dols (michael w.)_the leper in medieval islamic society (speculum 58:4, 1983, 891-916)
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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Medieval cademy of merica
The Leper in Medieval Islamic SocietyAuthor(s): Michael W. DolsSource: Speculum, Vol. 58, No. 4 (Oct., 1983), pp. 891-916Published by: Medieval Academy of AmericaStable URL: http://www.jstor.org/stable/2853789
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
http://slidepdf.com/reader/full/dols-michael-wthe-leper-in-medieval-islamic-society-speculum-584-1983 2/27
SPECULUM 58,4 (1983)
The Leper in Medieval
Islamic
Society
By Michael W.
Dols
There
s no fault
n theblind, nd theres nofault
n the
ame,
nd there
is no ault n the ick....
'
To the Western mind, no disease
is
so fearsome
and horrible
as
leprosy.
Leprosy
still
conveys the suggestion
of physicalrepulsiveness,
moral perver-
sion,
and
promiscuous
nfection; he leper is the archetypal utcast, ociety's
pariah
and
sometimes
ts
scapegoat.
We have inherited
uch ideas about the
disease and its victim argelyfromthe Middle Ages; since that
time the leper
has become
a
familiarfigure
n
Western iterature
nd art.2 The formation
of these
beliefs
regarding lepers
tells us a
good
deal about the
nature
of
European Christian ociety
n the medieval period
-
what was despised and
cast out
is as
revealing about
social attitudes as what
was cherished and
preserved.3
The leper affords similar insight nto the nature of traditional
slamic
I
wish
to
acknowledge
the
generous assistance
of Prof.
Manfred Ullmann
in
the preparation
of
this study,
which was
made possible
by a grant
from
the National
Endowment for the
Humanities.
In
addition,
would like to
thank
Dr.
Harry Hoogstraal NAMRU-3)
and Dr. Latif
Hanna (Director
of
the Leprosy Administration)
or
theirhelp
in
gathering nformation
n
this
topic
in
Egypt. Preliminaryversions
of this
study
were read at the annual meeting of the
American Research Center
in
Egypt (Detroit, April 1977)
and the
Colloquium
on
Biology,
Society
nd
History
n
Islam
(Philadelphia,
October
1977).
I am
verygrateful
or
the numerous
comments
and
suggestions
of
the
participants
of
these
meetings
as well as
other
readers,
especially
S.
D.
Goitein,
Fedwa
Malti-Douglas,
and Ira M.
Lapidus. Concerning terminology,
have retained "leprosy"
nd
"leper,"
which are today deprecated by medical science,
because the
disease
and its victims
were
named
in
this manner
in
the past and the stigma attached
to
the
names, especially n Europe, was significant. Islamic" is used to describe medieval
communities
and
their
ulture
n
which slam was the
predominant,
but
not exclusive
religious
faith.
I
(ur'an
24.60; trans.A. J. Arberry, he Koran nterpreted
New York, 1955), 2:54.
2
K. Gron, "Lepra
in
Literatur
und
Kunst,"
in
Victor
Klingmiiller, ie Lepra (Berlin, 1930),
pp. 806-42 (English
trans. in the International
ournalof Leprosy hereafter
ited as
IJL]
41/2
[1973], 249-83).
The
only
artistic
epresentation
f a
leper
in
the Middle
East,
to
my
knowl-
edge, is the Persian miniature
of
the sixteenth
or seventeenthcenturydiscussed by Gron,
English trans.p. 277 and fig.40.
3See
the followingrecentworks and theirbibliographies:Saul N. Brody,TheDiseaseofthe
Soul: Leprosyn MedievalLiteratureIthaca, 1974), pp. 60-106; Peter Richards,The Medieval eper
(Cambridge, Eng., 1977); Shulamith Shazar,
"Des
lepreux
pas
comme les
autres:
L'ordre de
Saint-Lazare dans le
royaume
atin de
Jrusalem,"
Revue historique67 (1982), 19-4 1; Hermann
H6rger, "Krankheit und religioses Tabu
-
Die Lepra in der mittelalterlich-fruhneuzeitlichen
Gesellschaft uropas,"
Gernerus
(1982), 52-70.
891
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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TheLeper n slamic
ociety
893
also have
been strickenby the illness.
The first,Abid ibn
al-Abras, on the
basis of his
name, may
have been leprous. Leprosy
would account for his
wife'saversion toward
him, which
is
mentioned
n his
poetry.8The
second
and more famous poet was al-Harith ibn Hillizah al-Yashkurl, who wrote
the seventh of the
Mu'allaqat. This poem is said
to have been
improvisedby
al-Harith before the king of al-Hirah,
Amr ibn Hind (A.D.
554-70), when
al-Harith pleaded the
case of
his tribe
against
another. He recited the
poem
in
the majlisor court of
the king,"who had ordered
hangings to be
set up to
keep him
apart from
the poet, since the latter
suffered fromtubercular
leprosy
(bara4);
overcome
by al-Harith's talent, Amr
ibn Hind is
said to
have had the hangings
drawn up, one
after nother,and to have
treatedthe
poet
with
singular
marks of
esteem,"
although
the
king
nclined toward
the
opposing tribe.9
The Islamic
world
seems
to have inheritedthe earlier Arabic
terminology
for
eprosy. The word
udhdmwas adopted for the
disease, probablybecause
the Arabic
root has the
sense
of "to
mutilate" r "to cut
off" and
is
descrip-
tive of the
serious disfigurement hat
may occur in
cases of lepromatous
leprosy.
Thus, ajdham pl.
adhmd) may mean
"mutilated,"having an
arm or
foot
cut
off,
or
"leper"
and
"leprous."10
The
use
of this
root
strongly
suggests
that
the
lepromatous
formof
leprosy
existed
n
pre-Islamic
Arabia.
The
use
of
the
term
bara4
appears
to
be
equally old;
it is derived from
an
Arabic root thatmaymean "to be white or shiny."Bara4was definitely sed
to
name leprosy,
probably
n its
early
stages or
in
its tuberculoid
form,but
may also
have been applied to other skin
disorders."
1882), 3:27 1;
Jahiz, l-Bursdnwa
l-'urjdn Cairo-Beirut, 1972), p.
73
f.; Muhammad
ibn
Habib,
Kitdb
l-Muhabbar Hyderabad, 1361/1942),p. 299.
8
C.
J. Lyall,
ed.
and
trans.,
The
Diwdns
of
Abi-dbn
al-Abras, fAsad,
and 'Amir bn
at-.Tufail,f
'Amir bn$a'sa'ah
(Leiden-London),
1913), pp. 6, 33-36,
38-39.
9EI
"al-Harith
h. Hilliza
al-Yashkuri" Ch. Pellat);
Lyall, TheMufaddaliydt, :90;
Ullmann,
Die Medizin m
slam, p. 243; al-Jahiz,
l-Bursdn, . 23.
10
See al-Murdada, Ghurar l-fawd'id Cairo, 1954), 1:5; E. W. Lane, Arabic-Englishexicon
(London,
1863-93), s.v. "judhamun."
"
See Lane,
Arabic-Englishexicon,
.v.
"bara$un."
Concerning
the Arabian
Peninsula,
Ibn
Hawqal claimed
in
the second half
of the tenth century
A.D.
that
eprosy was endemic to
the
Yemen, where it is today a common
malady. He also
mentioned the traditionof the
Prophet
that the dust
of
Medina immunizedthe people against
leprosy Configuratione la Terre
Kitab
Surat
al-Ard],
trans. J.
H.
Kramers and G. Wiet
[Paris-Beirut, 1964], 2:30, 35). In the
same
century, l-Muqaddasi claimed
not to have met any
lepers (majdhuim)
n
Arabia, although
those
afflictedwith
baraF
were
many Ahsan t-taqdszm,d.
M.
J.
de
Goeje [Leiden, 1906], p. 95).
It
is
likely hattraditional edouin life n
Arabia did not change appreciably
for centuries, o that
the
reports of Carsten Niebuhr and Charles Doughty are significant.Niebuhr, in the mid-
eighteenth century,believed that
leprosy
had
always been endemic there. He adds:
"Three
different arieties of this disease
are known here at
present; of
which
two, named Bohak and
Barras,
are
rather disgusting than
dangerous; but the
third,called
Juddam,
s very
malignant,
and
apparently
nfectious.
This
latter xhibitsthe same symptomswhich
the English physician
Hillary ascribes to what
he calls 'the leprosy of the oints'"
(Travels
through
rabia
and Other
Countries
n
the
East
[Edinburgh, 1792], 2:276).
Doughty,
n
the nineteenth
entury,
witnessed
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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TheLeper n slamic
ociety
895
do
not
elucidate the
meaning
of
al-abras.16
The
Qur'an
also recounts
the
biblical story f
Moses and the signs
given to
him by God; one of
these signs
was Moses'
placing
his
hand to his
body
and
showing
t
white "without vil."
The commentators ay that thisphrase means "withoutbaraF";that is, the
whitenesswas not
believed to be
leprosyor
a
comparable skin
disease.17
The
commentators ase their
opinion on
hadiths pious
traditions)
o
thiseffect.
Other
pious sayings
or
legends
concerning eprosy
were attributed
o
the
Prophet, and
they are
important because
they greatly nfluenced
social,
medical, and
legal views
of
the
illness.
Historically,
he
sayings of
Muham-
mad
may
recall social attitudes
toward
the disease
during
the
early Islamic
period.
In
any case, because of their
religious
character, the
principles
embodied
in
the hadith
iterature ssumed an
importancewith ater
genera-
tions and served as motives for social behavior. The best known of these
traditions s the
statement f
the Prophet thata
Muslim
should flee from he
leper as he would
flee fromthe
lion. Similarly,
nother
tradition ssertsthat
a
healthyperson
should not associate with
epers
for
a
prolonged period
and
should
keep
a
spear's
distance fromthem.18
The two pious
traditions re prescriptions or
social
action and appear to
deal with the moral and
medical
difficulties
osed by
the
leper.
The tradi-
tions
may have strengthened
the desire of
many Muslims to avoid
those
individualswho were
conspicuously
afflicted y the
disease
because it was
morally s well as physically ffensive. eprosywas believedbysome to be a
punishment
by
God for
immorality.
Consequently, we
find
that leprosy is
often
nvoked as a curse
on those
guilty
f
immoral
behavior.19
Medically,both
traditions eem to
express an
implicit
belief
n
the human
transmission
i'dd')
of
disease.20
The
idea
of
transmissibilitys
certainly ound
Karl Opitz, Die Medizin m Koran (Stuttgart, 906), pp. 22 f., 27, 39 f.; and
Mir-Hossein
Nabavi,
Hygiene nd Medizin mKoran Stuttgart, 967), p. 27
f.
16 At-Tabari,
Jdmi' l-bayan
t
afsir l-qur'dn Cairo, 1321/1903), 3:173, 7:77;
Fakhr
ar-Razi,
Mafdtih l-ghaybCairo,
1307-8/1889-90), 2:457,
3:465.
17
At-Tabari,Jdmi', 6:104, 19:78, 20:42; ar-Rz7i,
Mafidti,
6:19, 374, 404. The biblical ccount
(Ex. 4.6-7) differs rom he three accounts
n
the
Qur'an concerning
his
ign Flugel ed., 20.23,
27.12, 28.32).
Exodus
clearly ays
that...
when he drew t
[his hand]
out the skinwas
diseased,
white s snow" New English Bible).
