported through the docks.

13 The leper not only had his right of movement curtailed but he also lost his legal rights in regard to property, marriage and burials. As far back as 950 AD the Venedotian Code stipulated for a female that:

Should her husband be leprous and she leave her husband, the wife is to have the whole ofthe property,14

In 1200 the Synod of Westminster denied lepers the right to make a will, inherit property, or plead in a common court. The law made the leper an excommunicate. He was to be outside the community, incapable of instigating litigation, making gifts, or signing contracts.ls The property laws were severe. For example, in 1223 in Suffolk, Saloman of Wepstede claimed he was given land by John, before John became a leper. John's daughter Moira and her husband contested the claim saying John was a leper at that time. The court stated that if Moira could prove John was a leper at the time of the bequest, Saloman could not have the land.l6 Again in 1227 in Hereford, a woman called Agnes, wife of John of Westwick, sought to claim her legal rights to obtain property willed to her by her husband. However, Agnes was a leper, and as such could not sue for her property. The property laws were open to injustice, for if a leper could not make a will, any property belonging to him went to his lord or seigneur. As a result many a person was put in a leper hospital in order that his master could unjustly inherit the property.

The leper fared no better with regard to marriage. As early as 948 AD the Code of Laws (in force in Wales during the reign of Hywel Dda) stated:

For three causes a woman loses not her agweddi (dowry) though she may leave her husband,' to wit, on account of leprosy, bad breath, and default connections. 17

During the reign of King Edgar (959-975), leprosy was again a valid cause for divorce, but by 1180 the Church in Rome had changed its attitude towards divorce and the leper. In a letter from Pope Alexander III to the Archbishop of Canterbury he stated that leprosy was no longer grounds for divorce. Indeed, he went on to say:

We command that you should not delay in strongly persuading wives to follow husbands and husbands to follow wives who have contracted leprosy and to care for them with conjugal love. But if

14 they cannot be persuaded to do this you should strictly order them to observe continence whilst either ofthem is alive. And if they refuse to accept your order, you should excommunicate them. IS

By 1186, Pope Urban III felt that if a person became a leper during the period of betrothal then neither side had to feel compelled to marry the other. Once married, however, the answer to the problem of divorce varied considerably over the period of the Middle Ages. In 1254 in Kent for example, a woman called Amicia tried to marry again but was forced to reveal that her husband was a leper, and living in a leper hospital, and so the second marriage was not allowed to take place.

In death the leper remained isolated from the community. In pre-Norman times the leper was buried with other non-lepers in Christian burial grounds. However, in 1179 Pope Alexander III decreed in the Third Lateran Council a separatio leprosorum, which meant that lepers could no longer be buried in the communal cemetery, but should have their own priest, chapel and burial ground. When Edward I upheld the belief that lepers should have a Christian burial, there were a few instances of lepers being buried alive. 19 Although both the church and the government issued guidelines advising that the leper should live and conduct his life both in and out of society, a royal mandate in 1346 stated that men of knowledge without necessarily having medical knowledge should be responsible for diagnosing cases of leprosy since people who were believed to have been leprous were usually reported to the authorities by their neighbours.

At this point it might be useful to examine in a little more detail some of the accounts which have come down to us from that time concerning the treatment to be expected by those thought to be suffering from the disease. One of the better documented accounts of a reported leper was that of Joanna Nightingale of Brentwood in Essex, in 1468. Joanna's neighbours accused her of being a leper but she refused to be isolated, claiming she was not suffering from the disease. The neighbours sought to have her removed through the writ of De Leproso Amovendo, following which a Chancery Warrant was issued in the name of King Edward IV for her to be "diligently viewed and examined" by "certain discreet and loyal men of the county" 20 Contrary to normal practice the Lord Chancellor intervened and ordered that she be examined by the court physicians. The physicians, WilIiam Hatticlyff, Roger Marshall, and Dominus de Serego referred to

15 the works of Guy de Chauliac to detennine the presence of leprosy. After their examination of Joanna, the physicians stated:

First, we examined her person, and, as the older and most learned medical authors have directed in these cases, we touched and handled her and mature, diligent and proper investigation whether the symptoms indicative of this disease were in her or not,· and after an examination and consideration of each of the points which appeared necessary to be examined and considered, in order to arrive at a true knowledge of this doubtful matter, we found that the woman neither had been nor was a leper, nor ought, on that account to be separated from ordinary intercourse with mankind.21

They went on to explain that they had looked for forty different signs to indicate the disease, and found none.

A fonner Mayor of Winchester, Peter de Nuttle, (who in the course of his duty had expelled many lepers from the city) had in time found himself charged with being a leper, and was duly sent away from the city. However, Peter asked to be examined by both lay and medical men, in order to prove this was not so. The authorities were later to announce that:

From the inspection and examination before our council and by the council and by physicians expert in the knowledge of this disease, the said Peter is whole and clean, and infected in no part ofhis body.22

As a result of this exoneration, Peter de Nuttle was allowed to live where he chose and in peace.

William, the son of Nicholas Malesmains was attested to be a leper after a writ of De Leproso Avomendo was taken out against him. The Curia Regis Rolls of 1220 mention this episode, and that William Malesmains was committed to the leper hospital of St Mary Magdalene at Bidelington. However, the Nonnan decree that lepers were entitled to any inheritance before he became a leper still prevailed. When William attained his majority he left the hospital, went to his feudal lord, paid homage (and his fine) and returned to his property. No mention is made of whether William was still a leper at the time of his majority, or indeed if he ever actually suffered from the disease.

16 The stigma of leprosy and the fear of contamination remained for many years as witness the story of Nicholas Harris, a foot postman in Totnes, in 1620. He wished at the end of his '1onge, faitfull, and painifull service'; and for the rest of his ''irkesome life ''23 to live in an almshouse. The magistrates, meanwhile, had decreed he was a leper and must leave the town. Nicholas then made the journey to London where he petitioned the Royal College of Physicians to examine him and declare him free of leprosy. The physicians, after a thorough examination, declared him free of the disease and signed his petition accordingly.

The church initially accused the leper of heresy, and it was this view which prevailed until the twelfth century. A combination of the conversion of St Francis of Assisi, the Third Lateran Council in Rome, 11 79, and a twelfth century religious revival, brought about a change of attitude toward the leper. The charge of heresy had been directed towards a moral uncleanliness in the leper, similar to the sa ra'ath discussed in the previous chapter. The cleansing of the ten lepers in Luke 17:12-19 was seen as indicative of the 'unclean' moral state of the leper being ritually cleansed by the church:

Lepers therefore are a figure of heretics, for in that they blend evil with good, they cover the complexion ofhealth with spotS.24

Isadore of Seville who became Archbishop of Seville in 594 AD, was another who linked the disease with heresy. He related the various skin colours of the disease to the many schisms within the church. Leprosy was a false doctrine, therefore lepers were heretics. In the thirteenth century Gamer of Rochefort wrote that:

Leprosy is a sin, or indeed false teaching, as in Leviticus: if the stroke ofleprosy be in a man, that is ifsin or heresy be in a man, lepers are heretics as in Luke 17:12 there came ten lepers ... stained in the filth ofheresy.25

In the previous century Radulphus Aaviancensis linked various forms of the disease to differing sins, also illustrating at the same time the Levitical belief that leprosy could also be found in clothes. He attributed leprosy of the head and beard to a corrupt faith, leprous ulcers of the skin were from crimes and vices such as intemperance and adultery, whereas leprosy found in woollen or linen

17 garments showed depravity of virtue, allurement of the flesh or infidelity.26 He also believed that the leper was not one who had sinned as such, but one who had sinned but not repented. His was the "single moral failure of the denial ofthe church and its Laws'~27 He, like the church, suggested separation of the leper from all non-leprous people, not only from a fear of contagion of the disease, but also from contagion of the 'unclean' morals.

The end of the twelfth century and the beginning of the thirteenth century saw a more understanding appraisal of the leper. St Francis of Assisi attributed his conversion to his encounter with a leper. Having met him on his travels and turned away from him in disgust, he then reflected on his own life and attitude towards those less favoured than himself. Having found that his attitude was less than worthy he returned to the leper, gave him alms and kissed his hand. He later told his followers to take special care of lepers, and ensured that they all served for a period of time in a leper hospital. After this incident, lepers were seen as being the instrument for God's intervention in the redemption of a sinful man. Lepers became known as Christ's Poor; Aealred in the twelfth century and Matthew Paris in the thirteenth century referred to them as "Pauperes Christi, videlicet Lazares'~28

The Third Lateran Council of Pope Alexander III in Rome, 1179 published the Canon of De Leporsis, acknowledging that the church may have been less than Christian in its attitude toward the leper. At the same time, however, it decreed that lepers should not live with healthy men, thereby ensuring that lepers were separated from society and encouraged to live in hospitals situated outside the town. Le Goff29 reflects on the ambivalent attitude of the church in this instance, in which society and the church itself should adopt a more Christian stance toward the leper, but at the same time their hospitals should be sited a stone's throw from the town. However, the Council ensured that the leper was not denied the benefits of the church and decreed that leper hospitals could have their own chapel, priest and cemetery. In 1200 the cannon of De Leporsis was confirmed at Westminster in the Synod held by Hubert, Archbishop of Canterbury. He confirmed the leper's rights to a church, albeit their own, and further declared that lepers should pay no tithes for their gardens or cattle.

