Leprosy and the Order of St Lazarus - Museum of the Order of St John

Leprosy and the Order of St Lazarus - Museum of the Order of St John
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Leprosy has always been an extremely stigmatised condition, oftentimes being associated with aversion, segregation and isolation. What was leprosy, however and what did it involve? Furthermore, why were those with leprosy discriminated against and how were they treated?
In modern day medicine, leprosy is now also known as “Hansen’s Disease”, named after Norwegian scientist Armaeur Hansen who, in 1873, identified the causes of leprosy as the slow growing bacteria:
mycobacterium leprae
and
mycobacterium lepromatosis
. Leprosy can appear in numerous forms dependant on the individual. It primarily affects the skin, peripheral nerves and the mucous membranes. In its most extreme form, leprosy causes skin lesions, raised tumours, facial disfigurement and even the loss of fingers, toes and noses. In less severe manifestations other skin conditions could have potentially been confused for leprosy, like eczema and psoriasis.
Leprosy is likely to be spread through droplets from the nose and mouth during close and frequent contact with untreated cases and can take years to develop. The frequency is the important part to note, as short exposure with a leprous individual would not have done much. Generally, most people possess a natural immunity, so even at its height in the 13
th
century only 5-10% of the population would have had some form of leprosy.
Why then, has the condition been so stigmatised? A lot of the stigma stems from an enforced undesirable imagery. Lesions were considered a physical manifestation of one’s sin. As stated by Margery Kemp there was “nothing more loathsome or more abominable than to see or behold a leper”. Lepers were associated with the very bottom of society. They were regarded as vagabonds, beggars, heretics, criminals and sexual miscreants, and needed segregating and containing. There was a strong association of Leprosy with uncleanliness and disease. Because leprosy was considered highly contagious, even though we know now it isn’t, it’s likely that people also felt that these undesirable traits could be caught just as equally.
“Now  began  she  to  love  what  she  had  most  hated  be- foretime, for  there  was  nothing  more  loathsome  or more  abominable  to  her,  while  she  was  in  those  years of  worldly  prospenty,  than  to  see  or  behold  a leper, whom  now,  through  Our  Lord’s  mercy,  she  desired to  embrace  and  kiss  for  the  love  of  Jesus,  when  she had  time  and  place  convenient”
The Book of Margery Kempe, p.232.
Additionally, as per the meeting of the Third Lateran Council in 1179, lepers were considered the living dead. They were “liminal beings”, neither dead nor alive. Their bodies were thought to be “in transition”, a physical manifestation of purgatory on earth.
Lepers were considered under their own separate category within religious and government law. They were automatically barred from inheritance, unable to legally own property, and denied the right to plead in court or negotiate contracts. They were forbidden to enter inns, churches, mills or bakehouses, they were not allowed to touch healthy people or to eat with them and were excluded from bathing in streams and springs and were required to be buried in separate cemeteries. Lepers were ostracised from society, and in some areas required to wear identifying insignia or to carry a noisy instrument to notify others of their approach and leper status.
While there was most certainly a social derision towards those with leprosy, there were also those who wished to help. Aretaeus of Cappadocia, from the 1
st
century, identified the swelling and toughening of the face, and recommended various medicines and diets in the hopes of preventing the deterioration of the disease. At-Tabari of the 10
th
century, argued leprosy was caused from corrupt air, and recommended drinking wine in which a venomous snake had been submerged. Ibn-Sina of the 10
th
and 11
th
centuries identified both early symptoms and distinguished between leprosy and other skin ailments. He suggested treating leprosy through bloodletting, medical ointments, sulphurous waters and cauterisation of lesions. Eastern medical understanding of leprosy was extremely important as it was that which formed the basis for western knowledge of the disease until the seventeenth century.
