Walking Corpses: Leprosy in Byzantium and the Medieval West by Timothy S. Miller and John W. Nesbitt (review)

Timothy S. Miller and John W. Nesbitt have written a book that, despite its brevity, helps to redress significant lacunae in the study of medieval leprosy and of Byzantine medicine. Too often, medieval medical history has been treated as a mere curiosity, and relevant texts consequently neglected. In working with diverse and scattered sources, and attempting to synthesize the evidence of multiple genres, Miller and Nesbitt also point out desiderata for future research. The book’s introduction addresses the specter of leprosy in the medieval and modern imagination, and the ways in which it dominates popular ideas of medieval disease. In discussing how visible symptoms of leprosy may have affected interpretations of the disease by medieval physicians, theologians, and hospital donors, Miller and Nesbitt show a precision in analyzing medical symptoms and vocabulary which is lamentably rare in scholarship on medieval leprosy. Their attention to language is not always so careful, however. The book’s title, taken from a fourth-century sermon, is symptomatic of a tendency to interpret the elevated, emotional vocabulary of this genre as denoting widespread terror in the face of a disease that ran rampant in the Byzantine empire. Such a claim, however, is tenuous. The fourth-century increase in mentions of wandering lepers in need of support may indicate increased incidence of the disease. But alternate possibilities—that this reflected changing ideas about desirable structures of social support, or changing ideas about the desirable extent of Christian charity—are not explored. Perhaps as a result of the book’s brief length, and deliberately accessible prose style, Nesbitt and Miller leave several such points without explication from which they might benefit.

The first four chapters of the book engage with the treatment and perception of leprosy in the Byzantine world. The first chapter offers a useful study of medical vocabulary in the ancient world, the evolution of attitudes towards leprosy over time, and how the disease was represented in different regions and textual genres. Lepers are discussed as one category of recipients of Christian charity in the late antique world; the evidence suggests that they were among those likely to be excluded from multipurpose hospitals due to their special needs. The second chapter is perhaps the book’s most ambitious, discussing leprosy in the Byzantine empire. There are obvious difficulties associated with considering evidence drawn from a span of over a millennium, but the discussion of hospital development over time is admirably lucid. Miller and Nesbitt portray the Byzantine imagination as dominated by two competing visions of leprosy: as divinely-imposed affliction or Holy Disease. This is particularly intriguing in view of how much space existed between those poles in western discourse on the disease.

Chapter 3 engages with Byzantine medical discourse, contrasting the theories of Galen and Aretaios. Nesbitt and Miller query whether doctors working in “leper asylums” would have had time to serve private patients as well; it would be interesting to know more about their sources on how these doctors were paid, especially since medieval medical practitioners in western Europe usually served hospitals as part of their wider practice. This chapter also discusses regional and chronological developments in contagion theory. Nesbitt and Miller argue, more contentiously than they acknowledge, that this theory was influenced by religious belief in both Islam and Christianity. The challenge of retrospective diagnosis is delicately handled; Nesbitt and Miller offer a cogent consideration of how elephantiasis and judham may have corresponded to Hansen’s Disease. Chapter 4, on Byzantine leper hospitals, offers a thoughtful treatment of labile vocabulary in the sources, but problematically identifies the Zotikos leper hospital in Constantinople, and others, as “asylums.” Asylum is not only a loaded word but also, as the work of John Chircop, Guy Geltner, and others has shown, a flexible one well into the early modern period. Its use by Nesbitt and Miller is particularly puzzling in view of the...