ok, this is the research that I am doing over a paper for science. I am copying all of my finds into this folder so I can read up on the subject before I attempt to type a four page paper over it.
Leprosy Research
Cause
Leprosy is a chronic disease caused by a bacillus, Mycobacterium leprae;
M. leprae multiplies very slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear;
Leprosy is not highly infectious. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.
Symptoms
Leprosy mainly affects the skin and nerves;
If untreated, there can be progressive and permanent damage to the skin, nerves, limbs and eyes;
Paucibacillary (PB) leprosy results in one to five numb skin patches;
Multibacillary (MB) leprosy results in more than five numb skin patches.
History
Leprosy was recognized in the ancient civilizations of China, Egypt and India;
The first known written mention of leprosy is dated 600 BC;
Throughout history, the afflicted have often been ostracized by their communities and families.
Treatment today
Leprosy is a curable disease and treatment provided in the early stages averts disability;
With minimal training, leprosy can be easily diagnosed on clinical signs alone;
A World Health Organization (WHO) Study Group recommended multidrug therapy (MDT) in 1981. MDT consists of three drugs: dapsone, rifampicin and clofazimine. This drug combination kills the pathogen and cures the patient;
MDT is safe, effective and easily administered under field conditions. MDT is available in convenient monthly calendar blister packs to all patients;
Novartis and the Novartis Foundation for Sustainable Development have made MDT available free of charge to all leprosy patients in the world. Through WHO, this MDT is provided to countries in sufficient supply to treat all people diagnosed with the disease.
High effectiveness of multidrug therapy
PB patients treated with MDT are cured within six months;
MB patients treated with MDT are cured within 12 months;
Patients are no longer infectious to others after the first dose of MDT. In other words, transmission of leprosy is interrupted;
There are virtually no relapses, i.e. recurrences of the disease after treatment is completed;
No resistance of the bacillus to MDT has been detected;
WHO estimates that early detection and treatment with MDT has prevented about three to four million people from being disabled. This suggests great cost-effectiveness of MDT as a health intervention, considering the economic and social loss averted.
History of treatment
The first breakthrough occurred in the 1940s with the development of the drug dapsone, which arrested the disease. But the duration of the treatment of leprosy was many years, even a lifetime, making it difficult for patients to follow;
In the 1960s, M. leprae started to develop resistance to dapsone, the worlds only known anti-leprosy drug at that time;
Rifampicin and clofazimine, the other two components of MDT, were discovered in the early 1960s.
The elimination of leprosy as a public health problem
Elimination of leprosy as a public health problem is defined as a prevalence rate on the global level of less than one case per 10 000 persons;
The widespread use of MDT has reduced the disease burden dramatically;
Over the past 20 years, more than 12 million leprosy patients have been cured. The prevalence rate of the disease has dropped by 90% and leprosy has been eliminated from 108 countries out of 122 countries where leprosy was considered as a public health problem in 1985.
Figures on the current leprosy situation
Approximately 755 000 new cases of leprosy were detected during 2001. At the beginning of 2002, 650 000 cases were registered and were undergoing treatment;
In 14 countries in Africa, Asia and Latin America leprosy is still considered a public health problem;
According to the latest available information, intensive efforts are still needed to reach the leprosy elimination target in six countries: Brazil, India, Madagascar, Mozambique, Myanmar, and Nepal. Taken all together, these countries account for 90% of the prevalence of the disease in the world in early 2002;
At the start of 2002, about 70% of the worlds registered leprosy patients are in India.
Actions and resources required
Political commitment needs to be strengthened in countries where leprosy remains a public health problem;
In order to reach all patients, treatment of leprosy needs to be fully integrated into general health services. This is a key to successful elimination of the disease. Strong leadership by ministries of health is absolutely necessary, especially in some of the major endemic countries;
Partners in leprosy elimination need to further accelerate activities and ensure that human and financial resources are made available for the elimination of leprosy;
The age-old stigma associated with the disease remains an obstacle to self-reporting and early treatment. The image of leprosy has to be changed at the global, national and local levels. A new environment, in which patients will not hesitate to come forward for diagnosis and treatment at any health facility, must be created.
The strategy for leprosy elimination
The following actions are part of the ongoing leprosy elimination campaign:
Ensuring accessible and uninterrupted MDT services available to all patients through flexible and patient-friendly drug delivery systems;
Ensuring the sustainability of MDT services by building the ability of general health workers to treat leprosy;
Encouraging self-reporting and early treatment by promoting community awareness and changing the image of leprosy;
Monitoring the performance of MDT services, the quality of patients care and the progress being made towards elimination through national disease surveillance systems.
