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Leprosy: Biblical History, Etiology, and Treatment

Article · January 1996

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Running head: LEPROSY 1

Leprosy: Biblical History, Etiology, and Treatment

Jonathan Wayne Riddle

Human Structure and Function

Oakland Community College

February 8, 1996

Revised: August 16, 2016

LEPROSY 2

Leprosy: Biblical History, Etiology, and Treatment

“For, behold, the day cometh, that shall burn as an oven; and all proud, yea, and all that

do wickedly, shall be stubble; and the day cometh shall burn them, saith the Lord of hosts, that it

shall leave them neither root nor branch” (Malachi 4:1, King James Version).

The word leprosy in Hebrew is tsăra (tsaw-rah‟-ath_ from the tsăre (tsaw-rah) a primitive

root meaning to scourge (translated and figurative) (Strong, 1990, p. 101). The Greek form of the

word is lĕpra (lep‟-rah) from the word lĕpris (lep-is;) from lĕpo meaning to peel; a flake – scale.

(Strong, 1990, pp. 44- 45)

This disease has been known since biblical time, it has plagued man for millennia.

Leprosy was uncontrollable and untreatable, but it is now both thanks to science and medicine.

Leprosy can be described as “causing sores, scabs, crippling and loss of feeling. People with

were it were said to be „unclean‟ ” (Holy Bible King James Version Dictionary, n.d., p. 18).

Leprosy was described very well by the Hebrews in the Bible:

The Bible is a mine of information on personal and social hygiene and might even be

regarded as the first text of public health. The thirteenth and fourteenth chapters of

Leviticus contain explicit instruction to be observed by the priest in cases of leprosy. The

isolation of the patient, the washing or burning of infected clothing, and the disinfection

of houses, involving, if necessary, complete destruction, are all described in detail

(Guthrie, 1946, p. 30).

LEPROSY 3

The Bible goes on to state that:

And the Lord spoke unto Moses and Aaron, saying, When a man shall have in the skin of

his flesh a rising, a scab, or bright spot, and it be in the skin of this flesh like the plague of

leprosy; then he shall be brought unto Aaron the priest, or unto one his sons the priests:

And the priest shall look on the plague in the skin of the flesh: and when the hair in the

plague is turned white, and the plague in sigh be deeper than the skin of his flesh, it is a

plague of leprosy: and the priest shall look on him, and pronounce him unclean (Leviticus

13:1-3, King James Version).

There was great knowledge and fear of this disease.

“Take heed in the plague of leprosy, that thou observe diligently, and do so according all

that priests the Levites shall teach you: as I commanded them, so ye shall observe to do”

(Deuteronomy 24:8, King James Version).

There were also observations that on several different times Christ cured a man of

leprosy:

And it came to pass, when he was in a certain city, behold a man full of leprosy: who

seeing Jesus fell on his face, and besought him, saying, Lord, if thou wilt, thou canst

make me clean. And he put forth his hand, and touched him, saying, I will: be thou clean.

And immediately the leprosy departed him (Luke: 5:12-13, King James Version).

Leprosy can be traced down into the Middle Ages:

Besides hospitals there were institutions in which lepers could be segregated and nursed.

Leprosy was a common disease in the Middle Ages, and numerous leper houses or
LEPROSY 4

“Lazar” houses existed in Britain and throughout Europe. When he walked abroad each

leper was obliged to wear a distinctive dress, and to carry a bell or clapper to announce

his presence, and thus warn all persons to avoid him. After the fourteenth century the

number of lepers steadily declined, and by the seventeenth century the disease had almost

disappeared in Europe (Guthrie, 1946, p. 129).

Several centuries later there was a discovery. The leprosy bacillus was first identified by

Armauer Hansen of Bergen (1841-1912) in Norway, where the disease was endemic. Hansen

was the leading authority on leprosy of this time (Guthrie, 1946, p. 210). Leprosy is caused by

Mycobacterium leprae, while the two types of leprosy are tuberculoid leprosy and lepromatous

leprosy. It is also known as Hansen‟s Disease. Leprosy is a chronic disease, a systemic infection

that causes lesions to appear on the surface of the skin (Springhouse Corporation, 1988, p. 440).

