Authors: Priscilla Royal
Tags: #Fiction, #Mystery & Detective, #General, #Women Sleuths, #Historical
Leprosy, now properly called Hansen’s Disease, terrified our ancestors for thousands of years. Although frequently mentioned in the Bible, not every suspect case may actually have been the illness, but dread of this disfiguring, maiming, and fatal ailment made it the default diagnosis.
Since the mid-twentieth century, Hansen’s Disease has been curable, although the exact method of transmission remains unclear. Like the bubonic plague, AIDS, or tuberculosis, lack of knowledge about the method of contagion, joined with the failure to develop a reliable cure, fueled reactions based in atavistic fear. As one who remembers the early days of AIDS and has lost many friends, I can understand those feelings, but there is no excuse in the modern era to turn to superstition when medical science has the ability, given adequate backing, to discover the process of infection, treatments, and eventual cures. Medical knowledge was not so advanced in Prioress Eleanor’s thirteenth century. Hysteria existed, although compassion and love trumped fear far more often than we have been led to believe.
Because sins of the flesh are inevitably blamed for any incurable illness (a practice akin to the gathering of the usual suspects in
Casablanca
), unapproved sex was considered a likely cause for contracting leprosy in medieval times. As one example, some thought a man would catch it by having sex with a woman who had just slept with an infected person. Another assumed method of transmission was looking directly into a sick individual’s eyes or breathing the same air as the afflicted. (A direct touch, oddly enough, was less feared.) With this in mind, we can see that Herbert’s avoidance of his family actually shows his love and concern for them. As for Leonel’s easy access to his uncle, both would have concluded that the former was already exposed, but the precautions mentioned here would have been taken. In fact, Hansen’s Disease is very difficult to contract.
Despite the fear of contagion, not all lepers were segregated nor did they lose their rights. There is an early thirteenth century stained glass panel at Canterbury showing a mother tending her severely ill son. King Baldwin IV of Jerusalem not only ascended the throne after his illness was diagnosed but led in battle and ruled for eleven years until his death. Leper hospitals were built near cities and on busy roads so that the sick could directly seek alms from travelers. The reaction to the disease was as complex as its diagnosis.
Although medieval physicians did not know the origin or transmission method, archaeological digs at leprosarium cemeteries suggest an impressive diagnostic accuracy. In part because the responsible physician was very cautious about making a firm judgment with such a serious and terrifying illness, they tried to be quite precise. Doctors had some forty symptoms to consider before a final decision could be made. This list dates to the second century (Aretaeus) and was refined over the centuries by such medical men as Bernard de Gordon, Bartholomeus Anglicus, and Gilbertus Anglicus. Unfortunately, priests were also allowed to determine whether or not a person was infected. Their accuracy rate was not high.
Cures were sought, but in the Middle Ages, the best that might be expected was an easing of symptoms. Borderline Hansen’s Disease may take a long time to fully develop, for example, and baths in water with mineral or sulphur content (Harbledown Hospital near Canterbury was well-regarded), ointment massage, or an improved diet could make the sufferer feel better. This relief was sometimes confused with a cure. In other cases, the disease might be misdiagnosed (psoriasis, eczema, scabies) or temporarily improve. One form of the disease (
tuberculoid
) can spontaneously disappear.
The Order of St. Lazarus of Jerusalem (also called the Leper Knights) has a fascinating history, and I recommend the very readable Marcombe book listed in the bibliography following these notes. The Order was founded in early twelfth century Jerusalem and included infected brothers who were assisted by healthy ones. It was run, however, by a brother chosen from the lepers. The monks included Templars, who were allowed to switch Orders upon infection, and this provided a unique band of soldiers. Although their actual performance in combat was unsuccessful (and they probably served mostly as scouts or foragers), their presence was welcomed, albeit at a distance. Because the suffering of lepers was linked to that of Jesus and Job, soldiers felt the inclusion of the armed band in combat was like carrying a living relic into battle.
Although crusaders came to the Holy Land believing the illness was caused by sin, many were influenced by the eastern view that contagion was not a moral issue. As a consequence, they moderated their harsher views which resulted in greater acceptance and kinder treatment. The care given at the Order’s hospital was geared toward making the sick comfortable and included frequent baths in part because of the palliative effect but also to replicate the healing of Naaman in the Jordan River.
