Leprosy

This article examines the relationship between disease, pollution and sin in the Priestly writings, focusing on the rites for the purification of ṣara‛at in Leviticus 14. In particular, it will evaluate the contested question of whether this text is implicitly polemical in light of ancient West Asian rituals dealing with similar subject matter, especially a ritual for the treatment of skin disease from Emar. These comparisons will enable a more precise characterization of the Priestly agenda reflected in Leviticus 14 and suggest that the traditional notion of pollution in Israel has been deliberately reinterpreted.

Discusses the advantages and disadvantages of a diversified portfolio of CSR projects to increase engagement vis-a-vis a more focused approach that might achieve the critical mass to secure a more significant impact. As an illustration of the latter approach the case is put for a commitment to the elimination of leprosy.

We have examined the remains of a Pilgrim burial from St Mary Magdalen, Winchester. The individual was a young adult male, aged around 18-25 years at the time of death. Radiocarbon dating showed the remains dated to the late 11th-early 12th centuries, a time when pilgrimages were at their height in Europe. Several lines of evidence in connection with the burial suggested this was an individual of some means and prestige. Although buried within the leprosarium cemetery, the skeleton showed only minimal skeletal evidence for leprosy, which was confined to the bones of the feet and legs. Nonetheless, molecular testing of several skeletal elements, including uninvolved bones all showed robust evidence of DNA from Mycobacterium leprae, consistent with the lepromatous or multibacillary form of the disease. We infer that in life, this individual almost certainly suffered with multiple soft tissue lesions. Genotyping of the M.leprae strain showed this belonged to the 2F lineage, today assoc...

This essay was originally drafted for inclusion in the *Isis Critical Bibliography*, published by the History of Science Society, which had embarked on a Pandemics special issue. This essay is a complement to one on epidemic diseases in Afro-Eurasia, which (in its second version) focused mostly on plague. Together, the essays had two main objectives: to explain why the entry of "palaeosciences" was transforming the field of infectious disease history, and to show how findings from genetics were bringing new perspectives to the questions historians ask about disease histories in the pre-modern world. This essay looks at the question of what diseases were exported from the Old World to the Americas and Oceania in the period around 1500--and what diseases were already present.

Both essays were withdrawn from the *Isis* project in 2022 because the editor failed to follow the normal procedures of peer review. The present essay can be cited as Monica H. Green, "The Great Dying: The Epidemiological and Medical Implications of Old and New World Encounters in the Pre- and Post-Contact Eras," 10 June 2021, Academia.edu, https://www.academia.edu/49232098.

The "companion" essay on plague was rewritten and appeared as: Monica H. Green, "A New Definition of the Black Death: Genetic Findings and Historical Interpretations,” De Medio Evo 11, no. 2 (2022), 139-55, DOI: https://doi.org/10.5209/dmae.83788.

I welcome comments via email (monica.h.green@gmail.com).

This article aims to discuss the strategies for answering the rehabilitation needs of persons with leprosy-related disabilities in integrated settings through primary health care (PHC) services and community-based rehabilitation (CBR). While the provision of rehabilitation services through the PHC system remains problematic in most developing countries, the article concludes that CBR programmes have the potential for rehabilitation of leprosy-affected persons in integrated settings. However, the limited coverage of CBR programmes may pose an obstacle to such an approach. The author suggests the use of existing specific rehabilitation infrastructures meant only for leprosy-affected persons for initiating, sustaining and extending the CBR coverage to the surrounding communities. At the same time, the author asks for support and strengthening of organizations of leprosy-affected persons, promoting their active involvement in all rehabilitation processes.