Lepromatous leprosy is the more serious of the two types. It causes damage to the upper

respiratory tract, eyes, and testes, as well as the nerves and skin. Tuberculoid leprosy attacks

peripheral nerves and at times the skin on the face, arms, legs, and buttocks (Springhouse

Corporation, 1988, p. 440).

The disease is spread by airborne respiratory droplets containing M. Leprae or

inoculation through breaks in the skin. There is not much information to determine the length of

exposure needed to spread, but household and prolong contact are important (Benenson, 1985, p.

212).

The world prevalence is estimated at about 12 million. Prevalence rates of approximately

10:1000 are common in rural tropics and subtropics. The chief epidemic areas are SE Asia,

Philippines, Papua New Guinea, India, Korea, China, tropical Africa, some Pacific Islands and
LEPROSY 5

some areas of Latin America, however, the more important factor is not climate but socio-

economic factors (Beneson, 1985, p. 212).

Man is the only reservoir of proven significance. Feral armadillos in Louisiana and Texas

have been found naturally afflicted. Naturally acquired leprosy has been detected in a mangabey

monkey and dected in a chimpanzee captured in Nigeria and Sierra Leone, respectively

(Beneson, 1985, p. 212).

The author had a conversation with two Army Special Forces Medics who were training

at the hospital that the author was stated at. They both described leprosy as tough disease that it

is hard to stabilize, and is mostly found in Haiti. The conversation was a result of the Army

deploying a couple of thousand troops to Port-au-Prince, Haiti.

M. Leprae is difficult to culture, and it has to be grown on the mouse foot pads, or in the

nine banded armadillo. Regular culture and medication cannot be used. Lepromia test is the

intradermal injection of autoclavel M. Leprae. The Mitsuda reaction can be read 28 days later. It

is negative for lepromatous leprosy and is positive in tuberculoid leprosy.

The incubation period is four years for tuberculoid leprosy and twice that lepromatous

leprosy. It hardly occurs in children under three years of age (Beneson, 1985, p. 212).

Upon physical examination there appears of lesions such as macules or papules. Other

finds would be deteriorated fingers, damage nasal cartilage and bone, testicular atrophy,

peripheral edema (swelling), possible blinding in lepromatous leprosy. Thickening of cutaneous

nerves, anesthetic, saucer shaped skin lesions with clearly defined borders, and damaged

peripheral nervous system can be found in tuberculoid leprosy.

LEPROSY 6

Appropriate treatment with antimicrobial therapy is important as well as good preventive

medicine. Let‟s start with preventive medicine: decreasing exposure to infected persons, health

education and regular treatment with antimicrobial therapy.

The number one drug is a sulfone: dapsone, unless otherwise indicated, such as

hypersensitivity to the drug or failure to respond to treatment. Then a substitute drug therapy

with rifampin and clofarine which are used every month. (This is the minimal treatment

recommended by the World Health Organizatio (WHO)). The treatment of tuberculoid leprosy is

for a life-time in the treatment of the disease. There is no cure, however man can be treated and

managed.
 LEPROSY 7

References

Benenson, A. (1985). Control of Communicable Disease in Man (14th ed.). Washington D.C.:

The American Public Health Association

Guthrie, D. J. (1946). A History of Medicine (3rd ed.). London: J.B. Lippincott Company

Holy Bible King James Version. World Wide Publishers.

Holy Bible King James Version Dictionary.

Springhouse Corporation. (1988). Diseases and disorders handbook. Springhouse, Pa:

Springhouse Corp.

Strong, J. (1990). The new Strong's exhaustive concordance of the Bible: With main

concordance, appendix to the main concordance, topical index to the Bible, dictionary of

the Hebrew Bible, dictionary of the Greek Testament. Nashville: T. Nelson Publishers.

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