18
Al-Bukhari, as-Sahih (Bilaq ed.),
8:433.
See
also
Ibn
Qutaybah, 'Uyuin
l-akhbar
Cairo,
1925-30),
4:69.
For
other
hadiths
elated
to
leprosy,
ee Ibn
Manzuir, isan al-'arab,
14:354
f.;
Peter Bachmann, "Zum
Medizin-Kapitel
des Buches
'al-Baraka' von
al-Habagli,"Medizinhis-
torischesJournal
(1968), 33
f.
19
For example: "If anyone deprive
the Muslims
of
their food by cornering t, God
will strike
him with leprosy and bankruptcy."
Al-Muttaqi quoted by
Bernard
Lewis
in
Islam
from
the
ProphetMuhammad o the Capture fConstantinopleNew York, 1974], 2:129). See also Edward
Westermarck,
itual and
Belief
n Morocco
London, 1926),
1:484
ff.,
97
ff.;
R.
B.
Serjeant
and
R. Lewcock, eds.,
San'd':
An Arabian slamicCity London, 1983), p. 317a.
20
There is no distinction n medieval
Arabic between contagion and infection, lthough the
distinction s an
important
one in
modern epidemiology. See Ullmann, slamic Medicine,pp.
86-96;
Felix
Klein-Franke,Vorlesungeniberdie Medizin m slam, in
Sudhoffs
rchiv,Beiheft 23
(Wiesbaden,
1982), pp. 17-19.
On the
general subject
of
infection, ee Owsei Temkin, "An
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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896
The Leper n slamic ociety
in other Muslim
traditions hat are related to leprosy,21 n
most accounts of
leprosy
n
the medical treatises, nd
in
the nonmedical
literature.22 ever-
theless, he transmissibility
f disease
was denied by the Prophet n a number
of other traditions,which state that disease comes directly romGod alone.23
The tradition advising flight from
the leper is,
in
fact, preceded by
a
complete denial of interhuman ransmission
n the collection
of
al-Bukha-r1.24
Thus, the issue of transference s quite
contradictory;t
was the
subject
from
an
early
time
of
theological
discussions
that
attempted
to harmonize
these
traditions.25 he contradictionwas
not resolved;
it
would appear that many
witnessed contagion and found justification
for
it
in
the traditions,while
others seem to have adhered to
the principle of noncontagion.26
he
latter
were
partiallyustified
n
that eprosy
s considered
by
modern science to be
only moderately ontagious, and some individuals are not predisposed to it
at all.
Beyond the issue
of contagion, the
hadith
iteratureformed
the basis of a
medical
system
that is known as "Prophetic medicine,"
in
which medical
authority
was derived from the Prophet Muhammad.
In
this
way,
native
custom, superstition,
nd
magic were given respectability
nd
religious sanc-
tion.27
At the same
time, slamic society
was also heir to the Greek medical
tradition,
which was
richly
ultivated.28 hysicians rained
n
Galenic medi-
Historical Analysis of the Concept of Infection," n his The Double Face ofJanus (Baltimore,
1977), pp. 456-71.
21
A.
J.
Wensinck,
Concordance
t ndices e la tradition
usulmane, (Leiden, 1936),
s.v.judhdm,
baras. See also Siuheyl Unver, "About the History of the Leproseries in Turkey," in Max
Neuburger estschrift,d.
Emanuel
Berghoff Vienna, 1948), p. 447.
22 Mdliki
aw
appears
to
punish
the "inoculation"of
leprosy
s homicide
F.
H.
Ruxton,
trans.,
Mdliki aw [London, 1916], p. 317). See also al-Qazwini,Kitdb Aja'ib l-makhlWqdt,d. Ferdinand
Wustenfeld
G6ttingen,1849), 1:364; al-Murtad.,
Ghurar
l-fawd'id, :200.
23 See
A. J.
Wensinck,A
Handbook fEarlyMuhammadan
radition
1927; repr. Leiden,
1960),
p.
215.
24
Al-BukhflT, s-Sah4h, d. L. Krehl (Leiden, 1862-1908), 4:55, no. 19: ".I..l 'adwa lI
tiyarah
wa la hamah wa la safara wa firru
min
al-majdhfim ama tafirru
min
al-asad."
25
Ullmann,Die Medizin m slam, p. 243 f.;
Ernst
Seidel,
"Die Lehre
von
Kontagion bei
den
Arabern," Archiv ur Geschichteer Medizin 6/2 (1912), 81-93. See
also
my discussion
of this
problem as it concerns plague in The Black Death n theMiddleEast (Princeton, 1977), pp. 23-25,
92-95, 109-10, 119, 291-93.
In the
plague treatises, eprosy
s
usually
considered
contagious as
compared
with
plague; e.g., al-Manbiji,F7
akhbdr
t-ta
n,
Dar al-Kutub
al-Misriyah
MS no. 16
tibb alim, fols. 226r-230v.
26
Other traditions
ecommended supplication
to
God
for
relief
from
eprosy,
for the matter
should not be leftentirely o fate, .g., Ibn Hajar
al-'Asqaldni,
Badhl
al-ma'in
fifadl
at-ta
un,
Dar
al-Kutub
al-Misilyah
MS no. 2353
tasawwuf,
ol. 103r.
27
See J. C. Biirgel, "Secular and Religious Features of Medieval Arabic Medicine,"Asian
Medical
Systems: Comparative tudy, d. Charles
Leslie
(Berkeley, 1976), pp. 44-62; Cyril
Elgood,
"Tibb-ul-Nabbi
or
Medicine of the
Prophet. Being
a Translation of Two
Works
of
the
Same Name .
.
,"
Osiris 14
(1962), 33-196;
Ibn
Khaldfin,
The
Muqaddimah,
trans.
Franz
Rosenthal, 3 (Princeton, 1967), pp. 148-51. Concerning leprosy,
see
Westermarck,
itual and
Belief, :44;
Franroise
Legey,Essai defolklore
arocain
Paris, 1926), p.
141.
28
See
Ullmann,
slamic
Medicine, hap. 2;
Felix
Klein-Franke,Vorlesungen,hap. 5;
M.
W.
Dols
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TheLeper n slamic ociety
897
cine dealt
in
theirworkswith eprosy; practically very
medical
compendium
discussed leprosy
to some
degree,
and a few treatises were devoted to
it
exclusively.29
n
general, the doctors adopted
their
predecessors' descrip-
tions of the disease and theirhumoral interpretation f it. They emphasized
the ancient belief that eprosy was both contagious and hereditary, nd they
added to the earlier
methods
for
the care and treatment f the diseased. The
Islamic physicians ppear to have made significant dvances in the descrip-
tion of the disease,
particularly
n
their
accounts of skin lesions and
neurological symptoms. Despite its own inherent difficulties, he Arabic
terminologywas appropriate and more refined than that of the classical
authors,
and it
probably
influenced
Byzantine nomenclature.30Moreover,
the Arabic medical descriptions of leprosy were transmitted o medieval
Europe and served as the basis of Western understanding of the disease
untilthe seventeenth entury.31
The legal
status of the
leper
in Islamic
society
was
directly
elated
to the
pious traditions. Leprosy is not discussed
in the Arabic
legal
texts as
a
separate subject; rather,
t is treated
as a
disability
within
uch broad
areas as
marriage,divorce, nheritance,guardianship,
and
interdiction
f one's
legal
capacity
(4ajr).
Because
leprosy
is
considered
a mortal
illness,
the
leper
is
limited
in
his
legal rights and obligations
-
along
with the
minor,
the
bankrupt, the insane,
and
the
slave. The
leper's
status seems to
be
particu-
larly close to that of the mentally ll in most legal matters, speciallywith
regard to marriage
and
divorce.32
n Maliki
law, which s the most iberal
of
the schools
of law,
a
marriage
can be dissolved
by either person because
of
the disease.33 A
man
in
an
advanced state of
leprosy
should be
prevented
from cohabiting
with his slave wives and still more so
with
his free
wives,
which s consistent
with
a
belief
in
the
hereditary
nd
contagious
nature of
and A. S. Gamal,
Medieval slamicMedicine:
bn Ridwan's
Treatise On the
revention
fBodily
lls in
Egypt" Berkeley
and Los Angeles, 1984), introduction.
29
The distinction
etween Galenic and Prophetic
medicine regarding
eprosy has been dis-
cussed in my
"Leprosy in Medieval
Arabic Medicine," particularly
he
early-fifteenth-century
Tashal l-mandfi' y al-Azraqi (pp.
329-30).
This distinction,however,
should not be overem-
phasized because
we find a mixtureof the Galenic
and Prophetic
elements in some medical
work and, presumably,
n the actual
care
of
the diseased. Consequently,
a medical
pluralism
existed in
Islamic society,reflecting
oth
the varied orientationsof the
practitioners
nd the
varied expectations
of the patients.
For a discussion
of this
ubject,
ee
Dols and
Gamal,
Medieval
IslamicMedicine,
ntroduction.
30
Paul Richter, Beitrage
zur
Geschichte
der
Aussatzes,"
Archiv
ur
Geschichteer Medizin 4
(1911), 329
f.
31
Brody,TheDiseaseofthe oul,p. 45.
32EI2:
"Hadjr"
(J.
Schacht).
See
Y. Linant de
Bellefonds,
Traite de droitmusulman
ompare
(Paris, 1965), pp. 245-69; E.-L.
Bertherand,Medecine
thygieneesArabes Paris, 1855), pp.
93 f.,
423.
Bertherand
also notes
that advanced
leprosy
xcused
the afflicted rom
bligatory
eligious
observations p. 234).
33
G.-H.
Bousquet, Precis
de droitmusulinan
Algiers, 1950), p. 120;
N.
J. Coulson,
Successionn
theMuslim
amily Cambridge,
Eng., 1971), p.
19.
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898 TheLeper n slamic ociety
the malady that is found in the medical works. Also, Maliki law allows an
automatic guarantee of three days,
at
the expense of the seller
of
slaves,
against any "faults"
'uyuib)
n a slave; the guarantee is extended to one year
in case of madness or leprosy.34 n addition, the development of leprosy n a
slave
may be
a
cause
for
his or
her
manumission.35
In
general, these various interpretations f the disease permitted wide
spectrumof behavior by and toward the leper, ranging from
his
or
her
total
freedom to segregation
n
leprosaria. The wide range of popular responses
to the leper
is
reflected
n
the Arabic
chronicles
and
literature
hat mention
leprosy nd other skin disorders.
The earliest reference to lepers
in
the chronicles occurs
in
an
account
of
the Arab conquests.
Al-Balddhuri
reports
that
Caliph
'Umar
(13-23/634-
44) journeyed to Syria in 18/639 after the Muslim armyhad retreatedto
al-Jabiyah in the Golan southwest of Damascus) because of the famous
outbreak of plague at Amwas.36On his way to al-Jabiyah,
Umar apparently
encountered a Christian eper colony
n
distress,
nd
he made provisionsfor
feeding
them
and
for
their support.37
This brief incident
indicates
the
existence
of
segregated groups of lepers
in
Palestine;38
t
also demonstrates
34
Cf.
Shazar,
"Des
lepreux pas
comme
les
autres," p. 23.
35
Ruxton,MdlikiLaw, pp. 104, 106; Asaf Fyzee, Outline fMuhammadan aw (Oxford, 1949),
p. 147; J. W.
D.
