Volume 70. Number 4Printed in the U.S. A .

(ISSN OI48916X)

INTERNATIONAL JOURNAL OF LEPROSY

Saints Protectors from Leprosy: Historical Hints ofSuggestive Therapy?'

Amir Muzur, Ante Skrobonja, Vlasta Rotschild, and Ante Skrobonja, Jr. 2

The invocation of saints, motivated bythe belief that they are able to cure diseases,is a wide-spread phenomenon not only inthe popular Christian culture, but in otherreligions as well. However, the level of"specialization" of certain saints for partic-ular diseases has nowhere reached such va-riety and sophistication as it did in Christiantradition. These "specializations,'' oftenbased upon very simple linguistic associa-tions with the saint's name or iconography(I"), reveal not only the wit of the commonfolk, but also the pathology that was pre-vailing in a certain region, and the ideasabout that pathology and Lighting it at thetimes when medical knowledge was gener-ally scarce and unavailable ('').

As in the case of some other diseases andsyndromes, leprosy (Hansen's disease) wasa target of the "specialization'' of severalsaints. The first description of leprosy in theWest was provided not by the HippocraticCorpus or Galen, but by Avicenna in the10th century. In the Middle Ages, leprosywas spread all over Europe, but afterward italmost disappeared and became only spo-radic, anchored mainly in rural areas. Thedisease remained present in Scandinaviauntil late in the 19th century ( 5 ),

Interestingly, while in the West, leprosywas the symbol of terror, danger, isolation]sep iralio leprosun► (')], and outcastedness,

' Received for publication on 9 July 2002. Acceptedfor publication on I Aug ust 2002.

'A. Muzur, M.D., M.A., Ph.D., Laboratory of Neu-rophysiology, Department of Psychiatry. HarvardMedical School, Massachusetts Mental Health Center,74 Fenwood Road, Boston, MA 02115, U.S.A.; A.Skrobonja, M.D., M.Sc., D.Sc.; V. Rotschild, D.D.S.,M.Sc., Department of History of Medicine, School ofMedicine, University of Rijeka, Rijeka, Croatia: andA. Skrohonja, Jr., M.D., Health Center Rah. Rah.Croatia.

Reprint requests to: Dr. Amir Muzur at the aboveaddress or Telephone: 617-626-9475; Fax: 617-73.1-7851; E-mail: astir enuur@hmis.parvttrd.edu

in Islamic culture, the leper has neitherbeen exiled nor perceived as repulsive ( 7 ).

Reflecting the pathology of the time pe-riod, reports of miraculous healings of lep-ers were not rare in medieval Europe. De-parting from the strong belief that a criticalanalysis of more general historical sourcesand cultural context can offer relevant hintsfor the enrichment of the spectrum of mod-ern medical treatment, this paper intends topresent a short overview of the most vener-ated Christian traditional protectors fromleprosy and to try to suggest some possibleindirect effects of their invocation.

MA'T'ERIALS AND METHODSThe following overview of the saints was

complied from various literature, while theexample of St. Bernardino of Siena's heal-ing was found in primary sources. The crit-icism of the sources is provided in the Dis-cussion section.

RESULTSIn Christian tradition, the most venerated

saints invoked for protection against leprosyor for its cure, are Lazarus, Aegidius (Giles),Sylvester, George and Vincent de Paul.

There are at least two different Lazarusesin Christian tradition. One was Lazarusfrom Betania, who was resurrected byChrist according to the Gospel of John. An-other Lazarus was a poor leper, assistedonly by dogs that used to lick his sores.Lazarus' antipode was a rich man caring fornothing but his own pleasure. After theyboth died, according to the Gospel of Luke,the rich man suffered terrible torments,while Lazarus enjoyed being at Abraham'sside. It was this second Lazarus who shaped

In this paper, the term "leper'' is used only becauseit was necessary for historical accuracy. The authorsare fully aware of the otherwise inappropriateness andunacceptability of this terns.

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the cult of the saint venerated for protectionagainst leprosy. An order founded in the12th century was named after him that pro-vided nursing care for lepers. and the late-medieval quarantine hospitals were named"Lazarettos— (although they were not in-tended for lepers, but mainly for those in-fected by the plague) (").

Aegidius was born in the 7th century inAthens, Greece, but later transferred to theSouth of France to live as a hermit in acave. He was wounded in an accident by anawkward royal hunter, and the King, in try-ing to compensate the hermit, founded amonastery where Aegidius lived until hisdeath in c. 724. Aegidius is most ofteniconographically presented together with ahind that nourished him with her milk dur-ing his hermit life. Following this associa-tion, the popular tradition venerates Aegid-ius also as a protector of lactating mothers.One of the legends on Aegidius mentionshis curing lepers by touching them (").

Sylvester was a Roman hishop and Popefrom the 4th century. According to a legend,he cured Emperor Constantine from leprosyafter he had persuaded him to accept Chris-tianity (").

