Quarantine in Purgatory: Medieval Leprosy and the Dual Legacy of Good & Evil that it Created

 “And the leper in whom is the plague...shall cry, Unclean!  Unclean!  All the days wherein the plague is in him he shall be defiled; he shall dwell alone…”  

-from Leviticus 13:45-46 KJV

It is exactly one thousand one hundred and fifty years since the birth of your Lord Jesus Christ.

Day and night you wander barefoot through the countryside, heading south, towards the capital city of Winchester in the county of Hampshire.  You are travelling there because rumor has it that there is a place there for people like you, a place called a ‘Lazar’ House, that stands right in the shadows of the great cathedral that has only recently been built in the Anglican capital city to the great glorification of the one true Lord Jesus Christ.

It is a hospital, of sorts, where your people are quarantined and instructed in the cloistered and holy monastic life that can earn one’s way to Heaven.

Through the cold and the rain you continue on your journey.  You are clothed in a distinctive green cloak and an almost foolish looking beaver skin cap that both custom, and common law in this land, dictate that you must wear at all times.

Every few steps, or whenever you catch sight of another soul, you ring a tiny bell that you carry to give others warning of your approach.  People scatter before you like the smoke of holy blessed incense before the wind.  Some hold their hands up to their faces to cover their eyes in horror whenever they catch sight of you.

“In the name of the blessed Saint Lazarus give alms for my soul in purgatory!”  You beseechingly implore to all of those who are unfortunate enough to remain within earshot at your approach.

A few brave souls, seeking to earn their way to Heaven through charity, leave crusts of stale bread, oats or spoiled fruits and vegetables by the roadside for you to pick up and eat as you pass by.

To those you call out, “Blessed be you in the name of Saint Lazarus and in the name of God Our Father, the Holy Spirit and Lord Jesus Christ!”  But no one stays near long enough to hear your blessing.

Almost everyone fears you.  Rumors blame you, and those others who are afflicted like you, for all manner of crimes against humanity--infanticide, arson, drought, crop failures and the poisoning of Christians are just some of the woes that are blamed on people like yourself.

You are a leper.

Medieval Leper with Bell 

Known today as Hansen’s Disease, leprosy is a disease of the nervous system that is most often characterized by ulcerations and lesions that can breakout all over the surface of the body.  

In extreme cases, like the one of our wandering sufferer from the 12th century, leprosy results in the rotting away of fingers and toes and the formation of large bulbous pustules on the face that emit a putrid foul smelling odor.

It is believed that leprosy first entered England around the 4th Century CE, but it is known that by around the year 1100 the disease was becoming more and more widespread throughout western Europe.  It is thought that returning soldiers from the Crusades brought back with them from the Holy Land a far more virulent and contagious form of the disease than had ever been present in Europe up to that point.

Contemporary French writer of historical fiction Charles de Leusse summed it up best when he wrote regarding the Crusades that, “[T]he Crusaders fought war and they won leprosy.”

Hansen’s disease is contagious, at least somewhat, in that it can be transmitted from person to person through extended close contact, but it does have, compared to other infectious diseases, a very low transmission rate and is most often spread only through the exchange of bodily fluids such as blood or saliva.

However, during the High Middle Ages (roughly the years 1050-1350) in England and France the disease seemed far more prevalent than it ever had been in the past and the population lived in constant fear.  Those suffering from leprosy were forced to quarantine away from greater society at large; wear distinctive clothing and beg for charity in order to survive.

Of course, regarding the prevalence of leprosy at this time, the fact that Medieval people misdiagnosed conditions like smallpox, eczema and even acne as leprosy led to an enormous amount of fear and speculation regarding the cause and spread of the disease and made it appear much more threatening to Europe’s population during the Middle Ages than it actually may have been.

Depiction of a Woman with Leprosy from a Medieval Manuscript

In the 12th century there were two schools of thought regarding the treatment of lepers.  Most took the Old Testament as their guide, quoting from the Book of Leviticus, these individuals sought to ostracize lepers, and to shut them away from the rest of society in the hopes that this would stop the spread of the disease.  

But a few brave and Godly souls looked on lepers as being blessed.  It seems that when it came to lepers, there was a divide in the Medieval mind, where on the one hand no one single group in Medieval Europe was more persecuted than lepers, many on the other hand, saw lepers as truly holy figures who were already suffering through a form of purgatory on earth.

Those who viewed lepers as reverential figures used the New Testament, specifically the story of Lazarus, as their guide and inspiration.  

“There was a certain rich man, which was clothed in purple and fine linen, and fared sumptuously everyday/ And there was a certain beggar named Lazarus, which was laid at his gate full of sores..”

