Tuesday, December 22, 2009

Why were lepers excluded from medieval society?

Medieval European society was an extremely fragile one; unable neither to understand nor to protect itself in any significant way from the effects of either natural disaster or disease, and constantly under threat from the random violence of that society's own warrior elite.

This awareness of the fragility of medieval society lent impetus to the veneration of an ideal of an ordered, stable, and static society in which every man and woman had a place and a rank and where everyone, no matter how lowly or exalted, knew the rights and the obligations that their place demanded of them. Each was happy and content with his lot and stayed where he was put. However this was an unworkable and unachievable ideal; the reality of the Middle Ages was of a society that was more mobile, dynamic and with far more social mobility than is usually believed, and Journeymen, pilgrims, tinkers, gypsies, mendicants, beggars, entertainers, merchants and many others thronged the roads of Western Europe bringing to the communities that they visited news of the wider world, rare goods and services and, occasionally, trouble to be moved on.

Even if the idealised stable community could have been attained it could it could have done little when confronted with the manmade and natural tragedies that constantly threatened to overwhelm it. The only solution was to attempt to force those who stood outside to take their proper position within society.

In this world the leper was triply an outsider: often a wanderer, compelled to live by begging, her own body seemingly in revolt against herself, and her fate caused by God's wrath at her sins. The leper should have been the consummate figure of medieval loathing and fear. The medieval world was a place which was full of superstition, ignorance and cruelty, yet the medieval experience of leprosy was far more complex and subtle than just the fear that the leper might instil as an outsider.

Robert Moore's book, 'The formation of a persecuting society' treats the fate of the lepers as being a part of a wider change within medieval society in which Christendom began to define itself as exclusive and intolerant of all dissenters. His account of the lepers leans heavily upon an anachronistic account of the medieval attitude towards lepers which was created in the latter half of the nineteenth century, by western European physicians who, whilst working in the new colonies of the burgeoning European empires were encountering leprosy (mycobacterium leprae, or Hanson's disease), and were attempting to find historical justifications for the eugenic and social Darwinist polices which they advocated to counter both this disease in the Empire, and the perceived weaknesses within the populations of their own countries. The myth of a determined society, which through the complete isolation and exclusion of the leper was able to defeat the disease, matched closely to their own agenda but not the reality of the far more complex and sympathetic treatment that medieval lepers received.

The leper was simultaneously a figure that might instil fear but also compassion and charity, the leper in the abstract may be seen as a threatening outsider, but in reality as long as leprosy remained a living disease, the diseased individual would be a son, a father, a sister or a daughter- in other words, a part of the community.

The central ideological bulwark of the medieval world was the Church: its approach to the leper was similarly contradictory. In the Old Testament Leprosy was an affliction visited upon disobedient wives (Numbers 12) and insolent kings (Chronicles 26), whilst in the New Testament, Jesus associated himself closely with lepers, embracing them and curing them and, in the midst of his Passion, becoming Christus quasi Leprosus, taking on the likeness of a leper.

Leprosy was a disease that was directly linked to moral degeneracy; the church linked each separate disease to different sins, and imbalances in the humours that were believed to regulate the body. In leprosy's case these were sins of anger, envy and avarice, the sins which were punished by being made leprous in the Bible.

However Christ's association with lepers in the New Testament led the church to see in the suffering of the leper a direct relation to the sufferings that all mortals would suffer after their deaths whilst being purged of their sins in purgatory. The humble leper who meekly accepts the trials sent by God became a holy figure and lepers were held to be paupers Christi in the same way as Monks and hermits were and in their leper houses to form a quasi religious community. Job's story in the Bible, humbly accepting the travails and trials visited upon him by God and devil became in the Middle Ages an exemplar of the ideal of a humble acceptance of adversity and there are numerous accounts of religious figures who not only accepted without demur contracting leprosy, such as St. Alice the Leper but actively sought out infection as a means of proving their devotion.

The leper seemed became a 'fashionable cause' amongst the privileged of the age; Matilda, wife King Henry I kissed the sores of lepers as did Philip the Pious of France and Theobald of Blois, and donations to the building and maintenance of leper houses were considered particularly useful in offsetting the sins of the benefactors. Matthew Paris estimated that here were 19000 leper houses across Europe and over 100 in England; however one should be cautious before inferring that this profusion of charitable provision was evidence of large numbers of lepers in need of seclusion from society, At St. Giles Hospital in Norwich there was a master, 8 chaplains, 2 clerks in holy orders, 7 choristers, 2 sisters... and eight Lepers!

It has been suggested that only those who contracted the disease and were of noble birth were considered to be virtuous, although they may have assisted in the acceptance of the idea of the holy leper, much of the religious adoration of lepers, for example the embracing of lepers by Philip the Pious long predated Baldwin IV of Jerusalem or the Leper Knights of the order of St. Lazarus.

