Leprosy In Ancient And Early Medieval Times: WITH ESPECIAL REFERENCE TO THE

FRANKS
Author(s): Harold S. Snellgrove
Source: The Mississippi Quarterly , July 1954, Vol. 7, No. 4 (July 1954), pp. 1-10
Published by: The Johns Hopkins University Press

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 Leprosy In Ancient And Early Medieval Times
WITH ESPECIAL REFERENCE TO THE FRANKS

by

Harold S„ Snellgrove

Introduction

The early history of leprosy is rather difficult to follow. The Old

Testament contains numerous references to the disease, but modern medical
historians have proved that the Biblical terminology was used for a number of
skin diseases.1 In addition to Biblical writers, other artcient authors used the
word lepra to include such diseases as psoriasis, eczema, and various skin
disorders, -- possibly even syphilis?
Leprosy today, however, appears to be more analagous to what the
ancient world called elephantiasis. Although Artura Castiglioni suggests that
"Constantine the African (11th century) seems to have been the first writer to
give to leprosy its specific connotation,"3 Scribonius Largus, physician to
Emperor Claudius, indicated that during his day the words lepra and elephan
tiasis 'were being used synonymously.4

Leprosy appears to have been present in Egypt and the ancient Near
East from early times. That it existed in Persia around the seventh century
B. C. is evident from the writings of the Greek historian, Herodotus, who
claimed:

If a Persian has the leprosy he is not allowed to enter

a city, or to have any dealings with the other Persians;
he must, they say, have sinned against the sun. For
eigners attacked by this disorder are forced to leave
the country:. . . 5

Harold S.Snellgrove,who is Associate Professor of History at Mississippi

State College, is engaged j.n a study of French Medieval Leper Houses. This is
the introductory chapter.
^Isadore Duer,"Leprosy" in Tfilliam Osier and Thomas McCrae,Modern M
cine. Its Theory and Practice, 3 vols. (Philadelphia, 1907), III, 121. For a
detailed study of Biblical leprosy,see George Henry Tox, "Biblical and Modern
Leprosy" in Popular Science Monthly, XXIV (November, 1883-April, 1884), 797
800 and E. L. McEwen, "The Leprosy of the Bible in its Medical Aspect" in
Biblical Worldt XXX (1911), 194-202.
2
Arturo Castiglioni, A History of Medicinet trans, by E, G. Krumbhoar
(New York, 1941), p. 73.
3Ibid., p. 73.
4Scribonius Largus, Compositiones, ed. by George Helmreich (Leipzig,
1887), p. 97. 'Hoc etiam lepram et quam elephantiam dicunt sanat....'
5
George Rawlinson, trans. ,The History of Herodotus, 3 vols, (New York,
1859), I, 215.
-1

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2

That the disease was prevalent in ancient Mesopotamia is apparent from the
stone landmarks excavated there,6 and that it was to be found in Palestine is
gained from Biblical references, uncritical though some of them may be.7

Mantheo, an Egyptian historian of about 300 B.C. stated that at the

time of the great exodus there were eighty thousand Hebrews afflicted with
lepra in Egypt.8 The Latin poet, Lucretius, writing in the first century B.C.,
called attention to the "elephant disease which is found by the river Nile in
mid-Egypt and nowhere else. "9 Oribasius, physician to Emperor Julian, in
the fourth century A. D. wrote that "this sickness is especially well-known to
the Egyptians, " and that this disease struck not only common people but also
kings.10 A. modern medical historian, however, believes that the earliest
Greek writers on medicine were unacquainted with Egyptian leprosy except by
hearsay.11
From the absence of references, it would appear that leprosy was
practically unknown among the Greeks,12 and the Roman writers on medic
were careful to point out that leprosy was an Egyptian disease, almost un
known in Italy. Celsus, who lived during the reigns of Augustus and Tiberius,
noted that leprosy was hardly known in Italy;13 and Pliny the Elder, who lived
about the same time, pointed out that leprosy was brought back to Italy by the
army of Pompey the Great.14 Evidently the disease made little headway, for
Oribasius, during the fourth century, observed that leprosy was still uncommon
in Italy. 15 Legend would have it, however, that during this same century
Fausta, wife of Emperor Constantine, influenced her husband to idolatrous
practices which caused him to become afflicted with leprosy. * 6