Between the years 1130 and 1142, the Order of Saint Lazarus of Jerusalem was founded, named in the honour of St Lazarus, the patron saint of lepers. The official seal of the order showed a disfigured leprous brother covered in sores. In 1142 it became formally acknowledged by King Fulk of Jerusalem, and by 1255 it was recognised by Pope Alexander IV as a military and hospitaller order under the rule of Saint Augustine. The Order of St Lazarus was likely formed out of a need that was not being met by any other organisation. The 11
th
to 13
th
centuries were the height of the leprosy epidemic, however none of the other Orders were caring for lepers outside of their own brethren. While the Order of St John was known for its own care for the sick and poor, they did not accept lepers at all. And thus, the Order of St Lazarus was formed to provide a place of aid specifically for those afflicted with leprosy.
The first House of St Lazarus was built on the pilgrim route between the Mount of Olives and the River Jordan. By 1150, the brothers were wealthy enough to purchase additional lands and expand the Order. This was largely done with the support of several monarchs such as Queen Melisende and Kings Fulk, Baldwin III and Almeric. King Almeric was a notable individual who would eat food lepers had left behind, kiss each leprous brother daily after mass, washing and wiping their feet, making their beds, and carrying those feeling weak atop his shoulders. He was also observed to have, at times, washed his face with the same water that he had cleansed them with before. While more of an extreme case, Almeric was important in showing that the lepers within the care of the Order were not simply living corpses but human beings.
Additionally, it is important to remember the biblical stories involving Christ interacting with and healing lepers. Coupled with notable individuals, such as King Almeric, spending time in close contact with those with leprosy, there was a real emphasis on emulating Christ and providing care for those that were less fortunate.
The brotherhood was made up of a mix of leper knights and “healthy” brothers, and the Master was required to be a leper himself until 1253. From 1200, a legal code in Jerusalem stated that knights across all other religious orders that were afflicted with leprosy were required to join the Order of St Lazarus. It is unknown how many Orders may have followed through on this, as most other Orders like that of the Order of St John would take care of their own leprous brothers. They would essentially be “retired” from service and kept separate from the rest of the organisation. From 1250, however, you could say that a partnership with the Knights Templar was created as from that point onwards any Templar Knight that became afflicted with leprosy could transfer to the Order of St Lazarus if they wished. With each Knight that transferred, the Templars would also send money and resources to aid in their care.
As active knights, brothers of the Order that were bodily able were encouraged to participate in battles. The Order had no notable military success, with everyone being slain at the Battle of Gaza in 1244 only four men surviving the raid of Ramla in 1253, and all dying in the Battle of Acre alongside the Templars in 1291. it is important to acknowledge that these leprous knights were not being kept away or ostracised as was expected but were considered equal to men fighting from other Orders.
1291, however, did see the Lazarites expelled from Jerusalem. Fortunately for them, by this point the order had already purchased lands in other countries. The first Lazarite house in England had been established in 1150 with several holdings in Scotland by 1215. Most importantly was the French house established in 1154, which became the Order’s new headquarters.
13
th
century France was considered the centre of leprosy care. Leprosy communities known as leprosaria were built, and each one would have its own hospital, church, cemetery, and bakehouse with varying other establishments. By 1228 it was estimated that France had over 2000 leprosaria. Not all of these were owned by the Order of St Lazarus, but the Order had most definitely played a role in establishing the basic requirements for leprosy care and for treating those with leprosy like human beings.
Leprosaria were not designed to imprison lepers or to punish them in any way, but there were rules and restrictions for those residing within them. Lepers were not to leave a leprosarium without permission, and when they did leave, they were to always travel in pairs. There were not to be any games or private conversations between women and men, and by joining a leprosarium you were agreeing to monastic community life and were expected to participate in daily prayers.
“history of the crusades”, Yates Thompson 12, f.152v, British Library Archive
Lepers who wished to enter the leprosarium were expected to surrender their property and had up to 10 days inside to decide whether they wanted to join the community. If they decided to leave, they would receive back their belongings and were free to re-enter the secular world although, as we know, this would have been incredibly difficult to do. Most of the leprosaria in France followed these rules and regulations, although a few made interesting changes like the leprosarium of Brives that established a democratic committee of lepers to discuss any changes to be made.
