Josh: Josh Clark
Chuck: Charles W. "Chuck" Bryant
Vo: Voiceover Speaker
Vo: Welcome to Stuff You Should Know from HowStuffWorks.com.
Josh: Hey, and welcome to the podcast. I'm Josh Clark. There's Charles W. "Chuck" Bryant. There's Jeri. This is Stuff You Should Know, okay?
Chuck: Unclean, unclean.
Josh: What is that from?
Chuck: I think that's what people with leprosy were-they had to say. They had to, like, ring a bell and say unclean when they walked through town, so people would avoid them.
Josh: I knew about the bell.
Chuck: Yeah. I think they would have to say unclean, or at least that's the story I heard.
Josh: Man alive.
Chuck: It really says it all.
Josh: It really does. Leprosy.
Chuck: States and stigma.
Josh: Well, yeah. Hansen's disease, I think, is the preferred term for it these days.
Chuck: Is it?
Chuck: I knew it was called that, but I have, like, every article I saw didn't even mention that.
Josh: I know.
Chuck: Yeah, it's-I don't know who's preferring it.
Chuck: Mr. Hansen, I guess.
Chuck: Whoever he is.
Josh: Well, he's a 19th century, I think, Swedish or Danish physician.
Chuck: Oh, is that the deal?
Josh: The guy who discovered the actual bacteria-
Josh: -that does it.
Josh: Because we're talking leprosy and it's a bacterial infection, after all.
Chuck: Yeah. I think when folks hear the leprosy or leper colony they, a lot of times, may not even know what the heck it is. And, yeah, I guess we should just start off by talking about the disease a little bit.
Josh: Yeah. It's an ancient disease. I actually found something from the beginning of 2014, and they discovered a new form of leprosy.
Chuck: Oh, really?
Josh: New to humans, but it's actually very old. But the fact that they can take this new form, a newly discovered form, and compare it to the one we've known about for centuries-they actually found that the fact that they diverged so long ago makes them suspect that it's possible that leprosy, Hansen's disease, is the oldest infectious disease to humans around.
Chuck: Wow. Really?
Josh: They think that it definitely originated in Africa. That it traveled out with humans in however many waves that went out of Africa to spread around the rest of the world. And one of the telltale signs that it's extremely old is that it only infects humans. As far as we know, it doesn't infect any other animals except, supposedly, armadillos. And they think that armadillos caught it from humans as recently as 100 or 200 years ago.
Chuck: Well, that's why if you're going to see leprosy in the United States you're probably going to find it in Texas or Louisiana.
Chuck: Because of the armadillos.
Chuck: And there is leprosy here, I guess-I bet most people think that it's not in the United States at all, but it is. It's super rare. The CDC says they get about 100 new cases a year in the U.S., which is super, super low, and only about 20 to 40 of those are people born in the United States. The other 40 to 80, I guess, are bringing it in from another country.
Josh: Oh, gotcha.
Chuck: And have it for years without knowing it. Because leprosy generally takes four to six years to manifest itself.
Josh: I've seen 10 to 20.
Chuck: Well, I mean, it can take that long, but, generally, four to six years.
Josh: Which is a big problem.
Josh: Because, first of all, it's rare, but even in the parts of the world where it's not all that rare, like, you can be infected with leprosy, like you said, for many, many years.
Josh: And even if you do start to show symptoms, they don't just automatically point to leprosy. They can be skin rashes or respiratory problems or something like that. So by the time a doctor says, "Oh, you have Hansen's disease," you're in big trouble. Or it used to be the case.
Chuck: Yes. But now it is completely curable, which is great news. It is also not contagious at all, hardly; 95% of human beings have a natural immunity. So the biblical times and in the Middle Ages where lepers were-and we'll get to all this, but when they were-thought, like, if you come anywhere close that you're going to get this dreaded disease has never been true.
Josh: Yeah, the thing is, is as ancient as leprosy is, they still don't know exactly how it's transmitted.
Josh: They assume that it's transmitted like most other bacterial infections, like either through saliva or mucus.
