Although there is possible skeletal data which indicates that leprosy was in Britain in the 5th century, its social importance and biological prevalence peaked during the Late Medieval Period, approximately 1050 to 1550 C.E. (Manchester and Roberts 1989:267). The United Kingdom from 1050 to 1550 C.E. is characterized by strong religious zeal resulting from the crusades, and urban expansion. Urbanization caused poor living conditions, inadequate sanitary situations, and slow development of health related public works, which exacerbated the development of disease. This period was not only host to leprosy, but the Black Plague. In an effort to maintain control during a time of epidemics and fluctuating population size, the Church attempted to mediate by maintaining the social order and defining the way that diseases were to be viewed (Roberts and Cox 2003:391).
With the establishment of Christianity in the Early Middle Ages, there was little improvement in medicine or science. All knowledge of disease was either outdated, based on Ancient Greek views, or was taken directly from the religious texts (Roberts and Cox 2003:250). The Bible served not only as a spiritual guide, it was the only source of information that the Medieval people used to understand disease (Covey 2001:316). The prevalent belief was that spiritual deformation would lead to physical manifestations of the sins one committed (Rawcliffe 2006:48). The Bible has very specific rules for dealing with lepers and leprosy. Leviticus 13 proposes that a person who has skin blemishes, spots of inflammation or swelling which turn into “a leprous disease” should appear before a priest for their diagnosis (Coogan 2001:160HB). If the disease goes deeper than being a superficial skin problem, he is pronounced unclean and is only clean again when the flesh is clear of blemishes (Coogan 2001:161HB).
Descriptions such as this can reasonably be construed to indicate the presence of leprosy, however there are a number of inconsistencies such as the ability for leprosy to be just an itch and that it can be cured spontaneously. Lewis (1987) discusses how the Bible makes no reference to deformation, anesthetization of the extremities, and seems to be limited to skin damage. This discrepancy stems from a Medieval misconception of disease in the earliest versions of the Bible. The original Hebrew word used to describe the spiritual uncleanliness associated with skin problems was tsara’ath or zara’at (Cule 2002:150). When translated by the Greeks, the word zara’at was changed to lepra, which denoted scaled skin. The Greek leprosy we know today was referred to as elephantiasis, and lepra was a skin disease. When translated into Latin in the 11th century C.E., the word lepra continued to be used despite an association with the wrong disease (McEwen 1911:196). This series of translations and mistranslation led to the confusion that the leprosy as described by the bible was the same as leprosy the disease not only in the Middle Ages, but also in our present day society.
The two primary sources for information on dealing with leprosy were from the Bible or Greek medicine. Based on the Christian doctrine lepers were to be ostracized and segregated from society, for fear of moral and physical infection. In Leviticus 13.46, it reads that when there is a person with a “leprous disease” that they “shall remain unclean as long as he has the disease; he is unclean. He shall live alone; his dwelling shall be outside the camp” (Coogan 2001:162HB). The church also supported and perpetuated this belief; Pope Gregory I, in the 7th century C.E., thought that heresy was the cause of leprosy (Covey 2001:316). The cure for leprosy was the same as the cure for any sin: penance, prayer and faith.
A second considered cause of infection was an imbalance in humours or natural spirits, based on the Ancient Greek idea of health relating to balance of elements. Leprosy was thought to be contracted through airborne miasmas released from the infected person, and that scented pomanders with the proper humoral properties could neutralize its harmful effects (Roberts and Cox 2003:250). Based on the humoral concept of disease, leprosy could be easily cured by counteracting humours. Leprosy was a disease that was related to the element of fire, characterized by causing the body to become “hot and dry”. The cure was to eat and drink things which were “cold and wet” (Rawcliffe 2006:65-71). Other, more “medical”, cures of leprosy included blood-letting, and the consumption of scorpions and dirt taken from ant hills (Roberts and Cox 2003:270).
A diagnosis of leprosy in the Middle Ages “separated a man from society because of the infection he carried outwardly and the moral corruption that lay within him” (Brody 1974:59). De Leproso Amovendo, a writ in English Law from 1100 C.E., states that before a leper is to be removed from society, they must first have visible signs of disfigurement by the disease (Cule 2002:151). Diagnosis could range from a physical examination of the body for sores, to inspection of urine color, and consultation with astrological charts (Steane 1984:97). The act of separating a leprous individual from the community was a rite of passage known as the “Leper Mass”. This symbolic funeral proclaimed the infected individual as “dead to the world, but alive unto God” (Manchester and Roberts 1989:267). From this point, the leper was ostracized from society, with the leprosaria as his only form of safety.
This act of quarantining all lepers beyond city walls was viewed as the only way to be safe from infection, both physical and spiritual. Numbers 5.1-4 states: “The Lord spoke to Moses saying: Command the Israelites to put out of the camp everyone who is leprous… they must not defile their camp, where I dwell among them” (Coogan 2001:195HB). In 1179 C.E., Pope Alexander III issued a decree stating that lepers should be separated from healthy communities, worship in their own churches and be buried in leper cemeteries (Covey 2001:318). Lepers were also forced to identify themselves as diseased by wearing special clothing, like tunics with yellow crosses or ‘L’ stitched to them and carry bells (Covey 2001:318). This social degradation would have further asserted their separation from society. The healthy society was able to rid themselves of both leprous people and leprous food.
There are a number of historical limitations to this data. Due this misconceptions of the disease “no assertion of leprosy in old times can be accepted as indicating an infection with Hansen’s bacillus in the absence of clinical details sufficient to point the diagnosis” (Møller-Christensen and Hughes 1962:177). Another problem is the high subjectivity of historical accounts from later periods. Rawcliffe (2006:17-19) discusses how in the 19th century, the threat of contagion and the methods of eradication during the Middle Ages were glamorized for political purposes. Medieval documents have an extremely high chance of subjectivity. Not only were they mainly written by the elite, but many of them are fragmentary. The survival rate of medieval texts is highly variable, and there is no indication of its objectivity (Steane 1984:12). There is no way we can know the true extent of the perceived epidemic and to what degree it actually affected the lives of the British in the medieval times.