PART III.

Chapter 314,314 wordsPublic domain

THE ETIOLOGICAL HISTORY OF THE DISEASE.

To conclude the present hurried sketch of the British leprosy of the middle ages, it now only remains for me to consider, in relation to the etiology or causation of the disease, the rank, age, sex, etc., of those that were attacked by it; the effects of its hereditary transmission; and the question of its propagation by contagion. In connection with this last subject, I shall attempt to bring together under one view the stringent regulations and usages that were adopted by our ancestors, with a view of preventing the diffusion of the disease by means of communication between the infected and the healthy; and at the same time consider the light in which the despised lepers were regarded both by the civil and ecclesiastical law.

RANK OF THE PERSONS ATTACKED BY LEPROSY.

In this country the leprosy of the middle ages seems to have had its largest share of victims in the lower classes of society—amongst the “villeyns” or bondsmen of these times, and the poorer peasantry and burgesses, who, when shut up in the hospitals, were obliged either to depend upon the funds of these institutions, or to beg for their support. The exact trade and calling of the individuals admitted into the Scottish and English hospitals can only be very imperfectly gathered from one or two casual notices.[218]

Among the patients of Kingcase leper hospital, in Ayrshire, I have only found one whose rank I can trace. In the burgh of Prestwick[219] records for 1478-9, Anne Kerd is formally accused before the magistrates of the burgh of visiting Kingcase, and further “hir seik soun, att is lepper, repairis daili in her house [in Prestwick].” This Anne Kerd, having “a sick son that is leprous” seems from the old _Liber Communitatis_, etc., _de Prestwick_ of 1470 to have had assigned her a very small fragment of the burgh lands only, viz. “a porciunkle of commoun lande quilk acht after hir lyve to John Haveris airis (which belonged after her life [death] to John Haveris’ heirs).”[220]

Amongst the citizens of Glasgow who were at different times in the latter part of the sixteenth century ordered by the magistrates to be visited, under the suspicion of labouring under leprosy, most are recorded by their mere Christian name and surname; but two or three are entered in the burgh records in such terms as to show their occupation and probable rank, as “Robert ——, fleschor,” in 1573; “Mr. James ——, fleschor,” “Patrick Bogle, maltman,” and “Andro Lawson, merchand,” in 1581.[221] One of these individuals is reported by the Water Bailies as confined in the Glasgow leper hospital at the Brigend[222] in 1589, along with five other lepers. The whole list is interesting for our present purpose, as showing the trade and calling of the infected inmates, viz. “Andro Lawson, _merchand_; Stevin Gilmor, _cordener_; Robert Bogill, sone to Patrick Bogle; Patrick Birstall, _tailzeour_; Johne Thomsoun, sone to Johne Thomsoune, _tailzeour_; Daniel Cunninghame, _tinclar_.”

I am not aware of the existence of any similar complete list of the inmates of other British leper hospitals, to which I could refer with the view of ascertaining the occupation and rank of those that occupied them. We have scattered records, however, to show that men of riches occasionally became the victims of the disease, and passed their subsequent term of life in the leper hospitals. Thus, Jenkins, in speaking of the St. Mary Magdalene lazar-house at Exeter, states, “Richard Orange, Esq., a gentleman of noble parentage, and mayor of this city (Exeter) in 1454, being infected with the leprosy, notwithstanding his great wealth, submitted himself to a residence in this hospital, where he lived many years, and finished his days, and was buried in the chancel of the chapel. His grave, with a mutilated inscription, is still extant.”[223]

Some of the leper hospitals were specially endowed for persons above the lower ranks, who happened to become affected with the disease. In 1491, Robert Pigot gave by will to the leper hospital of Walsingham, in the archdeaconry of Norwich, a house in or near that town for the use of two leprous persons “of good families.”[224]

The malady was found among the clergy as well as among the laity, and some of the English leper hospitals were specially founded for the reception of leprous monks alone—as the hospital of St. Lawrence, near Canterbury, and, according to Tanner,[225] that of St. Bartholomew, at Chatham. From one of the edicts issued by Henry II. during the height of his quarrel with Archbishop Becket, it would appear that the dignitaries of the church occasionally did, or at least might, employ lepers in the high character of nuncios, for, in order to prevent Becket from putting the kingdom of England under an ecclesiastical interdict, Henry took all precautions that no official letters to that effect should be conveyed into Britain; and to secure this object the more surely, he enacted, that, if any individual did carry thither letters of interdict from the Pope or Archbishop, he should be punished “by the amputation of his feet if a regular; by the loss of his eyes and by castration, if a secular clergyman; he should be hanged if he were a layman; and burned if he were a leper” (_si Leprosus, comburatur_).[226]

In the extant account of the British leper hospitals, there are still preserved some instances in which these institutions were founded by the wealthy and noble after they had themselves become the victims of the malady. The leper hospital of Mayden Bradley, in Wiltshire, was founded by a female member of the rich family of the Bysets[227]—Camden alleges by a daughter of Manasser Byset, sewer to King Henry II., after she had herself become a leper. “This hospital,” says Leland, “was builded by one of the three heirs general of the Bisets, who, being a lazar, gave her part of the town of Kidderminster _in pios usus_.”[228]

If the earlier biographical notices that we possess regarding the nobility of Great Britain were as minute on their private as on their martial and political lives, we might probably have to record many more notices in regard to their bodily maladies of an import similar to the following:—The youngest son of Robert Blanchmains, Earl of Leicester, was himself a leper, and in the reign of Richard II. founded a leper hospital, dedicated to St. Leonard, on the north part of the town of Leicester.[229]

The royal families of England and Scotland did not always remain exempt from the suspicion, at least, and accusation of leprosy, if not from the actual attack of the disease.

Henry III. courted Margaret, Princess of Scotland, and the sister of Malcolm IV. The royal lady preferred the brave Hubert de Burgh, the minister of the English king. Hubert’s enemies afterwards alleged to King Henry, that he (Hubert) had dissuaded the Scottish princess from accepting the hand of the English monarch, by telling her “that Henry was a squint-eyed fool, a lewd man, a _leper_, deceitful, perjured, more faint-hearted than a woman, and utterly unfit for the company of any fair and noble lady.”—(Articles of Impeachment, as given by Speed.)[230]

In reference to this unfounded accusation, I may state that Ryland mentions it as a local tradition that the leper-house of Waterford in Ireland was founded by King John (the father of Henry III.) in consequence of his son’s being affected at Lismore with an eruption that was supposed to be leprosy.[231] But even supposing the tradition correct, it could scarcely have been Henry the eldest legitimate son of John, since, at the date of his father’s expedition into Ireland, 1209 and 1210, Henry was a child of only five or six years of age, and in all probability did not accompany his royal sire.

Different historians have alleged that Henry IV. was affected with leprosy in the latter part of his life. The immediate cause of his death seems to have been epilepsy, terminating, after a time, in an apoplectic attack; and some authors aver strongly that this was his only disease. Thus, in his Chronicles of England,[232] the celebrated old printer, Grafton, upholds that Henry was carried off by “a sore and sudaine disease called an apoplexie.” Hall, an author somewhat anterior in date, stoutly maintains this same view, for the king’s disease, as he observes, “was no lepry striken by the hand of God, as folish friers before declared, for then he neither would for shame nor for debility enterprize (as he did), so greate a journey as into Jewrie (Jerusalem), in his own persone, but he was taken with a sore apoplexye.”[233]

Hollinshed,[234] quoting implicitly this account from “Maister Hall,” gravely adds, and he “had none other greefe nor maladie.” The dogmatic authority of Hall on this, as on other points, is not to be over much relied upon.

We have little doubt that Dr. Lingard[235] had some sufficient evidence from the records of the times, for stating that Henry had at least “the most loathsome eruptions on his face.” Rapin[236] and Turner,[237] in their histories of England, both refer to Mezeray as their authority for averring that these eruptions consisted of leprosy. I find that Duchesne[238] also describes Henry as weighed down with a severe and grievous affection of leprosy; and Maydestone[239] alleges that it was this last disease, and solemnly considers it as a punishment inflicted on the king for his cruel treatment of Archbishop Scrope. Iohn Hardynge, whose authority is the more valuable from his being himself a contemporary of Henry IV., and a follower of his son, Henry V., describes in his rhyming Chronicles of English History the face of the king as disfigured by leprosy. As a portion of the last personal confessions of the monarch, Hardynge puts into his mouth the following penitent lamentations regarding the changes which the ravages of the disease had wrought upon his frame and face:—

“This wormes mete, this carryon full vnquert, That some tyme thought in worlde it had ne pere; This face so foule that _Leprous_ doth apere, That here afore I have had such a pride To purtraye oft in many place full wyde,” etc.[240]

These observations are certainly by no means sufficient either decidedly to confirm or controvert the opinion that Henry IV. was affected with leprosy; but they serve at least to show that, at the time at which he lived, rank of the highest kind was not considered as any adequate barrier against an attack of the disease.

