Over the next few days I’m going to be discussing the topic of leprosy from three perspectives: bioarchaeological, historical, and archaeological. As Roberts and Cox wrote in 2003 “The study of disease is multidisciplinary and interdisciplinary, and if it is not approached in this way then what is the point?”
Introduction to Leprosy
Epidemic disease has had a significant effect on the course of history, but we cannot directly excavate the bacterium that caused the disruptions. Leprosy was an epidemic disease that not only infected millions of people over a span of thousands of years, but it still remains a threat in Third World countries. Due to its destructive effects on the flesh of those infected, leprosy created a history of fear and segregation caused by misconceptions and rumor. In the United Kingdom, during the Middles Ages, 1050 to 1550 CE, leprosy reached its highest prevalence. In the mid-twelfth century alone it is estimated that there were 1.5 million cases of leprosy in England and Scotland (Covey 2001:317). Based upon the high number of people affected by the disease and the strong biocultural response to it, leprosy provides an appropriate candidate to conduct a multidisciplinary analysis of its prevalence and consequences in the past.
Large excavations throughout the United Kingdom and Europe, and have found indicators of leprosy in skeletal material. However, skeletons cannot inform on their full medical history, and we can only see what was imprinted on their bone (Roberts and Cox 2003:16-17). According to Wood et al. (1992:357) there is a “complex relationship between health of a community and the characteristics of the skeletons it leaves behind”. In order to mediate this relationship, they argue that there needs to be further development in the understanding of the role that cultural context plays in shaping the remains (Wood et al. 1992:357-8). Manchester and Roberts (1989:265) argue that the most objective way of finding leprosy in the past is through study of the skeletal remains of the population. DNA testing using polymerase chain reactions, in order to amplify bacteria in bone samples, has been able to isolate leprosy and recognize the disease with high accuracy in 14th century skeletons (Taylor et al. 2000:1133). While these provide a direct means of studying those infected by Mycobacterium leprae, Brown et al. (1996:183) argues that “Diseases cannot be explained as purely ‘things in themselves’; they must be analyzed and understood within a human context”. A purely biological approach ignores who the medieval population considered leprous. It is the social and religious beliefs that create this gap between the social community and their physical remains.
A solution for resolving the divide between the past actions of living populations and the physical, historical and material remains that we find in the archaeological record is to use them in conjunction to create a broader understanding. The research being done on leprosy in the United Kingdom focuses on either the historical documents or the skeletal remains. A more informed approach would involve the synthesis of the archaeology of the time period, historic texts and maps, and information on the skeletal population, both diseased and healthy. “Medieval leprosy affords perhaps the Western world’s clearest and most dramatic example of the relationships between disease, social stigmatization, and theological interpretation” (Hays 2005:35). To understand disease in the past, we must take a holistic viewpoint, looking first at the most direct evidence: the skeletal indicators of disease. Then, by considering historical and archaeological data, we will be able to understand how leprosy manifests itself in the archaeological record.
The next series of posts intends to show how there are specific markers in each of these three data sets, that when combined will make a powerful tool for interpreting medieval leprosy in the United Kingdom.
Works Cited will be posted in the final section as a reference guide for leprosy.