Leprosy in the Middle Ages

Sarah Austin — Thu, 4 Jun 2026 00:00:00 +0000

In my current book, I have a leprous character and so I needed to research the disease of leprosy to discover how people might have reacted to him and what my character's life would have been like as a leper.

During my research I became aware of how little human nature changes. Parallels in the attitudes towards the medieval leper and HIV and AIDS sufferers are apparent. In the 1980s, when AIDS first came to light, little was known about the disease especially by the general population. Many feared it and shied away from contact with any sufferer in case they too became infected. Often those with the disease were ostracised from society and made to feel unclean in the same way as the medieval leper.

What is leprosy?

Leprosy is a mildly infectious disease spread by droplets passed through the air. The disease starts with nerve damage beneath the skin's surface. This lack of sensation causes sufferers to injure themselves, causing skin lesions, ulcers and infections. Today, it is treatable but there was no cure in the Middle Ages. Positive diagnosis of this slow degenerative condition meant the remainder of life was one of suffering, physically and spiritually. Modern writers have recognised that leprosy was often confused in the medieval period with other diseases such a syphilis, lupus, psoriasis, and scrofulus - true leprosy was perhaps not as endemic as medieval diagnosticians thought. However, when considering medieval attitudes to leprosy, it is important to remember that people of this period were unable to distinguish between true leprosy and other similar looking diseases. They believed that those afflicted with these illnesses had leprosy and treated them as lepers.

A disease of the body and soul

The leper was heavily stigmatised with a reputation for immorality - his inner corruption was being punished by God in the form of leprosy. Interpretations of the Bible are largely responsible for the connection of leprosy with sin. Leviticus (ch. 13-14) pronounces the leper to be 'unclean' and that he must 'make an atonement ... to be cleansed before the Lord' (14:31). More explicit links between sin and leprosy are made elsewhere in the Old Testament. After rebuking Moses for marrying an Ethiopian, Miriam is afflicted by leprosy and her husband, Aaron, beseeches Moses 'lay not this sin upon us' (Numbers 12:11). Gehazi is stricken with leprosy as punishment for his covetousness (II Kings 20-27). In each case, the punishment of leprosy is meted out by God for a moral violation, a belief which continued into the medieval period.

Medieval interpreters connected various sins to leprosy. Maurice of Sully (c. 1170) lists the sins which brought leprosy - 'fornication, adultery, usury, robbery, theft, gluttony, drunkenness, and all those sins by which man is damned and sure to lose the love of God.' Lepers had broken divine law and were morally depraved. Their sinfulness, 'that no man may hide,' made their soul very loathsome spiritually, resulting in the manifestation of leprosy which made 'the body ugly, loathsome and monstrous.'

Through homilies and sermons, the Church expounded the idea that leprosy was the result of immorality and popular belief throughout the Middle Ages echoed these teachings. A vengeful saint was said to have stricken the Abbot of Evesham (d. 1044) with leprosy after he plundered a saint's tomb for relics. The Summoner's immorality in The Canterbury Tales, is epitomised by his leprous skin; Chaucer's contemporaries believed this form of the disease was contracted by illicit association with already infected women.

The leper was thought to be sexually depraved. Many contemporary writers believed that 'many burn with the desire for coitus.' In the legend Tristram and Isolde, a group of lepers offer to punish Isolde's passion by bringing her death through passion - 'bring her to my sick ones: they shall all love her, so that she will die dishonourably.'

Outcasts

The leper was branded as immoral - 'he was more contemptible and humble than other men' (Regulations of the leper hospital of St. Julian, near St. Albans). Such an attitude was reinforced by the way the leper was treated - he 'shall dwell alone; without the camp' (Leviticus 13:46). He was unfit to remain within the community and was banished in the form of a symbolic burial ceremony. In England, the leper was pronounced 'dead to the world' as earth was cast onto his feet (Office at the Seclusion of a Leper).

Once cast out, society expected the leper to take on the role of the penitent. In Church-controlled leper houses, inmates had to adopt monastic rule. At Illeford, they took vows of poverty, chastity, and obedience, and were expected to attend divine service at each of the monastic hours of the day 'unless prevented by grievous bodily infirmity.' The tone of the Bishop of London's directive suggests that only lepers on their death beds were excused.

Lepers were expected to follow this ascetic life without complaint 'since amongst all infirmities the disease of leprosy is held in contempt.' The prior of Sherburn leper hospital (regulations 1311-16) used a stick 'in the manner of a schoolmaster' to encourage the leper's observance of the rule and 'correct the disobedient.' By leper house rules they were confined to 'the closed interior of the hospital;' they were in effect imprisoned because of their condition.

