CHAPTER LXIX 



LEPROSY 



Synonyms — Lefinilion — History — Climatology — ^Etiology— Sym.ptomatology 

 — Diagnosis — Prognosis — Treatment — Prophylaxis— References. 



Synonyms. — Elephantiasis Graecorum. French : La Ldpre. Italian : Lebbra. 

 German: Aussatz. Norwegian : Spedalskhed. Arabic: Djudsam. 



Definition. — Leprosy is a chronic general disease, caused by the 

 Mycobacterium leprca Hansen, 1874, (usual term Bacillus lepm), 

 which produces characteristic lesions in the skin, mucosae, and 

 nerves. The method of infection is unknown. 



History. — Even at the present time there is occasionally much 

 difficulty with regard to the diagnosis of leprosy from allied diseases, 

 and therefore in ancient times and in the Middle Ages syphilis 

 and skin diseases without doubt were confused with it. Hence 

 the history is not easy to write. Nevertheless, such a repulsive 

 and striking disease must have been noticed by the ancients, and 

 therefore it is possible that the references in the Ebers Papyrus, 

 and in the English Bible, the Rig Veda, and ancient Japanese 

 books, actually refer to what we call leprosy, together with other 

 diseases, li this is so, leprosy is indeed ancient and widespread. 

 Certain authorities, however, are of opinion that the Hebrew word 

 Tsaraath, which the translators of the Bible have rendered as 

 leprosy, does not refer to such disease. It is probable that 

 the malady passed from Egypt to Greece, and later to Italy, 

 by means of Pompey's troops, and that it was disseminated 

 throughout Europe by the Roman legions, by traders, and later, 

 perhaps, by the Crusaders returning from the East. In any case, 

 leprosy gradually increased in Europe from the days of Pompey till, 

 in the thirteenth century, it existed to such an extent as to move 

 Church and State alike to combat its ravages. Stern measures were 

 enforced, and the lepers were isolated in lazarettos. They were com- 

 pelled to wear a special dress, to use a clapper when passing along 

 the roads, to only indicate with a stick the articles they desired to 

 buy in a market; while they were forbidden to drink frcm public 

 fountains, to touch children, to speak to a healthy person in a loud 

 voice, or to eat with any person other than a leper. Further, the 

 Church performed the Burial Service over a person who was diag- 

 nosed to be a leper, and therefore officially he was dead. The result 

 of this appears to have been beneficial, as the number of lepers 



1644 



