The living Dead Why lepers were considered monsters and how the world defeated a terrible disease

11 months ago

Leprosy left a deep mark in the history and culture of mankind. Until now, lepers are perceived as people who carry a threat and who need to stay away. In the past, the disease was very common, and the only effective means of control was the expulsion of patients from society, which is still practiced in some countries. Lenta.ru talks about leprosy, which became the scourge of Europe even before the plague and cholera and continues to terrorize the poor, despite the efforts of international health organizations.

Contagious ugliness
Compared to cholera and plague, leprosy is a silent and latent disease. After infection, it may take ten or even twenty years before the first symptoms occur. First, pain-insensitive spots appear on the skin, hands and feet begin to go numb. It is very important to begin treatment as soon as possible, because several months after the disease has manifested itself, irreversible damage to the peripheral nerves occurs. The person loses control of the muscles and is paralyzed. But even earlier, the body is attacked by secondary infections that affect the eyes, skin, mucous membranes and articular cartilage in the hands and feet. The fingers are deformed and shortened due to the death of the phalanges, facial features are distorted, trophic ulcers form.

The leprosy causative agent itself, the Mycobacterium leprae mycobacterium, is not a deadly killer, like a plague stick or cholera vibrio. This is an obligate parasite, unable to live outside human cells, so it is in his interests not to kill the host quickly. But it destroys the primary protective barrier of the body, making a person vulnerable to many other pathogens. Secondary infections are the leading cause of death for patients with leprosy.

A person with leprosy becomes a peddler of mycobacteria, infecting other people. At risk include poor people suffering from malnutrition and reduced immunity. Although it is still not entirely clear how M. leprae enters the body, it is believed that infection occurs through the upper respiratory tract. It is now known that a single close contact with diseased leprosy, for example, shaking hands or being near an infected person, rarely leads to infection. M. leprae is not sexually transmitted and does not enter the unborn baby if the carrier is a pregnant woman.

From the depths of centuries
Leprosy is one of the oldest diseases that was known in ancient China, India, Egypt, Greece and Rome. The first mention of it dates back to 600 BC. At the same time, other fungal skin diseases were often confused with leprosy. The word “leprosy” itself comes from the ancient Greek Λέπος, which means “scales”, and literally translates as “a disease that makes the skin scaly.” This word was used to denote any skin disease leading to peeling, but then assigned to leprosy.

Before the advent of modern medicine in Africa and Eurasia, the Trichophyton schoenleinii fungus was common, causing a favus, or scab, in which a firm crust forms on the skin. Patients with favus or psoriasis were also declared lepers, expelled from society or fell into leper colony. Syphilis was sometimes confused with leprosy.

In the Middle Ages, in the XI century, a large epidemic of leprosy flared up in Europe. Among experts, a single picture has not yet developed, where did the disease come from. Many experts believe that the cause of the outbreak was the Crusades, as a result of which M. leprae arrived in Europe from Palestine. In England, leprosy could get with the Vikings, who brought from the continent the fur of infected squirrels. According to an alternative hypothesis, leprosy arose in Europe itself and existed for several thousand years. In any case, the disease spread widely in the XII-XIV centuries, reached a peak in the XVI century, and then unexpectedly receded, turning into a “forgotten disease”. Now it is found only in poor countries.

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