Priests, monks, and clerks in holy orders who became lepers themselves were not answerable to common law, only ecclesiastical law. The unlucky man's fate was

18 decided by his bishop and a co-adjudicator of the bishop's own choosing. The De Leporsis stated that the church was responsible for removing the unfortunate leper from his office but attitudes varied within the church. When in 1035 Aelfeard, Bishop of London and Abbot of Evesham, found he had contracted leprosy, he immediately resigned his Abbacy. As a consequence of his infection, the monks refused to house him. In retaliation he removed all his books and sacred vessels and went to Romsey Abbey where he was made welcome and stayed until his death in 1044. In contrast to the monks at Evesham, Pope Clement III ordered that when clergy had to leave their living because of leprosy, they should always be supported by their benefices. The case of Philip, a leper priest of St Neots in Cornwall, illustrates this. He was allowed a room of his own in the vicarage, two shillings a week, and a further twenty shillings a year for his c1othing. 3o The threat of total seclusion from society was never applied to those lepers in holy or monastic orders, only to the lay leper. In Europe, and especially in France, more severe forms of isolation were practised. In 1318, in the Chronicle of Lannercost, it was recorded that Philip V had lepers burned alive after believing they had intentionally poisoned some wells. According to Berton Roueche, both Henry 11 and Edward I performed similar acts towards lepers. Henry 11 was believed to have strapped lepers to posts and burnt them alive, while Edward I had them buried alive in a cemetery.

The church throughout Britain and the rest of Europe, however, performed a burial service as part of the Office of Seclusion, whereby lepers were totally isolated from the community. This office is to be found in the Sarum Manual of Salisbury Cathedral. The priest carrying a cross, made his way to the leper's house. There he assured the leper that although he might be sick in body his soul could achieve salvation if he were to remove himself from society. The priest would then sprinkle holy water over him, then, chanting Libera me, Domine, he led the leper to church. On entering the church the leper knelt below a trestle that had been covered by a black cloth:

After the manner of a dead man, although by the Grace of God he yet lives in body and spirit}!

Under this trestle the leper heard mass and made his final confession. The priest then casts a spade of earth at each of the leper's feet in a symbolic gesture of burial and said, "Be thou dead to the world, but alive again unto God':32 The leper was then led away from the church, wrapped in the black cloth as if in a

19 shroud. Holy water was sprinkled again and intoning Libere me, Domine, the priest led him to the hospital. At the door of this hospital the leper was adjured never to set foot in a church or go to a market, mill or bakehouse. They must never wash themselves or their clothes in a stream or spring and only drink water from their own cup. They must always wear their leper clothes, so that they may be recognised and must never go unshod. They must not touch any goods they wish to purchase, but point at them. They were not allowed in taverns and they were not to have intercourse with any woman other than their wife. When on the road they must step well aside to allow others to pass without fear of contagion. Lepers must not touch other people, and must not eat or drink with healthy people. Following this, the leper entered the hospital where it was impressed upon him to recite his Pater Noster. Ave Maria. Credo in Deum. Credo in Spiritum. The priest then exhorted the leper to have patience so that his soul will become clean and whole. The Office of Seclusion was practised until the Reformation, though, at least in England, there were by then very few lepers to hear the Office read.

English laws were never as severe as those which pertained in Europe, and although Henry Il and Edward I are cited as exacting terrible punishments against the leper, the evidence suggests these were isolated cases and not typical of the times. Many kings were in fact tolerant of the lepers and tried wherever possible to alleviate some of their suffering. King John granted tolls and tithes from markets to the leper and in a period when begging was against the law, he exempted the leper. However, the church was to find itself in an unenviable position. Having decreed that leprosy was the result of the signal moral failure of the leper and his denial of the church and its laws, it was now presented with the figure of the Leprous Crusader, a knight whom the church had previously blessed, but who had now returned from his travels having contracted the disease. The church resolved this conflict by surrounding the Crusader with a holy aura.

The church's attitude towards lepers and leprosy, overlaid as it was with sin and heresy, is clearly reflected in the literature and art of the time and it is still possible to detect in superstition and folklore today, traces of the stigma the disease acquired at that time.

20 REFERENCES

1. Creighton, C. A History ofEpidemics in Britain. Volume 1. 1965, p.102.

2. Clay, R.M. The Medieval Hospitals ofEngland 1909, p.56.

3. Le Goff, J. Medieval Civilization. 1988, p.316.

4. ibid, p.316.

5. Browne, S.G. Some Aspects of History of Leprosy: The Leprosie of Yesterday. Proceedings ofthe Royal Society ofMedicine, 1975, 68, 488.

6. Clay, R.M. ref.2, p.53.

7. Browne, R.M. ref.5, p.488.

8. Creighton, C. ref.1, p.103.

9. Honeyboume, M.B. The Leper Hospitals of the London Area. Transactions of the London and Middlesex Archaeological Society, 1967, 21,7.

10. Hope, R.C. The Leper in England: With Some Account ofEnglish Lazar Houses. cl900, p.41.

11. Honeyboume, M.B. ref.9, p.8.

12. ibid., p.8.

13. Newman, G. On the History of the Decline and Final Extinction of Leprosy as an Endemic Disease in the British Islands. Prize Essays on Leprosy, 1895, 157,49.

14. ibid, p.35.

15. Brody, S.N. The Disease ofthe Soul' Leprosy in Medieval Literature. 1974, p.83.

16. ibid, p.35.

17. Weymouth, A. Through the Leper Squint. 1938, p.91.

18. Richards, P. The Medieval Leper and his Northem Heirs. 1977, p.62.

21 19. Browne, S.G. ref.5, p.489.

20. Richards, P. ref.18, p.40.

21. ibid., pp.145-146.

22. ibid., p.40.

23. ibid., p.147.

24. Brody, S.N. ref.15, p.124.

25. ibid., p.126.

26. ibid., p.133.

27. ibid., p.133.

28. Creighton, C. ref.1, p.79.

29. Le Goff, J. ref.3, p.316.

30. Clay, R.M. ref.2, p.69.

31. Richards, P. ref.18, p.123.

32. ibid., p.123.

22 Who would not turn aside from a leper, even though he were a son, or a father, or a brother?

J. H. Bayliss. Domus Leprosae - Community Care in Medieval England. Chapter Three

Leprosy Represented in Art. Literature. Superstition and Folklore.

As we have seen earlier, the leper, whilst not totally ostracised from society. was a figure surrounded by superstition, fear and rejection. With his leper clothes, c1apper or bell he was a distinctive member of society, his singularly uninviting appearance provoking fear and revulsion. And we shall now see that both the biblical writings and medieval teachings on heresy, sin and leprosy coloured the representation of the leper in Art and Literature. Many of the pictorial representations of leprosy are to be found in medieval manuscripts, in which the disease is visited upon those who have sinned, lusted or committed a heresy. Even today, many of the references in literature to the 'leper' or 'leprosy' still appear to bear moral overtones. Superstitions surrounding the disease include miraculous cures at specific wells or shrines, and many remedies believed to cure the victim of his disease are to be found in superstition and folklore.

The first pictorial representations of the leper are to be found in medieval manuscripts. He is invariably depicted with a spotted body, such spots being not so much a symptom of the disease more as an 'emblem'.! An example of this can be found as a marginal sketch in a manuscript belonging to Trinity College, Cambridge, where a physician can be seen examining a spotted leper. 2 A further marginal sketch can be found in the fourteenth century manuscript of the Exeter Pontifical. The spotted leper is pictured carrying a bell to warn of his presence, and around him are printed the words "sum good, my genty// mayster, for God sake'~3 A century later a leper of a similar appearance can be seen approaching a town gate along with a cripple. At the gate stands a figure with outstretched hands as if to warn the leper not to approach. This illustration is from the Miroir Historical by the Dominican monk Vincent of Beauvais.4

Luke's account (5:12-14) of the Healing of the Leper was a common subject. A pen and ink drawing from a ninth century illustrated Gospel of St Florin in Coblenz shows the leper first approaching the city gate and then, once inside, moving towards Jesus. Again he is represented as spotted, but instead of a c1apper or bell he has a horn to warn of his approach. Similar representations, varying in only their landscape settings are to be found in the tenth century Gospel of Otto III and in the eleventh century Reichenau Gospels from Limburg.

23 Under Mosiac Law the subject who has been healed is required to give thanks. In Christ's Healing of the Ten Lepers, Luke 17: 11-19, only one of the cured lepers, the Samaritan, returns to give thanks to Jesus. This incident is depicted beautifully in a miniature to be found in the Golden Gospels of Nuremburg (1020-1030). In the early Middle Ages manuscript illustrations were not the only medium in which artistic representations of the leper could be found. Scenes from Christ's Healing of the Leper can also be found on a ninth century Carolingian ivory and on the ninth century embossed gold relief binding of the Codex Aureaus belonging to the monastery of St Emmeran in Regensburg.5

During the following centuries there are many representations of the leper to be found, principally those of Job or Lazarus. A German engraving originating from around 1500 AD, shows Job sitting on a dung heap and whilst his wife berates him Saturn lashes him with a cat-o-nine-tails. In a woodcut by Hans Wechtelin in the Field Manual of Wound Medicine by the Strasbourg Surgeon Gersdorf in 1517, Saturn inflicts leprosy upon Job whilst Job's wife cries out "Bless God and Die': Both Durer and Lucas Cranach painted Job as a leper, and these early representations of the leper conform to the tradition of showing the leper with spots, postules and nodules spread over the entire body. 6 St Lazarus is almost always represented with a clapper, including a painting of Lazarus by Rembrandt. In 1419 an unknown Flemish artist painted the Legend of St Giles. The saint believed by many to be the Patron Saint of Lepers, is depicted protecting a hind from the king's huntsmen and receiving an arrow in his hand that was meant for the animal. Hans Holbein in 1576 made a painting of St Elizabeth giving wine and bread to a group of lepers. The painting shows the victims with red lumps on the face and arms, with legs swathed in bandages while a young man appears to have almost no eyebrows. Many other paintings of the leper can be found in the German and Italian Schools between the fourteenth and sixteenth centuries. Further representations of lepers can be found on the seals of two of the many leper hospitals. The seal of Holy Innocent's Hospital in Lincoln shows a leper on two crutches, one to support a paralysed arm and the other to support a leg wooden from below the knee.1 The seal of Mile End Leper Hospital, a work of the sixteenth century, depicts a crippled leper and a beggar wornan.s

Having briefly studied the history of pictorial representations of the leper, we now move to look at other ways in which sufferers may have been depicted in the past.

