Chapter II: Part I (2)

The sick had fire and candle, and all necessaries, until they either convalesced or died; and one of the chaplains was assigned to hear the confessions of the sick, to read the gospel to them on Sundays and holidays, and to read the burial-service for the dead. The old woman who attended on the sick had every week three wheaten loaves, and one mess of flesh or fish; and when a brother or sister was buried, the grave-digger had his meat and drink. Each leper had a yearly allowance for his clothing of three yards of woollen cloth, white or russet, six yards of linen, and six of canvass, and the tailor had his meat and drink the day on which he came to cut out their clothes. Four fires were allowed for the whole community. From Michaelmas to All Saints they had two baskets of peat on double mess days, and four baskets daily from All Saints to Easter. On Christmas eve they had four yule logs, each a cart-load (“unusquisque erit unius quadrigatae”), with four trusses of straw; four trusses of straw on All Saints eve and Easter eve; and four bundles of rushes on the eves of Pentecost, St. John Baptist, and St. Mary Magdalene; and on the anniversary of Martin de Sancta Cruce, every leper received five shillings and fivepence in money.

The good food, lodging, and raiment provided by the rich endowments of Sherburne were not without some alloy. The rules of the house were strict, and the religious duties enforced upon the inmates were of an austere character. “All the leprous brethren, whose health permitted, were every day expected to attend matins, nones, vespers, and complines. The bed-rid sick were enjoined to raise themselves, and say matins in their bed; and for those who were still weaker, let them rest in peace, _et quod dicere possint dicant_.” During Lent and Advent all the brethren were required to receive corporal discipline three days in the week, and the sisters, in like manner, _donec omnes vapulent_. And all these, and other laws, Bishop Kellaw “did by his charter confirm and order ever thereafter ‘_inviolabiter observari_.’”[99]

On the Continent the lazar hospitals partook of the same differences in regard to poverty and wealth as we have traced in Britain. In France, some of them, however, had become so very amply endowed by the commencement of the fourteenth century that they at last excited the avarice of Philip V., who subjected many of their inmates to the flames.[100] “They were burned alive” (_on les bruloit tout vifs_), says the historian Mezeray, “in order that the fire might purify at one and the same time the infection of the body and that of the soul.”[101] The ostensible cause for this act of fiendish barbarity was the absurd allegation, that (as the original ordonnance of Philip bears[102]) the lepers of France and other parts had been bribed to commit “the detestable sin and horrible crime” (detestabile flagitium et crimen horrendum) of poisoning the wells, waters, etc., used by the Christians. The real cause, there is little doubt, was a desire, through this flimsy excuse, to rob the richer hospitals of their funds and possessions; and this appears only too strongly in the anxiety displayed in the special wording of Philip’s original edict, that all the goods of the lepers be lodged and held for himself, (ordinavimus, _inter alia_, quod omnia bona eorum ad manum nostrum ponerentur et tenerentur.)[103] The persecution of them was again temporarily renewed in 1388, under Charles VI. of France.[104]

DATES OF THE APPEARANCE AND DISAPPEARANCE OF LEPROSY IN GREAT BRITAIN.

Much has been written regarding the date of the first appearance of Leprosy in western Europe.

By Astruc,[105] Bach,[106] and others, it has been averred that the leprosy of the middle ages was introduced from the East by those who returned from the crusades. Some of our own historians, as Fuller[107] and Heron,[108] allege that by this means it first reached Great Britain. It is quite possible, allowing the disease for the sake of argument to be contagious, that through the increased international intercourse of that period, it may have been propagated more rapidly and widely than would otherwise have occurred; but there are ample reasons and proofs for believing that it existed on the continent of Europe, and even as far westward as England, before the crusade fanaticism had drawn any converts from this country.

The first relay of Englishmen engaged in the crusade left in 1096, and returned two years afterwards. Several English leper-houses were founded before that period.

