Table Of ContentFollowing Stigma and Segregation of Individuals Afflicted with
Lepromatous Leprosy
Deanna
Bogaski
University
of
Manitoba
Key
Words:
burial
practices;
segregation;
stigma;
multibacillary
leprosy;
isolation;
compassion;
graves;
leprosaria;
Hansen’s
disease;
cross-‐cultural
compairison;
palaeopathology;
osteology;
endemic
disease;
germ
theory;
fear
of
infection
Abstract
Modern
Western
society
tells
a
tale
of
fear
and
exclusion
of
individuals
with
leprosy
on
a
global
scale,
yet
case
studies
from
across
the
globe
tell
a
tale
of
compassion,
not
of
stigmatization.
The
effects
of
leprosy
can
be
crippling
and
cause
disfigurement,
and
many
cultures
had
their
own
beliefs
associated
with
the
disease.
In
the
19th
century
a
rise
in
the
prevalence
of
leprosy
incited
fear
in
the
population
and
historical
methods
of
treatment
were
sought,
namely
Leprosaria.
In
this
case
fear
of
contracting
this
disfiguring
disease
cultivated
a
repulsion
from
those
affected.
Originally,
Leprosaria
were
founded
because
it
was
believed
that
those
who
had
contracted
the
disease
had
sinned,
and
through
living
a
life
of
piety
would
be
redeemed.
Modern
Western
society
believed
that
this
had
inadvertently
helped
to
isolate
the
contagious
disease.
The
model
was
mimicked
but
isolation
and
segregation
were
forced,
propagated
by
the
idea
that
this
was
the
method
to
which
all
afflicted
populations
had
eventually
turned,
finding
no
effective
alternative.
Archaeological
and
ethnographic
accounts
from
Japan,
India,
and
Europe,
demonstrate
that
in
most
cases,
segregation
was
not
a
method
practiced,
and
when
it
occurred
it
was
through
individual
choice;
many
infected
individuals
chose
to
remain
with
their
families
and
communities
until
death.
the
world
and
continues
to
persist
in
Introduction
certain
regions.
My
query
is
when
the
Leprosy,
now
known
as
Hansen’s
disease,
stigma
that
is
so
commonly
associated
is
associated
with
social
stigma,
fear,
and
with
lepers
and
leprosy
in
modern
hatred
in
both
life
and
death.
Visceral
Western
society
(Europe
and
North
reactions
occur
to
the
disfigurement
and
America)
originally
arose.
Is
it
possible
to
effects
of
this
disease
and
its
slow
and
assess
social
marginalization
or
ostracism
prolonged
progression.
This
is
a
disease
through
burials
and
archaeological
present
in
the
Old
World
(Asia,
Africa,
remains?
In
many
cases,
what
could
be
and
Europe)
at
least
since
the
rise
of
perceived
as
evidence
of
discrimination
urbanization.
It
has
spread
to
all
parts
of
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could
in
fact
be
much
more
complex.
The
Tucker
(2012),
and
Rawcliffe
(2006),
which
case
of
leprosy
throughout
human
history
revised
the
ideas
on
stigma
associated
illustrates
this
very
well,
in
finding
both
with
medieval
lepers.
Further,
research
normal
and
abnormal
burial
practices
of
conducted
in
other
countries
was
often
individuals
with
the
disease.
Through
an
published
in
the
national
language,
and
understanding
of
the
diseases
effects,
has
yet
to
be
translated
into
English,
such
archaeological
findings,
and
the
visible
as
further
information
on
the
peculiar
changes
in
perception
it
can
be
hoped
to
Nabe-‐kaburi
burials
from
Japan
to
be
gain
a
better
understanding
of
the
discussed
later
(Suzuki
et
al.
2014).
opprobrium
associated
with
the
disease,
As
well,
the
query
in
itself
has
limits
and
of
the
human
ability
for
compassion.
to
what
it
can
achieve.
Today
there
are
a
The
first
section
will
discuss
multitude
of
feelings
and
attitudes
limitations,
the
second
section
will
towards
leprosy,
individuals
have
different
introduce
the
bacterium
that
causes
reactions
and
the
same
scope
and
leprosy,
and
will
be
followed
by
complexity
can
be
thought
to
have
terminology.
The
fourth
section
discusses
occurred
in
the
past.
Attempting
to
what
social
stigmatization
of
leprous
understand
the
complexity
of
this
issue
individuals
was
believed
to
look
like.
Then
historically
through
an
assemblage
of
the
pathologies
found
in
archaeological
archaeological
sources
and
historical
remains
of
leprous
individuals
and
references
can
only
be
reflective
of
a
small
leprosy’s
physical
manifestations
will
be
portion
of
the
ideas
and
practices
that
discussed,
and
how
it
has
been
occurred
and
are
subject
to
individual
determined
if
an
individual
lived
with
interpretation.
The
archaeological
data
leprosy.