Chuck: Yeah, sure.
Josh: Like through a sneeze or something like that, or through cracks in the skin. And I saw both, that it's either very hard to catch or it's not that hard to catch. I saw that it doesn't live outside the human body for very long or it can still remain potent in, like, just basically on some sort of surface or whatever.
Chuck: Oh, really?
Josh: Yeah. But the last idea, that it doesn't stay active outside of the human body very long, is supported by the fact that they've never been able to come up with a leprosy vaccine because it can't exist outside of the human body, which is another idea or another reason why they think it's a very ancient human disease.
Josh: Because it's specifically tailored for humans. And do you know how it works?
Chuck: Yeah, sure. Well, you want to talk about how it actually-what it is and then how it affects you?
Chuck: Well, it is-they're little microbes called mycobacterium leprae, L-E-P-R-A-E.
Chuck: They're little, tiny rod-shaped microbes, and they infect the body and you will get skin sores and nerve damage and muscle weakness. And you're going to not be able to feel pain, which leads to more problems-like you will end up getting amputations because of gangrene because you injured your toes or your hands and you don't even know it.
Josh: Yeah. And the way that it does that on a cellular level is the leprosy bacterium hijacks what are called your Schwann cells. Your Schwann cells, they typically make some sort of fatty coating for muscle and nervous system tissue, right?
Josh: And it turns Schwann cells into stem cells, which is pretty magical if you ask me. And it says, "Go forth and go infect the muscle tissue of this human, and let's see what we can do." So, like, again, it's basically perfectly tailored to infect and hijack the human body and infect you in all these horrible, terrible ways. Like, it shortens your fingers is one of the symptoms.
Josh: Meaning that they just, kind of, start going back like pencil nubs that have been sharpened too many times.
Chuck: Yeah. If you're a biblical scholar, you have seen the word "leprosy" a lot in the Bible, but it didn't necessarily mean the specific disease. It could have been a variety of things, like eczema or psoriasis, because the word "leprosy" in the King James Bible in Hebrew, tzaraath, could be a host of diseases that kind of make you look gnarly, on the outside.
Josh: Yeah. But there is a passage in-at least in, I think Leviticus, which is old, man.
Josh: And it says that you, Hebrews, are supposed to keep an eye on anybody who has a skin sore, and if that skin sore starts to spread, that person is a leper and they are to live outside of camp. It was kind of an early understanding of contagious disease.
Josh: They didn't necessarily know what it was or what was going on but they knew enough to say, "You hang out over there."
Josh: Because we've seen before that if people with Hansen's disease hang out with everybody else, other people can catch it.
Chuck: Yeah. And that was the beginning of what would end up being leper colonies, and we'll talk about that a little more right after this break.
Josh: The holidays are here, man. We have way better things to do than go to the post office.
Chuck: Yes. That makes me go from jolly to grinch-like very fast.
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Chuck: So at first there were no leper colonies, per se; they were generally just shuttled to the outskirts of the city-
Josh: Or camp.
Chuck: -in London. Queen Matilda in 1118 founded, I guess, a camp that people could still come back into town and, like, beg for money and stuff, but they were always to go back to their camp at the end of the day.
Chuck: You know, just basically open land. It wasn't necessarily, like, some awful place to be. A lot of times these wealthy landowners would endow this land to keep these people there.
Josh: Yeah. Because they were sequestered or ostracized or just kept outside, people with leprosy, effectively, formed a subculture or a subset of the population. So you would have, like say, in a medieval town, like the Jewish section, and the leper section, and then like the blacksmiths or whatever.
Josh: And the executioner had to stay outside of town. So there were just like-
Chuck: The cobblers, don't mess with them.
Josh: Right. But I mean, they were like a subset of society.
Josh: And they were very frequently the butt of all sorts of reigns of terror.
Josh: Like people would be like, "Well, everybody's getting sick, so somebody poisoned the wells and it was probably the lepers."
