Tracing Leprosy: The paleopathological study of the individuals excavated from the Sant Llàtzer leprosarium in Barcelona, Spain (12th-18th c.).

Objective: Our objectives are twofold: to analyse the frequency of leprosy-related pathological lesions in the cemetery of Sant Llàtzer Hospital (12th-18th c.); and to examine how individuals affected by the disease were perceived and integrated into society during that period in Barcelona.

Materials: The skeletal remains of 87 individuals recovered from the cemetery.

Methods: All remains were analysed macroscopically and, when required, radiographed.

Results: Of the total number of individuals (n=87), 21 (24.1 %) showed evidence indicative of leprosy. Notably, the frequency of leprosy cases was lower in the 13th-15th c. (10 %; n = 50), the only period for which multi-person graves were documented.

Conclusions: The frequency of leprosy-related lesions in Sant Llàtzer is similar to that observed in other European Christian leprosaria, although it varies across the centuries. There is no funerary evidence that leprosy sufferers were treated differently than other citizens.

Significance: The cemetery of Sant Llàtzer, the first in Spain directly linked to a leprosarium, uniquely spans a significant period of activity. Its exceptionally preserved remains and rich records have offered unparalleled insight into the disease and its profound social implications.

Limitations: Leprosy affects the bone in only a small percentage of untreated cases. Moreover, poor preservation of skeletal remains may prevent diagnosis.

Suggestions for further research: Biochemistry, genomics, and proteomics might provide new insights into the disease, the origin and migrations of the individuals buried in Sant Llàtzer, as well as other aspects of their daily lives.