Then
specific
archaeological
gathered
cannot
ascertain
the
nuances
examples
from
Western
and
Eastern
of
an
individual’s
everyday
life.
contexts
will
be
examined
in
order
to
Bioarchaeological
examinations
are
largely
ascertain
if
the
modern
Western
belief
limited
to
qualitative
data
and
cannot
that
leprosy
is
a
globally
stigmatized
produce
verifiable
qualitative
data.
disease
holds
any
truth.
How
these
For
example
in
isotopic
analysis
diet
modern
Western
beliefs
came
to
existence
can
be
ascertained,
but
not
the
quality
and
will
lead
into
the
conclusion
on
whether
freshness
of
the
food
when
consumed,
leprosy
holds
social
stigma
on
a
global
which
could
be
affected
by
stigma;
food
scale.
may
have
been
given
to
individuals
with
leprosy
only
after
it
was
no
longer
suitable
or
desirable
for
others
to
eat
(Linderholm
Limitations
and
Kjellström
2011).
Further,
the
bones
A
limitation
that
I
faced
in
conducting
this
and
burials
themselves,
while
being
a
large
research
was
access
to
sources
I
wished
to
source
of
information,
may
also
pose
consult.
Some
limitations
were
due
to
the
many
limitations.
The
osteological
limits
of
the
University
of
Manitoba’s
paradox
comes
to
mind
when
assessing
library
resources
for
undergraduates,
such
the
apparently
healthy
skeletons
from
as
F.O.
Touati’s
influential
works,
cited
in
numerous
leprosaria
(Wood
et
al.
1992).
the
work
of
Brenner
(2010),
Roffey
and
Were
a
number
of
the
individuals
interred
Bogaski
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at
the
cemetery
of
the
hospital
at
the
speculated
origin
of
M.
leprae
is
Chichester,
England
healthy
as
it
would
approximately
40,000
years
ago
(Robbins
appear
from
their
bones
(Lee
and
et
al.
2009:6).
Skeletal
manifestations
of
a
Magilton
1989),
or
were
they
weak
and
the
more
ancient
origin
may
be
found
in
disease
caused
their
death
so
quickly
that
future
excavations.
osteological
changes
did
not
have
the
time
The
bacillus
has
a
single
clone
origin,
necessary
to
occur?
Empirical
evidence
as
suggested
through
analysis
of
the
from
DNA
analysis
has
proved
useful
in
genome
which
has
observed
nearly
positively
identifying
suspected
victims
of
identical
strains
in
numerous
location
Mycobacterium
leprae
(Suzuki
et
al.
2010).
across
the
globe,
although
it
was
possible
However,
to
do
such
an
analysis
on
all
to
classify
these
into
four
types
(Maiden
skeletal
material
would
be
costly,
both
in
2009,
Suzuki
et
al.
2010,
Grimm
2005).
The
time
and
money,
as
well
as
destructive.
current
theory,
based
on
the
large
portion
Finally
excavations
of
burial
sites
are
of
inactive
genes
in
the
chromosome
of
often
only
partial
excavations,
and
can
the
bacillus,
is
that
M.
leprae
underwent
give
only
a
glimpse
into
the
data
that
may
extreme
evolutionary
selection,
and
is
the
be
available;
this
could
easily
produce
outcome
of
bottlenose
selection
and
sample
biases.
For
example,
the
study
by
reductive
evolution
(Maiden,
2009:1265).
Lee
and
Magilton
(1989:275)
demonstrates
The
gene
decay
present
has
caused
leprosy
this
possibility
as
the
hospital
cemetery
to
be
an
almost
uniquely
human
disease,
that
was
excavated
extends
at
least
and
the
only
other
organism
to-‐date
who
beneath
the
modern
road,
and
perhaps
has
been
found
to
be
susceptible
is
the
even
further
north.
Further,
as
my
nine-‐banded
armadillo
(Maiden
research
occurs
through
secondary
2009:1265).
Regardless
of
the
endemic
sources,
I
only
have
access
to
data
that
has
presence
of
this
disease
over
the
course
of
been
excavated
and
published
on,
and
the
human
history,
research
on
M.
leprae
has
data
is
presented
in
a
manner
that
may
been
difficult
and
requires
much
limit
or
aid
in
my
research
efforts.
persistence.
The
bacillus
reproduces
slowly
and
resists
artificial
cultivation,
hampering
our
understanding
of
the
Overview
of
Mycobacterium
disease’s
aetiology
(Maiden
2009).
leprae
Leprosy,
or
Hansen’s
disease,
is
caused
by
Terminology
a
pathogen
called
Mycobacterium
Leprae,
which
has
affected
human
populations
for
The
terms
“leprosy”
and
“leper”
are
at
least
4,000
years
(Maiden,
2009).