24 One of the earliest representations may date back to 1411-1314 BC. A clay jar was excavated in the Canaanite temple of Amenophis JII in Beth-Shaa, Palestine. The jar was found in a shrine among other sacred cult objects that were part of some ancient agricultural rites, possibly a protection for the harvest. 9 The jar which has a human head modelled on top, had been used to store grain and flour. M. Yeoli believes that the head showed leonine leprosy in that:

The face has thickened cheeks and has assumed a swollen lose appearance; the nose is disfigured; the eyebrows bulge and the hair has fallen out from them; the natural lines and folds are strongly exaggerated. All these morphological changes point strongly to a 'leonine fades' oflepromatous leprosy.10

It is not fully understood why a leprous head should be depicted on a clay jar. Yeoli believes that the ''terror striking head of a leper" can be linked with the Tale of the Four Lepers of Samaria related in Kings Chapters 6-7. Samaria, in the hands of the besieging King of Syria, was in the grip of a famine, so great that mothers were supposedly eating their children. Elisha, the prophet, foretold that there would be a miraculous deliverance of grain and flour. The Syrians, on hearing of this prophecy, fled in fear of an army sent by God. Four lepers made their way though the abandoned Syrian camp and told of deliveries of grain and flour, and from this account it can be seen how the leper was to gain a reputation for protecting both the harvest and the grain, preventing famine and hunger.1 l

Very few sculptural representations of the leper are known to exist. In England, a little known medieval carving can be found in St Mary's Church at Melton Mowbray. It is known as the 'Leper-Head' and is believed to have originated from the nearby leper hospital at Burton Lazars. The hospital, the principal house for the Knights of St Lazarus in Jerusalem, was founded in 1150. The building ceased to exist as a hospital after the Dissolution (1536-1540), and was finally destroyed in 1700. The 'Leper-Head' is believed to date from around 1250-1350 and was one of the many sculptures which adorned the hospital. The head measures 11 cm x 10 cm and features sagging, everted eyelids (which does not allow the victim to close his eyes). a symptom of lepromatous leprosy. The head also shows damage to the nasal and mouth cavities and the collapse of the bridge of the nose, again indications of a person suffering from lepromatous leprosy.12 Marcombe and Manchester believe this 'Leper-Head' to be the only sculptural

25 representation of a leper known at present, and strongly dispute the evidence of the Canaanite jar discussed earlier.

In architecture too, there remain few examples indicating the existence of the leper, and no consensus as to the role of the 'Leper-Squints' or 'Leper-Windows' found in some of our English churches. The Leper-Squint or Hagioscope is an opening or aperture found at the North East angle of the South aisle, or at the South-East angle of the North aisle, and they were often glazed with leaded glass. Examples of these windows can be found throughout the country, but particularly fine examples are to be seen in Warwickshire and Derbyshire. It is argued that the relationship between the windows and lepers only dates back to Victorian England, and since lepers were denied access to a church the window may exist for some other unknown purpose. S.G. Browne supports this theory but states that in some rare circumstances lepers were allowed to peer through a low window, for example in Bergen, Norway.13 Contrary to this, G. Newrnan suggests that lepers were allowed to present themselves outside a church, as not all lepers were confined to a hospital. He believed that by peering through the window the leper was able to observe the elevated host at the altar, and that in some instances a church had a slab inserted into the windowsill in order that he may receive the sacrament without making physical contact. 14 Although RM. Clay does not support Newman's theory she does, nevertheless, refer to a manuscript that details how the leper, Blase Tupton, was able to attend the church of St Chad's, Shrewsbury in 1409:

Blase ... cam by chance to be a leeper, and made the Oryell which goy/he allong the west side of the churche-yarde, throughe which she cam aloft to heare seveys through a doore made in the churche wale, and so passyd usually uppon the leades unto a glasse wyndowe, through which she dayly sawe and hearde dayly serveys as longe as she lyvyd.15

Clay defends the account, believing that Blase Tupton was a privileged person, being the daughter of a townsman who had founded alms houses adjoining St Chad's. Other theories concerning the function of the squints vary from the ventilation of the church after the use of incense, to a means of communication for hermits in their cells built against the church walls. Charles Cox, whilst admitting that not all research on leper-squints had yet been completed, observes that often the presence of a leper-squint coincides with the existence of a nearby

26 leper hospital, an example of which may be St Werburg's Church in Spondon, Derbyshire.16

As we have seen, some of the early manuscripts drew their inspiration from the stories of lepers found in both the Old and New Testaments. Similarly, it is the teachings of the church, which had linked leprosy with the sins of lust and heresy, that influenced many authors, even continuing into modem literature where the words 'leper' and 'leprosy' still carry moral overtones.

Robert Henryson wrote The Testament of Cresseid in 1593. The poem is a sequel to Chaucer's Troilus and Cryseyde. Henryson was of the opinion that Chaucer had been too generous in his treatment of Cresseid and felt that she deserved a more appropriate punishment. Troilus is the son of Priam, King of Troy, and Cresseid was the daughter of Calchas, a priest. After the fall of Troy, Cresseid is sent to a Greek camp where she forsakes Troilus and becomes the lover of Diomede. Cresseid was considered to be a lustful and wanton woman after her desertion of Troilus, while Diomede, for all he "had all his appetite and more satisfied by this fair lady'; in his turn left Cresseid.n She, after this desertion, proceeds to become a whore and blames Venus and Cupid for all her troubles. Cupid demands revenge for this slur from Saturn, and Cynthia, Goddess of the Moon. Astrology was a significant element in medieval medicine and Saturn was considered to have jurisdiction over leprosy, as was seen earlier in the German representations of Job. Both Saturn and Cynthia decreed that "she shall suffer pain and torment, an incurable disease and be an abomination to all lovers': Saturn further decreed that "her insolence, play and wantonness shall be changed to a great disease': 18 For her pride and lustfulness the Gods decided to humiliate Cresseid by turning her into a leper, thereby giving support to the idea that leprosy was a venereal disease. As a leper Cresseid was described as having spots, and (in relation to Bartolomeus Anglicus who in his De Proprietatibus Rerum, likened the various coloured leprosy spots to the four humours), Cresseid's spots were judged to be melancholic, also in keeping with Saturn's jurisdiction over Melancholia as well as Leprosy. Cynthia condemns Cresseid saying

This saIl thou go begging, fra hous to hous With cop and dapper Iyke on Lazerous.19

27 The story of Tristram and Iseult is believed to have been compiled by Thomas of Erceldonne before 1300. Tristram is the nephew of King Mark of Cornwall. Tristram tells Mark of the beautifullseult living in Ireland, following which Tristram is sent there to ask for the hand of Iseult for King Mark. On their return journey, Tristram and Iseult fall in love. However, Iseult marries King Mark whilst continuing her love affair with Tristram. When the affair between the two was discovered, they were sentenced to bum at the stake for their adultery. Tristrarn escapes from the stake leaving Iseult behind. A group of lepers arrive, led by Yvain, who, in the manner of that time, was described as promiscuous and licentious. He appealed to King Mark to present him with Iseult, saying that burning was too short a justice, and that he could devise a worse punishment in keeping with her crime, and leaving Iseult wishing for death. Yvain explained:

See, I have here 100 companions. Give us Iseult, and let us have her in common. The sickness arouses our lust, give her to your lepers, no lady will ever have a worse end. Look, our rags are stuck to our oozing sores. She who in your presence took pleasure in rich stuffs lined with vair, in jewels and in rooms decorated with marble, she who enjoyed fine wines, honour and joy, when she sees the court of her lepers, when she is forced to enter our slums and sleep with us, then Iseult the Beautiful, the fair, will recognize her sin and will regret this fine fire of thorns.2o

King Mark agreed to Yvain's demands and, despite Iseult's protests, she was taken away by the lepers. Tristram, himself disgUised as a leper, rescues Iseult from Yvain, and all ends well. In this tale we see once more the leper depicted as a sexually motivated being and Iseult's punishment of possible leprosy was to be the consequence of her lust.

The Thirteenth Century romance of Amis and Amiloun is a tale of two identical brothers. Amis makes love to his lord's daughter, and when discovered is challenged to fight in combat to prove his innocence. Amis, knowing that he is guilty realises he will die, but Amiloun offers to take his place provided that Amis returns to Amiloun's wife posing as her husband. Being innocent Amiloun wins the combat, but instead of returning to his wife he marries the lord's daughter! Through this bigamous act Amiloun becomes a leper. Arnis, in the mistaken but common belief that leprosy can be cured through the blood of innocent children, now kills his own two offspring. The Gods, however, refuse to let Amis make this

28 sacrifice, and he returns home to find his children asleep and not dead as he believed, while Amiloun remains a leper as punishment for dishonesty.

The belief that leprosy can be cured by the blood of innocent children can also be found in the story of a Roman Emperor who had slaughtered many Christians. In response to these killings an angel came and visited the Emperor one night pouring water over him and causing him to become a leper. Believing in the cure of innocent's blood the Emperor now had many children brought to him. However, he took pity on the children and decided to live instead with his leprosy. As this was pleasing to God, He told the Emperor he could be cured if he became a Christian. We find this same theme in Der Arme Heinrich written by Hartmann Von Aue in 1195. Heinrich was considered to be a perfect knight, but was in reality vain and proud. For these sins he was to become a leper. Believing that the blood of a virgin could cure his disease he, on arrival at Salemo, arranged for a young virgin to be sacrificed. But before the girl dies Heinrich recognises his own sins and saves the life of the girl. In remorse he offers his own life to God and is miraculously cured.