Individuals in contact with patients who have leprosy have an increased risk of disease exposure, which reinforces the need for chemoprophylactic measures, such as the use of rifampicin. The objective of the review was to synthesize the best available evidence regarding the effectiveness of rifampicin chemoprophylaxis for contacts with patients with leprosy, and to synthesize the best available evidence on the experience and acceptability of rifampicin chemoprophylaxis as reported by the contacts and health professionals involved in the treatment of leprosy or Hansen's disease. In the quantitative component, individuals in contact with leprosy patients were included. In the qualitative component, in addition to contacts, health professionals who were in the practice of treating leprosy were included. The quantitative component considered as an intervention rifampicin at any dose, frequency and mode of administration, and rifampicin combination regimens.The qualitative component ...

The study determines the current situation of the respondents in classifying and identifying the burdens they feel and encounter whilst having the diseases and/or living with infected clients. The researchers can comprehend the effects in terms of physical, social, mental and emotional aspects that relates from day to day living of the respondents. Because of the stigma attached to it and long term treatment, they are experiencing difficulties and low self-esteem even the household members. There are some changes on their health status and psycho-social status, being judged and were not able to do or enjoy life normally because of suffering from disease. The study found out that the four aspects mentioned above of the respondents were profoundly affected, though the study shows there's no one inflicted violence against them. Still, words are far more hurting than actions. They naturally felt burdens such as jealousy, feeling ashamed of the disease and discomfort. Ways of approach in alleviation of burdens through treatment and prevention was escalated. The researcher recommends the following: Early detection of disease, regular checkup , proper hygiene/cleanliness, nutrition, avoid contact with untreated patients and seeking knowledge especially health education should be intensified. As the famous quote of Ralph Waldo Emerson goes "The First wealth is Health".

DEPS, P.D. et al. Aspectos epidemiológicos da transmissão da hanseníase em relação a exposição ao tatu 1. RESUMO A transmissão da hanseníase ainda hoje é um tema que necessita de estudos. Alguns autores demonstram a possibilidade dos tatus da espécie Dasypus novemcinctus serem uma fonte ambiental do Mycobacterium leprae. O inquérito epidemiológico realizado verifica a correlação do contato de seres humanos com tatus e a ocorrência de hanseníase. Discute-se, ainda, uma série de fatores que podem estar envolvidos no processo dinâmico do desenvolvimento da hanseníase. O objetivo foi verificar a freqüência dos contatos dos hansenianos com tatus e o inter-humano antes do seu diagnóstico, visando estabelecer uma possível forma de transmissão do M. leprae ao ser humano através do contato com tatus. Foram realizadas entrevistas com 107 pacientes ex-hansenianos (hansenianos já tratados com PQT) que moravam no Hospital-Colônia Dr Pedro Fontes em Cariacica/ES, 29 hansenianos e 173 não hansenianos de um serviço de dermatologia. O questionário coletou dados sobre o consumo de carne de tatu antes do diagnóstico, a existência de contatos conhecidos e/ou familiares portadores de hanseníase. Os dados foram analisados pela realização do teste do Qui-quadrado, correlação e teste exato de Fisher. Encontrou-se que 90,4% dos pacientes portadores de hanseníase ou ex-hansenianos consumiram carne de tatu antes do diagnóstico de hanseníase, enquanto 15% dos não hansenianos consumiram carne de tatu. No grupo de hansenianos sem contatos com outros pacientes com hanseníase antes do diagnóstico, 96,1% já tinham consumido carne de tatu e apenas 3,9% não o fizeram. O trabalho sugere uma possível fonte de M. leprae através do consumo da carne de tatu, principalmente, nos hansenianos sem história de contatos com outros pacientes portadores de hanseníase antes do seu diagnóstico. Descritores: Hanseníase, transmissão, tatu. INTRODUÇÃO A credita-se que os seres humanos doentes e não tratados, sejam os principais responsáveis pela transmissão do M. leprae. Fontes ambientais de M. leprae também já são bem conhecidas, uma delas é a transmissão zoonótica através de tatus infectados (WALSH et al.,1981). Porém, ainda não sabemos qual a importância destas fontes ambientais para a doença no homem. Dados da literatura revelam que a evidência de contatos conhecidos com paciente(s) hanseniano(s) entre os casos diagnosticados varia bastante. TAYLOR et al.,1965, relataram casos novos de hanseníase aonde nenhum contato Aspectos epidemiológicos da transmissão da hanseníase em relação a exposição ao tatu 1. Epidemiological features of the leprosy transmission in relation to armadillo exposure.

