Who holds pears like that?!

[Koen G]

Thanks, Marco! This must indeed be the leper with the clapper. The nymph holding the corresponding object certainly doesn't look like a paragon of good health, but this might be a relative thing among Voynich nymphs.

Regarding the "goiter", I assume that this is about the small humpbacked person in the image on top. Since he stores all his nutrients in this hump, he remains small.

[Bernd]

Probably a coincidence, but the hills behind the leper strangely resemble tubes...

   

[Bluetoes101]

Probably also worth noting this is the only green paint on the page (80r)
On 80v, green is seen with the "fighting nymphs", the less than healthy looking animal and the three nymphs bottom left, who I only just noticed are missing limbs (/hands)..

The idea also makes the "green water" images on 79r and 79v interesting

As with anything VM.. pinch of salt and all that, but thought worthy of note. 

[Barbrey]

In the context of Philomela, pears representing abortion or contraception makes some sense: killing her son and feeding him to his father.  I can’t remember the sequence though: if they represent adultery or rape, that’s in the story too. 

(Based on Koen’s older analysis of some of these pages illustrating this Ovidian myth).

With some of the former pictures, can’t help thinking of the expression “fruit ripe for the plucking”, used to describe attractive girls just post-puberty ready for seduction or rape.  Though sometimes widows too.