Bontius informs us that this disease was observed on the banks of the Ganges, where it was known by the name of Cowrap. Kaempfer noticed it in Ceylon and Japan. In Sumatra, whole generations are infected with both leprosy and elephantiasis; and those who are labouring under the latter disease, although it is not contagious, are driven into the woods. Christopher Columbus found lepers in the island of Buona Vista in 1498, and frictions of turtle blood were used to relieve them.

In our days it is a disease of rare occurrence, at least in Europe; yet it was observed at Vetrolles and Martignes, in France, in 1808, and at Pigua and Castel Franco, in Italy, in 1807. The elephantiasis still prevails in our West India colonies, more especially that species which is called “elephant leg,” and which is not uncommon at Barbadoes, St. Christopher, and Nevis. Parsons, in his Travels in Asia and Africa, informs us that a similar complaint exists on the coast of Malabar, where it is called the “Cochin leg.” The Hindoo physicians treat it with pills of arsenic and black pepper.A curious species of leprosy appeared in Rome under the reign of Tiberius, which was brought thither from Asia. The eruption first broke out upon the chin, whence it was called Mentagra, and is thus alluded to by Martial:

Non ulcus acre, pustulÆve lucentes;
Nec triste mentum, sordidive lichenes.

From the chin it extended over the entire body, and on its disappearance left scars more unsightly, if possible, than the former disease. Its virulence and difficulty of cure induced the Romans to send to Egypt for attendance. The same disease prevailed in the second century, and Soranus, a physician of Aquitania, was sent for to heal it. Crispus, a friend of Galen, is said to have discovered the best method of cure. Pliny has given an accurate account of the mentagra in his Natural History, lib. xxvii. cap. 1. According to the same writer, elephantiasis was brought to Rome by Pompey’s troops. Plutarch fixes its apparition to the time when Asclepiades of Bithynia flourished as one of his disciples. Themison wrote a treatise on the disease, which is mentioned by CÆlius Aurelianus, but has not been preserved from the ravages of time. Lucilius called the affection odiosa Vitiligo. The Gemursa of Pliny appears to have been a similar complaint; and Triller thinks that it was the Gumretha of the Talmud.

Formerly, in England, the causes of lepers were committed to the ecclesiastical courts, as it was prohibited to prosecute a leper before a lay judge, as they were under the protection of the church, which separated them from the rest of the people by a ritual. At this period a law existed, called Leproso amovendo, for the removal of lepers who ventured to mix in society. Thus leprosy may be considered one of the most terrific maladies inflicted on mankind. Holy Writ affords us abundant proofs of its fatal character. It is probable that this disease was first observed under the scorching sun of Egypt, whence it spread its ravages to Greece and Asia; and when the East was obliged to submit to the Roman legions, the conquerors carried the scourge of the vanquished to their own country. From Italy the disorder extended to France; and in the reign of Philip I. we find some members of the church militant, called hospitaliers, who spent their arduous life in attending upon lepers, and waging war against the infidels.

The Hebrew tribes, on quitting Egypt, were subject to three kinds of leprosy; all of them were distinguished by the name of Berat (????), or “bright spot.” One called Boak (???), of a dull white; and two named Tsorat (????), or “venom or malignity:” the first variety of the latter being the Berat Lebena, or bright white berat; and the next the Berat Cecha, or the dark and dusky berat; both of which were highly contagious, and rendered those who laboured under their attack unclean, and dangerous to society.

Manetho, Justin, and several historians, pretend that the Hebrews were expelled from Egypt in consequence of their being infected with this formidable disease; a reproach from which Josephus attempted to exculpate his countrymen. It appears, however, that, during their captivity of one hundred and thirty-four years, the Israelites laboured under this awful visitation; and, three thousand years after their migration we find Prosper Alpinus describing the banks of the Nile as the principal seat of the disease. Lucretius gives the same account of it:

Est Elephas morbus, qui, propter flumina Nili
Gignitur, Ægypto in mediÂ, neque prÆterea usquam.