James A. Tobey, Riders of the Plagues (New York, 1930),p.21. See also
Henry E. Siegrist. A History of Medicine, in progress, Vol. Is Primitive and
Archaic Medicine (New York, 1951), pp. 381,398.
7Among the Biblical references, attention may be called to Lev. xiiis46
and Num. vî1-4. Tlavius Josephus, "Antiquities of the Jews" in The Work of
Flavius Josephusp trans, by William Whitston, 2 vols, in one (Philadelphia,
1870), I, 311, comments of leprosy among the Jews. See also footnote 1 supra.
Q

E. L. McEwen, op. cit., p. 195.

9Titus Luoretius Carus, De Berum Natura, trans, by W. H. D. Rouse (Lo
Classical Library) (London, 1931), p. 522. The reference may be found in VI,
11:1114-1115.

^"®M. Bu8semaker and Charles Daremberg, eds., Oeuvres d

(Paris, 1876), VI, 197.
^George Henry Yox, op. Cit., p. 800.
!«i o

Hippocrates and Galen have little to say of the disease. Cf. Cecelia
C. Mettler, History Of Medicine,Si. by Fred A. Mettler (Philadelphia, 1947
613-615.
13 n
Aulus Cornelius Celsus, De Medicina, trans, by W„ G«, Spencer, 2 vols.
(Cambridge, 1935), I, 342-345.
14
Caius Plinius Secundus (Pliny the Elder), Historia Naturalis XXXVII,
ed. by Gabriel Brotier, 6 vols. (Paris, 1779), Book xxviis Chapter 5.
150ribasius, op. Ctt.,VI, 197.
^Eusebius (of Caesarea), "Prologomena, Constantine the Great" in .45e
lect Library of Nicene and Post-Nicene Fathers of the Christian Church, ed.
by P. Schaff and H„ lace, second series, 13 vols. (New York, 1890-1900), II,
150.

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 3

By the fifth century leprosy seems to have spread northward in Europe.

B. M. Gould and W. L. Pyle believe that Gaul was invaded by leprosy about
the second century A. D.17 F. H. Garrison concluded that leprosy began to
spread into northern Europe in the sixth and seventh centuries. 18 There is
proof, however, that by the latter part of the fifth century leprosy had become
established in Gaul. By 460 a leper house was functioning in Saint Oyen, 19
and St. Severinus of Marseilles, who died around 488, is known to have shown
mercy to lepers. 20

By the middle of the sixth century, the number of lepers in Gaul must
have increased considerably; for a church council meeting at Orleans in No
vember 549 passed the ruling that priests should minister to lepers and give
them clothing. 21 Thirty-four years later at Lyons a provincial council ordered
that bishops should furnish food and clothing for lepers.22

An interesting reference to leprosy among the Franks had to do with a

certain leper who presented himself to a disciple of Saint Columbanus and
who, after treatment, went away healed. 23 Other references to leprosy in
the early Frankish state will be treated with respect to care, treatment, and
legislation. Suffice it to say, however, that leprosy must have become wide
spread by the time of Pepin and Charlemagne, for both rulers issued regula
tions governing the conduct of lepers. 24

Early Descriptions of Leprosy

One of the earliest descriptions of leprosy or elephantiasis is found in

the medical writings of Celsus, who wrote as follows:

The disease which the Greeks call elephantiasis whilst

almost unknown in Italy, is of very frequent occurance
in certain regions; it is counted among chronic affec

