Leprosy, a name under which during the middle ages were confounded tubercular elephantiasis, elephantiasis of the Arabs (Barba-does leg), the scaly diseases of the skin (lepra and psoriasis), and other chronic skin diseases which were rendered rife and inveterate by a bad diet and want of cleanliness. The same confusion existed among the ancient Hebrews and Egyptians, and probably among other eastern nations, from the earliest historical times. The Hebrews brought the affliction with them into Palestine, and the stringent provisions of the Mosaic law show how dreadful must have been its ravages and how great the terror which it excited. Regarding it as a disease sent from God, for which no natural remedy could be prescribed, they required that the person supposed to be infected should show himself to the priest; and if in the opinion of the latter the disease was leprosy, he was declared unclean and immediately separated from the rest of the people. So strictly was the rule observed, that even kings afflicted with the disease were expelled from their thrones and shut out from society.

Outside the gates of cities and in secluded districts were usually found leper villages, an institution still existing in the East, where these outcasts of society dragged out their wretched lives, depending upon their own labors and the alms of the charitable for the means of subsistence. Hospitals for their relief or protection seem to have been unknown among any of the nations of antiquity. With the tide of emigration westward during the decline of the Roman empire leprosy was disseminated over Europe, and during the middle ages prevailed to such a frightful extent that from the 6th to the 15th century the efforts of lawgivers were unceasing to arrest its diffusion. Its principal ravages in the West date after the first crusades. The isolation of the infected was still the universal practice, but under the influence of Christianity a more humane spirit presided over the treatment of lepers, and hospitals and asylums on charitable or religious foundations were provided for their reception. In the 13th and 14th centuries these buildings almost literally covered the face of the continent, being numbered by thousands in every country.

Every considerable town had one or more of them in its neighborhood, and at one period it is said that scarcely a town or burgh in France was unprovided with such an establishment. Almost from the commencement of the Christian era pious fraternities are said to have been organized for the care of persons afflicted with leprosy; and Pierre de Belloy, in his Origine et institution de divers ordres de chevalerie, mentions an order of St. Lazarus, so called from Lazarus the beggar (Luke xvi. 20), the patron of lepers, which was established as early as A. D. 72. A military order of St. Lazarus was established by the crusaders at Jerusalem in the early part of the 12th century, whose duty it was originally to take charge of lepers and their asylums in the Holy Land. The knights hospitallers of St. Lazarus, after being driven out of Palestine, established themselves in France and instituted a celebrated hospital or lazar house outside the gates of Paris. Subsequently, under the protection of several popes, they settled in Sicily and lower Italy; but with the disappearance of the disease they lost their distinctive religious and charitable character, in accordance with which their constitution required the grand master to be a leper.

In general, however, hospitals for the reception of lepers were supported by chance eleemosynary contributions, and in secluded portions of the country the condition of the inmates was scarcely less pitiable than in ancient times. But even under the most favorable circumstances the leper was completely and for ever an outcast from the world, being considered both legally and politically as a dead person. Upon being set apart from his fellow creatures the ceremonial for the burial of the dead was pronounced over him, masses were said for the benefit of his soul, and, to carry out the illusion to the fullest extent, a shovelful of earth was thrown upon his body. His marriage ties were thenceforth dissolved, although he might contract a new marriage with a person similarly afflicted; he was prohibited from entering any church or place where food was prepared, from dipping his hands in any running water, and from taking up food or any other article necessary to him without the assistance of a stick or fork; and he was strictly enjoined to wear a peculiar dress by which he could be known at a distance, and to give notice of his approach by ringing a bell.

With the progress of civilization, and the improvement of the condition of the poorer classes, leprosy declined rapidly; and except in Norway and a few places in the south, it is now unknown in Europe. The horror which the various forms of the disease formerly inspired has, notwithstanding its disappearance, remained in full force, and the word leper at the present day designates a person whose social and physical condition has reached the lowest pitch of degradation. In the East it still exists in its ancient seats, and sporadic cases are found in the islands of the Indian archipelago, in the Hawaiian islands, on the coasts of Africa, in the West Indies, and in * Canada and elsewhere in America.