First Visual Evidence of Leprosy in the Continental Shelf of Iran.

Dear Editor-in-Chief

The history of leprosy dates back to the time of human existence and is also mentioned in the Avesta (1). The Vandidad refers to Thrita as the first Aryan physician who was capable of treating several diseases including leprosy (1). However, no visual example indicating the effect of leprosy on the Iranian culture and artifacts has been reported while it can be seen in other cultures in forms of paintings, carvings, and even the remaining masks (2). The author has recently found something in the remains of the Teppe Hasanlu dating back to the 1st millennium BC which can be considered as the first visual instance of the effect of leprosy on the Iranian art.

The Teppe Hasanlu civilization belongs to the northwest of Iran. Through excavations, ten different eras were detected at the hill, the most outstanding of which dates back to the 4th era, i.e. 133–800 BC (3).

There was a big fire at the time; yet, exceptional works, especially three small masks that are now preserved in the National Museum of Iran, survived the fire (4). The three masks belong to the same epoch. The first one is the face of a crowned human; ears as well as parts of the face including nose, eyes, and mouth are quite evident (Fig. 1-A & B).

Fig. 1:

(A & B) The first mask with no sign of leprosy. (C) Deformed nose and empty sockets indicating the effect of leprosy. (D & E) Empty sockets and damaged ear

Nevertheless, specifications of the second mask can be the evidence of the effect of leprosy (Fig. 1-C). As the picture shows, the nose is deformed which is quite compatible with the impact of leprosy on the nose cartilage tissue and deformity. Furthermore, the mask has empty sockets. The skull is depressed at eye points and they have almost disappeared. Finally, the ears are covered up and hidden under the crown.

Were the ears damaged due to some diseases and covered up? The view is evident in the other mask (Fig. 1-D & E). In this mask, although the nose is not deformed, the sockets are empty and the ears are damaged. Comparing the three masks, their differences are quite evident. The first mask shows a normal individual with specifically visible ears, eyes, and nose. However, the other two visuals show two people whose nose, eyes, and ears are deformed probably due to leprosy. These valuable remains of the Teppe Hasanlu can be probably considered as the first visual evidence of leprosy in the continental shelf of Iran.