To promote political commitment, leadership by ministries of health in endemic countries and partners support for leprosy elimination, the Global Alliance for Elimination of Leprosy (GAEL) was created in November 1999. Core members of the Alliance are governments of leprosy endemic countries, the Nippon Foundation, Novartis and WHO. The Alliance is co-operating closely with other national and international organizations, including the Danish International Development Agency (DANIDA), Handicap International, MORHAN, Pastoral da Criancia and the World Bank.
Definition of Leprosy
Leprosy is a chronic infectious disease which attacks the skin, peripheral nerves and mucous membranes (eyes, respiratory tract). Leprosy is also known as Hansen's disease because the bacillus which causes it was discovered by G.A. Hansen in 1873. It is most common in warm, wet areas in the tropics and subtropics.
Treatment of Leprosy
As of 1940, a treatment using dapsone is currently being used to suppress leprosy. Seldom is leprosy completely removed from the body; it can only be halted using a multi-drug treatment. Of the approximately two million cases (and half a million more each year), only one million are being treated in this way.
In addition, patients are taught to take care of themselves using a kind of visual check if they have significant nerve damage. Without the sensations of pain to identify cuts and bruises, patients must watch themselves constantly or be subject to dangerous infection.
What Leprosy Looks Like
Leprosy is characterized by multiple lesions accompanied by sensory loss in the affected areas. Usually, sensory loss begins in the extremities (toes, fingertips). In many advanced cases, gangrene sets in, causing parts of the body to "die" (necrosis) and become deformed.
Social Effects
Leprosy in all ages has been considered one of the more despicable diseases, and victims have been despised throughout history and kept in separate places (leper colonies, sanitariums). Even today, most people with leprosy are shunned by their neighbors and are held at arms length.
In the medieval period, leper colonies sprung up where victims of this then-untreatable disease would go to slowly die from the illness.
Leprosy throughout the Ages
by Eleanor E. Storrs
Until the coming of AIDS, leprosy was the most feared of infectious diseases. Even today, it warps the lives of millions of people; mostly in South America, Africa, and the Orient. The Black Death that swept though Europe in the last half of the 14th century, killing one third of the people, was more violent in its ravages. But it came and went quickly, like a great earthquake, followed by a series of after shocks.
Leprosy has tormented humans since the dawn of history; leaving lasting imprints on religion, literature, and art. It is a deep rooted part of the human psyche, with both mystical and physical meanings. Asians and Africans call it "the big disease" in many tongues because of the damage done to soul and body of those cursed with it.
We know nothing certain about the origins of leprosy, except that it is old, very old. An account of a disease that could be leprosy appears in an Egyptian papyrus inscribed about 1552-1350 B.C. But this is an imaginative guess, made by modern scholars that could be wrong.
Indian writings dated at 600 B.C, describe a disease that most experts agree was leprosy. It does not appear in the records of ancient Greece until the army of Alexander the Great came back from India in 326 B.C. In Rome, the first mention coincides with the return of Pompey's troops from Asia Minor in 62 B.C. Thus Asia could be the cradle of infection.
A Biblical Curse
The Bible often mentions a disease called leprosy. The words leprous or leprosy appear 54 times. It is from these accounts that the disease became linked to corruption of both spirit and body. The Book of Leviticus paints a chilling image of these ancient fears.
And the leper in whom the plague is, his clothes shall be rent, and the hair of his head shall go loose, and he shall cover his upper lip, and shall cry, unclean, unclean. And all the days wherein the plague is in him he shall be unclean; he is unclean: he shall dwell alone; without the camp shall his dwelling be.
The Bible equated this sickness with sin. It was a punishment by God for transgression. Thus Uzziah, King of Judah, wanted to burn incense in the temple of Jehovah, a ceremony reserved for priests. The priests opposed him, and Uzziah became angry. God struck him with leprosy.
And Uzziah the King was a leper unto the day of his death, and dwelt in a separate house, being a leper; for he was cut off from the house of Jehovah . .
The priests did not drive Uzziah into the wilderness like lesser sinners, but stripped him of power and denied him burial in the cemetery of kings.
