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Abstract
Before discussing the establishment and functioning of the first real leprosarium in Iran, a brief explanation is given of the pathology of leprosy, the various names are listed under which it was known in Persian, and the earliest archeological evidence of its occurrence is presented. Also, societal behavior in Imperial Iran towards lepers is highlighted, while reference is made to the earliest medical descriptions of leprosy in Persian. Little is known about the occurrence of leprosy in Iran over the centuries, as evidenced by the lack of knowledge about its prevalence among medical practitioners and institutions in Iran, even as late as the 1920s. Although segregated villages with lepers existed prior to 1926, it was only as of then that the Mehrab Khan village became the first true Iranian leprosarium, when regular institutional medical treatment was offered by American missionary physicians. The funding agencies, medical personnel and treatment, the living environment of lepers and their numbers in Mehrab Khan are discussed as well as how its population size and status changed over time, and how it was transformed into a structural component of public medical care. Finally and briefly, the establishment and functioning of two other Iranian leprosaria is discussed as well as the slow but sure disappearance of the disease in Iran.
Notes
1 CDC website https://www.cdc.gov/leprosy/index.html (accessed 2 July 2018).
2 Loghatnameh-ye Dehkhoda; Matin Citation1388, p. 643; Schlimmer Citation1970, p. 228; Zambaco Pacha Citation1924, p. 570; Wolff Citation1860–61, p. 286. According to Polak Citation1863, p. 175, the term pīs was used by Turkish speakers.
3 Brydges-Jones Citation1976, p. 78.
4 Schlimmer Citation1970, p. 123.
5 Zambaco Pacha Citation1924, p. 570. The Persian terms used for white leprosy probably mostly referred to non-leprous skin diseases, Polak Citation1865, vol. 2, pp. 307–8.
6 Griffith Citation1895, Book I, hymns XXIII and XXIV; Aufderheide et al. Citation1998, p. 148; McLeod at al. Citation1981; Bryan Citation1930, pp. 88–94.
7 Coloru Citation2017, pp. 65–6; see also Modi Citation1911; Modi Citation1917, p. 281.
8 Coloru Citation2017, pp. 65–6.
9 Moghadas Citation2015, pp. 1162–3.
10 Brown and Simcock Citation2012; Dols Citation1979.
11 Robbins et al. Citation2009; Robbins at al. 2013.
12 Blau and Yagodin Citation2005.
13 Dzierzykray-Rogalski Citation1980.
14 Anonymous Citation2009; Spigelman and Donoghue Citation2001; Matheson et al. Citation2009.
15 Coloru Citation2017, p. 70.
16 Najmabadi Citation1353, pp. 316–20, 460, 591; Matin Citation1388, pp. 642–53.
17 Matin Citation1388, p. 643.
18 Teixeira Citation1991, p. 228.
19 Elgood (Citation1951) and Najmabadi (Citation1353) don’t mention it at all. The same holds for the entry jodhām by Matin Citation1388 in the Dār al-Maʿāref Bozorg Eslāmī and by Dols in the Encyclopedia of Islam.
20 Polak Citation1865, vol. 2, p. 307.
21 Schlimmer Citation1970, pp. 28–31, 365–6 (q.v. melas); Polak Citation1863, pp. 178–9.
22 Polak Citation1863, p. 179.
23 Ibid., p. 177.
24 Ussher Citation1865, p. 652.
25 De Gobineau Citation1923, vol. 2, p. 259.
26 Römer Citation1906, p. 146.
27 Polak Citation1865, vol. 2, pp. 305–7, vol. 1, pp. 311–12; Polak Citation1863, pp. 175–6; Schlimmer Citation1970, pp. 228–54. Polak also tried to treat the illness and showed a case to his medical students in the Dār al-Fonūn. Vaqāyeʿ-ye Ettefāqiyeh, vol. 2, p. 1235 (no. 193, 19 Moharram 1271/March 8, 1856).
28 Häntzsche Citation1863, p. 181.
29 Klingmüller Citation1930, p. 50.
30 Loew Citation1908, p. 701.
31 Klingmüller Citation1930, p. 50.
32 IOR/L/PS/20/7, p. 88; Adamec Citation1989, vol. 3, p. 693 (Shiraz).
33 Schlimmer Citation1970, p. 306.
34 Häntzsche Citation1863, pp. 181–2; Fraser Citation1826, p. 200. In 1920 and thereafter, leprosy was seen more common than usual in Rasht. RG 91-19-9, “History of Resht Station,” p. 2; Resht Medical Report 1930, p. 3; Resht Medical Report 1931, p. 2.