Anderson, slamicLaw
in
Africa London, 1970), pp. 21, 51, 241;
EI2: "
Abd"
(R. Brunschvig); al-Jahiz, l-Bursdn, . 39. During the Middle Ages,
it
would be reasonable to
assume that sub-Saharan Africa was an important ource of leprosy, being transported ffec-
tivelyby the slave trade to North Africa and Egypt. In the nineteenth entury, according to
Mongo Park
and
Moore, leprosywas introduced nto West Africaby Sudan slaves. Kermorgant
stated that the disease increased
with
the spread
of Mohammedanism
owing
to no
precautions
being taken against
it"
(L. Rogers
and
E. Muir, Leprosy Baltimore, 1946], p. 23).
See
also
Terence Walz, Trade between gypt nd Bildd as-Su7ddn 700-1820 (Cairo, 1978), pp. 181, 196,
199.
36
Concerning
the
Plague
of
'Amwas and
the
controversial
ourneys
of 'Umar
to
Syria,
see
Lawrence I. Conrad, The Plague in theEarlyMedievalNear East (Diss., Princeton University,
1981), pp. 167-246, which supersedes my "Plague
in
Early Islamic History,"Journal of
the
AmericanOrientalSociety 4/3 (1974), 371-83; and Fred Donner, The Early Islamic Conquests
(Princeton,1981), p. 152.
37
Al-BalMdhuii,Kitdb
Futuih
l-bulddn, d.
M.
J.
de
Goeje (Leiden, 1866), p. 129,
11.
15-17:
"Hisham ibn 'Ammar told me that he heard it said by certain shaykhsthat on his way
to
al-Jabiyah
n
the province of Damascus 'Umar ibn al-Khattab passed by
a
group (qawm)
of
Christian
epers (mujadhdhamin),nd
he
ordered that
they
be
given something
out of
charity
(as-sadaqdt) and that food be assigned
to them."
Cf.
P.
K. Hitti,trans.,The Origins f the slamic
State 1916; repr.
New
York, 1968), 1:198. Concerning adaqah,
see Franz
Rosenthal, "Sedaka,
Charity,"
he
HebrewUnionCollege
Annual
23 (1950-51), 411-30.
38
For leprosy n early Byzantinehistory, ee Evelyne Patlagean,
Pauvrete economique
et
pauvrete
sociale Byzance e-7e
siecles
(Paris, 1977), pp. 108-11; M.
E.
Keenan,
"St.
Gregory
f Nazianzus
and
Early Byzantine Medicine,"Bulletin f
the
History f
Medicine
(1941),
16-18.
For
leprosy
n
Byzantine
medicine and
law,
see
Aristotelis
ftychiadis
nd S.
G.
Marketos, Aetiology,
Treat-
ment and Legal Definitions f Leprosy n Byzantium" in Greek), Materia
Medica
Greca 9 (1981),
579-82.
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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The
Leper
n slamic
ociety
899
the good
will
of
the Muslims
towards
the
conquered peoples, especially
the
disadvantaged, nd
sets
a precedent
for
ater
acts
of
charity.
A briefbut important tatement y
the historian
t-Tabari
says
that
Caliph
al-Wallid (86-96/705-15) conferreda number of benefits pon the people
of Damascus
in
88/707.
At-Tabari states: "He
provided
for the lepers (al-
mujadhdamin)
nd
said: 'Do
not
beg
from the
people.'
And he awarded
every nvalid a servant and every blind
man
a
leader."39
Since
there
is no
evidence of an earlierhospice
or
leprosarium
n
Damascus,
the
mendicancy
of those afflicted y leprosy
is
entirelypossible.
The
lepers
are not
desig-
nated as either Muslim or non-Muslim;
n
the
latter
case,
al-Walid's
action
would
be consistent
with the
philanthropy displayed
by
his
predecessor
'Umar. There
is no
evidence
of
any
other
comparable
acts
of
charity uring
the Umayyad Period.40
The brief nd ambiguous passage from at-Tabari has given rise to a good
deal of speculation. It has been suggested that
al-Walld
was responsible
thereby or the segregationof the lepers, possibly n separate
quartersof the
city.41 urthermore,Arab historianshave traditionally onsidered
him to be
the founder of the firsthospital in Islam.42 According to
al-Maqr
zi, the
well-known gyptian historian d. 846/1442), al-Walid built the firstmaristan
or
hospital
n
the year 88/707: the caliph "provided for doctors and others
n
the mdristdn,nd he ordered the restraint f the lepers
(al-jadhma)
est they
go out and stipendsfor them, and provisions for the blind."43 f al-Walid
instituted pious endowment (waqf) for their care, this is a very early
example of a practicethatbecame quite common n later
slamic society.
It is entirely possible that al-Wallidfounded a hospice
or quasi-medical
facility.44 enerally,the Muslims preserved and adapted
the institutions f
39At-Tabari,
Ta'rikh Cairo, 1964),
6:496, and also p. 437; cf. Ibn
at-Tiqtaqa,
al-Fakhri,
d.
Hartwig
Derenbourg Paris, 1895), p.
173,
11. -6.
40
For a general discussion of Muslim social services,
ee Norman A.
Stillman, Charity
nd
Social Services n Medieval Islam,"
Societas5/2 1975),
105-15; Dictionaryf theMiddleAges,
.v.
"Islamic Hospitalsand Poor Relief" Dols), in press.
41
S.
K.
Hamarneh, "Development
of Hospitals in Islam,"Journal fthe
History fMedicine
nd
AlliedSciences17
(1962), 367, considers
al-Walld's
action
as a simple act of
personal charity;he
suggests,however,
hat this ed to some formof
segregationof lepers; see
also Browne,Arabian
Medicine, . 16 f.
42
Al-Ya'qu-bi, a'rikh Beirut,
1960), 2:290,
11.
2-23:
"He [al-Walld] was the first o create
the
bimcaristdnor the sick
and the hospice
[ddr d-diydfah],nd he was the first
o provide for
the
blind,
the
poor, and the epers
[al-mujadhdhamzn]."
43
Al-Maqrizi,
l-Mawa'iz wal-i'tibarfl hikr l-khitat
al-dtharhereafterreferred o as
al-Khitat)
(1911-13; repr.
Cairo, 1970), 2:405;
see
also El2:
"Bimaristan"
Dunlop, Colin, and
$ehsu-
varoglu); Ahmad 'Issa,Histoire esbimaristansh6pitaux) l'epoque slamiqueCairo, 1928), p. 95. It
has been alleged by D. L. Zambaco
(La lepre traverses
siecles
t es
contreesParis, 1914], p.
367)
and Dr.
Latif
Hanna
("Leprosy
in the
U.A.R.:
Treatment and Prevention"
mimeographed])
that Ahmad
ibn Tfilfin
254-70/868-84) opened
a
leper asylum
in
Cairo,
but I have been
unable to find
ny
documentation
for this
ssertion.
44AI-Maqrizi in
referring
o the mdristdn f al-Walid seems
to
suggest
the
multifunctional
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900
TheLeper n slamic ociety
the newly onquered peoples, so that the caliph's benefactionwas
consistent
with
earlier Byzantine practice. The Christian population
had established
xenodochia
houses for
pilgrims
nd
orphans,
the
poor
and
the diseased
throughout he ByzantineEmpire before the Arab conquests.45 t should be
recalled that Christianity ad
been
responsible
for
the development
of
such
civilian
charitable institutions,which were
unknown in the
ancient world,
and
for their
dissemination
n
late antiquity.
A
number
of
early hospices
made accommodation especially for epers, or what were believed
to
be so.46
The famous hospital complex created by St. Basil
in
Caesarea
in
Cappadocia
(A.D.
369-72) contained a leprosarium.47 ishop Nona built a leper
house in
Edessa
in
the mid-fifth
entury .D. (see below);48
nd
the very arly hospital
of
St.
Zotikos
n
Constantinoplehad
been
transformed
nto a
leprosarium
by
the mid-sixth entury
.D.49
According to Procopius, Justinian onstructed
nature of the institution, s in the Byzantine xenodochium; e calls it
ddr
al-mardd
nd
ddr
a.d-.diydfahal-Khitat, :405). It should be noted that the hospitals in the Maghrib retained
apparently
this
older terminology. n
the
'Abbasid Period, when the hospital was fullydevel-
oped, it was called by the Persian name
mdristdn
r
bimdristdn,
hich persisted throughout
the
Middle
Ages. Today,
the term
mdristdn
n
Arabic-speaking
ountriesrefersusually to a mental
hospital, s opposed to mustashfdr ddr
sh-shifd'
or the general
hospital; this s due to the fact
that the medieval Muslim hospitals were remarkable for their care
of the mentally ll; see Dols,
Majntin:TheMadman nMedieval slamic ocietyforthcoming)nd idem, Insanity n Byzantium nd
Islamic Medicine,"Dumbarton aksPapers in press).
45
Concerning Byzantine terminology
or
the charitable
nstitutions, ee the conflicting iews
of D.
J. Constantelos,Byzantine hilanthropy
nd Social
Welfare New
Brunswick,N.J., 1968), pp.
149-288;
A.
Philipsborn,
"Der Fortschritt n der
Entwicklung
des
byzantinischen
Kran-
kenhauswesens,"Byzantinischeeitschrift4 (1961), 338-65;
idem,
"Les
premiers hopitaux
au
moyen
age
(Orient et Occident)," NouvelleClio 6 (1954),
145-52; idem, "lhpa
Nooo;
und die
Spezial-Anstaltdes Pantokrator-Krankenhauses," yzantion 3 (1963), 223-30; and Patlagean,
Pauvrete
conomique,
p. 193-94. Withregard
to the
persistence
f
such Byzantine
nstitutions
n
Palestine after
the
Arab conquest,
see
Timothy
S.
Miller,
"The
Knights
of Saint
John
and
the
Hospitals
of the Latin
West," Speculum53 (1978), 727. Specifically,
hazar ("Des lepreux pas
comme les
autres," p. 25)
states that
the Order of Saint Lazarus
in the
Crusader
Kingdom
had
its origin in a hospice for lepers that existed
in
Jerusalem
before the Latin conquest and was
administeredbyorientalmonks,probablyArmenians.
46 The historyof charitable institutions
imperial, monastic and private)
in
the Byzantine
Empire is documented
in
Constantelos,Byzantine hilanthropy,
.v. "lepers, leprosaria." See
also
Philipsborn, Der Fortschritt," p. 338-65; Zambaco, La lepre, p. 77-93 (English trans.: "Public
Charities
and
Leprosy
in Ancient
Byzantium,"
The
Urologic
nd
CutaneousReview
50
[1946],
187-94); idem,
Les
lepreux
mbulants e
ConstantinopleParis,
1898); idem, Voyages hez es epreux
(Paris, 1891)
-
Zambaco's works should be used
with
caution.
Despite
the
institutional are
for
the
lepers,
it is
apparent
that not all
lepers
were aided
in such
a manner.
The
hagiographical
literature,particularly,
mentions
lepers
who
were
brought
individuallyto the saints; such
accountsemphasize the spiritual spect of healing. See E. A. Wallis Budge, ed. and trans.,The
Histories f Rabban
H6rrnizzdhe
Persian and
Rabban Bar-'Idtd
London,
1902), 2/1:72 f.,
for
an
instance of such Christianhealing
in
Iraq, which
also
suggests
the
persistence
f
such
practices
in
the Islamic era.
47
R.
F.
Bridgman,L'h6pital
t
a
cite
Paris, 1963), p.
50.
48
J.