Lanfranc, Bishop of Canterbury, and the ecclesiastical favourite of William the Conqueror, died, according to the evidence of the Saxon Chronicle in 1089,[109] seven years previous to the first crusade. During his lifetime he founded two hospitals near Canterbury, one a house built of stone (lapideum domum decentem et amplum) for patients affected with various descriptions of diseases (variis infirmitatum qualitatibus), and the second an hospital constructed of houses of wood, and specially set aside for lepers (ligneas domos ad opus leprosorum.)[110] Somner states that this latter institution still exists at Canterbury as a charitable establishment.[111] Other English lazar-houses were probably of as early a date, or at least earlier than the first emigration for the crusades. Brigges alleges that the leper-house of St. Leonards in Northampton, was founded in William I.’s reign,[112] or before 1087; and one at Chatham was, according to Tanner, in existence before the termination of the short reign of his son, William Rufus.[113]

But more than a century even previous to the date of which we speak, leprosy had been made a subject of legislation in Great Britain. In a parliament held by Pepin, King of France in 757 at Campiegne, it was enacted that leprosy in a husband or wife be regarded as a cause of separation, and that the sound party might again remarry.[114] Lobineau, in his history of Brittany,[115] tells us as one of the effects of this law of divorce, that among the higher ranks of the city of Dol, there were a number (_quantité_) of husbands who had as many as three wives living at the same time. Now among the earliest extant code of laws enacted in any part of Britain, those, namely, of the celebrated Welsh King, Hoel Dha, who died about the year 950,[116] there is a canon to the same effect as that referred to, viz. that a married female was entitled to separation, and the restitution of her goods, provided her husband was affected with leprosy.[117] There is, however, as we shall afterwards see, great reason to believe that the word leprosy was then used as a generic term, including under it many different varieties of cutaneous affections.

I can offer nothing precise in regard to the exact period of the first introduction of Leprosy into Scotland. If, as I have already shown to be highly probable, the term Liberton is merely a conversion from leper town, it would render it likely that the disease was an early visitant of this country; for we know that Liberton is mentioned in various old charters of the reign of David I., who died in 1153.[118] In the Foundation Charter of Holyrood (1128) the mill and chapel “de Libertune”[119] are mentioned, and in the chartulary of Kelso, “William, parsona de Liberton,” signs as witness to some charters dated during the latter half of the twelfth century.[120] At a later date there figures repeatedly, in the ancient and well-known verses of Blind Harry, as an occasional companion of Wallace—

“Thomas Gray, parsone off Libertone,”

a member of the church militant, who in more than one instance seems to have thrown aside his bell and book for the purpose of sharing in the brave struggles and hardy adventures of the Scottish patriot.

But I can adduce much more solid proof than this unstable philological basis affords, for stating that, as far back at least as the latter half of the twelfth century, the disease was not only known in Scotland, but that hospitals were by that time actually erected for the seclusion of the victims of it. The hospital of Auldnestun, in Lauderdale, had, as I have already stated, three carrucates of land granted to it, as appears from the Melrose Chartulary, by Walter, the son of Alan. The date of this grant, as of most others in the old chartularies, is not preserved, but it is a fixed and well-ascertained fact in Scottish history that the donor of it, the first of the illustrious, and afterwards royal line of Stewarts, died himself as a Cluniac monk in Melrose Abbey in the year 1177.[121]

William the Lion, who died in 1214, confirmed, as we have seen, a grant to the leper-house of Aldcambus; and the hospital of Rothfan, near Elgin, was evidently established during, if not prior to, the reign of his son and successor, Alexander II. In the chapter of gifts to this Rothfan hospital, by John Byseth, Alexander is spoken of as the reigning prince, the preamble to the grant declaring that the endowment was bestowed “for the love of charity, for the soul of King William, and for the salvation of my noble lord King Alexander” (pro salute domini mei Alexandri nobilis Regis).[122] Alexander II. died in 1249, so that by this time the disease was certainly spread to the more northern parts of the kingdom.

All Scottish records of these earlier times are almost, as I have already observed, so entirely lost, that it now seems impossible to ascertain whether any leper-houses existed in this kingdom at a date antecedent to those to which I have thus alluded. That this was the case, however, is not improbable.

