Leprosy and Learning: Parshat Metzora

In honor of this week’s parsha, I went on a tour of my local leprosy hospital. I am fortunate to live around the corner from Hansen Hospital, an asylum and treatment center for patients with leprosy (or, more accurately, Hansen’s Disease) from 1877 to 2000. The building, a spacious two-story stone structure set in a walled compound across the street from the Shalom Hartman Institute, was designed by Conrad Schick, a German architect and missionary who also designed Mea Shearim and built several models of the Second Temple.

The outside of the Hansen building bears the inscription Jesus Hilfe, which is German for “Jesus Saves,” a testament to the Protestant community of Jerusalem which originally founded the hospital both to heal and to mission to the lepers who had formerly congregated as beggars at Zion Gate. The leprosy asylum, built to accommodate sixty patients, was a self-sufficient institution containing its own water cisterns, a vegetable garden, fruit trees and livestock. Patients spent their time sewing, drawing water, and performing daily chores. Since there was no known cure for the disease, they were treated with fresh air, a healthy diet, and a daily work routine, all of which were regarded as therapeutic.

Although the asylum was not a closed institution—patients were free to leave and entertain visitors—it was regarded as such. Leprosy still had tremendous stigma attached to it, although its bacterial etiology had been discovered by the Norwegian physicist Armauer Hansen in 1873. As Hansen proved, the disease is neither infectious nor hereditary. Nonetheless, the Biblical associations with the leper as unclean and impure, which can be found throughout this week’s parsha, continued to dominate:

As for the person with a leprous infection, his clothes shall be rent, his head shall be left bare, and he shall cover over his upper lip; and he shall call out, “Unclean! Unclean!” He shall be unclean as long as the disease is on him. Being unclean, he shall dwell apart; his dwelling shall be outside the camp. (Leviticus 13:45-46).

The Talmud, too, warns of the dangers of coming too close to lepers. The term used in Masechet Ketubot is not Tzara’at (the Biblical word which the Septagint inaccurately translated as “lepra” — a general term for skin diseases already in the first century) but rather Ra’atan. Steinsaltz defines Ra’atan as “the disease of Lepra, Hansen’s Disease, erroneously termed Tzara’at.” The Talmud offers a detailed description of the causes of the illness:

R. Yose related, An old man of the inhabitants of Jerusalem told me: There are twenty-four [kinds of] skin disease, and in respect of all these the Sages said: Intercourse is injurious. But most of all is this is the case with those afflicted with leprosy. What is the cause of it? — As it was taught: If a man had intercourse immediately after being bled, he will have feeble children; if intercourse took place after the man and the woman had been bled they will have children afflicted with leprosy. (Ketubot 77b)

In other words, according to the Talmud, leprosy is a congenital disease of those whose parents conceived them right after bloodletting. It was clearly thought to be contagious, since the rabbis kept their distance from the afflicted:

R. Yohanan issued the announcement: Beware of the flies of the man afflicted with leprosy. R. Zeyra never sat [with such a sufferer] in a place where the wind blew from their direction. R. Eleazar never entered his tent. R. Ammi and R. Assi never ate any of the eggs coming from the alley in which he lived.

There was, however, one rabbi who used to sit with the lepers and even study Torah in their presence:

R. Joshua ben Levi attached himself to these [sufferers] and studied the Torah; for he said, “A lovely gazelle and a graceful doe,” (Proverbs 5:19). If [the Torah] bestows grace upon those who study it, would it not also protect them?

Rabbi Yehoshua ben Levi believed that the contagion associated with leprosy would not affect him because he studied Torah. He cites a verse from Proverbs which, in its original context, refers to marital fidelity: “Find joy in the wife of your youth. A loving gazelle, a graceful mountain goat. Let her breasts satisfy you at all times. Be infatuated with love for her always.” He interprets this verse as being about Torah, and argues that if Torah is graceful (i.e. a bestower of grace), surely it also has protective power over those who study it. That is, he knows that the lepers are contagious, but he believes that by virtue of his Torah study, he is immune to illness.

Rabbi Yehoshua ben Levi came to mind today when I learned about Rabbi Aryeh Levin (1885-1969), who is part of the lore of the Hansen asylum. Reb Aryeh, who was appointed the official Jewish Prison Chaplain of the British Mandate in 1931, was famous for his visits to members of the Jewish underground imprisoned in the Central Prison of Jerusalem in the Russian Compound. He was also considered a tzadik for his work on behalf of the poor and infirm, and particularly for his visits to the leprosy patients. While most people kept their distance from the lepers, believing that they should “dwell apart,” Rabbi Levin visited them regularly, teaching them Torah and sitting with them outside. In this sense, he was a modern-day Rabbi Yehoshua ben Levi, a man who studied Torah in the presence of lepers with no concern for his own well-being.