Explores the relationship between responsible business and CSR and considers their contribution to employment and skills development, national challenges, social entrepreneurship and investment, and puts the case for more creative, joined-up and collaborative responses. Responsibility can be demonstrated by action to reach and include groups such as the digitally excluded and those afflicted with leprosy who still face economic, social and legal discrimination in certain countries. Published in a book of papers for the 10th International Conference on Corporate Social Responsibility as: Coulson-Thomas, Colin (2016), Responsible Business and Corporate Social Responsibility, in Ahluwalia, J S (Editor), Embedding CSR Mandate into Corporate Strategy, New Delhi, IOD Publishing, February, pp 26-39 [ISBN 978-81-930987-9-0]

The utopia that Boris Schatz described in his novella The Rebuilt Jerusalem: A Daydream, written in 1918 during his exile in Safed, is supposed to be realized in the year 2018. Schatz envisioned a paradisiacal Jerusalem. The Jews will coexist in harmony with nature and with the Arab residents of the city, and, with the consent of the Arab minority, they will build the Third Temple, which will serve as a museum for Jewish art and Jewish science. In this futuristic, utopian vision, the Land of Israel is a Biblical paradise where Jewish inhabitants wear Middle Eastern garb and have biblical names but lead modern lives.
In July 2015, a group of Jerusalem-based artists decided to conduct a dialogue with Schatz’s novella, contextualizing and materializing his utopian and paradisiac Jerusalem.1 They chose to do so not on the Temple Mount, where some traditions situate paradise2 but in the Talbiyeh neighborhood, inside the walls of the former leper’s home of Jerusalem, a nineteenth century hospital established outside the Old City’s limits and surrounded, like the city of Jerusalem, by its own walls.

Ninguna enfermedad como la lepra tuvo tantas consecuencias para los dolientes. Además de sus signos externos, fácilmente identificables, los malatos fueron en la Edad Media extirpados de la sociedad, desposeídos de sus bienes materiales y confinados en instituciones especializadas bajo el gobierno de la Iglesia, de la Corona o de otras corporaciones. El Hospital de San Lázaro de Sevilla, de fundación real, constituye un ejemplo inmejorable que permite acercarnos a la realidad social de los malatos durante el medioevo. El rico acervo documental de sus fondos posibilita establecer la relación del hospital con su realidad inmediata, el apoyo de la Corona durante su existencia, las formas de gobierno de la comunidad de gafos o las diferencias sociales existentes entre ellos.

No disease such as leprosy had so many consequences for the mourners. In addition to their external signs, easily identifiable, the lepers were in the Middle Ages extirpated from society, dispossessed of their material goods and confined in specialized institutions under the government of the Church, the Crown or other corporations. The Hospital of San Lázaro de Sevilla, of royal foundation, is an excellent example that allows us to get closer to the social reality of the
lepers during the Middle Ages. The rich documentary collection of its funds makes it possible to establish the relationship of the hospital with its immediate reality, the support of the Crown during its existence, the forms of government of the community of lepers or the social differences existing between them.

The meaning, cause, and remedy of the biblical ‫צרעת‬ have been the source of much debate. Traditional translations have rendered the word as leprosy, usually with the somewhat confusing caveat that despite the retention of leprosy, it does not mean leprosy. The root צרע‬ yields our problematic ‫צרעת‬ , proper names, and three occurrences of a stinging insect capable of chasing out Hivites, Canaanites, Hittites, and two Amorite kings! Shapira's MSS sensibly suggests a more dangerous fiend to the Canaanites than a hornet-the dreaded ‫צרעת‬ .