This
is
controversial
today,
as
the
opprobrium
confirmed
through
archaeological
associated
with
this
disease
in
a
time
of
evidence
from
an
ancient
skeleton
from
misunderstanding
continues
to
exist
India,
which
dates
to
2,000
BCE,
which
today.
This
has
resulted
in
the
disease
shows
pathology
consistent
with
a
being
renamed
“Hansen’s
Disease”
in
diagnosis
of
leprosy
(Robbins
et
al.
2009).
order
to
free
contemporary
sufferers
from
This
disease
may
have
affected
such
negative
connotations
(White
populations
for
generations
before
that,
as
2005:318).
Leprosy
refers
to
the
chronic
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infection
caused
by
M.
leprae,
and
the
historical
interpretation
of
disease
term
“leper”
refers
to
individuals
who
were
causation.
afflicted
with
leprosy
during
the
medieval
period.
My
choice
in
using
these
terms
is
influenced
by
my
desire
to
include
and
Stigma
Associated
with
Leprosy
understand
the
origins
of
this
stigma
as
It
has
long
been
believed
by
the
general
well
as
my
desire
to
maintain
a
tie
to
the
population,
myself
included,
that
leprosy
history
of
the
disease.
Using
these
terms
is
a
disease
that
carries
the
heavy
baggage
maintains
these
metaphorical
of
social
stigma,
fear,
hatred,
and
associations,
and
in
re-‐examining
misunderstanding
wherever
it
is
found.
historical
attitudes
can
perhaps
influence
Terms
such
as
the
“living
dead”,
and
contemporary
responses
to
such
terms.
In
depictions
like
Richard
Cooper’s
painting
some
cases,
the
terms
“leper”
and
“Medieval
villagers
scrambling
to
get
away
“Hansen’s
disease”
have
become
from
a
leper”
(as
seen
in
Rawcliffe
2006:15)
associated,
bringing
the
prejudices
of
the
aid
the
propagation
of
such
ideas.
past
into
the
present.
As
stated
by
White
Alongside
these
reports
there
are
various
(2005:318)
“if
popular
meanings
of
pieces
of
literature
that
vilify
lepers,
or
hanseníase
reproduce
those
of
lepra,
the
potentially
fabricate
rituals
of
separation
name
shift
could
be
rendered
irrelevant.”
and
social
death
associated
with
the
The
Latin
term
“lepra”
resulted
from
a
contraction
of
such
a
disease
(such
as
the
translation
of
the
Hebrew
“Zara’at,”
a
“Leper
Mass”
so
willingly
quoted
by
Covey
word
for
skin
diseases
found
in
the
Bible,
[2001:318]
which
is
of
a
questionable
and
originally
was
similarly
used
for
skin
source
[Rawcliffe
2006:
20]).
This
disorders
which
“turned
the
skin
rough,
propaganda
on
the
social
prejudice
and
scaly,
or
flaky”
(Brenner
2010:390).
The
cost
of
this
disease
has
likely
only
aided
in
definition
of
leprosy
did
not
become
creating
more
fear
of
infection
among
the
solidified
until
later,
with
translations
population.
from
Greek
and
Arabic
medical
texts
This
disease
was
not
feared
and
dating
to
the
11th
and
12th
centuries
CE
dreaded
because
it
was
fatal,
but
more
(Brenner
2010:390).
Rawcliffe
makes
the
likely,
because
it
was
not.
Fear
of
the
valid
point
that,
even
with
the
medical
effects
of
this
disease,
which
is
amongst
diagnosis,
in
medieval
times
there
were
the
most
crippling
and
potentially
is
the
“many
leprosies:
of
bodies
and
souls,
of
most
physically
disfiguring
infectious
saints
and
sinners,
of
men
and
metals,
of
disease,
is
a
large
contributor
to
the
animals
and
plants”
(2006:43).
Because
stigma
associated
with
leprosy.
This
this
is
a
study
of
a
disease’s
history,
any
infection
could
persist
for
the
remainder
sources
from
the
past
must
take
into
of
the
individuals’
life,
becoming
more
account
the
variety
of
meaning
ascribed
to
debilitating
and
disfiguring
as
the
the
term.
Stripping
the
term
from
the
infection
progressed,
with
no
known
cure
disease
can
only
serve
as
a
limit
to
our
until
the
1940s
(Sato
and
Narita
2003).
For
knowledge
and
understanding,
as
the
some
with
a
stronger
immune
response
knowledge
contemporary
western
the
infection
would
be
paucibacillary
and
biomedicine
offers
often
does
not
reflect
could
be
limited
to
a
small
lesion.
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Due
to
these
factors,
leper-‐houses
or
assault
(Gilmore
2008:73).
The
leprosaria
were
believed
to
be
places
of
paucibacillary
form,
also
known
as
isolation
for
the
victims
of
leprosy.