The New Testament treats lepers more kindly, but even so, sets them apart from other sufferers. Jesus healed the blind and deaf but cleansed the lepers, implying a moral stigma. And then came a leper to him, beseeching him, and kneeling down to him, and saying unto him, "If thou wilt thou cans't make me clean." And Jesus, moved with compassion, put forth his hand and touched him, and saith unto him, "I will; be thou clean." And as soon as he had spoken, immediately the leprosy departed from him and he was clean.
During the early years of Christianity, healers looked at lepers with revulsion, and priests considered them depraved. Aretaeus of Cappadocia, a physician of the early 2nd century wrote:
When in such a state who would not flee- who would not turn away from them, even a father, a son, or a brother? There is danger also from communication of the ailment.
The Church ordered regulations against lepers at the Council of Ancyra in 314 A.D., defining them as unclean persons, bodily and morally. People classified as lepers included heretics.
Medieval Myths
By the Middle Ages, priests and savants accused lepers of a host of sins: they angered easily, suspected others of wanting to hurt them, had grievous dreams, and were schemers and deceivers. Medical writers of the era thought they threatened society; not only through infection, but by evil behavior.
Most of them warned that they burn with carnal desire, branding leprosy as a venereal disease. Priests sometimes gave them mock funerals before thrusting them out of society.
Within the church let a black cloth . . . be set upon two trestles at some distance apart before the altar, and let the sick man take his place on bended knees beneath it between the trestles, after the manner of a man dead . . . and in this posture let him devoutly hear mass . . . The priest then with the spade cast earth on each of his feet saying: "Be thou dead to the world, but live again unto God."
The priest then led him into an open field and forbad him to enter churches or houses; wash his hands or clothes in springs or streams; wear anything but a leper's cloak; touch anything he wanted to buy; enter taverns to buy wine; or to lie with any woman but his wife. The priest told him never to talk to people unless down wind from them; never touch railings without gloves; never touch children or give them gifts; and never eat and drink with people other than lepers.
He must always wear the grey or black mantle of a leper, and not use the dishes and spoons of others. He must warn people of his miserable presence with horn, clapper or bell; and beg for alms with a bag tied to the end of a long stick.
These were the rules imposed on lepers. Of course, they also had to obey the commandments of Moses. The medieval church left them a legacy of shame, degradation and rejection.
Leprosy Strikes Britain
We do not know when leprosy came to Britain, but by the 11th century it was a grievous plague. The first Norman Archbishop of Canterbury, Lanfranc, founded a leprosy hospice at Harbledown, near the cathedral, sometime between his arrival in England in 1070 and death in 1089.
Queen Matilda, daughter-in-law of William the Conqueror, endowed a hospice for leprosy victims outside the gates of London in 1101, and dedicated it to St. Giles, the patron saint of outcasts. At her behest, the lepers gave a "Cup of Charity" to condemned prisoners as they passed the door of the hospice chapel on their way to the gallows at Tyburn.
Many other hospices, sometimes called lazar houses, were founded before the end of the 11th century. When the Black Death swept through the land, there were 200 in Britain alone and as many as 20,000 in Europe. But the number of patients in each was small, ranging from one to a hundred. An extreme case was St. Giles in Norwich- it had one master, eight chaplains, two clerks, seven choristers, two nuns and eight lepers- a classic case of featherbedding.
Even with this proliferation of hospices, there were probably no more than two thousand lepers living in them out of a population of three million. But I suspect that these were only for the well-to-do. Poor villagers ravaged by leprosy probably fled to fens and forests, as happened in Louisiana in recent times.
If lepers were moral outcasts why were some of them provided for so abundantly? The attitudes of priests, nobles and kings differed with place and time; so treatment ranged from good to bad, with bad prevailing. Some priests thought the disease was a gift of God, because He chose lepers to bear one of the heaviest burdens of man. Others saw in leprous skin the brand of spiritual rot. Thus lepers were seen as both holy and sinful. God gave them special grace, or punished them for their sins.
Royal Attitudes, Royal Victims
Some kings loathed lepers. Philip V of France and Henry II of England had them burned at the stake without religious rites. Edward I, Henry's great grandson, was more charitable. He allowed them ritual funerals. Afterward, he had them carted to cemeteries and buried alive.
Other kings were compassionate. Henry III, father of Edward and son of John of Magna Carta fame, authorized the lepers of Bridgenorth to gather one horse-load of wood daily from the royal forest. Eight years later he made the same donation to the lepers of Shrewsbury.
