The leprosarium of Saint-Thomas d’Aizier: The cementochronological proof of the medieval decline of Hansen disease in Europe?

Abstract

a b s t r a c tThis study compares the adult survivorship profiles of people interred in the Saint-Thomas d'Aizier leprosarium, estimated by cementochronology, to eight archaeological series in northern France dated from Late Antiquity to the Late Middle Ages, periods of significant visibility for Hansen's disease (leprosy). The goals are to understand the impact of leprosy on various social groups and to explore the cause of leprosy's decline by analyzing male and female fertility. Survival rates differed between medieval leprosy-free sites and the Saint-Thomas d'Aizier leprosarium, although this difference was statistically significant only for the female leprosarium sample. The selective female frailty, a consequence of social exclusion and the collapse of the quality of life, combined with the infertility of lepromatous couples, offer a multi-causal explanation to the end of the expansion and then decline of leprosy in southern and western European countries.© 2015 Elsevier Inc. All rights reserved. IntroductionDemographic factors related to leprosy in the past have been relatively underexplored, yet the disease is known to impact mortality and fertility. We therefore suspect that changes in demographic parameters played a role in the decline of this disease. Clinical analyses highlight the major role of specific pathologies on mortality and morbidity, such as suicide, tuberculosis (TB), renal insufficiency, and cancer (Tokudome et al., 1981). In addition, the possibility that couples affected by leprosy would have a lower fertility due to male infertility has been raised since the early 20th century (McCoy, 1913). McCoy was the first to discuss the frequency of orchiepididymitis (inflammation of the testicles) in lepromatous patients. The same year, Barbézieux (1913) argued that the decline of leprosy and its disappearance during the 17th century in France was due to the legal requirement that lepromatous persons and their descendants (i.e., "cagots") marry affected * Corresponding author. Tel.: +33 3 27 82 74 39.E-mail addresses: jblondiaux@nordnet.fr (J. Blondiaux), stephan.naji@gmail.com (S. Naji), jean-pierre.bocquet-appel@evolhum.cnrs.fr (J.-P. Bocquet-Appel), thomas.colard@free.fr (T. Colard), ameliedebroucker@hotmail.fr (A. de Broucker), cecile.niel@unicaen.fr (C. de Seréville-Niel).partners, in addition to male infertility. More recently, Beiguelman (1967) collected a large demographic dataset on leprosy patients and concluded that since orchiepididymitis is frequent among lepromatous males, many were rendered sterile. However, in the fertile fraction of lepromatous males, fecundity was similar to that of healthy males. Women's fertility, however, seemed to be unaffected, as demonstrated by the comparable spontaneous abortion rates observed between lepromatous and healthy females. Leprosy induced male infertility and a possible increased mortality of males and females due to leprosy and other pathogens should therefore be explored to assess their respective effects on the disease's 17th century dec...

Mycobacterium leprae: A historical study on the origins of leprosy and its social stigma

“…Many historians and archaeologists suppose that leprosy, such as other bacterial infectious diseases like syphilis, was absent in the New Continent and it was first brought from the Old Continent by the Columbus' troops and then by slaves from West Africa; after it was further spread by explorers and immigrants from Europe to both North and South America and in the Pacific's islands [35][36][37][38][39]. An important milestone about the disease's knowledge, a part from the discovery of M. leprae by Dr. G. Armauer Hansen in 1874, was the bacterial multiplication in the mouse footpad experimented by Dr. Charles Shepard of the Centers for Disease Control in 1959 [39,40]. Moreover, in 1968, Dr. Waldemar Kirchheimer of Carville and Dr. Eleanor Storrs of the Gulf South Research Institute inoculated the M. leprae in the nine-banded armadillo, causing a disseminated Hansen's disease in the animal's body [41][42][43].…”