These
tuberculoid
leprosy,
occurs
when
there
is
individuals
may
have
been
thought
of
as
a
strong
immunological
response,
and
“unclean”
or
“untrustworthy”
and
were
does
not
have
the
same
devastating
and
seen
as
evident
of
divine
punishment
for
disfiguring
effects
on
the
body
as
the
sin,
and
served
to
remind
others
to
live
a
multibacillary,
or
lepromatous,
form
may
life
free
of
sin
(Covey
2001:320).
Leprosaria
have,
in
which
the
bacillus
encounters
were
also
cited
in
the
19th
century
as
the
little
to
no
immunological
reaction
only
effective
management
of
the
disease,
(Gilmore
2008:73).
The
multibacillary
and
were
ascribed
with
the
decline
in
form,
if
left
untreated,
can
lead
to
loss
of
leprosy
seen
in
the
14th
century
in
Europe
sensation
that
may
result
in
lesions
(Rawcliffe
2006:13),
which
aided
in
subject
to
secondary
infection
(Gilmore
justifying
isolation
practices
at
the
end
of
2008:73).
the
19th
century
when
a
rise
in
the
Multibacillary
Leprosy
prevalence
of
leprosy
occurred.
Recent
research
on
medieval
leprosaria
has
shown
The
most
characteristic
features
of
that
this
degree
of
ostracism
and
fear,
multibacillary
leprosy
involve
the
which
we
associate
with
poor
medieval
rounding
and
abnormal
enlargement
of
sufferers,
may
in
fact
be
a
much
more
nasal
aperture,
disappearance
of
anterior
recent
development,
occurring
most
nasal
spine,
and
antemortem
resorption
of
acutely
in
the
colonial
era.
The
the
alveolar
process
of
the
maxillae
segregation
policies
while
at
first
were
(Suzuki
et
al.
2010:3).
Degenerative
and
voluntary,
later
became
enforced,
and
reactive
changes
on
the
palatal
process
are
forcible
separation
from
society
occurred
also
descriptive
of
the
disease
process,
and
in
many
places,
and
rewards
were
even
these
rhino-‐maxillary
changes
are
offered
to
those
who
brought
a
leper
in
exclusive
to
the
lepromatous
or
near
(Small
2009:36).
lepromatous
forms
(Mariotti
et
al.
2005:213).
Further
elements
that
can
aid
in
the
diagnosis
of
lepromatous
leprosy
Palaeopathology
of
Leprosy
involve
periostitic
changes
of
tibia
and
fibula
(Suzuki
et
al.
2010),
and
“resorptive
There
are
several
characteristic
lesions
changes
to
phalanges,
metatarso-‐
that
occur
in
the
skeleton
that
can
be
used
phalangeal
joints,
diaphyseal
remodelling,
to
diagnose
multibacillary
leprosy.
cupping
and
remodelling
of
the
joints”
Unfortunately
paucibacillary
leprosy
does
(Mariotti
et
al.
2005:313).
Another
element
not
often
have
these
characteristic
lesions
useful
in
diagnosis
(if
preserved)
would
be
and
the
effects
on
a
skeleton
may
be
in
changes
to
the
hyoid,
as
leprosy
often
overlooked
or
similar
to
other
pathologies
causes
lesions
of
the
larynx;
Gilmore
and
therefore
incapable
of
producing
a
(2008:82)
observed
skeletal
changes
in
positive
diagnosis.
When
contact
with
M.
36.6%
of
untreated
multibacillary
cases
to
leprae
occurs,
there
is
a
significant
amount
the
hyoid
as
well
as
to
the
3rd
through
6th
of
variation
in
individual
reactions
that
cervical
vertebrae.
depend
on
the
immune
responses
to
the
Bogaski
5
UMASA
Journal
Vol
33(2015)
adult
burial;
in
Vedic
tradition
(originating
with
the
Indus
civilization),
Archaeological
Examinations
and
cremation
of
the
bodies
of
individuals
Consideration
with
leprosy
was
not
practiced,
as
their
bodies
were
not
considered
appropriate
Through
an
examination
of
knowledge
offerings
to
the
Hindu
Gods.
Individuals
garnered
from
archaeological
excavations,
afflicted
with
leprosy
were
buried,
and
it
is
possible
to
illuminate
some
of
the
occasionally
buried
alive
in
parts
of
India
intriguing
and
varied
social
reactions
to
(Robbins
et
al.
2009).
Given
this
this
almost
uniquely
human
disease.
information
with
no
further
research
into
Beginning
with
the
suspected
area
of
the
cultural
context,
it
would
be
simple
to
origin
and
moving
onwards
to
various
identify
this
case
not
only
as
the
earliest
periods
and
regions,
the
stigma
associated
evidence
of
lepromatous
leprosy,
but
also
with
this
disease
throughout
history
is
as
the
earliest
case
exemplifying
blurred
and
questionable,
until
modern
stigmatization
of
an
individual
with
times.
leprosy
through
the
denial
of
normal
India
burial
practices
to
the
deceased,
or
even
The
earliest
archaeological
evidence
of
murder
in
cases
where
an
individual
is
multibacillary
leprosy
comes
from
the
buried
alive.
suspected
area
in
which
M.
leprae
Looking
at
an
ethnographic
account
originated,
India.