Loss of rights

As the leper was considered to be no longer living, he lost any legal rights he may have possessed - he could not make a will, inherit property or plead in the common law court. However, lepers still had rights under canon law concerning marriage and sexual intercourse. The Church decreed that a leper could 'contract a marriage' if he found someone willing. Also, a leper and healthy spouse were 'mutually bound to return the marriage debt to one another' unless both agreed to abstain while the other is alive. For the Church, leprosy did not alter the nature of marriage nor was it acceptable grounds for divorce. This is despite lepers being regarded as dead under civil law, a state of being symbolically initiated in a ceremony led by the Church.

The Church was faced with conflicting beliefs - the sinfulness of the leper, the need for segregation, and the sanctity of the marriage vow. As the latter was taken in God's name, the marriage oath was upheld and preserved. Otherwise, the leper effectively lost his human rights because of his disease - no civil law protected him and society despised him. He was cast out of his home, prevented from earning a living except through begging, and forbidden to have any contact with the healthy except under strict criteria. To medieval society, the leper was a pariah - his body bore the evidence of his spiritual corruption from which the community needed protection.

Or a gift from God?

Many believed the leper to have been chosen by God to suffer his purgatory on earth and, upon death, pass directly to heaven. Saint Hugh of Lincoln declared lepers to be 'the flowers of Paradise and the lucent pearls in the crown of the eternal king.' The more deformed a leper was, the brighter his soul shone. Such a conflicting attitude was borne from a confusion in the Middle Ages with the two Lazarus' of the New Testament. The beggar, Lazarus, who lay at the rich man's gate 'full of sores' was believed to be a leper. He was 'carried by the angels into Abraham's bosom' because in his lifetime he was given 'evil things: but now he is comforted' whereas the rich man, who had enjoyed a life of 'good things,' suffered the torments of hell (Luke 16:20-25).

Because God had especially blessed lepers, some sought them out as a form of Christian humility. Saint Hugh and Henry I's queen, Matilda, washed, dried, and kissed the feet of lepers in their own chambers. When Matilda's brother asked if the king knew of this, she replied that 'the feet of an Eternal King are to be preferred to the lips of a mortal king.' Saint Hugh spent time comforting and encouraging the souls of the afflicted, giving them 'hope for an eternal reward.'

Few chose to alleviate a leper's suffering personally. Instead, they endowed and maintained leper houses and provided alms for the inmates. During Henry II's reign, Hugh, Earl of Chester, gave the chapel of Sponne and half a carucate of land for the maintenance of Coventry's leper. Henry I, King John and the Archbishop of Durham, Hugh de Puiset, all founded leper houses. William Longspee bequeathed cattle to three leper houses and Henry II left legacies to a number of lazar houses. In this way, the pious were able to associate themselves with those chosen by God and benefit themselves spiritually through their charitable actions.

Fear - the overriding emotion

Fear and distaste of sufferers was a predominant attitude in the Middle Ages. Diagnosis of the disease meant an inevitable death which would be a long time in coming with no cure or alleviation and years of being at society's mercy. When queen Matilda encouraged her brother to help her wash lepers' feet, he 'was sore afraid ... and could on no account endure it.' It is basic human nature to recoil from distasteful afflictions that, unfortunately, modern man has not lost. The narrator of Saint Hugh's hagiography 'shuddered not merely to touch but even to behold those swollen and livid, diseased and deformed faces with the eyes either distorted or hollowed out and the lips eaten away.'

By the end of the twelfth century, it was believed that leprosy was contagious. The Canon De Leprosis (Rome 1179, Westminster 1200) stated that lepers could not live amongst the healthy. The prohibitions imposed on the way a leper must live seem excessive and are perhaps a reflection of the fear associated with this contagion. Lepers were instructed to only go out 'in their leper's dress, that you may be recognised by others' and were fobidden to enter public places. They were also warned they must not touch posts on a journey or items they wished to purchase nor must they drink or wash directly in a stream. If a leper was to meet someone, they must not answer until they 'have gone off the road to leeward' (Office at the Seclusion of a leper).

Conclusion

The world of the medieval leper was one of contradiction and inconsistency which revolved around two incompatible ideas - the disease was a sign of damnation by God for moral impurity and it was a gift from God signifying his grace. The Church decreed the latter but its bishops and priests sermonized about the spiritual degeneration of the leper. Out of fear, medieval society readily banished the leper from the community but provided alms as an act of charity for the salvation of their own souls.

Once diagnosed, the leper was compelled to depend upon those who wrote the laws depriving him of his rights to own property or to earn a living. Often, the leper sought sanctuary in leper houses from a society who feared and abused him but often these institutions were little better than physical and spiritual prisons. Diagnosis of this disease was a prediction of disfigurement, death and exclusion from society. The leper was viewed with fear, loathing and condemnation; any sympathy received would have been more akin to pity. For the leper, the remainder of life was little better than any imagined purgatory.

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Leprosy in the Middle Ages