A multidisciplinary approach to reconstruct the lived-experience of people with ‘leprosy’ and Hansen’s Disease in medieval England

Hansen's Disease (HD)/’leprosy’ is one of the most culturally-laden diseases in human history, largely attributable to dramatic and debilitating physical lesions. As such, ‘leprosy’, and those inflicted with it, have frequently been the subject of negative generalisations resulting from the conflation of HD with ‘Biblical leprosy’, and nineteenth-century fearmongering by media. Recent historic and bioarchaeological research has, however, suggested that the lives of ‘lepers’ were more varied, and better, than previously assumed. This thesis aims to explore the variation in lived-experience of medieval HD/’leprosy’ sufferers by using a multidisciplinary life-course approach to holistically interpret a myriad of osteologically and biomolecularly reconstructable proxies of health and social status/treatment. Osteobiographies (n=559), palaeopathological descriptions (n=554), δ13C and δ15N isotope data of early (n=56) and late life (n=56), aDNA confirmation of M. leprae infection (n=25) and radiocarbon data (n=15) were collected from nineteen English sites spanning the Early to late Medieval period. The results of this study show that poor childhood health (enamel hypoplasia, short stature, cribra orbitalia, low dietary isotope values) increases the likelihood of (severe) HD infection in later life. Both (severe) HD infection and poor childhood health make it more likely that individuals are provided with additional care in/through care-institutes such as leprosaria. Dentine isotopic results indicate that those who develop HD/’leprosy’ tend to stay close to the communities they grew up in, either entering local leprosaria, or remain living with friends/family. Within and outside these institutes, rib isotope results suggest that individuals are provided with suitable diets, often lower in marine fish, with adjustments made to accommodate oral lesions. Though life within leprosaria was likely not ‘easy-living’, with much work required to keep the gardens, brewery, kitchen and livestock rearing organised, those with impairments appear to get physically easier workloads based on Schmorl’s nodes and osteoarthritis. All in all, those with HD/’leprosy’ do not die at an earlier age than those without, likely because of the amount of support and care offered to them. Examination of funerary context indicates that when they do pass away, extra effort and care is invested into their burials. In short, those with HD/’leprosy’ do not lose their identity due to their disease, nor are they discriminated against for it. Rather, due to inherent differences in pre-disease identity, means to support oneself, and support from leprosaria, friends and family, combined with the freedom to choose between different life-paths, there is a large amount of variation in the lived-experience of medieval English HD/’leprosy’ sufferers.