PART I.
Few subjects in pathology are more curious, and at the same time more obscure, than the changes which, in the course of ages, have taken place in the diseases incident either to the human race at large, or to particular divisions and communities of it.
A great proportion of the maladies to which mankind are liable have, it is true, remained entirely unaltered in their character and consequences from the earliest periods of medical history down to the present day. Synocha, Gout, and Epilepsy, for instance, show the same symptoms and course now, as the writings of Hippocrates describe them to have presented to him upwards of two thousand years ago. The _generatio de novo_ of a really new species of disease “is (says Dr. Mason Good[2]) perhaps as much a phenomenon as a really new species of plant or of animal.” Dr. Good’s remark is probably too sweeping in its principle; for, if necessary, it might be easy to show that, if the particular diseases of particular animal species are liable to alteration at all, they must necessarily alter more frequently than those animal species themselves. In pursuing such an inquiry, the pathologist labours under comparative disadvantages. The physiologist can, by the aid of geological research, prove that the individual species of plants and animals inhabiting this and other regions of the earth, have again and again been changed. The pathologist has no such demonstrative data to show that, in the course of time, the forms and species of morbid action have undergone great mutations, like the forms and species of normal life. But still we have strong grounds for believing that, in regard to our own individual species alone, the diseases to which mankind are subject have already undergone, in some respects, marked changes within the historic era of medicine. Since the first medical observations that are now extant on disease were made and recorded in Greece, various new species of human maladies have, there can be little doubt, made their original appearance. I need only allude to small-pox, measles, and hooping-cough. Again, some diseases which prevailed formerly, seem to have now entirely disappeared from among the human race—as, for example, the Lycanthropia of the Sacred Writings, and of Oribasius, Aetius, Marcellus, and various old medical authors.[3] Other maladies, as that most anomalous affection, the English sweating-sickness of the fifteenth century, have only once, and that for a very short period, been permitted to commit their ravages upon mankind. And lastly, we have still another and more extensive class, including maladies that have changed their geographical stations to such an extent, as to have made inroads upon whole districts and regions of the world, where they were formerly unknown, leaving now untouched the localities which, in older times, suffered most severely from their visitations.
Among this last tribe of diseases no one presents a more curious subject of inquiry than the European leprosy, or tubercular elephantiasis of the middle ages. This malady is now almost entirely, if not entirely, unknown as a native endemic disease on any part of the Continent of Europe; and yet from the tenth to the sixteenth century it prevailed in nearly every district of it. Laws were enacted by Princes and Courts to arrest its diffusion;—the Pope issued bulls with regard to the ecclesiastical separation and rights of the infected;[4]—a particular order of Knighthood was instituted to watch over the sick;—and leper hospitals or lazar-houses were everywhere instituted to receive the victims of the disease. The number of these houses has certainly been often erroneously stated, in consequence, as far as I have been able to trace it, of a strange mistake committed by Ducange, in quoting from Matthew Paris a passage in which that historian contrasts the respective possessions belonging in the thirteenth century to the Hospitalarii, Knights Hospitallers, or Knights of St. John, as they were termed, and the Knights Templars. The 19,000 lazar-houses in Christendom, as interpreted by Ducange, mark in Matthew Paris’ work merely the number of manors or commanderies of the Hospitalarii, and have no reference whatever to leprosy or lazar-houses.[5] But still that an immense number of leper-houses existed on the Continent at the period mentioned, is abundantly shown in many of the historical documents of that age. Louis VIII. promulgated a code of laws in 1226, for the regulation of the French leper hospitals; and these hospitals were at that date computed to amount, in the then limited kingdom of France, to not less than 2000 in number—(_deux mille leproseries_).[6] They afterwards, as is alleged by Velley,[7] even increased in number, so much so that there was scarcely a town or burgh in the country that was not provided with a leper hospital. In his history of the reign of Philip II. Mezeray uses the same language in regard to the prevalence of leprosy and leprous patients in France during the twelfth century.[8] Muratori gives a nearly similar account of the extent of the disease during the middle ages in Italy;[9] and the inhabitants of the kingdoms of Northern Europe, equally became its unfortunate victims.[10]
I have no desire, however, to enter at present into the extensive history of the leprosy of the middle ages, as seen in the different quarters of Europe. My object is a much more limited and a much more humble one. I wish only to adduce various evidence to show that the disease extended to this the most western verge of Europe, and at one time prevailed to a considerable extent in our own kingdom of Scotland, which, at the period alluded to, was one of the most remote and thinly-populated principalities in Christendom. I shall have frequent occasion, at the same time, to illustrate my remarks by references to the disease as it existed contemporaneously in England.[11]
In following out the object adverted to, I shall commence by an enumeration of such leper hospitals as I have detected any notices of in old Scottish records. The knowledge of the mere existence of most of these hospitals has been obtained more by the accidental preservation of charters of casual grants to them than by any historical or traditional notice of the institutions themselves. The information, therefore, which I have to offer in regard to most of them is exceedingly slight. The following meagre notes regarding the two first Lazar or Leper-houses, Spitals, Spetels, or Spitles,[12] which I shall mention, show the truth of this remark.
SCOTTISH LEPER HOSPITALS.
_Aldcambus, Berwickshire._—A Leper Hospital existed at Aldcambus, in the parish of Cockburnspath, Berwickshire, as far back as the reign of William the Lion.