Why these differences in outlook? They were probably reflections of personal traits. Henry II was an empire builder who abetted the murder of his archbishop, Thomas Becket. Edward I was a fearsome fighter who crushed the Scots at Dunbar and Falkirk. History remembers Henry III and his father John for their weaknesses. They may have felt they needed God's aid, and sought the prayers of anyone who could help them get it, even the leper's.
Yet Henry II had mixed feelings about lepers. He gave 40 marks to Harbledown hospital while on a pilgrimage to Canterbury to do penitence for the murder of the Archbishop. He may not have done this entirely from remorse. In 1158, during a visit to Paris, he made gifts to lepers and the poor, 12 years before Becket's murder.
Some kin of these kings were lepers. These include Henry II's daughter-in-law, Constance of Brittany, and his cousin Baldwin IV, the "Leper King" of Jerusalem. The disease blinded Baldwin; so he appointed regents. This led to power struggles among the nobles. He finally had to yield his throne to a five year old nephew.
Henry IV, the first Lancastrian King of England, died of an ailment that many people thought was leprosy. A skin disease ravaged his face so badly that he was repulsive to behold. There is no proof he had leprosy. But he had usurped the throne of his cousin Richard and possibly murdered him. In the eyes of his enemies, this crime and his mottled face equated him with a leper.
Robert the Bruce
The case of Robert the Bruce of Scotland is puzzling. We saw his bones displayed at a leprosy congress in Norway, where they were on loan from a Danish museum to show how leprosy causes bone damage. We were curious to learn how the remains of Scotland's greatest hero, the victor of Bannockburn, wound up in a foreign museum. We tried to visit the museum while in Copenhagen, but it was closed when we arrived.
We picked up the trail again in Scotland. Bruce died in 1329 of a mysterious ailment called the " great malady." He was ill for only two years, and his physicians did not quarantine him. No one mentioned leprosy until a generation later. Yet many reference books give it as the cause of his death.
He was buried at Dunfermline Abbey, and the site of his tomb forgotten. It was rediscovered in 1812. His skull was pitted and the upper jaw and nose eroded by disease. The people we talked to claimed he died of syphilis instead of leprosy. Physicians often confused these diseases in the middle Ages.
A cast of his skull is in the Anatomy Department of University of Edinburgh. The mysterious bones we saw in Norway were those of a man ravaged by leprosy, but are unlikely to be Bruce's.
We can add a curious postscript to this story. In a film called Braveheart Robert the Bruce, the eighth of his name, is portrayed as a clear skinned warrior. However, Hollywood showed his father, Robert the seventh, as a horribly disfigured leper. This old legend simply will not die.
The Stigma
What was this medieval leprosy that preyed on kings and commoners? Was it the disease we know today? In the minds of many, leprosy is not just a disfiguring disease: it is a disgracing disease. But its victims have done nothing to merit disgrace.
To ease their lot many caring people have looked for ways to soften the impact of the dreaded word. Some want to abolish it altogether and substitute Hansen's disease, after the discoverer of the leprosy bacillus. Others have sought to cleanse the word by showing that the aura of evil attached to it arose from accidents of history. They base their arguments on word origins, descriptions of disease and old works of art.
Most medieval savants thought that leprosy was the Biblical disease tzaraat, a Hebrew word used to describe ritual impurity associated with a skin ailment. When the scholars of Alexandria translated the Old Testament into Greek, they rendered tzaraat as lepra. The Greek lepra, meaning scaly, was a skin disease that is now unknown, but was not leprosy. About 300 B.C., physicians of Alexandria described a type of leprosy that they called elephas. In some way, the symptoms of elephas became associated with lepra that had acquired overtones of evil from tzaraat. Thus, the mystique of medieval leprosy may have resulted from fusion of three nuclei. The Greeks gave a name and the Hebrews an aura of evil to a disease described by Egyptians.
Most physicians do not think that Biblical leprosy was the disease we know today. Symptoms of tzaraat appear in many patients, but not in the same combinations mentioned in the Bible. It is likely that tzaraat was a state of ritual impurity associated with several skin diseases. Leprosy might have been one of them.
Paintings of Biblical and historic characters preserve the medieval image of leprosy. Among these are Miriam, Naaman and Emperor Constantine. But artists of the time often pictured the disease in a stylized way that lacks interpretive value. Typically, they showed the victim with bright red spots of the same size distributed uniformly over his body.
