Before the first notice of the earliest Scotch leper-house that I have been able to trace—viz. that of Auldnestun, about 1170, similar establishments were abundant in England. The charters of many of them appear to have been either granted or confirmed in the reign of Henry I., who died in 1154, and was a contemporary of the Scotch Kings, Edgar, Alexander I., and David I.; and it is not unworthy of remark that two, if not more, lazar-houses were founded in England by natives of Scotland prior to the date of the earliest Scotch leper-house that I have been able to discover. For Malcolm IV. founded and endowed one in his principality of Huntingdon in 1165;[123] and sixty years earlier, or in 1101,[124] Matilda, the “gode Queene Maud” of Henry I., and daughter of Malcolm III. of Scotland, established the hospital of St. Giles, Bishopsgate, for forty lepers, a chaplain, clerk, and messengers.
But at whatever respective periods the disease first appeared in England and Scotland, there are strong reasons for believing that it continued to prevail in the latter kingdom long after it had ceased, or almost entirely ceased, in the former. In the preface to the statutes of the leper-house of St. Albans, drawn up about 1350, and already referred to as published in the supplement to Matthew Paris’ history,[125] it is stated that the number of lepers that presented themselves for admission had diminished so much by that time, that their expense of maintenance was below the revenue of the institution; “in general,” it is added, “there are now not above three, sometimes only two, and occasionally only one.” In exactly the same year (1350) that this report was drawn up for St. Albans, was it thought necessary to institute the leper-house at Glasgow; and nearly one hundred years later, or in 1427, the Scottish Parliament deemed it proper to legislate on the subject of lepers.
The hospital of St. Mary Magdalene, at Ripon, was established in 1139 for the relief of all the lepers in that district. In the time of Henry VIII, it contained only two priests and five poor people to pray for all “Christen sowlez.”[126]
At Illeford, in Essex, an hospital was instituted in the reign of Henry II. or Richard I. for thirteen lepers. In one of the reports of the commissioners for suppressing colleges, hospitals, etc., in the time of Edward VI., it is observed, in regard to the state of this Illeford Hospital, that though founded “to find 13 pore men beying Lepers, 2 pryests, and one clerke—thereof there is at this day but one pryest and 2 pore men.”[127]
By the same commission most other lazar-houses were reported as having no leprous patients, and yet only a few years previously was the leper-house of Aberdeen built, and forty or fifty years afterwards (in 1591) the Edinburgh hospital at Greenside was established. We have several later notices of the disease among us. In the Aberdeen Kirk-Session Register, vol. i., it is stated that, on the 13th May 1604, the kirk-session ordained “Helene Smythe, ane puir woman infectit with leprosie, to be put in the hospitall appoyntit for keeping and haulding of lipper-folkis betwixt the townis; and the keyis of the said hospitall to be deliverit to her.”[128]
As late as 1693 we have some records of the lepers of Kingcase. On the 11th March of that year a complaint was lodged by the procurator-fiscal “anent the intruding of the lepers of Kingcase upon the priviledges only propper to the burgess and freemen (of Prestwick) by there resorting to the shoar, and taking up certain timber and other wrack, and casting greater quantities of peats and turf off the common and moss, &c., which, being seriously pondered by the magistrates, &c., they ordained that none of the said lepers of Kingcase do so under the penalty of ane hundredth pund, toties quoties, to be paid by ilk ane (each one) of them in caise of failyie (failure).”[129]
The disease appears to have continued in the northern islands of Scotland long after it had disappeared from the mainland, and, indeed, all other parts of Great Britain. In Shetland it has been known for centuries. I have already made a quotation from Brand to show that it was at Lerwick as late as the latter part of the seventeenth century. In some districts of Shetland it continued still later. Apparently most of those there affected either belonged to or were sent to the Island of Papa. I have in my possession a MS. extract from the Session-books of Walls, showing the expenses incurred in keeping the lepers at Papa from 1736 to 1740. Four of them appear to have died during these years, and two of the entries are for the “tobacco”[130] used at their funerals. In 1742 there is a long entry in the Session Records of Walls, earnestly enjoining a day of public thanksgiving for the supposed total deliverance of the country from the effects of the leprosy.
The disease, however, was not eradicated entirely. Mr. Jack, the resident clergyman, who wrote the account of the parish of Northmaven for the Statistical Account of Scotland, published in 1798, seems to have seen what he terms several miserable cases of the disease, and adds, that in many instances there is reason to suspect a hereditary taint.[131] Dr. Thomson urged his pupil, Dr. Edmondston of Lerwick, to trace out the history of the disease in the north, and that gentleman has made the following observations upon it in his work on the Zetland Isles:—
“Elephantiasis, known by the name of leprosy, was very frequent in Zetland about sixty years ago, but its occurrence since that time has only been occasional, and at present scarcely an instance of it is to be met with. A native of Zetland, a few years ago, was received into the hospital of Edinburgh, labouring under true elephantiasis. I have seen obscure degrees of it in Zetland, where the face was bloated, the skin scaly and rough, and the voice slightly hoarse; but they did not terminate fatally, nor was the affection apparently communicated to others. The last instance I saw of it was in the person of a boy. His friends could assign no cause for its appearance, and said that it had come on spontaneously, and proceeded gradually. The disease had been stationary for some time before it fell under my observation.”[132]
As so far confirmatory of the disease having thus longer remained in Shetland than in the more southern parts of these kingdoms, I may here mention that in the middle ages it was very common,[133] and has since long continued to linger in the neighbouring Faroe Islands, and in Iceland. It appears, from Debes’[134] evidence, that true tubercular leprosy, as we shall see in the sequel, continued to prevail in the Faroe Islands (the nearest land north of Shetland) in the middle of the seventeenth century. Still later—viz. in 1768, Petersen[135] found 280 lepers in the hospitals in Iceland. Olafsen,[136] Troil,[137] Holland,[138] and Henderson,[139] have each, from personal observation, described the disease as existing in that island; and the French Government expedition in 1836, under Gaimard,[140] have, in the beautiful work they are at present publishing, already given several excellent coloured sketches of natives affected with tubercular leprosy. The disease, according to various authors, still prevails in the northern kingdoms of Norway and Sweden. I am not by any means sufficiently intimate with the literature of the Scandinavian radesyge, to venture to offer any decided opinion with regard to its nosological nature, and its alleged relation to the leprosy of the middle ages. As far, however, as I am acquainted with the subject, it appears to me that under the name of radesyge, two, if not more distinct species of disease were, by Holst and the other authors who first wrote upon it, confounded and described together. One of these, the radesyge properly so called, is probably nearly allied to, if not identical with the sibbens of Scotland. Another of the supposed varieties of the disease, the spedalskhed or spetälska, seems on the other hand to be a different nosological species, hereditary, non-contagious, chronic, incurable, and identical in many, if not in all its characters, with true tubercular leprosy. The spetälska seems confined to particular and more limited localities in the north than the radesyge; and when we look to the descriptions of it as seen at Ostrobothnia by Udmann,[141] or as given by Hünefeld,[142] in regard to the disease at Bergen, we certainly find these descriptions very exactly answering to the definitions of tubercular or Arabian leprosy given by our best nosologists and pathologists, and which I shall have occasion afterwards to discuss at some length. Besides, radesyge is a disease which is believed by many to have made its first appearance in Sweden and Norway during the last century, while the spetälska was known at a greatly earlier date. The present hospital for it at Bergen was, as Hünefeld[143] informs us, founded as early as the year 1268.