B. Segal, Edessa "the lessedCity" Oxford, 1970), pp. 71 f., 148, 184
f.
49 Bridgman,L'hopital, . 51.
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TheLeper n
slamic
ociety
901
xenodochia
n
Antioch, Jerusalem,
and
Jericho
in
A.D.
535.5? Slightly ater,
baths were erected for epers outside
the
city
f
Scythopolis Baysan)
because
lepers were forbidden by Byzantine aw to enter the forum or to use the
public baths, as we learn fromJohnChrysostom c.
A.D.
347_407).51
To my
knowledge,the inscription rom
the baths at Scythopolis s the only one from
this period that refers pecifically o leprosy.52 he early Byzantinefounda-
tions
were
imitated and developed by the Muslims; this process is clearly
seen
from
the late eighth century
.D.
in
the
creation
in
Baghdad of large
hospitals,where leprosy and
other chronic ailments were treated n special
wards.53
Nonmedical writers ook cognizance
of
leprosy
and similar maladies
dur-
ing the early Abbasid Period,
when Arabic belles-lettres lourished.Al-Jahiz
(d. 255/868-69) and Ibn Qutaybah (d. 276/889), especially,collectedpoetry
and
narrative ccounts on
this
topic.
Al-Jahiz's ollection
s
found
in
the
first
section
of
his
al-Bursan
wa
l-'urjan
a
comprehensive
but
problematic
work
for our
purposes.54
The book as a
whole
is
concerned
with
large
number of
physical nfirmitiesuch as skin
disorders, ameness, paralysis, nd deafness
and
personal
characteristics
uch
as
baldness, leanness,
and
ugliness.55The
author's
objective
in
this curious
compilation
is to show
that
physical
infirmitiesnd peculiaritiesdo
not hinder an individual from being a fully
active
member
of
the
Muslim
community
r
bar
him
from mportant ffices.
Al-Jahizmaintainedthat physical ilments re not social stigmasbut are what
may be called signs of divine blessing or favor.56Thus, he countered the
50
Procopius, Of the
Buildings fJustinian,
rans.
A.
Stewart,
Palestine
Pilgrims'
Text
Society
(London,
1896), pp. 71, 142
f.,
147.
See also
G.
E. Gask and
J. Todd,
"The
Origin
of
Hospitals,"
in E. A.
Underwood, ed.,
Science,
Medicine nd
History:
ssays
n
the volution
f
Scientific
hought
and
Practice
Oxford, 1953), 1:122-30.
51
Consolatio
d
Stagyram
.13
(Patrologia
raeca, 47.189).
For the
prohibition
f
lepers'
using
publicfountains, ee
M. E.
Keenan,
"St.
Gregory
f
Nyssa
and
the Medical
Profession,"
ulletin
of
he
History
f
Medicine15
(1944),
160.
52
M. Avi-Yonah, The
Bath of the Lepers
at Scythopolis,"srael
Exploration ournal 13 (1963),
325
f.; English
trans.:"Theodore the
shepherd / llots,
renewingthem,
the
baths
/
to those sick
with the
very grievous/disease of
leprosy
/
n
the time
of the seventh
ndiction
n
the year 622
[of
the
Pompeian
era
of
Scythopolis, .e.,
A.D.
558/9]" (p. 325).
The
inscription
uses the
euphemism
Mjop4r
or
keipa;
see
ibid., p. 326,
and
Patlagean,
Pauvrete
&onomique,
.
111.
53
S. K.
Hamarneh, "Medical Education
and Practice
in
Medieval Islam,"
in
The
History f
Medical
Education, d.
C.
D.
O'Malley
(Berkeley, 1970), p.
41. The
importance
f
the
hospital
has
been
largely
neglected by most scholars
dealing
with
Islamic urbanism; its significance
s,
however,
ndirectly
eflected
y
the factthat
the
budget
for
the
Mansuri hospital
was
the
largest
of
any public
institution
n
late
medieval
Cairo
(see
Carl
Petry,The CivilianElite
of
Cairo n the
Later
Middle
Ages Princeton,
1981], p. 216).
54
Pp.
8-110.
55
One suspects that
al-Jahiz's
extraordinary nterest n the subject
was due to his own
infirmities,
malformation f the eyes
(ja4iz,
"with a
projecting ornea") and ugliness see
EI2:
ital-Djahiz"
[Ch.
Pellat]).
56
Al-Jahiz,
l-Bursdn, p. 10, 35.
This
belief was also
extended to the mentally ll; see E.
W.
Lane, Manners nd
Customs
f theModern gyptians1836;
repr. London, 1966), pp. 234-35,
and
myMajnun:
The
Madman
n
Medieval
slamic
ocietyforthcoming).
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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902
The
Leper
n
slamic ociety
contrary pinion that the
infirm
hould
be disparaged
or
satirized
for
their
afflictions.57he afflicted
were spiritually ompensated by God.
As a
conse-
quence, al-Jah.iz ttached
special merit to
the lives and works of these more
sensitive ouls.58
Specifically, l-Jahiz
iscussed
the bursan
those who sufferedfrom
baras;
according to the author,
the infirmity as widespread among
the Arabs and
affectedmen
and women of all classes. The
difficulty ith l-Jah.iz's iscus-
sion
of
the numerous
examples of people
stricken y baras s thatthe ailment
is used
in
a generic
sense to encompass a wide variety
f
skin
disordersof an
apparently nonmalignant
nature, which
usually caused an alteration
of the
skin and a loss of pigmentation.59
t
was
not
the author's
intention
o
give
detailed descriptions
f these cutaneous alterations,
ut the descriptions hat
he does offerdo notresemble clearlyrecognizablecases of leprosy.60n only
two
instances s
leprosy (judhdm)
mentioned. In the first, l-Jahizdiscusses
more serious, chronic
diseases and shows some familiarity
with Galenic
medicine; he considered
baras
ess serious
thanjudham nd cancer,
although
he referred o al-baras
l-'atiq as equally malignant.The lattermay
well refer
to a form of advanced
leprosy.61Secondly, following an account
of the
treatment
f
baraF
by cauterization
and incision, al-Jahiz reported that the
people
of
Mecca
expelled
a man who had contracted aras,fearing
ontagion
of diseases
like udhdm.62
This belief
in
the contagious nature
of
baras
is
exceptional, for al-Jah.iz oes not otherwisemention t as a characteristic f
baras,whereasjudham
was
commonlybelieved to be contagious.
In any case,
al-Jahiz's
engthypresentation
f individual cases
of skin
irregularities up-
ports
his
view that such afflictions hould induce sympathy,
f
not
praise,
in
fellow
Muslims.
Most of the
poets
quoted by
Ibn
Qutaybah say
that skin disorders should
not be the cause of scorn
and revilement
ut
should
prompt
the sufferer o
repentance.63
or
many, the leper, like
other diseased persons, was afflicted
by
an unknowable
God,
and
the
leper
should
resign
himself
o
God's
will.64
57
In one instance Ja'far ibn
Yahya (EI2: "al-Baramika"
[D. Sourdel])
is reported to have
sufferedfrom
baras;
the condition was considered by
some as a
punishment
for
disobedience,
but al-Jahiz ays that this idea was
believed by others to be foreign,being
derived from
the
doctorsof the Hind (al-Bursan, . 36)
58
See,
for
example, the story
of
Abu Ja'far,
the
leper,
in
The
ThousandNights nd a Night,
trans.R. F. Burton 1885-88; repr. New York, 1962), 3:1887-90.
59
I.e.,
wadah,
rqat,
sla',
bayd1,
arash,
bahaq
aswadlabyad,
bqa', aqshar,muraqqa'.
The author
relates
the
various
forms of baras to skin conditions
in
animals, particularly
horses
-
ablaq,
muhajjal, hurrah.
60
The only exception to thisgenerality s one description
f
burash al-Bursdn,
. 50).
61
Ibid., p. 36. Incidentally, l-Jahiz states here that
the
Persians
had a greater aversion
towardbaras.
62
"They fear
contagion ofjudhdm,
aras,arab, safar, adasah,
and
udrd" ibid., p. 52).
63
Ibn Qutaybah, Uyuinl-akhbdr,:63-67.
64
See Hellmut
Ritter, as
Meerder eele Leiden, 1955), pp. 242, 519
f.
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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The
Leper
n slamic
ociety 903
Furthermore,
bn
Qutaybah
nd
al-Jahiz
itenumerous
eferenceso
possi-
ble cases of eprosy
n
Arabic
oetry,
s
in
the
fierce
oetic
uels
of
Jarir
nd
Farazdaq,65 nd they dentify
oets
who were themselves
eprous,66mong
themAyman bnKhuraym,n Arabpoetfavored y heUmayyads.67here
are otherhistorical
eports
f
probable
nstances f the
disease t
this
ime.68
An
interesting
xample s
Ibn
Muhriz, famous
musician nd singer
f
Mecca,
who does not seem to
have
appeared
much n
public
becauseof his
leprosy nd had his
compositionserformedy slavegirl.69
The mostmportant olitical
igure n early
slamichistory ho mayhave
been afflicted y leprosywas
'Abd al-'Azliz
d. 85/704),
he
son of
the
Umayyad aliphMarwan .
He was appointedgovernor
f
Egyptby
his
father
nd
was later confirmed
n
this
office
y
his
brother, aliph
Abd
al-Malik. ortwenty ears Abdal-'Aziz roved capableruler, lthought s
reported hathe was stricken
y
the
diseaseknown s "lion-sickness."70his
was a
common
uphemism
or eprosyjudham)
nd can be
traced
back
to
the
description
f
leprosy y Aretaeus
f
Cappadocia
n
the second
entury
A.D.71 The leonine
ppearance
f
the eper s
caused primarilyythe oss of
the eyebrows
nd the swellingnd toughening
f the face.
Abd al-'Azliz as
givenmany
medications or
the
ailment,
ut
they
were neffective.here-
fore,
his
physicians
dvised
him
to
moveto
Hulwan
becauseof ts ulfurous
springs,
nd he
built
hisresidence here.72
Bathing t specificites, specially otsprings, asconsidered o be par-
ticularly
eneficial
or
epers,
nd theassignmentf special
baths o lepers,
as at
Scythopolis, ayhave been a
common
ractice
n
many
egions. ften
the
reputation f
these iteswas due to
religious ssociations.
or example,
we know
rom
Gregory f Tours
that athing
n
theJordan nd inparticular
at the
place whereChristwas
baptizedwas
regarded s a sovereign ure for
leprosy.73 ther
bathing
laces owed their eputations or
healing o pre-
Christian
ults,
s
did
theBaths f
Elijahnear
Gadara,where heprocedures
followed
ppear identical o those
customaryt Aesculapia.74
his is re-
65
The
Naka'id
of
Jarir
nd
al-Farazdak, d. A. A. Bevan
(Leiden, 1908-9),
2:1007; Jarlr,
zwan
(Cairo, 1969-71), 1:283;
al-Jahiz, l-Bursan,
. 28 ff.;Joseph Hell,
"Al-Farazdak's
Lieder auf
die
Muhallabiten,"
Zeitschrift
er
Deutschenmorgenlandischen
esellschaft9 (1905),
608; W.
Fischer,
Farb-
und
Formbezeichnungenn
der prache er
ltarabischenichtung
Wiesbaden, 1965), p. 269.
66
Ibn
Qutaybah, Uyuinl-akhbdr,
:63-67.