European artists used this convention from the 9th through the 15 centuries. By the 16th century, paintings began to show deformities of face and limbs. Leprosy in the late middle Ages was the same disease we know today.
Decline in Europe
The disease began to wane in Western Europe at the close of the middle Ages. Once rampant in Britain, by the 18th century it lingered only in the Shetland Islands. It reached a late peak in Norway during the 19th century, but the last leprosy hospital there closed in the 1950s. Physical disease receded, but reverberations of moral corruption linger in our language. Thus William Cowper wrote:
When nations are to perish in their sins,
tis in the church the leprosy begins.
In the 19th century, Tennyson associated leprosy with morality in his phrase:
A moral leper, I,
to whom none spoke.
Clearly, the words leper and leprosy carry overtones of evil.
Association of leprosy with sin is not unique to Western culture. Chinese and Hindu attitudes were similar, although for different reasons. Mohammedans claim they were more tolerant. Yet in 1253, Saracens killed all the lepers living in the hospice of the Order Hospitalier St. Lazare de Jerusalem.
Medical science did not vanquish leprosy in Europe. The reasons for its recession are still debated, and are still unknown. While it faded in Europe, it is still a major problem in Africa and the Orient. Explorers and settlers spread it throughout South America and the languid isles of the South Seas.
The stigma associated with leprosy perished for all time with the discovery that the disease occurs naturally in wild armadillos. Before then, many believed that leprosy was a unique punishment inflicted by God on humans for their sins. Now it must be looked upon as a bacterial infection devoid of religious significance. The mystique surrounding leprosy had started to collapse in Hawaii a century before.
Pestilence in Paradise
Hawaiians, long isolated from the rest of the world, were highly susceptible to white men's diseases. When leprosy struck, the authorities rounded them up and dumped them like trash on the shores of the island of Molokai. There they lived like starving animals stripped of humanity.
This time their exile could not be blamed on ancient priests or medieval kings, but on our own people; descendants of New England missionaries who had settled there only 50 years earlier. Father Damien, a Catholic priest of Belgian birth, heard of their plight and hastened to Hawaii to help them. He wrote:
For ten years past this scourge has spread itself in our archipelago in so frightful a manner that the government deemed itself obliged to exclude from the society of other islanders all those infected with it. Now these unfortunates, confined to a corner of the island of Molokai, hemmed in by impassable mountains and the seashore, are in perpetual exile. Of more than 2,000 conveyed here, 800 are still living . . .
We visited Molokai in 1984. A rim of cliffs towering to 4,000 feet bounds the north shore. Crouched beneath them lies a peninsula, two to three miles wide at cliff base, that juts two miles into the sea. A baby volcano burped up this sliver of land millions of years after monstrous bursts of lava flung Molokai above the water. Now it's little more than a green mound, its crater filled with grasses and scrub.
Calm beaches rim the west shore where the leprosarium now stands. But ragged volcanic rocks, flanked by stubs of black basalt, their tops rounded by pounding surf, guard it in the east. This was the rugged site of Kalawao, the final destiny of many exiles.
From anchored ships, sailors heaved supplies and cattle overboard to be hauled in by the few able bodied men of the colony. Then they rowed the newcomers to shore in longboats, to join the maimed hosts that preceded them. Food was poor, shelter scanty, the community lawless. There was no way out by land or sea.
When Father Damien came to Molokai, he found a small chapel dedicated to St. Philomena, but little else. For awhile he slept under a tree, but with the help of gifts from Honolulu, built a small house. From there he wrote of his charges:
These spots (caused by leprosy) cover the whole body, and sores appear on the feet and on the hands. The flesh decays and yields an infectious odor. The breath of the lepers poisons the air . . . I sometimes experience a feeling of repugnance. I am quite puzzled how to administer extreme unction when the hands and feet are but one sore. It is the sign of approaching death.
Damien choked down his repugnance, and strove to fill the needs of his flock. He bettered food supplies, built shanties and taught order to a lawless community. He always prayed with the dying, no matter how foul their sores.
With the help of those who could work, he built a road to the west shore of the peninsula, Kalaupapa, where St. Francis' church and the leprosy hospital now stand. There the shore is sandy and the surf mild. Eleven years into his self-imposed exile, Damien found he had leprosy. He had long been in the habit of beginning his sermons with "We lepers . . . "
Now it was true. His plight stirred sympathy throughout the world for Damien and his cause. Help came to Kalawao. Brother Joseph Dutton, an American Civil War Veteran, came to share Damien's burdens. Mother Marianne and her group of Catholic Sisters opened a school for girls, children of leprosy victims, at Kalaupapa, the" clean" coast of the peninsula.