17b. m. Gould and *. L. Pyle, Anomalies and Curiosities of Medicine

(Philadelphia, 1900), p. 911.
iay. H. Garrison, An Introduction to the History of Medicine, 3 vols.
(New York, 1922), p. 170.
^®Sdirard Ehlers, "Leproseries Danoises du Moyen-Age" in «7cüUIS#IV (1899),
p. 191, citing Langebeck, ed., Scripta rerum danicarum, III» 568.
20"Vita s. Severini* in Monumenta Germcuiiae historica, Auetores Anti
quissimi, I, 20.
21j. D. Man si and others, eds., Sacrorum concilioram nova et amplissima
collectio, new edition, 53 vols. (Paris, 1901 ff), IX, 134.
22Mansi, IX, 943.
23
"Vita Columbani Abbatis Discipulorum que Eius Liber II* in M,£r,H.t
Scriptores Rerwn Meroving., IV, 147.
24~ • „ ;
See infra, pp.

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4

tions; in this the whole body becomes so affected that

even the bones are said to become diseased. The sur
face of the body presents a mutiplicity of spots and of
swellings, which, at first red, are gradually changed
to be black in color. The skin is thickened and thinned
in an irregular way, hardened and softened, roughened
in some places with a kind of scales; the trunk wastes,
the faces, calves and feet swell. When the disease is
of long standing, the fingers and toes are sunk under
the swelling: feverishness supervenes, which may
easily destroy a patient overwhelmed by such troubles.25

Cassius Felix, writing about 29 A. D. , declared that elephantiasis was

so called because of certain characteristics of the disease that were similar
to the calloused bodies of elephants. He further asserted that the disease
frequently caused the tips of the fingers to fall off, the voice to become uneven,
the breath to give forth a bad odor, and the eruptions of rotten blood to be
changed into a thickened quality.26 Pliny the Elder observed that the disorde
made its appearance in the form of a small pimple on the nose. From this the
disease spread over the whole face, mouth, breast, and hands, -- covering
them with foul eruptions.27

Aretaeus of Cappadocia, a Greek physician who lived in Rome during

the second half of the second century A. D. , gave a lurid account of elephan
tiasis. Of this disease, he wrote as follows:

But the commencement of the disease gives no great

indication of it; . . . nor does it display itself upon the
surface of the body, . . . but lurking among the bowels,
like a concealed fire it smolders there, and, having
prevailed over the internal parts, it afterwards blazes
forth on the surface, for the most part beginning, . . .
on the face, . . . but in certain cases from the joint of
the elbow, the knee, and knuckles of the hands and feet
.... upon the increase of the affection, the respiration
is fetid from the corruption within of the breath. . . .
Urine thick, muddy, like that of cattle. ...
* ff ♦

25
Celsus, De Medicina, pp. 342-345.
*? ß
Cagsiu8 Telix, De Medtcina ex Graecis Logicae Sectae Auctoribus Liber
Translatus Sub Artabure et Calepio Consulibus, ed. by Valentin Rose (Leipzig,
1879), pp. 177-178.
27
Pliny the Elder, Historia Naturalis, Book xxv, Chapter 2.

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 5

. . . Nose, with black protuberances, rugged; promi

nence of the lips thickened, but lower part livid; nose
elongated; teeth not white indeed, but appearing to be
so under a dark body; ears red, black, contracted, re
sembling the elephant. . . ; ulcers upon the base of the
ears. . . ; shrivelled all over the body with rough wrin
kles; but likewise deep fissures, like black furrows
on the skin; and for this reason the disease has got
the name elephas.
sfc * *

. . , Sometimes, too, certain of the members of the

patient will drop off, such as the nose, the fingers, the
feet, the privy parts, and the whole hands; for the ail
ment does not prove fatal, so as to relieve the patient
from a foul life and dreadful sufferings, until he has
been divided limb from limb. . . ,28

Marcellus Empiricus, a fourth century medical writer, observed that

elephantiasis first appeared on the face in the form of pustules of various and
unequal size. At length they so increased that the bones, the fingers, and the
limbs became affected. 29 Vegitius Renatus, noted that the signs of the disease
were a burning itch on the oack; hard scales, a fermenting of pustules in the
nostrils, feet, and head; the decaying of the stomach; the development of a
bitter cough; and a burning sensation in the mouth. 30 Prudentius in the same
century stated that leprosy corrupted the body, 31 and Oribasius noted that the
disease usually began on the face and that the nerves and bones soon became
diseased. 32

