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On Lepers and the Diagnosis of Leprosy

From Unclean! Unclean! by Paolo Zappa, translated from the Italian by Edward Storer; Lovat Dickson Limited; London and Toronto; 1933; pp. 69-71

In the Middle Ages, the leper was dead to the world, but he was free to roam the countryside and build himself a hut where he liked. He could see again his own fields, cultivated by his “heirs” so long as he did not approach the “living.”

The following Decalogue had to be observed by him :

“The leper must not go about without his black cowl.

“He must not enter churches, mills or bakeries.


“He must not come to fairs or markets

“He must not wash face or hands at public drinking-fountains.

“He must not touch anything except with his stick.

“He must not take alms save with his bag on the end of a long stick.

“He must not answer if spoken to until he who speaks to him is to windward of him.

“He must not walk along narrow ways at evening-tide.

“He must not live in town or village.

“His only dwelling must be in the open country far from men and the roads. By order of the King. So be it.”

The leper was often present at his own funeral in the church. Before the ceremony the priest, in stole and surplice, waited for him on the threshold of the church to read in public the medical certificate declaring him leprous before God and man.

“We, sworn physicians, have examined Messer X------- by order of the authorities, to disclose if he be leprous. We have found as follows:

“We have found, particularly, his face to be pimply and of a violet colour. We pulled a hair from his beard and another from his eyebrow, and at the root of each hair a minute fragment of flesh was attached.

“We found small tubercles round the eyebrows and behind the ears. The expression is fixed and 71 immobile. The breath is evil, and the voice hoarse and nasal. . . .

“From these and other unmistakable signs we solemnly declare that Messer X------- is a leper. He must, therefore, be set apart from the company of the healthy, since Holy Writ admits that his sickness is contagious.”

Whereafter the priest sprinkled holy water on the man and invited him to enter the house of God, dressed in black. A catafalque stood in the central nave. After a requiem mass for the reposed of his soul, the leper, covered with a white sheet, was taken to the cemetery to where a tomb had been prepared for him.

The burial, however, was merely symbolical. The priest took a handful of earth, and cast it over the leper’s head.

“My brother, this is the sign that you are dead to this world. You will be born again in Christ. Therefore be patient as Christ and the saints were patient, so you will enter Paradise, where there is no evil nor sin, nor stain, and all is bright as the sun.”

The priest then recited a litany, and with due precaution handed the leper a black cowl, a small basket, a barrel and a stick, at the top of which was a kind of rattle or castanet.

“Receive this habit in token of humility. Receive this basket and barrel for your food and drink. The stick with the rattle is to warn passers-by of your presence on the road.”


This stick with the rattle at the end allowed the leper, though considered legally dead, to move along the road of living men. On hearing folk approach, it was his duty to sound his rattle three times. The passing traveller changed his direction, or skirted wide of the leper, making the sign of the Cross.

The contaminated outcast went on his way to meet his cruel fate.

This was the treatment meted out to lepers in the Middle Ages and right up to about the end of the eighteenth century. At any rate, documents found by Ambrose Paré in the archives of the hospital Hôtel de Dieu in Paris bear witness to this.

In succeeding centuries, isolation was resorted to and leper-houses were built. Sometimes these were called pest-houses.

These places were at one and the same time charitable hospices and prisons where the sufferers, withdrawn from society and torn from the affection of their families, deprived of liberty and the enjoyment of their possessions, were relentlessly shut up and forbidden any contact with the outside world. Neither relations nor friends were permitted to visit them. These institutions were to all intents and purposes prisons.

The prison aspect of the leper-houses was especially marked in North America. The lepers were forcibly deported to a deserted island near New York, or shut up in miserable leper-houses as in the state of Illinois, or in pest-houses as in the state of California.

Elf Note--It seems quite clear that some cultures in the Middle Ages were much more humane in this case than some in Modern times.

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