The Gesta Romarum contains stories that were often included in sermons for the common people, and leprosy was sometimes the subject of these stories where it was invariably linked with sexual depravity. This belief that leprosy and sexual or moral depravity are somehow linked, was to remain during the next centuries. John Ford in 1633 wrote 'Tis a Pitv She's a Whore, in which a brother loves a sister and makes her pregnant. A Friar tells the brother "Beg heaven to cleanse the leprosy oflust that rots the soul'; and the sister is described as having a '1ust­ be-Iepered body'; while in the nineteenth century, Alfred Lord Tennyson was to write '14 moral leper, I, to whom none speak':21

Sexual and moral associations formed a part of the many superstitions and folklore that surrounded the disease. Indeed, the alternative name of a Lazar for a leper reflects a mis-translation of the story of Lazarus, who in Luke Chapter 16 is described as 'a man full ofsores': In the eyes of the church, Lazarus became one and the same as Lazarus of Bethany in John Chapter 11. Many medieval leper hospitals were dedicated to St Lazarus and also his sisters Martha and Mary. The sister Mary also became confused with Mary Magdalene, after whom many hospitals were known as the Maudlin or Magdalene. Other leper hospitals or lazar houses were dedicated to St Leonard, a French hermit whose dates are unknown.

29 Many miracles were attributed to him by returning crusaders and he became the Patron Saint of Prisoners and Lepers. A similar story is that of St Giles, another hermit of unknown date. As we heard earlier he was wounded by an arrow whilst protecting his pet hind from the hunt. He became the patron saint of cripples and beggars. St George, the patron saint of England, was believed by the Scandinavians to be an allegorical representation of the Christian Faith fighting the disease of leprosy and many Scandinavian leper hospitals were dedicated to this saint.22

There are superstitions surrounding the ruins of leper hospitals, places not only to be avoided for reasons of possible infection, but also through the fear of sexual and moral contamination. Leper-stones, smooth flat stones where food was left for the leper, were also an object of fear. It was believed that the disease itself could contaminate crops, and it is recorded that monks have destroyed sacks of grain believing them to be leprous.23 In Scotland it was held that leprosy and witchcraft were linked. In 1597 Matjorie Bysseth of Eglin was charged with witchcraft by friars of the area. They believed she had repeated her prayers backwards and had transformed herself into a hare. During the enquiry, a leper from a nearby Lazar house stated:

At ye day ofPentecost last, thys woman did give unto me ane shell of oynment, with which I annoynted my hand to cure ane impostule(swelling) which had cum over it, beholde, from that day untyll thys it hath shrunk and wythered as you see it now.24

Following the leper's declaration, the woman was taken to a pool and ducked until she drowned.

Not all lepers were regarded with such superstition, and stories exist of compassion being extended towards them by royalty. One such story related by Roger De Hoveden, concerns King Edward the Confessor, who on approaching Westminster Abbey in a royal procession, passed by a leper. The king's concern was such that he carried the leper on his back, praying for the man's recovery, and miraculously the leper was cured. Queen Matilda, wife of Henry I, and benefactor of St Giles Hospital, bathed and kissed the feet of lepers, and invited them into her palace, though her brother, King David of Scotland, witnessing these actions, was both shocked and afraid and found himself unable to follow suit.25

30 Wells and shrines were often accredited with miraculous powers, and many hospitals were sited near these healing springs or Leper-Wells. Examples of these hospitals are to be found at Hambledown, Burton Lazars near Melton Mowbray, Peterborough, Newark and Nantwich.26 The curative powers of springs is told in the story of King Bladud who died in 844 BC. Bladud was forced to leave home when he became a leper, and in his wanderings discovered diseased swine bathing in hot springs. Seeing the swine emerging from the pool cured from their disease, Bladud built baths around the springs and the town became known as Bath.27 The Shrine of St Thomas of Canterbury was also supposed to provide a miraculous cure for leprosy. Holy Water was made from a drop of the saint's blood diluted from the well found under the crypt of the cathedral. William of Canterbury, a custodian of the shrine, tells of the leper Randulf of Langton, who on his way to enter a leper hospital paused by the shrine. During the next nine days he drank of, and washed in, the holy water and was marvellously cured of the disease.28 St Thomas was also attributed with healing a leper named Gerard. This same leper had a vision of himself lying in the saint's tomb, where St Thomas breathed through a gap in the tomb and into Gerard's mouth. Gerard then travelled to Canterbury where he drank and washed in the holy water and was cured.29

Many herbs and wild flowers were believed to cure the leper. Yellow dock, sorrel, burdock, elm bark, wormwood, wall stone crop, celandines and even the common daffodil were all believed to heal the open sores and ulcers or even the blindness of a leper. More exotic cures were recommended. Bartolomeus Anglicus, for example, wrote that a red adder with a white belly but without its venom, head or tail, cooked with leeks, should be eaten by the patient who would surely be cured!30

As noted above, the leper was often represented with spots. The chequered pattern on the wild flower Fritiliaria Meieagris resulted in it being known as Lazerus Bell, while its alternative name of Leopard's Bell reflects the corruption of the name "leper" into "leopard" which appears to bear the same spots as the disease.31 Place names indicate today the one time presence of lepers or their hospitals. Liberton in Edinburgh was formerly a Liper-town, and in Ireland 'lour', 'loure' or 'lowre' at the end of a name as in Knockaunalour and Ballyloure tell of the leper hospitals that once existed in those communities.32

31 And so we have seen that, although the leper was considered an outcast, his affliction being a result of heresy and sexual depravity, his image has come down to us in art, literature, superstition and folklore. And yet, pariah as he was, there did exist places of refuge willing to accept the outcast. And it is these sanctuaries - the Leper Hospitals or Lazar Houses - that we now go on to study in the next chapter.

REFERENCES

1. Brody, S.N. The Disease ofthe Soul' Leprosy in Medieval Literature. 1974, p.48.

2. Richards, P. The Medieval Leper and his Northern Heirs. 1977, p.103.

3. ibid., p.52.

4. Le Goff, J. Medieval Civi1isation. 1988, p.316.

5. Schiller, G. /conography of Christian Art. Volume 1. 1969, pp.175-176.

6. Gran, K. Leprosy in Literature and Art. International Journal ofLeprosy, 1973, 41 (2), 255.

7. Rubin, S. Medieval English Medicine. 1974, p.160.

8. Clay, R.M. The Medieval Hospitals ofEngland. 1909, p.47.

9. Yeoli, M. A "Fades Leontina" of Leprosy on an Canaanite Jar. Journal ofthe History ofMedicine and Allied Sciences, 1955, 10(3),332.

10. ibid., p.332.

11. ibid., p.333.

12. Marcombe, D. & Manchester, K. The Melton Mowbray "Leper-Head": An Historical and Medical Investigation. Medical History, 1990, 34, 89- 90.

13. Browne, S.G. Some Aspects of History of Leprosy: The Leprosie of Yesterday. Proceedings of the Royal Society ofMedicine, 1975, 68, 491.

32 14. Newman, G. On the HistOly of the Decline and Final Extinction of Leprosy as an Endemic Disease in the British Islands. Prize Essays on Leprosy. 1895, 157,33.

15. Clay, R.M. ref.8, p.201.

16. Cox, J.C. Notes on the Churches ofDerbyshire. Volume 3. 1877, p.289.

17. Brody, S.N. ref.1, p.174.

18. ibid., p.174.

19. Steams, W.M. Robert Henryson and the Leper Cresseid. Modem Language Notes, 1944, 59, 267.

20. Le Goff, J. ref.4, pp.316-317.

21. Richards, P. ref.2, p.5.

22. ibid., p.8.

23. Browne, S.G. ref.13, p.487.

24. ibid., p.492.

25. Bayliss, J.H. Domus Leprosae - Community Care in Medieval England. Nursing Times, 11 January, 1979, 63.

26. Clay, R.M. ref.8, p.63.

27. ibid., p.63.

28. Rubin, S. ref.7, p.162.

29. ibid., p.163.

30. ibid., p.161.

31. Richards, P. ref.2, p.8.

32. Weymouth, A. Through the Leper Squint. 1938, p.52.

33 We lepers can no doctor get: Here must we stay and wait and fret: Until our time is up.

P. Richards. The Medieval Leper and his Northern Heirs. Chapter Four

The Leper Hospitals of Medieval England.

Leper Hospitals or Lazar Houses were unlike the hospitals we know today, being more a house of retreat where the leper could live than a place where he would receive attention. Many of the hospitals were referred to as "Spittles", defined as either a 'foul' or 'loathsome place' or used as an abbreviation of the word 'hospital'. However, many of the hospitals termed 'leper' or 'lazar houses' were often nothing more than places of refuge for the generally infirm. In this respect the list of leper hospitals compiled by Dugdale in The Monasticon may well not be a true reflection of the amount of leprosy occurring in medieval England.1 The leper hospital may well be regarded as a form of prison, an almshouse, or even a monastery. In this latter hospital, the inmates were required, as were the monks, to take vows of chastity, obedience and piety.

As we saw earlier, leprosy is believed to have existed in this country from the time of the Roman occupation, but the first mention of a leper hospital in England was by Gregory of Tours, c560 AD, in his Historia Francorum. The first fully documented evidence of a hospital is that of St Leonard's in Northampton, founded in 1087, and Harbledown, founded by Archbishop Lanfranc who died in 1089. The dates of these hospitals dispel the theory that leprosy was introduced into this country by the Crusaders; the first knights to leave England for the Crusades departing in 1096. The rise in the number of hospitals was due in no small part to the Cannon of De Leporsis of the Third Lateran Council in Rome, 1179. The Cannon states that lepers should not dwell with healthy men. In consequence leper hospitals were built outside the town or city walls. As will be seen later, the number of leper hospitals in the medieval period has been disputed and this causes difficulty in assessing the exact extent of leprosy in this country at that time. Many hospitals did exist, however, and they were funded by charitable organisations, municipal authorities or monastic orders. Their original purpose of care and attention to the leper often degenerated into financial irregularities, embezzlement and indiscipline. Yet for the leper, banned from entering the city gate, or from begging in the streets, the leper hospital was his only refuge.

