perjantai 9. elokuuta 2013

Leprosy

File:Leprosy.jpg
A leper. Picture from Wikicommons.
Leprosy is caused by the bacteria Mycibacterium leprae, which is related with the bacillus causing tuberculosis and borreliosis. The bacillus was found by the Norwegian A.G. Hansen in 1873, and is also called the Hansen’s disease. The bacillus cannot survive long outside a human body, and is therefore not easily contagious. In families where one person’s caught the leprosy infection, but continued to live among the other family members, in times none of the other family members has caught the same infection.[1]

Now-a-days leprosy can be cured with antibiotics, but until the 20th century, when the antibiotics were created, it was an incurable decease. After catching the infection, it might take up to ten years before signs of the disease emerge, and it is therefore hard to know from where the infection has come. This, in addition to incurability and the belief that leprosy was a punishment from God for a sin, made it a much feared disease.[2]

There are two kinds of leprosy: the tuberculoid leprosy and the lepromatose leprosy. The first goes straight to the nerves, and can paralyse parts of the body and blood circulation is disturbed.[3] The lepromatose leprosy causes skin deformations and bumps. Usually, leprosy shows signs of both kinds. Since the nerves are out of order, the patient easily hurts him- or herself, and the bumps in the skin get open. Since the blood circulation does not work as well as it should, the wounds does not heal as they should. Infections and even necroses can be a result of this, which has given the picture that lepers loose limbs, such as toes, fingers and noses. Leprosy can be very painful; but is not in itself a deadly disease. Lepers often live in conditions in which other diseases also spread, and the immunity system  of the patient is lower than of a healthy person, lepers often catch other diseases, which can be dangerous for them.[4]
In most of Europe, leprosy was most spread during the Middle Ages. In Scandinavia, the epidemic was worst during the 17th century. It was, thought, not an unknown disease before that either: Finland’s first leper hospital, Saint George’s Hospital, was founded in Turku in the 14th century. In Sweden and Denmark this happened even earlier. Leprosy was after the Middle Ages mostly a lower class disease. Wealthy people usually had better nutrition and immunity, and also hygiene got better during this time for them.[5] In the 18th and 19th centuries most Finnish cases of leprosy were on the coast, which gave reason to a theory that the infection spread by fishes.[6]
Memorial cross for the 663 lepers who died in Seili.

In the Bible Jesus cures a leper, which has given the interpretation that leprosy was God’s punishment for a sin. According to some theories, not only the decease was contagious, but also the amorality. The mix of religion and medicine was a result of antic and medieval translations gone wrong.[7]

Peter Richards explains the misunderstandings as follows:
In the Bible is a vague description of different skin disorders, which in Hebrew was called tsara’ ath. In Greek, this was translated as lepra. The Greek also had a diagnosis of what today is meant by leprosy, which they, because of the skin disformations, called elephantiasis. The Greek documents and research survived thanks to the Arab scientists, who translated them into Arabic. The Arabs already had a disease named das fil, equivalent in name with elephantiasis. Therefore, they translated the Greek elephantiasis to juzam. When the Arab documents were translated into Latin, juzam was translated to be lepra. This is how the religious collection of skin disorders (the Greek lepra), and the well-defined disease (the Greek elephantiasis) were considered one. The disease today called elephantiasis, which is caused by tropical filarial worms, is the same one that the Arabs called das fil.[8]

In Finland, the worst epidemic was over by the 18th century, and for example, a decision was made that no more lepers were to be taken to the hospital of Seili.[9] The decision was not changed when a new epidemic of leprosy came in the 19th century.[10] The last leper hospital in Finland was at Orivesi, and it was closed in 1953.[11] Globally leprosy still is spread in areas, where people hardly gets the medical treatments needed, such as in parts of India and Brazil.


Sources:
Richards, Peter, The Medieval leper and his northern heirs (Cambridge 1977).
Turunen, Sakari, Achté, Kalle, “Seilin hospitaali 1619 – 1962”, p. 4 – 46, Käytännön lääkäri 1/1976.
Vuorinen, Heikki S., Tauti(n)en historia (Tampere 2002).


Lisa Svanfeldt-Winter




[1] Heikki S. Vuorinen, Tauti(n)en historia, (Tampere 2002), pp. 153, 155.
[2] Vuorinen, p. 155.
[3] Vuorinen, p. 153.
[4] Vuorinen, p. 153 – 154.
[5] Peter Richards, The Medieval leper and his northern heirs (Cambridge 1977), p. 95.
[6] Vuorinen, p. 165.
[7] Vuorinen, p. 156.
[8] Peter Richards, The Medieval leper and his northern heirs (Cambridge 1977), p. 9.
[9] Sakari Turunen, Kalle Achté, ”Seilin hospitaali 1619 – 1962” p. 4 - 46, Käytännön lääkäri 1/76, p. 20.
[10] Vuorinen, p. 166 – 168.
[11] Richards, p. 89.

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