Marianna Mapes, Disease and the Body Politic: The National Leprosarium at Carville, Louisiana
Negotiating the "Limitations" of Illness
In 1894, a facility to quarantine Americans with leprosy (now known as Hansen's Disease) was founded on the site of the former Indian Camp Plantation in Carville, Louisiana, halfway between Baton Rouge and New Orleans (Mizell-Nelson 2003, 306). Though leper colonies had been operational in the American South for more than one hundred years, the leprosarium at Carville was the first of its kind in the nation (ibid.). It was borne out of persistent, nationwide – indeed, global –stigma around individuals with leprosy, fueled by deep misunderstandings of its causes (Sermrittirong and Van Brakel 2014, 37) and the mythification of the disease through, e.g., wisdom literature (Gussow and Tracy 1971, 698). Given the common belief that leprosy was highly contagious, quarantine of all individuals with the disease was mandated once the leprosarium came under federal control in 1921 (Mizell-Nelson 2003, 308). Through the 1930’s, it was standard practice for patients to be assigned pseudonyms upon their arrival at Carville “in order to protect their families’ reputations” (Mizell-Nelson 2003, 309).We now know that leprosy is a highly treatable, chronic infectious disease caused by Mycobacterium leprae (World Health Organization). Leprosy is a disease of both low pathogenicity and low virulence – it is spread only through droplets from the nose and mouth, and can remain latent for up to 20 years; though it can cause significant damage to the skin and nerves, it can be cured with multidrug therapy (WHO). But even at Carville – that is, in spaces designed for the deployment of clinical expertise in the treatment of leprosy – deep misconceptions about the causes and progression of the disease flourished. To date, discussion of the architecture at Carville has been quite limited; it is this lacuna in scholarship that I aim to address here, delving into a rich variety of sources covering aesthetic trends in the American South, the history of architecture as a form of social control, and even the ethical norms governing medical practice during Carville’s years of operation.
As indicated in the images below, during its years of operation, the leprosarium carved up physical space in ways that reinforced rigid norms regarding which bodies were deemed unworthy of civic engagement -- and therefore, of being seen in the public square. Though disability theory is not the sole conceptual lens that I consult for this project, it is especially valuable in understanding Carville – with all its vestiges and artifacts of oppressive thinking about wellness and disease – as a site of negotiation, transformation, and reclamation of citizenship. Carville offered limited opportunities for new ways of engaging with the bodily autonomy of which patients had long been deprived (for example, it was not until the early 1950’s that Carville patients successfully regained their right to vote, or were permitted to go on leave to visit family; “Crusade in Carville”). Stripped of their birth names, patients responded not by reclaiming those names, but by constructing even richer, more imaginative identities for themselves, if only for one fleeting evening.
"Tuberculosis was the leading cause of death in the United States during the late nineteenth and early twentieth centuries. Leprosy, on the other hand, was rare, but the disease was more greatly feared by the public. It is thus hardly surprising that the nation's only leprosarium was the nation's most gloomy and rigidly regulated sanatorium" (Mizell-Nelson 2003, 309).
The spatial arrangement of the leprosarium and the structure of the buildings themselves present an interesting reference point for evolving understanding of the nature of the disease and shifts thinking more generally about patient autonomy and the role of medicine. We find that the built environment is outgrown by deepening scientific understanding so that the structures reflect traditional medical lore’s conception of leprosy. The ways in which certain structural features are rendered obsolete by a firmer grasp of the disease and proper treatment stand as artifacts of a different conceptual framework for thinking about wellness and medicine.
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