Martyr of Molokai
Sympathizers throughout the world mourned Damien's death. Robert Louis Stevenson, then a journalist, visited Hawaii to write the story of the "Martyr of Molokai." It was well he did, since Damien had enemies, even after death.
One of them, Dr. Hyde, a Presbyterian minister from Honolulu, wrote a letter to a newspaper saying Damien was coarse, bigoted and immoral. Stevenson wrote a thundering reply that shook the conscience of the Protestant world. Point by point, he ripped Hyde to shreds:
"Damien was coarse" . . . you make us sorry for the lepers who had only a coarse old peasant for their friend and father . . . "headstrong" . . . I thank God for his strong head and heart! "Damien was bigoted" . . . in him his bigotry, his intense and narrow faith, wrought potently for good, and strengthened him to become one of the world's heroes and exemplars.
Damien's martyrdom, magnified by Hyde's stupidity and Stevenson's eloquence, marked a turning point on how the world looks at lepers. People finally realized they were victims of disease, not depraved monsters.
In 1936, Belgium moved Damien's body from Molokai to Louvain with all the panoply the nation could muster. Left behind were the remains of his helpers and followers, Brother Dutton and Mother Marianne. It would have been better to have left Damien to rest with them.
When we visited Molokai, the hospital had ceased taking new patients. The Medical Director, Dr. Oliver Hasselbladt, told us the grounds would become a National Monument when the last old leprosy patient died. "If the church ever canonizes Damien," he said, "these grounds will become as holy as Lourdes.
Cajun Country
Leprosy is still endemic in Hawaii and six mainland states, including Louisiana. Early settlers or slaves from Africa might have brought it there during French and Spanish colonial days.
Or French Canadians could have carried it when the British expelled them from Acadie in the 18th century. Physicians found leprosy in their homeland, New Brunswick, in 1817. It must have been there much earlier.
Longfellow told the story of their exile in his epic poem about Evangeline and her lover Gabriel. In real life, his heroine was Emmeline LaBiche. She landed at St. Martinsville, a town on Bayou Tech, about 12 miles north of my home in New Iberia, to find that Gabriel, in real life, Louis Arceneaux, had married another woman.
These Acadians, now called Cajuns, fanned out along the southwest coast of Louisiana, and are the dominant ethnic group in a 22 parish region known as Acadiana. During my life there, I heard many tales about local people with leprosy.
A family named Landry had two children with the disease, people said. They lived in an attic to hide from health officials. A nurse with long experience in the area told me that many leprosy victims had taken refuge in remote parts of the Atchafalaya Basin; a vast wilderness of slow waters hemmed in by levees. A great flood drove more than 40 of them to high ground, where people saw them wandering in nearby hamlets.
Denis Comeaux caught many armadillos for me, but I never met him. He had a corroding skin disease and shunned outsiders. All my contacts with him were through his family. One day I went to his house to collect animals. His wife said he had died. I will never know for sure if Denis had leprosy.
Much later I learned that people who handle armadillos can get leprosy from them. I also found many wild armadillos with leprosy in the area where Denis lived.
Leprosy was part of New Iberia folklore and had a long history in Louisiana. We know the disease occurred in New Orleans in colonial days, since a hospice called La Terre de Lepreax stood near the city then. But in 1804, New Orleans physicians claimed they were unable to find it among local residents.
There the question rested until 1872, when Dr. W.G. Kibbe of Abbeville, about 20 miles west of New Iberia, sent Felecien Ourblanc to New Orleans for examination by Dr. Joseph Jones. Felecien had leprosy.
The Road to Carville
During the next few years, physicians found other cases near Abbeville. They made additional surveys in New Orleans and rural Louisiana. By 1892, they concluded that leprosy, formerly thought to occur only in people of foreign birth, was endemic in Louisiana, mostly among whites.
The state selected a smallpox hospital in New Orleans, managed by Dr. J. C. Beard and his son, for care of patients. The hospital got little attention until 1893. A reporter from the Daily Picayune wrote a story about a girl from New Iberia with leprosy. She was shipped to New Orleans in a boxcar labeled freight, and lodged in Dr. Beard's "Pest House." The reporter visited her, and in his article claimed neglect and possible starvation.
