More than a decade in the making, this book was well worth the wait. It is a thorough compendium of knowledge on not only the history and (bio)archaeology of leprosy, but also its epidemiology and evolution.
At its heart, it puts the people who have been affected by this horrendous disease throughout history, aware that they have too often been relegated not only to the fringes of the societies in which they lived (and continue to live), but also to the fringes of our collective history. Roberts seeks to rectify this by correcting many of the myths that continue to be propagated around this disease, one that, despite its notoriety, still remains poorly understood by the general populace.
The first part of the book outlines the biology of the disease. While the initial chapter discusses the two bacteria that cause leprosy, how the disease is transmitted, and theories on how it has spread across the globe, Chapter 2 outlines how the individual is both physically and mentally affected by leprosy, delving into the details of the many different symptoms that can occur. The third chapter then discusses how leprosy is diagnosed and treated today, comparing it with the methods most commonly used before the advent of modern medicine.
The second half of the book explores the archaeology and history of the disease. Chapter 4 details the many different ways that the disease can affect the bone and what differential diagnoses are appropriate. The detection of the disease using archaeological scientific techniques, including ancient DNA, is also briefly discussed. Chapter 5 is a prodigious undertaking, outlining the archaeological evidence that currently exists for leprosy across the globe, from the Old World to the New, while Chapter 6 does the same using historical evidence. The book concludes with a short chapter on the future of the disease, both clinically and academically.
Roberts’ meticulous attention to detail and clarity shines through in her ability to provide such a comprehensive tome. It is must-read material for every bioarchaeologist and medical anthropologist, or anyone with an interest in the history of disease and medicine.
Leprosy: past and present, Charlotte A Roberts, University of Florida Press, £135, ISBN 978-1683401841. Review by KK.