The study of twelfth century skeletons in South Acre, Norfolk by M011er­ Christensen and Hughes, revealed that one out of the 161 examined had leprosy,

34 giving an incidence of 0.62% of the disease for that groUp. 2 J. Bayliss believes that the figure represents 1% of the population or a total of 10,000 lepers in twelfth century England. The spread of the disease, as would be expected, reflected the density of the population throughout the country. The presence of the leper hospitals can be used as a reasonable indicator of the extent and location of the disease. East Anglia and the Thames Valley were areas which had a high proportion of hospitals, especially in Norfolk where six hospitals alone existed in the city of Norwich. The more sparsely populated areas of the Western and Midland counties had a relatively low incidence of hospitals. It is believed that the disease was at its height during the eleventh, twelfth, and thirteenth centuries, declining in the fourteenth century and hardly discernible by the fifteenth century. However, there was a sudden inexplicable appearance of the disease in sixteenth century Cornwall. A hospital at Honiton was founded in 1530 by Thomas Chard, Abbot of Ford, although this outbreak appears to have been isolated.3

As we have suggested, the number of leper hospitals in England has been open to question. Creighton believes there were not more than 50 hospitals and he was also of the opinion that leprosy was a little known disease and lepers no more common than the village idiot. However, the consensus is that there were around 200 hospitals in thirteenth and fourteenth century England, with accommodation for around 4,000 lepers,4 (see Figure 1). C. Hope compiled the following list of known hospitals in the various counties of England:5

1 Berkshire 1 Herefordshire 4 Oxfordshire 2 Buckinghamshire 6 Hertfordshire 2 Shropshire 2 Cambridgeshire 1 Huntingdonshire 6 Somersetshire 3 Cornwall 15 Kent 3 Staffordshire 1 Cumberland 1 Lancashire 10 Suffolk 4 Derbyshire 2 Lincolnshire 1 Surrey 6 Devonshire 4 Leicestershire 6 Sussex 3 Dorsetshire 7 Middlesex 3 Warwickshire 2 Durham 22 Norfolk 4 Westmoreland 4 Essex 5 Northamptonshire 7 Wiltshire 6 Gloucestershire 3 Northumberland 1 Worcester 2 Hampshire 3 Nottinghamshire 20 Yorkshire

/ Total 1173/

35 THE LEPR~.~OSPITAl~S: . BRITISH ISLES. . «.f DURINGTltEMIDDLE AGES.: q cr ..p

Figure 1.

36 Hospitals were funded through bequests, or by charitable organisations, monastic orders, and local dignitaries such as the Mayor and Aldermen of London. Admission fees to the hospitals, tolls and taxes from fairs and markets, and exemptions from the tithes in accordance with the Cannon of De Leporsis of 1179 contributed to the finances. Moreover, the rent from parcels of land termed Terra Leprosorum were also used for the upkeep of the leper hospitals. However, all but a few of the richest hospitals were underfunded and many were unable to provide even the basic necessities of care and attention, and consequently some of the hospitals rejected the leper in favour of fee paying non-leprous patients. For many people the fear of old age, poverty and the absence of a family, overrode the fear of leprosy and they sought the shelter of a hospital, albeit one canying a danger of infection.

Proctors were also employed by many of the hospitals to solicit for alms. Although, as in the reign of King John, lepers were allowed to beg, they were in the main restricted to begging outside their own hospital. It is not known whether the proctors were themselves lepers, but over a period of time a proctor could graduate from beggar to administrator and even warden of the hospital. In some rare instances the proctor also sold indulgences, many believed to have been counterfeited, and so, by the fourteenth century, his activities were severely restricted.6 The founding and the upkeep of many of the hospitals were the results of bequests and endowments from royalty, the church and laymen. Henry I endowed the hospital of Holy Innocents in Lincoln, Henry 11 the hospital of St Leonard in Derby, and John founded St Leonard in Chesterfield. John of Gaunt left 5 nobles to every leper hospital in London which had 5 or more lepers resident, and 3 nobles each to those with less. In 1307, Bishop Bitten of Exeter, left money to lepers in 39 locations and the Bishop of Durham founded one of the largest leper hospitals, Sherbum, in his diocese. 7 For a time the Black Death of 1348 reduced the amount of charitable donations and bequests but by the fifteenth century Edward IV was financing the continuing presence of the lepers at Holy Innocent's Hospital in Lincoln:

To fynde and susteyn there yerely for ever, certeyn Lepurs of oure meialx Suruantez and oure Heires and Successours, yf eny suche be founde. 8

37 Bequests from laymen varied in generosity from William de Paveli, cl240, who left 12d each to 8 leper hospitals in Northampton, Brackley, Towcester, Newport Pagnell, Hoclive and Stratford,9 to Robert Chichele, a former mayor of London, who in 1438 left £100 to supply bread and ale to five leper hospitals in London for the "Lepers, infinn, poor and lunatic':!O

The Rules of St Augustine prevailed in many of the leper hospitals founded or managed by the monastic orders. Mendicant orders such as the Franciscans served in leper hospitals. Indeed, as we have already noted, St Francis preached the duty of serving and caring for lepers wherever they could be found. J.R. Green in his Short History of the English People (1874) wrote:

The Friars first work lay in the noisesome lazar-houses, it was amongst the lepers that they commonly chose the site of their houses.!!

In Italy, the Franciscans worked closely with the leper hospitals, but this rarely occurred in England. Other mendicants were the Bethlehemites and Maturin or Trinitarian orders. The former established the London hospital of St Mary of Bethlehem, whilst the hospitals of the latter were often used as hostels for wandering lepers and pilgrims.!2

The Knights of St La2arus of Jerusalem in England were a crusading order established in the Holy Land in 1120 and their special purpose was to establish leper hospitals. The origins of the order lay in a leper hospital outside the walls of Jerusalem. With the onset of the Crusades they became a Hospitaller and Military order. Any member of the Knights Templar who contracted leprosy was ordered to join the Order of St La2arus, and, if married, his wife was to enter the convent of St La2arus at Bethany.!3 The mother house of the order was established at Boigny near Paris. At the same time preceptories were established in England, the main one being located at Burton La2ars near Melton Mowbray in Leicestershire. Initially, the members of the order were themselves lepers who established nine leper hospitals in England including St Giles' in London. The hospitals of St La2arus, who followed the rule of St Augustine, were very wealthy and powerful. The order was in existence until the fifteenth century in England and the nineteenth century in France.

38 Leper hospitals were built on the outskirts of a town or city and, with few exceptions, housed between two and ten lepers. The building of leper hospitals accelerated in the twelfth and early thirteenth centuries, and by the late fifteenth century many of the hospitals were housing elderly and infirm patients rather than lepers. Some of the hospitals, as we have seen, were run by monastic orders according to the rules of St Augustine, and therefore required male lepers to be housed separately from their wives, and in some instances the wife was also required to take a nun's vow of chastity and obedience. Some hospitals housed both male and female lepers and others such as Alkmonton, Bristol, Bury St Edmonds, Woodstock, Tannington and Arundel were for females only. Many ordinary hospitals were specific in their refusal of leper patients and those alms houses founded by Richard Wittington in London denied admission to those ''infecte with lepre or eny suche other sicknesse intollerable':14

The leper hospitals were under the jurisdiction of the master and Lanfranc believed that only those "of skill, genUeness and patience "should be in charge of a hospital. 15 In some instances, such as the hospitals founded by the Knights of Lazarus, the master was himself a leper, and the hospital of St Leonard in Lancaster also elected a leper from within their midst to be their master. The staff of such hospitals was comprised of ecclesiastics who served as priests, and attendants who helped nurse those confined to bed and assisted with the laundry. In the hospital the inmates were required to attend mass and every day to say the Paternoster. Ave Maria .. Credo in Deum. Credo in Spiritum and the Benedicite. They were also obliged in many of the hospitals to observe canonical hours, attending Matins, Prime, Evensong, None, Vespers and Compline. The staff of the hospitals usually wore the monastic habit of brown or black and a cloak with a cross stitched upon it. The cross of the Knights of St Lazarus was green which had from Roman times been considered the colour for hospital services.1 6 The dress of the inmates varied from hospital to hospital but usually consisted of a cloak, hood, coat and shoes with the clothes being of a russet colour with a black cloak and hood. The women's headgear consisted of a double veil, white within and black outside. The leper was not allowed to go unshod and whenever he was allowed to travel outside it was with a bell or wooden clapper to warn of his approach. Whilst in hospital the leper was expected to be obedient and any digressions were punished, often by a diet of bread and water, or in a few isolated cases by flogging or expulsion.

39 The leper's diet in a hospital varied according to the financial means of the hospital. An inmate of St Julian's hospital in St Albans could expect to receive every weekend, seven loaves of bread (five white, two brown), and every seventh week 14 gallons of beer with extra on feast days! On the feast of St Martin the leper could also choose one pig for his own consumption. At Sherburn in Durham, the inmates had a loaf of bread and a gallon of ale a day, meat on three days of the week, fish and cheese on the others. At the opposite end of the scale, some hospitals were given tainted pork or salmon to supplement the inadequate diet.!7 When entering a hospital the leper renounced all his personal possessions his family, however, were often allowed to visit the patient and at Sherburn those visitors who had a long journey were offered overnight accommodation.

A more detailed account of the history and conditions in some of the hospitals found in Medieval England is now given below, The majority of the hospitals were built in the twelfth century, though some, like St Leonard's in Northampton and St Nicholas' of Harbledown were built in the eleventh century. This latter hospital was a timber framed building in the woods of Blean a mile to the north of Canterbury and on the pilgrim route to that city. The hospital accommodated 100 lepers and originally housed both males and females. During the reign of Henry II a women's leper hospital was built nearby at Tannington housing 25 women. Being on the route to Canterbury the hospital at Harbledown benefited from the pilgrims, indeed Henry II gave 50 marks to the hospital when on his pilgrimage to the shrine of Thomas Beckett. The hospital no longer exists but the church which was attached to the hospital stands today.