Saint Gregory of Nyssa, brother of Saint Basil, described leprosy in

most horrible terms. "What words could describe, " he said, "the unsightly
disfigurement of sufferers from leprosy. Gradually over all their limbs and
organs of sensation rottenness spreads and devours them."33 He also ob
served that their bodies were covered with wounds, sores, and gaping cavities
and that the odor from them was almost unendurable. 34

28
Aretaeus of Cappadocia,On the Causes and Symptoms of Chronic Diseases,
iif 13,29 oited in Mettler, History of Medicine, PP« 243-244.
Marcellus Empiricus, De Medicamentis liber, ed. by George Helmreioh
(Leipzig, 1889), passim.
30
Vegitius Renatus, "Ars Veterninariae sive Mulomedicinae* in Scriptores
Rei Rustica Veteres Latini, 4 vols. (Bipontus, 1787), I, 236.
31
Aurelius jPrudentius, Opera Omnia, 3 vols. (London, 1824), I, 191.
320ribasius, Oeuvres, VI, 197.
33 1
Gregory of
of Nicene a
34
Sister Mary Emily Zeenan, "StoGregory of Nazianzus and ^arly Byzantine
Medicine" in Bulletin of the History of Medicine, (1941), pp. 17,18.

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6

Evidently by the latter part of the sixth century, the words lepra and
elephantiasis were no longer being used interchangeably, for Saint Isidore of
Seville described each separately in his Etymologies. "In leprosy, " he says,
"the skin is covered with a roughness similar to scales, whence it takes its
name, whose color becomes black, then white, and then red. On the body of
man, leprosy is so diagnosed if at various times a different color appearsa
mongthe well parts of the skin, or if it is so diffused everywhere that it makes
the whole of the same defiled color, " 35 Elephantiasis, he states, "is called
a sickness from its similarity to elephants, whose hardness and toughness of
skin naturally gives the name to the sickness in men, because it makes the
surface of the body similar to the skin of elephants, or because the great
suffering brings forth the name. " 36

Cures and Treatment

Cures suggested.by the ancient writers are interesting. Celsus sug

gested the following:

At once, therefore, at the commencement, he should

be bled for two days, or the bowels loosened by a black
hellibore, then a scanty diet is to be adopted so far as
can be borne; after that the strength should be a little
reinforced and the bowels clystered; subsequently,
when the system has been relieved, exercise and run
ning is to be used. Sweating should be induced primarily
by the patient's own exertion, afterwards also by dry
sweatings, rubbing is to be employed with moderation
so that strength is preserved. The bath should be
seldom used; neither fatty nor glutinous nor flatulent
food; wine is properly given except on the first days.
Plantain crushed and smeared on seems to protect the
body best. 37

Scribonius Largus in the first century A. D. suggested that black sul

phur mixed with common oil would cure leprosy,38 and Cas sius Felix stressed
frequent purgations.39 Pliny the Elder believed that wild mint was good for
the disease, and that the disease was of so loathsome a nature that any form
of death was preferable to it. 40

35
"S.Isidori Hispalensis Episcopi Etymologiarum Libri lV*in J. P. Migne,
Patrologiae Cursus Oompletus, Series Latina, LXXXII, 191-192.
36Loc. Oit.
37
Celsus9 De Medicina, 342-345»
38
Scribonius Largus, Composttiones, p. 97.
39Cassius Felix, De Medicina. pp. 177-178.
40
Pliny the Elder, Historia Naturalis, Book xx,Chapter 22 and Book xxvi,
Chapter 1.