In the Chartulary of the Priory of Coldingham is preserved a charter by which that monarch confirms a grant of half a carrucate of land to this hospital. I shall give a transcript of the charter, which has hitherto remained unpublished. I do so that it may serve as a fair specimen of the various similar charter documents to which I shall have occasion to allude in the course of the following remarks. It is entitled “Confirmatio donationis Hospitali de Aldcambus facta:”—“Willelmus Dei gratia Rex Scottorum omnibus probis hominibus totius terre sue Clericis et laicis salutem. Sciant presentes et futuri me concessisse, et hac cartâ meâ confirmasse donationem illam, quam David de Quicheswde fecit Hospitali de Aldcambus et Leprosis ibi manentibus, de illa dimidia carucata terræ in Aldcambus quam Radulfus Pelliparius tenuit: tenendam in liberam et puram et perpetuam eleemosinam, cum omnibus libertatibus et aisiamentis ad predictam terram juste pertinentibus, ita liberé et quieté sicut carta predicti Davidis testatur: Salvo servicio meo. Testibus Willelmo de Bosch. Cancellario meo, Waltero Cuming, Davide de Hastings. Appud Jeddewrith, xvi. die Maij.”[13]
_Aldnestun in Lauderdale._—At Aldneston another leper-house existed. It was under the control of the Abbey of Melrose. In the Melrose Chartulary there is preserved a charter headed “Carta Leprosorum de Moricestun.” In this charter, Walter Fitzallan, Steward of Scotland, granted to this hospital of Auldnestun and its inmates (Hospitali de Auldnestun et infirmis fratribus ibidem residentibus), a carrucate and a half of land in the village of Auldnestun; another carrucate and a half, which Dame Emma of Ednaham held (tenuit per suas rectas divisas), with the common pasturage and easement (asiamento) of the forests of Birkenside and Ligarrdewude (Legerwood), and a right to grind at his mill without paying multure.[14]
_Kingcase, Ayrshire._—At Kilcais or Kingcase, on a bleak muir in the parish of Prestwick, and about two miles from the town of Ayr, stood, for several centuries, an hospital for Lepers. The general tradition of the surrounding country avers that this hospital was founded by King Robert the Bruce. In the article on Ayr, recently published by the Rev. Dr. Auld and Mr. Cuthill, in the New Statistical Account of Scotland,[15] the foundation charter of Robert Bruce is said to have been purchased by the Magistrates of that town in 1786. I am obligingly assured, however, by Mr. Murdoch of Ayr, that no such document is known to exist among the archives of that town. It is probable that the hospital existed before the time of Bruce. In a charter to the monastery of Dalmulin, contained in the Chartulary of Paisley Abbey,[16] and of the date of the reign of William I. of Scotland, among other lands and localities in Kyle and the immediate neighbourhood of Kingcase, the term Spetel-Crag occurs. Now the term Spetel was a prefix applied, both in Scotland and England, to all hospital lands and possessions, and to these alone; and history records no other hospital whatever in Kyle, from which this appellation of Spetel Craigs could be derived. But whether Bruce was the original founder, or, what is more probable, a liberal endower of the hospital, we know this at least of the history of the Kingcase Leper Hospital, that it possessed at one time pretty extensive lands and property in the parish of Dundonald, and in Kyle Stewart.[17]
These, like many other hospital grants, came after a time to be perverted from their original objects of charity, and applied to the aggrandisement of particular individuals. Thus the family of Wallace of Newton obtained from James II. a feu-charter of the Kingcase estate of Spittalshiels, for the annual payment of eight merks Scots, and sixteen thrave of straw. In reference to this, the land of Spittalshiels has yet (observes Sir Walter Scott, in a note to his _Lord of the Isles_[18]) to give, if required, a quantity of straw for the lepers’ beds of Kingcase, and so much to thatch their houses. Along with Spittalshiels the Wallaces acquired the office of Hereditary Keeper or Governor of the Hospital itself, and of the other lands pertaining to it. In the family of the Wallaces of Craigy this right of patronage and presentation to Kingcase was long held, with all the remaining endowments of the hospital. These privileges were exposed at a judicial sale of the estate of Craigy, and purchased, 1784, by the burgh of Ayr, for £300. The magistrates, from this right, exact feu-duties from the lands formerly belonging to Kingcase, to the annual extent of sixty-four bolls oatmeal, and eight merks Scots money. This revenue has been made over to the poor’s house of Ayr. In virtue of it the magistrates have the privilege of presenting a certain number of inmates to this latter institution.[19]
No records remain as to the original extent of the Kilcais Hospital. The number of lepers supported was, during the latter years of the institution, limited to eight. Before the hospital revenues and lands were despoiled the number might have been greater. The only remnants of the buildings which are now left consist of the massive side-wall of a house 36 feet long and 17 wide. This is generally alleged to be the ruins of the chapel merely of the hospital; and under this view it is certainly calculated to give us a high opinion of the ancient extent and endowments of the institution. Sir Robert Gordon, in a description of Kyle, published in 1654, in Bleau’s _Atlas_, states that the persons admitted to the charity were then lodged in huts (_tuguria_) in the vicinity of the chapel.[20]
_Glasgow._—In 1350, in the reign of David II., the Lady of Lochow, daughter of Robert Duke of Albany, erected a leper hospital at the Gorbals of Glasgow, near the old Bridge.[21] She endowed this hospital with some lands and houses in the city. The magistrates of Glasgow seem to have exercised the privilege both of searching for lepers among the inhabitants, and of consigning them to this hospital. From the Burgh Records, presented some time ago by Mr. Smith to the Maitland Club, it appears that in 1573 the magistrates ordained four persons, named as lepers, “to be viseit (inspected), and gif they be fund so, to be secludit of the town to the Hospital at the Brigend.”[22] A similar edict was issued in regard to two other individuals in 1575,[23] and in 1581 eight more seem to have been dealt with in the same manner.[24] The Bishops of Glasgow appear also to have had a right to present patients to the hospital. In 1464, Andrew Muirhead, who then held the bishoprick, availed himself of the privilege by presenting one patient.
