The Prejudice against Lepers.
It will have been inferred, from many particulars given, that the segregation of lepers in the Middle Ages was far from complete, and that many ministered to them without fear and without risk. The same hospital received both leprosi and others, the hospitals were served by staffs of chaplains, clerks and sometimes women attendants; and yet nothing is anywhere said of contagion being feared or of the disease spreading by contagion. The experience of these medieval hospitals was doubtless the same as in the West Indies and other parts of the world in our own day. It is true that the medical writers pronounce the disease to be contagious, ut docet Avicenna; but the public would seem to have been unaware of that, and they certainly lost nothing by their ignorance of the medical dogma, which, in the text-books, is merely the result of a concatenation of verbalist arguments. At the same time it is clear that there was a certain amount of segregation of the leprous. The inmates of the hospital at Lincoln are significantly described as “de ejectibus” of the city. The third Lateran Council based one of its decrees upon what must have been a common experience, namely, that lepers were unable to mix freely with others, and that they were objected to in the same church, and even as corpses in the same churchyard. There are some particular indications of that feeling to be gathered from the chroniclers.
One of the most remarkable histories is that of a high ecclesiastic in the pre-Norman period. In the year 1044, Aelfward, bishop of London, being stricken with leprosy (lepra perfusus) sought an asylum in the monastery of Evesham, of which he was the prior. The monks may have had more than one reason for not welcoming back their prior; at all events they declined to let him stay, so that he repaired to the abbey of Ramsey, where he had passed his noviciate and been shorn a monk. He carried off with him from Evesham certain valuables and relics; and his old comrades at Ramsey, undeterred by his leprosy or counter-attracted by his treasures, took him in and kept him until his death. The incident can hardly be legendary for it is related in the annals of Ramsey Abbey by one who wrote within a hundred years of the event[194].
Another case, which may also be accepted as authentic, is given by Eadmer in his Life of Anselm. Among the penitents who sought counsel and consolation of Anselm while he was still abbot of Bec in Normandy, with a great name for sanctity, was a certain powerful noble from the marches of Flanders. He had been stricken with leprosy in his body, and his grief was all the greater that he saw himself despised beneath his hereditary rank, and shunned by his peers pro obscenitate tanti mali[195].
Besides such notable cases, we find more evidence in the ordinances of the hospital of St Julian at St Albans, which have been preserved more completely than those of any other leper-house. Forasmuch as the disease of leprosy is of all infirmities held the most in contempt, the unfortunate person who is about to be received into the St Albans house is directed to work himself up into a state of the most factitious melancholy; he is reminded, not only of the passage in Leviticus about “Unclean, unclean!”, but also of the blessed Job, who was himself a leper (in the 14th century his boils became identified with the plague, and in the end of the 15th century the patriarch was claimed as an early victim of the lues venerea); and further of the verse in the 53rd of Isaiah: “Et nos putavimus eum leprosum, percussum a Deo, et humiliatum[196].” The St Albans house, with its six beds, appears to have been carefully managed, and its inmates well provided for; but the unreal atmosphere of the place had been too much for the leprous or other patients of the district; for we find it on record that they could hardly be persuaded to don its russet uniform, and submit themselves for the rest of their lives to its discipline.
There can be no question, then, that persons adjudged leprous were shunned, driven out or ostracised by public opinion, and even legislated against. The reality of these practices should not be confounded with a real need for them. Least of all should they be ascribed to a general belief in the contagiousness of the disease. In practice no one heeded the medical dogma of leprous contagion, because no one attached any concrete meaning to it or had any real experience of it. There was prejudice against lepers, partly on account of Biblical tradition, and partly because the “terribilis aspectus” of a leper was repulsive or uncanny. Further, in genuine leprosy, the most wretched part of the victim’s condition was not his appearance (which in a large proportion of cases may present little that is noticeable to passing observation), but his unfitness for exertion, his listlessness, and depression of spirits, owing to the profound disorganisation of his nerves. A leprous member of a family would be a real burden to his relatives; and in a hard and cruel age he would be little better off than the stricken deer of the herd or the winged bird of the flock. To become a beggar was his natural fate; and as a beggar he became privileged, by royal patent or by prescription, while beggars in ordinary were under a ban.
