1 N I tRN A I ION AI. JOUtt NAL OF LEI'ROSY Volumc 38, Nu mber !l P rinlerl ill Ih e U .S.A .

Leprosy in Society

v. ."Leprosy" in Occidental Literature1.:!

Olaf K. Skinsnes and Robert M. Elvove3

Prior studies of social concepts of, and Theirs is a culture from which, with the reactions to, leprosy in this series, ap­ exception of South America, the actual dis­ proached the relationship mainly from an ease of leprosy has become alm ost extinct. examination of Asian experience with the Some, as phys icians or sufferers from lepro­ dis ea~e ( 11 .12) . This avenue was em­ sy, have seen and experienced the disease ployed because it was recognized that folk­ but their social reaction to it has been lore and history pertaining to leprosy in the largely conditioned by their own culture Orient can scarcely have been influenced as is evidenced by the repeated state­ by Biblical1y derived traditions. A conclu­ ment that the Bible is responsible for soci­ sion from the study suggested that the dy's reaction to the disease. There is little social opprobrium which accompanies lep­ writing on, or examination of the ' ,Vestern rosy is a reaction to that complex of folklore of leprosy, except as related to pathologic changes which identifies leprosy concepts expressed in the Biblc. as an entity, and is not based on translation This insistance on attributing responsibi!­ errors of the past nor on a heritage of ity to a single major source for concepts Biblical misconception regarding the dis­ about leprosy in th e Occi dental world, sug­ ease (1 3). The social reaction to leprosy is gests the need for a broader evaluation of so characteristic and virtually specific, it other possible inSuences as part of a search was postulated, that when it is present it for a better understanding of society's reac­ may be concluded that leprosy also is, or tion to this disease. Accordingly, a survey has been, present in the society which has been made of the us e of leprosy in reflects these concepts. It was further sug­ Occidental literature, beginning with many gested that the presence of this pattern of of the earlier classical writers and extend­ social reaction in antiquity may be consid­ ing to the writers of current popular ered as evidence that leprosy was present fiction such as the detective and espionage at the time even though records of the age variety, currently popular on newsstands may be naive, inconclusive, or inclusive of and quite unlikely to have been derived also other disease under terms presently from use of the Bible as a reference work. reserved exclusively for the etiologically specific entity known as leprosy. EARLY EUROPEAN MILIEU Use of the word "leprosy" in Western Though an appreciable amount of lepro­ world translations of the Bible has recently sy appeared on the European continent in been repetitively attacked. The chorus of the aftermath of the breakup of the Roman writers on this subject has been, for the Empire, it was apparently not till about the most part, a product of vVestern culture eighth century that it became a major sensitive to the Western cultural heritage. problem. The infection was quite wide­ spread in the Dark and Middle Ages. For 1 R eceived for publication 9 April 1970. 2 Portions of this study a re a by· product of the two hundred years of the Crusades studies aided by Grants AT -08644 and AI-08645 ( 1100-1300 A.D.) leprosy was at its height from the Tational Institute of Allergy and Infec­ in Western Europe, including England. tious Di seases, National InstilUtes of Health, Be­ Ih esda . Maryland 20014. Then, at the beginning of the 14th century 3 O. K. Skinsnes, M.D., Ph.D., Professor of Path­ it began to decline. This was the general, ology, niversit y of Hawaii School of Medicine, though not the universal pattern, for Scot­ Leahi Hospital, 3675 Kil auea Ave" Honolulu, Hawaii, 968 16; R. M . Elvove, M.D. 3103 Fair­ land, by example, was not seriously affect­ field Avenue, Riverdale, New York i'0463. ed till the 13th century and did not finall y 294 38, 3 Skillsnes & Elvove: Leprosy in Society. V. 295 get rid of lcprosy till thc 17th century, and This iteh is not compatible with modern in Norway the height of the epidemic was concepts of I prosy, but Dante explicitly not reached till the 19th century. identifies it as such by sayin g, "And the Remarkabl y, during the Crusades there other leper answered mockingly" [124]. was a lessening of social revulsion to lepro­ Here leprosy is used as a punishment for sy; leprophilia, bordering on religious hys­ evil doing, the devil being spoken of as teria, often appeared. This followed from punishing fal sifiers, or alchemists, by tortur­ the fact that Crusaders sometimes came ing them with leprosy. home with leprosy, though they had been Chaucer.. in the General Prologue to T he promiscd absolution from sin and salvation Canterbury Tales makes fun of the Friar after d eath, by Peter the Hermit and others, (Frere) by stating that he knows innkeep­ for their part in the "Holy Wars." How ers and barmaids ("hostiler and tappes­ could men who had fought "in the service tcre") better than he did the laza rs ( person of Cod" suffer from a disease which was with leprosy) or beggars: equated with sin ? In the res ultant reversion He knew the taverns weI in every toun in attitude, leprosy was held by somc to be and everich hostiler and tappestere a "Holy Disease" and lazar houses for the Bet than a lazar or a beggestere; care of those so infected sprang up wi de­ For unto swich a worthy man as he Accorded not, as by hi s facultee spread. To have with sike lazars aqueyntaunce. With the decline of leprosy in Europe, [240-245] taking place followi ng the conclusion of the Chaucer here echoes the then reccnt Crusades; there was again a hardening of socio-reli gious fad of usin g service to those attitude toward the affli cted and once with leprosy as "holy service" and derides again leprosy came to be widely regarded the man of God for preferring to luxuriate as a dirty, disgraceful malady. in association with innkcepers and bar­ THE EARLY WRITERS-DANTE maids. The re is, however, none of the overt sexual connotations of leprosy whi ch appar­ (IT ALlAN) AND CHA VCER (ENGLISH) ently are referred to in his description of the Summoner : D a nte ( 1265-1321 )4 a nd Chauce r A SOMONOUR was ther with us in that place, ( 1340?-1400 ), writing toward the end or That hadde a fyr-reed cherubynnes face, after the Crusades, refer to leprosy. For saucefieem he was, with eyen narwe. The followin g reference (6) from Dan­ As hoot he was and lecherous as a sparwe, With scalled browes blake and pil ed berd. te's Inferno, Canto XXIX, is found in each Of his visage children were aferd. of these four English translations: the P01t­ Ther nas quyk-silver, Iytarge, ne brymstoon. able Dante, the Modem Library edition, Boras, ceruce, ne oill e of ta rtre noon; the Carlysle-Wadestead translation, and Ne oynement that wolde c1ense and byte, That hym myghte helpen of his whelkes white. John Ciardi's translation. According to the Nor of the knobbes siltynge on his chekes. account, the men, Arezzo and Capocchio, WeI loved he garJeek, oynons, and eek lekes, are being punished in hell for "practicing And for to drynken strong wyn, reed as blood : alchemy," that is, falsifying metals: [623-635] They were covered with great scabs from head to Walter C. Curry in Clwucer and the foot Medieval Sciences (4) states that this de­ .. . those two spirits of the stinking ditch scription is of leprosy, reflecting the medie­ scrubbed at themselves with their own bloody claws val concepts. He quotes Bernardus de Gor­ to ease the furious burning itch. don's medieval description : And as they scrubbed and clawed themselves, their . The infallible signs are these : A falling out and ::I nails scabbiness of the eyebrows, a roundness ( rotundi­ drew down the scabs the way a knife scrapes ties of the eyes, and an enlargement of the nostrils bream. externally and a contracti on interna ll y. Bre a thin ~ [79-84]5 becomes difficult, and the patient speaks as if

