Scarcely different from the preceding in the period of invasion is the course of anæsthetic leprosy, one of the characteristic symptoms of which is the anæsthesia of the little finger, which may occur even before any lesions appear.
Add the torture of an unquenchable thirst in the last stages of the disease, and, as the patient usually preserves his mind unaffected to the end, the utter prostration resulting from his complete helplessness and the sight of the slow and unrelenting process of decomposition of his body, and it is easy to understand how truly, in the Book of Job (xviii, 13), leprosy is called "the firstborn of death".
At the same time it began to spread in the colonies of America and the islands of Oceanica.
"It is endemic in Northern and Eastern Africa, Madagascar, Arabia, Persia, India, China and Japan, Russia, Norway and Sweden, Italy, Greece, France, Spain, in the islands of the Indian and Pacific Oceans.
Such lepers as were not confined within these asylums had to wear a special garb, and carry "a wooden clapper to give warning of their approach.
They were forbidden to enter inns, churches, mills, or bakehouses, to touch healthy persons or eat with them, to wash in the streams, or to walk in narrow footpaths" (Creighton). Leprosy in the Middle Ages.) Owing to strict legislation, leprosy gradually disappeared, so that at the close of the seventeenth century it had become rare except in some few localities.
The average course of leprosy is about eight years, the mixed type being more rapidly concluded.