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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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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






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






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






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






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.






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.






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






900


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.






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).






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.






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.







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.






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.






906


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).






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.







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






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,






910


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.






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.







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.






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.






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

dols (michael w.)_the leper in medieval islamic society (speculum 58:4, 1983, 891-916)

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