George is the hero of the Golden Legend,telling the story of his killing a dragon thatwas eating maidens. He died in c. 304 inPalestine after being tortured and beheaded.Beside being the patron of several Euro-pean nations (England, Germany, Greece,etc.) and cities (e.g., Ferrara), he has beeninvoked as a protector front herpes, skindiseases, syphilis, and, for unknown rea-sons, leprosy (' 1 ).

Vincent de Paul (1581-1660) was an intel-ligent peasant from southwest France, whobecame a priest. During his exciting life, hewas enslaved by the Turks and freed afterhe had converted his owner to Christianity.He organized helping the poor and nursingthe sick, and became the chaplain at theroyal court. In addition to lepers, prisoners,charitable workers, and many others consid-ered Vincent de Paul to be their patron (").

Occasionally, many other saints provedto be successful in curing leprosy, althoughthey may eventually have "specialized" inother diseases. A particularly interesting re-port can be found in the hagiographies ofBernardino of Siena (1380-1444), an excel-lent popular and innovative preacher who,

after he had introduced the cult of a platewith Jesus' name, had to face the accusationof heresy. Bernardino of Siena healed aleper in a story with almost belles letirescharacteristics. The leper was given Ber-nardino's footwear (calccos; sanclale) bythe Saint himself. After he had left the city,he felt stones in the new shoes. When theleper took off the shoes, he noticed that hislegs had been cured up to the knees (adgemia). Shortly afterwards, when he in-tended to empty the sandals of sand, he no-ticed that he was cured ad rent's (that is, upto the back: strange that one has to removeshoes in order to find out the state of theback). The third time, after having repeatedthe same procedure, the leper was curedcompletely (' ").

DISCUSSIONThomas Aquinas recognized three groups

of miracles. The first group contains phe-nomena which are not feasible by any nat-ural power (e.g., that the sun reverses itscourse). Miracles from the second groupare events that can occur, but not in this par-ticular subject (e.g., speech in a dog, aman's flying). The miracles of the thirdgroup, on the other hand, are those whichare feasible by natural powers, but not inthis manner or with this speed (e.g., the in-stant cure of a leper) (').

Analyzing miracles certainly is not aneasy task. However, an enormous corps ofliterature speaks about miraculous beatings,relating some of them to the cases of lep-rosy, and both our scientific consciousnessand curiosity prevent us from neglectingthem. Some of the cases described probablycan be discarded as parabolas and literarytohoi that served some other aims thanmedical reporting. Since the laws regardingthe extremely long incubation period of thisdisease ready symptoms appear 3 to 5 yearsafter infection, but clinical evidence of in-fection may appear in as little as 6 months,or as long as 20 years'' (')] were hardlyknown, it was probably considered a mira-cle every time someone touched a leper anddid not become infected. On the other hand,the disfigured areas of the body are usuallycovered by lepers; therefore, the leper him-self cannot observe the possible gradual de-clining process. When he/she notices the im-provement, immediately after contact with

70, 4^Mu.,-.1o; et al.: Saints'^Leprosy^271

a saint, he ascribes the merit to the invoca-tion, as might have been the case describedin the story of St. Bernardino of Siena.

Indeed, some cases of real healing proba-bly occurred, since it is well-known that thelesions caused by tuberculoid leprosy, a lessmalignant form than the Iepromatous, mayheal spontaneously ( 12 ). But, as an infectiousdisease, leprosy certainly must also be influ-enced by the psycho-neuro-immunologicalaxis. It was Rossi and Cheek who stirred upour modern, scientifically-based interest inthe topic of the use of suggestion in medicaltreatment. The limhic-hypothalamic systemhas been defined as "the locus of informa-tion transduction from the neural incodingof the languages of the mind (thoughts, sen-sations, etc.) into the messenger molecules"( 21 ). The hypothalamus was shown to beable to activate the sympathetic-system con-trol centers via the lower brain-stem relaystations (heart rate, blood pressure, bodytemperature, gastrointestinal activity, etc.)(`"). Hypothalamic nuclei are directly con-nected with the pituitary gland as well, thusopening new pathways for influencing theentire endocrine system. The hypothalamusitself sifts oxytocine and vasopressine, de-posing them into the rear pituitary lobe,while the releasing factors such as CRF,GI IRF, TRH, CRI I, etc., produced by hypo-thalamus, dictate the release or inhibition,respectively, of the release of the anterior-pituitary hormones such as ACTH, prolactin,etc., which control the reproductive, sexual.metabolic, and vegetative body regime ("')By using these connections with the sympa-thetic and endocrine system, suggestionscan (always via the hypothalamus) provokesignificant reactions of the immune systemas well. The major immunoregulatory or-gans (lymph nodes, spleen, thymus) are fur-nished plentifully with the nerve fibers ofthe autonomic system ('"). Certain hypotha-lamic lesions were found to provoke sup-pression in the number of the splenocytesand thymocytes and to result in a decrease illantibody production ('). Cells secreting In-terleukin-1, the neuromodulator with im-munological effects and a possible role inhealing neural damage, have also beenfound in the hypothalamus