The medical knowledge of the medieval world was extremely limited; like the image of heaven and the ideal of society and the ancient Greek idea of the elements the combination of which made up all of the physical world- Earth, water, air and fir. The health of the body was believed to depend upon the maintenance of a temperate balance of coldness, wetness, heat, and dryness. Within the body of man was believed to be four humours, the mixture of which would determine both health and temperament- the melancholic was cold dry and earthy, the phlegmatic cold and wet, like water, the choleric, hot and dry, like fire, and the sanguine hot, damp and airy. A preponderance of one humour over all others would result in disease. Moral behaviour and the eating of foods which were considered to contain the qualities lacking in the afflicted person were the preferred remedies offered by medieval physicians. Despite the severe limitations of medieval medical knowledge the physicians did recognise at least that leprosy was contagious, a fact that was missed by the 'scientific' social Darwinists of the 19th century who did so much to rewrite the history of medieval lepers.

It was this recognition of the contagious nature of leprosy that was the real reason for the exclusion of lepers from wider society; however the 19th century impression of the nature of the leper houses as being austere, enclosed, and remote virtual prisons was far from the reality for most such houses. Firstly, the Idea of leper houses being remote was based on a misconception of what was meant by being outside in medieval terms. Leper houses were situated in liminal positions, outside of city walls, or at crossroads and on untillable lands but not on the whole in remote places which would have been impractical for the provision of the residents. When the incidence of leprosy had fallen to such an extent that the leper houses were lying empty they were converted into alms houses and hospitals, uses that would not have been practical if situated far from civilisation. Neither were the conditions in which the residents' were kept austere and penitentiary; although the physicians attempted to cure or alleviate the symptoms of leprosy by altering the diet and thus the balance of the humours, the provisioning of lepers was not miserly- the abbot of Reading provided for each resident of the hospital of St. Mary Magdelen to:

"...receive as a daily supply half a loaf of bread and half a gallon of middling beer (cervisie mediocris); also 5d. a month for buying meat. In Lent the bread was to be of barley. The scale of clothing was generous; each one was supplied with hood, tunic and cloak, and with two woollen vests and under-linen. The hood or cape was to contain three ells of cloth, the tunic three, and the cloak two and a quarter; these were supplied as often as required. Each inmate also received ten yards of linen yearly, and one yard of serge for shoes. Fifteen yards of linen were supplied every second year for covering the tables."

Neither were lepers treated as prisoners inside the leper houses, instead they were encouraged to travel to sites of pilgrimage in the search of a miraculous cure, and were able to come and go from their houses with the permission of the house. The houses were organised on a religious model with strict rules which if broken would lead to expulsion from the house:

The rules of the house were strict. For incontinence or striking a brother the punishment was expulsion; for defamation or disobedience to the master, fasting on bread and water in the midst of the hall, the culprit's portion of meat and drink being placed on the table and distributed by the master. No one was allowed to leave the house or stand at the gate without a companion. Anyone desirous of leave of absence for one, two, or three nights had to obtain permission of the master and of the whole convent, but if for longer the master's consent was necessary, and then only with a companion. The brothers were to prepare to rise at the first ringing of the bell, and when it rang for the third time to enter the church. If anyone found anything on the premises it was not to be concealed, but shown to the brethren and placed in the common fund; but if it was found outside it might be considered the finder's if he so willed. Alms given by anyone to an inmate on the roadside for infirmity were to go to the common purse. No one was to enter the wash-house without a companion, nor was anyone to send the servant of the house any long distance without leave.

Some of the evidence presented to support a persecuting approach toward lepers depends upon a particular interpretation of evidence, for example, the third Lateran council is presented by Moore as a defining moment in the construction of a persecuting society. However Colin Morris reads the council as ensuring that lepers who were living within leper houses were provided with churches and cemeteries of their own.

Most notoriously was the case of the 'Leper's Mass' a liturgy allegedly intoned over the newly diagnosed leper cutting them off from the rest of humanity and the communion of the Church. Cited repeatedly in histories of Leprosy, this has been exposed as a 16th Century innovation by Carole Rawcliffe which there is no evidence of ever being used by the Church

While there is no doubt that there is an increase in the efficacy of central state and church power in the period after 1000AD, Moore is mistaken in seeing this as being driven by an urge to exclude those who failed to conform; Catholicism, as the universal Church, considered itself the only route to salvation, and that to stand outside of the embrace of the church was to court eternal damnation. As shepherd the duty of the Church and of its loyal servants in the state was to save those members of the flock who stray; the improvements in the ability of the state and the church to police the general population were aimed at enforcing inclusion, not exclusion. Moore attempts to impose an anachronistically modern interpretation on the motives of "the princes and prelates" who he describes as being the architects of his 'persecuting society'; they were not motivated by greed for pecuniary gain nor lust for power, but in order save the transgressor from Hell. Reaching for scare stories about lepers may fill the pages of horrible histories but teach us nothing about the real fate of the leper and those who lived around them.








Grigsby, B.L. Pestilence in medieval and early modern English literature London 2004

McCall A. The medieval underworld London 2006


Moore, R. I. The formation of a persecuting Society: Authority and deviance in Western Europe 950-1250AD Oxford 2007

Morris, C. The papal monarchy: The western Church from 1050 to 1250 Oxford 1991

Rawcliffe, C. Leprosy in Medieval England London 2006

Richards, the medieval leper and his northern heirs London 2000


'Hospitals: Reading', A History of the County of Berkshire: Volume 2 (1907), pp. 97-99. URL: http://www.british-history.ac.uk/report.aspx?compid=40075 Date accessed: 07 December 2009


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