4 Parellthes is ellclose dale or ex planaLOry co m­ 5 Brackcls cnclose pocm lillc. dlaplcr or scc ti on ments. and Iincs. or pagc references as a ppropriate. 296 International Journal of Leprosy 1970

through the nose; on the face there is a kind of Both these authors re Rect concepts of pallor verging upon the deathly and the appear­ venereal association and transmission of ance of the face is terrible with its fixed look. leprosy, such as those noted in Asian socie­ Curry concludes: . ties (1l , 1 ~). Purchas in his PiJgl'immage Chaucer has indicated the two principle causes of ( 1613 ) ties this to the hereditary concepts the disease: the Summoner is "le cherous as a of leprosy by saying, "They say it procureth sparwe," and is accustomed to the eating of oni ons, garli c, and leeks and to the drinking of the Leprosie in children which are then strong wine, red as blood. The rascal is either . gotten. " [216]. Living in the same general criminally ignorant or fooli shl y indifferent. He period, John Donne ( 1573-1631 ) also might have learned from any physician of hi s makes this association with sexual peccancy time, or before, that leprosy may be contracted by in his "Elegy IV, the Perfume;" illi cit association with women infected wi th it, that garlic, oni on and lee ks produce evil humours in the By thee th e seely Amorous sucks hi s death, blood, and that red wine of all oth ers is the most By drawing in a leprous harlot's breath ; powerful and heating of drinks. [59-60] At about the same time Edmond Spenser POST-MEDIEVAL USAGE ( 1552-1599) was perhaps faintly echoing One of the earlies t treatises in English this theme when, in The Faerie Queene, he discussing the problems of public welfare wrote: and relief was Simon Fish's "A Supplica­ G reat troupes of people traveild thitherward cyon for the Beggars" written in 1529. The Both day and night, of each degree and pl ace, prose demonstrates strong simil arities to But few returned, having scaped hard, With baleful beggerie, or foule disgrace, Latin construction (7). Which ever after in most wretched case, Most lamenta bl y complaineth their woeful mise ry Like loathsome lazars, by the hedges lay. unto Your Highness your daily bedemen, the Thither Duessa bad him bend hi s pace: wretched, hideous monsters (on whom scarcely for For she is wearie of the toilsome way, horror any eye dare look), the foul, unha ppy sort And also ni gh cqnsumed is the lingering day. of lepers and other sore people, needy, impotent, [f, iv, 3] blind, lame, and sick, that live only by alms, how th at their number is daily so sore increased that all Leprosy is here the "loathsome" depth to the alm s of all the well-disposed people of this which "great troupes of people" have fall­ your realm is not half enough for to sustain them, en. Duessa, the evil woman, tempts th3 but that for very constraint die of hunger. hero to the same end. [32] In another portion of the same work What good Christian can be able to succor us poor lepers, blind, sore, and lame, that be thus yea rl y Spenser further equates leprosy with evil , oppressed? fi gurati vely using the term descriptively to [32] indicate the mouth of one of the seven These be they that corrupt the whole ge neration of deadly sins as follows: mankind in your realm th at catch the pox of one woman and bear them to another, that be brent He hated a ll good workes and vertuous deeds, with one woman and bear it to another, th at catch And him no Ie sse, that any like did vse, the lepry of one woman and bear it to another. And who with gracious bread the hungry feeds, [34] His almes for want of faith he doth abuse: And eke the ve rse of famous Poets witt Mr. Fish's solution to the problem was as He does backbite, and spightful poison spues fo llows: From leprous mouth on a ll , that ever writt: Tie these holy, idle theves to the ca rts to be Such one vil e Envie was, that fifte in row did silt. whipped naked about every market town till they [I, iv, 32] wi ll fall to labor, that they, by their importunate In "Colin Clout's Come Home Agalne," begging, take not away the alms that the good Spenser has Colin Clout represent Spenser Christian people would give unto us sore, impo­ tent, miserable people, yO UI' bedemen. himself and his ideas. In the followin g, Colin contemplates Utopian conditions: R. Copeland in Guydon's Quest, Chiru.l'g. ( 1541) says : For there a ll happie peace and. plenteous s t or~ Conspire in one to make conte nted blisse : Then ought ye to enquire of he hath had ye No wayling there nor wretchedness is he ard, company of a ny lepress woman . ... A woman is No bloodie issues nor no leprosies, not so daungerous to be a lepress to hybyte with a No griesly famine, nor no raging sweard, lazare, as it shu Id e be a man to habyte with a No nightly bod rags, no r no hue and cries lazarous woman. [310-315] 38, 3 Skinsnes & Elvove: Leprosy in Society. V. 297

John Donne, in a usage reminiscent of ously employed by Cowper, Hobbes, Spen­ the above, puts th e same thought more ser and Donne. Leprosy represented the negatively: spiritual loathsomeness which results from But yet as long as I rema in in this great hospital, sin and, in fact, is sin itself. This harks back this sick, this distasteful world, as long as I remain to the Hebrew concept of tsara'ath which in this leprous house, this fle sh of mine, tbis heart, was translated as "leprosy" in the Sep­ though prepared for thee, prepa red by thee, will tuagint (13). still be subject to the invasion of mali gn and pestilent vapors. A number of writers use the term "lepro­ [8] sy" in the general sense of a loathsome evil. This is another fi gurative usage in which Thus Christopher Marlowe (1564- 1593 ) leprosy is an im age of the spiritual disease has Barabas in The Jew 'Of Malta. make the which plagues the world. William Cowper's followin g utterances: "Expostulation" ( 1781) in a similar usage [ ha' the poison of the city for him, And the white leprosy, but ere he sha ll have her pinpoints the source of such moral decay: I'll sacrifice her on a pile of wood. When nations are to perish in their sins, [II, iii, 56] T is in the church the leprosy begins. This is apparently the worst revenge of [96] which Barabas can conceive. The "white Thomas Hobbes in his Leviathan ( 1651 ) leprosy" may refer to or be derived from speaks of "Such men as are cleansed of the Biblical descriptions. In two other plays, Leprousie of Sin by Faith." [III, xli, 265] , The Cantentians [1091] and II Henry VI and J. Brown in Shaftesbury Characters [1678], Marlowe uses the line: ( 1751 ) announces, "What this leprosy of false J..'