67
EI2: "Ayman
bn Khuraym"
Ch. Pellat).
68
Ibn
Sa'd,
at-Tabaqdt
l-kabir,
d. E.
Sachau et al.
(Leiden, 1904-40), 3:117,
5:113.
69E12:
"Ibn Muhriz" eds.).
70
Abui Salih,
The Churchesnd Monasteries
f Egypt
nd
Some
Neighbouring
ountries,
d. and
trans.B. T. A. Evetts, n AnecdotaOxoniensia (Oxford, 1895), fol. 52b: "Wa innahu i'tarahu
ad-da' al-ma'raf
bi-da
al-asad wa huwa
l-judham."
71
TheExtantWorks
f
Aretaeus,
he
Cappadocian,
d.
and trans. Francis Adams
(London,
1856),
pp.
213-29/366-73,
236-40/494-97.
72
AbiuSalih,
The Churches
nd Monasteries
fEgypt,
ol. 52b
(p.
154).
73
Cited in
Avi-Yonah,
"The Bath
of the
Lepers
at
Scythopolis," . 326.
74
John
Wilkinson,Jerusalem
ilgrims efore
he
Crusades
Warminster, 977), p.
34.
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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904 TheLeper n slamic ociety
ported by an anonymous Christianpilgrim
from
Piacenza
who
wrote about
A.D.
570 a
vivid
description
f his
ourney
in
Palestine:
We went o
a
city
alled
Gadara,
which
s
Gibeon,
nd
there,
hree
miles rom he
city,here re hot pringsalled heBaths fElijah.Lepers recleansed here,nd
have theirmeals from he inn there at public expense. The bathsfill
n
the
evening.
n
front f the basin
s
a
large
tank.When
t is
full,
ll the
gates
are
closed, nd they re sent
n
through
small
oor with
ights
nd
incense,
nd sit
n
thetank ll night. hey
fall
sleep,
nd the
person
who
s
going
o be cured ees a
vision.Whenhe has told
t the
springs
o not flow or
week.
n
one weekhe
is
cleansed.75
The pilgrimfrom Piacenza also describes
the Baths of Moses
at
Livias:
In these lso lepers re cleansed.A spring herehas very weetwaterwhich hey
drink s a cathartic,nd it heals many iseases.
This is
not farfrom he Salt Sea,
intowhich heJordan lows, elow odom and Gomorrha. ulphur nd pitch re
collected n that hore. Lepers ie
in
the sea there ll through he day
in
July,
August, nd theearly artof September.n theevening heywash
n
theseBaths
of
Moses.
From ime
o timeby the
will
of God
one of them s
cleansed, ut for
most f them tbrings omerelief.76
Bathing
at Livias
and
at the hot
springs
near Tiberias
continued
to be
considered efficacious or curing eprosy by Christians
n
the Middle Ages.77
Jews
who
were afflicted y eprosyalso sought healing
in the
springs
nd
the
salubrious
air
of Tiberias during the medieval period.78 Although there is
little evidence that the rituals associated with the ancient Aesculapia were
perpetuated by
the
Muslims,79
he resort
o
bathing
n
particular prings
s
a
treatmentfor leprosy
and
other skin diseases appears quite common,
and
there
s a
striking ontinuity
f
such
practices
t
specific
ites
from
ncient
to
modern times.
For
example,
an
anonymous
Italian
merchant, raveling
between
Aleppo
and
Damascus
to
Tauris
in
the early sixteenth entury,witnessed he
follow-
ing:
Six miles
outside
he
city Orfa/Edessa]
s a wonderful ell which
heals
lepers,
75
Ibid., p. 81; see also
pp. 6 f.,
157.
76 Ibid., p. 82.
77
See ibid.,
pp. 69, 81, 164, 174;
Philipsborn,
Les premiersh6pitaux,"
p.
147.
78
Communication
f S.
D.
Goitein
June
13, 1977);
the
relevantGeniza
material
n
lepers
will
be collected
n the fifth olume
of his AMediterranean
ociety.
ee
Goitein,
A
Mediterranean
ociety
(Berkeley, 1967-78), 2:97; Jacob Mann,TheJews nEgypt ndin Palestine nder he dtimid aliphs
(Oxford,
1920-22), 1:166
f., 2: 192-95.
See also al-Muqaddasli,
Description
f
Syria, rans. G.
Le
Strange,Palestine
Pilgrims'
Text Society
3 (London, 1896),
p. 83
f.
79To my knowledge,
the only
example
of the use of incubation
by
Muslims s given
by
Yaqut
in
623/1225
in
his description
of Burak, a village near Aleppo;
see G.
Le
Strange,
trans.,
Palestine
under
the Moslems London,
1890), p.
425. Vestiges
of this practice
may
be found
elsewhere,
s
in the case of
the Well of Job,
which s discussed
below.
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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The
Leper
n slamic
ociety 905
provided hey o therewith evotion, eeping his rder.First heymust ast
ive
days, nd each day of the fast hey
rink
requently
f
the water,
nd
every
ime
they
rink
hey
mustwash
themselves
ith
t,
but after hefive
daysthey
o
not
washanymore, ut still rink p to the tenth r twelfthay; and so thevirtue f
the
holy waterfreesthem from his nfirmity,r at least keeps
it from
going
further. nd
I
have seen this ffectwithmyown eyes
n
Orfa,manywho came
infirm
oing waywell.80
This was the well-knownWell of Job (Bir Eyup), located outside the south
gate of Edessa.81 The leper house thatBishop Nona had built in the mid-
fifth entury
A.D.
was placed near the well. In the twelfth entury
A.D.
the
well was called the
"well
of those who
sufferfrom
elephantiasis [i.e.,
lep-
rosy]," and it was visited especially by Muslims. In A.D. 1145, Zangi,
the
Muslim ruler of northern Mesopotamia and Syria, captured Edessa and
visitedthe principal monuments.He himself ufferedfromgout and
bathed
his
legs
in
water
from
the Well of Job.
Zangi
is
reputed
to have said:
"I
believe
that
the blessing of Christ can perform wonders
like this." He
ordered
that a
large hospice
should be built there
for
the afflicted
nd
that
all
the fields around it should be used
for
the maintenance
of
the hospice.
This did not happen, however, because the plan was annulled by
Zangi's
death shortly thereafter. n the mid-seventeenth entury, Thevenot ob-
served men
and
women bathing
at
thiswell
n
the
belief
that ts water
healed
leprosy. To the present day, the sick pass the night at the well, particularly
those suffering rom skin ailments,
nd this
quarter
of
Edessa
is
called the
Eyiip Mahallesi, the quarter of Job.82Clearly,natural springswere a
focus
of
healing for epers.
There is no way of determining he extent of leprosy n the Middle East
during the medieval period.83There
are
general statements
bout the
preva
80
Anonymous, The Travels of a
Merchant
n
Persia,"
n
A Narrative
f talian Travels
n Persia
in the
ifteenth
nd Sixteenth
enturies,d. and trans. Charles
Grey London,
1873), p. 144.
81
In Christianity,ob was closely associatedwith eprosyfor obvious reasons and
was often
regarded as
the patron saint
of lepers; see Brody,TheDisease
ofthe oul,
p. 48 et passim.
82
Segal,
Edessa, pp.
71 f., 148, 184 f., 250
f.
83
There
is no evidence that Muslims
spread leprosy
to Europe during the early
Islamic
conquests
or that the Crusades increased
the disease in Europe because of contact
with the
peoples of
the Middle East,
as alleged by some historians
e.g., Zambaco,
La
lopre,
p. 96 f.;
Michel Foucault,
Madness nd Civilization
New York, 1973],
p. 6); cf. Dieter Jetter,
rundziige
er
Hospitalgeschichte
Darmstadt,1973), p.
18.
If
this were so,
it
surelywould have
entered into
the
Westernpolemical
literature
f the
time;
no
such
accusations
against
the
Muslims,
however, an
be found. The Crusades
themselves,by
the
mass migration
of peoples,
may have aggravated
leprosy
n
Europe.
Yet it s
veryprobable
that
the
prevalence
of leprosy mong
the
Crusaders
in
the Middle East (e.g., Baldwin IV [d.
A.D.
1206], see A History fDeedsDone beyondhe eas, trans.
E.
A.
Babcock and
A. C.
Krey New
York, 1943], 2:296, 460)
was
responsible
for the
reintroduc-
tion
of public
bathing
nto Europe
-
of the Islamic type
the hot steam bath
or
hammdm)
ather
than
the
Roman (hot
and cold baths
or
thermae). ee
George Sarton, ntroductiono
theHistory f
Science,2/2
Baltimore, 1931),
p. 631; Loren MacKinney,
Medical llustrations
n
Medieval
Manu-
scripts London,
1965), pp.
96-98.
Concerning
the leprosyof Baldwin IV, see Shazar,
"Des
lepreux pas
comme les autres," pp. 37-40.
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906
TheLeper n slamic ociety
lence of the disease, such
as that by al-Muqaddasi,
who remarked that epers
were numerous
n
Syria
and Fars.84Palestine s particularlywell documented
because of Europeans' interest n the Holy Lands;
their ccounts attest o the
presence of lepers, especially n Jerusalem.85n the Crusader Kingdom the
Order of Saint Lazarius
was established primarily or knights fflictedwith
leprosy.86Occasionally
the Arabic sources mention
prominent individuals
who suffered from leprosy, such
as
the philosopher
and physician Abui
l-Barakat al-Baghddli,
who died ofjudhdm bout 560/1163.87
Yet, the fear of leprosy, as well as its frequent
confusion with other skin
disorders,
was
common
and
is
illustratedby
the following tory
of
Usamah
ibn
Munqidh (d.
584/1188),
the well-knownmemorialist
t
the
time of the
Crusades:88
Ibn-Butlan89 as for ome time ttached o the service f mygreat-grandfather,
abu-al-Mutawwaj uqallad
bn-Nasrbn-Munqidh. here appearedon mygrand-
father,bu-al-Hasan
All
ibn-Muqalladbn-Nasrbn
Munqidh may
Allah's
mercy
rest pon his oul ),whowas then till young oy, ome
white potswhich reatly
disturbed
is
father or
fearthat he maladymight
e leprosy. o he summoned
ibn-Butlan nd said to
him, See whathas appeared on the body of All." The
physician
ooked it
over
and
said,
"I
demand five
hundred
dinars
to treat
his
malady
nd
cause
it to
disappear."My great-] randfather
aid to
him.
If
thou
hadst treated
All,
would
not have been satisfied
ith
fivehundreddinarsfor
thee."Seeingthatmy great-] randfatherasangry,bn-Butlanaid: "I am thy
servant nd thy lave,
iving n thy enevolence. did not say
what said
except
jokingly.
s
for hose hings
n
All, hey
re
nothing
ut kin
ruptions
aused
by
youth.
As
soon
as he
is
fully dolescent, hey
will
disappear.Worry ot, herefore,
about t, nd listen otto someone
lse
who
might aythathe would
ure
him
nd
84
Al-Muqaddasi, Descriptionf
Syria,p. 66; B. A. Collins,Al-Muqaddasi:The Man and
His
Work
(Ann Arbor, 1974), p. 248.
85
Wilkinson, erutalem ilgrims, p. 3, 84, 137. Concerning leprosy n the Latin Kingdomof
Jerusalem,
see Ernest
Wickersheimer, Organisation
et
legislation
sanitaires u
royaume
franc
de Jerusalem 1099-1296),"
Archivesnternationales
'histoire
es sciences 6
(1951), 689-705;
E. E.
Hume, "Medical Work
of
the
Knights Hospitallers
of Saint
John
of
Jerusalem,"
Bulletin
f
the
Institutefthe
Histmy
fMedicine (1938),
461.
