leprosy and the island of molokai -- 8/01/18
Today's selection -- from Get Well Soon by Jennifer Wright. Leprosy and the island of Molokai:
"People have been very afraid of [leprosy] from the beginning of recorded history. It is mentioned in the Bible, where it is often associated with sin. Leviticus 13:45-46 says: 'And the leper in whom the plague [is], his clothes shall be rent, and his head bare, and he shall put a covering upon his upper lip, and shall cry, Unclean, unclean. All the days wherein the plague [shall be] in him he shall be defiled; he [is] unclean: he shall dwell alone; without the camp [shall] his habitation [be].'
"Sunday school teachings notwithstanding, this is not true. Leprosy has nothing to do with whether someone has a shiny, clean soul or body. No diseases have anything to do with anyone's soul. Leprosy is a bacterial disease, caused by Mycobacterium leprae. The Norwegian doctor Gerhard Hansen identified the bacterial cause in 1873, and the disease today is often called Hansen's disease. ...
"The Mycobacterium leprae can pass into a body through an open cut or through mucous membranes in the nose. That seems like an easy way to become infected, but the good news is that most individuals aren't especially susceptible to the disease. To contract it, people have to be in constant, close contact with lepers.
Leprosy manifests in two ways. The first is tuberculoid leprosy, where rough, scaly lesions develop over the skin. That's because the disease sets off a cellular reaction in which immune cells rush to isolate the bacteria. The reaction spreads to the nerves in the affected areas and stops nerve signals from being transmitted, so sufferers lose sensation at that site. Sometimes this kind of leprosy resolves, though in other cases it progresses and turns into lepromatous leprosy. In those cases, the bacteria spread all over the body, causing open sores on the face and body. In some cases, the disease also leads to blindness.
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| Leprosy in Tahiti, circa 1895 |
"The most notable feature of leprosy -- and in many cases the first symptom of the disease -- is the loss of the sense of touch. That doesn't sound terrible until you realize that if you are accidentally walking over broken glass, it is good to know that. It's also good to know if you burned yourself or chopped off your finger while cooking or otherwise injured yourself in a way that should be tended to. And the injuries don't have to be that extreme to cause problems! With no feeling in your limbs, you could just not notice an everyday blister from too-tight shoes and continue walking around in those shoes until the sore becomes infected. It's because of the resulting infections from these injuries that lepers came to be associated with missing fingers, hands, or feet -- the bacterium itself doesn't actually cause them to fall off. However, it does cause muscles to weaken in a way that results in deformities. For instance, lepers are often thought to have hands that look like claws. That's because the muscles in their hands are no longer strong enough to extend their fingers.
"Today, like many historical plagues, leprosy can be treated with antibiotics, which are provided for free by the World Health Organization. It is yet another disease that, if you have enough resources at your disposal to buy and read this book, you are never going to need to worry about. But it understandably terrified people of the past. Because the symptoms of the disease were so obvious, the people who had it were regarded as outcasts. In fact, some people thought the best way to fight the disease was to make sure no one had contact with any lepers at all.
"In 1865 the Hawaiian government enacted 'An Act to Prevent the Spread of Leprosy.' It claimed that a portion of land -- which would end up being on the island of Molokai -- would be set aside for leprous individuals. This is where it got scary:
The Board of Health or its agents are authorized and empowered to cause to be confined, in some place or places for that purpose provided, all leprous patients who shall be deemed capable of spreading the disease of leprosy ... it shall be the duty of the Marshal of the Hawaiian Islands and his deputies, and of the police officers, to assist in securing the conveyance of any person so arrested to such place, as the Board of Health, or its agents may direct, in order that such person may be subjected to medical inspection, and thereafter to assist in removing such person to place of treatment or isolation, if so required, by the agents of the Board of Health.
"In short, if you were suspected of being a leper, the government was going to hunt you down and forcibly move you off to quarantine.
"If this policy does not strike you as desirable or in any way okay, you are not alone. There is even a Jack London story, called 'Koolau the Leper,' in which the protagonist is a leper who would rather fight and die than go to Molokai. The story begins with him saying: 'Because we are sick they take away our liberty. We have obeyed the law. We have done no wrong. And yet they would put us in prison. Molokai is a prison.'
"I would have gone with hellhole rather than prison, but however you phrase it, conditions on Molokai were dire."
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