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CHAPTER V THE
LEPER IN “From the benefactions and possessions charitably bestowed upon the hospital, the hunger, thirst and nakedness of those lepers, and other wants and miseries with which they are incessantly afflicted . . . may be relieved..” (Foundation Charter of Sherburn.) At the outset it is necessary to state that inmates of lazar-houses were not all true lepers. Persons termed leprosi, infirmi, elefantuosi, languidi, frères malades, meselles, do not necessarily signify lepers in a strict sense. Gervase of Canterbury, writing about 1200, speaks of St. Oswald’s, Worcester, as intended for “Infirmi, item leprosi” ; and these words are used synonymously in Pipe Rolls, charters, seals, etc. “Leprosy” was an elastic term as commonly used. In the statues of one hospital, --48-- the patriarch Job was claimed as a fellow-sufferer—“who was so smitten with the leprosy, that from the sole of his foot to the crown of his head there was no soundness in him.” A lazar was one “full of sores,” and any person having an inveterate and loathsome skin-eruption might be considered infected. Disfiguring and malignant disorders were common. Victims of scrofula, lepra, lupus, tuberculosis, erysipelas (or “St. Anthony’s fire”) and persons who had contracted disease as the baneful result of a life stained with sin, would sometimes take advantage of the provision made for lepers, for in extremity of destitution this questionable benefit was not to be despised. In foreign lands to-day, some are found not unwilling to join the infected for the sake of food and shelter ; we are told, for example, that the Hawaiian Government provides so well for lepers that a difficulty arises in preventing healthy people from taking up their abode in hospitals. On the other hand, it often happens that those who are actually leprous refuse to join a segregation-camp. No one,
however, can deny that
leprosy was once exceedingly prevalent, and after weighting all that
might be
said to the contrary, Sir J. Y. Simpson and Dr. George Newman were
convinced
that the disease existent in I. Pioneers of Charity One practical outcome of the religious revival of the twelfth century was a movement of charity towards the outcast. The Lazarus whom Jesus loved became linked in pious minds with that Lazarus ulceribus --49-- plenus neglected by men, but now “in Abraham’s bosom,” and the thought took a firm hold of the heart and imagination. Abandoned by relatives, loathed by neighbours, the famished leper was now literally fed with crumbs of comfort from the rich man’s table. The work of
providing for
“Christ’s poor,” begun by the great churchmen Lafranc and Gundulf, was
carried
into the realm of personal service by Queen Maud (about 1101), the
Abbot of
Battle (before 1171) and High, Bishop of Lincoln (about 1186). Queen Maud is the brightest ornament of the
new movement. Like St. Francis of “He especially compassionated the forlorn condition of those afflicted with leprosy and elephantiasis, whom he was so far from shunning, that he frequently waited upon them in person, washing their hands and feet, and, with the utmost cordiality, imprinting upon them the soothing kisses of love and piety.” St. High used
to visit in certain
hospitals, possibly those at --50-- See or the
Mallardry at Lincoln.1 He would even
dwell among the
lepers, eating with them and ministering to them, saying that he was
inspired
by the example of the Saviour and by His teaching concerting the beggar
Lazarus. On one occasion, in reply to a
remonstrance from his Chancellor, he said that these afflicted ones
were the
flowers of
These noble pioneers were doubtless important factors in moulding public opinion. They may often have out stepped the bounds of prudence, but, as one has observed, “an evil is removed only by putting it for a time into strong relief, when it comes to be rightly dealt with and so is gradually checked.” As long as possible the world ignored the existence of leprosy. The thing was so dreadful that men shut their eyes to it, until they were shamed into action by those who dared to face the evil. The Canon of the Lateran Council of 1179 acknowledged that unchristian selfishness had hitherto possessed men with regard to lepers. We need not suppose that the heroism of those who ministered to lepers was that which boldly faces a terrible risk, but it was rather that which overcomes the strongest repulsion for hideous and noisome objects. There is no hint in the language of the chroniclers of encountering danger, but rather, expression of horror that any should hold intercourse with such loathsome creatures. The remonstrance’s of Prince David and of William de Monte were not primarily on account of contagion.—“What is it that thou doest, O my lady? --51-- surely if the
King knew this, he
would not deign to kiss with his lips your mouth thus polluted with the
feet of
lepers ! ” “When I saw Bishop Hugh touch
the livid face of the lepers, kiss their sightless eyes or eyeless
sockets, I
shuddered with disgust.”—If St. Francis raised an objection to inmates
wandering outside their precincts, it was because people could not
endure the
sight of them. The popular opinion
regarding
the contagious nature of the disease developed strongly, however,
toward the close
of the twelfth century. The Canon De Leprosis ( 3. Civil Jurisdiction (a)
The Writ for Removal.—The right to expel
lepers was acknowledged before it was legally enforced.