In none of these alleged cases of leprosy in the royal family of England is the proof of the actual existence of the disease at all indubitable and complete. The evidence is more certain and satisfactory in regard to the occurrence of the malady, in its genuine form, in other scions of the House of Anjou than those who ascended the throne of England. I allude especially to the case of Baldwin IV., King of Jerusalem, a direct descendant, like the royal Plantagenets of England, from Fulk, Count of Anjou and Touraine. All historians seem to agree in stating Baldwin IV. to have laboured for some years under elephantiasis, and to have ultimately resigned his sceptre in consequence of disability from that disease. He was, says Fuller, when speaking of him under the year 1174, “enclined to the leprosie called elephantiasis.”[241] By the year 1183, “the leprosie had arrested him prisoner and kept him at home. Long” (adds the same historian) “had the king’s spirit endured this infirmity, swallowing many a bitter pang with a smiling face, and going upright with patient shoulders under the weight of his disease. It made him put all his might to it, because when he yielded to his sicknesse, he must leave off the managing of the State; and he was loth to put off his royal robes before he went to bed, a crown being too good a companion for one to part with willinglie. But at last he was made to stoop, and retired himself to a private life.”[242]

The disease, as has been above observed, did not spare the royal family of Scotland. At least two cases of leprosy are alleged to have occurred among the members of it. The first and earliest of these, however, is much more a matter of fable than of fact, and the story, as told us by Hector Boece and Dempster, is, in all probability, due rather to their love of historical romance than their knowledge of historical records. Fiacre, the subject of it, still holds a place as a saint in the Catholic calendars of France and Germany. Among the long list of oaths[243] which Rabelais, in his Pantagruel, long ago put into the mouth of the garrulous Panurge, one is an imprecation “par l’espine de Saint Fiacre.” This Saint Fiacre or St. Fithulk (as he was sometimes termed) was the reputed son of Eugenius IV. King of Scotland. Preferring a cloister to a court, he is said to have retired into France, and to have led the life of a religious solitary in a cell granted to him by Pharo, Bishop of Meaux. After his father was dead and his brother deposed, the Scottish nobles sent a deputation to Fiacre with an offer of the throne of his ancestors. But “quhen (to state the result in Boece’s words) thir ambassatouris was brocht to his presence, he apperit to thair sicht sa ful of _lipper_, that he was repute be thaim the maist horribill creature in erd” (on earth).[244] Spottiswood fixes the era of his death in the year 665.[245]

The case of King Robert the Bruce is a more recent and a more authenticated instance of leprosy in the royal family of Scotland. All authorities agree in stating that the Bruce suffered under a “lang seknes,” as Wyntoun[246] expresses it. Froissart, who visited the Scottish Court in the reign of his grandson Robert II., describes, in more than one passage, the Bruce as having been afflicted with and died of “_la grosse maladie_,” “sore greved with ye great sickenes”[247] as Lord Berners has translated it.[248] In their editions of Froissart’s works, Sauvage,[249] Buchon,[250] and Johnes,[251] severally comment upon “la grosse maladie” of Froissart, as signifying the leprosy. I have already adverted to this expression as being quite synonymous in words and meaning with the Saxon term for the disease. Further, that Bruce was really affected with and died of leprosy, seems to be borne out by the evidence of the older historians. Hemingford, a contemporary of Bruce’s, describes him as “lepra percussus;”[252] and Walsingham uses the same language both in his _Chronica_[253] and in his _Ypodigma Neustriæ_;[254] Boece speaks of Bruce as dying of leprosy (ex lepra fato concessit);[255] and Buchanan gives to his disease the more unequivocal name of elephantiasis (“nam in elephantiam incederat”).[256] Leland, in the translation which he has given in the first volume of his _Collectanea_ from the famous _Scalacronica_, speaks of ambassadors being sent from England to “Murrefe (Moray), the guardiane of Scotlande in the nonage of King Davy, whos fader dyed of the Lepre;”[257] “_qui mort estoit de lepre_,” in the words of the original works.[258] In the old and valuable _Chronicle of Lanercost_, which has only been for the first time printed within the last two years, the disease and death of the Bruce are mentioned in terms equally precise. In speaking (p. 254) of Randolph and Douglas entering England in 1326, the Chronicle states that the Scottish army was not led by Bruce in person, because “factus erat Leprosus.”[259] His death is thus announced in a subsequent page (264) of these old and probably contemporary records, under the year 1329, “mortuus est Dominus Robertus Brus, Rex Scotiæ, leprosus.”

I shall close these remarks by alluding to one other reputed case of leprosy in a descendant of the royal families of Scotland. The celebrated Constance, Duchess of Britanny, who was allied to the royal families both of England and Scotland (being a granddaughter of Malcolm III. of Scotland, and the English Princess Margaret Atheling, and at the same time a descendant of a natural daughter of Henry I.), is generally alleged by historians to have suffered and died from leprosy.[260] William of Nangris (as Lobineau observes) “has shown that she died of leprosy (_de la lepre_), a disease with which females were occasionally attacked in these times.” Lobineau places the date of the decease of Constance in the year 1201.

SEX OF THE LEPERS.

The modern history of tubercular leprosy would seem to show that the disease attacks the male in a larger proportion than the female sex. From the table which Dr. Adams collected and published of patients admitted into the leper-house of Funchal, Madeira,[261] from 1702 to 1803, it appears that during that period 526 infected males were admitted into the hospital, while the corresponding list of infected females amounts only to 373. The enumeration of the lepers in the Glasgow leper hospital in 1589,[262] and those entered into the Greenside hospital of Edinburgh in 1591 (the only two old lists of patients of such institutions in Britain that I am acquainted with), show the diseased inmates of these two establishments to have been all males. A large proportion of the English lazar-houses seem, from the language of their charters, to have been endowed entirely for males (_fratres leprosi_), but, at the same time, we have abundant evidence in the same documents that females often suffered from the disease.[263] Some of the lazar-houses were founded and endowed for admitting infected inmates of both sexes (_fratres et sorores leprosæ_). Thus Tanner states that the old lazar-house of St. Nicolas, York, contained both male and female lepers.[264] Mackarell and Bridges both mention the same fact with regard to the hospitals of St. Nicolas at Lynne Regis,[265] and of St. Leonard at Northampton;[266] and the inmates of the leper-house of St. Giles, Shrewsbury, bore, according to Owen and Blakeway,[267] the style of the prior, brethren and sisters of St. Giles. A few of the English hospitals were indeed entirely devoted to the reception of leprous females. Thus the hospital of Mayden Bradley was founded in the time of Henry II. for those of the female sex only (_pro mulieribus leprosis_); and the hospital of St. James, Westminster (which, says Bishop Tanner, stood on or near the place now occupied by the palace of the same name), was destined, as the renewed charter of Henry III. bears, for fourteen leprous girls (_quatuordecim Leprosis puellis_).[268]

AGE OF THOSE ATTACKED—DURATION OF THE DISEASE.

There are no documents (as far as I am aware) which directly throw any light on the age of the inmates of the leper hospitals. The expression, however, of _puellæ_, which I have just quoted as applied to the inmates of St. James’ Hospital, shows the youth not less than the sex of the inmates of that institution, and so far demonstrates that the disease then, as it does now, sometimes attacked its victims very early in life. Baldwin IV. of Jerusalem, (whose case I have already referred to) was affected with the disease while still a minor, and surrendered his crown at the age of 23, in consequence of the ravages which the disease had by that time made upon his constitution. “He died young,” says Fuller, “at five-and-twenty years of age—a king happie in this, that he died before the death of his kingdome.”[269]

King Robert the Bruce, another, as we have already seen, of the royal victims of the malady, died at the age of 55.[270] But it is difficult to fix the precise date of the first attack of the disease in the case of the Scottish king, and hence difficult to deduce the exact duration of the malady in this particular instance. His faithful biographer, Barbour, describes him as “tuk with sic a sicknes” before the battle of Inverury in 1307, “that he mycht nothyr rid na ga”[271]—(that he might neither ride nor walk). Kerr, in his _History of the Life and Reign of the Bruce_, seems to hint that this was the commencement of the disease which ultimately carried him off;[272] and indeed Barbour, in a subsequent part of his poem, describes his fatal malady as “beguth”—(begun)

throuch his cald lying Quhen in his gret myscheiff wes he.—P. 407.