Josh: And then the lepers-all the lepers would be rounded up and killed. So lepers, definitely, were subjected to execution. As recently as, I think, I saw the 1930s, in 1937 in China soldiers were, like, hunting down lepers and executing them for being lepers.
Chuck: Yeah. I mean, I think we've talked about this a lot on the show, people fear what they don't understand as a society. And they didn't understand leprosy. They didn't know where it came from. They thought it might be hereditary. They thought it was super contagious, like just touching someone would infect you.
Chuck: And so just because of the appearance that someone with leprosy would have-you know, they didn't want to see them. They wanted them away, so they couldn't be infected, and so they didn't have to look at it.
Josh: Right. Okay, so the thing is, is up until the 19th century, basically, although they were a subset of society, they were still, technically, part of society, lepers were. Even though they lived on the outskirts away from town, they were still part of society. In the 19th century there was a movement to basically say, like, "We don't want you to have anything to do with us any longer."
Josh: Like, you go over there. Like, you're not a part of our society any longer. You're your own thing, just go away forever. And there was actually a law in Illinois, I guess in Chicago, an ordinance, and it was called an ugly law.
Chuck: Yeah, in 1881, and it said, "Any person who's diseased or deformed, so as to be unsightly or disgusting object, has to stay away off the streets and away from public places."
Chuck: Because that's how they talk in Chicago. [LAUGHS]
Josh: So, I know. So I've seen Saturday Night Live before.
Josh: So no longer are you allowed in town to-
Chuck: It's an awful law.
Josh: -beg for alms or anything. Like, yeah, we decided, like, we don't want to look at you any longer, so you are not a part of our culture any longer. And that was in Chicago alone; this happened elsewhere. There was an outbreak in the 1850s in Hawaii, and the Hawaiian government said, "Yeah, I think we're gonna finally just say you guys can't be part of our culture any longer." And so they made leprosy a crime, so if you had leprosy you were a criminal, and therefore, you could be excommunicated, ostracized, banished, as under law.
Chuck: Yeah. That was when Hawaii was an independent monarchy. In 1865 they passed the act to prevent the spread of leprosy. And like you said, they might as well have been-they were criminals. And as the article opens up, in 1879 they describe a night in January where they-police officers rounded up a bunch of people stricken with leprosy, and basically sent them off on a boat to Kalaupapa Peninsula, and said, "This is your new home and you're not ever going to leave." So it makes the analogy of a prison, but it points out that even in a prison you can get visitors, and you may get out one day when your sentence runs out. If you had leprosy, you could get-not have any contact, and you were there for life.
Chuck: Very, very messed up.
Josh: Yeah. And that, apparently, went for leper colonies that were run like prisons, where the patients were treated like prisoners.
Chuck: Yeah. They weren't being attended to like a hospital.
Josh: No. It was like, you're in jail.
Josh: There was a particular difficulty for, say, like, the warden of the jail because you couldn't use the same kind of carrots and sticks that you could on a typical prisoner.
Josh: Because there was no hope that you were ever going to leave the leper colony, and that was part of the point. Like, it was your relationship with society at large was severed, and you were never coming back. Kids were taken from their families at very young ages, like, knowing that they were never going to see them again.
Chuck: Yeah. This one guy, there was a quote from a superintendent of a South African leper colony on Robben Island. His name was S.P. Impey, and he said in his notes in the 1890s, "You cannot starve them. You cannot flog them. All you can do is deprive them of their liberty."
Chuck: Which is really sad.
Chuck: You know?
Josh: So a lot of places set up actual prisons inland, but a lot of countries said, "That island over there that nobody wants, we're gonna make that a leper colony." So there are places in the Caribbean, in the Indian Ocean, in the Pacific, off of South Africa, like you just said. But one of the most famous leper colonies of all time was that one, I think it's Kalaupapa, if I know my native Hawaiian.
Josh: It would be Kalaupapa Peninsula on Molokai. And in 1866, a year after they enacted that leprosy criminal code in Hawaii, they set it up. And it was different because you didn't need any fences or walls or anything like that. Just the natural surroundings of the place. It was a peninsula, so it's surrounded on three sides by water, and then it just so happened that on that fourth side that was connected to land there's a sheer, 2,000-foot cliff.