The
individual
found
is
a
dating
from
1869,
by
A.
Campbell,
we
can
male
approximately
37
+/-‐
5
years
of
age,
perhaps
understand
this
not
as
an
and
dates
to
approximately
2000
BCE
inhumane
act,
but
one
of
compassion.
The
(Robbins
et
al.
2009).
The
skull
of
this
individual
who
was
afflicted
with
leprosy,
individual
exhibits
all
the
diagnostic
when
feeling
that
their
decaying
state
was
criteria
of
lepromatous
leprosy.
too
much
of
a
burden
on
relatives
and
Antemortem
tooth
loss,
remodelling
of
friends
“expresses
a
desire
to
bury
himself
the
alveolar
process
of
the
maxillae
and
of
alive”
(Campbell
1869:195).
The
relatives
the
nasal
aperture
and
pitting
in
the
who
care
for
the
sufferer
would
try
to
palatine
process
are
all
easily
observable
discourage
this
thought,
until
eventually,
and
support
a
diagnosis
of
multibacillary
they
would
agree.
Once
the
relatives
leprosy
(Robbins
et
al.
2009).
This
adult
acquiesced
the
request,
a
funerary
rite
was
found
in
a
flexed
position
inside
a
appears
to
have
commenced,
the
entirety
stone
enclosure
and
was
buried
in
vitrified
of
the
village
may
present
themselves,
a
ash
from
cow
dung,
which
may
be
from
pit
was
dug,
which
the
leper
voluntarily
funerary
rites
(Robbins
et
al.
2009).
entered,
then
the
individual's
friends
The
remains
were
found
in
northwest
proceed
to
bury
him
or
her,
and
finally
a
India,
and
the
presence
of
new
pottery
few
days
later
opium
water
was
shared
at
styles
and
monumental
architecture
the
home
of
the
deceased
(Campbell
suggest
this
large
settlement
was
in
1869).
Considering
the
individuals
contact
with
the
Indus
civilization
probable
knowledge,
due
to
the
endemic
(Robbins
et
al.
2009).
This
connection
presence
of
this
disease
in
India,
of
the
could
explain
the
abnormal
presence
of
an
abysmal
existence
of
a
leper
once
the
Bogaski
6
UMASA
Journal
Vol
33(2015)
disease
progressed
to
a
significant
extent,
Late
Middle
Ages.
The
meaning
of
the
requiring
aid
with
quotidian
activities
pots
covering
the
heads
is
speculative,
but
such
as
feeding,
bathing,
and
dressing,
it
has
been
hypothesized
that
it
offered
a
this
practice
seems
analogous
to
form
of
protection
for
the
living
from
the
contemporary
practice
of
euthanasia,
in
leprous
individuals.
which
a
suffering
individual
may
ask
for
Individuals
from
Nabe-‐kaburi
burials
aid
in
ending
their
life
if
they
lack
the
from
two
sites
were
analysed,
two
from
ability
to
do
so
themselves.
Although
this
“Tawara-‐ga-‐yatsu”
and
one
from
practice
is
not
without
controversy,
it
can
“Usukobo”,
both
sites
dating
to
the
18th
be
viewed
as
a
method
of
harm
reduction.
century
CE
(Suzuki
et
al.
2014).
The
Campbell's
(1869)
account
is
individual
TK5
from
“Tawara-‐ga-‐yatsu”
extremely
ethnocentric
in
this
regard,
and
was
buried
with
two
iron
pots
and
one
does
not
take
into
account
the
societies
mortar
pot
covering
his
head
as
well
as
desires
and
customs,
which
may
hold
some
currency
and
three
glass
beads,
and
meaning
and
provide
purpose
to
the
the
head
of
individual
TK6
was
covered
leprosy
sufferers.
For
example,
Purein
with
one
iron
pot,
while
a
mortar
pot
Singh,
an
individual
with
leprosy,
was
covered
his
feet,
he
had
five
pieces
of
voluntarily
burnt
to
death
in
1866
currency,
and
also
displayed
skeletal
(Campbell
1868:196).
When
an
individual
lesions
characteristic
of
leprosy
(Suzuki
et
with
leprosy
was
burnt
to
death,
it
was
al.
2014).
At
the
“Usukobo”
site,
individual
believed
to
provide
safety
to
their
entire
K48
was
examined;
buried
in
a
bent
family
from
the
infection,
and
so
Purein
position,
with
an
iron
pot
on
the
head,
Singh
may
have
honourably
sacrificed
and
containing
a
smaller
iron
pot,
a
pipe,
himself
for
the
sake
of
his
kin,
whereas
and
an
iron
tablet,
this
skeleton
also
Campbell
(1869)
portrays
the
family's
aid
showed
skeletal
changes
characteristic
of
in
his
death
as
a
terrible
crime
that
leprosy
(Suzuki
et
al.