On the 9th August 1589, a report was given in to the magistrates of Glasgow, stating that six lepers were at that time in the house.[25] As late as 1664, the ground-rents of this hospital were uplifted by the water-bailie, an official who, according to an entry in the city records of Glasgow, was in the custom of giving in annually the number of lepers in the hospital at the Brigend. This hospital, like that of Kingcase, was dedicated to the Gallovidian Saint, St. Ninian.
_Edinburgh._—A leper hospital formerly existed at Greenside, which was then a suburb, and not, as now, a constituent part of the city of Edinburgh. The history of the hospital and its laws are preserved in the Town-Council records. In 1584 the city Magistrates issued orders for finding a commodious place for a leper-house.[26] In 1589, they passed an Act for building such an institution at Greenside, and apparently with money granted to them for that purpose, by John Robertson, a merchant in Edinburgh, and others, in pursuance of some previous vow.[27] On the 23d November 1591, five leper inhabitants of the city were consigned to this hospital.[28] Two of the wives of the lepers voluntarily shut themselves up in the hospital along with their diseased husbands. I shall afterwards recur to the strict laws which the inmates were bound to observe. In a charter of rights given to the city in 1636 by Charles I. there are enumerated among the other grants which he confirms to them, “the lands of old called the Greenside, with the leper-house and yard situate on the same, arable lands, banks, and marishes thereof, for the present occupied by the lepers of the said house.”[29] The hospital, however, does not appear to have been of long duration. In 1652, the magistrates ordered that the roof of the leper-house be taken off, and its wood, slates, etc. used to repair the town milns and other public buildings;[30] and in 1657, a similar appropriation was made of the stones contained in the walls of the leper-house, and in the fence around its yard or garden.[31]
_Aberdeen._—In an old manuscript _Description of bothe Touns of Aberdeen_, by James Gordon, as quoted in the entertaining _Book of Bon Accord_, the following notice of a leper hospital at Aberdeen occurs:[32] “Such as go out at the Gallowgate port towards Old Aberdeen, haff way almost, may see the place where of old stood the lepers’ hospital, called the seick-house, hard by the way syde. To which there was a chappell adjoyned, dedicated to St. Anna, quhome the Papists account patronesse of the lepers. The citizens licencit one Mr. Alexander Galloway, the person of Kinkell, for to build that chappell anno 1519. Now both these buildings are gone, and scarcely is the name knowne to many.” “On the 18th August 1574, the Regent Morton, and the Lords of the Privy-Council commanded the Magistrates of Aberdeen to uptake fra James Leslie, present possessioure of the croft and myre pertening to the Lipperfolk, the yeirle dewtie tharof off the five yeiris bypast; and thairvith, and sic vthir collectioune as may be hade, to caus the said house be theikkit (thatched, roofed) and reparit for the resett of the said Lipperfolk in tym cuming: and to caus roup the said croft and myre, to quha vill giff maist yeirle dewtie tharfor fra thre yeir to thre yeir: And to caus the haill proffeit to be employit vpon the upolding of the said hous, and sustentation of the Liperfolks that salbe tharin.”[33]
In the beginning of the eighteenth century the hospital and grounds were sold under the direction of the magistrates, and the money received appropriated to the establishment of a fund for a proposed lunatic asylum. The leper croft now belongs to King’s College.[34]
_Rothfan, Elgin._—A leper-house seems to have existed from an early period at Rothfan, near Elgin. John Byseth made a gift to this hospital at Rothfan of the Church of Kyltalargyn, for the avowed purpose of maintaining seven lepers, a servant and chaplain. The donor retained to himself and his successors the privilege of preserving the number complete, by filling up the vacancies. On his request and presentation, William, prior of the hospital, was admitted to the church in 1226.[35]
The precise date of Byseth’s charters is not preserved, but they seem to have been drawn out during the reign of Alexander II. or III. From their phraseology the hospital evidently was in existence previous to that time.
The lands pertaining to this hospital are still known under the name of the Leper Lands,[36] though the institution itself has been long obsolete.
_Shetland._—Lastly, we have records of several small and temporary lazar-houses in Shetland. Thus, long ago, Brand (the honest missionary, as Hibbert terms him) states that in that country the “scurvy sometimes degenerates into leprosy, and is discerned by hairs falling from the eyebrows, the nose falling in, etc., which” (he adds), “when the people come to know, they separate and set them apart for fear of infection, building huts or little houses for them in the field. I saw the ruines of one of these houses about half-a-mile from Lerwick, where a woman was for some years kept for this reason. These scorbutick persons are more ordinarily in Dunrossness and Delton, and more rare in other places.”[37]
“Formerly” (says Dr. Edmondston, another and more recent author on the Shetlands), “when leprosy was very prevalent, the unfortunate individuals who were seized with it were removed to small huts erected for the purpose, and there received a scanty allowance of provisions daily, until the disease put a period to their miserable existence.”[38]
NUMBER OF HOSPITALS, AND EXTENT OF THE DISEASE.
The Scottish lazar-houses that I have thus enumerated, though few in number, are still sufficient to show that the disease for which they were instituted was generally diffused over the extent of the kingdom. Thus, we have found the establishments in question spread from Berwickshire to Shetland, and from Aberdeen to Ayr. More research than I have been able to bestow upon the matter would no doubt bring to light notices of various additional hospitals. In some Scottish towns names and notices still exist sufficient to lead to the probability of lazar-houses having formerly existed in them, though that evidence is in other respects altogether incomplete.
