Leprosy – DDT – Jan 12

Ok I really liked the OP of this thread and I’m not actually a smart person or an academic but I want to see this thread succeed so Ive taken a topic I have a casual interest in, written an outline on what makes me interested in it, and now I’m gonna make a big ole’ effort post about it. It won’t be as good as CMTM’s because he has a real working knowledge of his subject and I’m neither a scientist nor a scientifically inclined person so this is kind of a struggle for me to pin together, but here goes.




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Nigerian Mask: A representation of leprosy disfigurement


Photo credit: Charles Davis. Photo courtesy of the National Museum of Health and Medicine.
I think leprosy is a really interesting topic because it’s something that has seriously effected -every generation of humanity- and we are incredibly lucky to live in a time in which ONLY a few hundred thousand people are diagnosed every year, and ONLY 1-2 million people are permanently disabled due to the condition. I also think it’s interesting because understanding leprosy offers insight into how medical practice and thought was developed, because when you’re historically talking “leprosy” you may actually be talking about several diseases which touched every corner of the planet. Actually covering everything about such a broad topic would be incredibly daunting and I’m going to cut and skim a lot so bear with me as I organize my thoughts on the whole broad subject.

What is leprosy? A Brief Plagiarism of Wikipedia

Leprosy, also called Hansen’s disease, perhaps biblically called Tzaraath, is a disease caused by the bacteria Mycobacterium leprae. It effects nerve tissue and mucosa in the upper respiratory tract and causes skin lesions. If it is not treated, it can progressively cause permanent damage to the skin, nerves, limbs and eyes. Secondary infections – not leprosy itself – can cause the tissue loss people associate with the disease’s ability to “make limbs fall off”. The disease most likely spreads from person to person via respiratory droplets and around 95% of humanity is naturally immune to leprosy.

Historical controversy – What was Jesus curing?

My first exposure to “leprosy” was in sunday school. Jesus healed lepers. It was a really big deal. And it didn’t just pop up in the bible – the oldest known written reference dates to Egypt in 1550 BC, and similar reports are known to exist in ancient China, India, so on and so on. But when we’re talking about leprosy in ancient texts, from the Torah to Egyptian papyrus scrolls, are we talking about Hansen’s Disease? Some scholars today suggest these illnesses might have been a number of skin afflictions, maybe even syphilis- we only have a handful of translated symptoms to consider in the diagnosis, and historians just kind of do the best they can in piecing it together. I’m personally more interested in treating leprosy as a single disease because I feel that that is how the people most afraid of it would have thought about it. Everyone here is aware the pre-modern world wasn’t really a blind, backwards swamp like high school textbooks blah blah blah, but leprosy really was hard to get a bead on, and lots of people for thousands of years really were afraid of it, and out of that fear grew a lot of ritual and belief that I think is really cool. So that’s what I want to think about. So, where do I even start.
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Moses, the Big Dawg of the Old Testament, pictured
here probably being a dick on behalf of Yahweh
The torah uses the word “Tzaraath” to describe what might be Leprosy. In Exodus 4:30, the less visually popular of Moses’ miracles granted to him by the burning bush- second fiddle to turning a staff into a snake but equally impressive to the ancient world, I guess- was to turn his hand from normal flesh to flesh stricken with Tzaraath and back again. In Numbers 12:10, Miriam is cursed with the disease, and Aaron will plead to Moses on her behalf for a cure from G-d. Rabbinical scholars suggest that this means Tzaraath was a spiritual infection as much as it was a physical ailment, one that can effect the body, clothing, and buildings, and a condition that should be treated with religious purification by a priest rather than a medicine man. I’m cautious of playing any more fast and loose with Jewish scholarship than I already am here so I guess I want to point to this as a really common theme in the history of leprosy: Blaming the victim of leprosy for angering god and earning divine punishment.

Where did leprosy come from? It came from India, maybe.