2014).
DNA
analysis
became
punishable
by
law.
confirmed
the
presence
of
M.
leprae
in
both
individuals
showing
osteological
Japan:
“Nabe-‐kaburi”
evidence
for
leprosy,
and
returned
Nabe-‐kaburi
burials
from
the
15th
to
the
negative
results
for
individual
TK5,
who
19th
centuries
found
in
Japan
translate
to
did
not
display
skeletal
lesions
associated
“pot
–
put
on”,
and
are
very
descriptive
of
with
leprosy
(Suzuki
et
al.
2014),
what
these
burials
entail;
an
individual
is
indicating
these
burials
occurred
not
only
buried
with
a
pot
of
iron
or
of
mortar
over
in
leprosy
patients,
but
also
in
a
broader
their
heads,
for
some
yet
to
be
determined
range
of
the
society.
reason
(Suzuki
et
al.
2014:1).
There
are
105
According
to
Suzuki
et
al.
(2014)
there
burials
of
this
type
found
to
date,
and
5
are
two
hypotheses
in
circulation
on
the
out
of
21
skeletons
examined
displayed
meaning
of
these
burials.
One
hypothesis
pathologies
consistent
with
leprosy
is
that
these
pots
were
a
burial
method
to
(Suzuki
et
al.
2014).
Suzuki
and
colleagues
block
disease.
The
second
hypothesis
is
(2014)
noted
similarities
between
the
that
these
individuals
died
during
a
three-‐
Nabe-‐kaburi
burials
and
leprosy
patient
day
ceremony
for
the
ancestors
to
return.
burials,
and
believe
their
study
can
shed
The
ancestors
would
find
this
rude
and
light
on
social
discrimination
from
the
Bogaski
7
UMASA
Journal
Vol
33(2015)
would
have
beaten
their
heads
if
they
present
for
millennia
in
Europe
without
encountered
them
on
the
passage
between
stigma
evident
in
burials
can
be
insightful.
worlds
and
so
the
pots
were
used
to
This
may
reveal
that
it
may
not
have
been
protect
the
deceased
(Suzuki
et
al.
2014:1).
due
to
the
increased
prevalence
of
the
disease,
but
because
of
migrations
of
Suzuki
et
al.
(2014)
also
note
the
grave
peoples
and
their
beliefs.
goods
in
these
burials
are
similar
to
those
found
in
common
cemeteries,
and
these
The
earliest
palaeopathology
with
a
burials
are
often
found
with
ceremonial
determined
diagnosis
of
leprosy
in
Europe
devices
used
for
cleansing
the
spirit
and
is
from
Italy,
and
is
found
in
a
skeleton
offering
salvation
in
the
case
of
an
unusual
dating
to
the
4th
century
BCE,
which
is
death.
Further,
these
individuals
were
consistent
with
the
current
stance
on
the
buried
with
valuable
items,
such
as
the
spread
of
the
disease
(Mariotti
et
al.
iron
pots,
provided
with
currency
2005:321).
The
skeleton
displays
lesions
(possibly
for
the
passage
to
heaven),
and
and
bone
remodelling
in
the
metatarsals,
lived
long
enough
to
develop
and
reduction
in
their
medio-‐lateral
palaeopathologies
indicative
of
leprosy,
diameters,
the
tibia
and
fibula
show
signs
suggesting
palliative
care
(Suzuki
et
al.
of
periostitis,
and
the
hands
show
features
2014).
The
only
difference
in
the
burial
which
indicate
hyperflexion,
all
of
which
treatment
of
these
individuals
from
the
are
usual
manifestations
of
leprosy
burial
treatment
of
others
is
the
“Nabe”
on
(Mariotti
et
al.
2005:314-‐316).
Some
other
their
heads
(Suzuki
et
al.
2014:7).
Further
typical
manifestations
of
leprosy
are
not
these
theories
are
not
mutually
exclusive,
present,
such
as
the
resorption
of
the
as
an
individual
afflicted
with
leprosy
anterior
nasal
spine
and
of
the
alveolar
could
pass
away
at
any
given
time.
If
the
process
of
the
maxillae,
but
the
palatine
prevalence
of
leprosy
was
high
in
this
process
does
show
pitting
and
porosity,
population
a
number
of
individuals
may
which
is
equally
if
not
more
important,
in
display
skeletal
markers,
yet
could
have
the
diagnosis
of
leprosy
(Mariotti
et
al.
lived
without
social
stigma.
Cross-‐ 2005).
Mariotti
et
al.