In the immediate neighbourhood of Edinburgh a leper station probably existed at a date greatly earlier than that of the Greenside Hospital. In his _Caledonia_,[39] the late excellent antiquary and philologist, George Chalmers, expresses his belief in the opinion suggested by the Rev. Mr. White, that the name of the village of Liberton (two miles south of Edinburgh) is merely a corruption of Liper town,—liper being the old Scotch term for leprosy; and, as is well known, the letters _p_ and _b_ being constantly interchanged for one another in the composition and transmutation of words. This idea is certainly in no small degree countenanced by the circumstance that the lands of Upper Liberton (Libertune) in some old writs are described under the name of “terrarum de Spittle town” (Hospital town.)[40]
Besides, the “Oily or Balm Well of St. Catherine’s at Liberton,” had been long held in high estimation in curing cutaneous diseases, and still maintained great repute as late as the sixteenth and seventeenth centuries. In his brief but interesting _Cosmography and Description of Albion_, Boece, Canon of Aberdeen, at the commencement of the sixteenth century, states that the oil of this well “valet contra varias cutis scabricies.”—_Historiæ Scotorum_ (1526), p. xi.[41]
J. Monipennie alleges that its oil or “fatness is of a sudain operation to heal all salt scabs and humors that trouble the outward skin of man.”[42] Dr. Hare makes mention of it to the same purpose.[43] After the institution of the monastery of St. Catherine of Sienna (_Scotticé_, Sheens) on the Burrow Moor, at a short distance south of the city walls of Edinburgh, the Dominican nuns belonging to it made, in honour of St. Catherine, an annual solemn procession to the chapel and balm well of Liberton.[44]
This “oily or balm well” of Liberton was sufficient to excite the admiration and engage the protective care of the credulous King James VI. In a curious monograph[45] on the virtues of the well, published at Edinburgh in 1664, the author, “Mathew Mackaile, Chirurgo-Medicine.” indulges himself (p. 117) in the following historical eulogium and anathema in regard to it:—
“His Majesty King James the Sixth, the first monarch of Great Britain, of blessed memory, had such a great estimation of this rare well, that when he returned from England to visit this his ancient kingdom of Scotland in anno 1617, he went in person to see it, and ordered that it should be built with stones from the bottom to the top, and that a door and a pair of stairs should be made for it, that men might have the more easie access unto its bottom for getting of the oyl. This royal command being obeyed, the well was adorned and preserved, until the year 1650, when that execrable regicide and usurper, Oliver Cromwell, with his rebellious and sacrilegious accomplices, did invade this kingdom, and not only deface such rare and ancient monuments of Nature’s handwork, but also the synagogues of the God of nature.”
But it is unnecessary to insist further upon such problematical evidence in regard to the probable extent and prevalence of the disease in Scotland. A proof of this, of a much stronger character, is afforded by the simple fact that, as late as the reign of James I. the victims of the disease were made the subject of a direct and special legislative enactment in the Scottish Parliament held at Perth in the year 1427. I shall quote one short clause from this act “anent Lipper Folke”[46] (as it is termed), to illustrate both the apparent prevalence of the malady at that time, and this circumstance, that the burghs of the kingdom are then spoken of as possessing, or obliged to possess, lazar-houses of their own. The second clause is to the following effect: “Item, that na Lipper Folke sit to thig (beg) neither in kirk nor kirkzaird, nor other place within the burrowes, but at their own hospital, and at the port of the towne and other places outwith the burrowes.”
It is impossible to form any approach as to the number affected in this country. The hospitals that I have enumerated do not seem calculated to contain many patients. As we have already seen, that of Ayr contained at least eight patients; Rothfan, seven; five were admitted into the Greenside hospital at its first opening in 1591; and in a report of the Glasgow hospital, submitted to the magistrates in 1589, six lepers were reported as then belonging to that institution. These data are entirely inadequate to draw any conclusion from, and the more so, that here, as in England, the disease was probably more extensively spread during the eleventh, twelfth, and thirteenth centuries than afterwards; and it is exactly at that remote period that all our Scottish records are most defective.
In these early times the very words employed to designate the disease show its extent and severity. Somner, Lye, and Bosworth, in their several Dictionaries of the old Anglo-Saxon language, all quote the remarkable expression, “_seo mycle adl_,” “the mickle ail” or great disease, as signifying “elephantiasis” or “leprosie;” and it is worthy of observation, in reference to the same point, that the delightful old French chronicler, Sir John Froissart, who visited Scotland in the time of Robert II., applies, as we shall afterwards see, the analogous term of “la grosse maladie” to one noted case of leprosy in this country. Some further idea may be formed of the frequency of the disease, at least in the border counties of Scotland, when I state that, before the year 1200, there existed various hospitals for the exclusive reception of lepers in the immediately adjoining English counties of Northumberland, Cumberland, and Durham. Three alone of these hospitals contained as many as ninety-one lepers in all—viz. the hospital of Sherburne, near Durham,[47] contained sixty-five; St. Nicholas, Carlisle,[48] contained thirteen; and Bolton, in Northumberland, founded, as its charter[49] bears, by Robert de Roos, “pro salute animae meae et omnium antecessorum et successorum meorum,” was endowed for other thirteen.