The leper hospital of St Julian's was a daughter foundation of the Abbey at St Albans, and was founded in the time of Abbot Gregory (1119-1146). The hospital was built by the road leading to London for six "Lazars or pauperes Christi':!8 A sister foundation, for leper women, was dedicated to St Mary. As we have already noted, the inmates did not want for food, neither did they go cold, as all inmates and brothers were allocated 14 shillings a year to buy firewood.1 9 The rules were stringent at St Julian's and although they were well treated physically, the leper was nevertheless not allowed to forget the nature of his disease. In the rules it was stated that "those who were infected were to humble themselves below all other men '; and they were to go to the hospital church on a regular basis, not leave the hospital, should always wear their leper dress and not live with their wives. 2o On entering the hospital the leper made a will bequeathing

40 two thirds of his possessions to the hospital and naming the beneficiaries of the remainder. By 1344 Abbot Michael of St Albans accused his two predecessors of diverting the funds of the hospital to "unworthy and damnable uses'; and also accused them of oppressing both the male and female lepers in the two hospitals. By this time the number of leper inmates in the hospital had been reduced to two or three and on occasions to only one.

The principal preceptory of the Knights of St Lazarus of Jerusalem at Burton Lazars also housed a hospital dedicated to the Blessed Virgin and St Lazarus and was funded by Roger de Mowbray between 1138-1162. The hospital was to house an unspecified number of leper patients and eight non-leprous knights. The hospital no longer exists having been dissolved during the reign of Henry VIII. The Earl of Chester founded a leper hospital dedicated to St Leonard at Sponne, Coventry in 1181. The knight on returning from the crusades was concerned that some of his knights having contracted leprosy had no hospital to care for them, and so established the hospital in Sponne. From Coventry we move to Lincoln where there exists some confusion as to who founded the Mallardny or Holy Innocents' leper hospital. The foundation is ascribed to both Henry I and Remegius, Bishop of Lincoln in the late twelfth century. The hospital housed 10 lepers who had previously been in the king's service. By the reign of Edward III (1327-1377) only one of the inmates was a leper. Among the inmates was a condemned criminal, Margaret Everad, who had survived hanging, and was then incarcerated in Holy Innocents'. Henry VI in 1457 forcibly annexed the hospital to the Knights of St Lazarus at Burton Lazars.

One of the largest leper hospitals in England was Sherburn hospital in Durham, founded by Hugh de Puiset, Bishop of Durham, in 1181 and dedicated to The Saviour, The Blessed Virgin, St Lazarus and his sisters Mary and Martha. The hospital building included a great hall, a chapel, a masters' lodge and housed 65 lepers, male and female. A steward, three priests, four clerks, a prior and a prioress were employed in the hospital. The inmates were well clothed and fed with each leper being entitled to six feet of cloth in white or russet wool and twelve feet each of linen and canvas. As at St Julian's the inmates were expected to follow the canonical hours saying at each service the prescribed number of Paternosters and the same again for the souls of the Bishops of Durham and those departed, amounting to some 161 Paternosters a day! If this was not enough, when a brother or sister died, a further 300 Paternosters were said for 30

41 days.21 Sherburn was unusual in that it allowed friends and relatives of the inmates to stay overnight and receive hospitality. During the fourteenth century Sherburn, like St Julian's, suffered from maladministration: buildings were allowed to become derelict, resources wasted or used for personal gains. By 1434 Sherburn had reduced the number of beds from 65 to 13 with only two set aside for lepers and by 1552 there were no lepers in residence. During the sixteenth century the hospital became an alms house and later the building became a part of Christ's Hospital which still exists on the site today.

A brief account is now given of the history of some of the 10 leper hospitals which were strategically placed around the outside of the city walls of London. The London hospitals were St James in Westminster, St Giles in Holborn, Highgate, Knightsbridge, Kingsland near Hackney, Miles End, The Lock near Southwark, Hammersmith, Enfield, and Rotherhithe near Bermondsey. These hospitals made a ring around the city as illustrated in Figure 2. By 1549 only six hospitals were still in existence and on 25 October that year all six were transferred to the jurisdiction of St Bartholomew's Hospital, where two Aldennen and five Commoners were to supervise the day-to-day administration of the leper hospitals.22 The six hospitals were The Lock, Kingsland, Hammersmith, Highgate, Knightsbridge and Mile End. Nothing is heard of the latter hospital after 1549 and nothing of the first four named as lazar houses after 1623. From then only The Lock and Kingsland remained as general hospitals but they too closed in 1760. The last case of leprosy in London appears to have occurred in 1557.23

Kingsland hospital was founded in 1280 near Hackney (and Stoke Newington) on the Great Northern Road by the citizens of that area. The first foreman of the hospital was William Wassheman who took an oath to prevent lepers from entering the city. Many bequests were made to the hospital among which was that of Dame Joan Frowyk of Ealing who left 4d to each inmate of the lazar houses at 'Newington Greene' so that they may pray for her soul. Kingsland was one of the lazar houses to become an 'outhouse' to St Bartholomew's Hospital. After 1760 when Kingsland ceased to exist as a hospital the building was put to various uses, being at one time a chandlery. The chapel attached to the hospital survived until 1846 when the public house "The Star and Garter" was built on the site. Highgate leper hospital was founded in 1473 at a time when leprosy was on the wane. A citizen and yeoman of King Edward IV, William Pole, became a leper and wishing to help other lepers requested of the king a parcel of land

42 <;1V.w"~H ~3Q'3' "3\-U. MOWS Cl. Noo.... 0'"1 .¥:> ~ SC'P'O"d.,V "YIO'3W :iHJ.. ... 0 HV"\d H~>lS V between Highgate and Holloway. The land was granted and a hospital and chapel, dedicated to Christ and St Anthony, was built. The hospital stood at the foot of Highgate Hill on a piece of land later known as Field Lazarette or Lazarcot Field.24 The king appointed the master of the hospital and this prerogative existed until the seventeenth century. By 1563 Highgate was no longer a leper hospital but became an alms house or "Poor House". The hospital was finally sold as a private property to Ralph Harrison for £130.lOs in 1643.

The leper hospital at Knightsbridge is believed to have been founded in either the thirteenth or fourteenth century by the citizens of London. The hospital was sited about a quarter of a mile from the present Hyde Park Corner. However, first mention of the hospital was in 1475, when a vicar of Norfolk, Thomas Wood, was declared as a patient of the "Spittel howse of Knygtyes 8rygge beside Wesfminster':25 The hospital was built in the Manor of Westminster Abbey, and it would appear that the Abbey had patronage of the hospital. No date is known for the cessation of its function as a hospital, but it is known that both the hospital and its chapel were still in existence in 1708.

The hospital of St James' was one of the earliest hospitals founded in London and is believed to date back to the Norman period. The hospital was for women only and provided care and attention for 13 women, looked after by a master and eight brothers, four of whom were priests. St James' was a rich hospital having an income of more than £100 per annum.

Another important leper hospital, that of The Lock at Southwark, was built on the Old Kent Road near Southwark Bridge. The hospital was dedicated to St Mary and St Leonard and was financed by both the City of London and the Crown. Its name of the 'Lock' or 'Le Loke' was derived from the obsolete French term meaning 'rags'. Although the first reference to the hospital is dated 1315, the hospital is believed to have existed before this time. Both Edward II and Edward III gave permission for the lepers to beg for alms. Many bequests were made to the hospital including one from John Gower, the poet, who lived in Southwark. Like all the London hospitals discussed above, Southwark was an 'outhouse' to St Bartholomew's and the last recorded incidence of leprosy in London in 1557 was almost certainly the two patients who were sent to The Lock 'as they are to be found to be lepers; there to remain':26 As was the case with so many other leper hospitals, The Lock became a hospital for the poor and infirm and in 1636 Martin

44 Bond, a treasurer of the hospital, had the chapel rebuilt and an inscription placed on the door saying:

MB This chapel was built to the honour of God, and for the use of the poor, infirm and impotent people harboured within this hospital May, Mar Bond Esq. Treasurer, Anno 1636.27

The hospital was closed in 1760 but the chapel remained until 1809 when it was pulled down to make way for the building of Great Dover Street.

The leper hospital provided for the welfare of the inmate, but not for his medical treatment. Each hospital had its own rules and regulations and religious observances. Some of the hospitals were more strict in their religious regulations, with some of the lepers and even their wives having to take the vow. The standard of care offered depended entirely on the institution's financial status and often this was precarious with a few hospitals unable to provide even the basic necessities. Other hospitals suffered from incompetence, maladministration and corruption. For many sufferers though, the Medieval Leper Hospital provided shelter, care, and even a degree of warmth and comfort.

REFERENCES

1. Creighton, C. A History ofEpidemics in Britain. Volume 1. 1965, p. 97.

2. Bayliss, J.H. Domus Leprosae - Community Care in Medieval England. Nursing Times, 11 January, 1979,66.

3. Newman, G. On the History of the Decline and Final Extinction of Leprosy as an Epidemic Disease in the British Islands. Prize Essays on Leprosy, 1895, 157,49.

4. Hope, R.C. The Leper in England: With Some Account of English Lazar Houses. cl900, p.17.

5. ibid., p.17.

6. Richards, P. The Medieval Leper and his Northern Heirs. 1977, p.38.

7. Clay, R.M. The Medieval Hospitals ofEngland. 1909, p.38.

45 8. ibid, p.45.

9. ibid, p.181.

10. Rawcliffe, C. The Hospitals of Later Medieval London. Medical History, 1984,13.

11. Browne,5.G. Some Aspects of History of Leprosy: The Leprosie of Yesterday. Proceedings ofthe Royal Society ofMedicine, 1975, 68, 489.

