By John Magilton and Frances Lee
British Archaeology, Issue 104 (2009)
Introduction: St James’s hospital, Chichester, was founded in the early 12th century for eight leper brethren. Excavation of part of the cemetery provides a unique opportunity to study leprosy when the disease was at its peak until its virtual eradication from the British Isles, and to examine the varied afflictions of Chichester’s sick poor from the late middle ages until the later 17th century.
Leprosy (or Hansen’s disease) is a chronic condition caused by Mycobacterium leprae. In extreme cases, the individual’s face turns blotchy and lumpy, the nose has a foul discharge and the bridge of the nose eventually collapses. It commonly leads to bone changes, particularly to the skull and limb extremities, as a result of which it can be identified in the excavated bones of infected people. The skull alterations, consisting of inflammatory changes to the oral and nasal surfaces of the nose and smoothing of the nasal orifice, are caused by infection and erosion. Indirect changes of leprous infection result from nerve damage and loss of sensation: hands and feet suffer constant minor injuries which lead to ulceration, and infection spreading to the bone.
The oldest evidence for leprosy in Europe comes from a fourth-third century BC cemetery in Italy, at Casalecchio di Reno, Bologna, where a male skeleton exhibited many of the classic signs of the disease; in Britain it has been recognised in Roman skeletons at Cirencester (Gloucestershire) and Poundbury (Dorset). There was an epidemic in western Europe between around 1100 and 1300, when several thousand leprosaria, or leper hospitals, became home for afflicted people. While it remains a health problem today in South America, Africa and Asia, for reasons not fully understood, in 14th century Europe the disease died out in all but the remotest areas.