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Essay | Leprosy in the 12th and 21st century | Leprosy in the 12th century

The following parts of my essay have my own copyright in formulation of words, opinions and otherwise sources are mentioned.

The past couple of weeks I have followed the History of Healthcare course as an elective course to broaden my knowledge.
We had to give a presentation about a free chosen subject. I chose to give a presentation about the ‘Antiquity and the Olympics | Medicine in the pre Hippocratic Era’.
And as a final product I chose to write an essay about ‘Leprosy in the 12th and 21st century’.

For these blog posts I will divide my essay into four parts: ‘Introduction’, ‘What is Leprosy?’, ‘Leprosy in the 12th century‘, ‘Leprosy in the 21st century and a conclusion part’.

Greetings by Sophie

Leprosy in the 12 th century
The spreading and isolation

During the Middle Ages, leprosy was already known as an endemic disease that occurred now and then and mostly in the Middle East. Circa the eleventh and twelfth century, leprosy was spread more often the west, Western-Europe nowadays. In the southern parts of The Netherlands they started by isolate the infected humans from the healthy humans by gathering them into special houses for people with the leprosy disease. These houses were also known as the lazar houses and their number increased to numerously in the region of Artesia (now known as ‘Artois’) (Boelaert, 2014). It was not the first kind of isolation of leprosy infected humans because Jerusalem had already for centuries in history special villages outside their city for the sick and infectious people. (Wyler, 1959).

The Netherlands and Flanders

In 1106 A.D. was a lazar house founded in Sint-Omaars and in 1119 in Kamerijk. This was during the crusades and for a long time it was thought that those crusades increased the spreading of leprosy and caused an outbreak of the infection disease. This was misunderstood because the first lazar houses in Western Europe were already founded in the eleventh century. A century later lots of crusades, and the famous children’s crusade of 1212 in the thirteenth century, took place. But it was not illogical thought because of the long incubation period and medics did not
know exactly what was causing the infection disease. One of Flanders monarchy members was a leprosy victim. It was Boudewijn IV (1161 – 1185), king of Jerusalem and grandson of Fulco V from Anju the ancestor of the Flemish monarchy. His life with leprosy is documented by his nearest people and therefore it was thought that through contact of the crusaders with the Middle Eastern people, the leprosy disease was spread suddenly and rapidly. (Boelaert, 2014) (Porter, 2006)

Leprosy theory and diagnostics in the 12th century

During the twelfth century physicians were trying to figure out how leprosy was caused. By what? In which circumstances? What made it such a terrific disease?. What the physicians knew during the Middle Ages, was partly attributable to the humor theory of disease that was explained by the writings of the Greek author Galen (129 – 201 A.D.). Galen explained the humorism by four directions. (Grant, 2000)

In the Middle Ages the physicians believed that the black bile was the major culprit that causes leprosy. They believed that by an abnormal distribution of this fluid through the body, this was causing the illness and the later on disabilities. The physicians assumed that the liver was too dried out and hot at the same time which then caused a cooking temperature of the blood. And this blood transformed into the black bile residue. According to Galen this black bile was spreading throughout the body but not equally spread. (Grant, 2000).

Humorism according to Galen
Figure 2: Humorism according to Galen

In the centuries of the Middle Ages superstition was also common. The humanity which had to deal with the leprosy infection disease, believed that even lentils and meat of a donkey could contribute to the development of the disease. In the twelfth and thirteenth century, the physicians tried to search for an unnatural cause of leprosy rather than the already partially believed natural cause. The humorism of Galen was combined with the symptoms into a new four-part classification of the leprosy disease. The table is as follows:

(Boelaert, 2014) (Demaitre, 2007)

Leprosy treatment in the 12 th century

When a human was diagnosed in the twelfth century with one or (often) more types of leprosy, the human was sent to a lazar house unless he or she could pay a physician. This physician could advice a woman to take a bath full of herbs and menstrual blood. Because they believed that bad blood (the black bile) could be fought with strong blood. They believed that ‘the menstrual blood fought against the rotting of the leprosy’ (Boelaert, 2014). The physician advised men in rarely circumstances, that he should be castrated. During the twelfth century they also tried to prevent leprosy by bloodletting and catharsis (purgation). But there was not much known about what exactly caused the disease and how exactly to cure the humans and prevent others. It is in this period of superstition a miracle that an infection disease like leprosy, is accepted in general as a disease without exactly knowing or suspecting what did really cause this leprosy. Two enturies and a few decades later, humanism associated the Black Plague with leprosy. What was not right but it was not inconceivable either for that period of time. The Black Plague occurred in the 14th century and Leprosy exists already for at least 2000 years because in Christianity it is believed that Jesus Christ has healed a leper. (Boelaert, 2014) (Grant, 2000) (Porter, 2006).

  • Boelaert, J. R. (2014). De medische renaissance van de twaalfde eeuw. In J. R. Boelaert, De medische renaissance van de twaalfde eeuw (pp. 78 – 88). Antwerpen – Apeldoorn: Garant Uitgevers nv.
  • Demaitre, L. (2007). Leprosy in premodern medicine | A malady of the whole body. Baltimore: Baltimore Publishers.
  • Grant, M. (2000). Galen on Food and Diet. London and New York: Routledge. Hansen Disease – Frequently Asked Questions. (2017, January). Retrieved from HRSA:
  • Porter, R. (2006). The Cambridge History of Medicine. In R. Porter, The Cambridge History of Medicine (pp. 27, 29, 68, 76, 90, 182, 359,). New York: Cambridge University Press.
  • Wyler, W. (Director). (1959). Ben Hur [Motion Picture].

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