Before the first notice of the earliest Scotch leper-house that I have been able to trace—viz. that of Auldnestun, about 1170, similar establishments were abundant in England. The charters of many of them appear to have been either granted or confirmed in the reign of Henry I., who died in 1154, and was a contemporary of the Scotch Kings, Edgar, Alexander I., and David I.; and it is not unworthy of remark that two, if not more, lazar-houses were founded in England by natives of Scotland prior to the date of the earliest Scotch leper-house that I have been able to discover. For Malcolm IV. founded and endowed one in his principality of Huntingdon in 1165;[123] and sixty years earlier, or in 1101,[124] Matilda, the “gode Queene Maud” of Henry I., and daughter of Malcolm III. of Scotland, established the hospital of St. Giles, Bishopsgate, for forty lepers, a chaplain, clerk, and messengers.

But at whatever respective periods the disease first appeared in England and Scotland, there are strong reasons for believing that it continued to prevail in the latter kingdom long after it had ceased, or almost entirely ceased, in the former. In the preface to the statutes of the leper-house of St. Albans, drawn up about 1350, and already referred to as published in the supplement to Matthew Paris’ history,[125] it is stated that the number of lepers that presented themselves for admission had diminished so much by that time, that their expense of maintenance was below the revenue of the institution; “in general,” it is added, “there are now not above three, sometimes only two, and occasionally only one.” In exactly the same year (1350) that this report was drawn up for St. Albans, was it thought necessary to institute the leper-house at Glasgow; and nearly one hundred years later, or in 1427, the Scottish Parliament deemed it proper to legislate on the subject of lepers.

The hospital of St. Mary Magdalene, at Ripon, was established in 1139 for the relief of all the lepers in that district. In the time of Henry VIII, it contained only two priests and five poor people to pray for all “Christen sowlez.”[126]

At Illeford, in Essex, an hospital was instituted in the reign of Henry II. or Richard I. for thirteen lepers. In one of the reports of the commissioners for suppressing colleges, hospitals, etc., in the time of Edward VI., it is observed, in regard to the state of this Illeford Hospital, that though founded “to find 13 pore men beying Lepers, 2 pryests, and one clerke—thereof there is at this day but one pryest and 2 pore men.”[127]

By the same commission most other lazar-houses were reported as having no leprous patients, and yet only a few years previously was the leper-house of Aberdeen built, and forty or fifty years afterwards (in 1591) the Edinburgh hospital at Greenside was established. We have several later notices of the disease among us. In the Aberdeen Kirk-Session Register, vol. i., it is stated that, on the 13th May 1604, the kirk-session ordained “Helene Smythe, ane puir woman infectit with leprosie, to be put in the hospitall appoyntit for keeping and haulding of lipper-folkis betwixt the townis; and the keyis of the said hospitall to be deliverit to her.”[128]

As late as 1693 we have some records of the lepers of Kingcase. On the 11th March of that year a complaint was lodged by the procurator-fiscal “anent the intruding of the lepers of Kingcase upon the priviledges only propper to the burgess and freemen (of Prestwick) by there resorting to the shoar, and taking up certain timber and other wrack, and casting greater quantities of peats and turf off the common and moss, &c., which, being seriously pondered by the magistrates, &c., they ordained that none of the said lepers of Kingcase do so under the penalty of ane hundredth pund, _toties quoties_, to be paid by ilk ane (each one) of them in caise of failyie (failure).”[129]

The disease appears to have continued in the northern islands of Scotland long after it had disappeared from the mainland, and, indeed, all other parts of Great Britain. In Shetland it has been known for centuries. I have already made a quotation from Brand to show that it was at Lerwick as late as the latter part of the seventeenth century. In some districts of Shetland it continued still later. Apparently most of those there affected either belonged to or were sent to the Island of Papa. I have in my possession a MS. extract from the Session-books of Walls, showing the expenses incurred in keeping the lepers at Papa from 1736 to 1740. Four of them appear to have died during these years, and two of the entries are for the “tobacco”[130] used at their funerals. In 1742 there is a long entry in the Session Records of Walls, earnestly enjoining a day of public thanksgiving for the supposed total deliverance of the country from the effects of the leprosy.