I may here take the opportunity of stating that the labours of different English antiquaries, and more particularly the investigations of Leland, Dugdale, and Tanner, into the Monastic History of England, tend to show that at an early period many leper-houses were scattered over England and Wales. In searching through the works of these authors, and more particularly through the late splendid edition of the _Monasticon Anglicanum_, with the numerous additions of Caley, Ellis, and Bandinel, I have found references to between eighty and ninety English lazar-houses.[50]
In the second and third volumes of the _Monasticon Anglicanum_ (1st edition) above ninety[51] charters or other notices of English hospitals are published, and of these twenty-one at least were hospitals for the reception of lepers. Bloomefield[52] mentions eighteen leper-houses in Norfolk alone; and Taylor,[53] in his _Index Monasticus_, enumerates twenty in that single county. Six of these were placed in Norwich or its immediate vicinity, and five at Lynne Regis.
OBJECTS, CHARACTER, AND GOVERNMENT OF THE LEPER HOSPITALS.
The leper hospitals, both in Scotland and elsewhere, were intended merely as receptacles to seclude the infected, not as houses in which a cure of them was to be attempted. They were charitable and hygienic rather than medical institutions.
At the present day tubercular leprosy is still regarded as a disease which sets at defiance all the powers of the medical art. Our ancestors had so firm a belief in the same doctrine, that, in the case of one of the unfortunate wretches who was tried in Edinburgh in 1597 for witchcraft, amongst the gravest of the accusations brought against the panel was this, that she (Christian Livingstone) “affirmit that she culd haill (cure) leprosie, quhilk (the libel adds) the maist expert men in medicine are not abil to do.” Some of the means of cure she had employed have never, I am afraid, been allowed a place in any of our pharmacopœias. I may allude, therefore, as a specimen to one of them amongst others—viz. (and I quote the words of the libel) “she took a reid cock, slew it, baked a bannock (cake) with the blude of it, and gaf (gave) the samyn to the Leper to eat.”[54]
I leave it to the dogmatism of the pharmacologists to decide whether more potent virtues should be ascribed to this recipe of Christian Livingstone’s or to that deliberately offered with the same purport by our celebrated countryman Michael Scott. “It ought to be known” (says the great Fifeshire philosopher) “that the blood of dogs and of infants two years old or under, when diffused through a bath of heated water, dispels the Leprosy without a doubt” (_absque dubio liberat Lepram_).[55]
The miraculous properties of the relics of saints were in some instances strongly relied upon as an article of the Materia Medica, fit among other things to cure this incurable malady. Fosbroke[56] mentions a fountain near Moissac, described by Peyrat (abbot of that place, in the fourteenth century), the waters of which were so medicated by the relics of a saint contained in the neighbouring abbey that the crowds of lepers who resorted to it bathed and were immediately cured. But the valued fountain was not sufficiently powerful to avert the disease being communicated to the monks, or to save them even when once they were contaminated; and at last, according to the confessions of the abbot, it was shut up in consequence of some of the order dying of the very malady which their famed waters could infallibly remove.
In the sequel, when considering the causes of the disease, and the regulations of medical police, adopted in regard to the infected, I shall have occasion to speak at length of the strict rules to which the inmates of most of the leper-hospitals were subjected—not for the sake of medical treatment, but with the purpose only of preventing the dissemination of the malady.
Besides being places for the isolation of the infected, the leper-hospitals of Scotland and England were often, like the corresponding institutions of the continent of Europe, founded and endowed as religious establishments; and, as such, they were generally submitted to the sway of some neighbouring abbey or monastery. Semler[57] quotes, indeed, a Papal bull, appointing every leper-house to be provided with its own churchyard,[58] chapel, and ecclesiastics—(cum cimiterio ecclesiam construere, et proprio gaudere presbyterio)—an order against the latter part of which the poverty of many of the hospitals in Great Britain formed a very secure guarantee. The Greenside Hospital in Edinburgh, being founded at a very late period, partook, perhaps, less of the character of a religious establishment than most others in the kingdom.
The rules established for the domestic and religious duties of the inmates belonging to it, by the commissioners appointed by the magistrates of the city, were few and simple, viz.—
“That the said persons, and ilk ane (every one) of thame leif (live) quetlie, and gif (give) na sclander, be banning, sweyring, flyting, skalding, filthie speaking, or vitious leving, or any oyder way, under the paynes to be enjoynit by the counsall.
“That thair be appoyntit ane ordinair reider to reid the prayeris evrie Sabboth to the said lepperis, and ane commodious place appoyntit to the said reider for that effect.”[59]
Over some of our Scotch lazar-houses, chaplains, and religious officers with the high-church title of priors, were placed.
The prior of Rothfan Hospital was, at the intercession of the founder of the house, admitted to the church. There was one chaplain under him.