The oldest skeletal records of leprosy come from bones in India dated back to 2000BC. India has a unique relationship with leprosy to this very day in that it is still a place with lepers’ colonies, it is a place with some stigmas toward sufferers of the disease, and some 70% of new cases of leprosy every year come from India. In 1939, India passed the Motor Vehicle Act which forbade leprosy patients from getting a drivers’ license, and in 1990 the Indian Rail Act forbade leprosy sufferers from traveling by train. There are various discrimination laws that bar leprosy patients from participating in local elections. I don’t know a lot about these and I’m not going to spend time condemning a country I am wildly ignorant about. Instead I think I’ll talk about Hydnocarpus wightiana.
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Hydnocarpus wightiana, seen here looking
like something txn or gvb would bake into a pie
It’s a tree. It’s been used in Indian medicine and Chinese traditional medicine for the treatment of leprosy for centuries, long before Western medicine introduced sulfones and antibiotics. The oil from this tree, called chaulmoogra oil, was loaded with fatty acids that produce antimicrobial activity. I don’t know exactly what that means, but it seemed to be the most effective treatment for leprosy from the dawn of time to the 19 freaking 20’s. Rama, the 7th avatar of Vishnu, is supposed to have acquired leprosy and then cured it by eating the fruit of the Kalaw tree. He used the cure to save the princess Piya and the two of them then shared their discovery with the rest of India. The chaulmoogra oil was “rediscovered” by the western world in 1854 when Frederic John Mouat treated sufferers at Bengal Medical College with the substance and published a paper noting marked improvements over previous western traditions. What were those previous western traditions? Pretty much every stereotype and punchline of medieval medicine could potentially come from the treatment of leprosy.

There seemed to be two different approaches to fighting the illness – prevention and cure. IThe most well known preventative measure of leprosy is ostracization. Leper’s colonies are what first jump to my mind, but also common in the West was making lepers wear easily identifiable clothing, or carrying bells when walking through town to ward off uninfected individuals. No one will be surprised if the medieval church is on the less progressive side of history regarding leprosy. Some Catholic scholars write that in the 13th century, the Catholic Church and civil leaders declared lepers legally dead so that their goods and property could be confiscated. The Church expected a leper’s spouse to serve and care for their partner until they died. Forming a parallel to the Tzaraath, the special garments and tools worn by lepers were blessed before receiving it, again drawing on the idea that leprosy is something to be purified by god and the result of His wrath.

Now I’d feel bad if I didn’t summarize at least a little bit about the more gruesome curatative treatments of leprosy in the dark ages, so here goes: Treatments with arsenic and hellebore. Treatments of scarification, treatments of castration. Screw it, I’ll cover the other weird stuff I could find thru-out time- drinking blood, bathing in blood, lamb’s blood, people’s blood. Pliny liked snakes, but also scorpions and frogs on occasion, and Gaucher liked cobra venom especially. Then there was Boinet in 1913, MORE THAN A HALF CENTURY AFTER THE REINTRODUCTION OF CHAULMOOGRA OIL, who insisted on bee stings- as many as 4000 bee stings. Fuck that guy. Eventually the scientific revolution happened, people started studying the shit that was happening to them, they had better tools, so on, and finally in 1873 a Norseman named G. H. Armauer Hansen identifies Mycobacterium leprae in response to a surge in interest and research following outbreaks in Norway, Iceland and England in the 1830’s.
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The National Leprosarium of the United States. Note the cool hat,
a sure marker that you’re seeing a genuine picture from antiquity.

In 1894 an abandoned sugar plantation a few miles outside of Baton Rouge, Louisiana became the “Louisiana Leper Home” – one of the first “leprosariums”, a care and research center for lepers. Many of its patients were admitted under mandatory quarantine, and never left the hospital again. In 1921 the U.S. government took over the area, now called Carville, Louisiana, and made it the national leprosarium of the united states. The facility operated for most of the rest of the 20th century, even surviving the 80’s when Reagan dismantled most other public health service hospitals thanks to the patronage of Louisiana’s most famous political family, the Longs.

Today it is both a leprosy museum and a much smaller care facility for its few remaining patients.

That’s all I got, folks

I’m kind of running out of steam here at this point. One of the first “modern” treatments for leprosy, dapsone, was introduced in the 1940’s and by the 1950’s resistant strains of the disease were already being reported. In the 1970’s a multi-drug treatment regimen of dapsone, rifampicin, and clofazimine was developed that is still widely used today. In 1985, 122 countries were identified as places in which leprosy was a “major public health concern”. In 2002, there were 14 countries on that list. Humanity is, for the first time since we started counting the years this way, by and large enjoying a nice reprieve from the disease. Even the number of new cases in India has been steadily dropping since at least 2005. Hopefully the bacteria doesn’t outsmart us, because man, it would suck to live like our ancestors in this regard.

Anyway, I’ve exhausted my ability to summarize the topic. I wanted to talk about the hawaiian island of Molokai and the “Land of the Living Death”, Kalaupapa Village, but it’s almost 4am now and anyone that’s actually interested in any of this can easily find everything I’ve collated here on their own without much trouble. I’ll post my sources, becuase I want to make it clear once again that this is all more or less straight plagiarism. I hope anyone that made it this far learned something, and isn’t slamming their head into the table because of my ignorance. Have a good night y’all, and maybe stretch your fingers out a little and be thankful you’ll probably get to keep them for the majority of your natural life.