But if the affection commenced in so acute a form at that date, it must have lasted for the long period of twenty-two years, as his death did not take place till 1329. If the disease under which the king suffered so severely in 1307 had been leprosy, it would not in all probability have left his activity and individual prowess for so long a date unimpaired. The battle-axe which, on the evening before the battle of Bannockburn, cleft at a single blow the helmet and skull of Henry de Bohun, could scarcely have been wielded by the arm of one whose body had for some years previously been the seat of a mortal disease. Some facts, however, would seem to show that the malady had assumed a marked and severe form a considerable time before the Bruce’s death. I have already shown, from the _Chronicle of Lanercost_, that three years before his demise the Bruce was already so incapacitated by the inroads of the leprosy that he was unable to undertake the command of the army in their descent upon the northern counties of England.[273] The same reason rendered him, as we are informed by Barbour, unable to attend the peaceful nuptial feast of his son at Berwick in 1328. It may not be considered uninteresting to add, as a part both of the history of the man and of the disease under which he was labouring, that during these three last years of his life, and whilst “the sicknes” affected his body “so fellely” (to use Barbour’s words), “and him trawaillat sa that he considered death certen,” his naturally energetic mind was still active and vigorous. The accounts of his chamberlain, preserved in the Register House of Edinburgh,[274] show that, during the very last year of his life, he was busied in making experiments on ship-building and navigation in his retirement at Cardross Castle, near the banks of the Clyde, in Dumbartonshire. Within a month before his death, he indited from this place a letter (the original of which still exists among the old archives of Melrose Abbey, preserved in the General Register House, Edinburgh[275]), desiring his heart to be buried within the precincts of that monastery,—a wish which he changed, a short time before he expired, into the well-known commission to his favourite follower and friend, “ye gentle knighte of Douglas,” viz. “I woll yat, as soone as I am trespassed oute of this worlde, ye take my harte oute of my body, and embaume it, and present it to the Holy Sepulchre at Jeruslem, saying my bodie can nat come.”[276]

HEREDITARY TRANSMISSION OF THE LEPROSY.

Few facts in the history of tubercular leprosy seem to be more universally admitted by all writers on the disease, both ancient and modern, than the transmission of the predisposition to it from parents to offspring. The Greek and Arabian physicians considered it as a malady in which all the fluids of the body were equally diseased (corrumpens pariter omnes humores corporis). “Fit itaque (adds Haly Abbas, the well-known Arabian author of the tenth century, in his chapter “De Elephantia”), cum humoribus spermatis corruptio, cum et humores et sperma ex sanguine fiant, in tantum, ut in generatione passio haec transeat in filios.” (Theoric, lib. viii. cap. 15.) Avicenna and the later Arabian authors, with Theodoric, Lanfranc, and other European writers of the middle ages, express a similar belief in the hereditary transmission of the disease; and in the same spirit, our countryman Gilbert, writing, as we have already seen, in the thirteenth century, observes, “Lepra est interdum morbus primus, sicut ex spermatibus primis matris et patris Leprosis. Sanguis enim corruptus interius, qui est nutrimentum foetus, corrumpit foetum.”[277]

Amid the scattered fragments relative to the former history of leprosy in this country, it can scarcely be expected that we should have preserved for us any individual data bearing directly upon the transmission of the disease from father to son. I have met, however, with one notice, which, though imperfect, it may not be considered uninteresting to quote in regard to the present question. In the Burgh Records of Glasgow for 1581, Patrick Bogle is ordered to be inspected for leprosy;[278] and eight years afterwards (1589) “Robert Bogill, _sone_ to Patrick Bogle,” is reported as an inmate of the leper-house belonging to the city.[279]

It is unnecessary to adduce the opinions of modern authors in support of the occasional hereditary transmission of leprosy, as all observers who have described the disease from their own observations, and that in the most different and distant parts of the world, seem uniformly agreed upon this point. Dr. Heineken, in his account of the inmates of the leper hospital at Funchal, Madeira, in 1825,[280] states that in three of the cases no hereditary taint was known; the aunt of a fourth (p. 21) was a lazar; the uncle and two brothers of a fifth (p. 18) laboured under the same disease; the mother, brother, and son of a sixth (p. 19), were lepers, and all of them affected before himself; and in a seventh case (a female aged 35) her father, mother, three sisters, and two brothers, had already all died of elephantiasis.

Among the seven cases of elephantiasis seen by Dr. Kinnis in the Mauritius,[281] three were Mozambique slaves, and could give no satisfactory account of their parentage. Of the remaining four—the first could give no history of her father and mother, but had brothers and sisters in perfect health: the ancestors of the second patient had not been affected with leprosy, but her husband had laboured under it for two years before death: the third case was a daughter of these parents, and one of her brothers had died of elephantiasis: the fourth patient appeared to have inherited the predisposition from the family of his maternal grandmother, who was never attacked herself, but who lost two sisters and three nieces by the disease.

These and other similar data show that the predisposition to leprosy, like the predisposition to other hereditary diseases, may occasionally show itself only in one or two individual members of a family; and may sometimes lie dormant for one or two generations, to reappear in a subsequent one. “God and Nature,” says the reverend author of a description of the Faroe Isles, formerly quoted, “deals wonderfully with such people (lepers) in their marriages, for amongst the children, they beget some clean and some unclean. It has also been taken notice of that two living together in marriage, though the one be found infected, they live together as before, as long as one doth but murmur of it, till the magistrate doth separate them, and yet the sound remaineth uninfected; whereas another is often taken with the disease by a very little conversation.... What is this? but that God confirms the truth of his word, taking pleasure in them that live in a just wedlock, and wander in lawful ways, putting their hopes in him, that neither fire nor water, contagious disease, nor dangerous pestilence shall hurt them.”[282]

In some of the few districts of Europe in which cases of the disease have continued to linger down to a late period, the malady seems to be transmitted through an old hereditary taint in particular families, rather than generated by existing external circumstances acting on the bodies of those who now become its victims. The tubercular leprosy exists still, or at least existed lately, in the districts of Martigues and Vitrolles[283] in the south of France. The cases, though very few, have still been well marked. M. Vidal, who, towards the end of last century, described several instances of the disease which he saw at Martigues, states that, with one problematical exception, the malady was in every case hereditary.[284] “May we not,” he adds, “conclude from this, that if the local causes which are generally assigned for leprosy be true, they have not, at least in our country, sufficient power to originate the disease (la faire naître), but generally only to develope and perpetuate it in the descendants of ancient lepers?”[285] The same family predisposition probably perpetuated the malady for some generations in the few cases that occurred in Shetland, in the latter part of the last century. The case of the Shetlander Berns, as mentioned in a preceding Part, was an instance in which the disease was apparently the result of hereditary transmission from his ancestry.

The predisposition from hereditary constitution to leprosy, and some other diseases, was well known to our forefathers; and, if we place credit in the account of the “auld manneris” of the Scotch antecedently to the reign of Malcolm Canmore, as “compilit be the nobil clerke, Maister Hector Boëce, Channon of Aberdene,” they were accustomed to practise hygienic measures that were assuredly more summary than humane, in order to arrest the diffusion of disease by such channels. For, to quote the words of Boëce:—“He that was trublit with the falling evil (epilepsy), or fallin daft or wod (insane), or having sic infirmitie as succedis be _heritage_ fra the fader to the son, was geldit (_castratus_), that his infekit blude suld spreid na forthir. The women that was fallin _Lipper_, or had any other infection of blude, was banist fra the cumpany of men, and gif scho consavit barne under sic infirmitie, baith scho and hir barne war buryit quik (if she conceived a child under such infirmity, both she and her child were buried alive”).[286]

EXTERNAL EXCITING CAUSES OF LEPROSY IN THE MIDDLE AGES.