-nowledge may end in, I am un­ I am no loathsome leper, look on me. willing to say." Curiously, his contemporary, William John Milton (1608- 1674) continued this Shakespeare ( 1564-1616) uses the same theme. Several references in his Paradise line when the Queen in II Henry IV says: Lost refer to leprosy. Thus, "a leper once What, doest thou tum away and hide thy face? (i.e., N aaman, II Kings 5) he lost and I am no loathsome leper. Look on me. gain'd a king [I, 471] . . ." Later he Whether it is because of the two iambs, the describes a "lazarhouse." From the context alliteration, or the appropriate feeling, it is it appears that he meant a hospital. A pali remarkable how often in literature the of the view of the future that Mi chael gave words '10athsome" and "leper" are brought Adam is thus couched: together. Immediately a place Among Shakespeare's references to lep­ Before his eyes appeared, sad, noisome, dark, rosy, the longes t and most famous appears A lazar-house it seemed, wherein were laid Numbers of the diseased, all maladies. in Hamlet. The Ghost of Hamlet's father [XI, 479] explains the cause of his death to Hamlet: Upon my secure hour thy uncle stole This forward view from the Garden of With juice of cursed hebenon in a vial, Eden lists the horrors of the future result­ And in the porches of my ear did pour ing from Adam's fall. In an earli er poem, The leprous distillment, whose effect "the Hymn," Milton looked forward from Holds such enmity with blood of man That swift as quicksilver it courses through the present and imagined a world free from The natural gates and a lleys of the body, "leprous ,sin": And with a sudden vigor it doth posset For if such holy song And curd, like eager droppings into mild, Enwarp our fancy long The thin and wholesome blood. So did it mine, Time wiIJ run back and fetch the age of gold, 'And a most instant tetter barked about, And spekl'd vanity Most lazarlike, wi th vi le and loathsome crust, Will sicken soon and die, All my smooth body. And leprous sin will melt from earthl y mould, [I, v, 60-72] And Hell it self will pass away. "Eager" is here synonymous for acid. So [XIV, 13 8] Hamlet's uncle poured a poison into his Thus, Milton used leprosy in the same brother's ear which, according to the ghost, fi gurative sense in which it had been previ- immediately gave him a "leprous" eruption, 298 International Journal of Leprosy 1970 curdled his blood, and killed him. In "lep­ render judgment. Saturn and the Moon rous distillment" the usage is symbolic were appointed to render the verdict: rather than specific, using the word "lep­ Then thus proceeded Saturn and the Moon. rous" to mean "wil" or "poisonous." When they the matter ripely had digest; Shakespeare, thus regarding leprosy as For the despite to Cupid she had done, And to Venus open and manifest, loathsome, also uses it in several instances 1n all her life with pain to be opprest, as part of a curse. In Antony and Cleopat­ And torment sore, with sickness incurable. ra, Scarus says of Cleopatra after she has And to all lovers be abominable. fl ed from a sea battle: This doleful sentence Saturn took in hand, On our side like the tokened pestilence, And passed down where mournful Cresseid lay: Where death is sure. Yon ribaudred nag of Egypt­ Then in low tone in this wise he did say; "Thy great fairness and all thy beuty gay, Whom leprosy o'ertake!- i; the midst 0 ' the fight ... Thy wanton blood, and eke thy golden hair, Hoists sa il and flie s. Here I exclude from thee for evermair. [lH, x, 11-14] [ change th y mirth into melanchol y, And Thersites swears in Troiltls and Cres­ Which is the mother of all pensiveness; ida: Thy moisture and thy heat to cold and dry; Then if she that le ys thee out says thou art a fair Thine insolence, th y play and wantoness To great di sease : thy pomp and thy riches course, I'll be sworn and sworn upon't she never shrouded Into mortal need; and great penuritie Thou suffer shall, and as a beggar die. any but lazars. [II, iii, 36] The Moon further defin es the sentence: And, again , Timon in Timon of Athens "From health of body I thee now deprive, curses: And to thy sickness there shall be no cure, But in dolour thy days to endure . . . . Itches, blains, Sow all the Athenian bosoms, and their crop Thy crys tal eyes mingled with blood I make Be general leprosy! Thy voice so clear; unpleasant, weak and hoarse; [IV, i, 30] Thy lusty complexion o'erspread with spots black, And vivid lumps appearing in thy face. Leprosy is referred to on six additional Where thou comest, each man shall flee the place; occasions in Shakespeare's plays. Since Thus shalt thou go begging from house to house, none is remarkable they will here be noted With cup and clapper, like one lazarous." onl y by the following references: These pronouncements were passed to I H enry IV [IV, ii, 24-29] Cresseid in a dream. When she awoke and Henry V [I, i, 15 ; If, iii , 801] looked in a polished glass she found that Troi/us and Cressida [V, i, 71] Timoll of Athens [IV, iii, 35 & 37] her fa ce was indeed deformed. She called her father, who when: Larkey (8) has noted that the tragic and ill-starred tale of Troilus and Cressida was He looked on her ugly leper face, The which before was white as lily-flower: on e of those strange love romances of the Wringing his hands, oftimes he said, Alas! Middle Ages that intrigued poets and was That he had lived to see that woeful hour' told in many different ways by Boccaocio, For he knew well that there was no succor Chaucer, Shakespeare and others. He To her sickness; ... noted particularly the treatment of the This rendering of th e story of Troilus and story by Robert Henryson who in his Cresseid, deriving from the 15th century, is "Testament of Cresseid" attempted a con­ of interest for its association with leprosy of clusion to Chaucer's version of the story. In concepts previously noted ( 12) to be simi­ this version, Cresseid, having deserted her larly associated with leprosy in the Orient; Trojan lover, Troilus, is in turn deserted by the physical mutilation and loss of beauty, her Greek lover, Diomed, and so became punishment from the gods for sexual pec­ the scorn of both the Trojan and Greek cancy and defi ance of the gods, outcast camps. Cresseid felt that all her troubles status as the supreme penalty, hopelessness were due to the two gods Venus and Cu­ because of incurability. The tragic working pid, and denounced them in their own out of these factors in the life of Cresseid is temple. Cupid, incensed, called on the subsequently detailed poignantly by the gods of the universe-the seven planets-to poem. 38, 3 Skinsnes & Elvove: Leprosy in Society. V. 299