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 7

Marcellus Empiricus suggested that leprosy might be cured by the fol

lowing remedies: the ashes of a burned fish and burned elephant, mixed with
blood and smeared on the body; ground native soda with honey and an ox's
intestine; the root of asparagus boiled down in vinegar and tri ta; crushed wild
mint leaves; and cedar oil. He further suggested the placing of ground ele
campane upon the body. At first this would make the body sore, but by wiping
away the pus and decayed skin, the body would be new and without scars. 4*
Oribasius, on the other hand, suggested cooked vipers with a sauce made of
water, oil, warts, and "aneth"; purgatives; promenades; exercises; salves;
mineral water baths; sweats; and salves for the ulcers. 42

Although one reference to the use of oil43 and another to the use of th
bath 44 were found, most of the references to the cure of leprosy among th
Franks have to do with the supernatural powers of the clergy. An example is
pertinent: On a certain day, while Gaugericus, Bishop of Cambrai, was en
gaged in prayers, a certain leper came to him. Up to this time the leper had
been a sinner. Moved by the bishop, he was pardoned of his sins and was
baptized. Then after having heard mass and after having been blessed by the
bishop, the deacon, and the priest, the leper was as if he had never been af
flicted withleprosy.45 Similar stories appear in the Merovingian chronicles. 46

Attitude Toward Lepers

Something of the attitude of the ancients and the early Franks toward
lepers can be found in the sources. According to Herodotus, Persians af
flicted with the disease could not enter cities or have any dealings with other
Persians.*? From stone landmarks, it appears that lepers of ancient Baby
lonia were banished to the desert.48 Laws of the Jews condemned lepers to
the wilderness and forbade them from entering cities.49 And the Roman

■'■Marcellus Empirions, De Medicamentis, passim.

42
Oribasius, Oeuvres, vi, 197.
43"Vita Columbani Abbatis Discipulorum que Eius Liber II" in M.ff,H.,
Scriptores Herum Meroving., iv, 147.
44
"Vita Riohardii Confessoria Centulensis Actore Alouino" in M.G-.H.
Scriptores Herum Merooing., IV, 392.
45 •
"Vita
Meroving., Hl, 653.
46
Tor stories similar to that told in footnote 45 supra, see also "Vita
Desiderii Episcopi Viennensis" in M.Cr.H., Scriptores Berum Meroving., HI,
640, "Virtutes Tursei Afcbatis Latinacensis" in ibid., IV, 441, and "Vita
Romarici Abbatis Habendensis" in ibid., IV, 224.
47
Herodotus, History, *, 215.
43
James A. Tobey, Riders of the Plagues, P« 21 and Henry E. Siegrist, 4
History of Medicine, I, 381.
49
See footnote 7 supra.

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8

physician, Oribasius, writing in the fourth century, felt that lepers ought to
remain outside the city. 50

Fear of contagion from lepers also prevailed among the early Franks.
According to one writer, Rotharis, King of the Lombards, issued a regulation
in 643 depriving anyone afflicted with leprosy the right of remaining in the
kingdom and of holding property.51 In a capitulary of 757, Pepin, King of the
Franks, provided that "if a leprous man had a sound wife and wished to give
her freedom to marry again, she might do so if she wished. " The converse
of this was also true. 52 And Charlemagne later followed this law with another,
in which he stated that "lepers might not intermingle with other people. "53

Even though lepers were generally regarded with loathing and fear
during the ancient and early medieval times, at a rather early date certain
benevolent men began to show mercy to those afflicted with the disease. In a
panegyric on Saint Basil, Saint Gregory of Nyssa extolled the work of his
brother among lepers as follows:

There is no longer before our eyes that terrible and

piteous spectacle of men who are living corpses, the
greater part of whose limbs have mortified, driven
away from their cities and homes and public places
and fountains, aye, and from their own dearest ones,
recognizable by their names rather than by their fea
tures: they are no longer brought before us at our
gatherings and meetings, in our common intercourse
and union, no longer the objects of hatred, instead of
pity on account of their disease; composers of piteous
songs, if any of them have their voice still left to
them. Why should I try to express in their tragic
style all our experiences, when no language can be
adequate to their hard lot. He however it was, who
took the lead in pressing upon those who were men,
that they ought not to despise their fellow men, nor to