The investigation of the causes of diseases has, probably more than any other department of medicine, been marked by belief without evidence, and assertion without facts. The history of the opinions which have at different times been so freely offered and adopted with regard to the production of leprosy, and the numerous explanations which have been proposed with respect to the causes of its almost epidemic prevalence in Europe in the middle ages, and its nearly complete suspension in the same region of the world at the present day, might easily, if time and space permitted, be made to form a chapter highly illustrative of the above general remark. The frequency of the disease in former times has been confidently ascribed by different authors[287] to peculiarities in the diet, dress, personal and domestic habits, etc., of our forefathers. And certainly their mode of life was in many respects specially calculated to generate derangements and eruptions of the skin. The good old Saxon practice of bathing[288] appears to have become forgotten after the date of the Norman conquest; and in the subsequent history of these early times we might trace various indirect and direct causes of cutaneous disease, in the close hovels and unventilated dwellings of the period;[289] in the habits of personal uncleanness;[290] in the rough straw bedding then generally[291] in use, and which “hard lodging” Hollinshed describes as still used by the servants in his day, “with seldome (he adds) anie sheete vnder their bodies to keepe them from the pricking straws that run oft through the canvas, and rase their hardened hides;”[292] and probably also in the articles of diet[293] on which the general community were obliged to subsist in times before the improvement of agriculture, and the introduction of that “schamefull intemperance” (as old Boece[294] fanatically terms it), “when na fische in the see, nor foule in the aire, nor beast in the wod may have rest, but are socht heir and thair to satisfy the hungry appetit.” For the investigation of this and other allied questions in the history of the production of our older epidemic and endemic diseases, the works of Hollinshed, Strutt, Henry, Chalmers, Macpherson, and others, contain a great and available mass of materials. But, in consequence of the unforeseen extent to which our present remarks have already lengthened out, we are forced to abstain from entering into this topic, and discussing the notes which we have collected in regard to it. At the same time, however, we may pause to observe that we believe it would be no easy matter to point out the exact differences in those physical conditions of the inhabitants of this country in former and in modern times, which may have led to the prevalence of the disease amongst our ancestors, and to its disappearance amongst us. If poverty in diet, or personal wants, and filth, and wretchedness in their deepest degrees, could generate the malady, there are certainly still numerous spots in continental Europe, and even in our own land, where, unfortunately, all these elements of disease are in our own day in full and active operation, without any such specific result following; the alleged causes are present without the alleged effects.

In order to attain anything like satisfactory results of the supposed physical causes of leprosy in Great Britain in former times, the whole question would require to be thoroughly investigated in connection with two others, viz., the allied physical circumstances,—_firstly_, of the inhabitants of those countries in which the disease in the same way formerly raged; and, _secondly_, of those districts of the world in which it is still prevalent. It is only by following such a line of inquiry that we could hope, if at all, to separate mere matters of opinion from matters of fact, and at last to obtain, by a kind of reasoning by exclusion, the exact physical condition or conditions of a people that are capable of originating or of spreading this particular species of disease. The difficulty of the problem may be easily appreciated by glancing for a moment at the diversified _geographical localities_ and circumstances under which the tubercular leprosy is known at the present day to appear. In modern times it has been found existing, to a more or less limited extent, in places the most distant and the most dissimilar in regard to temperature, climate, situation, soil, etc., as in Sumatra,[295] under the equator, and in parts of Iceland almost within the verge of the Arctic Circle;[296] in the temperate regions of both hemispheres, as (in the southern) at Hamel en Aarde[297] in the Cape district, and (in the northern) at Madeira[298] and Morocco;[299] in the dry and arid plains of Arabia,[300] and in the wet and malarious districts of Batavia[301] and Surinam;[302] along the shores of Guiana,[303] and Sierra Leone,[304] and in the interior of Africa,[305] Hindostan,[306] Asia Minor,[307] and Asiatic Russia;[308] on the sea-coast, as at Carthagena,[309] and thousands of feet above the level of the ocean, as on the table-land of Mexico;[310] on some of the islands in the Indian,[311] Chinese,[312] Caribbean,[313] and Mediterranean[314] seas, and on the continents of Asia, Africa, and America.

CONTAGION AS A CAUSE OF LEPROSY.

Most modern pathologists seem inclined to call in question the contagious nature of tubercular leprosy, as it at present exists in different parts of the globe.

Cullen, Darwin, and Good are almost the only English physicians of later times that have admitted the contagious character of the disease, and that not from personal observation. The evidence bearing against the doctrine of this mode of its diffusion is principally of a simply negative kind. In some of the districts in which the malady is endemic, the sick are seen to maintain a free intercourse with the healthy, without the disease being frequently or at all communicated to the latter; the nurses of the lazar hospitals are alleged to remain uninfected; lepers often continue long in the midst of their families without spreading the scourge to any of the other members; and occasionally a husband and wife are seen living in wedlock for years, one of them deeply affected by the disease, and the other remaining perfectly sound. Instances, exceptional to these general remarks, are certainly occasionally observed, as in a case quoted in a previous page from Dr. Kinnis, of a wife becoming infected subsequently to both her husband and daughter suffering from an attack of the malady. In such cases as this, however, we must recollect that the repetition of the disease in two or more members of the same family may merely depend upon the same external or general morbific agencies, acting upon the constitution of all the sufferers.

At least, whenever, from circumstances, this source of fallacy is avoided, the evidence of the contagion of leprosy seems to become more and more defective. Thus, when the disease happens to be imported in the person of an infected individual from a district in which it is endemic, to one in which it is unknown, the malady seems to have no tendency whatever at the present day to spread to any of the inhabitants of the new and healthy locality. Persons labouring under tubercular leprosy are occasionally, for example, sent from southern stations to England and France. In such not unfrequent cases the malady has never, I believe, been known to be communicated, in one single instance, from the infected person to those resident inhabitants of the new district, among whom he was living in free and daily intercourse.[315]

Did the leprosy extend and prevail over Europe in the middle ages as independently of propagation by contagion as the perpetuation of the disease seems to be in most localities at the present day?

If we deferred to the mere opinion of the older medical and historical authors, the contagious character of the disease at that era would appear to be undoubted. These authors express an unanimous opinion on its contagious propagation; and it is not till we come down to the professional writers of the seventeenth century, as Fernelius[316] and Forestus,[317] that we find this doctrine ventured to be called in question.

The evidence, however, left us by the older authorities and physicians on this point, is an evidence of opinion rather than of facts. They have bequeathed to us merely their own dogmatic inferences, without vouchsafing to state any of the individual data upon which their general deductions were founded. As far, however, as we may judge by a few loose fragments which we may still gather up from amid the imperfect and scattered records of the disease, the European leprosy, if it were contagious, when epidemic in the middle ages, was at least less so than the combined medical and popular belief of those times would seem to represent it. In the Edinburgh hospital in 1590, two of the lepers’ wives lived uninfected with their husbands; and a few of the English leper hospitals, as those of Ripon, St. Magdalene, Exeter, and St. Bartholomew, near Oxford, were endowed for the purpose of serving as retreats at one and the same time both for the merely poor and the truly leprous.

Individuals stricken with leprosy were sometimes looked upon by the superstitious spirit of the age as persons directly smitten by the hand of God; and we find in history traces of rich and noble, and even of royal devotees, endeavouring to expiate their sins and propitiate the good will of Heaven, by occasionally devoting themselves, and that with perfect impunity, to such duties to the sick as offered the most certain means of calling down the disease upon their own bodies, provided it had been at all so contagious as was generally supposed. Saint Louis (Louis IX.) of France visited the leper hospitals every third month, personally rendered the most abject services to their inmates, fed them, and bathed their sores with his own hands.[318] Henry III. of England is reported to have annually, on Shrove Tuesday, engaged in the same duties.[319] Robert II., the son of Hugh Capet, enacted the devotee in the same manner, imprinting kisses with his lips on the hands of the lepers (_ore proprio figens leprosorum manibus oscula, in omnibus Deum collaudabat_).[320] The old English historian, Matthew Paris, relates, in his usual quaint and gossiping style, an anecdote illustrative of a similar degree of charitable penance and defiance of contagion being practised by the Scottish Princess Matilda, the queen of Henry I. of England. Speaking of some transactions in the year 1105, he observes—

“At the same time David (King of Scotland), the brother of Matilda, Queen of the English, came to England to visit his sister, and when, on a certain evening, he came by her invitation to her chamber, he found the house filled with lepers (_domum invenit Leprosis plenam_), and the Queen standing in the midst, having laid aside her cloak, she with both hands girded herself with a towel, and water being placed in readiness, she began to wash their feet, and wipe them with the towel, and embracing them with both hands, kissed them with the utmost devotion. Upon which her brother addressed her thus; ‘What is this which you are doing, my Lady? in truth if the King knew this, he would never deign to kiss with his lips your mouth, contaminated by the pollution of the lepers’ feet!’ and she, smiling, replied, ‘Who knows not that the feet of an Eternal King are to be preferred to the lips of an earthly king? Behold it was for this that I invited you, dearest brother—that you might learn by my example to perform similar actions. Do, I beseech you, that which you see me doing.’ And when her brother had made answer that he would by no means do such things, as she persevered in her employment David with a smile withdrew.”[321]

