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11 - Leprosy in Medieval Europe: An Immunological and Syndemic Approach
- Edited by Lori Jones, University of Ottawa, Nükhet Varlik, Rutgers University, New Jersey
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- Book:
- Death and Disease in the Medieval and Early Modern World
- Published by:
- Boydell & Brewer
- Published online:
- 17 December 2022
- Print publication:
- 29 November 2022, pp 295-318
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Summary
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, as well as in their conduct as in their dress, to bear themselves as more to be despised and as more humble than all other men.
Leprosy deeply impacted on the lives of medieval European populations, even though its prevalence declined after the thirteenth century. Social attitudes and responses to the disease varied in time and space, making its history and the reason for its decline difficult to reconstruct or explain with any certainty. One hypothesis for this decline is cross immunity between the biologically related pathogens responsible for leprosy and tuberculosis; that is, cases of leprosy may have diminished due to the increasing prevalence of tuberculosis. However, without ruling out some partial impact of tuberculosis, other environmental, social and biological factors should also be considered when examining changes in the prevalence of leprosy. This chapter explores how different biosocial factors affected – either increased or decreased – an individual’s capacity to mount a proper immunological response against leprosy, in order to explain changes in its prevalence in medieval Europe. In particular, the chapter uses a syndemic approach to consider how a set of different biosocial factors could have worked together, synergistically (or counter-synergistically), to affect an individual’s capacity to fight leprosy.
This chapter does not offer a complete historical and bioarchaeological review of leprosy in medieval Europe. Instead, it uses historical and bioarchaeological evidence to explore how larger bioecological environments and social structures converged to produce infected or uninfected spaces. This, in turn, reveals that complex and heterogeneous immunological landscapes marked the disease’s prevalence. The syndemics approach helps to expand the ‘immunity’ concept by replacing it with ‘immune competence’. It also generates a new dialogue among and between disciplines such as immunology, bioarchaeology and history to reconstruct potential interactions between them. It equally helps to identify mortality burden contributions of chronic infectious diseases and biosocial factors in past populations.
Hansen’s disease is an infectious disease caused by Mycobacterium leprae, which com-monly generates a chronic infection primarily affecting nerves and skin.
Heterogeneous Immunological Landscapes and Medieval Plague: An Invitation to a New Dialogue between Historians and Immunologists
- Edited by Monica H. Green
- Introduction by Carol Symes
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- Book:
- Pandemic Disease in the Medieval World
- Published by:
- Amsterdam University Press
- Published online:
- 23 January 2021
- Print publication:
- 01 January 2015, pp 229-258
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Summary
I have been asked by some of my friends to write something about the cause of this general pestilence, showing its natural cause, and why it affected so many countries, and why it affected some countries more than others, and why in some countries it affected some cities and towns more than others, and why in one town it affected one street, and even one house, more than another, and why it affected nobles and gentry less than other people.
WHEN THE FRENCH astrologer and physician Geoffrey de Meaux (fl. 1310–49) wrote these words around 1349, he was trying to assess, from a scientific perspective, the great challenge of applying the universal principles of the science of the stars to the very particular task of explaining why some people survived while others around them died in the wake of the Black Death (Horrox 1994: 165). His close contemporary, the Florentine author Giovanni Boccaccio (1313–75) similarly wrote that “not all those who adopted these diverse opinions died, nor did they all escape” (Boccaccio [1353]/1982: 9): suggesting, as Geoffrey did, that a complex selective process was at work during a plague outbreak.
In his treatise on surgery, Guy de Chauliac (d. c. 1368), a leading medical authority and physician to three successive popes, described the causes of mortality as twofold in his discussion of the bubonic plague: one active and universal, one passive and particular. Regarding the latter, Guy wrote: “The particular, passive case was the disposition of each body, such as cachocymia, debility, or obstruction, whence it was that the working men and those living poorly died” (1363/1974: 774). In other words, we can argue that Guy explained that cases of heterogeneous mortality were The image above shows a physician (with a case for medical implements hanging at his belt) lancing a bubo on the neck of a woman afflicted with plague. A young man (probably his assistant) steadies the patient; meanwhile, her husband strips off his tunic to reveal a bubo under his arm, readying himself for the same lancet. A small boy also holds up his arm, perhaps indicating that he, too, feels a bubo developing. A smaller child lies in bed, ill or asleep. Above the scene, a devil brandishes a lancet of his own—one that will inflict plague, rather than treat it—but an angel deflects his aim.