It might be thought that Rabbinical commentaries or existing Jewish custom might help to throw a light on the subject, but neither of these is any real help. The Talmud teaches that zara'ath refers to any disease with cutaneous eruptions or sores, and indeed some references appear to demonstrate that the writers considered the disease non-contagious ; as, for example, the rule that a bridegroom, suspecting himself affected, might wait till seven days after his marriage before reporting his condition. The Rabbinical comments, instead of correlating the Levitical description with known medical facts, are rather engaged in impressing the importance of a literal adherence to the text of the Mosaic law.
Modern custom among the Jews in the East does not seem to view true leprosy with the aversion of even Moslems and Christians. Of six cases of well- marked leprosy among the Jews of Jerusalem which the present writer can recall, only one of them, a stranger from India, was in any way isolated, and he only after he liad been in the English Hospital for some days among all the other patients ; when he could no longer be kept he was sent to the Leper Hospital, where he died. The other cases, a Russian Jewess, three Spanish Jewesses, and a Spanish Jewish boy, all lived at home and mixed freely with their friends ; the boy, indeed, long after he had marked symptoms of anaesthetic leprosy, con- tinued to attend a large Jewish boys' school Avith- out any sign of opposition or trouble. The Eastern
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Jews, on the other hand, mauifest at times great fear of the contagiousness of tuberculous, or as they would popularh' be called, 'scrofulous' affections of the skin and of the lymphatic glands. These seem bj- tradition to be recognized as contagious.
When it is remembered that it is only in very recent years, in the life of the present generation of medical men, that the true nature both of lep- rosy (elephantiasis) and of 'scrofula" has been discovered, it is diliicult to believe that the Jews of Palestine, even in XT times, recognized the sharplj'-dehned varieties of disease we do to-day. It is therefore probable that, wliile the leprosy of the NT certainly included some developments of the disease we now know as psoriasi'i and allied affections with a scaly eruption, and almost cer- tainly a proportion of cases of ' true leprosy,' it may also have included cases of 'lupus,' 'scrofu- lous' (i.e. tuberculous) glands, and varieties of parasitic skin affections, such as ' ring^vorni ' and favus, both of which are very common among the Jews of the East to-day.
True leprosy (elephantiasis) has for so many centuries been identified with the disease now called by that name, and, indeed, is likely to be for so many generations, that some description of this disease, especially as it occius to-day in the Holy Land, is here not out of place. It is a disease of world-wide distribution, though apparently dying out of most European lands, where, as in Englaml and France, it was once rampant. India, China, South Africa, and the Sandwich Islands are to-day the great habitats of leprosy. Climate appears to have no real effect on it. It is not hereditary ; the children of lepers, if removed to healthy sur- roundings at an early age, seldom take the disease, wliile advance of the disease usually produces sterility. There is no doubt that it is contagious, but only by close personal contact ; attendants on lepers run very little risk if they are careful ; and they cannot, as was once supposed, carry the contagion to others. Although the almost world-wide custom of isolating lepers is founded upon the doubtful tradition of this being the special and peculiar disease described in the Mosaic law, yet from every point of vieM" this is desirable both for the poor \"ictims themselves, who are always to some degree incapacitated and suffering, and for the sake of their healthy neighbours. Al- though a leper in the street is no danger to the passer-by, he must in his home be a danger to his family, and no other disease reduces a human being for so many years to such a hideous wreck.
With respect to the ultimate cause of leprosy, Hansen has demonstrated (1S71) that it is due to a special micro-organism, the bacillus leprcc, similar in appe.arance, and to some extent in the action on the human tissues, to the tubercle bacillus. How the poison enters the body is not known. The disease occurs so sporadically that there must be some cause other than contagion ; but what this may be has never been proved. The theory recenth* revived by Mr. Jonathan Hutchinson, F.R.C.S., that the disease is due to a diet of tish. is not borne out by the facts. In Palestine, in particular, the great majority of the lepers liave never eaten fish at all, as they come from inland villages : fish is very seldom eaten by the Moslems in Palestine, and the only people who eat it — the Jews regu- larly, and the Christians at tlieir fasts when living in the cities — suffer least from this disease.
Leprosy manifests itself in three forms: (1) the tubercular or nodular, (2) the anresthetic, and (3) the mixed. Chronic cases, however they begin, tend to assume in the later stages the third or mixed type.