Chuck: Yeah, so they were trapped.
Josh: They were trapped, but they were trapped in paradise, and it had an effect. It had a different effect.
Chuck: It did, and we will talk about that effect, right after this break.
Chuck: Most of us big-shot corporate executives like ourselves-
Josh: Yeah. [LAUGHS]
Chuck: -rely on email to communicate with each other, our clients, coworkers, we do it all the time. We have to exchange files, a lot of big MP3 files for us.
Chuck: And it can be kind of a pain.
Josh: Yeah. And we want these things to be confidential because our files are important, man. So we hate dealing with things like file size restrictions, balance backs, clogged inboxes, security breaches, all because of a single email attachment that we want to send. What's the solution, Chuck?
Chuck: The solution, my friend, is Citrix ShareFile.
Josh: Ah, yes.
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Chuck: So, Josh, you were talking about the different effect that this leper colony in Hawaii had because it wasn't-it was Hawaii, after all.
Chuck: You know? I mean, I don't want to make light of it, but it was a nice place. It was very fertile. They grew vegetables. They had a lot of food supplies.
Chuck: Local fruits were rampant. And there was a Belgian-born Roman Catholic priest named Reverend Jozef De Veuster, who went by Father Damien, and he really made a huge difference in the life of these people. Tried to make it as normal-sort of like a village, as he could, you know? They built the schools. They built churches. He started choirs and planted trees, started a band.
Josh: He gave these people a life.
Chuck: Like, as much of a normal life as they could have.
Chuck: He treated them like people.
Chuck: Which-and like human beings.
Josh: Yeah. Not just human beings, but also people who had an infectious disease, like patients.
Josh: Patients who could still walk and talk and move around and needed some sort of distraction or some sort of fulfillment. Father Damien came and gave this to these people.
Chuck: He also badgered the government for money.
Chuck: Which was good, because they actually had an advocate for the first time.
Josh: Yeah. It was basically like the 5th Avenue of regulars, but on the leper colony in Hawaii.
Chuck: That's right. Unfortunately, very sadly, Father Damien, himself, got leprosy and died at the young age of 49 in 1889, but he was canonized as a saint.
Josh: A saint.
Chuck: 120 years later.
Josh: During the big saint sweep of '09.
Chuck: So that was-that's a pretty neat ending to that story.
Chuck: For him.
Josh: And that the leper colony in Kalaupapa Peninsula. Man, I'm proud of myself for saying that one right. That is now a national park. It was created or turned into a national park in 1980, but the crazy thing is, there's still people that live there, at least as recently as 2003.
Chuck: What do you mean people that live there?
Josh: Like people-
Chuck: With leprosy?
Chuck: Oh, okay.
Josh: There was a guy I saw-I guess in 2003 there were a lot of people that were told they could leave or something? I think they were just waiting for the last generation to die out, and they said, "You know what? We've got this thing kind of licked here in the United States, so if you guys want to leave, go ahead." And some people said, "I've spent, literally, my entire life here. I don't want to leave, this is my home." So it's a national park with inhabitants, which is rare.
Chuck: Yeah. That's a good point. In the 1920s in the U.S. we started to change our tune a little bit, and the U.S. Public Health Service said, "You know what? Let's start a leper colony in Carville, Louisiana that's actually a hospital of sorts, where we treat these people, and try to make their life better, and to find-try and find a cure." Which is, I think, what directly led to the first drugs in the 1940s being established, one called Promin that, apparently, is a pretty nasty way to treat it because the injections were so painful, but it was a good start.
Josh: So it was painful. Apparently, they figured out-but it was an antibiotic that did work, and they figured out that if you added it to a cocktail of other drugs, apparently it was easier to take because it was in pill form, I think, is what they changed it to-
Chuck: Oh, really?
Josh: -in the '50s.