12. Clay, R.M. ref.7, p.21O.

13. Thomson, W.McL. The Order of St Lazarus of Jerusalem. The Medical Journal ofAustralia, 1991, 155,778.

14. Rawcliffe, C. ref.lO, p.7.

15. Clay, R.M. ref.7, p.l43.

16. Thomson, W.MCL. ref. 13, p.778.

17. Bayliss, J.H. ref.2, p.65.

18. Creighton, C. ref.1, p.90.

19. Richards, P. ref.6, p.30.

20. Browne, 5.G. ref. 11 , p.488.

21. Richards, P. ref.6, p.54.

22. Honeyboume, M.B. The Leper Hospitals of the London Area. Transactions of the London and Middlesex Archaeological Society, 1967, 21,9·10.

23. ibid, p.3.

24. ibid, p.18.

25. ibid, p.38.

26. ibid, p.47.

27. ibid, p.47.

46 Be dead to the world but living to God.

J. H. Bayliss. Domus Leprosae - Community Care in Medieval England. Chapter Five

Leper Hospitals in Medieval Derbyshire.

In the previous chapter we discussed the history and foundation of leper hospitals in medieval England, their number, rules and regulations, financial status, and geographical location all of which were used as indicators of the extent of leprosy throughout the country. Derbyshire was on the edge of the more densely populated areas of that time which were the Southern Counties and East Anglia. Just four leper hospitals existed in Derbyshire and, typical of the institutions of that time, were very small, each housing only a few lepers. The hospitals were to be found at Alkmonton, Chesterfield, Derby and Spondon and we will now move to look more closely at each.

The village of Alkmonton (medieval Alchementune) lies a few miles south of Ashbourne in the parish of Longford, (see Figure 3.). The village was described in the Doomsday Survey as being held by Henry de Ferrars. During the reign of Edward I the lands were held by the Bakepuze family and it was Robert de Bakepuze who in 1100 founded a women's leper hospital dedicated to St Leonard. The Bakepilze line had died out by the time of the reign of Richard II and the estate was purchased by Sir Waiter Blount. After his death it would appear that his second wife Dame Sancha de Ayala re-founded the hospital in 1406. It had, like so many hospitals, declined as a leper hospital due to lack of patients. The new hospital had its own chaplain who was to pray for the souls of Dame Sancha and her children. In 1474, Waiter Blount, Lord Mountjoy and great-grandson of the first Waiter Blount, changed the nature of the hospital to one housing seven poor men. In his will he directed that his executors should:

Appropriate land to the yearly value of ten pounds to the hospital of St Leonard, situated betwixt Alkmonton and Bentley, in order that prayers might be offered for the souls of himself, his ancestors, and family, for the souls of the Duke of Buckingham, Earl Rivers, and Sir John WoodvJlle, and for the souls of the ancient lords ofthe hospital!

The hospital was to maintain seven poor men of the area none of whom should be under 55 years of age. They were to be paid 2s 4d per week, and the hospital was to have pasture for seven cows, firewood from the estate of Lord Mountjoy and each man was to have a gown and a hood every third year. The gowns were

47 MQ~fielcA ASHBOURNE •

EIIQstone •

Rocester • AlkMonton o Leper HospitQI Alkmonton Old HQU

IAT10XE.TER

SKETCH MAP OF THE ALKMONTON AREA.

Figure 3.

48 to be either white or russet and on the sleeve of each a red cross was to be stitched in the manner of 5t Anthony's Cross. None of the men was allowed to go begging, and if found to be doing so they were then dismissed. Lord Mountjoy also founded the chapel of 5t Nicholas at Alkmonton, so that Mass could be said yearly on the feast day of 5t Nicholas. The leper hospital, like so many others, was closed in 1547 for "superstitious observances"2 and the ''income taken from lepers and pensioners, conferred on unscrupulous courtiers'~3 Nothing remains today of the hospital, or the chapel dedicated to 5t Nicholas, only the font still exists and that now stands in 5t John's Church, Alkmonton, erected in 1843.

The leper hospital in Chesterfield was also dedicated to 5t Leonard and housed both male and female lepers. The hospital was built near Rother on the outskirts of the town on what is still known as 5pital Bridge, (see Figure 4.). The hospital is believed to have been founded in the twelfth century, but we do know that in 1195 King John, (Earl of Mortain, as he then was), charged the hospital £6 rent per annum in lieu of tolls from markets and fairs. And during the first year of his reign, John granted a charter to the hospital of "simple protection'~4 The hospital was part of the Manor of Chesterfield and in 1206 the income due to the hospital from this manor was £6 10s. The following year King John, in a charter dated 26 July, confirmed 'To God and the Blessed Leonard and to the infirm of Chesterfield a rent charge of £1 in exchange for the grant that he had originally made of the market dues'~5 Later Henry III granted oaks from the Royal Forest for the repair of the hospital chapel, and six acres of pasture in the Peak Forest. The crown had in 1221 allowed the lepers to beg for alms and this was confirmed by Edward in 1276. By 1291 the Taxation Roll had valued the hospital at £6.13.4.

There is also a record of money from Hugh, son of Alan de Dukemonton:

'To the hospital of St Leonard for Lepers at Cesterfeld of homages, wards, reliefs, etc., from land granted to the said hospital by Ascer de Tapton, in the said Hugh's fee in Bramton. Witness Peter, dictus senescallus de Brimington, Simon fif. Roberti de Wytington and Hugh dePecco':6

By 1535 the commissioners compiling the Valor Ecclesiasticus could not estimate. the annual income of the hospital as the ownership of the Manor of Chesterfield was in dispute between John Blythe, Archdeacon of Coventry and George, Earl

49 .. . ·_--_ _-- -- .---~

..,.-'1 .

.J;(... , 1/.11

11-1-0• Rill

_0

__-3- lS

.,-

.'f>,

Figure 4.

50 of Shrewsbury, and later Francis, Earl of Shrewsbury. The manor had been granted for life to John Blythe by Henry VllI in 1507. However,

By vertue of an acte of Parlyament Margaret late Countess of Salsburye (who held the manor of Chesterfield) took it from John Blythe by the space of twenty three yeres paste and dyd grante the lordship in exchange to George late Erie of Saloppe, so Frauncysse now Erie ofSalop is in possessyon ofthe hospytalr7

No mention is made as to the structure of the hospital but it is believed to have been built of wood. Its existence as a leper hospital ended at the time of Edward VI when the property was seized by the crown.

A third leper hospital dedicated to St Leonard was to be found in the town of Derby. The hospital was founded by the Normans and was referred to as the ''Maison de Dieu"or "House ofGod'~8 The hospital was situated outside the town near Osmaston, (see Figures 5. and 6.). St Leonard's is believed to have been a royal foundation with grants from Henry 11 exempting the hospital from taxes and escheats. The history of St Leonard's hospital is a troubled one, with indiscipline, misappropriation of funds and even murder present throughout its life as a leper hospital. The first recorded master of the hospital was Henry de Roucestre who, in 1305, with Henry Howes, a fellow brother, was accused of killing Henry Bonde, though both were later acquitted. The hospital provided accommodation for two lepers and two companions, a chaplain, a master, and paid an annual rent of 5s 6d to the Abbot of Darley. No mention is made of how many brothers were housed in the hospital to look after the inmates, nor if they were members of a particular monastic order. It is known, however, that all who lived in the hospital took vows of obedience, chastity and poverty.

In 1316 the hospital was in the custody of Roger de Luchierche, chaplain to Edward 11. Protection was given to the hospital as it was so impoverished that it could hardly feed the inmates. In the same year, however, the King commissioned Adam de Brown, Herbert Payer and Edmund de Grymesby to enquire into the abuses of hospital discipline and if necessary to punish the brethren. The warden, Roger de Luchierche, two able bodied brethren and two infirm brethren had to appear before the commissioners. The warden admitted that the hospital had no rules, no particular dress, no regular prayers, and no alms collected on a regular basis. Indeed, he then accused Roger de Duranthorpe, one

51

' :, ' , ' \\ \, ~, :' of the infirm brethren, of stealing the hospital's charter and using it to gain sums of money. Roger de Duranthorpe was further accused by the warden of taking 133 sheep belonging to the hospital and selling the wool. He was also believed to have sold 58 lambs and stole 22s 8d from the farm, none of which was spent on the hospital, but instead was used to coerce the bailiffs into joining with him to bring about the downfall of the hospital. Roger de Duranthorpe admitted the theft of the charter but refused to hand it over to the commissioners and consequently was ejected from the hospital.9

The hospital descended into further misrule and decay under the master Thomas de Golgington. A king's clerk, he was made master in 1328; he was also a surgeon and master of Bolton Hospital in Northumberland. The situation at St Leonard's was so grave that in 1340 the king forced the hospital to receive Henry de Fyndern as a brother for life, providing him with food, clothing, a chamber of his own, freedom to come and go as he pleased, and all free of charge. Year after year the crown appointed commissioners to examine the misrule of the hospital, master was succeeded by master until the hospital was finally closed during the reign of Henry VIII. Mention is made of the hospital and its environs in two grants of land in the fourteenth century:

Grant from John de Mor/eye of Derby to John de Bredon of an acre and a half of arable land in Derby lying in Le Walfield. Namley in Littledale and near the house of the Lepers. (1352}.1O

A grant from John de Bredon of Derby to WaIter de Holbrok of an acre and a half of land in Derby, lying in Le Wallfeld, namely in Lyteldale and near the lepers House. (1359).11

The hospital is believed to have been situated in what is now Leonard Street which lies off the Osmaston Road and close to the site of the present Derbyshire Royal Infirmary.

The last Derbyshire hospital was to be found in Spondon, five miles from Derby, (see Figure 7.). The leper hospital was a preceptory for the Knights of St Lazarus in Jerusalem, whose principal house was at Burton Lazars near Melton Mowbray in Leicestershire. The Manor of Spondon is recorded in the Doomsday Survey as belonging to Henry de Ferrars (who also owned the manor at Alkmonton), and included a church and a priest. In the twelfth century his grandson William de Ferrars granted the manor to the Order of St Lazarus or, as they were commonly

54 Heanor. EastlNood •

• llkeston

NOTTINGHAM Leper Hospital o Locko Hall

Spondon

• Burton-upon-Trent

SKETCH MAP OF THE SPONDON AREA.