35 Zambaco Pacha Citation1924, p. 569.
36 Vaume 1886, p. 160.
37 Anonymous Citation1902, p. 46.
38 IOR/L/MIL/17/15/8, p. 42.
39 Administration Report 1908, p. 12.
40 IOR/L/PS/10/284, Neligan to Walter Townley, February 3, 1914.
41 IOR/L/PS/10/284, Neligan to Walter Townley, November 4, 1914.
42 Neligan Citation1926, part II, p. 694.
43 Schlimmer Citation1970, pp. 238–55.
44 Monzavi Citation1348, 5: 3398.30; Azizi and Bahadori Citation2011, p. 426.
45 Klingmüller Citation1930, p. 50.
46 Häntzsche Citation1863, pp. 182–3.
47 Vinkhuijzen Citation1868, p. 188.
48 Brydges-Jones Citation1976, p. 436 note.
49 Loghatnameh-ye Dehkhoda; see also Matin Citation1388, p. 643 (bloodletting, diet, etc.).
50 Loew Citation1908, p. 701.
51 Klingmüller Citation1930, p. 50.
52 Rusta'i Citation1382, vol. 1, p. 473.
53 Mashad Medical Report 1935–36.
54 Government of Great Britain Citation1945, p. 421.
55 Häntzsche Citation1863, p. 182; Zambaco Pacha Citation1924, p. 570. On the belief in contagion, see Floor Citation2018, pp. 47–8.
56 Loew Citation1908, p. 701; Wilson Citation1896, pp. 271–2.
57 Wilson Citation1896, pp. 271–2.
58 Loew Citation1908, p. 701; Polak Citation1863, p. 176; Polak Citation1865, vol. 1, pp. 311–12; vol. 2, p. 305; Wilson Citation1895, p. 140; de Gobineau Citation1923, vol. 2, p. 259 (deformed beggars at Miyaneh); Watelin Citation1921, p. 6 (near Alulak); Häntzsche Citation1863, p. 183; Loew Citation1908, p. 701; Feuvrier Citation1900, p. 120; Lycklama 1872, vol. 4, p. 30; Brugsch, Citation1886, p. 170.
59 Polak Citation1863, p. 176. The governor of Gilan once expelled lepers from Rasht who had come suddenly from Ardabil. Häntzsche Citation1863, p. 183.
60 Zambaco Pacha Citation1924, pp. 569–70.
61 Vaume 1886, p. 159.
62 Zambaco Pacha Citation1924, p. 567.
63 Häntzsche Citation1863, p. 183.
64 Wilson Citation1895, pp. 140–41; Cochran Citation1899, p. 105.
65 Wilson Citation1895, pp. 140–41; Neligan Citation1926, part II, p. 693; Brugsch Citation1863, vol. 1, p. 179.
66 Bradford Citation1906, p. 502.
67 IOR/L/PS/10/284, Neligan to Walter Townley, February 3, 1914.
68 IOR/R/15/2/1297, Adviser to Political Agent, March 21, 1942.
69 IOR/R/15/2/1297, Adviser to the Govt. of Bahrain to Political Agent, September 12, 1942.
70 Government of Great Britain 1945, p. 421.
71 Nasiri Citation2008, pp. 241, 246; Mehrab Khan built a mosque in Mashhad in the Darvāzeh-ye Nowghān quarter, which mosque still exists. Adhari-Khakestar Citation1395, p. 80.
72 Moʾtamen Citation1348, p. 411; Adhari-Khakestar Citation1395, p. 80.
73 RG 231-1-6, p. 67.
74 Adhari-Khakestar Citation1395, pp. 81–2.
75 Nezam al-Saltaneh Citation1361, vol. 2, p. 366.
76 Adhari-Khakestar Citation1395, p. 82.
77 Klingmüller Citation1930, p. 50.
78 RG 231-1-6, p. 67. Adhari-Khakestar Citation1395, p. 90 mentions that prior to Dr. Lichtwardt’s regular visits Dr. Stoker of the British Consulate-General in Mashhad did so, but not with what frequency and over what period.
79 RG 91-20-2, Mashad Medical Report 1929–30, p. 39.
80 An American Christian charity organization that aims to eradicate leprosy and was founded in 1906.
81 RG 231-1-6, p. 67; Adhari-Khakestar Citation1395, pp. 83–4, 89–90. According to Moʾtamen 1348, p. 412, the original building measured 80 by 80 meters and had thirty-eight rooms in which the lepers lived. In the middle was the kitchen. The small hospital was located in the south side of the building and had a courtyard for healthy family members.