Josh: Or '60s. And then they added it to other drugs because the bacteria was starting to get resistant to this antibiotic alone.
Josh: So they came up with a cocktail in the '60s or '70s, and now have a regimen that can cure-cure-
Josh: -leprosy in six months. And it all came out of this leper colony at Carville, Louisiana. And there's a really, really neat documentary called Triumph at Carville about that, about how this place in Louisiana was the place where humanity licked leprosy. And it's-Carville, Louisiana is named after James Carville's family and he's in it. He talks a lot about it.
Chuck: Oh, really? That guy?
Josh: Because yeah, he grew up, like, down the road from it.
Chuck: I could listen to him talk, just that accent.
Josh: For sure.
Chuck: I love it.
Josh: But apparently, like, there was this, kind of, open secret that inhabitants would just leave every once and a while and there's, like, a bar nearby where they would go and drink beers and everything.
Josh: They'd just sneak out and sneak back in, drunk. Like in the '50s or whatever.
Chuck: Good for them.
Josh: Everybody just kind of left them alone and they did their own thing.
Chuck: Well, that's cool.
Josh: Yeah. It's a neat documentary.
Chuck: It took, obviously, a cure for leprosy to begin to change the stigma, and the tide did start to turn on that stigma in the 1960s and leper colonies started to close one by one. I think in Japan, they were one of the last nations to quarantine patients. They ended it in 1996. I think in Romania there is still one colony where, supposedly, there are a few elderly patients still there. But India is where it's a huge problem, still. Not a huge problem, but the biggest problem.
Josh: Well, there's a lot of debate over just how big of a problem leprosy is. Apparently, the World Health Organization has said, "We basically want to eradicate leprosy."
Josh: And so a lot of people accuse them of fudging the numbers. As one doctor put it, like, "The best way to eradicate a disease is to stop reporting it."
Josh: So there's between, say, I think the World Health Organization says 100,000/250,000 new cases a year.
Josh: And this one doctor, who, admittedly, has to do with this leprosy vaccine, says, "No. I think it's more between, like, 1 million and 2.5 million new cases a year."
Chuck: Oh, those are new cases?
Chuck: I thought there were less than 200,000, period.
Josh: The reporting is all over the place.
Chuck: Then it's all over the place.
Josh: And it's questioned. That's all I can say about that.
Chuck: India, Brazil, and Indonesia are the top three countries. And I know that in India there's a colony in Kasturba Gram, near New Delhi, and it still has that stigma there.
Chuck: There are people there that are cured of leprosy that stay there because their families don't want them back. If you have leprosy, you are still likely to be ostracized away from your family because it has-they just think it reflects badly if you have, like, a boy and a girl and the boy has leprosy and the girl doesn't. Like, that girl won't even be able to find a husband because the brother-
Josh: Oh, really?
Chuck: -in-law has leprosy.
Chuck: So they're still sending them behind closed doors, which is super sad because it's just a disease like any other and it's very treatable. It's because of the stigma of how it makes you look.
Chuck: You know?
Chuck: And I saw this thing, there was an inmate in an Ohio prison, this week, that was just treated for leprosy.
Chuck: He was just discharged from Ohio State Medical Center-Ohio State University Medical Center. The Ohio State University Medical Center. [LAUGHS]
Josh: You just won some fans.
Chuck: And he was just treated for, like, a few days. Apparently, once you start this drug cocktail, they can cure you in six months, but you're not even infectious after, like, a few days of it.
Chuck: So they put him back in the prison and he had it before he-you know, he had had it for years. I don't know if it's-
Josh: Man, where'd he get it? An Armadillo or something?
Chuck: No, he was from, I think, Micronesia.
Chuck: So they think he got it there.
Chuck: Brought it over here, didn't know he had it, ended up in jail. I'm not sure what he's in jail for.
Chuck: Not for having leprosy, I know that.
Josh: Not in the U.S., buddy.
Chuck: But they basically said, "All right. You're going back to jail. Nothing to worry about. Going back to prison."