Berkeley's Alciphron ( 1732 ) mentions Her skin was white as leprosy, "Leprous ' Egyptians, driven from their And she is far Iiker Death than he; Her flesh makes the still air cold. country on account of that loathsome dis­ [III, 190-194.] temper" [VI, paragraph 24] and Cole­ brooke's 1801 ] oumal in Life [ed. 1873, John Keats evokes rich and exotic imagery as he asks in "Isabella; or The Port page 176] also reiterates society's felt need to ostracize the sufferer, remembering that, of Basil" (1818): "Last month ... a young man was going to Why were they proud? Because their marble founts be buried alive, on account of the leprosy." Gush'd wit.h more pride than do a wretch's tears?- Why were they proud? Because fair orange-mounts USE OF LEPROSY BY THE Were of more soft ascent than lazar stairs? ROMANTIC WRITERS [XVI, 3-4] The Romantic writers were wont to call Here Keats was describing the Florentines up vistas of ancient times and exotic, dis­ who had grown rich off their colonies and tant places as part of their imagery. They colonial labor. He similarly uses leprosy in sometimes incorporated leprosy in this "The Cap and Bells" [XXVII, 6]. imagery, refl ecting the concepts and mean­ Charles Dickens (1812-1870) in Barnaby ings already related to leprosy by the ear­ Rudge calls up a far-away image with his lier writers. The general use and connota­ "one oId leprous screen of faded Indian tions of the word and its relatives were leather." [XXXI] thus already well es tablished. No fewer than 15 references to leprosy William Wadsworth (1770-1850) in his can be found in the poetry of Robert "Imitation of Juvenal, Satire VIII" wrote: Browning (1812-1889). Seven of these oc­ cur in The Ring and the Book, a murder A leprous stain! er half his thread was spun. Ripe for the block that might have spared hi s son. mystery set in the Rome of 1698. Several [107] quotations will serve to illustrate the dra­ Samuel Taylor Coleridge's (1772-1834) matic quality of this work as representative of Browning's work in generaL Leprosy was sonnet, "Sweet Mercy" dwells on ancient used for its shock effect, utilizing already days and Christ's bond with the poor and established connotations and meanings as­ suffering. The latter are represented as sociated with it in literature. "lazars" and the term is clearly derived from Christ's parable of Lazarus and the Whether through favor, feebleness, or fault. rich man [Luke 16:19-31]. No matter, leprosy has touched our robe And we unclean must needs be purified. He did not so, the Galilean mild, [1Ir, 1377] Who met the Lazars turned from rich men's doors, And called them friends, and wept upon their And again: sores. A woman spy-suborned to give and take In a later "Sonnet to Earl Stanhope" Letters and tokens, to do the work of shame The more adroitly that herself, who helped Coleridge writes of strong individuality and Communion thus between the tainted pair nobility gained through integrity. Leprosy Had long since been a leper thick in spot, is used in a figurative sens e but as rep­ A common trull of the town. resenting a blemish or fault: The "tainted pair" refers to an association Alone thou wendest in thy stately pace, between a priest and a married woman, . Thyself redeeming from that leprous stain, and the description given refers to a wom­ Nobility. an servant who assisted them in their li­ In the following stanza from the Ancient aison. In yet another reference in this work, Mariner Coleridge us es the Biblical' leprosy is associated with sin: whiteness of leprosy in his description of Till they all weep, physician, man of law. the female of the two passengers on the Even that poor old bit of battered brass, spectre-ship, as he creates an exotic and Beaten out of all shape by the world's sins, horrifying imaginary scene: Common utensil of the lazar·house. [Ill, 795] Her lips were red, her looks were free, Her locks were ye ll ow as gold : Further references to leprosy are to be 300 International Journal of Leprosy 1970 found in The Ring and the Book, [II, 627; Spawn, weeds, and filth , a leprous scum, Made the running rivulet thick and dumb III, 35; V, 1169]. And at its outlet fl ags hugh as sta ke s In "A Blot on the 'Scutcheon'" by the Dammed it up with roots knotted like water same author, lepros'y is presented as a pun­ snakes. ishment for the sin of dissimulating, remin­ [lIT, 70] iscent of the above noted association with Byron ( 1788-1824) in Don Juan writes as falsifica tion by Dante in The Inferno: part of an "anatomy lesson": ... some fierce leprous spot T he liver is the lazaret of bile, Will mar the brow's dissimulating. But very rarel y executes its function, A similar sin-associative reference is fo und For the first passion stays there such a while. T hat all the rest creep in and form a juncti on, in Brown in g' s "Paraclesus As pires": Like kn ots of vipers on a dunghill's soil, T he utcerous barky scurf of leprosy Rage, fear, hate, jealousy, revenge, compunc­ Which fin ds-a man, and leaves-a hideous thing tion, T hat can not but be mended by hell -fire. So that all mischiefs sprin g up from this entrail , ( IV, 140 ) Like earthquakes from that hidden fire ca ll 'd centra l. In "The Inn Album" Browning tells of an [TT, ccxv] old gambler who plans to fl eece a wealthy youth but who is himself shorn. He pro­ Henry Miller ( 1891- ) in the T 1'O'pic poses to liquidate his debt by handing over of Cancer incorporated this summative de­ a lady he has seduced. The response fol­ scriptive use of leprosy as a sin gle, almost random example of what he considered an lows : absurd di sease, namely pres ent day civi­ Make me 'amends by marriage'- in your phrase, lized life. The words "leprosy, leprous and Incorporate me henceforth, body and soul, With soul and body which mere brushing past leper," as Miller uses them, have almost no Brought leprosy upon me-'marry' these! meaning in context. They lose sense and [IV, 1572] meaning just as does life itself in the book. Later in "The Inn Album" the drama con­ Some examples: tinues: I sit down beside her and she talks-a fl ood of Forth from those arms' enwinding leprosy talk. Wild consumptive notes of histeria, [sic] At last I struggle : uncontaminate : perversion, leprosy. I hear not a word because she [VIT, 721 1 is beautiful and I love her and now I am happy and willing to die. [pg. 21] LEPROSY AS SIMPLY AN OPPROBRIUS Later: DESCRIPTIVE TERM There ""as a touch of spring in the a ir, a poisonous Growing out of the disease-related use of malefic spring that seemed to burst from the leprosy descriptive words has com e the man-holes: Night after night I had been coming back to this quarter attracted by certain leprous extension of th e word use to purely de­ streets which only revealed their sinister splendor scriptive terminology which carries, howev­ when the light of day had oozed away and the er, the opprobrium developed in the other whores commenced to take their posts. usages. Thus, Sir Francis Bacon's Natural [pg. 42] Hist01'Y of 1626 states, "If the Crudities, On two other occasions in the same book, Impurities and Leprosities of Metals were Miller uses the descriptive term "skull of a cured, they would become Gold." [Par. leper" with crass sexual overtones. [pgs. 326] . 223, 225] . . "Leprous," in addition to meaning "of, or like leprosy," had come to have a botanical NONMEDICAL, DEFINITIVE USE OF usage in which, according to the Oxford LEPROSY English Dictionary, it means a "plant cov­ ered with white scales resembling the skin A few writers have used leprosy more of a leper." definitively or have become involved in its Percival Bysshe Shelley ( 1792-1822 ) problems. Thus, in A Burnt Out Case, used "leprous" in a similar manner in "The Graham Greene ( 1904- ) dealt with Sensitive Plant": characters set in a jungle leprosarium. Lep- 38, 3 Skinsnes & Elvove: Leprosy in Society. V . 301

