Beggars, metaphors, and stigma: a missing link in the social history of leprosy.

Students of leprosy stigma are at odds over its sources, intensity, and current presistence. On the basis of a study of leprosy in Thailand that combined an archival survey with anthropological field-work, the present article offers a different thesis on these issues from those that have been proposed thus far. The thesis suggests that prior to the discovery of a cure for the disease, its sufferers encountered ambivalent rather than severly stigmatizing reactions. Yet the public's selective exposure-mainly to beggars with the disease-paved the way to the perception of leprosy as the epitome of stigmatization and to its transformation into a metaphor for degradation. Progress in the medical treatment of the disease significantly improved patients' social acceptance but also allowed them to keep their illness a secret. Their consequent disappearance from the public eye turned the figurative use of leprosy in the spoken language into the main source of shaping its image. This development contributed to the irrefutability and perpetuation of the negative image, and even to its intensification to the extent of utter divorce from concrete reality. After expounding this thesis, the paper discusses its potential contribution to resolving the disputes over the roots, severity, and persistence of leprosy stigma on the international level.