Figure 7.

55 known, the Burton Lazars. This grant was confirmed by Henry 11 in 1180 and again in 1200 by John. The Order of St Lazarus was also granted land in Spondon at Locko, or as it was known Lockhay. It is believed that the name Locko is a derivative of 'Lock' or 'Loke', names both indicating the presence of leper houses. The land at Lockhay and Nether-Lockhay was held by Edmund, Earl of Lancaster, and amounted to forty acres. The Earl gave the Order land elsewhere in Spondon to the value of £10, as well as the church and rector, also land valued at £5 in Borrowash and property in Chaddesden.

The hospital was dedicated to St Mary Magdelene and reference was made to it in the Patent Rolls of Edward IlI, as Domus de la Maudelevne de Lockhav ordinis milicie Sancti Lazar Jerusalem. 12 The hospital is believed to have existed in the twelfth century soon after William de Ferrars granted the land to the Burton Lazars. As a hospital it provided a refuge for lepers, as a preceptory it contributed funds or 'apport' to the mother house of the Order in France.13 Dr Marcombe believes the number of lepers at Locko to have been four and that each leper may have been drawn from the propertied class in the Spondon area, donating grants of land in return for admittance to the hospital. The hospital was ruled directly from Burton Lazars, confirmation of which can be seen for example in 1351 when Hugh Michel who at the time was both preceptor at Locko and Master of Burton Lazars. 14 In 1347 when Hugh Michel was summoned by the crown with reference to payments made by the hospital to the mother house in France, the hospital was referred to as "La Maydelyn", and (as England was at war with France at that time) those payments were regarded as both unpatriotic and treasonable. In order that the hospital should continue as a refuge for lepers, Burton Lazars were ordered to pay £20 per annum to the Warden and Scholars of King's Hall, Cambridge in order that the college could erect new buildings. The order was to remain in effect until hostilities ceased between the two countries.

Life was not always smooth running in the hospital. In 1283 a dispute broke out between the hospital and the Abbot of Dale as to possession of a mill at Burgh near Spondon. The Abbot and his men burned down the mill and took a quantity of goods belonging to the Order. The riot was considered so serious that the master of the leper hospital complained to the Sheriff of Derby, but the outcome of the complaint is not known. A more serious event occurred in 1364 when Geoffrey de Chaddesden, a member of a well respected and long

56 established local family, was challenged to the Mastership of the Burton Lazars and Proctor General of the Order in England by Nicholas de Dover. The dispute went before the Pope and in 1365 Geoffrey de Chaddesden was referred to as a "vagabond" and only as a brother of the order and was imprisoned at Burton Lazars. Or Marcombe puts forward the theory that Geoffrey de Chaddesden, who in 1372 gave up his chair as master of Burton Lazars in return for 40 marks per annum, may have retired to Locko as this is the last record of Locko either as a preceptory or hospital. The hospital may well have ceased to exist, for, as we noted earlier, this period saw a decline in the incidence of disease and the subsequent closure of many leper hospitals throughout the country. The property belonging to the Burton Lazars at Locko was taken from them by Henry VIII during the Dissolution of the Monasteries. The estate of Locko consisted of Nether Locko to the South and Upper or Over Locko to the North. It is believed that the hospital was built at Over Locko, (see figure 8.). Until recently no physical evidence had been found of the hospital. Reference was made around 1700 to a walled and paved well, known as St Anne's Well, found behind a house at Over Locko which is thought to have been in existence since 1544. Or Marcombe believes that there is a direct tenurial link between the estate of Over Locko, the house and the hospital of the Burton Lazars. 15 The water from the well fed fishponds belonging to the house and then on to turn a mill at Chaddesden. The fishponds almost certainly date back to the hospital; as we have seen earlier many hospitals were sited near springs. The Derbyshire Archaeological Society believed they may have found the remains of the hospital lying at the northern end of the present ornamental pool, created during the landscaping of Locko Park in the eighteenth century. The area under consideration includes a holy well, moated enclosure, and house platforms. More research, however, is required before a positive identification can be made.

Other indications that point to the presence of a leper hospital are the 'Leper­ Squints' or 'Low Windows' in St Werburg's Church in Spondon, while one of the roads leading to Locko is called "Lousy Graves Lane". However, as we have seen, doubt exists as to the function of the leper squints and Lousy Graves is perhaps more likely to refer to the burial ground of plague victims rather than those of leprosy.

57 mE PRECEl"Tbitt OF TIlE KNIG1ITS OF ST LAZARUS ATLOCKO

co co

-'-'-'-'-'-.- ...... \

~

0 0 '" u , • , a; C >- I 2: C ,• :r: ~ u.o I Q ~ ~ C/J Q 2: • 0 • 2: « • a: l- Q Ul -« "- "- en

,

->< ~ n..'" '!.---r.-::::-::-~~.... .' •••••••. '0. "':,. 0 oX ...... '0. -0, ••••• 0 ,.' !.J .-.. ,...... 0 -'

Figure 8.

58 In concluding this study of medieval leprosy it may be stated that the extent to which the disease occurred in Medieval times in this country is still a matter of debate and that, as we have seen, the number of leper hospitals in existence in the Middle Ages may not be a true indication of the severity of the disease. Charles Creighton was of the opinion that leprosy was not an epidemic disease:

There might have been a leper in the village here and there, one or two in a market town, a dozen or more in a city, a score or so in a whole diocese. In other words, the village leper was probably as common as the village idiot. 16

Now, however, it is believed that the disease was more widespread than previously thought, being in existence several hundred years and at its peak during the twelfth and thirteenth centuries.

The disease was no respecter of persons and members of the Royal Family were equally vulnerable. Henry III is believed to have been a leper. Edward the Black Prince is quoted as bathing in the Holy Well at Harbledown "for his leprosy':17 Margaret of Anjou, wife of Henry VI, is also believed to have been a sufferer as was Robert the Bruce, who in the Chronicon de Lannercost is quoted as:

Dominus autem Robertus de rus, quia factus fuerat leprosus, ilia vice (anno 1327) cum eis Angliam non intravit. 18

Charles Hope also declares that Robert visited London and bathed in the waters of St Lazarus' Well on Muswell Hill near the present Alexandra Palace.

The decline of the disease is commonly attributed to the Black Death of 1348, since it attacked those already made vulnerable by leprosy. It is also believed that the hospitals themselves were impoverished by the catastrophic effect of the plague on the economy, previously hit by the famine of 1315-16. The segregation of the leper is no longer believed to have been a significant factor in the decline of the disease, as those with Tuberculoid Leprosy were not necessarily disfigured and went undetected and yet carried the most infectious form of the disease. In reality the decline can be attributed to a number of factors coming together, the most significant of these being the raising of living standards and the quality of food, (with less reliance upon badly salted or preserved meat and fish and a greater use of fresh meats and vegetables). Another factor that might be taken into consideration is that leprosy and tuberculosis are closely allied diseases

59 and it is thought that as leprosy declined so there was significant rise in the number of tubercular patients. This would seem to indicate that the patient's immune system may have resisted leprosy but instead developed its associate Tuberculosis.

Very few remains of leper hospitals are in existence today. As we have seen many of the hospitals became alms houses and many were so small they were soon destroyed, not only through lack of use, but also through the effects of the Dissolution of the Monasteries. Those leper hospitals that survive to be seen in some part today are St Julian's in St Albans, St Michael's in Warwick and Sherburn in Durham. But we also have a legacy not only in art and literature but also in the names of places. Although the disease was only present for a brief span of time it should not be forgotten and, as in Derbyshire, forms a small but important part of our history.

REFERENCES

1. Cox, J.C. Notes on the Churches ofDerbyshire. Volume 3. 1877, p.196.

2. Lysons, D. & Lysons, S. Magna Britannia. Volume 5. 1817, p.201.

3. Cox, J.C. ref.1, p.197.

4. The Victoria History of the County ofDerbyshire. Volume 2. 1907, p.81.

5. ibid., pp.81-82.

6. Jeayes, I.H. Descriptive Catalogue of Derbyshire Charters. 1906, p.52.

7. VCH ref.4, p.82.

8. Simpson, R. History and Antiquities ofDerby. 1826, p.284.

9. VCH ref.4, p.85.

10. Simpson, R. ref.8, p.121.

11. ibid., p.121.

12. Cox, J.C. ref.1, p.294.

60 13. Marcombe, D. The Preceptory of the Knights of St Lazarns at Locko. Derbyshire Archaeological Journal, 1991, 111, 53.

14. ibid., p.54.

15. ibid., p.55.

16. Browne, S.G. Some Aspects of the History of Leprosy: The Leprosie of Yesterday. Proceedings ofthe Royal Society ofMedicine, 1975, 68, 490.

17. Hope, R.C. The Leper in England: With Some Account ofEnglish Lazar Houses. cl900, p.29.

18. Creighton, C. A History ofEpidemics in Britain. Volume 1. 1865, p. 77.

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Browne, S.G. Some Aspects of the History of Leprosy: The Leprosie of Yesterday. Proceedings of the Royal SOciety ofMedicine, 1975, 68, 485-493

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Cox, C. Churches ofDerbyshire. Volume Ill. Chesterfield: W Edmunds, 1867.

Creighton, C. A History ofEpidemics in Britain. Volume I. London: Frank Cass & Co., 1965.

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Gran, K. Leprosy in Literature and Art. International JournalofLeprosy, 1973, 41(2), 249·283.

Honeyboume, M.B. The Leper Hospitals of the London Area. Transactions of the London and Middlesex Archaeological Society, 1967, 21, 1·54.

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65 /