From Archive to Algorithm: Leprosy, Paleopathology and Digital Paleography at the Hospital of São Lázaro, Coimbra

Abstract

The Hospital of São Lázaro of Coimbra, incorporated into the Hospitals of the University of Coimbra in the eighteenth century, was one of the main institutions for the treatment of leprosy patients in Portugal. This study focuses on the historical and paleopathological characterization of leprosy patients’ admissions between 1870–1900, based on the analysis of 57 books, which contains admission registers and clinical records, preserved in the Archive of the University of Coimbra. A total of 239 individuals diagnosed with leprosy were identified among 71,484 admissions (0.33%), enabling the reconstruction of the biodemographic and clinical profile of patients, patterns of hospitalization, average length of stay, and associated comorbidities and mortality. The research further distinguishes between “institutionalized lepers” and “occasional lepers,” shedding light on relevant aspects of hospital management and nineteenth-century medical practices. The application of statistical methods combined with the cross-referencing of diagnoses and comorbidities, provides significant insights into the clinical course of leprosy and its paleopathological contextualization. In addition, this study presents the ongoing project to transcribe the historical records of the Hospital of São Lázaro (1684–1772), using the Transkribus platform and Handwritten Text Recognition (HTR) models. This innovative approach enables the conversion of difficult-to-read manuscripts into searchable and standardized text, fostering the creation of open-access databases relevant to paleography, the history of medicine, and paleopathology. The integration of AI, written historical sources, and methods from biological anthropology represents a significant advance in the interdisciplinary study of infectious diseases and the historical and social trajectory of leprosy in Portugal.