86
Shazar,
"Des
lepreux pas
comme les
autres," pp. 19-41.
Besides
the
residences
for
epers
in
Jerusalem
in
the twelfth
entury
nd
in
Acre
in
the thirteenth
entury,
t is
possible
that the
order
had
hospices
for
epers
in
Beirut,Tiberias, Caesarea,
and Ascalon (ibid., p. 27).
87EI2: "Abui l-Barakat
al-Baghdddli"
S. Pines);
Mahmuid
ibn
(Abdli,
Ta'rikh
tibb
Tehran,
1353/1934),
p,
709. For other individuals
see ash-Shabushti,
Kitdb
ad-Diydrdt,
d.
G.
Awwad
(Baghdad, 1966) p. 36; Ibn
'Abd
Rabbih, al-'Iqd aI-farid Cairo, 1940-68),
6:147; al-Bakni,Kitdb
Mujam (Das geographische &rterbuch),d. Ferdinand Wustenfeld G6ttingenand Paris, 1876),
2:733; EI2, Supplement: Ghdzi Khan"
(M. Hasan).
88
EI, first d.; "Usama" (Ign. Kratschkovshy).
89EI2: "Ibn Butlan"
J.
chacht).
This Arab Christian physician visited
Antioch n 443/1051
and observed the following:
"In
the town is
a
Bim5ristAnor hospital),
where the patriarch
himself ends the sick; and everyyear he causes the epers to enter the
bath, and he washes their
hair
with
his own
hands"
(Le Strange,
Palestine
nder he
Moslems,
. 371).
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8/18/2019 Dols (Michael W.)_The Leper in Medieval Islamic Society (Speculum 58:4, 1983, 891-916)
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The
Leper n
slamic
ociety
907
therebymake
moneyfrom
hee.
All
thiswill
disappearwith
he maturityf
the
youngman."
And things
urned
ut
ust as he had
said.90
The fear of
leprosy
prompted
discriminatorymeasures
against the
afflicted.Accordingto Ibn al-Ukhuwwa d. 729/1329),themuhtasib,r mar-
ket
nspector,
must not allow
people
suffering
rom
eprosy
to
use the
public
baths.91Also from
Egypt,
an
endowment
deed
of Sultan
Barsbay
(825-41/
1422-38)
statesthat
those
suffering
specially
from
eprosy
judham w baras)
should
not be
employed.92
The
specificdiscrimination
gainst epers
in
these
two
instances,
although
rare,
shows that
the
theological
objections to
the
notionof
contagion might
have
very
ittle
ractical
ffect.
In
North
Africa
(excluding Egypt) and
southern
Spain, there
is no
evi-
dence of
leprosaria
in
the
pre-Islamic
period
and
only
slight
evidence
for
Christianhospitals.93 uring the Islamic era, leprosariawereestablished nd
special
quarters were
designated
for
lepers.
The
quarters
seem
generallyto
have
existedoutside
the
walls of the
cities,
often n
conjunction with
eper
cemeteries.The first
Muslim
hospital
n
North Africa
appears
to
have
been
built n
al-Qayrawan,the
capital
of
Ifriqiyah,
bout
A.D.
830;
it
was
known
as
the Dimnah
Hospital. Near it
was situated
a separate
building called the
dar
al-judhamd'
the
house
of the
lepers
-
where
lepers
were
given
medical
attention.94
urther
west, the
Almohad
sultan
Ya'qub al-Mansur
(580-95/
1184-99)
founded
hospitalsfor the
nsane,
the
blind,
and
lepers.95
According to Leo Africanus, he suburbanquarter (harah)forlepers out-
side
Fez
comprised
about two
hundred
houses
in
the
early
sixteenth
entury.
They had
their own
leaders,
who
received the
revenues of several
endowed
properties.The
writer,who had
himself
been the
secretary
f the
maristann
90
Usamah ibn
Murshid
bn
Munqidh,
Memoirs f an
Arab-Syrian
entleman,rans.
Philip Hitti
(1929;
repr.
Beirut,
1964), p.
215 f.;
see
also
pp.
36,
149.
Shazar
("Des
lepreux
pas
comme
les
autres," p.
40) also
suggests the
Muslims'
fear
of
leprosy in
the
accounts of
the
capture
of
Robert,
he
eprous
count
of
Zerdana,
duringthe
Crusades.
91
Ma'dlim
al-qurba, d.
R.
Levy
(1938),
chap.
42; cf. Avi-Yonah,"The Bath of the Lepers at
Scythopolis,"
p.
325-26.
See also N.
Ziyadah,
al-Hisba
wal-muhtasibfi
-Islam
Beirut,
1963),
p.
119.
92
Ahmad
Darragh,
ed.,
L'actede
Waqfde
Barsbay
Hujat
WaqfBarsbay)
Cairo,
1963),
p.
56.
93
For
North
Africa,
see
M.
S.
Belguedj,
La
medecine
raditionnelle
ans
le
Constantinois
Stras-
bourg,
1966),
pp.
17-24.
For
Spain,
a
single
xenodochium as
clearly
established n
Merida
after
A.D.
589;
see Dieter
Jetter,
eschichte
es
Hospitals,
(Wiesbaden,
1980),
pp.
15-27. The
possibil-
ityof
such
charitable
Christian
nstitutionsn
the
western
Mediterranean
poses
the
question of
continuitywith
imilar
slamic
nstitutions.
94
Hamarneh,
"Development
of
Hospitals,"
p. 375.
Incidentally,
l-MMliki
ells
the
story
f
a
virtuous man in
al-Qayrawan named
Shaqran,
who
was
tempted
by
a
woman of
the
city.
He
prayed to God to change his nature and avert this evil fromhim. The man was strickenby
leprosy
judhdm),
nd
the
woman
expelled
him
fromher
house.
Thus,
"God
protected
him
from
her
evil.
He was
afflicted
with
ulcers in
his
hands and
feet
until
he
died; he
chose
affliction
f
this
world
over
the
affliction
f
the
hereafter"
al-Mdlikli,
itdb
Riydd
n-nufis
i
tabaqdt
ulamd'
al-Qayrawdn,d. H.
Mu'nis,
1
[Cairo,
1951],
p. 227).
95
EI2:
"Bimaristan."
See
Roger
Le
Tourneau,
Fzs
avant e
Protectorat
Casablanca,
1949),
pp.
72, 110;
Klingmuller,
ie
Lepra,
p.
30.
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908 TheLeper n slamic ociety
Fez for two years, says that the lepers were well provided
for. Furthermore,
the leaders of the lepers were responsible for freeing
the city of anyone
strickenby
the
disease. When they recognized someone
with the
malady,
they had the authority o make him leave the cityand dwell in the leper
quarter. When a leper died withoutheirs,half of his possessions went to the
leper community nd the other half to the person
who called attention o the
case.
If
the
leper
had
children,
the
goods
were
inherited
by
them.
Among
the leperswere also those who
had various skin diseases and other ncurable
illnesses.96 t is, then, not so surprisingto learn from
Leo Africanus that
when syphilis
rrived n
North Africa, pparentlybrought by
the
Jews
who
were
driven out of
Spain,
the first o be contaminated were considered as
lepers. They were forced out
of their homes
and
obliged
to live
with
the
lepers.97
Surveying
the cities of Islamic
Spain, Levi-Provensal
asserts that most
of
the towns
n
the west seem to have had
a
leper quarter outside the citywalls.
The leper houses were supported by pious foundations and were often
placed close to the aristocraticparks.
This was
especially
the
case
of
Cor-
doba,
where
in
the ninth and tenthcenturiesA.D. the Munyat Adjab was a
large orchard in the western suburb that was a charitable foundation of
'Adjab,
one
of the
wives of
Caliph
al-Hakam
I
(180-206/796-822).
The
endowment
provided
that
some of its revenue would
support
in
perpetuity
the eperswho weregrouped together n an isolatedleprosariumnearby.98
As
in
the Middle East, springs were believed to be beneficial for the
leprous. Leo Africanus tells us that at al-Hammah in southern
Tunisia the
water
leaving the city
was
collected, forming lake,
north of the
city,
hat
was called
the Lake
of the
Lepers.
The water was supposed
to have the
ability
o cure
lepers
and to heal
bodily sores,
and
a
large number of lepers
lived around the lake in cabanas.
The author observed
the admirable effects
of the
sulfurous
waters,
which
he
had tried to
drink.99
Until recent times
n
North
Africa,
urative
properties
were oftenattributed o
natural
springs,
n
association with ocal saints; the springswere thought obe advantageous for
skin
diseases, particularly eprosy.100
In Anatolia the Turks
built numerous
hospitals
n
the
ater
Middle
Ages,101
96Jean-Leon 'Africain, escription
e
l'Afrique,
d.
and trans. A.
Epaulard (Paris, 1956),
1:229.
97
Ibid., p. 60 f.; see also Zambaco, La
lopre,
.
100.
98
t. Ikvi-Provensal,
Histoirede l'Espagne musulmane, (Paris and Leiden, 1950), p. 188; 3
(Paris and Leiden, 1953), pp. 335, 382, 434. Jetter
Geschichte
es
Hospitals,
:36) concludes that
there s no clear evidence for hospitals n Umayyad Spain (A.D. 756-1031); the leprosarium n
C6rdoba "is the only establishmentfor the isolation of lepers in Islamic Spain that can be
proven withreasonable certainty."
99Jean-Leon l'Africain,Description e
l'Afrque,
2:399. A similar instance of mineral waters
being used for the cure of lepers
in
Algeria s cited
by Zambaco, La
lopre,
. 318.
100
Westermarck, itualand Belief,1:87; Legey,Essai defolklore, . 158.
101
The Black Death is commonly accepted as
marking the beginning of the gradual disap-
pearance
of
leprosy
from
Europe.
This
decline
has yet
to be
explained satisfactorily;
ee William
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TheLeper
n
slamic
ociety
909
following
he
precedent of the Islamic mdristdn.
02
They
constructed
hospitals
in
Kaysari
A.D.
1205),
Sivas A.D.
1217),
Kastamonu A.D.
1272), and
Amasya
(A.D.
1308).103
A
leper
house that was
built
at Edirne in
the timeof
Murad
II (824-55/1421-51) functioned for almost
two centuries. n
A.D.
1530
Sulayman
the
Magnificent
rected a
leprosarium n
Scutari,
which
survived
into modern
times. As in the
Islamic
West, the
leprosaria
or quarters
were
located
outside the
cities. A
leper house
founded by Selim
I in
920/1514 in
Istanbul,
which
survived until
1920, is a
good
example.104
It
has been
described
n
the
following
manner:
The leprousweretaken are of
by
the
religious
oundations[;]
0 loaves
of
bread
as
well s soup and
ricewere ent o them ach
day
from
he
foundations
f
Atik
Valide.
Their wood for he
winter
s
well
s
their
arments
ere
quallyprovided
from his ame foundation. onations fmoney nd sacrificesfsheep givenby
those passing
hrough
he
city
f
Uskudar
on
their
way
to
Anatolia
were
also
accepted.