The cagots were a poorly understood marginalised group found on both sides of the western Pyrenees. They started to become prominent from the thirteenth century before largely disappearing in the twentieth century. This paper describes a curious incident in Biarritz in 1721. To explain what happened, it gallops over 500 years of history to examine the reasons cagots faced discrimination. In doing so it considers the ambiguity of medieval leprosy, the rise of the persecuting society, changing attitudes to poverty, defiled trades, the birth of racism, Jews and violence, Gypsies and assimilation, honour and pollution and conflict between communities and the state.

"Humanity needs a global reset because the unjust, pre-pandemic world is not worth going back to. Return to normal would also mean a return to old social structures inspired by self-sufficiency, nationalism, protectionism, isolation, individualism, and excluding our poorest brothers and sisters. Is this a future we can choose?" 1 -  P. Francesco

"Like many modern fields of knowledge, anthropology was founded on relations of hierarchy and deep inequality. Undoing these legacies is crucial for our field, given its commitment to pluralize ways of knowing and being in the world……" Prof.

11 de junio de 2014 - Este documento constituye un breve trabajo investigativo de nivel exploratorio y diseño documental, que busca presentar un resumen de la vida y obra del médico venezolano Jacinto Convit, haciendo énfasis en su calidad humana hacia los enfermos de hanseniasis. También se menciona especialmente el circulante interno de las leproserías nacionales de Venezuela.

OBJETIVOS: Avaliar a eficácia e segurança de esquemas
terapêuticos (medicamentosos ou não) para tratamento da
dor neuropática na lepra. MÉTODOS: Consideraremos como
público alvo pacientes com lepra apresentando dor neuropática,
virgens de tratamento, ou em curso do tratamento convencional
(poliquimioterapia), ou aqueles no período pós-tratamento,
sendo um total de 60 pacientes sem neurite ativa, tratados
com amitriptilina, ou gabapentina (por divisão aleatória);
e 60 pacientes com neurite ativa, que receberão terapia
imunossupressora (prednisona, metilpredinisolona e azatioprina).
Pacientes serão avaliados quanto ao comprometimento
sensitivo com instrumentos tais como TSA, a ENMG e CHEPS.
Adesão medicamentosa será avaliada por contagem da cartela
fornecida com os medicamentos nas consultas; e pela presença
dos pacientes nas datas pré-estabelecidas para as consultas.
RESULTADOS: O projeto ainda se encontra em andamento,
porém se esperam três desfechos: manutenção da dor, apesar
do medicamento empregado; não tolerância ou não adesão ao
tratamento instituído; melhora da dor. CONCLUSÕES: Lepra é
uma doença que afeta populações de países não desenvolvidos,
preferencialmente as classes sociais mais baixas e, com isso,
não oferece um retorno lucrativo suficiente para investimentos
em pesquisa e desenvolvimento de novas terapias. O suporte do
CNPq, FINEP e Ministério da Saúde mostra a importância de estudos
voltados para o controle da dor neuropática nesta doença.

This public talk, "On the Edge of a Pandemic World: The Later Medieval Western Mediterranean within Afro-Eurasian Disease Networks," is part of a series organized at New York University entitled *Spanish Flus: Pandemic Disease in the Iberian World from the Middle Ages through the Present*. Information for this and all the lectures in the series can be found at this link: https://www.kjcc.org/news/spring-2022-lecture-series-spanish-flus-pandemic-disease-in-the-iberian-world-from-the-middle-ages-through-the-present/.

Background information on the diseases discussed in my lecture can be found in these two essays (both open-access):
Monica H. Green, "Climate and Disease in Medieval Eurasia" (2018), https://oxfordre.com/asianhistory/view/10.1093/acrefore/9780190277727.001.0001/acrefore-9780190277727-e-6
Monica H. Green, "The Great Dying: The Epidemiological and Medical Implications of Old and New World Encounters in the Pre- and Post-Contact Eras", https://isiscb.org/special-issue-on-pandemics/essay.html?essayID=25

Part 1 of my 18 chapter history of Peruvian archaeology centered on Julio C. Tello.  The focus of this history are the years 1880 to 1925.  This first part includes discussions of Ashmead, Uhle, and Tello's San Marcos, Harvard and European studies.  Bibliography in Part 4.

