History of leprosy
The history of leprosy was traced to its origins by an international team of 22 geneticists using comparative genomics of the worldwide distribution of Mycobacterium leprae.
The four strains of M. leprae are based in specific geographic regions where each predominantly occurs:[1] They created a map of the dissemination of leprosy in the world.
[4] Later, Indian scientist Shantaram Yawalkar and his colleagues formulated a combined therapy using rifampicin and dapsone, intended to mitigate bacterial resistance.
The word leprosy comes from ancient Greek Λέπρα [léprā], "a disease that makes the skin scaly", in turn, a nominal derivation of the verb Λέπω [lépō], "to peel, scale off".
The first attested English use is in the Ancrene Wisse, a 13th century manual for nuns ("Moyseses hond..bisemde o þe spitel uuel & þuhte lepruse."
[7] The ability to use historical records to trace the spread and treatment of leprosy in antiquity is greatly limited by confusion over which skin diseases were being discussed.
The Greek term employed to translate the Hebrew was lépra (λέπρα, "scaly"), which possessed an entirely separate diagnostic history which dealt with psoriasis and dandruff, only being applied to leprosy in a later period.
Debatably, the oldest known records of genuine Hansen's disease are the Indian vedas, whose kuṣṭha (कुष्ठ, "eating away") is clearly focused on leprosy by the time of Suśruta's Compendium, which prescribes chaulmoogra oil as the remedy;[11] unfortunately, its usual dating to 600 BC is wrong and the present text may be as recent as AD 600.
[12] Similarly, the "Great Chronicle" of Sri Lanka describes royal ancestors of Gautama Buddha who contract leprosy, flee to the wilderness, and cure themselves using herbal medicine sometime before 700 BC but the present text dates to the 5th century or later.
The Vendidad of the Zoroastrian Avesta, surviving only in texts after AD 1300 but presumably recording practices nearly as old as the Vedas, discusses leprosy as paēsa (Avestan: 𐬞𐬀𐬉𐬯𐬀) and prescribes direct application of cow's urine as a cure.
[13] Writing in the 5th century BC, Herodotus mentions the Persian practice of shunning native lepers and deporting foreign ones as part of a discussion of that area's peculiar habits; he reported that they considered the condition to have been caused by offense against the sun god.
[17] In 1846, Francis Adams compiled The Seven Books of Paulus Aegineta, which included a commentary on all medical and surgical knowledge and descriptions and remedies from the Romans, Greeks, and Arabs.
[18][19] A proven ancient human case was verified by DNA taken from the shrouded remains of a man discovered in a tomb next to the Old City of Jerusalem; it was dated by radiocarbon methods to AD 1–50.
Likewise, the disfiguring skin disease favus is caused by Trichophyton schoenleinii, which appears to have been common throughout Africa and Eurasia before the advent of modern medicine.
[24] Mycobacterium leprae, the causative agent of leprosy, was discovered by G. H. Armauer Hansen in Norway in 1873, making it the first bacterium to be identified as causing disease in humans.
Mouat indicated that the oil was the product of a tree Chaulmoogra odorata, which had been described in 1815 by William Roxburgh, a surgeon and naturalist, while he was cataloging the plants in the East India Company's botanical garden in Calcutta.
In 1901, Sir David Prain identified the chaulmoogra seeds of the Calcutta bazaar and of the Paris and London apothecaries as coming from Taraktogenos kurzii, which is found in Burma and Northeast India.
The oil mentioned in the Ayurvedic texts was determined to be from the tree Hydnocarpus wightianus, known as Tuvakara in Sanskrit and chaulmugra in Hindi and Persian.
At the University of Hawaii, the young chemist Alice Ball developed a chemical process that made the oil less hydrophobic and therefore more readily absorbed by the body.
[32][33][34] To ensure a supply of this agent, Joseph Rock, Professor of Systematic Botany at the College of Hawaii, traveled to Burma to procure seeds of the trees.
Numerous leprosaria, or leper hospitals, were founded in the Middle Ages; Matthew Paris, a Benedictine monk, estimated that in the early thirteenth century, there were 19,000 across Europe.
Withdrawal from everyday life was considered symbolic of ritually separating themselves from the world of the flesh, as a redemptive action, on behalf of the whole of society.
Robert Cochrane was the first to use DDS, the active component of promin, at the Lady Willingdon Leprosy Settlement, in Chingleput, near Madras, India.
John Lowe was the first to successfully administer DDS orally at Uzuakoli Leper Settlement, in Nigeria, in spite of indications that the drug was highly toxic.
[4] Later, Indian scientist Shantaram Yawalkar and his colleagues formulated a combined therapy using rifampicin and dapsone, intended to mitigate bacterial resistance.
The 44th World Health Assembly (WHA), held in Geneva in 1991, passed a resolution to eliminate leprosy as a public-health problem by the year 2000 – defined as reducing the global prevalence of the disease to less than 1 case per 10,000.
[45] Writing in the Encyclopædia Britannica 2008, Kearns and Nash state that the first mention of leprosy is in the Indian medical treatise Sushruta Samhita (6th century BCE).
[54] The asylum superintendents believe that this separation was beneficial in order to avoid infecting the children of diseased parents and to prevent further births.
McLeod and Robin D. S. Yates identify the State of Qin's Feng zhen shi 封診式 (Models for sealing and investigating), dated 266–246 BCE, as offering the earliest-known unambiguous description of the symptoms of low-resistance leprosy, even though it was termed under li 癘, a general Chinese word for skin disorder.
[16] This 3rd century BCE Chinese text on bamboo slip, found in an excavation of 1975 at Shuihudi, Yunmeng, Hubei province, described not only the destruction of the "pillar of the nose" but also the "swelling of the eyebrows, loss of hair, absorption of nasal cartilage, affliction of knees and elbows, difficult and hoarse respiration, as well as anesthesia.