Obviously, modern science has collectedsignificant evidence that suggestion may beable to influence health and disease. Where

might the suggestive power of the saints/protectors originate'? It is to be assumed thata major role in believing in miraculous curewas the conception of the development ofdisease, and, hence, of its elimination. Inthe Middle Ages, the appearance of the dis-ease was mainly attributed to moral causesI i.e., sins O1. To that supposition, one hasto add a constant referral to Biblical andother parabolas claiming that the cure waspossible, as well as the fact that most of thesaints have disposed of various suggestion-conducive characteristics (i.e., unusualphysical marks, bizarreness, or even psy-chopathological traits). Some saints, like St.Francis of Assisi, even used to evoke popu-lar adoration by kissing lepers. The mind ofa leper certainly was prepared to receive asuggestive influence. After all, having beenproclaimed "dead unto the world, but aliveunto Christ" and having already left all pri-vate property to the heirs ('S) the leper didnot have much to lose.

There were even saints, like St. Abbo,who, quite prophetically, instructed lepersthat "only the lepers' own faith can curethem" (' 3). SS Cyr and John composed awitty "test of faith," requiring the patientsto load themselves with a donkey pack-saddled and to shout, "I am an imbecile,completely deprived of intelligence!," or toslap the face of the first passerby, or to eat apoisonous snake, or to dig himself into thesand of a neighboring beach. It was said inthe same legend that a leper, who had beenadvised to cover his body with camel clung,did cover his body, but not his face and,therefore, only on his face, leprous traces re-mained ("). For practicing their "method,"SS Cyr and John were accused of using thewell-known Hippocratic and Galenianremedies, and to us, this approach seemsvery original, and correctly based on thesuggestion-healing principles.

As expected, in our short overview of tra-ditional Christian saints invoked for protec-tion against leprosy, one encounters onlyancient and medieval saints (Vincent dePaul being the youngest one), which coin-cides well with the presence of leprosy inEurope. It is, however, essential to remem-ber that, since leprosy has been even moreconstantly present in other parts of theworld, the reports of miraculous healingscan be found in other religions and cultures

272^ International Journal of Leprosy.^ 2002

as well. In the opus on the life and deeds ofSri Caitanya, there is mention of the leperVasudeva, who came to the house of Kurn iato see Caitanya Mahaprabhu, but he (Va-sudeva) heard that the Lord had alreadyleft. "When Vasudeva started to moan fornot having seen Caitanya Mahaprabhu, theLord came back and embraced hint. Assoon as the Lord touched him, both his lep-rosy and his misfortune disappeared.'' (")Maybe under Christian influence. in certainregions (Nepal and Punjab, for instance)Muslin saints specialized as well, e.g.,Sakhi Samar for eye complaints, MakhdumSahib for eye diseases and exorcisms,Shaikh Saddu for melancholy, Guga Pir andMadar Shah for snake bite, Pir Jahaniya forleprosy, etc. H.

in conclusion, we would like once againto stress the importance of a criticalapproach to historical medical and non-medical sources. However, as we hope tohave proved by this paper, those materialsmay become a precious source of modernmedical considerations. Present scientificknowledge on psychoneuroimnnunologicalinteractions may shed important light onmedieval miracle reports. Hopefully, thosereports might provide suggestions for en-riching modern medical treatment and, inparticular, for increasing the successfulbondage between patient and physician.

SUMMARYA short overview of several saints, vener-

ated in Christian tradition as protectorsfrom leprosy, is offered as an introductionto a more substantial debate on the possibil-ity and sense of analyzing historical sourcesand the use of their interpretation for modernmedical practice. A possible psychoneu-roimmunological mechanism has been ad-vanced to relate some of the healings of lep-rosy reported in historical materials.

RESUMENSe presenta una breve revisión de la literatura sobre

varios santos venerados en la tradición Cristiana con-siderados como protectores contra la lepra. La revisiónpretende servir como introducción a un debate mássubstancial sobre la posihilidad de analizar las fuenteshistóricas y el uso de su inlcrpretaeieín en la prácticamédica moderna. Ya se ha propuesto, por ejervplo, unposible mecanismo siconeuroinmcmológico para ex-plicar algttnos de los casos de coración de la lepra re-portados en varias documentos históricos.

RÉSUMÉAprès une courte introduction traitant dc plusicurs

Saints vénérés dams la tradition chrétienne comine pro-tectcurs contrc la lèpres cct article presente tin débatstir la possihilité et I'intérct d'analyser les sources his-tariques, ainsi que stir ('utilisation de leer interpréta-tion pour la pratique nnrdicalc moderne. tin nnrcan-isme psycho-acuro-inunuuoIogiquc a did avance pourcclier certames kuérisoa5 de Dprc qui ant été rap-portdes dans les ouvrages historiques.

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