Luke 16:19-20 KJV

The passage above begins the parable of Lazarus in the Gospel according to Luke.  In this parable when Lazarus the beggar dies he is carried to Heaven by angels, but when the rich man who has ignored the beggar dies, he is cast aside and into a hell of sorts.  Jesus relates the parable of Lazarus in the Gospel of Luke as a way to show believers in Him the value of good works and charity towards others.

Using this parable as their guide many clerics during the High Middle Ages viewed lepers as people to be served and Saint Lazarus quickly became revered as the Patron Saint of Lepers.

From this desire to perform good works on earth leper hospitals were born sometime in the 11th century.  A leper hospital or “Lazar House” (Lazar for Lazarus) in the terminology of the time period was not a hospital in the modern sense of the word.

A Medieval leper hospital was, most probably, a place where lepers travelled to be quarantined from the rest of society, but at the same time to enter into monastic orders, which enabled them to be treated with a certain amount of dignity and security that they just did not and could not receive in the greater world at large where the spread of the disease was feared and rumor and speculation ran rampant and unchecked.

As Simon Roffey, Lecturer in History at the University of Winchester in the United Kingdom states, “Hospitals at the time (medieval hospitals) were places where people were looked after rather than given any treatment.”

Though freedoms inside a Medieval leper hospital were severely curtailed, almost nonexistent really, being looked after was most probably far better than being actively persecuted.

Saint Mary Magdalen hospital in Winchester in Hampshire County, in the United Kingdom is thought today to have been England’s first Lazar House and may have been established as early as the year 1000.  Bones unearthed by archaeologists at the site of Saint Mary Magdalen have been radiocarbon dated to sometime between the years 960-1030 CE making it, quite possibly, the first ‘Lazar House’ or hospital specifically dedicated to the quarantine of lepers to appear in the United Kingdom.  By the year 1300 there were upwards of 300 leper hospitals throughout the British Isles alone.

Artist's Rendering of a Medieval Hospital

Leper hospitals such as Saint Mary Magdalen’s near Winchester were most often built on the outskirts of large towns or cities and consisted of a series of small cottages centered around a main chapel.  Personal hygiene and general sanitation would have been stressed and a leper’s life in quarantine, much like a monk’s, would have been centered around the rhythm of scheduled daily prayers. While in quarantine lepers would have been able to receive supervised visits from family members and because they were now quarantined in one central location, their individual hospital would have been supported by alms or charity from the local parish or townspeople, eliminating the need for degrading begging to ensure survival.

Lepers like the wandering sufferer that begins this article would have walked for hundreds of miles just to reach the relative safety and deliverance of a ‘Lazar House’ such as Saint Mary Magdalen’s in Winchester.

However, during the 14th century many ‘Lazar Houses’ no longer became sustainable as leprosy began to diminish across the European continent.  It seems that after nearly three centuries of exposure, the people of western Europe may have developed a sort of herd immunity to the disease which severely curtailed its spread.

Unfortunately, leprosy has never completely been eradicated from the world despite the fact that it is relatively easily treated with a medication regimen today.  As leprosy began to recede though, and their numbers dwindled, lepers once again began to face greater rates of persecution in western Europe at the end of the fourteenth century.

After the Black Death, the bubonic plague pandemic that swept through Europe and the world in the 1340’s and 50’s and killed nearly half of Europe’s population, those suffering from leprosy were no longer viewed as blessed, or in purgatory, but rather they were now seen by all as a threatening scourge upon society.  After the plague all disease, no matter its cause or how it spread, was viewed as terrifying and of the devil, and lepers rarely received any help from any organizations including the church after about the year 1400.

As the 15th century dawned, those few still unfortunate enough to be marked by the sores and boils of leprosy in early modern Europe were no longer quarantined, they were now ostracized.

Medieval Woodcut Depicting Care of Lepers

Today, many of us tend to view leprosy and the Medieval response to it as a tragedy that brought out the worst in human nature.  And in a sense, a leper’s life during the Middle Ages was a sort of hell, or purgatory on earth.

But, for a brief moment in history, from about the year’s 1100-1300 a few charitable and noble souls within the context of the Christian tradition, went beyond themselves and banded together to form ‘Lazar Houses’ hospitals named after Saint Lazarus, to effectively quarantine lepers from a threatening society and give those who suffered from this debilitating, dehumanizing and disfiguring disease a sense of human dignity and security.

Though the practice of ‘Lazar Houses’ to treat lepers lasted for but a brief time in the course of history, and though most Medieval people looked upon lepers as less than human monsters to be scorned and avoided, we can look to a few places from long ago like Saint Mary Magdalen in Winchester and the Monastic orders that created it, to remind us all of the better and more noble side of human nature even in a time of great fear.