82 RG 91-20-2, Mashad Medical Report 1932–33, p. 5.
83 Adhari-Khakestar Citation1395, p. 91.
84 Adhari-Khakestar Citation1395, p. 85; for a list of other payments made by the shrine in 1929 to help the lepers at Mehrab Khan, see ibid., pp. 86–7.
85 Ibid., p. 90.
86 RG 91-20-2, Mashad Medical Report 1932–33, p. 5.
87 Adhari-Khakestar Citation1395, p. 87.
88 Ibid., pp. 87–8.
89 Kaempfer Citation2018, p. 92.
90 Adhari-Khakestar Citation1395, p. 90. Also, government officials sent lepers to the leprosarium. On 27 April 1935 the mayor of Mashhad had two lepers detained who were begging in the city and sent them to the leprosarium. Adhari-Khakestar Citation1395, p. 92.
91 RG 91-20-2, Mashad Medical Report 1935–36, p. 6.
92 Adhari-Khakestar Citation1395, pp. 81, 89.
93 Ibid., p. 89.
94 Ibid., p. 88.
95 RG 91-20-2, Mashad Medical Report 1929–30, pp. 40–1.
96 Adhari-Khakestar 1395, p. 250 doc 10. The extra help was given in the form of pūstīns, see ibid., p. 90.
97 RG 91-20-2, Mashad Medical Report 1931–32, p. 17 (on p. 7 a photo of Dr. Lichtwardt examining a leprous patient).
98 RG 91-20-2, Mashad Medical Report 1935–36, p. 5.
99 RG 91-20-2, Mashad Medical Report 1937–38, pp. 2–3.
100 RG 91-20-2, Mashad Medical Report 1938–39, p. 1.
101 Adhari-Khakestar 1395, p. 242, doc. 4 (17 Ordibehesht 1317 rec.)
102 RG 91-20-2, Mashad Medical Report 1942–43, p. 2; Mashad Medical Report 1945–46, p. 3.
103 Adhari-Khakestar 1395, p. 89.
104 Ibid., p. 95.
105 Ibid., p. 94.
106 RG 91-20-2, Mashad Medical Report 1931–32, p. 17; RG 91-19-9, Resht Medical Report 1930, p. 3; Resht Medical Report 1931, p. 2.
107 RG 91-20-2, Mashad Medical Report 1935–36, p. 5.
108 RG 91-20-2, Mashad Medical Report 1936–37, p. 4.
109 Adhari-Khakestar 1395, p. 94.
110 RG 91-20-2, Mashad Medical Report 1931–32, p. 17.
111 RG 91-20-2, Mashad Medical Report 1935–36, p. 5.
112 RG 91-20-2, Mashad Medical Report 1937–38, p. 3.
113 RG 91-20-2, Mashad Medical Report 1939–40, p. 3.
114 RG 91-20-2, Mashad Medical Report 1940–41, p. 2.
115 RG 91-20-2, Mashad Medical Report 1938–39, p. 2.
116 RG 91-20-2, Mashad Medical Report 1942–43, p. 2.
117 RG 91-20-2, Mashad Medical Report 1944–45, p. 2.
118 RG 91-20-2, Mashad Medical Report 1945–46, p. 2.
119 Of the sixty arrivals in 1934, twenty-five were from Afghanistan. Mashad Medical Report 1934–35, p. 3.
120 RG 231-1-6, pp. 67–8; RG 91-20-2, Mashad Medical Report 1928–29, p. 2; Lichtwardt Citation1934, pp. 75–6; Moʾtamen Citation1348, p. 412; Adhari-Khakestar 1395, pp. 80, 90–91.
121 RG 91-20-2, Mashad Medical Report 1929–30, pp. 41–2.
122 Presbyterian Church Citation1930, p. 187.
123 RG 231-1-6, p. 67.
124 Adhari-Khakestar Citation1395, pp. 84, 90; RG 91-20-2, Mashad Medical Report 1932–33, p. 4; Mashad Medical Report 1929–30, p. 39; Mashad Medical Report 1934–35, p. 3; Mashad Medical Report 1935–36, p. 5; Mashad Medical Report 1938–39, p. 1; Mashad Medical Report 1944–45, p. 2.
125 RG 91-20-2, Mashad Medical Report 1929–30, p. 39.
126 Adhari-Khakestar 1395, p. 92. Art. 1123 of the new Iranian civil allowed a man to cancel the marriage “in case his wife had black leprosy (juzam) and leprosy (baras).” IOR/L/PS/12/3416. The expulsion of the two women very much upset the community of lepers, because in 1938 and 1939 they requested an allowance for them. Adhari-Khakestar 1395, p. 242, doc. 4 (17 Ordibehesht 1317 rec.)