In England, Burton Lazars (Leicestershire) was the Order’s administrative center although it was a small one. In the late 1270s, it had a master and eight monks. The brothers wore a grey habit, with the couped cross of St. Lazarus, and were bearded, perhaps to hide facial disfiguring. Someone of Baron Herbert’s rank might well have communicated with them, intending to join the Order. His administrative talent alone would have been welcomed at a time when the Order owned considerable land. After the fall of Acre in 1291, the center suffered a decline but struggled on until dissolved by Henry VIII.
Debates over legend and fact continue about the original
assassins
. The word may have come from
hashishiyyun
, or
hashish user
, a derogatory term applied to the
Nizaris
by their Muslim detractors and intended to suggest moral degeneracy rather than a person who actually took hashish. Historically, they were a splinter faction of the Ismailis, who had previously split from the Shiites, and exist today as a very peaceful group, ruled by the Aga Khan.
In any case, the crusaders feared them, believed all the superstitions they heard, and even embellished the tales, especially about the era of Rashid al-Din Sinan, the original “Old Man of the Mountain” and most legendary twelfth-century leader of the Nizaris. Hugh and Leonel would not have been alone in their assumptions.
In fact, the Nizaris probably didn’t use the drug to commit their relatively few assassinations or joyfully leap to their deaths at their leader’s whimsical command. They certainly did not become phantoms to evade heavily guarded targets. As for the stubborn persistence of the legends, we owe much to that consummate storyteller, Marco Polo.
That noted, medieval Nizaris did include some members willing to undertake suicide missions against the enemies of their faith, both Christian and Muslim, although most preferred missionary work which is usually less violent. These
assassins
were highly successful primarily because they gained the target’s confidence before stabbing him to death. The man who tried to kill Edward I was a convert to Christianity and a trusted servant to the crusader cause. As for the medieval use of hashish, the drug was available in the Holy Land, and some soldiers of all types may have used it to gain courage in battle.
On a lighter note, the drink called
Ypocras
, offered Eleanor by Margaret, was named after Hippocrates and considered very healthy. The base was red wine, just turning sour, which was spiced with cinnamon, ginger, cloves, and honey. For those interested, there is a translated recipe easily found on the Internet from the
Gode Cookery
. One ingredient that may sound strange is still available today: grains of paradise. I’ve tasted it. Although it was a pepper substitute, merchants called it
grains of paradise
because they claimed the spice came directly from the Garden of Eden. Spurious marketing hasn’t changed much in eight hundred years…
The history of Hansen’s Disease is grim, but the excellent books on the subject are enlightening. They prove that brave and curious people have always been willing to push beyond ignorance to discover the facts hidden by superstitious prejudice. This may be called
science
, but the compassion involved is also one of the finer human virtues. For this reason, I did not find the books depressing and list some for readers who wish to learn more about treatments and attitudes in the medieval era. Not all was the way we often assume.
As always, I do not pretend to be an authority on any subject. The experts may guide but cannot be blamed when I stray off the path.
The Assassins: The Story of Medieval Islam’s Secret Sect, by W.B. Bartlett, Sutton Publishing, 2001
By Sword and Fire, by Sean McGlynn, Weidenfeld &Nicolson, 2008
English Castles 1200-1300, by Christopher Gravett, Osprey Publishing, 2009
Handbook of Leprosy, by W.H. Jopling & A.C. McDoughall, CBS Publishers (fifth edition), 1996
Leper Knights: The Order of St. Lazarus of Jerusalem in England, 1150-1544, by David Marcombe, Boydell Press, 2003
Leprosy in Medieval England, by Carole Rawcliffe, Boydell Press, 2006
Leprosy in Premodern Medicine: a Malady of the Whole Body, by Luke Demaitre, Johns Hopkins University Press, 2007
Medicine & Society in Later Medieval England, by Carole Rawcliffe, Alan Sutton Publishing, 1995
Medieval English Medicine, by Stanley Rubin, Harper & Row Publishing, 1974
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