I.,' rt:HNA nON AL J 01 ' H :-.' AL 0,- LH'HOS) Volume 43 . Numoer 2 Prilltet! ill till' U. S .A. An Overview of Research on the History of Leprosy Part 1. From Celsus to Simpson, Circa. 1 A.D. 1,2 Part 2. From Virchow to M011er-Christensen, 1845-1973 3 J Philip A. Kalisch The hi story of leprosy, important as it un­ lo us a nd now controversial literature accu­ doubtedly is, receives sca nt attention from mulated during an unbroke n continuity of leprologists today. Occasiona ll y, a signifi­ more than a th ousa nd years, perhaps even cant article may appear in Danish, German, several millenniums. With this disputed a r­ French, and in isolated in stances British a nd cheological a nd semanti c problem we are American periodicals, but on the whole the not conce rned. Needless to say a recent im­ production is but a trickle and largely re­ plicatio n tha t lep rosy ex isted in ancient mains unnoticed. This void is unfortunate Egypt has not gone unchallenged (11 2). Be because the study of leprosy history makes that as it may, the Roman writer Celsus ( 37 ), it possible for today's leprologist to immerse who was born in 25 B. C., a nd the R oma n himself in the lives and times of the great politician, Plinius Secundus, born in 23 A. D. leprosy investigators of the past, their ac­ (191), both had many antecedent writings to complishments and id eas, and their influ­ aid them in their fairly distinct descriptions ence on their own and subsequent periods. of leprosy as .did the later Greek physicians. In this way the leprologist can identify him­ Galenus ( 83 ), Aretaeus (1 0), a nd Soranus, of self with the mature minds of yesteryear and Ephesus ( 223 ). consider himself a link in the great chain of The advance of know ledge co nce rning tradition that shapes his work. leprosy was abruptly halted by the collapse Moreover, because the history of leprosy of the Roman world after 300 A.D., and by has critical medical, social, cultural, psycho­ three centuries later there was almost no logical and educational functions; because medical knowledge available concerning the leprologists are all prisoners of the past, in disease in the Western world. Although the sense that their options are limited by copies of the preceding works and other what has gone before and their preferences treatises were probably extant, by 600 A.D. are shaped by their image of who they are practically no layman could read those and what leprosy has meant to mankind, it books. Thus, the embryo of leprology was is of the utmost importance that they try to dead in western Europe, a casualty of the free the history of leprosy from the myth and semi barbaric hordes who had no tradition of error that surrounds it. The following bibli­ learning. ographical survey of works on the history of The knowledge of leprosy had never sunk leprosy seeks to stimulate additional re­ so low in the East during these centuries as search in the field by identifying some of the it had in western Europe. Constantinople significant works upon which the contempo­ survived successive attacks by the Arabs rary leprologist may build. and preserved its libraries, and the Greeks who peopled it had a high regard for learn­ PART 1 ing, which was resumed when conditions At the time of Christ, what was known as permitted. During this time such physicians leprosy or elephantiasis had elicited a nebu- as Aurelianus (15), Aetius, of Amida (3), Paulus Ageineta (1 86), and Oribasius of Per­ gamun (1 81) substantiated the existence of I Received for publicati on 23 May 1973. 1 Part 2 of this pa per was presented a t the Tenth In­ the disease and traced it to prehistoric times. ternatio nal Leprosy Cong ress, Bergen, No rway, 17 Oribasi us very much praised the eating of August 1973 . vipers, for he writes that this gave a wonder­ ) P. A. Ka li sch, M.A., Ph. D., Associate Professor and Research Scientist, History of Nursing Research Proj­ ful help and relief to "lepers." The Arabs, ect, University of Michiga n Medical Center, 428 Victor though they lacked the tradition of scholar­ Vaughan Building, Ann Arbo r, Mi chi gan 48104. ship, were an able people whose ancestors 129 130 International lournal of Leprosy 1975 had lived on the edge of all the great civiliza­ ben [become] grete, the vertue of smellynge tions of antiquity, and they respected erudi­ faylyth, and the brethe stynkyth ryght tion. Once firmly in control of a vast empire, fowle," and when the disease is advanced the Moslems supported learning, and the they are "unclean, spotyed, glemy, and quy­ great caliphs, including Haroun-al-Raschid, thery [watery], and the nosethrilles ben had camel caravans laden with Greek and stopye, the