HLTA01 - Chapter 14

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University of Toronto Scarborough
Health Studies
Caroline Barakat

HLTA01 Plagues and People Chapter 14: Leprosy Leprosy, the Striking Hand of God - Had many references from the Bible - Mentioned in both the Old Testament and the New Testament o Seen as unclean and displeasing to God - “Disease of the Soul” and was very highly contagious A Look Back - Most likely began in the Far East around 1400 BC o Accurate descriptions of the disease in the sacred Hindu writings of the Veda as well as accurate descriptions in Chinese literature - Earliest account was in an Indian text between 600 and 400 BC - Nei Chang ( a book of medicine) o Described the disease with symptoms of stiff joints, hair loss (eyebrows and beard), flesh becomes nodular and ulcerates, numbness results, and the bridge of the nose begins to change color and rot th - May have either been brought from India to Greece in the 4 Century BC or spread from the Far East to the West along trade routes arriving in the Mediterranean - Evidence of the disease from bones dating from AD 500 to 700 - Emperor Constantine suffered from leprosy - Pagan priests believed that bathing in the blood of sacrificed children would cure him - Saraath – used mainly to describe many skin conditions o Became lepros - The sinfulness of the disease stigmatized the lepers - Lepers – crafty, irascible, suspicious, and had a desire for lustful sex - The disease was also sometimes known as an insatiable sexual appetite (satyriasis) - Leprosy became accepted as the divine punishment for the sins of the flesh - There was confusion between syphilis and leprosy in the 16 century th - Alienation and stigmatism of the lepers was worsened by the disfiguration of the hands and face o Their sore bodies lead to the belief that they were contagious o They were not considered nice people and were out-casted from society - 1179 – segregation of lepers from society – not allowed to mix with the crowds o Couldn’t touch anything unless they bought it o Wore a distinctive garment and had to announce their presence with a bell/clapper - Often strapped to a pole and burned alive - Lazar houses/ lazarets – refuges for the lepers th - Went from pandemic to epidemic in 12 Century o 19, 000 lazarets in 13 and 14 century England th th o Between the 16 and 18 century however, the lazarets slowly closed down and then altogether disappeared  Leprosy decreased - Knights that participated in the Crusades had contracted leprosy and created their own spiritual order o Order of Lazarus o Contributing factor to spread of leprosy th th - Spread from Spain and Africa to America in 16 and 17 centuries - Rediscovery of leprosy in 1860’s of those of foreign births o Hawaii tried quarantine and segregation o Lepers were loaded onto a ship and sent to Kalawao o Leper colony was formerly made in 1865 o Chinese were singled out as the source of leprosy, however 97% of the lepers were Hawaiian o Father Damien  Resident priest for 3 months yes but stayed for 16 years  Cleaned and bandaged sores, built homes and hospitals, reservoirs and a plumbing system  Buried many leprosy victims - Considered a disease especially associated with the Chinese - Louisiana Home for Lepers became the American National Leprosarium at Carville in 1921 - Males and females were separated to avoid contact - Remaining leprosy patients in Carville were set free by Bill Clinton and receive $33,000 annually, as well as having lifelong medical care for their disease and be able to reside anywhere they wanted The Disease of Leprosy - Mycobacterium leprae – found by Gerhard Armauer Hansen - Leprosy disease is more modernly called Hansen’s disease - Acid-fast bacillus - Cannot be grown into tissue culture o Grows very slowly and only in humans, mice, and nine-banded armadillos o Takes 2 weeks to divide - In mice, bacteria grows best in the footpad - No known vectors or reservoir hosts - No satisfactory way of determining past infections and preventing inapparent ones - Spread is derived from clinical cases - Low infectivity and different manifestations o Tuberculoid leprosy – skin nodules o Lepromatous leprosy – bacteria in microphages and skin - Most patients show tuberculoid type – develops 1-2 years after exposure o Manifestation depends on immune system of victim - Lepromatous leprosy – do not respond to bacilli o Bacteria is multiplied and results in the spread to multiple organ involvement and leads to facial deformity and blindness  Also shortening of digits (fingers) and osteoporosis o Testes are damaged - Death results most commonly from renal failure, pneumonia, and tuberculosis - Natural resistance is highest amongst African blacks, and lowest among Caucasians - Enters through the nose and go
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