(2005)
stated
the
examination
of
all
Nabe-‐kaburi
burials
intent
to
obtain
DNA
from
the
remains,
with
non-‐Nabe-‐kaburi
burials
is
a
future
which
would
determine
without
doubt
if
research
area
that
would
help
elucidate
the
individual
had
leprosy,
and
which
this
burial
method’s
meaning.
could
also
uncover
the
type
of
leprosy.
Currently
no
further
articles
have
been
Europe
published
on
this
specimen,
which
would
There
is
speculation
that
a
skeleton
dating
help
to
elucidate
the
spread
of
the
disease.
to
approximately
2000
BCE
from
Scotland
This
burial
is
the
same
orientation,
had
leprosy,
due
to
changes
in
the
rhino-‐
and
placement
as
the
other
burials
of
the
maxillary
region
(Roberts
2007).
This
period,
and
thus
at
such
a
point
in
time,
would
stimulate
a
change
in
the
believed
perhaps
at
the
point
of
introduction
of
the
spread
of
the
disease
to
Europe,
currently
disease
into
Europe,
no
prejudice
or
held
to
be
approximately
4th
century
BCE
spatial
segregation
can
be
seen
(Mariotti
(Mariotti
et
al.
2005).
Although
DNA
et
al.
2003).
The
conclusions
drawn
from
analysis
has
proved
inconclusive,
the
the
early
burials
conducted
by
Mariotti
et
suggestion
that
this
disease
has
been
Bogaski
8
UMASA
Journal
Vol
33(2015)
al.
(2003)
is
mirrored
in
the
findings
of
the
piety,
such
that
if
an
individual
became
research
conducted
by
D.A.
Lunt
(2013)
on
afflicted
with
leprosy
while
leading
a
two
individuals
from
Scotland
dating
from
religious
life,
it
may
have
been
deemed
600-‐1100CE,
which
show
evidence
for
unnecessary
to
relocate
them
from
their
leprosy,
but
no
spatial
segregation.
These
brethren
(Rawcliffe
2006:254-‐256).
The
individuals
are
found
in
cemeteries
for
the
foundation
of
leprosaria
was
influenced
by
general
public,
and
are
actually
located
at
beliefs
that
the
afflicted
had
sinned,
and
the
centre
of
an
area
in
the
graveyard
the
physical
illness
represented
an
ailment
showing
“the
most
careful
arrangement
of
of
the
soul,
and
therefore
could
be
seen
as
the
graves”
(Lunt
2013:317).
Lunt
(2013)
important
sites
of
conversion
(Brenner
states
that
the
Scottish
burials
are
similar
2010).
Rawcliffe
(2006:264)
mentions
the
to
the
majority
of
archaeological
data
from
religious
devotion
necessary
to
maintain
Britain,
where
most
skeletons
diagnosed
residence
at
such
institutions,
and
states,
with
leprosy
are
buried
in
contextually
“far
from
attempting
to
detain
unwilling
normal
settings.
While
literature
on
or
difficult
residents,
most
leprosaria
had
leprosy
burials
in
“normal”
cemeteries
in
always
moved
quickly
to
evict
possible
England
is
difficult
to
locate,
there
are
troublemakers”.
many
leprosaria
cemeteries
that
contain
a
The
medieval
hospital
and
cemetery
of
high
percentage
of
apparently
healthy
St
Mary
Magdalene,
at
Winchester
in
individuals
(Lee
and
Magilton
1989),
and
England,
shows
the
almost
exclusive
there
is
no
spatial
segregation
of
leprosy
presence
of
lepers.
Roffey
and
Tucker
sufferers
in
England
at
Blackfriars
Friary,
(2012)
argue
that
this
was
not
a
practice
of
Ipswich
(Mays
2009).
exclusion,
but
an
example
of
sufferers
Mays
(2009)
speculates
that
in
some
wishing
to
pursue
religious
vocation
being
cases,
due
to
familial
relations,
the
custom
provided
with
a
place
to
do
so,
which
also
of
burying
leprous
individuals
in
leprosy
provided
the
necessary
care.
The
hospital
cemeteries
could
be
disregarded.
individual
most
afflicted
with
the
disease
This
is
based
on
a
rare
genetic
scapula
was
an
adult
male,
between
26-‐35
years
of
anomaly
found
in
two
lay
burials
within
age,
who
would
have
needed
daily
care
Blackfriars
Friary,
one
of
which
showed
with
feeding,
dressing
and
bathing
due
to
leprous
lesions,
involving
changes
to
the
the
extreme
progression
of
lepromatous
rhino-‐maxillary,
region,
the
tarsals,
the
leprosy
(Roffey
and
Tucker
2012).
The
fibula
and
the
tibia
(Mays
2009).
The
burials
in
the
cemetery
of
this
hospital,
religious
order
is
dependent
on
donations
dating
as
early
as
1066
CE,
are
carefully
to
maintain
function,
and
so
Mays
(2009)
laid
out,
with
anthropomorphic
graves,
believes
that
if
a
benefactor
relationship
similar
to
those
seen
in
high-‐status
would
be
sacrificed,
the
custom
could
be
ecclesiastical
sites,
and
there
is
a
broad
overlooked.
