In June 1781 the physician Nicolaus Arbo, practising in the district of Strømsø in eastern Norway, received a letter from a chamber councillor in the neighbouring county of Telemark. The councillor requested that Arbo take compassion on two poor, single male peasants, whom he had met in a ‘most miserable and lamentable state’. Both of them had been discharged from the hospital as incurable, and they now dwelled in a tiny peasants' hut, entirely ostracized by the community, which feared infection. The councillor pitied these two unfortunates, and their ‘utterly deplorable fate’ had triggered his request to the physician. One of them, named Hans, was thirty-six years old. His health had begun deteriorating five years earlier, and the infirmity reappeared a few years later, with ulcers in the throat and under the nose. Eventually the whole lower part of the nasal cartilage and most of the upper lip were completely destroyed by the disease. He looked ‘extraordinarily repulsive’, but his health was otherwise good. The other, John, was thirty years old. His suffering had commenced three years earlier with ulcers in the throat and loss of the uvula. He had also contracted a disease of the chest, and his speech was severely impaired due to shortness of breath and increasing hoarseness. The colour of his face was pale and yellowish.