All
these
were
collected
by the
priest
of the
mosque
found n the
leprosery, ho
was at
the same time
director fthe nstitution.
he
patientsived
in
their
ooms
nd
could
marry mong
hemselves.
s
the
passerby
id
not
ike o
approach he
building,heir
ifts
ere
deposited
n
the
eight
hollow
tones
ut
on
either ide
of
theentrance oor....
[In
1934]
there
were,
n
an
isolated
uilding,
10
wooden
roomsfor
the married
nd
6
roomsfor the
bachelors,
ach with
fireplace.
sidefrom
hese,
here
were2
rooms or he
priest,
washhouse or
he
whole
eprosery,
large
Turkish ath nd a
mosque
with mineret.
he
outside
wallswere f stonewhile he nner onstructionasof wood.The institutioneing
located n the
borders
f
the cemetery,
he patientswho died
were
mmediately
buried
here,
utno
tomb
tone
was
erected
ver heir
raves.105
To an
increasing degree,
lepers and
leprosaria were noticed
by Western
travelers
n
Muslim
countries, nd
the travelers' ccounts
contribute o
our
knowledge
of the
treatment of the
diseased.106
For
example, Carsten
McNeill, Plagues
and Peoples
(Garden City, N.Y.,
1976), pp. 175 ff., 283,
where an
unlikely
solution s
suggested. The pandemic and
its
recurrencesprobablydestroyed
arge numbers
of
lepers because of theirexceptionalvulnerability o other diseases. However likely his may be, I
have
found
no evidence for
the cessation of leprosy n
Islamic
society n the later Middle
Ages.
102
The
relationship f the
early Turkishhospitals
to the
Byzantine
enodochia
s
unclear. The
devastation
of
the
Byzantine cities
where
Turkish
hospitals
were built
Caesareia, Sebasteia,
Castamon,
and
Amaseia
(see
Speros Vryonis,
The
Decline
of
Medieval
Hellenism n Asia
Minor
[Berkeley, 1971], p.
26 et
passim)
-
and their architecturalplan
(the Persian zwdn
form)
strongly uggest
a
discontinuity
ith
Byzantinepractice.
103
See El2: "Bimaristan"; A.
Siuheyl Jnver,
Sur
l'histoiredes
h6pitaux turcs,"
Atti el
Primo
congressouropea
i storia
spitaliera
6-12
giugno 960) (Reggio Emilia,
1960), pp.
1240-57.
104
SuheylCnver,
"About the
History
f the
Leproseries
n
Turkey," pp.
447-50.
105
Ibid.,p. 448.
106
There
is practically
no
mention
of
true
leprosy
by
Western
travelers
n
the Middle
East
during
the medieval
period.
The
only
reliable
report
of
leprosy
in
Egypt
is the
account
of
Prosper Alpini (1553-1617)
in
his
Medicina
AegyptorumLeiden,
1719), p.
56
et
passim;
French
trans.by R. de
Fenoyl, La medecine es
tgyptiens
Cairo, 1980), 1:49f.,
55
f., 95,
where
Alpini
notes the
widespread use
of
blood-letting nd the
frequency
of
leprosy
among
the
poorer
classes.
See
also
Alpini,
Histoire
naturelle
e
l'Egypte,
rans.
R.
de
Fenoyl (Cairo, 1979),
1:77,
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910
TheLeper n slamic ociety
Niebuhr, writing
n
the mid-eighteenth entury,denied the Turks' fear of
contagion, s representedby the leprosaria. He observed:
The Turks, rom misconceptionf thedoctrine f predestination,se no precau-
tions gainst heplague leprosy];
ut
heArabians, lthough
rue
Mussulmans,
re
morecareful n respect o the eprosy. he last prince f Abu Schaehhr sed to
sendto the sleof Bahhrein
ll who
were ttacked
ith he
eprosy,
r with enereal
complaints.
t
Basra, epers
re shut
up
in a
house
by themselves;
nd there s a
quarter
n
Baghdad
surroundedwith
walls,
nd full f
barracks,
o which
epers
are carried
yforce,
f
they
etire
ot hither
oluntarily;
utthe
government
oes
not eem
to
provide
with
ny are
for hemaintenance
f
those
epers.They
came
out
every riday
o the
marketplace
o ask
lms.107
Evident in Niebuhr's observations re the conflictingdeas about the con-
tagious nature of leprosy, the contrasting treatment of lepers, and the
possible freedom of lepers to associate with
the
healthy.
t seems
that epers
commonlybegged
in the
streets
f
the
cities,despite
the
pious endowments
on their behalf and
laws against mendicancy.While many
must have been
genuinely eprous,
it
was not unusual during
the
medieval period
for
men
and women
to
feign
the disease
by
intentional
disfigurement
n
order
to
receive
public charity.108 eception
of the
opposite
kind
was
also
apparently
common
in
the
slave
market,
where a
buyer
had
to be on
his
guard against
the concealmentof leprous soreson the bodies of slaves.109
In 1805,
the
German travelerUlrich Seetzen ourneyed throughthe Mid-
dle East and
remarked on the
hospitals
for
epers
in
Damascus. His
report
s
particularly nformative
bout the
Christian
minorities nd
the
Arabic ter-
minology egarding eprosy:
Ha.zaratl-ikhwahs the name of the hospital or epers
n
Damascus.The
sick
re
called
mujddhim,
nd the
sickness,
d'
al-qu'tal.Among
the
Christians
re
about
forty atients Catholics,
Greek
and Maronite
?].
. .
There
are here three
hospitals
or
eprosy,
f which wo
belong
o
the
Christians
nd are called
ha,zrat
al-ikhwah.ne of thesebelongs o theMaronitesnd the other o theCatholics,
and contain bout
fifty
male
and
female
epers. Among
the Greeks
re ten
to
fifteen
epers.
These
lepers upport
hemselves
y donations, equests,
ollections
of alms n
the
city,
n Hauraii
nd
elsewhere,
nd
also
by ending
ut
their
opper
2:225.
Concerning eprosy
n
nineteenth-century
gypt,
ee Marcel
Clerget,
Le
Caire,
2
(Cairo,
1934), p. 16; Description
e
'Egypte: Etat moderne, (Paris, 1809), pp. 492-98 (Larrey), 2/2 Paris,
1822), p. 697 (Jomard);
A.-B.
Clot-Bey,
Apercu
eneral sur 'Egypte,2 (Paris, 1840),
p.
356
f.
The
contagionist/anticontagionist
iewsof the
period strongly
ffected he
writing
f medical
history,
especially
the
anticontagionist
iews of
Clot-Bey
and Zambaco.
Clot-Bey recognized, however,
that hecontagiousnatureofleprosyhad been held bythepeoples of theLevant.
107
Niebuhr, Travels hrough rabia, 2:276 f. See also William Wittmnan,ravels
n
Turkey,
sia
Minor, yria nd Egypt 1803; repr. New York, 1971), pp. 352, 446, 542
f.
108
See C.
E.
Bosworth,The Mediaeval slamic Underground, Leiden, 1976), pp. 24, 84, 100:
"Vitiligo
baras)
or leprosy judhdm) an be simulated by boiling up and then applying to the
body a compound of indigo-leaf, asil, cubeb and green vitriol r copperas....
109
Ibn Butlan quoted in Lewis, slam rom he rophetMuhammad, :273.
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The
Leper
in Islamic
Society
911
kettles, hichwere bequeathed
o them.The
Muslimhospital s called ami' al-
qa'dtilah.
t layoutside f the
city, orth f the Bab ash-SharqI,
nd
ha:d
garden
and more income fromreal
estate than the
Christian ospitals]. here were
twentyatients ere.1"0
According to the German
consul in Damascus, Dr. Wetzstein,
he more
correctname
of the Muslim hospital was hawsh
l-qa'd(ilah,
r "enclosure for
the
diseased,"
where the diseases were commonly
understood
to be syphilis
(dd' al-faranj)
nd leprosy baras);
among the educated inhabitants
he latter
was calledjudham.
The
termjami'
l-qa'a(ilah
was explained by
the factthat a
mosque was part
of the
complex
of
buildings.
The
mosque had a minaret
and a quarter for transient
epers. As for the Christian hospitals,
only one
survived
until the mid-nineteenth
entury;
Dr. Wetzstein aw
it
before t was
burned down along with tsinmates n 1860. It was a long narrow building
with
about
forty ooms and all were occupied.
Furthermore,
Dr. Wetzstein
observed that
the
lepers appeared
in the citywith "cringing hamelessness."
He
passed
by
the
market
of
the city
ne
day and had seen a
group of lepers
besiege
the store
of
a merchant
n
order
to collect a debt."' The merchant
vainly protested that
he had paid the small
sum already to the poor of his
quarter. The
partiallymutilatedfigures ttacked
him, and he was forced to
pay the sum
again. Finally,
Dr.
Wetzstein
noted
the
popular superstition
f
not
using the proper name
of a disease lest
one fall under its power."12
Leprosy was also probablycommon in the countrysidefrommedieval to
modern times;
most of our documentation,
however,
comes
from the
major
cities,
as
in
the case
of
Damascus.
Leprosy,
as
well as
syphilis
nd
elephan-
tiasis,frequently
ccurred
in
Egyptian villages
n the
nineteenth
entury."13
The
villagers
usually
received
verypoor
medical
treatment:
For those who are leprous,
hey
use a
recipe
very
well-known
mong
the
"old
women" rom
ncient
imes.
t
is to
eat
every
morning
or
en
days
the
heads
of
scorpions,
riedover hefire.
hen the
patient
will
be
cured
if
Allah
permits-
or elsehewillperish t thehandsof theminionsf Satan he
Accursed."14
110
Ulrich
J. Seetzen's
Reisen
durchSyrien,
alastina,
Phonicien,
ie Transjordan-lander,
rabia,
Petraea
und Unter-Aegypten
Berlin,
1854-59), 1:120
f. and 277
f. Numerous
lepers
and lep-
rosaria
are reported
to have
been seen
in the
nineteenth
enturyby Europeans
in
the
cities
of
Syria-Palestine;
ee
Klingmuller,
ie Lepra,
p.
49; William
M.
Thomson,
The
Land
and the
Book,
1
(New
York
and London,
1908),
pp.
529-35
et passim.
1"I
This
behavior
does not seem
to have
been
unusual
because
the lepers
in
Jerusalem
n
the
nineteenth
entury
ormed
a beggars'
guild
with a
leader
and lived
on the slopes
of the
Mount
of Olives
in caves,
near
the pool
of
Siloam
(see
Wilkinson,
Jerusalem ilgrims,
. 171);
from
there,they pread out in all directions o beg (Klingmiuller,ie Lepra,p. 49).
112
"Aus
einem Briefe
des Herrn
Consul Wetzstein
n Prof.
Fleischer,"
eitschrift
er
Deutschen
morgenldndischen
esellschaft
3
(1869),
309-13.
For
the unrestricted
movement
of
lepers
in
nineteenth-century
gypt,
ee
Zambaco,
La
lopre,
.
367 f.
113
Zambaco,
La
lopre,
. 368.
114
John Walker,
Folk
Medicine
n
ModernEgypt
London,
1934), p.
23;
concerning
this
treat-
ment,
ee Ibn
al-Baytar,
l-Jdmi'
-mufraddt,
(Bulaq,
A.H. 1291),
p. 128,1.
16.