wasen of the voys is rough and Latin books brought to Baghdad, where they the voys is horse, and the heere falls." Some engaged Nestorians, Jews, and Persians to 200 years later in the late 1400's Valesco de translate these works containing knowledge Taranta, a physician of Montpellier, strongly of leprosy into Arabic as documented by the recommended castration as the cure for lep­ laborious efforts of Janus Damascenus (48), rosy si nce the disease was caused by too Issac Israeli (11 3), the great Rhazes (196), Ali great a dryness and by the removal of the Abbas ( 6), Avicenna (1 8), Abulcasis ( 2), testicles the body would be moistened ( 240 ). Avenzoar (1 6), and Averroes (1 7). This Many of his contemporaries held views that knowledge was available to the new schools were just as far fetched. They included Bar­ which arose at Baghdad, at Cairo, and fi­ tolomeo Montagnana of Padua (1 71), Pietro nally at Cordova in Spain. Collectively, the d' Argellata of Bologna (I I), Ferrari de Gradi Arabs not only helped to preserve the an­ of Pavia ( 75 ), and Hans von Gersdorff of cient knowledge of leprosy but may have Strassbourg ( 84). made important additions to it. By and large, An early 20th century historian of leprosy, however, the Arabic writers seem to have Hans Carlowitz (36) completed a disserta­ never entirely abandoned the notion that tion under the direction of Karl Sudhoff they were but humble disciples following in which compared most of the important 13th the footsteps of great masters, whom they and 14th century commentators on leprosy were bound to revere, imitate, and quote, including Teodorico Borgognoni (230), Gil­ but never overthrow. Thus, they excelled in bert, the Englishman ( 86 ), Guglielmo da Sa­ the synthesis of prior accumulated knowl­ liceto (95), Arnaldus de Villanova (12), Lan­ edge rather than in original findings. franco, of Milan (134), Bernard de Gordon Meanwhile, Christian Europe slowly ( 23 ), Vitalis de Furno (245), John of Gaddes­ struggled to lift itself out of barbarism and den (125), Henry de Mondeville (170), and superstition aided by Jewish physicians who Guy de Chavliac (97). Carlowitz found that circulated Greco-Arabic knowledge through­ the authors differed from each other only out the Christendom and by translations of slightly and that all except those who lived Greek and Arabic medical treatises into before Bernard (ca. 1285-1308) made use of Latin. About \060, Constantinus Africanus Bernard's U/ium medicinae. He noted that (45) brought a cargo of Islamic medical lore Henry of Mondeville and John of Gaddes­ to Salerno and with the aid of his transla­ den were particularly alike as they frequent­ tions of Greek and Arabic works in medicine ly used the same phraseology, for example. spurred the resurrection of such knowledge Carlowitz concluded that all these physi­ in Italy. His description of leprosy under the cians relied less upon their own observations title "De morborum cogni.tone and cura­ than upon the work of such famous Arabian tione" with its theory of four species of lep­ physicians as Rhazes, Ali Abbas, Avicenna, rosy was heavily borrowed from an Arabic and their 11th century commentator, Con­ work by A vicenna ( 18) who in turn had bor­ stantinus Africanus. The most original of the rowed it with a little alteration from the accounts appeared to be those by Gilbert Greeks themselves. Platearius, a 12th cen­ and Bernard de Gordon. tury s uccesso r to Constantinus, diligently Throndike, Sarton, and Singer have all followed up this theory in his compendium remarked on the fact that no notable con­ entitled Practica 10. Serapionis (190). tributions were made to medical literature, The author of the most popular encyclo­ including that pertaining to leprosy ( 5), for pedia of medieval medicine, in the 13th cen­ more than a century after the Black Death. tury, the Franciscan Bartholomaeus Angli­ The effects of the cataclysmic plague pan­ cus (21) testified that persons afflicted with demic that killed an estimated 43 million leprosy have "redde whelks and pymples in people in the Christian world during the mid the face , out of whom oftenne runne blood 1300's, are impossible to assess. It is impor­ and matter; en such the noses swellen, and tant to note, however, that an added obstacle 43 , 2 P. A. Kalisch: Research on the History 0/ Lepros.\' 13 1 during that time was implicit in the lack of tran sla ted int o Engli sh in 1630. Philippus the printing press to foster the distributio n Schopff of Augsburg published a nother spe­ of the knowledge tha t did exist. Books were cialized effort in 1582 (21~ ) followed four written by ha nd and copies were expensive.