In the records of the burgh of Prestwick there is an incidental entry, showing that there was a prior placed over the Kingcase Hospital near Ayr in 1507, for “George Yong, Prior of Kingiscase, accusyt Thome Greif of four barrels of beyr, and the said Thomas grantyt 24 shillings, but denyit ye beer.”[60] We have already seen that there were chapels annexed to the Kingcase and Aberdeen Hospitals. Our history of the other lazar-houses in Scotland is so imperfect as not to enable us to state whether they were equally well provided; but certainly many of the richer leper and other hospitals in England had, as appears from their better preserved records, free chapels attached to them, with resident regular or secular canons. In the Sherburne Leper Hospital, near Durham, there were, besides the prior, four priests and four attendant clerks.[61] The hospital of St. Giles, Norwich, was provided with a master or prior, and an establishment of eight regular canons acting as chaplains, two clerks, seven choristers, and two sisters; while the only permanent residents to whose wants they were required to minister were eight poor bed-ridden subjects![62]
Both the ecclesiastical officers of the leper hospitals, and the leprous inmates themselves, were in general strictly enjoined, by the foundation charters and regulations of their institutions, to observe strict religious formulæ, and especially to offer up prayers for the souls of the founder and his family. That the duties connected with this last office were in some instances by no means slight, will be sufficiently apparent by the following extract from the laws of the leper hospital at Illeford, in Essex, which I translate from the regulations established for the house in 1346 by Baldok, Bishop of London:—[63]
“We also command that the Lepers omit not attendance at their church, to hear divine service, unless prevented by grievous bodily infirmity; they are to preserve silence there, and hear matins and mass throughout, if they are able; and whilst there, to be intent on prayer and devotion, as far as their infirmity permits them. We desire also and command that, as it was ordained of old in the said hospital, every leprous brother shall, every day, say for the morning duty a Pater noster and Ave Maria, thirteen times; and for the other hours of the day respectively, namely, the first, third, sixth hour of the vespers, and again at the hour of the concluding service, a Pater noster and Ave Maria seven times; and besides the aforesaid prayers, each leprous brother shall say a Pater and Ave thirty times every day for the founders of the hospital and the bishop of the place, and all his benefactors, and all other true believers, living or dead; and on the day on which any one of their number departs from this life, let each leprous brother say in addition, fifty Paters and Aves, three times, for the soul of the departed, and the souls of all deceased believers. But if any one shall openly (_manifeste_) transgress the said rules, or any one of them, for each transgression let him receive a condign punishment according to the amount of the offence, from the Master of the said hospital, who is otherwise called the Prior. But if a leprous brother secretly (_occultè_) fails in the performance of these articles, let him consult the priest of the said hospital in the Penitential Court.”
In several of the hospitals the passions of the inmates were endeavoured to be restrained by the laws laid down by their Superior. Thus the articles of the leper-house of St. Julian, at St. Albans, contain the following significant regulations of Abbot Michael _de accessu Mulierum_. “And since by the access of women scandal and evils of no slight nature arise, we above all things forbid that any woman enter the hospital of the brothers, with the exception of the common laundress of the house, who must be of mature age and discreet manner of life (maturæ aetatis et bonae conversationis), so that no suspicion can attach to her. And she must not presume to enter the house at suspicious times, but at the proper hours, so that her entrance and exit may be seen by all. But if a mother or sister, or any other honest matron, come there for the purpose of visiting the infirm, she may have access to the one with whom she wishes to speak, and this may be done by the permission of the Custos; without which they are not to enter, whatever may be their rank. But women of light fame and evil reputation are by no means to enter the houses.”[64]
The Custos, Master, Dean or Prior, and in some houses the Prioress,[65] seems in general to have had full control over the leprous inmates of the hospital. Thus, in the laws which have been transmitted to us of the Sherburne Hospital, it is laid down that members were to be punished for disobedience or idleness, at the discretion of the prior, by corporal correction with the birch, “_modo scholarium_.” Offenders who refused to submit to this chastisement had their diet reduced to bread and water, and after the third offence were liable to be ejected.[66]
Matthew Paris has left us a copy of the vow which the lepers of the hospital of St. Julian, at St. Albans, were obliged to take before admission. I append a translation of it as a document highly illustrative of this part of our subject:—
“I, brother B, promise and, taking my bodily oath by touching the most sacred Gospel, affirm, before God and all his saints in this church, which is constructed in honour of St. Julian the confessor, in the presence of Dominus R. the Archdeacon, that all the days of my life I will be subservient and obedient to the commands of the Lord Abbot of St. Albans for the time being, and to his archdeacon; resisting them in nothing, unless such things should be commanded as would militate against the Divine pleasure. I will never commit theft, nor bring a false accusation against any one of the brethren, nor infringe the vow of chastity, nor fail in my duty by appropriating anything or leaving anything by will to others, unless by a dispensation granted by the brothers. I will make it my study wholly to avoid all kind of usury, as a monstrous thing, and hateful to God.[67] I will not be aiding and abetting, in word or thought, directly or indirectly, in any plan by which any one shall be appointed custos or master of the Lepers of St. Julian, except the person appointed by the Lord Abbot of St. Albans. I will be content, without strife or complaint, with the food and drink, and other things given and allowed me by the master, according to the usage and custom of the house. I will not transgress the bounds prescribed to me, without the special license of my superiors, and with their consent and will; and if I prove an offender against any article named above, it is my wish that the Lord Abbot or his substitute may punish me according to the nature and amount of the offence, as shall seem best to him, and even to cast me forth an apostate from the congregation of the brethren, without hope of remission, except through the special grace of the Lord Abbot.”[68]
