Leprosy and tuberculosis in the Byzantine 

 monasteries of the Judean Desert 



Joseph Zias 



In his classic work of 191 1 on biblical 

 medicine, the German physician J. 

 Preuss noted that there were nearly as 

 many books and treatises on the subject 

 of biblical leprosy as there were on cir- 

 cumcision in the Bible (Preuss 1978). 

 However, despite the plethora of writ- 

 ten information on this ancient disease 

 which, according to literary sources, 

 existed as early as 600 B.C., scant ar- 

 cheological evidence of leprosy exists 

 prior to a.d. 1200. In fact, prior to the 

 publication of Preuss's encyclopedic 

 work, there had been only one find 

 from the postbiblical period (a.d. 5(X)) 

 in Nubia (Smith and Dawson 1924). 

 Even today, despite the intense world- 

 wide activities of archeologists and 

 physical anthropologists, no indisputa- 

 ble physical evidence of the disease has 

 been found, with the exception of iso- 

 lated instances in the United Kingdom, 

 North Africa, and the cemeteries of me- 

 dieval Danish leprosaria. In Israel, 

 where evidence of man's presence is 

 over one million years old, and where 

 thousands of skeletal remains have 

 been uncovered, evidence of leprosy 

 has eluded us. In fact, S.G. Browne 

 noted in 1975 that not a single case had 

 ever been found in ail of the Fertile 

 Crescent. 



In the spring of 1983, excavations 

 were carried out at the Judean Desert 

 monastery of Martyrius, which had 

 been founded in the fifth century and 

 destroyed by the Persians in a.d. 614, 

 never to be rebuilt. Here a common 

 grave was discovered in an ancient 

 church fioor, dated by inscription to 



Zagreb Paleopathology Symp. 1968 



492. The grave contained the skeletal 

 remains of nine men and one woman, 

 four of whom showed bilateral mutilat- 

 ing changes on the hands and feet 

 which were originally thought to be as- 

 sociated with leprosy (Figure I ). Sub- 

 sequent study of the material by the au- 

 thor with American and European 

 specialists in paleopathology showed 

 that our original diagnosis of leprosy 

 was incorrect. Despite the widespread 

 involvement of the small bones of the 

 extremities with numerous lytic de- 



.rf^ 



structive foci, the concentric absorp- 

 tion of the phalanges, metatarsal and 

 metacarpal bones, which is common in 

 leprosy, was absent. Moreover, three 

 individuals showed ankylosis of the 

 vertebral column and the sacroiliac 

 joint, which is not usually associated 

 with leprosy. The widespread skeletal 

 involvement of the disease with varying 

 degrees of architectural destruction 

 suggests that psoriatic arthritis is the 

 preferred clinical diagnosis rather than 

 leprosy as was earlier reported (Zias 



Figure I. Phalanges of the hand. (Courtesy of Israel Antiquities Authority. T 

 Sagiv) 



197 