prosy was dealt with both symbolicall y and uprooted, sick people were sent; away from directl y. their families, cut off from their work, and In 1908 Lew Wallace published his dra­ without anything to keep them occupied. It matic Ben Hul' (Ii) in which he reiterated also was a place where there was no care or and summated many of the popular errors treatment. These descriptions vividl y por­ regarding leprosy which are embedded in tray the typical situati on resulting from Western literature as noted above. His viv­ society's neglect, which in turn fed back to id portrayal of th e outcast life of those with society a basis for its misconceptions, fears, leprosy in Biblical times lent itself well to suspicion and opprobrium. the film version of the story that was in due Stevenson went on to give his personal, course presented in "epic" style. Both pre­ 1891 observa tions of the colony, where he sentations havc been roundly denounced noted that the inmates were cheerful, by many as "inimical to th e cause of lepro· clean, well-carcd for, and comfortable. In sy," but both, as historical novel, were but the face of cxtreme physical deterioration dramatizing the inimical con cepts and reac­ and deformity he found them unselfcon­ tions already embedded deep in culture.: scious, because all were so: and the social subconscious. The girl at Hookena, a leper at large among the Earlier Robert Louis Stevenson (1850- clean, held down her head. I was glad to find she 1894 ) ([(I) became concerned with leprosy would soon walk with her face erect among her fellows, and perhaps be attended as a beauty. in Hawaii and wrote of these in the form of letters to be found in his The South Seas, The changes that Stevenson found, he Letters from a Leisurely Traveler and attributed to the work of Father Damien "Father Damien : An Open Letter to the and so he became in volved in the defense Reverend Doctor Hyde of Honolulu" of this priest again st the attacks of his ( 1912 ). The South Seas in several consecu­ detractors, notably Reverend Doctor Hyde tive letters considers the history of leprosy of Honolulu whom he lambas ted with great in the Hawaiian Islands, the history of the literary style, concluding in part: lazaretto (the author's term ) 'On Molokai Well, the man who tried to do what Damien did, is Island, and descriptions of Stevenson's ob­ my father, and the father of the man in the Apia servations of this leprosarium and its inhab­ ba r, and the father of all ' who love goodness; and he was your father too, if God had given you the itants at the time of his visit. He noted that grace (0 see it. many factors contributed to the lawlessness lpg. 441] of the early days of this institution and . explains them as follows: The work of Father Damien and the writings of Stevenson mark a notable turn­ They were strangers to each other, collected by in g point in regard for those who have common calamity, disfigured , mortall y sick, ban· ished without sin from home and friends. Few leprosy, and in th e writing about leprosy. would understand the principle on which they were They both led away from prior tendencies thus forfeited in all that makes life dear; many to equate the patient with the di sease and must have conceived their ostracism to be ground­ pointed to a recognition of the humanity ed in malevolent caprice; a ll came with sorrow at and need of those who became afHicted. hea rt, many with despa ir and rage. [pg. 186] This was aided by the fact that Gerhard Arnnuer Hansen, contemporary of Dami en This is followed by a description of Molo­ and Stevenson, had discovered the bacil­ kai in those early days: lary cause of leprosy, Mycobacterium lep­ 'There is no law in this place'-was their word of me. salutation to the new·comers; cards, dancing, and As part of the newer stream of writing debauch were the diversions; the women served as about leprosy, in contrast with the continu­ prostitutes, the children as drudges; the dyin g were callously uncared for; heathenism revived; okole­ in g use of the disease for its shock effect in IUlII was brewed and in their orgies the disfigured much of the "vriting noted above" there sick ran naked by the sea. This is Damien's came to be much over-reaction akin to the picture; these traits were viewed through the tarn­ sentimental, almost unreasoning Jeprophilia ish of missionary spectacles . .. [pg. 187] that followed the Crusades. Some psycholog­ This is a description 'O f a place where ic b asis for such reaction has been aptly 302 International Journal of Leprosy 1970 dctail ed h y Ryri e (10). But at the same " But they're lepus! she exclaimed. "Lepers!" A time therc began to develop a responsible shiver of horror shook her entire frame. - So MallY Steps to Death , by Agatha Christi e. body of work, the literary quality of which Pocket Boo k. J 956. time will determille. Among such works note should be taken of Who Walk Alone " How dare yo u spy on the intimate pleasures of a guest?" Tim snarled. "In my country you would be by Perry Burgess (2); Alone No Longe1' by castrated and thrown to the dogs for th at. you leprosy pati ent Stanley Stein ( til) in collab- stinking foreskin of a leprous hyena." 0ration with Lawrence C. Blochman; and - Tsimmis ill Tallgier, By Mallory T. Knight, M olokai by O. A. Bushnell (3) . Award Books, 1968. In recent years there has bcen consider­ LEPROSY ON CONTEMPORARY able agitation in some quatters to change NEWSSTANDS the des ignation "leprosy" to "Hansen's Dis­ Some of the works refcrred to above can, case." This effort now begins to be reBeeted of course, be found in paperback editions in the newsstand offerings without the on contemporary newsstands. There re­ so ftening effect that the proposers of the mains, however, also the question of how, change hoped for. Thus: and how extensively, leprosy is used in the All the questions were about as welcome a~ a general, contemporary light reading mate­ diagnosis of Hansen's Disease. - A Deadly Shade of Gold, John D. MacDonald. rial that is currently popular. Fawcett Publications, 1965. Over the past twenty years a random surveyG has ,been made of newstand offer­ "They sa rcifice to the Tiki tonight ," she said angrily, "and the grave worms crawl. But you ing of paperback popular novels o~ det.ec­ wouldn't know abollt that, would you? For God's tion, espionage, adventure and hlstoncal sa ke, don't you own a parell ? Or some slip-s lops? fi ction. The survey docs not include the Didn't your research team tell you this was the so-call ed "love romances" or fiction with a island where love was born? Why did you take the racial message. Covering about 1,200 titles, trouble to come? Why not se nd one of your IBM robots with stainless steel te sticles? Tell it how it does, however, provide some index of many islanders have syphilis, how ma'ny Hanse n's current use of leprosy and the extent of disease, how many missionaries ...." such use. The works come from both British - Th e Paper Pistol COlltract, by Philip Atlee, and American presses. Fawcett Publications, 1968. About 5 per cent of these works used