This scandal forced the legislature to set up a State Board of Control. Health officers suggested many sites for a home for lepers near New Orleans, but property owners opposed them. Finally, the state leased Indian Camp Plantation on a bend of the Mississippi, about 85 miles up river. Physicians thought this would be temporary and hoped to find a site closer to Charity Hospital. But property owners fought all attempts to relocate in the city. Finally, the state bought Indian Camp Plantation, and gave it a new name - Louisiana State Home for Lepers.
The home was isolated and run down, and there was no resident physician most of the time it was under state control. On January 3, 1921, the Federal Government annexed the property and patients. It became the first and only U.S. Public Health Service Hospital devoted exclusively to leprosy. Most people know it as Carville.
In March of 1968, I went to Carville to propose use of the armadillo as an animal model for leprosy research. This visit was the first step in an agonizing collaboration with U. S. Public Health Service that would endure for four years.
Cajun Country
Leprosy is still endemic in Hawaii and six mainland states, including Louisiana. Early settlers or slaves from Africa might have brought it there during French and Spanish colonial days.
Or French Canadians could have carried it when the British expelled them from Acadie in the 18th century. Physicians found leprosy in their homeland, New Brunswick, in 1817. It must have been there much earlier.
Longfellow told the story of their exile in his epic poem about Evangeline and her lover Gabriel. In real life, his heroine was Emmeline LaBiche. She landed at St. Martinsville, a town on Bayou Tech, about 12 miles north of my home in New Iberia, to find that Gabriel, in real life, Louis Arceneaux, had married another woman.
These Acadians, now called Cajuns, fanned out along the southwest coast of Louisiana, and are the dominant ethnic group in a 22 parish region known as Acadiana. During my life there, I heard many tales about local people with leprosy.
A family named Landry had two children with the disease, people said. They lived in an attic to hide from health officials. A nurse with long experience in the area told me that many leprosy victims had taken refuge in remote parts of the Atchafalaya Basin; a vast wilderness of slow waters hemmed in by levees. A great flood drove more than 40 of them to high ground, where people saw them wandering in nearby hamlets.
Denis Comeaux caught many armadillos for me, but I never met him. He had a corroding skin disease and shunned outsiders. All my contacts with him were through his family. One day I went to his house to collect animals. His wife said he had died. I will never know for sure if Denis had leprosy.
Much later I learned that people who handle armadillos can get leprosy from them. I also found many wild armadillos with leprosy in the area where Denis lived.
Leprosy was part of New Iberia folklore and had a long history in Louisiana. We know the disease occurred in New Orleans in colonial days, since a hospice called La Terre de Lepreax stood near the city then. But in 1804, New Orleans physicians claimed they were unable to find it among local residents.
There the question rested until 1872, when Dr. W.G. Kibbe of Abbeville, about 20 miles west of New Iberia, sent Felecien Ourblanc to New Orleans for examination by Dr. Joseph Jones. Felecien had leprosy.
The Road to Carville
During the next few years, physicians found other cases near Abbeville. They made additional surveys in New Orleans and rural Louisiana. By 1892, they concluded that leprosy, formerly thought to occur only in people of foreign birth, was endemic in Louisiana, mostly among whites.
The state selected a smallpox hospital in New Orleans, managed by Dr. J. C. Beard and his son, for care of patients. The hospital got little attention until 1893. A reporter from the Daily Picayune wrote a story about a girl from New Iberia with leprosy. She was shipped to New Orleans in a boxcar labeled freight, and lodged in Dr. Beard's "Pest House." The reporter visited her, and in his article claimed neglect and possible starvation.
This scandal forced the legislature to set up a State Board of Control. Health officers suggested many sites for a home for lepers near New Orleans, but property owners opposed them. Finally, the state leased Indian Camp Plantation on a bend of the Mississippi, about 85 miles up river. Physicians thought this would be temporary and hoped to find a site closer to Charity Hospital. But property owners fought all attempts to relocate in the city. Finally, the state bought Indian Camp Plantation, and gave it a new name - Louisiana State Home for Lepers.
The home was isolated and run down, and there was no resident physician most of the time it was under state control. On January 3, 1921, the Federal Government annexed the property and patients. It became the first and only U.S. Public Health Service Hospital devoted exclusively to leprosy. Most people know it as Carville.
In March of 1968, I went to Carville to propose use of the armadillo as an animal model for leprosy research. This visit was the first step in an agonizing collaboration with U. S. Public Health Service that would endure for four years.