According
to
the
data
distribution
of
age
along
with
the
presence
published
in
Mays’
(2009)
study,
another
4
of
both
sexes
(Roffey
and
Tucker
2012).
cases
of
leprosy
are
present
in
the
burials
There
is
also
the
burial
of
a
pilgrim
of
this
friary.
It
seems
that
Mays
(2009)
present
in
this
cemetery,
demonstrating
did
not
take
into
account
the
importance
further
that
this
was
a
religious
site
of
that
leprosaria
placed
on
religion
and
some
importance
(Roffey
and
Tucker
Bogaski
9
UMASA
Journal
Vol
33(2015)
2012).
individuals
with
data
obtained
from
an
isotopic
analysis
of
19
other
human
While
burials
in
“normal”
cemeteries
skeletons
from
the
same
cemetery,
but
in
England
may
be
difficult
to
locate,
there
located
closer
to
the
church,
to
test
the
was
a
study
conducted
in
Odense,
notion
that
these
individuals
were
treated
Denmark
that
shows
many
burials
of
differently
in
life
as
well
as
death,
in
this
individuals
with
leprosy
alongside
healthy
known
stratified
society.
The
data
individuals
(Boldsen
and
Mollerup
2006).
obtained
indicates
that
all
of
these
The
prevalence
of
leprous
lesions
in
individuals
had
the
same
diet,
even
ordinary
cemeteries
ranges
from
14-‐17%
though
the
leprous
individuals
were
before
1400
CE,
after
which
rates
decline
buried
at
the
periphery
of
the
churchyard,
(2006).
The
researchers
suggest
that
a
place
reserved
for
the
low
status
segregation
did
take
place,
as
well
as
individuals
(Linderholm
and
Kjellström
discrimination,
based
on
the
separation
of
2011).
the
individuals
with
the
most
advanced
facial
lesions
to
the
leprosarium
(2006).
In
this
case,
the
burial
place
is
not
This
is
based
on
the
foundation
of
the
reflective
of
the
deceased’s
life,
as
we
leprosarium
between
1270
and
1280
CE,
the
would
expect
to
see
differences
in
the
diet
high
prevalence
of
leprosy
present
in
its
if
these
individuals
were
social
pariahs,
cemetery
(95%),
and
the
following
decline
although
quality
and
freshness
of
the
food
in
leprous
burials
in
normal
cemeteries,
eaten
cannot
be
assessed.
There
is
although
this
also
coincides
with
a
decline
mention
of
burial
regulations,
and
a
law
in
the
prevalence
of
leprosy
in
the
assigning
areas
farthest
from
the
church
population
(2006).
While
this
may
be
a
for
the
burial
for
the
poor
and
outcast
factor
of
segregation,
it
may
also
be
a
(Linderholm
and
Kjellström
2011:925).
This
question
of
care,
and
the
quantitative
data
is
the
cause
for
the
spatial
segregation,
provided
by
these
burial
locations
does
which
may
simply
be
due
to
reserving
the
not
provide
the
qualitative
data
that
the
areas
closest
to
the
church
for
those
who
study
by
Roffey
and
Tucker
(2012)
are
more
likely
to
be,
or
to
become,
provides.
A
study
focused
on
using
benefactors.
This
law
has
no
bearing
on
qualitative
data
in
this
location
may
show
the
life
of
these
individuals,
and
they
were
that
those
with
facial
lesions
were
those
cared
for
long
enough
to
develop
skeletal
most
in
need
of
care,
and
therefore
lesions,
perhaps
by
the
church,
perhaps
by
housing
within
the
leprosarium.
family,
or
perhaps
by
the
community.
In
Sigtuna,
Sweden,
Anna
Linderholm
Summary
and
Anna
Kjellström
(2011)
conducted
an
These
cases
all
illustrate
the
need
to
isotopic
analysis
of
6
individual
skeletons
understand
more
than
the
spatial
showing
evidence
of
leprosy
in
their
arrangement
of
a
cemetery,
which
may
or
remains.
These
individuals
were
buried
at
may
not
be
indicative
of
the
life
of
the
the
periphery
of
the
churchyard
and
thus
individual.
Spatial
segregation
in
burial
are
believed
to
of
a
lower
social
stratum
practices
can
express
social
segregation,
(Linderholm
and
Kjellström
2011).
but
practices
vary
in
different
regions.
Linderholm
and
Kjellström
(2011)
proceed
There
is
no
clear
universal
way
in
which
to
contrast
the
data
obtained
from
these
leprosy
was
treated,
and
no
clear
signs
Bogaski
10
Description:palaeopathology; osteology; endemic disease; germ theory; fear of infection. Abstract . word for skin diseases found in the Bible, and originally was