An entry upon the statue-book may be merely
the official recognition of an established custom.
The fact that where use and wont are
sufficiently strong, law is unnecessary, is illustrated to-day in --52-- of his friends to a certain Maladria in Bidelington, where he abode for two years. This was the leper-house near Bramber, mentioned four years previously in a Close Roll as “the hopsital of the infirm of St. Mary Magdalene of Bidelington.” Legislation on
this subject was chiefly
local. The Assizes of London had
proclaimed in 1276 that “no leper shall be in the city, nor come there,
nor
make any stay there.” Edward III
supplemented existing measures by an urgent local edict for This social problem continued to vex municipal authorities. A precept was issued (1369) “that no leper beg in the street for fear of spreading infection.” The porters of the eight principal gates of the city were sworn --53-- to refuse them admittance. (That barbers—forerunners of the barber-chirurgeons—were included among the gate-keepers in 1310 and 1375, was perhaps due to their supposed capability of recognizing diseases.) If a leper tried to enter, he should forfeit his horse or his outer garment, and if persisting, be taken into custody. The foreman at “le loke” and an official at the Hackney lazar-house were also bound to prevent their entry into the city. The “Customs of Bristol,” written down by the recorder in 1344, declare “that in future no leper reside within the precincts of the town.” Imprisonment was the penalty—a plan of doubtful wisdom. The measures ordained by the burgesses of Berwick-on-Tweed were summary :— “No leper shall come within the gates of the borough ; and if one gets in by chance, the serjeant shall put him out at once. If one willfully forces his way in, his clothes shall be taken off him and burnt, and he shall be turned out naked. For we have already taken care that a proper place for lepers shall be kept up outside the town, and that alms shall be there given to them.” 5 --54-- Municipal
documents record the
expulsion of lepers. In The law
evidently had no power to
touch a leper unless he made himself a source of public danger. No one interfered with him as long as he
remained in a quiet hiding-place, quitting it, perhaps, only at night. Individuals, sheltered by the affection or
self-interest of relatives, might never come under the ban of the law :
in the --55-- that it lies where a leper is dwelling in a town, and will come into the church or amongst his neighbours.7 English
legislation was never
severe regarding lepers. We may believe
that the tolerant sprit of a certain thirteenth-century Scottish canon
prevailed throughout “And in this same yere [1318] (sic) the Mysseles [lepers] (sic) thorow oute Cristendam were slaundered that thei had mad couenaunt with Sarasines for to poison alle Cristen men, to put uenym in wellis, and alle maner uesseles that long to mannes use ; of which malice mony of hem were conuicte, and brent, and many Jewes that gave hem councel and coumfort.” 9 --56-- declares “that
the mezel cannot
be heir to any one.” In the days of
Stephen, for example, Brien Fitz-Count was lord of On the other
hand, Lord Coke
declares that “ideots, leapers &c. may be heires,” and he comments
thus
upon Bracton and Britton :— “if these ancient writers be understood of
an
appearance in person, I think their opinions are good law ; for
[lepers] (sic)
ought not to sue nor defend in proper person, but by attorney.” 13 Possibly the
Norman custom of disinheritance
prevailed in --57-- de Gaugy proves that in 1278 this Northumbrian baron was not liable to forfeiture. He was excused, indeed, from appearing in the presence of Edward I, but was directed to swear fealty to an official. Although spoken of as his brother’s heir, Adam did not long enjoy his property. He died the same year, childless, but leaving a widow (Eve), and the barony passed to a kinsman. 14 The Norman maxim that the leper “may possess the inheritance he had before he became a leper” is illustrated by the story of the youthful heir of Nicholas de Malesmeins. Having attained full age, he left the hospital where he had been confined, appeared before his feudal lord, did homage, made his payment, and entered his fief. 15
Although
leprosy was a penal
offence, only laymen could be cited and dealt with by the king, mayor
or feudal
lord. Clerks in holy orders had to answer
to their bishop. In the case of
parochial clergy, the diocesan was responsible for their suspension
from
office, as stated by the Canon De
Leprosis. Lucius III (1181-1185)
decreed that they must serve by coadjutors and wrote to the Bishop of
Lincoln
on the subject. 16
The Episcopal registers of --58-- minister the
sacraments, cited
him to appear at Rose with a view to appointing a coadjutor. 17 It was ordered
by Clement III that when clergy
were thus removed, they should be supported from the fruits of their
benefices. Sir Philip, the leper-priest
of St. Neot in