In quoting, against the alleged strong contagion of the olden leprosy, the preceding instances of complete exposure to the infection of the disease, and yet, at the same time, of complete escape from it in some well-known historical personages, let it not be inferred that the victims of the malady were usually looked upon by the general community with feelings of devotion and pious commiseration. On the contrary, the subjects of this “_foedissimus omnium morborum_” were, as a body, regarded alike by the church and by the people as objects of disgust. The Council of Ancyrus decreed that lepers were only to be allowed to worship amongst the Hyemantes, or those public penitents who, on account of the enormity and turpitude of some of their sins, were obliged to stand in the open air, and not even allowed to come under the porch of the church.[322] The Council of Worms granted to lepers a liberty of receiving the sacrament of the body and blood of Christ, but not with those in perfect health.[323] Guido de Monte Rocher, in his _Manual for Curates_, states, that to some lepers the sacrament cannot be given, because “non possunt corpus Dominicum sic recipere et tractare in ore suo, quin rejicerent ipsum, sic multi, quibus reciderunt labia et dentes et sunt totaliter corrosi usque ad guttur.”[324]

The preamble to the laws of the hospital of St. Julian’s, drawn up by Abbot Michael, asserts, that “amongst all infirmities the disease of leprosy may be considered the most loathsome, and those who are smitten with it ought at all times, and in all places, and as well in their conduct as in their dress, to bear themselves as more to be despised and as more humble than all other men.” The canons of the Church of Scotland, as drawn up in the thirteenth century, deal with the unfortunate lepers more humanely than most other ecclesiastical judicatories; for after recommending them to be admonished to respect the churches of their districts, it is added that, if they cannot be induced to do so, let no coercion be employed, seeing that affliction should not be accumulated upon the afflicted, but rather their miseries commiserated (_cum afflictis addi non debeat afflictio, sed ipsorum, miseriis sit potius miserandum_.)[325] But the contempt displayed towards them seems to have been almost proverbial as late as the age of Elizabeth. Thus Shakespeare makes Margaret of Anjou exclaim to the afflicted and suspicious Henry VI., after the murder of his uncle, the Duke of Gloucester,

Why dost thou turn away and hide thy face? I am no loathsome leper, look on me.[326]

Maundrell, one of our early English travellers in Palestine, alludes to some cases of leprosy in terms portraying simply but strongly the fearful effects and character of the disease. After speaking of some cases of leprosy that he met with in his journey, he states (to quote his own words), “At Sichem, near Naplous, there were not less than ten lepers,—the same number that was cleansed by our Saviour not far from the same place, that came a-begging to us at one time. Their manner is to come with small buckets in their hands to receive the alms of the charitable, their touch being still held infectious, or at least unclean. Their whole distemper was so noisome that it might (he adds) well pass for the utmost corruption of the human body on this side the grave.”[327]

Various authors have alleged that the institution of leper hospitals, and laws for the separation and seclusion of the infected, were formed more from imitation of the Levitical institutions regarding the leprosy than from direct observation and proofs of the contagious character of the disease. The avoidance, however, and separation of the sick, have been recommended and followed by authors and by communities over whom the Levitical laws could have exercised no influence, direct or indirect, and to whom, indeed, these laws were in all probability totally unknown.

After describing the horrors and course of elephantiasis or tubercular leprosy, the old Roman physician, Aretæus, adds, “seeing the infected with this disease are such, who would not fly them? (_aufugiat_), or who would not turn aside from a leper, even although he were a son, or a father, or a brother, since there is fear lest the disease should be communicated? (_quum metus est ne morbus communicaretur_). Hence, many have banished those that were dearest to them into solitudes and mountains.”[328]

A knowledge of the laws and customs of the Jews in all probability never reached, or at least certainly never influenced, the opinions of the inhabitants of Tonquin—a kingdom which was formerly a part, and long a tributary, of China, and where the general religion is the idolatry of Fo and of Lanzo, with sects of the literati or followers of Confucius;[329] yet in that country those infected with leprosy are treated on the same principles of separation from the general community as we find applied to them in other and distant districts. “In Tonquin, leprosy is so common,” says Richard in his history of that country, “that there are pieces of land assigned where those attacked by it must reside. They are shut out from society; and it is even lawful to kill them if they enter cities or towns.”[330] In a country like Tonquin, it is difficult to conceive how laws and usages of this kind could have originated in anything except a belief in the contagious nature of the disease, as derived from the observation of its mode of diffusion. At all events, the old institutions and customs of the different kingdoms of Europe, in regard to lepers, seem all to have been originally founded on such a belief in the possibility of the contagious communication of this dreadful and dreaded disease from the sick to the healthy. These institutions and customs I propose now to sketch very briefly, and that principally as they bear upon the usages formerly observed towards lepers in England and Scotland. I shall consider them as they refer to—1. The separation of the infected from the general intercourse of society; 2. The laws prohibiting their entrance into towns; and 3. The restrictions under which they were placed as inmates of the hospitals.

SEPARATION OF LEPERS FROM THE GENERAL AND HEALTHY COMMUNITY.

After all that I have already had occasion to state relative to the objects of the leper hospitals, and the selection of the infected, it is almost unnecessary to add that in Great Britain, as upon the Continent,[331] lepers were obliged, either by law or usage, to seclude themselves from society when once the disease was discovered upon their persons.

The chancery warrant of Edward IV., quoted in the Second Part of these papers, speaks of the retirement of a leper from society as a matter of custom and duty, and empowers the sheriff of the county to remove the suspected person to a secluded place, as is the usage (_prout moris est_), provided the actual existence of the disease was made out.[332]

There exist in the old records of Scotland both local and general enactments enforcing the retirement and seclusion of lepers. The Scottish “Burrow Lawes” (_Leges Burgorum_) are generally allowed to have been drawn up as early as the twelfth century.[333] They are a code intended apparently for the government of the four first royal burghs of Scotland, viz. Berwick, Roxburgh, Edinburgh, and Stirling. Their sixty-fourth chapter contains some regulations regarding “lippermen.” The first of these regulations provides in the following terms for the lodgment in hospital and sustenance of the “lippermen” of the burghs:[334]—

“Gif ony man dwelland or borne in the King’s Burgh is striken with leprosie, and hes substance and geir of his awin to sustaine and cleath himselfe, he sall be put in the hospitall of that burgh quhere he dwells. And gif he hes na thing to liue upon, the burgesses of that burgh sall make ane collection amongst them, for meat and claith to him; and that collection sall be the summe of twentie shillinges.”[335]

The canons of the Church of Scotland, as drawn up or authorised by the provincial ecclesiastical councils held at Perth in the years 1242 and 1269, speak of those attacked by leprosy in this country, as being “separated from society in accordance with general custom (_de consuetudine generali a communione hominum separantur_) and retired to secluded situations.”[336]

I have already, in Part II., quoted a clause from the acts of the Perth Parliament of 1427, empowering and enforcing the dignitaries and officers of the church to search diligently in their parish visitations for any persons affected with leprosy, and to commit them to the keeping of either the civil or ecclesiastical authorities, according as they happened to be “Clerkes” or “Seculars.”

PROHIBITIONS AGAINST THE INFECTED ENTERING TOWNS.

Lepers were compelled, by other reasons than mere custom or common law, to retire from society. They were of necessity driven to seek the asylum of the lazar hospitals, in consequence of the statutes, both of the general country and of local communities, prohibiting any citizen from retaining a person labouring under leprosy in his house, and preventing the infected from entering within the gates of the towns and villages.[337]

The old Scottish Burrow Lawes have stringent clauses upon this head, for they hold that “na man should presume, or be so bauld as to harberie or ludge ane lipperman within the burgh, under ane full amerciament.” And further, “lippermen sall not enter within the towne, bot in passing throw it, and sall not gang fra dure to dure, but sall sit at the ports of the burgh, and sall seek almes fra them that passes in and comes furth.”[338]

By the later general act of the Perth Parliament, the unfortunate beings affected with the disease were again prohibited from entering towns except for the purpose of purchasing victuals, and this they were only allowed to do on three days of the week, the act strictly providing that—

“_Item_, Na lipper folke, nouther man nor woman, enter nor cum in ane Burgh of the Realme but thrise in the oulk (week) that is to saie, Mondaie, Wednesdaie, and Fridaie, fra ten hours to twa after noone; and quhair faires and mercattis fallis on thay dayis, that they leave their entrie in the Burrowes, and gang on the morne to get their living.”[339]

Various towns and local judicatories in the country seem to have at different times passed laws enforcing more strictly the observance of exclusion of the infected from their own limits and districts. Some of these local enactments have been preserved; and I shall quote such as I have been able to discover, with a view to show the general fear formerly entertained of the contagion of the disease, and the measures that were adopted to prevent its communication.