Did either of these rabbis believe that Torah was a cure for leprosy? Is that why they studied with the lepers? It is difficult to know. The Talmud prescribes an elaborate treatment for those afflicted with this malady:

What is the cure? Abaye said: Pila, ladanum, the rind of a nut tree, the shavings of a dressed hide, sweet-scented clover and the calyx of a red date-tree. These must be boiled together and carried into a house of marble, and if no marble house is available they may be carried into a house [the walls of which are of the thickness] of seven bricks and a half. Three hundred cups [of the mixture] must then be poured upon his head until his cranium is softened, and then his brain is cut open. Four leaves of myrtle must be brought and each foot [in turn] lifted up and one [leaf] placed [beneath it]. It is then grasped with a pair of tweezers and burned; for otherwise it would return to him.

The Talmud seems to suggest that leprosy was some sort of bug in the skull requiring elaborate surgical extraction. Prior to the surgery, the cranium had to be softened by means of a concoction worthy of the weird sisters in Macbeth. All that toil and trouble, once the cauldron had bubbled, was then poured onto the skull to prepare it for surgery. This is a far cry from the first modern brain surgery (with anesthesia and antiseptic methods) performed in 1884 at the Epileptic Hospital in London, just one year before the cornerstone of the Hansen asylum was laid. The surgery was to remove a tumor, and not to treat a leper. The modern cure for leprosy is an antibiotic discovered in 1981; today it is administered free of charge by the WHO to patients around the world. The last leprosy patients left Hansen’s Hospital in 2000, and the building was closed and shuttered until April 2009, when it was re-opened to the public as a museum. “I grew up down the street from here,” one elderly woman told me during our tour this afternoon. “We used to pass the hospital on our way home every day. We’d always cross the street and run as fast as we could, so that the lepers would not catch up with us.”

The fear of lepers seems to be as old as recorded human history. Ancient legends suggest the reason that the Israelites were released from bondage in Egypt was that the ancient Hebrews were carriers of leprosy. Perhaps the fear stems from the mysterious nature of the illness, whose cure was unknown for so long yet whose symptoms were so alarming and repulsive: inflamed and discolored skin, and limbs that rotted and then fell off. In the Bible, Miriam gets leprosy for speaking Lashon Hara about her brother Moshe, suggesting an association between leprosy and sin. Indeed, the Talmud’s cranial surgery remedy is not surprising given that the stigmas associated with leprosy are not all that different from those associated with mental illness, whose etiology remains largely unknown to this day. We do not know what makes a person schizophrenic or bipolar, so we feed a concoction of chemicals that block the reuptake of serotonin to the little bug in the brain. Mental illness is often thought to be someone’s fault – the bad mother, or the hyperactive school child (or the parent who conceived after bloodletting, say). Our understanding of the brain—that organ by means of which we learn about everything in the world including the brain itself—is vastly behind our understanding of any other aspect of our biology. In lieu of scientific knowledge, we speak in terms of legend and lore, sin and blame – which is what leprosy and mental illness have in common.

When we exited the leprosy hospital into the bright light of a warm spring afternoon, D and I thought we might sit and learn Daf Yomi in the beautiful overgrown garden surrounding the hospital building. We wanted to imagine ourselves as Rabbi Yehoshua ben Levi, learning Torah among the lepers. After the horrific pictures of skin inflammation and suffering that we had seen inside the hospital museum, some sort of remedy seemed in order. But instead of daf yomi, I thought of a sugya in Eruvin that begins with a statement of Rabbi Yehoshua ben Levi, the rabbi of the lepers:

Rabbi Joshua ben Levi stated: If a man is going on a journey and has no one accompanying him, let him occupy himself with the study of Torah, since it is said, “For they are a graceful wreath upon your head” (Proverbs 1:9). If he feels pain in his throat, let him engage in the study of Torah, since it is said, “And chains about thy neck” (Proverbs 1:9). If he feels pain in his bowels, let him engage in the study of Torah, since it is said, “It shall be a healing to thy navel” (Proverbs 3:8). If he feels pain in his bones, let him engage in the study of Torah, since it is said, “And marrow to thy bones” (Proverbs 3:8). If he feels pain in all his body, let him engage in the study of Torah, since it is said, “And healing to all his flesh” (Proverbs 4:22). (Eruvin 54a)

Does Torah really bring “healing to all his flesh”? Is it really a סם חיים, an elixir of life, as we are told later on in this Eruvin sugya? I do not know. But if someone had to open my skull and pour something inside, I, for one, would like that thing to be Torah.

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