The duty of reporting and examining cases fell to the clergy, doctors, civil officers or a jury of discreet men. (Cf. Fig. 7.) A curiously complicated lawsuit brought into the King’s court in 1220 relates how a certain man had custody of the children of Nicholas de Malesmeins. When the eldest-born became a leper, his perplexed guardian took the young man to the King’s Exchequer, and before the barons of the Exchequer he was adjudged a leper, and consigned to a hospital. (See pp. 52, 58.) [Illustration:
Leper and
Physician.] In ordinary
cases, the leper
would show himself to the parish priest as the only scholar. It was the village priest who helped the
stricken maiden to enter “Badele Spital” near --59-- cure, as
related by Reginald of
Durham. (See p. 97.) The register of
Bishop Bronescomb of The writ of removal ordered the careful investigation of cases in the presence of discreet and lawful men having the best knowledge of the accused person and his disease. Probably the best was not very good, for many judged by the outward appearance only. The Bishop of Lincoln, directing the resignation of a clergyman (1310), says that he is besprinkled with the spot of leprosy. The decree of 1346 condemns “all those who are found infected with leprous spots” to be removed. Anthony Fitz-Herbert, writing in 1534, points out that the writ is for those “who appear to the sign of all men that they are lepers,” by their voice, disfigurement and noisome condition. In medical treatises, great stress was laid on the necessity of investigation with pondering and meditation. The Rosa Anglica of John of Gaddesden (physician to Edward II) declares that “no one is to be adjudged a leper, and separated from intercourse of mankind, until --60-- the figure and
form of the face
is actually changed.” The contemporary
French doctor, Gordon, uses almost the same words ; and, repeating his
precautions, observes that “lepers are at the present day very
injudiciously
judged.” A later writer, Guy de Chauliac
(circa 1363) says :— “In examination and judgement of lepers, there must be much circumspection, because the injury is very great, whether we thus submit to confinement those that ought not to be confined, or allow lepers to mix with the people, seeing the disease is contagious and infectious.” Sir. J. Simpson gives copious extracts from Guy’s Chirurgia, which has also been translated into modern French (1890). Guy describes fully the examination of a suspected person, giving in detail all possible symptoms. It may here be observed that Bartholomew Angelicus, his contemporary, enumerates among the causes predisposing to leprosy, dwelling and oft talking with leprous men, marriage and heredity, evil diet—e.g. rotten meat, measled hogs, flesh infected with poison, and the biting of a venomous worm : “in these manners and in many other the evil of lepra breedeth in man’s body.” Guy advises the doctor to inquire if the person under examination comes of tainted stock, if he have conversed with lepers, etc. He must then consider and reconsider the equivocal and unequivocal signs of disease. After a searching investigation—not to be confined to one day—the patient must either be set free (absolvendus) with a certificate, or separated from the people and conducted to the lazar-house. About the time
that John of
Gaddesden was professor of medicine at --61-- leprosy,
“experienced physicians”
were summoned to examine a provincial magnate. The
mayor and bailiffs of royal “as it appears, from
the
inspection and examination before our council by the council and by
physicians
expert in the knowledge of this disease, that the said Peter is whole
and
clean, and infected in no part of his body.” A few days later the sheriff of Hampshire was directed to make a proclamation to the same effect, so that Peter might dwell as he was wont unmolested. 20 The royal
mandate of 1346
reiterated the stipulation that men of knowledge should inquire into
suspected
cases. It therefore seems unlikely that
a There is an
interesting document extant
concerning a certain woman who lived at --62-- authority of a medical certificate of health. The neighbours of Johanna Nightingale petitioned against her, complaining that she habitually mixed with them and refused to retire to a solitary place, although “infected by the foul contact of leprosy.” A writ was therefore issued by Edward IV commanding a legal inquiry. Finally, Johanna appeared before a medical jury in the presence of the Chancellor. They examined her person, touched and handled her, made mature and diligent investigation, going through over forty distinctive signs of disease. She was at length pronounced “utterly free and untainted,” and the royal physicians were prepared to demonstrate this in Chancery “by scientific process.” 21
Alleviation was
sometimes sought in medicinal waters. Here
and there the site of a hospital seems to have been
selected on
account of its proximity to a healing spring, e.g. Harbledown, Burton
Lazars, Tradition
ascribes to bathing
some actual cures of “leprosy.” Bladud the Briton, a prehistoric
prince, was
driven from home because he was a leper. At
length he discovered the --63-- from early
days, for there was
long distributed in [Illustration:
Elias, Leper
Monk.] There was
rivalry between the
natural water of --64-- the martyr less
than he ought to
have done, and might not have countenanced the pilgrimage.