It is undoubted that the privilege of begging accorded to lepers was abused, and was claimed by numbers who feigned to be lepers[197]. The one severe edict against lepers in England was the ordinance of Edward III. for the exclusion of lepers from London in 1346; it is clear, however, from the text of the ordinance that the occasion of it was not any fixed persuasion of the need for isolating leprous subjects, but some intolerable behaviour of lepers or of those who passed as such. The mayor and sheriffs are ordered to procure that all lepers should avoid the city within fifteen days, for the reason that persons of that class, as well by the pollution of their breath, etc. “as by carnal intercourse with women in stews and other secret places, detestably frequenting the same, do so taint persons who are sound, both male and female, to the great injury etc.[198]” That is the old confusion which we have already noticed in Bernard Gordonio and Gilbert; it is an edict against lepra in its generic sense, and against the same class that William Clowes characterizes so forcibly in his book on the morbus Gallicus in 1579. At a date intermediate between those two, in 1488, an order was made by the provost of Paris, that “lepers” should leave the city; but that is too late a date for leprosy, although not too early for syphilis. On the 24th August, 1375, the porters of the City Gates were sworn to prevent lepers from entering the city, or from staying in the same, or in the suburbs thereof; and on the same date, the foreman at ‘Le Loke’ (the Lock Hospital in Southwark) and the foreman at the leper-spital of Hackney took oath that they will not bring lepers, or know of their being brought, into the city, but that they will inform the said porters and prevent the said lepers from entering, so far as they may[199].
When all word of leprosy had long ceased in England the porters of the City Gates had the same duties towards beggars in general. Thus in Bullein’s Dialogue of 1564, the action begins with a whining beggar from Northumberland saying the Lord’s Prayer at the door of a citizen. The citizen asks him, “How got you in at the gates?” whereupon it appears that the Northumbrian had a friend at Court: “I have many countrymen in the city,” among the rest an influential personage, the Beadle of the Beggars[200].
While it cannot be maintained that lepers were tolerated or looked upon with indifference, yet it was for other reasons than fear of contagion that they were objectionable. The prejudices against them have been already illustrated from periods as early as the eleventh century. They were, to say the least, undesirable companions, and in certain occupations they must have been peculiarly objectionable. Thus, on the 11th June, 1372, in the city of London, John Mayn, baker, who had often times before been commanded by the mayor and aldermen to depart from the city, and provide for himself some dwelling without the same, and avoid the common conversation of mankind, seeing that he the same John was smitten with the blemish of leprosy—was again ordered to depart[201]. It does not appear whether the baker departed that time, nor is there any good diagnosis of his leprosy; there was certainly a prejudice against him, but the occasion of it may have been nothing more than the eczematous crusts on the hands and arms, sometimes very inveterate, which men of his trade are subject to.
It is clear also from a singular case in the Foedera, that a false accusation of leprosy was sometimes brought against an individual, perhaps out of enmity, like an accusation of witchcraft. In 1468 a woman accused of leprosy appealed to Edward IV., who issued a chancery warrant for her examination.
The writ of 3rd July, 1468, is to the king’s physicians, “sworn to the safe-keeping of our person,” William Hatteclyff, Roger Marschall, and Dominic de Serego, doctors of Arts and Medicine; and the subject of the inquisition is Johanna Nightyngale of Brentwood in Essex, who was presumed by certain of her neighbours to be infected by the foul contagion of lepra, and for whose removal from the common intercourse of men a petition had been laid in Chancery. She had refused to remove herself to a solitary place, prout moris est; the physicians are accordingly ordered to associate with themselves certain legal persons, to inquire whether the woman was leprous, and, if so, to have her removed to a solitary place honestiori modo quo poteris. On the 1st of November, 1468, the court of inquiry reported that they found the woman to be in no way leprous, nor to have been. The woman had been brought before them: they had passed in review twenty-five or more of the commonly reputed signs of lepra, but they had not found that she could be convicted of leprosy from them, or from a sufficient number of them; again, passing in review each of the four species of lepra (alopecia, tinia, leonina, and elephantia) and the forty or more distinctive signs of the species of lepra, they found not that the woman was marked by any of the species of lepra, but that she was altogether free and immune from every species of lepra[202].