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912 TheLeper n slamic ociety
Leprosy
still
exists
n
the
Middle
East,
and
many
of
the traditional
prac-
tices nd beliefsregarding
the disease
persist."15
The European traditionthat lepers should
be separated from societywas
sustained
throughout
the medieval
period. Although
the
separation
varied
in its severity ccording
to time and place, the convention was maintained
until modern times."16
he reasons for the
segregation of lepers from the
healthy
were fear of
contagion
and fear of religious mpurity; he latterwas
formalized
n
Levitical aw and was clearly
expressed
in
ecclesiastical egisla-
tion.-17According to Peter Richards,
the
dread of moral defilementwas
more
compelling
than
the fear of contagion.
It was only afterthe onslaught
of the
Black
Death
in
the mid-fourteenthentury
hat ncreased
importance
seems to have been attached to contagion;
because plague was observably
contagious, t is probable thatthe Black Death accentuated such a
belief."18
In any case, the distinctive
reatmentof lepers in medieval Europe
was
created largely by
religious ideas about the
disease; lepers, as a social and
moral group, were reflections
f theirdisease, which could be either
a testof
martyrdom, urgation,
or punishment for sin.1"9 n effect,medieval
Euro-
peans
tried to accommodate two
incompatible
deas of leprosy:
"the
disease
was
the
sickness
both of the damned
sinner
and
of
one given special
grace by
God."'120
The conviction hat
eprosy
was divine
punishment
was
clearly
the
dominant Christian
belief,hardlytempered by the pious assurances
of salva-
tion.121
The factthat Islamic societydid not forma correspondinglyharsh
judgment of the leper
may be attributed
to
the
strengthof the Galenic
interpretation f the disease and to the weakness
of religiousproscription.
The classical medical descriptions of leprosy
formed the basis
for the
medical understanding f
the
disease
in
both
Islamic
and
Christian ocieties.
At the
source,
Hellenistic
doctors were
not unanimous
concerning
the
115
See
E.
Kohout,
T. Hushangi, and B. Azadeh,
"Leprosy
in
Iran," IJL 41/1
1973), 102-11;
R. Eshraghi,
"Social Aspects of Leprosy,"Meshed
MedicalJournal
in Persian) 3 (1969), 381-89;
H. A. Lichtwardt, Leprosy in Afghanistan,"JL 2/1 (Manila, 1935), 75 f.; Klingmiiller, ie
Lepra, pp. 39-50; Zambaco,
La lepre, pp. 317 ff., 330, 367-81,
389-92, 542-61,
567-70;
M. A.
K.
el-Dalgamouni,
"The
AntileprosyCampaign
in
Egypt,"
JL 6/1 1938), 1-11; Hanna,
"Leprosy
n
the U.A.R."
116 Rotha
M. Clay,
TheMediaevalHospitals fEngland London,
1909), pp. 52-54, suggests
hat
the attitudes toward lepers
became gradually
more
severe
in
England from the late twelfth
century.
117
Brody,
The
Disease
of
the
oul, pp.
107-46.
The
view that
eprosy
resultedfrom sinfulness
or impurity
s vividly xpressed
in
medieval European alchemy;
the common base
metals are
often
referred to as
"leprous"
for
being
allegorically n
a state of
sin.
See E. J. Holmyard,
Alchemy1957;
repr. Baltimore, 1968), pp. 162-63
et passim.
118
Richards,The MedievalLeper,pp. 48-6 1.
119
Judith
. Neaman, Suggestionf
the evil
(Garden City,
N.Y.
1975), p.
112.
120
Brody,
The Disease
of
the
Soul, pp.
100-101
and
pp.
68, 101-14;
see also
Shazar,
"Des
lepreux pas
comme les autres,"
p. 38 f.; Foucault, Madness and
Civilization, .
6
f.
A
helpful
discussion of the paradoxical
Christian
view of illness may be found
in Darrel W. Amundsen,
"Medicine
and Faith
n
Early
Christianity,"
ulletin
f
the
History f
Medicine 6
(1982),
334
ff.
121
See
myBlack
Death
n the
Middle
East, p. 291,
n.
3.
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914 The Leper n slamic ociety
nate the diseased: the blind, the lame, and the sick bear no fault or
blame
(haraj),
and
it is
permissible
for
all
men to
gather
and eat
together.129
s we
have seen, it was even possible for al-Jahiz
o
argue
that
llness was a
virtue
for the afflicted.
n
addition, urists and doctors took a relatively ationaland
noncondemnatoryview of the disease. As a result of all these contending
ideas in Islamic society, he leper might have been separated but was not
stigmatized.
In
addition to the religious, egal,
and
medical reasons
for
a more benign
view of leprosy nd
its
victims,medieval
Islamic
society ppears, generally,
o
have lacked a well-defined social structure in comparison to medieval
Europe.130
There was not the strongEuropean sense of group identification,
affiliation,nd conformity
o
models of
behavior.'3' Social relations were
more fluid, personal, and informal in Islamic society; social institutions
before the Ottoman
Period were
noncorporate
n nature.132 hese
general-
izations seem to be applicable to both the
civilian elites and the
marginal
groups
in
Islamic society. Within
this context of fluid social
organization,
therefore, t is not surprising
hat
epers
were not
clearlydistinguished
s
a
social group and strictlyncarcerated
n
leprosaria.
The leprosarium is a concrete expression of social attitudestoward lep-
rosy. As
a
refuge for the despised,
the
leper house was ubiquitous through-
out
medieval Europe.'33 With regard to the segregation of lepers in the
Middle
East,
the
picture s
not
so clear. Leprosy certainly xisted,
and
lepers
were often treated
n
the hospitals. But there is no persuasive evidence for
separate leprosaria
or
leper quarters
in the
medieval Middle
East. It
has
been shown, however,that n North Africa and Andalusia leper houses and
distinct uarters for epers existed
in
the Middle Ages.
The
probability
hat
lepers were at least partially eparated fromthe restof the community n the
129
See
n.
1
above
and
Opitz,
Die
Medizin
m
Koran, p. 40.
130
R. P.
Mottahedeh,Loyalty nd
Leadershipn an Early slamicSociety
Princeton, 1980); I.
M.
Lapidus, Muslim
Cities n the Later
Middle Ages (Cambridge, Mass.,
1967); A.
L.
Udovitch,
"Formalism and Informalism n the Social and Economic Institutions f the Medieval Islamic
World,"
n
Individualismnd
Conformity
n
Classical slam,
ed. A.
Banani and S.
Vryonis
Wiesba-
den, 1977), pp.
61-81.
131
C.
W.
Bynum,
Did the
Twelfth
CenturyDiscover the Individual?" in her
Jesus s Mother:
Studies
n the
piritualityftheHigh MiddleAges Berkeley,
1982), pp. 82-109.
132
Petry, he
Civilian lite ofCairo,
p. 324 f.; GeorgeMakdisi,The Rise of
Colleges: nstitutionsf
Learning n slam
nd theWestEdinburgh, 1981), p. 224
et passim.
133
The
establishment f special
asyla for lepers
in
Europe is attestedas
early as the
fourth
century .D. (E. H.
Ackerknecht, istory nd Geography
f theMost
mportant iseases New York,
1961], p. 112), but
this should not
be interpreted s evidence of the
arrival of a
new
disease.
Rather, t was probablythe resultof
the Christianization
f the empire, which took seriously
he
biblical njunctions bout how to treat persons withdisfiguringkin diseases. For the medieval
European leprosaria, see
Jean
Imbert,Les h6pitaux n droit anonique
Paris, 1947), pp.
149-95;
Brody,
The Disease
of
the
Soul, pp.
69
f., 73-78;
Richards,
The Medieval
Leper, p.
11
et
passim;
J.
H.
Mundy, "Hospitals
and
Leprosaries
in
Twelfth- nd
Early-Thirteenth-Century
oulouse,"
Essays
n
Medieval
Life and Thought, d. J. H. Mundy et al.
(New York,
1965), pp. 181-205;
K.
Sudhoff,
"Aus
der
Geschichtedes Krankenhauswesens
m friuheren
Mittelalter n
Morgenland
und Abendland,"
Archivfiur
eschichteerMedizin21
(1929), 199-203.
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916
The Leper n
slamic ociety
leprous king Baldwin
IV (A.D.
1173-84) may have had a
salutary mpact on
the image of the leper
in
Crusader society; at least the
description
of
the
king by
the chroniclerWilliam of Tyre reflects
noncondemnatory
iew
of
leprosy. Furthermore, he legislationof the Crusader Kingdomis consistent
with such
a
view.
Shazar disavows
any
Muslim
influence
n
this
matter;139
yet,
the
similarity
o
the
status of
the
leper
in
Islamic
society
s
striking.
n
the discussion
of
Crusader legislation,
which
s
the
primary
ource of
infor-
mation,
Shazar
points
out
the
discrepancy
between
the Livre au roi and
the
Assisesde la cour
des
bourgeois.140
The former
stipulated
that the wife of
a
leprous soldier could
not remarry nd
must
retire o a convent.The
second,
which
deals
with
the
nonmilitary
lass,
is
exceptional
in
allowing
the annul-
ment by an
ecclesiasticaludge
of
a
marriage
in
which
either
partner was
leprous and the remarriage of the healthypartner. Shazar suggeststhat the
difference etween
the
two aws may be explained
by the special concern of
the legislator
to
protect the
knights
from
contamination by the
leprous
knight's
wife.
Regarding the bourgeois, the
danger of contagion is appar-
ently
disregarded.
It
is enticingto
suggest
in
this
unique
instance
that the
burgher
class
in
the
Crusader state was more
amenable to Islamic practice
regardingthe annulment
nd
remarriageof lepers.
A
number of salient features
distinguish he status of the
leper
in
Islamic
society and
in
medieval
Western Europe. The Western
characterization f
the leper as bad-temperedand oversexed was unknownin Islamic society;
neither was
the disease considered
to
be
fiercely
ontagious. The leper
in
Islamic
societywas not
considered to have been
strickenby an
unmitigated
evil
-
the "disease
of the
soul"
-
that
entailed
both
a
civil
and
religious
livingdeath, severing
him
entirely rom
his
community
nd
religion.There-
fore,
we do not find
in
the Middle
East
any governmental
regulation
of
lepers, any ritual for
separating the leper from the
community,
ny distin-
guishing costumes, or
any communal
persecution
of the
afflicted.The
Is-
lamic leprosarium may have had
the features of an almshouse
as
well
as a
hospital, but it lacked the monastic aspect of European lazar houses,which
demanded
penitential discipline.
Finally,
a
vivid
reflection f the
contrast
between
eprosy
n
medieval Islanic and
European
cultures s the
absence
of
the
leper
as a stock
character
n
Arabic, Persian,
nd Turkish
iterature.141
CALIFORNIA STATE
UNIVERSITY,
HAYWARD
139 Shazar
is3
however,greatly
mistaken
bout
Muslim
practices
nd beliefs
regarding
eprosy
(ibid., p. 23
f.).
140 Ibid., pp.
20,
23-25,
36.
141
Brody, The
Disease of the
oul, pp.
147-97.
In
general,
leprosy appears
to
have lacked the
metaphoric
potency in Islamic
society
that it
possessed
in
medieval
European
society.
For
example,
R. I.
Moore
has shown that
heresy
n the
West was oftenconsidered a
disease,
pestis,
r
more
specifically
epra
"Heresy
as
Disease,"
in
The
Concept f
Heresy
n
the
Middle
Ages
1
th-13th
C.], ed.
W. Lourdaux and D.
Verhelst
[The
Hague,
1976], pp.
1-11);
see also
Shazar,
"Des
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