ACCRETIONS TO THE BIBLICAL leprosy, usually as a single descriptive CONCEPTS effort to convey a feeling of disgust, misery, horror or other opprobrium; sometimes le­ A brief summary of Biblical concepts gitimately as indicating the presence of per­ regarding tsara'ath, translated "leprosy," sons with leprosy but using the term "lep­ provides a useful reference background. er." Forgotten are earlier terms of lazars , Taken by itsel£, without interpretive accre lazarettos. The words used are pre­ tions provided by Bib~ical scholars and so. eminently leprosy, leprous and leper. A few ciety, the concept is quite simple. History, examples will suffice to demonstrate the experience, and the teaching of the proph­ generally unimaginative usage: ets convinced the Hebrews that they were a special people, chosen by Yahweh to bo. "Wait!" Honey Lamb ran to the biggest oil paint­ His peculiar representative. As such, they ing. Tugged at the side of the leprous gilt frame. - Dead SlIre, by Stewart Sterling, Dell Book, 1949 were to be a separate, clean people, uncon tamminated by the sin and idolatry evidenl Panic was nothing to what T began feeling now, among other peoples. Repeatedl y, howev ­ Panic was like a mosquito bite on a dying leper. -13 French Street, by Gil Brewer, Gold Medal er, as individuals and as a people they Book, 1951. departed from this ideal and such lapses , "Got any other angles on him ?" He shook his were sin-moral spots or blots. Such defile­ head. "Nope. He was just a louse; a leper, they ment was spiritual tsara'ath. It had to be . called him." (referring to a blackmailer) . recognized and cast away, or departed - Bodies in Bedlam, by Richard S. Prather. Gold from, else it would spread in th eir society Medal Book. 1951. and render it spirituall y unclean-as it did _ 6 Unsupported by any research grant. repetitively. Such uncleanness came to be , .38, .3 Sldnsnes & E(vove: Leprosy in Society. V. 303 associ ated with concepts also of physieal ently physical discharges or pus ) were also defllem ent and violation of dietary, e.g., the decmcd unclean and contagious and de­ eating of pork, and other taboos. Some manded ritual purifications as did also physical afflictions were also recognized as spilled scmen and menstrual discharge. unclean and transmissible and therefore These, however, were recognized as tem­ requiring ostracism, or separation, in order porary and did not require ostracism or to keep them from spreading from individ­ segregation. Other tsara'ath concerned cer­ ual to individual. These were legally tain types of spots or growths on house defin ed and, as with moral defil ement, th e wall s and ·clothing which were not well priest was th e judgc. defin ed or spccified. They, too required ritual clcansing. The phys ical personification of tsara'ath The Biblical accounts make no sexual was defined as a rising or swelling, a scab connotations with rcspect to the origin of or ha Id spot, or a bright or white spot in the sk in . If the hair of the area turned white or the blemishes. The affliction was not re­ garded as hcreditary; no child is recorded yell ow, this was rcgarded as confirming as having had it; there is no indication of evid ence as was also the appearance of raw associated rotting or fallin g off of PaIts of Hesh ( probably ulceration ). If the spot or the body such as fin gers , toes, nose, or privy blemish spread, it was "unclean" whcrcas if parts; there is no mention of associated it rcmaincd stationary it was "clcan." If the deformity of the extremities and baldness "raw flesh " turned white (healing scar?) it was not evidcnce of tsara'ath. All these was "clean." If the bl cmish did not clear up concepts arc later accretions, deriving from uncl eI' observation of up to two wceks, then socicty's experience with and misapprehen­ the affli cted ,vas required to "live without sion concerning lcprosy. These and rclated the ca mp" and to shout his uncleanness to concepts form the major basis for thc above all who might approach him. If subse­ noted uses of leprosy in literaturc and quently the affliction subsided and disap­ folk-lorc. They can not be attributed to the peared, the afflicted could again be de­ Bible but are a product of latcr social clared cl ean and, after various ritual purifi­ reaction. The reasons for such reaction cations and sacrifices, could be returned to have already been presentcd and dis­ society. Though the Bible does not specifi­ cusse d. (13). call y equate physical tS{Jra'ath with moral delinquency, the sacrificcs and purifications Despite these in congruities with respect demanded for restoration to society, as well to leprosy, as the disease is presently as the outcast status of the afflicted incH­ known, the reasonableness of the original ca tes such symbolic cquation. Also, i~ three translation of tsara'ath as '1eprosy" has been instances it is recorded that p ersons were previously noted (I~) and does not here smitten with leprosy because of reprehensi­ require repetition. ble acts. Miriam was made "leprous" for seven days because she rebelled against the DISCUSSION leader Moses ( Numbers 12: 1-15). Gehazi, From this survey it seems evident that, who was servant to the prophet Elisha as prcviously noted for the Orient (II, 12- when the latter cured Naaman of "lepro­ 13), so also in Oecidental societie the sy," was striken with the disease because of unique complex of symptoms and manifes­ his avarice (II Kings 5). This instance tations that comprise leprosy set this di­ provides the only hint in the Bible of a sease apart as a particular object of horror belief in the hereditary naturc of thc di~­ and opprobrium. ease in that the descendants of Gchazi' It is tempting to belicve that in all these were also cursed "forever" with the affli c­ literary and folklore traditions it is the tion. Finally King Azariah (also call cd disease of leprosy that societies have react­ Uzziah) was made leprous because of im­ ed against and not the persons who have piety (II Kings 15:1-7 and II Chronicles suffered with it. Though this is basically 26 ). true in that, were it not for their disease, Other conditions termed "issues" (appar- the sufferers would not be outcast; it is .304 International Journal of Leprosy 1970 equally true that in horror and fear of the of leprosy are those of Aulus Cornelius disease, for long moments in history, the Cel.sus (9) circa 30 A.D., and Aretaeus (1) sufferer with leprosy has been lost sight of second century A.D. (quoted, ( 1 ~ » . Nei­ by society save as a personification of the ther of them mentions neural involvement disease. For brief periods, notable in Jesus or anes thesia. Those who have made an Christ, in the immediate post-Crusades issue of the Biblical lack of mention of period and, fortunately, since the work of these characteristics seem not to have pur­ Damien and Hansen, recognition of the sued this is.s ue to a point of study as to individual as distinct from his affli ction has when and by whom these neural involve­ Bi ckered and gained ground. ments were first recogni zed and described. It is evident that much of Western litera­ Without specific pursuit of this matter, the ture's. characterization of leprosy is medi­ first reference to the neural in volvement in cally