The first use of "lupus" as a disease.

Objectives: Describe the history of the use of the term "lupus" as a disease and to point out the inaccuracies of previous lupus historical articles and correct the historical record.

Methods: An exhaustive review of Medieval and later texts regarding the use of the term "lupus" as it was used for the name of a disease as well as personal communications with Medieval experts who have studied this topic.

Results: There are three possible first uses of "lupus" as a disease: an affidavit written in 963 AD by Eraclius (Bishop of Liège, Belgium), in a 12th century historical account of the Bishop of Liège, falsely ascribed to the 9th century Bishop Herbernus, or in an 1170 AD letter written by Pierre de Blois about the death of archbishop Stephan du Perche. The first use of "lupus" in a medical text was by Rolando da Parma in a 1230 AD surgical treatise. Lupus, Latin for wolf, was not used to describe lesions that looked like wolf bites. Instead, it was first used to describe potentially deadly skin lesions that devoured the affected person's skin and "internal matter." The first described lupus treatment was freshly killed chicken flesh applied to the lesions so they would "wolfishly" eat the chicken rather than the person's flesh. At least 25 modern historical articles, book chapters, and academic theses on the topic contain incorrect dates, story authorship ascriptions, reason for the use of "lupus" and other facts. There is no proof that Hippocrates described lupus. The Basilica of St Martin (Liege, Belgium), was originally built in the 10th century by Eraclius, Bishop of Liege, out of gratitude to St Martin for curing him of "lupus."

Conclusions: The first use of the word "lupus" as a disease originated in either the 10th or 12th centuries. It described a deadly disease affecting the buttocks and legs that "wolfishly" devoured the person's flesh and "internal matter" as well as doctor-prescribed fresh chicken flesh placed on the lesions. Authors of medical history articles should evaluate original historical texts and not simply repeat what other modern articles have written.