Pliny and Marcellus Empiricus refer the calamity to the same source. They state, however, that it was more general in the lower classes, although it sometimes attacked their sovereigns; an event which added to the horrors of the infliction, since it appears that royalty had the privilege of bathing in human blood as one of the most effectual curative means. Gaul and Avicenna attribute its fatal prevalence in Alexandria to the influence of the climate, and the quality of their food. The Persian writer thus expresses himself: “Et quando aggregatur caliditas aËris cum maliti cibi, et ejus essentia ex genere piscium, et carne salitÂ, et carne grossÂ, et carnibus asinorum, et lentibus, procul dubio est ut eveniat lepra, sicut multiplicatur in AlexandriÂ.”

The Boak, or slighter berat, which is not considered to be contagious, still bears the same denomination amongst the Arabs, and is the ?ep?a a?f?? or dull white leprosy of the Greeks. The bright white and dusky berats of the Hebrews were distinguished on account of their malignity, and with the Tsorat (????) are still called among the Arabians by the Hebrew generic term with a very slight alteration, for the Berat Lebena is their Beras Bejas, and the Berat Cecha, the Beras Asved.

While the Arabians borrowed the Hebrew terms, the Greeks took their denominations from the same source; and from Tsorat they adopted the word Psora. The Tsorat is restrained by the Hebrews to the contagious form of leprosy. Amongst the Greeks Lepra was a generic synonyme of Berat or Beras.

This confusion in the adaptation of the names given to the varieties of leprosy has occasioned much perplexity in the study of the disease. Actuarius, in endeavouring to rectify these errors, has produced a greater confusion. According to him, they are different forms of a common genus. However, the most important distinction was that which defined the contagious and the non-contagious forms. The leprosy described by Moses under the name of Boak or Bohak was the a?f?? of Hippocrates; Seeth the fa???; Saphachath and Misphachath the ?e????; and Bahereth the ?e???; and according to Carthenser and other writers, this leprosy was the LeucÉ of the Greeks.

The elephantiasis was long confounded with leprosy; but the former is a tubercular affection of the skin, widely different from the scaly leprosy, and certainly not contagious. Its singular name was derived from the condition of the surface of the huge misshapen limbs of those who were affected with the malady, and which bore some resemblance to the leg of an elephant. This morbid state is not uncommon in the island of Barbadoes, and in England it has been called “the Barbadoes leg.” The original Arabic name for this affection was Dal Fil, or “the elephant’s disease,” which is now the common denomination; although it is frequently abridged into Fil alone, literally Elephas. The elephantiasis is not even alluded to by Moses in his descriptions of leprosy. However, the elephant leg of the Arabians is a disease totally different from the specific elephantiasis, which is a disorder of the skin, the roughness of which led to the name, and which the Arabians called Juzam or Judam.

These errors of description amongst medical writers have of course occasioned much obscurity and perplexity in the productions of travellers and historians, who have generally confounded all these diseases with the Hebrew leprosy, or the leprosy which for so long a period desolated the fairest portions of Europe, where every country was crowded with hospitals established for the exclusive relief of the malady. The number of leper-houses, as they were denominated, has been singularly exaggerated. Paris has been made to assert that there were nineteen thousand of these hospitals, whereas he merely stated that the Knights Hospitalers, under various patron saints, but more particularly St. Lazarus, were endowed with nineteen thousand manors to support their extensive establishments; and he thus clearly expressed himself: “Habent Hospitalarii novemdecim millia maneriorum in Christianitate.” It appears that in the reign of Louis VIII., France had no less than two thousand of these hospitals. Leprosy was well known in the eighth century, and St. Ottomar and St. Nicholas, were considered the first founders of establishments for its treatment in France and in Germany. The Crusaders, however, by their connexions with the East, materially increased its inroads in Europe, and the disgusting malady appears to have been considered as a proof of holiness. Moehser, in his work “De medicis equestri dignitate ornatis,” informs us that the Knights of the order of St. Lazarus were not only intrusted with the care of lepers, but admitted them into their noble order: their Grand Master was himself a leper. The Crusaders, returning from their useless wars, eaten up with the disease, received the honourable distinction of being pauperes Christi, morbi beati Lazari languentes. The most distinguished individuals in the land attended upon them with the utmost humility; and Robert, King of France, used to wash and kiss their filthy feet to keep himself in odour of sanctity. All these attentions, however, did not always prevent the lepers from complaining of their complicated sufferings, but they were exhorted by holy men (who of course had never experienced the miseries of the malady) to be of good comfort, as their illness was a blessed favour conferred upon them as the elect of the land. St. Louis thought the Sire de Joinville an unbeliever; for having once asked him which he would prefer, being a mezieu or laide (a leper), or having to reproach his conscience with any mortal sin, his favourite replied to the singular question, that he would rather be guilty of thirty deadly sins; whereupon the sanctified monarch severely rebuked him by telling him in the quaint language of the times, “Nulle si laide mezeuerie n’est, comme de estre en pÉchÉ mortel.”