inaccurate. A number of recent dis­ leprosy that has come to our attention is the cussants have attributed Western ].ep­ Atlas Colorie de Spedalskhed ( 5) pub­ rophobia to Biblical teaching. Although lished in 1847 by Daniel C. Danielssen and some of the con cepts brought out in this Carl Wilhelm BoecP. In all probability review are similar to Old Testament de­ there are earlier notices of this phenom­ lineations (e.g. , Leviticus xiii & xiv) they enon, but it seems evident that no notice are not therefore necessarily entirely de­ was taken of it in literature, that its medi­ rivative therefrom. Europe lived with lep­ cal l'ecognition came relatively late, and rosy for several centuries, reacting with that society did not impute much signm­ both leprophobia and leprophilia. Though cance to these characteristics. Ab.sence of teachings of the Church were strong and its recognition in the Book of Leviticus dominant during this period it is not un­ more a social and literary than a medical likely that much of the reaction to leprosy treatise, compil~d during the Babylonian derived from direct experience, observation captivity of the Hebrews (597-538 B.G ), and reaction and was not merely a parrot­ can scarcely be argued as evidence that the ing of ancient beliefs. Indeed, it has been disease grouping designated tsara' ath in the postulated (13) that the very presence of original text did not include the entity of the pattern of social reaction is in itself lepro.sy as it was later known. indicative of the presence of the leprosy In the ancient past it is not so much complex even in th e absence of accurate medical witness as the social reaction medical description of the disease as it is which gives evidence of the presence of now understood. leprosy. From the above review there emerges a pattern of concept and reaction Much attention has been given to the which can be briefly symmarized: fact that the Biblical accounts of leprosy do l. Strong, often violent, aversion toward not mention the significant feature of neur­ the afflicted, both as individuals and al involvement and anesthesia in leprosy. a group, resulting more from their From this it is reasoned leprosy could not physical appearance than from func­ have been part of the disease complex tional disability. rendered as "leprosy" in translations of the 2. Affliction believed to be incurable, ex­ Old Testament, since it is thought that such except perhaps occasionally by spe­ an important feature would inevitably have cial supernatural intervention. been noted. With respect to this notion, it 3. Identification of the affliction with is pertinent to note that not on e of the many references presented in the above supernaturally decreed punishment review, drawn from a span of several cen­ for moral, usually sexual peccancy. turies, refers to neural involvement or anes­ 4. Transmission equated with venery. thesia as being a feaure of leprosy. Yet 7 There is. however, mention of ~n es th es i a . there is no ques tion that the diseas e re­ muscle wasting and formication in the Oxford ferred to in these references is leprosy as it Bodleian Library (M. S. Ashmole 1398, text on leprosy, fo . 14 3- 144) Document from the 14th is known today. century, published in translation by Charles Singer Two of the earliest medical descriptions (J. Hist. Med . 4 (1949) 237-238). 38, 3 Skinsnes & Elvove: Leprosy in Society. V. 303

5. A beli ef that the afflicti on may be reacti on to leprosy, would appear to be the hereditary. guideline that emerges fo r meeting the 6. Ostracism of the affli cted by society, continuing problem. This is an approach often in an organized and prescribed that ·has led to conquest in other disease manner. and social problems; and leprosy com­ pounds medical and social problems to a This pattern is essentially the same as that unique degree. In the contemplation of this previously noted (12.14) in vari ous Orien­ disease it is impossible to be either purely tal societies. In that study it was postulated the humal)ist or the scientist. For society, that when this pattern of social reaction the psychologic change required is for­ and belief exists in a society it is evidence midable for "leprosy," in the histori cal and of the presence of leprosy even if the literary rather than the medical sense,-or medica l witness is defi cient. This tllesis is bettcl' , tsara'ath- is deeply embedded in strengthened b y the present study. culture and still lies deep in the soul of It is clear that to thus argue is not to humanity. So deep it lies that one may well maintain that all use 'Of the word "leprosy," despair of fulfillment of Spenser's vision in and other related words, identifies true "Colin Clout's Come Home Againe," noted leprosy any more than the literary or com­ above : mon application of the word "bas tard" al­ For there all happie peace and plenteous store ways identifies a true bastard. Many above Conspire in one to make contented blisse: noted quotations attest to the wide use of No wayling (wailing) there nor wretchedness is leprosy to indicate opprobrium and d e­ heard, scriptive connotations not directly related No bloodie issues nor no leprosies, No gries ly famin e, no no ragin g seward , to the disease itself. It seems, however, to No night bod rags (forays) , nor no hue and cries. be a fact that leprosy has always been a part of the moiety that has been designated Mos t fortunately, recent, real and contin­ "leprosy" and that its characteristics of mu­ uing advances iu the treatment of leprosy tilation, associated with incurability and are also the most potent therapy fo r its progressive debilitation have been the core social pathology. They break the pattern of complex from which the social reaction to both the social and medical pathol'Ogies of the moiety has derived. As in creasing med­ th e disease for they promise relief fr om the ical and social understanding have peeled chronicity and deforming effects 'Of the away the 'Other entities that were complex­ disease, and perhaps, in time, from the ed with leprosy, leprosy has emerged and disease itself with consequent negation of been left as the sole assignee of the odium the whole pattern that has so disturbed fo r which its core characteri sti cs were origi­ society. They make possible repl acement of nally and predominantly responsible. In the image of a divinely ordain ed, irrevoca­ the process, leprosy has been defined as an ble retribution with that of an understood etiologic, pathologic and clinical entity that disease subject to management and control. can in itself be understood and through this SUMMARY understanding provides a basis als'O for an understanding of the long standing social A survey is presented, and illustrated by pathology that h as been associated with quotations, of the use of leprosy in Occi­ "leprosy." dental, non-medical literature from Dante With this understanding there seems no (126.5-1321 A. D. ) to contemporary paper­ longer to be any valid rational for contin­ backs. This literature uses leprosy as de­ ued opprobrium or fear (as di stinct from scriptive and representative of alm ost all caution), nor does there seem to be any im agin able contumely :md social opprobri­ reason for continuing attempts to attribute um. The