In England, leprosaria became known as Lazar Houses, of which there had been roughly 300 total by the sixteenth century. Of these, only 12 had been officially recognised as belonging to the Order of St Lazarus. There was actually very little done here in England by the order for those in the community with leprosy. With exception of the Hospital of St Giles, the other 11 Lazarite houses were focused on gathering members and resources to dispatch to their other hospitals across Europe and the Middle East, like the role of the Order of St John in Clerkenwell.
In England, many non-official lazar houses were established as an act of piety, often by nobles or other religious institutions, although they did tend to fizzle out and close after a time. This was typically due to a combination of poor funding and the strong stigma around lepers, in which under English Law they were thought on the same level as those excommunicated from the church.
“Omne Bonum”, Royal 6 E. VI, f.301, British Library Archive
There is little known about many of these houses with exception of a few. One of those was St Mary de Pre, which was founded in the 1190s by St Albans and run by leprous nuns. They did not last long but were around just long enough for chronicler Matthew of Paris to make a report on it. Matthew of Paris typically had little interest on the work of women in the church, so the fact that he mentions them at all, shows just how hard the nuns were working.
By the 1540s, cases of leprosy had dwindled in England, and the Order of St Lazarus was officially dissolved as part of the dissolution of the monasteries. The English Lazarites went to join their brothers in France. Non-Lazarite leprosy care did continue after the Lazarites left England however as cases rapidly decreased so too did the need for aid.
Leprosy does still very much exist today. The World Health Organisation states that around 200,000 people are diagnosed every year with leprosy still occurring in more than 120 countries. In modern medicine, leprosy is considered curable with multidrug therapy, and those in need are helped by varying world organisations such as Leprosy Mission and, of course, Order of St Lazarus.
Click here to explore Leprosy Mission’s Website, and it’s colour coded world map detailing which areas of the world are still affected by leprosy today.
Sources
Barber, Malcolm, “The Order of Saint Lazarus and the Crusades”,
The Catholic Historical Review
80.3 (1994) p. 439-456.
Brodman, James W., “Rule and Identity: The Case of the Military Orders”,
The Catholic Historical Review
87.3 (2001) p. 383-400.
Byrne, Philippa, “Making Space for Leprous Nuns: Matthew Paris and the Foundation of St Mary de Pre, St Albans”,
Gender in Medieval Places, Spaces and Thresholds
(2019) p. 45-60.
Dols, Michael W., “The Leper in Medieval Islamic Society”,
Speculum
58.4 (1983) p. 891-916.
Hume, Edgar Erskine, “Medical Work of the Knights Hospitallers of Saint John of Jerusalem”,
Bulletin of the Insitute of the History of Medicine
6.5 (1938) p. 399-466.
Kempe, Margery.,
The Book of Margery Kempe
, Butler-Bowdon, W., eds. (London: Oxford University Press, 1954) p.23.
Miller, Timothy S., “The Knights of Saint John and the Hospitals of the Latin West”,
Speculum
53.4 (1978) p.709-733.
Schreyer, Kurt, “Christ and the Leper from the Chester Cycle (ca. 1531-75)” in
Medieval Disability Sourcebook: Western Europe
, McNabb, Cameron Hunt, eds. (California: Punctum Books, 2020) p. 428-433.
Sterns, Indrikis, “Care of the Sick Brothers by the Crusader Orders in the Holy Land”,
Bulletin of the History of Medicine
1 (1983) p.43-69.
Swanson, R.N., “Review of ‘Leper Knights: The Order of St Lazarus of Jerusalem in England c.1150-1544 by David Marcombe”,
Albion: A Quarterly Journal Concerned with British Studies
36.2 (2004) p. 282-283.
Welch, Christina, and Brown, Rohan, “Chapter 4” in
From Villainous Letch and Sinful Outcast, to ‘Especially Beloved of God’: Complicating the Medieval Leper through Gender and Social Status
, Weikert, Katherine and Woodacre, Elena, eds. (Oxford: Berghahn Books, 2021), p. 48-60.
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