127 RG 91-20-2, Mashad Medical Report 1936–37, p. 4.
128 Adhari-Khakestar 1395, p. 93.
129 RG 91-20-2, Mashad Medical Report 1930–31, p. 6; Mashad Medical Report 1936–37, p. 5.
130 RG 91-20-2, Mashad Medical Report 1929–30, pp. 42–4; Mashad Medical Report 1928–29, p. 6; Mashad Medical Report 1938–39, p. 5. On alepol, see Bhandari Citation1932 and Dikshit Citation1932. For the treatment with chaumogra oil and treatment in general, see Klingmüller Citation1930, pp. 676–743. For the 1929 budget allocation for female cleaners, see Adhari-Khakestar 1395, p. 86 (item 6).
131 RG 91-20-2, Mashad Medical Report 1931–32, p. 16.
132 RG 91-20-2, Mashad Medical Report 1932–33, p. 4.
133 RG 91-20-2, Mashad Medical Report 1932–33, p. 4.
134 RG 91-20-2, Mashad Medical Report 1931–32, p. 17.
135 RG 91-20-2, Mashad Medical Report 1935–36, p. 5; RG 231-1-2, Hoffman to Mother, 04/10/1936.
136 RG 91-20-2, Mashad Medical Report 1936–37, pp. 3-4; Mashad Medical Report 1935–36, p. 5.
137 Mashad Medical Report 1937–38, p. 3.
138 RG 91-20-2, Mashad Medical Report 1935–36, p. 5.
139 RG 91-20-2, Mashad Medical Report 1936–37, p. 3.
140 RG 91-20-2, Mashad Medical Report 1936–37, p.4. It is interesting that in 1942 the work on farms was decried by a local newspaper as “woe betide” the villagers who employed lepers; see Adhari-Khakestar 1395, p. 94.The village mullah probably was called Aziz Khan and was himself a sufferer of leprosy. Moʾtamen Citation1348, p. 411, note.
141 RG 91-20-2, Mashad Medical Report 1937–38, p. 2.
142 RG 91-20-2, Mashad Medical Report 1938–39, p. 2; Mashad Medical Report 1939–40, p. 3; Idem, Mashad Medical Report 1940–41, p. 2; Mashad Medical Report 1944–45, p. 2.
143 RG 91-20-2, Mashad Medical Report 1945–46, p. 2; Mashad Medical Report 1942–43, p. 2; Mashad Medical Report 1944–45, p. 2.
144 Adhari-Khakestar Citation1395, p. 89.
145 Azizi and Bahadori Citation2011, p. 428; Moʾtamen Citation1348, pp. 412–13. Moʾtamen’s text is copied in Ataredi Citation1371, vol. 2, pp. 511–13.
146 Adhari-Khakestar Citation1395, p. 96.
147 Iran Almanac 1963, p. 379. According to Moʾtamen Citation1348, p. 413 the shrine paid the Health Department 50,000 rials/month for its work at Mehrab Khan in 1957.
148 Azizi and Bahadori Citation2011, p. 428.
149 Ataredi Citation1371, vol. 2, p. 513.
150 Administration Report Citation1908, p. 12; Das Citation1911; Anonymous Citation1909.
151 Administration Report 1910, p. 20.
152 RG 91-19-9, Resht Medical Report 1930, p. 3.
153 Gilmour Citation1924, p. 30; see also Polak Citation1865, vol. 1, p. 132 (leper colonies in Azerbaijan, Khamseh, and Khalkhal).
154 Rasooli. and Allen Citation1958, pp. 22–3.
155 https://fa.wikipedia.org/wiki/بابا باغی (accessed June 15, 2018).
156 Andrews Citation1950, p. 2.
157 https://www.mehrnews.com/news/1018043/ (accessed June 15, 2018).
158 https://fa.wikipedia.org/wiki/بابا باغی (accessed June 15, 2018).
159 Iran Almanac 1963, pp. 378–9.
160 Azizi and Bahadori Citation2011, p. 427.
161 Matin Citation1388, p. 645.
162 https://fa.wikipedia.org/wiki/بابا باغی (accessed June 15, 2018); http://www.bartarinha.ir/fa/news/90156/ (accessed June 15, 2018); http://www.hamshahrionline.ir/details/304736 (accessed June 15, 2018).
163 Iran Almanac Citation1970, p. 496; Matin Citation1388, p. 645; Pahlavi Citation2005, p. 143. For leprosy related medical education and research in Iran, see Azizi and Bahador Citation2011, pp. 428–9.
164 Aziz and Bahadori Citation2011, p. 428.
165 http://tb-lep.behdasht.gov.ir/Leprosy_Situation_In_Iran_World.aspx (accessed June 14, 2018).