Notwithstanding the sanctity of their disease, lepers were by various laws separated from the healthy portion of the community. The ceremonies used on these occasions were curious; and we find the following description of them in the History of Bretagne: A priest in his sacerdotal robes went to the leper’s dwelling, bearing a crucifix. He was then exhorted to submit with resignation to the affliction: he afterwards threw holy water upon him, and conducted him to church. There he was stripped of his ordinary vestments, and clothed in a black garment; he then knelt down to hear mass, and was again sprinkled with holy water. During these ceremonies, the office for the dead was duly sung, and the leper was finally led to his destined future residence. Here he again knelt, received salutary exhortations to be patient, while a shovelful of earth was thrown on his feet. His dwelling was most diminutive: his furniture consisted of a bed, a water-jug, a chest, a table, a chair, a lamp, and a towel. He further received a cowl, a gown, a leathern girdle, a small cag with a funnel, a knife, a spoon, a wand, and a pair of cliquettes, (a sort of castanets,) to announce his approach. Before leaving him, the priest added another blessing to these gifts, and departed, after commanding him under the severest penalties never to appear without his distinctive apparel, and barefooted; never to enter a church, a mill, or a baker’s shop; to perform all his ablutions in streams and running waters; never to touch any article he wanted to purchase, except with his wand; never to enter drinking-houses, but to buy his liquor at their doors, having it poured into his barrel by means of the funnel graciously given him for that purpose; never to answer any question unless he was to windward of his interlocutor; never to presume to take a walk in a narrow lane; never to touch or go near children, or look at a good-looking wench; and only to eat, drink, and junket with his brother lepers; and invariably to announce his unwelcome approach by rattling his castanets.

The offsprings of these sequestrated creatures were seldom baptized; and when this rite was performed, the water was thrown away. After this oration his ghostly adviser took his final leave, and the patient’s former dwelling was burnt to the ground. The sepulchre of St. Mein, in Britanny, was frequently visited by these poor creatures; and on such occasions they were obliged to have both their hands covered with woollen bags, as a distinguishing mark amongst the other pilgrims. Lepers were only allowed to intermarry with fellow-sufferers; yet we find in one of the Decretals of St. Gregory, that any woman who chose to run the chances of contagion could please her fancy. St. Gregory perhaps thought this the most effectual method of preventing the dreaded intercourse, as most probably, had it been prohibited, lepers would have been in great request, they having always been notorious for their amorous propensities. Muratori informs us that these unfortunate persons did not always submit quietly to these severe regulations, but several times joined the Jews in a revolt against the authorities.

This affliction has been observed in various countries. In Iceland it is called Likraa; in Norway, Radesyge or Spedalskhed. It is to be apprehended that many of these cases of leprosy belong more particularly to the elephantiasis: such is the red disease of Cayenne, and the Boasi of Surinam.

It is especially in the East, its probable original seat, that leprosy is observed. In Damascus there are two hospitals for its treatment. The waters of the Jordan are still considered efficacious in its cure, and the waters of Abraham’s well are looked upon as a specific. In Candia the disease was common, and lepers were noted for their obscene profligacy. From Crimea it has also been carried to Astracan, whence it infected the Cossacks of JaÏck. Pallas and Gmelin have given an accurate account of its invasion.