Thus, in the statutes of the Society of Merchants or Guildry of Berwick-upon-Tweed, said to have been drawn up by the mayor and others in “the Zeare of God 1283-84,” it is strictly provided that “Na lipper man sall enter within the portes of our burgh; and gif any by chance enters within them, he sall be incontinent put forth be the sergant of the burgh. And gif any lipper man uses commonlie contrair this our discharge, to come within our burgh, his claithes wherewith he is cled sall be taken from him and sall be brunt, and he being naked sall be ejected furth of the burgh. Because it is provyded be the common councill, that some gude man sall gather almes to them, that they may be sustained in ane place competent for them without the burgh. And this is to be understand of lipper folk, indwellers within the burgh, and not of them quha dwells without the burgh.”[340]

Some of the smaller burghs and villages of these early times had their individual rules and statutes upon the same point. The burgh of Prestwick, Ayrshire, which contains at present, and probably never contained more than about 1000 inhabitants, is situated about half-a-mile north of the leper hospital of Kingcase. The old official records and statutes of this small burgh, to which reference has repeatedly been made in the preceding pages, have lately been printed from the original MS. by Mr. Smith of Swinridgemuir. The earliest burgh record that has thus been preserved is a collection of the laws of the burgh, “Statuta Burgi de Prestwick maide by the haile consent of the community of the same at the Cross of the same burgh, and to be keepit and rafit unremittable and unrevocable.” The date of this collection, or probably re-collection of the burgh laws, is 1470. The fourth of the statutes fixed upon “for the common profit of the said burgh in time coming for everlasting memorans” is to the following effect:—

“It is statut yat na man inhabitant ye said burghe or weman commoun or intromet with ye sic folk (commune or intromit with the sick people) of Kingcase, vnder ye pain of exiling ye said burghe when thai ar ourtane (overtaken) be ane enquest yairupon, mair plainli yan ony oyder persounis or persoun duelland in all ye land about.”—P. 15.

In the minuted records of the burgh, different cases occur of persons accused in accordance with this statute. Thus, on December 1, 1477, Anne Kerd and Andro Sauer are accused of repairing to Kingcase.[341] On the 26th April of the second following year, 1479, it was alleged with regard to the said Andro Sauer, that he “repairis till Kingcase daily and nigtly and his wif and his bairnis.”[342] This Anne Kerd seems to have had the property of a burgess. At last, in November 1481, the same rebellious Prestwickian, “Andro Sauer, is fund in daili reparand to Kingcase, and yis the xxti court yerein, and is abill till infect ye hale toune; and weris ye seik folkis clathis and bonnettis.”[343] After this date no more mention is made in the records of Andro, who repeatedly figures in them previously, for other more serious deeds than that of repairing to Kingcase. I find, however, that others of his name, and probably of his kindred, fall into the same error for which he himself appears to have been banished. Thus, in 1496, Anne Sauer, Marion Myllar, Ellane Browne, and Anne Duncane, “are ilkane severale in amerciamentis for the selling of ale and intromettin of the folkis of Kingcase again the statutis of the towne.”

Few or none of the very early records and laws of the magistrates of Edinburgh have been preserved, but amidst some lately recovered, of a date as late as 1530, we find the following statute anent the “Leper Folke,”—“It is statut and ordanit be the Provost, Baillies, and Counsell of this burghe that na manner of Lipper persone, man nor woman, fra this tyme furth, cum amangis uther cleine personis, nor be nocht fund in the kirk, fische merket, nor flesche merket, nor na other merket within this burghe, under the pane of burnyng of their cheik and bannasing off the toune.”[344]

Some of the old edicts and regulations made in regard to the diseased in London have been preserved for us by Stow. According to the record of Edward III., that king sent, in 1346, “a commandment under his Great Seal, to the mayor and sheriffs of London, willing them to make proclamation in every ward of the city and suburbs, that all leprous persons within the said city and suburbs should avoid within fifteen days, and that no man suffer any such leprous person to abide within his house, upon pain to forfeit his said house, and to incur the king’s further displeasure. And that they should cause the said lepers to be removed into some out places of the Fields, from the haunt and company of all sound people.”[345] From some of the city records it further appears that the magistrates ordered “That the lepers walk not about the streets, nor tarry there; that the keepers of the gates swear that they will not permit lepers to enter into the city.” “There was at one time,” adds Stow, “a brief for removing them from the city and suburbs. At another time there was an edict for levying a hundred shillings out of a tenement of the lepers, and delivering it to their officers for sustaining them.”[346]

RESTRICTIONS PLACED UPON THE INMATES OF THE LEPER HOSPITALS.

The chance of contagion was provided against by other means besides the mere separation of the infected from the community, and their banishment to the lazar hospitals. In many instances the regulations and statutes to which the lepers were subjected, as inmates of these hospitals, were strongly restrictive, and framed with a view of preventing them from spreading the disease to others by any dangerous degree of personal communication with the healthy. The occasional severity of the restrictions to which, with this view, the leper inhabitants of the hospitals were subjected, affords us a curious example both of the great dread in which the disease was held, and of the extent and stringency of the measures of medical police which the local judicatories of this country had in these times both the power and the will to exercise.

The rules of the Greenside Hospital, Edinburgh, present in themselves a striking proof of this, and the occupants of the hospital were bound to observe these rules under the penalty of death. “That this,” observes Arnott, “might not be deemed an empty threatening, a gallows was erected at the gavel of the hospital for the immediate execution of offenders.”[347]

The persons placed in the Greenside Hospital in 1591 were five male lepers with two of their wives—viz. (to quote the record) “Robert Mardow, James Garvie, Johnn MacRere, James Wricht, and Johnn Wilderspune, lepperis, togidder with Isobel Barcar, spous to the said Robert Mardow, and Janet Galt, spous to the said James Garvie.” Among other regulations enacted in regard to them, it was specially ordained, “That nane of the said personis Lepperis, or their wyffes, depart or resort fra the said hospitall to na oyder pairt, or place, bot sit still thairat, and remayne thairin nicht and day, halyday and wark-day; and that they resave na oyder maner of personis, oyder man or woman, within the said place, bot sic as sall be placit with thame thairin, at command of the said Counsall and Session; and that they keip the dure of the said hospitall fast and clois, fra the dounpassing of the sone to the rysing thairoff, under the payne of hanging.”

“That the said Jonet Galt only cum to the markatts for buying sic viveris as is necessary to the saids personis, and presume to gang to na oyder pairt nor place in her cuming and returning to and frae the said markatts, under the payne aforesaid. Quhilk and other injunctions being red to the personis foresaids, they agreit thairto, and promisit to obey and underly the samyn, under the paynes therabove written. And thairfore, for the better obedience thairof, and for terrefying the said lepperis to transgress the samyn, the said commissioners has thocht meitt and expedient that there be ane _gibbet_ sett up at the gavell of the said hospital; and that the forme and order thairof be insert baith in the buiks of Counsall and Sessioun of this burgh, _ad perpetuam rei memoriam_.”[348]

The tenor of the regulations of the British leper hospitals was probably in few or no other cases so extremely stringent as in the establishment at Greenside. At least, if we may judge by the records of most of those hospitals, the rules of which have been accidentally preserved, the restrictions placed upon the inmates were confessedly great, but certainly by no means so severe either in their degree or in the punishment applied to them, as in those which we have just cited. Besides, in most institutions, the prior, master, or warden of the hospital, exercised a discretionary power in relation to the degree of seclusion of the lepers of their establishment.

