THE DIAGNOSIS OF ST. FRANCIS: EVIDENCE FOR LEPROSY Any venture into understanding the medical conditions of St. Francis of Assisi must be undertaken cautiously. The sources of information available to modern investigators cannot provide the degree of precision we have come to expect in the age of the CATscanner . Recent progress in the methodology of medical historical research now permits, however, a comprehensive and rigorous study of the subject founded upon firm knowledge of both the sources for the life of St. Francis and medical science. The present study pursues four avenues of research in approaching a medical diagnosis for St. Francis. The first is a comparison between the descriptions of St. Francis' medical signs and symptoms in the early biographies and our modern understanding of the natural history of diseases. The second method is an attempt to understand the medical terms used by the early biographers as they were understood by medieval medical practitioners (i.e., a medicalhistorical approach). The third method is "paleo-epidemiological" and consists of an application of our understanding of the prevalence and distribution of diseases in the medieval Mediterranean world to what is known of St. Francis' illnesses. The fourth method is "paleo-pathological" and draws conclusions from an examination of available data regarding the remains of St. Francis. Finally, we discuss the differential diagnosis and some of the implications of our conclusion. We propose that it is possible, if not probable, that St. Francis suffered from clinically significant leprosy of the borderline or tuberculoid form and died of complications related to this underlying illness. l82JOANNE SCHATZLEIN and DANIEL P. SULMASY I. A MEDICAL HISTORY OF ST. FRANCIS BASED UPON A CLOSE READING OF THE EARLY BIOGRAPHIES.1 In any attempt to interpret the medical signs and symptoms of St. Francis' it is imperative that we understand the terms used in the early biographies as the authors themselves understood them. In order to do this we must first delineate precisely what the early biographers have actually written about the health of St. Francis. This will allow us to construct a medical case history. Neither the medical-historical literature nor the Franciscan literature has yet produced a satisfactory case history for St. Francis. Previous studies have habitually been imprecise in their interpretation of the medical significance of the biographies. Lambertini for example, mentions multiple episodes of fever during St. Francis' ill-fated youthful military ventures.2 The sources make no mention of fever at this time in the life of Francis. Ciancarelli, repeating Lambertini's unsubstantiated inference regarding fever,3 also suggests that Francis contracted tuberculosis from his mother, Lady Pica, who "came from France" (a country Ciancarelli describes as "civilized" and therefore a place where "tuberculosis was common").4 Schmucki has roundly criticized this argument.5 Not only is French birth insufficient evidence for making a diagnosis of tuberculosis, but the French origin of Lady Pica, never made explicit in the sources, is itself only an hypothesis. Moorman has laced his account of the life of St. Francis with symptoms related to tuberculosis which are grossly extrapolated from the actual accounts in the early biographies.6 Another author, 1 The following abbreviations will be used for references to the literary sources of Francis' life: iC, Thomas of Celano, Vita prima; 2C, idem. Vita secunda; 3C, idem, Tractatus de miraculis; 3S, Legenda trium sociorum; LM, St. Bonaventure , Legenda major; Lm, idem, Legenda minor; LP, Legenda of Perugia; SP, Speculum perfectionis. English translations of these works are found in Marion Habig (ed). St. Francis of Assisi: Writings and Early Biographies (Chicago: Franciscan Herald Press, 1983). 2 Gastone Lambertini, "Le malattie e le stimmate di S. Francesco," Studi Francescani 7 (1974): 110. 8 Santé Ciancarelli, "Le malattie di Francesco di Assisi," Analecta Tertii Ordinis Regularis 14 (1978): 274-75. * Ciancarelli, 273. 5 Ottaviano Schmucki, "Opera circa S. Francisci vitam," Collectanea Francescana 43 (1973): 4°5-°7· 8 Lewis J. Moorman, "TB and Genius as Manifested in St. Francis of Assisi ," Annals of Medical History 9 (2) (n.s. Ill) (1930): 556-59. The Diagnosis of St. Francis183 E. F. Härtung, has dated the "quartan fever" described in LP 39 and SP 61 to the time of...
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