I have only very briefly to advert to one other subject, before closing these remarks on the government of the English leper hospitals. I have already alluded to a special order of knighthood having been established at an early period for the care and superintendence of lepers. Belloy[69] carries back the origin of this order in Palestine to a very early period in the history of the Christian church. We know as a matter of greater historical certainty that the knights of St. Lazarus separated from the general order of Knights Hospitallers about the end of the eleventh or commencement of the twelfth century.[70]
From the locality of their original establishment, and from their central preceptory being near Jerusalem, they were at first generally designated Knights of St. Lazarus, or of St. Lazarus and St. Mary of Jerusalem. Latterly they were conjoined by different European Princes with the Military Orders of Notre-Dame, Mount Carmel, and St. Maurice.[71]
Saint Louis brought twelve of the Knights of St. Lazarus into France, and entrusted them with the superintendence of the Ladreries or leper hospitals of his kingdom.[72] The first notice of their having acquired a footing in Great Britain is in the time of King Stephen. During the reign of that sovereign their head establishment in England at Burton Lazars, Leicestershire, was built by (as Nicols[73] states) a general collection throughout the kingdom, but chiefly by the assistance of Robert de Mowbray. Here they gradually acquired considerable wealth and possessions.[74] I find that the Hospitals of Tilton, of the Holy Innocents at Lincoln, of St. Giles, London, the Preceptory of Choseley in Norfolk, and perhaps various others, were betimes annexed to Burton Lazars as cells containing “fratres leprosos de Sancto Lazaro de Jerusalem.” Nicols has printed not less than thirty-five charters relating to the House of Burton Lazars. Its privileges and possessions were confirmed by Henry II., King John, and Henry VI. It was at last dissolved by Henry VIII.[75] The only settlement of the Knights of St. Lazarus in Scotland that I have been able to find, was in the town of Linlithgow, and the notice of it is very imperfect and unsatisfactory. It is contained in a document of the reign of Alexander II., and preserved in the Chartulary of Newbottle, in which reference is expressly made to land held “de Fratribus de Sancto Lazaro” at Linlithgow.[76] That the Lazarites had an establishment or establishments in Scotland as well as in the sister kingdom, appears borne out by a fact recorded by Helyot,[77] that in 1342, John Halliday, a Scotsman, was appointed Governor of the Knights of St. Lazarus both in England and Scotland, by the Grand Master of Boigny in France, who was at that period the reputed head of the order. Indeed Pennecuik, on the authority of Maimbourg (_Histoire des Croisades_), asserts that the “Knights of St. Lazarus were numerous everywhere, but especially in Scotland and France.”[78]
The first and original object of the Knights of St. Lazarus seems to have been the care probably of the sick generally, but in a special manner of those affected with leprosy.[79] They received lepers into their order, superintended the inmates of the lazar-houses, and, till the standing rule to the contrary was allowed to be changed by Pope Innocent IV., they were obliged to elect a leper to be their Grand Master;[80] “eatenus consuetudine observatâ ut Miles leprosus domûs Sancti Lazari Hierosolymitani in ejus Magistrum assumeretur.”[81]
Toussaint de S. Luc, in his History, Ceremonials, etc., of the Order of St. Lazarus, after it was united in 1608 by Henry IV. of France to those of Notre-Dame and Mount Carmel, states that the candidates for this united knighthood were obliged, upon the Holy Evangelists, to swear _inter alia_, “to exercise charity and works of mercy towards the poor, and particularly lepers” (_et particulièrement les lepreux_.)[82]
What extent and what kind of sway, if any, the Lazarite Knights of England and Scotland were ever allowed to exert over the lepers of the kingdom generally, or over the inmates of these leper cells and hospitals that more especially belonged to them, I have not been able to ascertain from any of the British historical records of the middle ages that I have had an opportunity of consulting. It is, however, only too probable that the Lazarites, like most of the other early orders of knights, were induced by pride and avarice to turn from their original objects of love and charity to others,—to views of power and aggrandisement for themselves.
EXTENT OF ENDOWMENT OF THE HOSPITALS, DIET, ETC.
Most of the Scottish leper-houses were very poorly or not at all endowed. Their principal subsistence seems to have been derived from casual alms. Each of the doomed inmates of the hospitals was, like the leper-struck heroine of the old Scottish poet, Henryson, by
... cauld and hounger sair Compellit to be ane rank beggair.[83]
The inmates of the Greenside or Edinburgh lazar-house were allowed four shillings Scotch (about fourpence sterling) per week, and for the remainder of their subsistence they were, according to the original rules of the institution, obliged to beg at the gate of their hospital.[84] The leper-house at Aberdeen was supported from the public funds of the town; but in 1591 James VI. granted a charter to “Robert Abell and remanent of the pure (poor) leprous personis and thair successors” in the hospital, to draw one peat of custom from every load of them brought to the markets of Aberdeen, in consequence (as the words of the original charter bear) “of the smallness of the rent appointit for the leprous personis in the Hospitall being unable to sustene thame in meet and fyre, quhairthrow they leif verie miserablie.”[85]
Other Scottish lazar-houses, however, were comparatively wealthy. Thus, I have already mentioned that the Kingcase Hospital, near Ayr, had some large and extensive landed properties attached to it.
The inmates of most of the smaller English leper-houses seem also to have principally depended for their subsistence upon the precarious contributions of the charitable. One of the lepers of the hospital at Beccles was, by a royal grant, empowered to beg for his leprous brothers.[86] Several of the larger English hospitals, however, were well endowed, and the food, clothing, etc., of the inmates amply provided for.
In some instances these endowments consisted of the accumulations of large and voluntary charities; in others they were made up of rich grants, left for the avowed purpose of founding chantries for the spiritual peace and pardon of the donor and his family; and in other cases, again, they were originally obtained as direct propitiations to the church for misconduct and crime. Indulgences[87] of forty days’ pardon seem to have been occasionally granted by the bishops and other ecclesiastical dignitaries to all the benefactors of the hospitals.