Thus, among the rules of the leper hospital of St. Magdalene, Exeter, it was provided that “no brother or sister shall go or pass out of the house beyond the bridge, without the gate of the said hospital, without the license of the Warden or his deputy, upon pain to be put into the stocks, and to have but bread and water for one day.”[349]

Again, among the many rules enacted by the Abbot Michaele for the regulation of the hospital of St. Julian, in the neighbourhood of St. Albans, I may select the following as characteristic illustrations of the point which we are now considering:—

“Let no one presume to transgress the bounds fixed of old, (_metas ab antiquo statutas_), of which one is placed in the south, another in the north, as they still remain in view, except the custor of granges and granaries, to whom the charge is committed to the master.

“Let no brother venture to enter the bake-house or brew-house in any manner, with the exception of the brother to whom the charge is assigned, who, when he enters, may not approach the bread and beer, in touching or handling them in any way; since it is not meet that men of such infirmity should handle those things which are appointed for the common use of men.

“Let no one of the brothers attempt to go beyond the bounds of the hospital, namely, in the direction of the king’s road, without his close cape, in going to church or returning, nor stand or walk about in the said street before or after service (nor, indeed, at any hour of the day before or after dinner); but when divine service is finished, let them enter their hospitals with all haste, unless any one wishes to remain in the church, that he may have leisure for prayer and meditation. In like manner, we command that there be no standing in the corridor, which extends in length before the houses of the brothers in the direction of the king’s road; and that no brother hold conversation there (_teneat ibi parliamentum_) with another; but if any brother wish to hold colloquy with another, let one go to the other in order, as he may wish, through the said corridor, without standing by the way, unless some stranger chance to meet him, with whom he may briefly speak and pass on. But if an honest man and true come there, for the purpose of visiting an infirm brother, let him have access to him, that they may mutually discourse on that which is meet.”[350]

In considering under a previous head the extent of endowment of the British leper hospitals, we have seen that the inmates of many of the poorer institutions depended more or less entirely for their means of subsistence upon the casual alms which they were able to beg from the charitable. In a few favoured cases the lepers were specially authorised to pursue this occupation beyond the district of the hospital. A charter was given by King John to the lepers of St. Lawrence’s Hospital, Bristol, granting them great privileges of this kind. Some of the passages in this charter are curious, as illustrative of the present point. I append a translation of a part of it from the copy of the original document as published by Dugdale:—

“John, by the grace of God, King of England, etc., to the Archbishops, etc., greeting, know ye that we, for the love of God, have granted, and by this charter have confirmed to the lepers near Bristol, a croft beyond the gate of Lacford, on the road to Bath, to dwell there, as the charter which we gave them while we were Count Moreton reasonably proves; know ye also that we have received these lepers into our protection, and therefore desire and command that ye befriend and protect them (_quod eos manu teneatis et protegatis_), and cause no impediment to them, wherever they shall be asking alms in our lands, as our letters-patent which we granted unto them when Count Moreton rationally testifies,” etc.[351]

Grants and liberties, such as the above, were certainly, however, rare. In general the lepers were restricted as to the districts and places in which they presented themselves to seek for alms. We have already seen the Burrow Lawes ordering that they “sall not gang fra dure to dure, but sall sit at the ports of the burgh, and seek alms fra them that passes in and furth;” and the Scottish Parliament of 1427 enacted that they should not be allowed to sit and beg “neither in kirk nor in kirk-yairdis,[352] nor other places within the burrowes, but at their owne hospital, and at the part of the town and other places outwith the burrowes.” But even in exercising this vocation in these stated places, the unfortunate petitioners seem to have been everywhere obliged to use certain precautions, with the view of prohibiting them from diffusing the disease.

In Scotland, and in various other parts of Europe, they were obliged, for this purpose, to use a “clapper” or rattle, in order that the noise created by it might warn the healthy of the presence of an infected fellow-mortal, whilst, at the same time, they carried a “cop” or receiving dish, into which the charitable might drop their alms.[353] Muratori tells us that in Italy the lepers made their presence known at a great distance (_longe positos_) by the noise of a certain piece of wood. Marmotrecti describes more minutely the instrument as composed of wood, and formed of two or three tablets of it, which the leper struck together when seeking bread (_quas concutit leprosus quaerendo panem_).[354]

In the celebrated old Scoto-Saxon poem of Sir Tristrem, composed probably about the middle of the thirteenth century,[355] and valuable (to use the words of an acute critic)[356] “for its pictures of ancient manners” and the customs “of Scotland in the days of Alexander III.,” the hero of the romance is, at one stage of his adventures in Cornwall, represented as assuming for disguise and concealment the appearance of a leper or mesel.[357] In this character the poet provides him with the usual cop and clapper (stanza 80, p. 181).

Ganhardin gan fare, Into Bretaine away; And Tristrem duelled thare, To wite what men wald say; Coppe and Claper he bare, Til the fiften day, As he a mesel ware: Under walles he lay, To lithe.

We have already, in the Second Part of the present paper, seen Henryson, in the sixteenth century, describing his leper heroine as arrayed

With cop and clapper like ane Lazarous.

And from the advice proffered by the other lepers to the weeping Cresseid after she is actually removed to the lazar-house, the importance and frequent use of the clapper is sufficiently shown—

I counsall thee mak vertew of ane neid, To leir to clap thy clapper to and fro, And leir efter the law of lipper leid.[358]

Into some towns the lepers seem to have been allowed the liberty of entry, provided they used their clappers, to advertise the passing inhabitants of their presence, and thus allowed them to shun the supposed danger of their contact. The magistrates of Glasgow made the carrying of clappers one of the conditions on which they admitted the occasional entrance of the inmates of the Brigend hospital into their city, one of their edicts for October 1610 running thus:—“It is statut and ordanit that the Lipper of the hospital sall gang (walk) only on the calsie (street) syde near the gutter, and sall haif clapperis and ane claith upoun their mouth and face, and sall stand afar of quhill they resaif almous, or answer under the payne of banischeing them from the toun and hospital.”

One of the statutes of the Greenside hospital, Edinburgh, was to the effect—

“That nane of the lepperis cry or ask for alms, utherways then be thair clapper; and that every ane of thame, his day about, sitt at the dore of the said hospitall to that effect, the rest allwayes remaining within the samyn, and that thay distribute equallie amongs thame quhatsoever money they purches be thair said begging, and gif the just declaration thairof to the visitour appoynted everie Setterday, under sic payne as the counsill shall injoyne unto thame.”

LEPERS REGARDED AS DEAD PERSONS BY THE CIVIL LAW.

According to the tenor of various old civil codes and local enactments, when a person became affected with leprosy he was looked upon as legally and politically dead, and lost the privileges belonging to his right of citizenship.

By the law of England lepers were classed with idiots, madmen, outlaws, etc., as incapable of being heirs; and a leper removed by a writ _de leproso amovendo_ could not be a guardian in socage.[359]

Rotharis, king of Lombardy, as early as the eleventh century, decreed that when any one became affected with leprosy, and the fact was known to the judge or people, so that the leper was expelled from society and dwelt in seclusion, he had no power to alienate his effects or dispose of them to any one (_non sit illi licentia res suas alienare aut thingare cuilibet personæ_). For, it is added, from the very day on which he is expelled from his home, he is to be regarded as dead (_tanquam mortuus habetur_).[360] The same was the law of Normandy, according to Dufresne[361] and Delamarré;[362] and Lobineau, in his history of Brittany,[363] speaks of it being formerly in accordance with the rituals of various churches.

The leper was not looked upon in the eye of the law alone as defunct, for the Church also took the same view, and performed the solemn ceremonials of the burial of the dead over him on the day on which he was separated from his fellow-creatures and consigned to a lazar-house. He was from that moment regarded as a man dead amongst the living, and legally buried, though still breathing and alive. The ritual of the French church retained till a late period the various forms and ceremonies to which the leper was subjected on this day of his living funeral. Ogée[364] and Pluquet[365] have both described them.