In honor of World Leprosy Day 2022, and in the midst of the still on-going COVID pandemic, I posted a Twitter thread on 30 January 2022. The thread addresses the question of what "endemic" means, and it suggests that the current status of leprosy in the US (where it is an enzootic in certain armadillo populations) and in Brazil (where strains deriving from both Europe and Africa are present) is exemplary of how deeply rooted the processes of "endemicity" are.

This is a select list of recent work (Anglophone) in the fields of medical history, bioarchaeology, and genetics that help us reconstruct the global history of leprosy. Items with an asterisk (*) are available open-access; other items may be available on authors' websites, etc.

Carmen Săpunaru Tămaș and Kathryn M. Tanaka, eds.
This paper explores Japanese (matsuri) as a community event and its importance in a community affected by Hansen's disease: Japan's first national sanatorium Nagashima Aisei-en and the surrounding community. The paper aims to generally introduce broad connections to Nagashima and the surrounding communities through a summer festival held on Aisei-en. This piece serves as an introduction of resident writing about the meaning, experience, and importance of matsuri from the 1920s to the present, as the festival has been disrupted by the global COVID-19 pandemic.

Recent research has allowed historians to assess the case of the Order of Saint Lazarus during the Crusades.
Those “lepers not like the others”, set in a hospital in Jerusalem, have been integrated in the institutional components of welfare set of the Holy Land during the twelfth century . The legendary “Leper knights” have found a more concrete and intelligible existence within the orders focused on warfare in the 13th century. In the end, nowadays, we are dealing with a sort of “classical” hospitaller and military Order, having a lot in common with the Temple or the Hospital of Saint-John at their beginning. It nevertheless has specific features, giving it an individual position in the history of the crusades. The dimension of leprosy, within medieval conceptions and perceptions, is a special feature which has now been thoroughly discussed .
Yet, few things have been said about the order after the crusades. It is a subject widely studied concerning the other Orders, may it be the dramatic end of the Temple, the evolution of the Hospitallers of Saint-John through the Mediterranean sea, or that of the Teutonic knights towards Prussia. The history of what can be called the “Later crusades” is indeed a fascinating period, with institutional and political shifts moving the medieval world to the modern period. Though lacking of a positive popular imagery during the first decade following the loss of Jerusalem, behind the old ideal remains a widespread organisation composed of military, political and religious powers settled on different territories : Jerusalem gave way to Rhodes, Cyprus, Venice, Malta and Marienburg.
The case of the Order of Saint Lazarus is yet absent from that scheme. What happened ? How did it manage to “survive” to the popular nostalgia of the crusading period and its critics ? What position did he find among the renewed crusading institutions ? How did it justify its existence, along with the original combination of warfare and welfare which was its originality ? This is the theme on which this paper will focus.

On 10 February 2020, Ellen Muehlberger and I engaged in a question-and-answer session on Twitter, revisiting a 2009 essay of mine that had appeared in the journal *History Compass*. The essay had offered a survey of the state of the field of medieval medical history. It was pitched specifically at "general" medieval historians: those who did not identify as doing medical history, but may have had some cause to engage with medical historical questions in the course of their research.

In this Q-and-A, Muehlberger asks me to reflect on my particular motivations in writing the essay; why the topics of health and disease are particularly challenging to research since there are no special archives for such materials; and what points I'd want to stress if I were to attempt a new overview of the field a decade later.

Since long Twitter threads can sometimes be a challenge to read, I have reformatted our exchange here, correcting typos and providing some links. I'd be happy to respond to further queries, either on Twitter (@monicaMedHist) or via e-mail (monica.h.green@gmail.com).