50
Oribasius, Oeuvres, VI, 197.
51
Agnes Lambert, "Leprosy Past and Present" in Nineteenth Century, XVI
(1884), p. 468.
52
"Capituiaria Pippini Francorum," in Recueil des historiens des Gaules
et de la France, V, 643 and "Pippini Capituiaria" in M.G-.H., Leges, I, sec. 2
p. 39. Basing his reference on the laws ol Rotharis, king of the Lombards,
Thomas Hodgkin, Italy and Her InvadersP vols.(Oxford, 1894), VI, 201
"If a woman became afflicted with leprosy, her betrothed was not bound to
marry her."
53 -
"Karoli Magni Capituiaria* in M.G-.H., Leges, I» sec. 2, p. 64.

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 9

dishonour Christ, the one Head of all, by their inhu

man treatment of them;. . . He did not therefore dis
dain to honor with his lips this disease, noble and of
noble ancestry and brilliant reputation though he was»
but saluted them as brethren, not as some might sup
pose, from vainglory, . . . but taking the lead in ap
proaching to tend them. . . . The effect produced is to
be seen not only in the city, but in the country and be
yond, and even the leaders of society have vied with
one another in their philanthropy and magnanimity
towards them. . . . Basil's care was for the sick, and
the relief of their wounds, and the imitation of Christ,
by cleansing leprosy, not by a word, but in deed. 54

Saint John Chrysostom, who lived about the time of Saint Basil, stated
that "it was formerly the custom for lepers to be cast from the state, but now
this is not done. 1,55 Evidently the work of men such as Saint Basil was begin
ning to have some effect, but it would be easy to overstress this point in view
of documentary evidence to the contrary.

The humane treatment of lepers also early took the form of establish
ing leper houses for those afflicted. In the third session of the Council of
Chalcedon, Ischyrion complained that his patriarch, Dioscorus, had mis
applied funds for founding such a house.56 By the second half of the fif
century, leper houses were already functioning among the Franks. Edward
Ehlers discovered that such houses were operating at Saint Oyan in 460, at
Chalons, Saone, in 570, and at Verdun in 634. 57 And L. de Keyser found that
Belgium alone had from seven to eight hundred leper houses before the cru
sades. 58

Despite the work of Basil and other early churchmen, the policy of the
church towards lepers was slow in assuming its form. A church council
meeting at Orleans in November 549 decreed that priests should minister to
lepers, give them clothing and food, and show them mercy because of their
intolerable infirmity. 59 Thirty-four years later a provincial council at Lyons
decided that bishops should furnish food and clothing for the lepers of their

"^"Panegyric oil S. Basil by Gregory of Nazianzus* in A Select Library Of

Nicene and Post-Nicene Fattiers, second series, Vu, 416„
55'
Johannis Chrysostomi Archiepiscopi Cons tantinopolitani Opera Omnia,
ed. by Bernard de Montafaucon, 13 vols. (Paris, 1718-1738), VI, 129.
56
Mansi, VI, 1013,1017.
57
Edward Ehlers, op, cit.. p« 191„
58
L. de Keyser,"Ueber die belgischen Leproserien im Mittelalter," (a re
view) in JajULS, XVII (1912), 286-288.
59Mansi, IX, 134.

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10

city and that lepers should not leave the city without license.60 At length a
council meeting at Worms tookthe attitude that lepers, "if they had been faith
ful Christians, might partake of the body and blood of the Lord. They might
not, however, be allowed to celebrate the feast along with those who were not
afflicted. " 61

Today modern medical teaching has removed much of the stigma at

tached to the word leprosy or Hansen's Disease, as it is now called. There
are many, however, who still hear the word with fear and loathing. If modern
medical teaching has not been able to eradicate such an attitude, what, then,
must have been that of ancient and early medieval man, who lacked the bene
fits of modern medical knowledge and who was bound on all sides by supersti
tion and magic.

60
Mansi, IX, 943.
61Mansi, XV, 875.

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