On a lovely grassy hill outside Winchester in southern England once stood a hospital named after St Mary Magdalen, the patron saint of leprosy.
There’s nothing there now, but the name of the hill—Magdalen Hill—prompted archaeologists to dig there in 2008, searching for graves that once lay next to the medieval hospital.
So recounts Britain’s best-known archaeologist and TV presenter, Alice Roberts, in a new video released by New Scientist magazine.
Speaking at New Scientist Live in London, the Professor of Public Engagement in Science at the University of Birmingham discusses leprosy in the Middle Ages and how modern genetic PCR tests could finally help eradicate it by 2030.
Dr Roberts devotes a chapter to the discovery of buried remains at Magdalen Hill in her new book, Crypt: Life, Death and Disease in the Middle Ages and Beyond, which is a Sunday Times bestseller. This project has prompted archaeologists and historians to rethink their views of the treatment of leprosy in the Middle Ages.
“New scientific techniques are helping archaeologists and historians interpret the past, but actually we can bring that knowledge back into the present,” Dr Roberts says in the video.
For at least 400 years from the late 11th Century, Magdalen Hill was home to a leprosarium (leprosy hospital).
From 2008 to 2015, excavations led by Dr Simon Roffey and Dr Phil Marter of the University of Winchester unearthed evidence for more than 100 burials as well as a chapel, infirmary and alms houses. What surprised the scientists was the care and dignity with which the remains had been buried, which contradicted the widespread assumption that people affected by leprosy were treated as unclean outcasts.
Their subsequent research suggested that leprosariums may not have been simply isolation camps for the sick but religious communities like monasteries, founded to care for their patients. They believe many of these patients would have survived the disease and lived out their lives at Magdalen Hill in relative comfort.
Dr Roberts’ specialism is osteoarcheology, the study of bones and what they reveal about how a person lived and died, and she has written three books about what we can learn from graves. In the new video, she shows pictures of the very well-preserved skeletal remains that were found next door to the former hospital.
“As you can see there, some of those skeletal remains had very obvious evidence of disease. So you’ve got evidence of infection in the bones. So you can see that fibula, which is the lower bone in that image, has got a lot of florid new bone growth. That’s what bone does when it’s infected,” she says.
“There were also changes in the hands, where the finger bones had always disappeared, so they’d been attacked by infection as well. There were changes in the feet, and in fact one foot had been amputated. When you start to see this, you start to think of leprosy, because leprosy actually attacks your nerves. So, it means that you lose sensation in your extremities. And this is the point at which you go as a paleo pathologist, it’s obviously leprosy. There’s nothing else it can be. So leprosy directly attacks the facial bones and you end up with this face that we actually call the face of leprosy, facies leprosa, where the palette, the upper teeth mostly disappears … there’s soft tissue damage as well.”
This deeply disfiguring and stigmatizing disease is still with us today, she says, although at a fraction of what it was in the Middle Ages when it was spread by trade, crusades and pilgrimages from one end of Europe to the other.
“There’s about 200,000 new cases a year, and the World Health Organisation is aiming to eradicate it by 2030,” she says. “That’s only six years from now, but I think they’ve got a pretty good chance of doing it.”
The reason for her optimism is not only the focus on improving access to health care in countries where leprosy is still prevalent, but because of a new weapon in the arsenal, which is genetics.
“So as you all know, we can identify diseases now on the basis of DNA. You know that because we have just lived through this and we have all experienced swabbing noses and throats and sending samples off for PCR tests, the genetic test. You can do them for anything that’s got DNA or RNA. And so you can do, you can do PCR tests for leprosy. This is transformative because it means that we can identify a patient with leprosy and test all their contacts – all their close family and friends. You usually find about a quarter of them have got asymptomatic leprosy and you can start them on antibiotics.
So if we can identify the patient, we have the tools to treat the disease now, and so with these genetic tests, I think, we’re going to get very close to combating leprosy and eradicating it.”