Josh: He was like, "Uh, great."
Chuck: And I'm sure the prisoners are probably worried because they don't listen to this podcast.
Chuck: Well, some of them do.
Josh: It's probably working in his advantage.
Chuck: Yeah, like, stay away from that guy.
Josh: Unless he's sad and lonely, then that's different. So if this, kind of, got to you and you want to do something, World Leprosy Day is January 25th, 2015.
Chuck: That's right. We're a little early. We're kicking off World Leprosy Day in November.
Josh: Yeah, we are. And if you want to know more about leprosy or Hansen's disease, you can type either one of those in the search bar at HowStuffWorks.com and it'll bring up this article. Since I said that, it's time for listener mail.
Chuck: I'm going to call this "One-Hit Drummer." "Hey guys. I have no idea how I missed your one-hit wonder podcast from a while back until now, but it brought back a lot of memories. I was in a band called SR-71, which you may remember had a hit called 'Right Now,' which reached number two on the Billboard Modern Rock Charts in 2000."
Josh: That is high up.
Chuck: "And, generally, inescapable that summer. There're definitely some mixed feelings on the subject, but I'd have to say having had one hit is better than having none." Do you know the song?
Josh: I went and listened, I looked it up and I did not recognize it, honestly.
Chuck: I didn't either, and that's because I don't listen to the radio.
Josh: Same here, man.
Chuck: And in 2000 I wasn't listening to the radio. But it seemed like a very 2000 sort of song when I heard it, you know?
Chuck: It fit that time period.
Josh: Oh, yeah, and the video too.
Josh: And the dude's hair.
Chuck: I worked on a lot of videos like that at the time. Like, it seemed like there was a lot of street partying and skateboarding and, like, you know?
Chuck: A lot of that going on.
Chuck: "Although I got a brief, small taste of the sweetness that is fame, it was enough to make me realize that what I thought I wanted wasn't very satisfying. The upside was having plenty of stories to tell, and fortunately, I keep a tour journal containing details that have mostly been lost from memory-late-night TV, daytime talk, guest spots on short-lived TV shows, several incredible gigs. Can't forget the 40 Watt Club in Athens. An amazing trip to Japan, and one of the strangest experiences ever on German MTV. They make for some great life experiences that helps me see marketing for what it is, and all its forms. The major label recording experience and the constant touring were beneficial from a musical standpoint, although playing the same bunch of tunes every night quickly became maddening. And I'm happy to know that I don't want to be on the merry-go-round of or tour bus, rolling Petri dish,"-gross-"unless I'm the one running the show. Thanks for a great show. Please keep at it. There's so much to know." And that is Dan Garvin.
Josh: And that's one to grow on.
Chuck: Formerly of SR-71, and I emailed him to see if he cared to say what he's doing now and I didn't hear back from him. But I think he-
Josh: Well, let's make something up.
Chuck: Yeah, no.
Chuck: I think he's still drumming and, like, teaching and I think he has a recording studio. I think he's taken, like, that road instead of the drudgery of the tour bus.
Josh: Are you making all that up?
Chuck: No, no, no. I think that's real.
Josh: What is that based on?
Chuck: His Wikipedia page.
Josh: Oh, I gotcha.
Chuck: Yeah. [LAUGHS]
Josh: Okay. I was going to say-
Chuck: Where else would I find it?
Josh: I don't-I thought you were just making it up and wouldn't admit it.
Josh: Thanks a lot, Dan. That's pretty cool, man. If you had a one-hit wonder, would you have-no, you wouldn't have one, you'd be a one-hit wonder, right?
Chuck: And your name is not Lou-fake Lou Bega [LAUGHS].
Josh: We'd love to hear from you. You can tweet to us @SYKSPodcast, or you can say hey on our Facebook page at Facebook.com/StuffYouShouldKnow, you can send us an email to StuffPodcast@HowStuffWorks.com, and you can just browse our awesome free site, StuffYouShouldKnow.com.
Vo: For more on this and thousands of over topics, visit HowStuffWorks.com.