Week #3 - Sherman Ch. 14; Kiple P. 834-839.docx

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27 Nov 2012
(Reading) Week #4 | Sherman Ch. 14
Chapter 14
Leprosy, the Striking Hand of God
A Look Back
- claimed that leprosy was brought from India to Greece in the fourth century BC by the soldiers of Alexander the Great, but also possible that leprosy spread from the Far East to
the West along the trade routes, arriving in the Mediterranean about the time of Christ
- best description of leprosy in Europe comes from Aractus, a contemporary of Galen, in AD 150
- leprosy then spread further west
- Disease of the soul
- sometimes the disease was known as satyriasisan insatiable sexual appetite
- Earlier thought to be a hereditary illness, or caused by a curse or by punishment from God
- Lepers were stigmatized: E.g. special clothing, arrival notification
- some good Christian people did sympathize with the plight of the leper, and almshouses or refuges were established for them
- called Lazar Houses or lazarets
- pandemic of leprosy reached epidemic proportions in the 12th century and had its peak in Europe in the 13th and 14th centuries; the construction of 19,000 lazarets
- by the 16th century most of the lazarets had been closed, and by the 18th century they had all disappeared
- knights participating in the Crusades contracted leprosy, and in 1048, they formed their own spiritual order, the Order of Lazarus
- return of these knights to Europe was probably a contributing factor to the spread of leprosy throughout Europe
- leprosy spread from Spain and Africa to the Americas in the 16th and 17th centuries
- as late as the mid-nineteenth century there were thousands of cases in Scandinavia, and with the importation of Chinese laborers into the Pacific islands by the colonizing
Europeans, the disease was spread further
- leprosy, by the early 1860s, had reached epidemic proportions on the Hawaiian Islands
- in an effort to halt its spread, the Hawaiian Kingdom followed a practice of quarantine using isolation and segregation
- officials rounded up the lepers and loaded them onto ships bound for a settlement at Kalawao, on an isolated peninsula of Molokai’s north shore
- in 1865, a leper colony was formally established on Molokai that housed a total of 142 individuals
- in 1873, Father Damien, a Roman Catholic priest from Belgium, joined the colony as its resident president
- Father Damien cleaned and bandaged sores and built homes, a hospital, a reservoir, and a plumbing system, and for the next decade and a half he buried many hundreds of leprosy
- he came to be called the ―Martyr of Molokai‖ and was beatified in 1995
- Father Damien’s leprosy caused much fear and reinforced the belief that the disease was highly infectious
- by 1870, leprosy was considered one of the diseases specifically associated with the Chinese
- in 1894 the state of Louisiana established a Louisiana Home for Lepers
- run by the Sisters of Charity, it was a neglected asylum
- by 1917, a leprosy bill was passed to establish a leprosarium
- the old Louisiana Home for Lepers became the American National Leprosarium at Carville
- patients were sent there by special leper trains, some arrived in shackles accompanied by armed guards, and their mail both ingoing and outgoing was disinfected
- babies born to the patients were given up for adoption
- patients were not permitted to marry until 1952
- the American National Leprosarium at Carville, La., was purposely placed between the men’s and women’s penitentiaries as a means for preventing mingling of the sexes, since it
was hoped that the fear of contracting leprosy by passing through this ―zone of contagionwould scare the inmates from considering escape for conjugal visits
- by 1956, the Carville Leprosarium became a voluntary hospital under the Public Health Service and was renamed the Gillis W. Long Hansen’s Disease Center
- up until the 1960s, strict public health laws forbade those with leprosy to use public transport, to fly over certain states, to use public restrooms, or to live freely in society
- in 1997, the last 135 (of the maximum number of 450) hospitalized were ―set free‖ as President Bill Clinton transferred the facility back to the state of Louisiana, where it has
become a school and training center for at-risk youth
The Disease of Leprosy
- it is believed that after the bacteria enter the body (via the nose or through open wounds), they somehow find their way to the Schwann cells that surround the nerve cells
- the affinity for Schwann cells by M. leprae is due to the high affinity of the bacterium for a specific region of the molecule laminin found on the outer surface of these cells; once
they adhere to the laminin using a bacterial surface protein called H1p, they invade
- the mechanism of invasion is unknown, but once inside the Schwann cell they are temporarily protected from the host’s immune system
- the immune system attacks the infected Schwann cells, destroying nerves
Where Leprosy Is
- it is estimated that there are 15 to 20 million cases worldwide, found mostly in the tropics
- the fear of contagion, coupled with the possibility of disfigurement, has contributed to an acceptance of terrible cruelty toward lepers
- it is usually acquired in childhood, but infection can occur even at age 70
- most of the new cases (~750,000 annually) occur in India, Brazil, Indonesia, Myanmar, Philippines, Venezuela, Cameroon, Uganda, Nigeria, Malawi, Burkina Faso, Zambia,
Thailand, and Japan
- males are more frequently infected than females (2:1)
―Catching‖ Leprosy
- the bacilli are shed with the skin, but most bacilli are found in the nasal secretions
- the route of entry into the body is uncertain, but it may be through inhalation since the bacteria cannot penetrate the skin directly
- leprosy seems to occur in clusters of families, suggesting that susceptibility depends on genetic factors, but since few of the members of a family contract the disease, leprosy is
considered a disease of low virulence
Dr. Armauer Hansen of Norway
- Discovers the leprosy germ under a microscope
- Mycobacterium leprae (M. leprae )
- Leprosy is now also called Hansen's Disease
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