Tropical Terrors

A brief review of tropical diseases

Leprosy (Hansen's Disease")

A brief history

This title is an oxymoron - more than any other disease known to man, leprosy has been making a dramatic impression for thousands of years. Because of the disfigurement, disability, and eventual death of its' victims, in western society it was assumed to be caused by the sins and transgressions of those suffering - therefore no one felt bad about isolating and ostracizing them. The print below, "Christ healing the lepers", is from around 1020 AD.

Christ healing the lepers - around 1020 AD.

In Leviticus, Chapter 13, the Lord gave Moses and Aaron specific instructions on diagnosing leprosy, how contact with those with leprosy, their clothing, their beds, etc. should be avoided, and how to determine when it would be safe for those victims to go forth into society. These laws probably pertained to many of the bad lesion-causing diseases of the day, including syphilis (the "great pox") and the much more contagious smallpox, although the descriptions of leprosy lesions are quite accurate.

The isolation of those with leprosy, practiced over time, probably was more cautious than necessary, but it probably reduce the spread somewhat. Continued contact with victims does put someone at risk - family members of leprosy victims have a rate of 5-10% of eventually getting the disease. Isolation of victims in separate communities probably made their life easier by reducing the ostracism which they would otherwise be faced. In Hawaii, 800 lepers were sent to live at the leper colony on the island of Molokai. In 1873 Father Damian went to spend a few weeks ministering to these unfortunates. He decided to stay after seeing the promiscuity and degradation with which they lived. He greatly cleaned up the colony in several ways, and set a famous example of being willing to be exposed to those with the disease. Unfortunately he succumbed to the disease himself - developing lesions by the year 1876, nerve damage by the year 1883, and dying in the year 1889. In the same year that Father Damian went to Molokai, Armauer Hansen discovered the bacillus responsible for the disease (thus it is also called "Hansen's Disease").

It should be noted that for leprosy sufferers the term "leper" is pejorative, and brings to mind the terrible ostracism and "blaming the victim" attitudes of the past.

Prior to the late 1930's and early 1940's, antibiotics were not available to treat the disease, although natural products such as oil of hydrocarpus had some success. Major advancements in medical science have resulted in the elimination of the more severe forms of the disease. The AFIP archives document a very unfortunate young man of 14 years who presented to a clinic in Hawaii in 1933 with the early stages of "lepromatous leprosy".

Young man with early stages of leprosy.

Unfortunately, it would be several years before medications would be available which might have prevented the terrible progression of the disease seen two years later:

Terrible progression of leprosy in 14-year old after only two years, 1933. AFIP photo

Anyone who would like to have a deeper understanding of how leprosy - and the paranoia around it - affected its sufferers should read Alan Brennert's "Moloka'i" It is one of the best books I have ever read, although bringing me to tears a number of times.