pattern of social reacti on to the this odium to any specifi c social force such di sease that emerges is similar to that which as the Bible, or for attempting to hide the has previollsly been postulated as bein g suf­ disease under a new name. fi ciently characteri stic for leprosy to sug­ A sense of humanity coupled with ra­ gest that this reaction pattern may be used tionality, both usually absent from society's as evidence of the presence of leprosy in a 306 International Journal of L eprosy 1970 given society even if med ical descriptions lepra. Ademas, se destacan ocasiones contempor­ of leprosy in that society arc inadequate. In aneas en las cuales los autores usan la designaci6n seeking its effect, this literature makcs vir­ "Enfermedad de Hansen" en vez de lepra, pero con las mismas implicaciones desagradables tually no sp ecific' mention of anesthesia, que han ca racterizado los escritos en que se ha claw hands, loss of eyebrows, collap se of usado la palabra lepra. Esta evidencia sugiere the nose, blindness, lagophthalmos an d que el ca mbio de nombre de la enfermedad ha ulcers of the feet. Nevertheless, there is no tenido escaso efecto sobre la mayor parte de q uestion but that leprosy, as it is known to­ las conce pciones erradas de la sociedad. day, was the disease meant in this litera­ ture. T his suggests that more ancient, n0n­ MSUM£: medical literature, such as the Bible, should On presente ici, avec des exemples et des not be faulted for sim il ar omissions. Nor can citati ons, les resultats d' une enquete portant such omission s b e accepted as proof that sur Ie recours a la lepre dans la litterature occi­ leprosy was not at least part of the disease dentale non medica Ie, depuis Dante (1265- 132 1) jusqu' aux li vres de poche contemporains. Celie complex to which they applied the same lillerature utilise la lepre comme moyen descriptif concepts of social opprobrium that have re­ et com me illustration de presque to utes les cently been , and are stilI applied to leprosy. situati ons imaginables d'opprobe socia Ie. L'aspect Additionally, contemporary instances are de la reaction socia Ie a la maladi e, tel qu'il noted wh ere authors use the designation appara1 t ainsi, est semblable a celui que I'on a "H an sen's Disease" in p lace of leprosy but jusq u' a present considere comme etant suf­ with the same odious connota tions tha t h as fisa mment ca racteri stique de la lepre pour sug­ characterized writings using the word lep ­ ge rer que ce type de reacti on pellt etre utilise comme la preuve de la presence de lepre dans rosy. T his evidence suggests that change of une societe don nee, meme si les descriptions disease n ame h as little e ffect on the thrust medi ca les qui en sont faites, dans celie societe, of society's m isconceptions. sont inadequates, En vue d'obtenir cet effet cette Iitterature ne fai t virtllellement a u c un ~ RESUMEN mention specifique de I'anesthesie, des mains en griffes, de la perte des sourcils, de l'effondre­ Se presenta una revi si6n, ilustrada con citas ment du nez, de la cecite, de la lagophthalmie et bibliografi cas, del uso de la lepra en la literatura des ulceres aux pieds. Pourtant, on ne peut occidental no-medi ca desde . Dante (1265- 1321 douter que la lepre, telle qu'elle est connue A. D.) hasta edi t- iones de bolsillo contemporaneas. aujourd'hui , soit la meme maladi e que ce li e a Esta literatura utiliza la lepra como descripci6n laquelle celie litterature se refere. Celie con­ y representaci6n de todo el oprobio contumaz statation suggere que la litterature non medi cale social imaginable. EI modelo de reacci6n socio- plus ancienne, telle que la Bible, ne doit pas 16gica ante la enfermedad que emerge es similar etre incriminee pour ex pliquer de telles omissions. al que se ha postulado prev iamente como On ne peut davantage considerer que de telles suficientemente ca racteristico de la lepra como omissions constituent la preuve que la lepre para suge rir que este modelo de reacci6n puede n'appartenait pas, du moins en partie, au com­ ser usado como evidencia de la presencia de plexe nosologique auquel on a applique les le pra en una sociedad determinada, aunque memes concepts d'opprobe socia Ie qui ont las descripciones medi cas de lepra en esa sociedad recemment ete et sont encore appliquee la sean i.nadecuadas. Para conseguir su objetivo, a lepre. De plus, on a rei eve divers exe mples esta hteratura virtualmente no hace menci6n contemporains dans lesqllels les auteurs ont es pec!fica de anestesia, manos en garra, perdida utilise Ie terme " maladie de Hansen" au lieu du de ceJas, colapso de la nari z, ceguera, lagoftalmos terme lepre, mais ce pendant avec la meme y ulceras de los pies. Sin embargo, no hay duda connotation odieuse qui a caracterise les ecrits que la enfermedad a que se refiere esta literatura qui employent Ie terme " lepre." Ceci suggere es la lepra, tal como se conoce hoy en dia. Esto que la modification du nom de la maladie a sugiere que no se debe culpar de omisiones peu d'effet sur Ie poids des prejuges de la societe. similares a literatura no-medica aun mas antigua, tal como la Biblia. Tampoco se pueden REFERENCES aceptar estas omisiones como prueba de que la lepra no era por 10 menos parte del complejo 1. ADAMS, F. (translator) The Extant Works de enfermedades a las cuales se aplica ban 'los of Aretaes the Cappadocian . London, The mismos conceptos de oprobio social que han New Sydenham Society, 1856 pp. 368- sido recientemente, y aun son, aplicados a la 372. ' 38, 3 Skinsnes & Elvove: Leprosy in Society. V. 307

2. BURGESS, P. Who Walk Alone. New York, LO. RYRlE, C. A. The psychology of leprosy. H enry Holt & Co., 1940. Leprosy Rev. 22 (1951) 13-24. 3. BUSHNELL, O. A. Molokai. New York, 11. SKl NSNES, O. K. Leprosy in society. I. World Publishing Co., 1963. "Leprosy has appeared on the face. " Lep­ 4. CURRY, W. C. Chaucer and the Mediaeval rosy Rev. 34 (1964) 21-35. Sciences. New York, Barnes & Noble, Inc. 12. SKlNSNES, O . K. Leprosy in society. II. 1960. The pattern of concept and reaction to 5. DANlELSSEN, D . C. and BOECK, C. W. leprosy in Oriental antiquity. Leprosy Rev. Atlas CoI01'le de Spedalskhed. Bergen, 34 (1964) 106-122. Norway, Norwegian Government, 1847. 13. SKlNSNI):S, O. K. Leprosy in society. III. The relationship of th e social to the medi­ 6. DANTE, A. The Inferno. John Ciardi cal p athology of leprosy. Leprosy Rev. 34 (translator). New York, The New Amer­ (1964) 175-181. ican Library, 1954. 14. SKlNSNES, O. K. Le prosy in society. IV. 7. HEBEL, J. W., Ed. Prose of the English T he genesis of lepra-angst. Leprosy Hev. Renaissance, New York, Appleton-Cen­ 39 (1968) 22.3-228. tury-Crafts, 1952. 15. STEI N, S. and BLOCI-U"CA N, L. C. Alone No 8. LARKEY, S. V. Leprosy in Medieval Ro­ Longer. ew York, F unk & Wag naIls Co., mance: A Note on Robert H enryson's Inc. 1963. Testament of Cresseid. Bull. Hist. Med. 16. STEV ENSON , R. L. The Vailima Edition of 3S (1961) 77-80. the Works of Robert Louis Stevenson. 9. LEE, A. ( translator ). Of elephantiasis, by New York, P. F . Collier & Son Company. Aulus Cornelius Celsus. In : Celsus de Vol. 9, 1912. Medicine, London, E. Cox, 1831, pp. 17. WALLA CE, L. Ben HUI", A Tale of Christ. 231-232. New York: H arper & Brothers, 1908