A priest robed with surplice and stole went with the cross to the house of the doomed leper. The minister of the church began the necessary ceremonies by exhorting him to suffer, with a patient and penitent spirit, the incurable plague with which God had stricken him. He then sprinkled the unfortunate leper with holy water, and afterwards conducted him to the church, the usual burial verses being sung during their march thither. In the church the ordinary habiliments of the leper were removed; he was clothed in a funeral pall; and while placed before the altar between two trestles, the _Libera_ was sung, and the mass for the dead celebrated over him. After this service he was again sprinkled with holy water, and led from the church to the house or hospital destined for his future abode. A pair of clappers, a barell, a stick, cowl, and dress, etc. etc., were given to him. Before leaving the leper, the priest solemnly interdicted him from appearing in public without his leper’s garb—from entering inns, churches, mills, and bake-houses—from touching children, or giving them ought he had touched—from washing his hands or anything pertaining to him in the common fountains and streams—from touching in the markets the goods he wished to buy with anything except his stick—from eating or drinking with any others than lepers;—and he specially forbade him from walking in narrow paths, or from answering those who spoke to him in the roads and streets, unless in a whisper, that they might not be annoyed with his pestilent breath and with the infectious odour which exhaled from his body;—and last of all, before taking his departure, and leaving the leper for ever to the seclusion of the lazar-house, the official of the church terminated the ceremony of his separation from his living fellow-creatures by throwing upon the body of the poor outcast a shovelful of earth, in imitation of the closure of the grave.

LIST OF LEPER HOSPITALS IN GREAT BRITAIN.

In Part I. I enumerated specially the different Scottish leper hospitals with which I was acquainted, and referred in general terms to the number of similar institutions that had existed in England. Under the idea that a connected view of all the British leper hospitals might prove interesting, I have drawn out the following alphabetical list of such of them as have come to my knowledge in the course of the preceding inquiries. To the locality of each hospital and its special designation, or rather dedication, I have added the dates, as nearly as they could be ascertained, either of its original foundation, or of the first notice of it to be found in historical records. Among the unarranged mass of materials contained in the _Notitia Monastica_, and in the _Monasticon Anglicanum_, (to which works I am principally indebted for the notes of the English leper houses), references exist to many old hospitals, the individual objects of which are now utterly forgotten and unknown. If sufficient records of them had been preserved we would probably have been enabled to increase to a much greater extent the subjoined list of institutions for lepers, as many of them, there is little doubt, were set aside (like those we now enumerate) for the reception of the victims of that disease, whose olden history, in as far as relates to this country, we have so hastily and imperfectly attempted to trace.

LIST OF LEPER HOSPITALS FORMERLY EXISTING IN GREAT BRITAIN.

APPENDIX.

ADDITIONAL NOTES BY JOSEPH ROBERTSON, LL.D.

LEPER HOSPITAL OF GLASGOW.

Sir James Simpson’s Paper, Part I. p. 10.—“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.—(Gibson’s _Hist. of Glasg._ p. 52; Cleland’s _Glasg._ vol. i. p. 68.)”

There is some mistake here. If the leper hospital was founded by the Lady of Lochow, daughter of the Duke of Albany, it must have been a hundred years after 1350. The dukedom of Albany was not created until 1378, and the first daughter of that house who married a Knight of Lochow was Marjory, the wife of Sir Duncan Campbell, who died in 1453.

The earliest record notice of the hospital which I have observed is in 1494, when William Steward, prebendary of Killern and rector of Glassfurd, endowed a chaplain to serve in the chapel of St. Ninian, which he had lately built, “_ad Hospitale Leprosorum degentium prope Pontem Glasguensem_.” He provided that yearly, on the anniversary of his death, twenty-four poor scholars should assemble in the chapel of the hospital to perform certain services, for which one penny was to be paid to each of them, along with one shilling to the lepers—“et leprosis non sociatis degentibus in dicto Hospitali xijd.” The lepers were to ring the chapel bell for the _Salve Regina_ every night, and to pray in the chapel for their benefactors.—(_Regist. Episcopal. Glasg._, vol. ii. pp. 488-490. Edinb. 1843, Mait. Club.) In 1505 we have “pauperibus leprosis in Leprosario Sancti Niniani trans pontem Glasguensem degentibus.”—(_Liber Collegii Nostre Domine Glasguensis_, p. 259. Glasg. 1846, Maitland Club.) In 1528, James Houston, sub-dean of Glasgow, founder of the Lady College (now the Tron Kirk) of Glasgow, ordered twelve pennies to be distributed yearly, on the anniversary of his death, to the lepers beside the Bridge of Glasgow, and others, who should appear in the churchyard of the Lady College to say orisons for his soul—“_leprosis extraneis et commorantibus juxta Pontem Glasguensem comparentibus in cimiterio prefecto Ecclesie Collegiate oraturis Deum_.”—(_Lib. Coll. Nostre Domine Glasguensis_, p. 51.) The Tron Kirk or Ladye College was on the north side of the Clyde, and within the burgh of Glasgow, so that we have here proof that lepers in 1528 were not forbidden to enter the burgh. Contrast this feeling towards them with the feeling shown in the Leges Burgorum and Statuta Gilde of the twelfth and thirteenth centuries, printed in the _Acta Parliamentorum Scotiæ_, vol. i., and with the banishment of all lepers from Glasgow in 1593 and 1594, as instructed by the Kirk-Session Records, abridged in Wodrow’s _Biograph. Collect._, vol. ii. part ii. p. 41.

Did this difference of toleration arise from some corresponding difference in the intensity or general diffusion of the disease?

LEPER HOSPITAL AT STIRLING.

The existence of a leper-house at Stirling is proved by entries in the Rotuli Scaccarii Regum Scotorum, MS. in the General Register House.

1463-4. “Et leprosis prope burgum de Striuelin ex elimosina Domini Regis percepientibus annuatim octo bollas farine—viij bolle farine.”

Rot. Scacc., No. 251.

1466-7. “Et leprosis prope burgum de Striuelin ex elemosina Regis de anno compoti—viij bolle farine.”

Rot. Scacc., No. 257.

1473-4. “Et leprosis prope burgum de Striuelyne ex elemosina Regis—iiij celdre farine.”

Rot. Scacc., No. 266.

1497-9. “Et leprosis ad finem orientalem burgi de Striuelin percepientibus annuatim octo bollas ex elemosina Regis de dictis annis [7 Jul. 1497-10 Jul. 1499]—iiij celdre farrine auenatice.”

Rot. Scacc., No. 314.

1499-1501. “Et leprosis ad finem orientalem burgi de Striuelin—j celdra farrine auenatice.”

Rot. Scacc., No. 319.

1504-5. “Et leprosis de Striuelin in elimosina viij bolle ordei—viij bolle farrine.”

Rot. Scacc., No. 329.

1505-6. “Allocatur compotanti in elimosina leprosis ad finem burgi de Striuelin de termino compoti—viij bolle farrine [auenatice].”

Rot. Scacc., No. 331.

1506-7. “In elimosina leprosis ad finem burgi de Striueling—viij bolle farrine.”

Rot. Scacc., No. 333.

1511-12. “Et leprosis prope finem ville de Striueling in elemosina de anno compoti—viij bolle ordei.”

Rot. Scacc., No. 347.

Observe how literally the situation of the leper-house, as described in the language of record “_ad finem burgi_,” answers to Henryson’s phrase—“yone hospitall _at the tounis end_.”

LEPER HOSPITAL OF ABERDEEN.

The leper hospital of Aberdeen was in existence before 1363. A charter of that year describes certain lands as bounded by the king’s highway leading from the burgh of Aberdeen _versus domos Leprosorum_; and again _a domibus dictorum Leprosorum_.—(_Registrum Episcopatus Aberdonensis_, vol. ii. p. 283.)

The use of the plural _domos_ and _domibus_ may possibly denote that there were two hospitals, as at Canterbury and elsewhere—one for men and one for women.

The Regent and the Privy Council interposed for the repair or restoration of the leper hospital of Aberdeen in 1574; in 1578 it was placed under the charge of a master; and in 1591 there were patients in it.—(_Selections from Ecclesiastical Records of Aberdeen_, pp. 20, 23. Aberd. 1846, Spald. Club.—_Extracts from the Burgh Records of Aberdeen_, 1570-1625, pp. 70, 71. Aberd. 1848, Spald. Club. _Book of Bon Accord_, p. 342.) There would seem to have been an outbreak of leprosy in Scotland about this time. It was in 1584 that the Magistrates of Edinburgh issued orders for finding a commodious place for a leper-house; in 1589 a leper-house was ordered to be built; and in 1591 there were five patients in it. (Sir James Simpson’s Paper, Part I. p. 11.) So also in Glasgow, in 1586 the Kirk-Session of Glasgow gave orders that “the Lepper Folk’s House or Spittal beyond the Bridge” should be visited, “to see how the same should be reformed.” These orders were renewed in 1587; in 1588 “the yard of the Lepper House” was built; and in 1589 six lepers are found in the Hospital. (Wodrow’s _Biographical Collections_, vol. ii. part ii. pp. 40, 41. Sir James Simpson’s Paper,