The disease, however, was not eradicated entirely. Mr. Jack, the resident clergyman, who wrote the account of the parish of Northmaven for the Statistical Account of Scotland, published in 1798, seems to have seen what he terms several miserable cases of the disease, and adds, that in many instances there is reason to suspect a hereditary taint.[131] Dr. Thomson urged his pupil, Dr. Edmondston of Lerwick, to trace out the history of the disease in the north, and that gentleman has made the following observations upon it in his work on the Zetland Isles:—

“Elephantiasis, known by the name of leprosy, was very frequent in Zetland about sixty years ago, but its occurrence since that time has only been occasional, and at present scarcely an instance of it is to be met with. A native of Zetland, a few years ago, was received into the hospital of Edinburgh, labouring under true elephantiasis. I have seen obscure degrees of it in Zetland, where the face was bloated, the skin scaly and rough, and the voice slightly hoarse; but they did not terminate fatally, nor was the affection apparently communicated to others. The last instance I saw of it was in the person of a boy. His friends could assign no cause for its appearance, and said that it had come on spontaneously, and proceeded gradually. The disease had been stationary for some time before it fell under my observation.”[132]

As so far confirmatory of the disease having thus longer remained in Shetland than in the more southern parts of these kingdoms, I may here mention that in the middle ages it was very common,[133] and has since long continued to linger in the neighbouring Faroe Islands, and in Iceland. It appears, from Debes’[134] evidence, that true tubercular leprosy, as we shall see in the sequel, continued to prevail in the Faroe Islands (the nearest land north of Shetland) in the middle of the seventeenth century. Still later—viz. in 1768, Petersen[135] found 280 lepers in the hospitals in Iceland. Olafsen,[136] Troil,[137] Holland,[138] and Henderson,[139] have each, from personal observation, described the disease as existing in that island; and the French Government expedition in 1836, under Gaimard,[140] have, in the beautiful work they are at present publishing, already given several excellent coloured sketches of natives affected with tubercular leprosy. The disease, according to various authors, still prevails in the northern kingdoms of Norway and Sweden. I am not by any means sufficiently intimate with the literature of the Scandinavian radesyge, to venture to offer any decided opinion with regard to its nosological nature, and its alleged relation to the leprosy of the middle ages. As far, however, as I am acquainted with the subject, it appears to me that under the name of radesyge, two, if not more distinct species of disease were, by Holst and the other authors who first wrote upon it, confounded and described together. One of these, the radesyge properly so called, is probably nearly allied to, if not identical with the sibbens of Scotland. Another of the supposed varieties of the disease, the spedalskhed or spetälska, seems on the other hand to be a different nosological species, hereditary, non-contagious, chronic, incurable, and identical in many, if not in all its characters, with true tubercular leprosy. The spetälska seems confined to particular and more limited localities in the north than the radesyge; and when we look to the descriptions of it as seen at Ostrobothnia by Udmann,[141] or as given by Hünefeld,[142] in regard to the disease at Bergen, we certainly find these descriptions very exactly answering to the definitions of tubercular or Arabian leprosy given by our best nosologists and pathologists, and which I shall have occasion afterwards to discuss at some length. Besides, radesyge is a disease which is believed by many to have made its first appearance in Sweden and Norway during the last century, while the spetälska was known at a greatly earlier date. The present hospital for it at Bergen was, as Hünefeld[143] informs us, founded as early as the year 1268.

In the Second Part I will take an opportunity of considering at length the nosological nature of the leprosy of the middle ages, particularly as it was seen prevailing in Great Britain. I will inquire into the rank, age, etc., of those attacked, and point out some of the causes which have been considered as connected with the dissemination of the disease; and lastly, I will endeavour to bring together some of the strange regulations of medical police that were adopted in England and Scotland with regard to the infected.