Again, the term lepra, as used by the Greek physicians themselves, signifies morbid changes in the skin, marked by the presence of scales, and which changes in the skin have no relation whatever to either the Arabian or Greek elephantiasis; but the same term lepra, as used by the Arabic translators, was applied to designate the latter of these two affections, viz. the Arabic “Juzam,” or elephantiasis of the Greeks. Hence, the _elephantiasis of the Greeks_ and the _lepra of the Arabians_, or more properly of the Arabian translators, are expressions altogether synonymous, as being employed to designate the same individual disease; and it is of the first importance to hold this fact in view in studying the histories of the European leprosy, which have been left us by our own and by other medical authors of the middle ages.[152] For we must further recollect that the knowledge of the Greek tongue was almost entirely lost during the dark ages, and that nearly all learning being then confined to the Moors and Arabs, the scholastic language was principally the Arabic. Thus it happened, that when the love of literature and the pursuit of science began to revive about the twelfth century, the medical as well as the philosophical writings of the ancient Greeks were read and studied by the inhabitants of Western Europe through the medium of Arabic translations of them, or in Latin versions made from these translations.[153] The designations of individual diseases were known to the learned student, and to the medical practitioner and author of the times in question, by the names only under which they were described in these versions. The _elephantiasis_ of the Greeks, or corresponding _juzam_ of the Arabians, was rendered by the term _lepra_ in almost every Latin translation from the Arabian or Saracenic school; and hence it is that we find this term lepra used by the medical and other authors of the succeeding period, as the common appellative for the individual disease to which the two former designations were originally applied. In many medical works of the middle ages the single name “_lepra_”[154] is employed; in the writings of others, and more particularly of later authors, it has the distinctive designation (_Lepra Arabum_) added to it,[155] in order to discriminate it from the _Lepra Græcorum_ or scaly eruptions, to which that term was primarily applied by the Greeks. In still more modern times, and with the same view, the _Elephantiasis Græcorum_, Juzam, or Lepra of the Arabians, or rather of the Arabian translators, has been very frequently termed (as I believe was first proposed by Vidal)[156] tuberculous leprosy (_Lepra tuberculosa_), in order to distinguish it from the other very different disease, the scaly leprosy of the Greeks (_Lepra vulgaris_, _Lepra squamosa_, etc.) But, whatever may be the difference in the nomenclature of different authors, we are to hold this in recollection, that the various terms of the elephantiasis of the