**3.1 From the ancient times to the end of the feudal era (~1867)**

Leprosy existed in Japan from the ancient times and statements about the disease were mentioned in Nihon Shoki (AC.720), which is one of the two oldest written documents in Japan. According to the concept of defilement, Hansen's disease patients were considered to be defiled beings because of their change in appearance. In Buddhism, leprosy is considered as a punishment from heaven and a disease caused because of karmic retribution. Patients stayed at home so that they do not stand out, or lived in areas that were designated for the feudal outcast group and thus coexisted in society. Patients who could no longer live in their hometowns would beg at the gates of temples and shrines, or depart on wandering journeys and were called "wandering lepers."