On his way, Elias met returning pilgrims, who
gave him some of the water of We see from the story of the monk Elias that the ministrations of the physicians and the use of medicine were sought by lepers. Bartholomew says that the disease, although incurable “but by the help of God” when once confirmed, “may be somewhat hid and let, that it destroy not so soon” ; and he gives instruction about diet, blood-letting, purgative medicines, plasters and ointments. Efficacious too was (we are told) the eating of a certain adder sod with leeks. There is no information forthcoming as to the remedial treatment of lepers in hospital. The only narrative we possesses Chatterton’s lively description of St. Bartholomew’s, Bristol, the Roll of which he professed to find ; it satisfied Barrett, a surgeon, and a local, though uncritical, historian. A father of the Austin Friary came to shrive the lepers (for which he received ten marks) and to dress --65-- their sores (for which he was given fifty marks) saying, “lette us cure both sprite and bodye.” When barber-surgeons came for an operation—“whanne some doughtie worke ys to bee donne on a Lazar”—friars attended “leste hurte ande scathe bee done to the lepers.” The friars’ knowledge was such that barber-surgeons were willing to attend “wythoute paye to gayne knowleche of aylimentes and theyr trew curis.”
Disease was sometimes regarded as an instrument of divine wrath, as in the scriptural case of Gehazi. Thus Gilbert de Saunervill after committing sacrilege was smitten with leprosy, whereupon he confessed with tears that he merited the scourge of God. The popular view that it was an expiation for sin is shown in the romance of Cresseid false to her true knight. But except in signal cases of wrong-doing this morbid idea was not prominent ; and the phrase “struck by the secret judgement of God” implies visitation rather than vengeance. Indeed, the use of the expression “Christ’s martyrs” suggests that the leper’s affliction was looked upon as a sacrifice—an attitude which illuminated the mystery of pain. St. Hugh preached upon the blessedness of such sufferers : they were in no wise under a curse, but were “beloved of God as was Lazarus.” Those responsible for the care of lepers long ago realized exactly what is experienced by those who carry on the same extraordinarily difficult work to-day, namely, that leprosy develops to a high degree what is worst in man. Bodily torture, mental anguish, shattered nerves almost amounting to insanity, render lepers wearisome --66-- and offensive to themselves no less than to others. These causes, together with the absence of the restraining influence of family life, make them prone to rebellious conduct, irritability, ingratitude and other evil habits. Hope was, and is, the only thing to transform such lives, else intolerable in their wintry desolation. St. Hugh therefore bade lepers look for the consummation of the promise :— “Who shall change our vile body, that it may be fashioned like unto His glorious Body.” 24 Alleviation of the agonized mind of the doomed victim was undertaken first by the physician and afterwards by the priest. A recognized part of the remedial treatment advocated by Guy was to comfort the heart. His counsel shows that doctors endeavoured to act as physicians of the soul, for they were to impress upon the afflicted person that this suffering was for his spiritual salvation. The priest then fulfilled his last duty towards his afflicted parishioner :— “The priest . . . makes his way to the sick man’s home and addresses him with comforting words, pointing out and proving that if he blesses and praises God, and bears his sickness patiently, he may have a sure and certain hope that though he be sick in body, he may be whole in soul, and may receive the gift of eternal salvation.” --67-- his consolation the verse of Isaiah is recited :— “Surely He hath borne our griefs and carried our sorrows, yet did we esteem Him as a leper, smitten of God and afflicted.” The same passage from the Vulgate is quoted in the statutes for the lepers of St Julian’s :— “amongst all infirmities the disease of leprosy is more loathsome than any . . . yet ought they not on that account to despair or [Illustration:
A Leper.] murmur against God, but rather to praise and glorify Him who was led to death as a leper.” After separation the fate of the outcast is irrevocably sealed. Remembering the exhortation, he must never frequent places of public resort, nor eat and drink with the sound ; he must not speak to them unless they are on the windward side, nor may he touch infants or young folk. Henceforth his signal is the clapper, by which he gives warning of his approach and draws attention to his --68-- request
[request for alms]. (Fig.
26.) This instrument consisted of tablets
of wood, attached at one end with leather thongs, which made a loud
click when
shaken. In Compelled to leave home and friends, many a leper thus haunted the highway—his only shelter a dilapidated hovel, his meager fare the scraps put into his dish. To others, the lines fell in more pleasant places, for in the hospital pain and privation were softened by kindness. --69-- ~Footnotes -end chapter five-
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