A bull of Pope Alexander III., which has been already referred to, granted all leper hospital possessions an exemption from the payment of tithes.[88] The canon was not universally adhered to in England, for, in the account which Archbishop Parker drew up in 1562 of the hospitals in the diocese of Canterbury, while Herbaldone and Bobbing leper-houses are reported as “not charged with the taxes of the tenths,” it is declared of the leper hospital of St. Laurence, Canterbury, that “the same is taxed and payeth the perpetual tenth.”[89]
From the _Valor Ecclesiasticus_, taken in the time of Henry VIII., it appears that whilst forty-eight hospitals, leper-houses, and lazar-houses in the diocese of Norwich and county of Norfolk possessed only a revenue of about £158 in all,[90] the rentals, on the other hand, of certain individual hospitals were comparatively great for that period. Thus, the revenues of Herbaldone[91] Hospital, Kent, and St. James’, London,[92] were each rated at £100; of Sherburne above £140;[93] of Maiden Bradley at near £200;[94] and those of the establishment and “veri fair hospital” (as Leland terms it),[95] of Burton Lazars were valued above £260.[96] In some of these richer institutions the inmates were, as I have just remarked, well provided for. As illustrative of this, I may quote the diet-table, etc., of one or two of the wealthier leper hospitals. Thus, among the rules published in the Additamenta to Matthew Paris, as established about the middle of the fourteenth century by the Abbot Michaele for the leper-house of St. Julian, near St. Albans, we find the following regulations laid down with regard to the commons of the leprous brothers (de distributionibus fratrum leprosorum):—[97]
“Let every leprous brother receive from the property of the hospital, for his living and all necessaries, whatever he has been accustomed to receive by the custom observed of old in the said hospital, namely, every week seven loaves, of which five shall be white and two brown, made from the grain as thrashed from the ear; also, every seventh week, fourteen gallons of beer, or eight-pence (octo denarios) for the same. Let him have, in addition to this, on the feasts of all the saints, on the feast of Saint Julian, the purification of the Blessed Mary, the Annunciation, the Trinity, Saint Albans, Saint John the Baptist, the Assumption of the Blessed Mary, and the Nativity of the same, for each feast, one loaf, one jar of beer, or a penny for the same, and one obolus, which is called the charity of the aforesaid hospital; also, let every leprous brother receive, at the feast of Christmas, forty gallons of good beer, or forty pence for the same. Also, let each receive on the said feast his share of two quarters of pure and clean corn, which is called the great charity. Also, at the feast of St. Martin, each leper shall have one pig from the common stall, and that there may be a fair division of the pigs amongst the brothers, according to the custom observed of old, we desire that the pigs, according to the number of the lepers, may be brought forward in their presence, if it can conveniently be done, otherwise in another place fit for the purpose, and there each, according to the priority of entering the hospital, shall choose one pig (otherwise a sum of money to be distributed equal to the value of the pigs). Also, each leper shall receive on the feast of Saint Valentine, for the whole of the ensuing year, one quarter of oats. Also, about the feast of St. John Baptist, two bushels of salt, or the current price. Also, at the feast of St. Julian, and at the feast of St. Alban, one penny for the accustomed pittance. Also, at Easter one penny, which is called by them ‘Flavvonespeni.’ Also, on Ascension-Day, one obolus for buying potherbs. Also, on each Wednesday in Lent, bolted corn of the weight of one of their loaves. Also, on the feast of St. John the Baptist, four shillings for clothes. Also, at Christmas, let there be distributed in equal portions among the leprous brothers, fourteen shillings for their fuel through the year, as has been ordained of old for the sake of peace and concord. Also, since, by the bounty of our Lord the King, thirty shillings and fivepence have been assigned for ever for the use of the lepers, which sum the Viscount of Hertford has to pay them annually at the feasts of Easter and Michaelmas, we command that the said 30s. and 5d. be equally divided among them in the usual manner; and we desire the brothers to be contented with the aforesaid distributions, which have been accustomed to be made amongst the leprous brothers of old: But the residue of the property of the said hospital we order and decree to be applied to the support of the Master and Priests of the said Hospital.”
The dress of the lepers is laid down in regulations equally precise. “The brothers are to have a tunic and upper tunic of russet, with a hood cut from the same, so that the sleeves of the tunic be closed as far as the hand, but not laced with knots or thread after the secular fashion. They are to wear the upper tunic closed down to the ankles, and a close cape of black cloth, of the same length with the hood, as they have been accustomed of old.” A particular form of shoe was also ordered, and if the order was disobeyed, the culprit was “condemned to walk daily barefooted until the Master, considering his humility, said to him—enough.”—P. 168.
The diet-roll of the large hospital at Sherburne is still more complex than that of St. Julian’s. I extract the heads of it, and of some other particulars with regard to the internal economy of the house, from Surtees’ elaborate work, in which copies of the original documents are given at full length.
The daily allowance of the lepers of Sherburne was a loaf weighing five marks, and a gallon of ale to each; and betwixt every two, one mess or commons of flesh three days in the week, and of fish, cheese, or butter, on the remaining four; on high festival, a double mess; and, in particular, on the feast of St. Cuthbert, in Lent, fresh salmon (_salmones recentes_), if it could be had; if not, other fresh fish; and on Michaelmas day four messed on one goose. With fresh fish, flesh, or eggs, a measure of salt was delivered. When fresh fish could not be had, red herrings (_allecia rubea_) were served three to a single mess; (and it was specially enjoined that they, or aught that was served up, was not to be putrid, nor corrupt, nor from animals that had died of disease)[98]; or cheese and butter by weight; or three eggs. During Lent each had a razer (_rasarium_) of wheat to make furmenty (_simulam_), and two razers of beans to boil; sometimes greens or onions; and every day, except Sunday, the seventh part of a razer of bean meal, but on Sunday a measure and a half of pulse to make gruel. Red herrings were prohibited from Pentecost to Michaelmas, and at the latter each received two razers of apples. The lepers had a common kitchen, and a common cook, fuel, and utensils for cooking, etc.—viz. a lead, two brazen pots, a table, a large wooden vessel for washing or making wine, a laver, two ale vats, and two bathing vats.
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.