Diseases

DISEASES. The diseases mentioned in Scripture appear largely to have been well-known entities—probably identical with those that now exist, especially in semitropical climates like that of Palestine. Instead of naming the disease involved, however, the Bible often simply mentions symptoms (e.g., fever, itch, sore).

I. Diseases With Primary Manifestations in Skin. The hygienic measures outlined in Leviticus agree with modern concepts of communicable disease control, especially regarding the availability of running water and the isolation of the patient. Two kinds of skin disease are recognized in Leviticus: (1) those classified as tsāra‘ath (so-called leprosy in kjv), which were believed to require isolation, and (2) those not requiring isolation. Lev.13.1-Lev.13.59 gives clear diagnostic distinctions and procedural guides based on the developmental characteristics of the various diseases. Spinka believes that human tsāra‘ath diseases include leprosy, syphilis, smallpox, boils, scabies, fungus infections (e.g., favus, tinea, actinomycosis), all of which are known to be potentially contagious, and also pemphigus, dermatitis herpetiformis, and skin cancer, which are doubtfully contagious. In addition there are classified as tsāra‘ath certain mold and fungus growths in houses and on cloth, conditions assuming importance from the standpoint of human allergy, often with manifestations in the form of asthma.

A. Diseases requiring isolation

1. Leprosy, also known as Hansen’s disease, as defined today, is the name for disease processes caused by the microorganism Mycobacterium leprae. There are two types: (a) the lepromatous type begins with brownish-red spots on the face, ears, forearms, thighs, and/or buttocks that later become thickened nodules and, losing their skin covering, become ulcers (“sores”) with subsequent loss of tissue and then contraction and deformity. It was apparently the lepromatous type that was chiefly in view in the biblical cases of true leprosy. (b) The tuberculoid type is characterized by numbness of an affected area of skin and deformity such as fingers like claws resulting from paralysis and consequent muscle wasting (atrophy). The advanced forms of leprosy are not described in Lev.13.1-Lev.13.59, presumably because this chapter is concerned with early diagnosis. Advanced leprosy would be seen only in isolation outside the camp.

2. Syphilis is regarded by Spinka as probably the disease called the “botch of Egypt” in Deut.28.27 (kjv; niv “boils of Egypt”). It is a disease that from time to time throughout the ages has burst forth in virulent form with high mortality, e.g., Israel in Num.25.9. It is chiefly spread by sexual intercourse and is often associated with gonorrhea (cf. tsāra‘ath associated with “bodily discharge” in Lev.22.4). Starting with a hard ulcer on the private parts, after some weeks raised spots (papular eruption) appear on the torso and extremities (almost never on the face), with no itching. Years later, syphilis of the vital organs such as heart, liver, or brain may become evident, often with fatal outcome. This late type of syphilis seems to be in view in Prov.7.22-Prov.7.23 where, referring to a harlot, it says, “He followed her like an ox going to the slaughter... till an arrow pierces his liver, like a bird darting into a snare, little knowing it will cost him his life.” Syphilis may be present also from birth and give rise to abnormalities such as those listed in Lev.21.18ff.

3.Smallpox, uncontrolled, is a serious scourge of mankind, though over the last quarter of a century there has been a remarkable decrease of incidence. It consists of red spots that turn rapidly into blisterlike pustules over the entire body, including the face. A. R. Short suggested that Job’s so-called boils (Heb. sheḥîn) were actually smallpox, since true boils do not occur in such profusion. This Hebrew word—occurring thirteen times in the OT and usually translated “boil(s)”—may indicate several types of diseased skin, today referred to as (a) papule (a raised red spot), (b) vesicle (a small blister containing yellow fluid; called “blain” in kjv and asv), (c) pustule (a small blister containing pus), (d) boil (a deep, broad inflammation about a hair root resulting in death of the tissues in its center, with pus formation about this core, the pus discharging through an external opening), (e) carbuncle (a large boil with multiple openings), and (f) malignant pustule (anthrax).

4. Hezekiah’s “boil,” which was almost fatal, may well have been a true boil or carbuncle. Another suggestion is that it was anthrax. The local application of a poultice of figs has been recognized therapy for gumboils in comparatively recent times. Its use by Hezekiah at the command of God’s prophet (2Kgs.20.7) has often been cited as divine approval of the utilization of medicinal means of therapy.

5. Festering boils (Heb. shehîn, “boil breaking forth with blains,” Exod.9.9 asv) has provoked much speculation and two alternative explanations. (a) Both man and beast were infected with virtually the same disease called smallpox in man and cowpox in cattle, the germ of cowpox being originally utilized for vaccination against smallpox. (b) The “terrible plague” (Exod.9.3, asv “very grievious murrain,” the fifth plague) was anthrax of animals, later transmitted to man as malignant pustule (anthrax). Untreated, anthrax is a fatal infectious disease, chiefly of cattle and sheep, characterized by the formation of hard lumps and ulcers and symptoms of collapse. In man without modern therapy it is often fatal.

6. Scabies is called “the itch, from which you cannot be cured” (Deut.28.27). It is caused by a tiny insect allied to spiders that burrows under the skin. The itching is intense. Infection is spread to others through close bodily contact. The ancients knew no cure for it, but it readily responds to modern medicines.

B. Diseases not requiring isolation.

These are skin diseases (Heb. gārāv and yallepheth), called “scab,” “scall,” and “scurvy” in KJV. They probably include what today are known as eczema, psoriasis, and impetigo. Of these only impetigo is very contagious; it is of very superficial character without system manifestations. The scurvy of modern medicine, which is cured by eating high vitamin C citrus fruits, obviously is a different disease from the scurvy of KJV. Modern scurvy is not a skin disease and could not occur among the fruit and vegetable-eating Israelites.

Inflamation.—which is present in wounds, bruises, and sores—is aggravated by accompanying infection when the skin is broken. “Wounds” are usually due to external violence; when the skin is unbroken they are called “bruises.” A “sore,” more properly called an ulcer, is a wound in which the skin and the underlying tissues are laid open, almost invariably becoming infected. For example, the Hebrew noun yabbāl, which occurs only once in the OT (Lev.22.22), was defined by Gesenius as a “running sore” (see niv). It has been variously translated as “discharge” (rsv), “infected sores” (MLB), and “wen” (asv, kjv).

II. Diseases With Primarily Internal Manifestations.

A. Plague evidently played a major role in OT history. It begins with fever and chills that are followd by prostration, delirium, headache, vomiting, and diarrhea. Caused by the germ Pasteurella pestis, two forms of plague occur: (1) bubonic and (2) pneumonic, both forms being sudden in onset and very serious.

1.Bubonic plague apparently broke out among the Philistines when they placed the captured ark of God in an idol temple (1Sam.5.1-1Sam.5.12). This disease is transmitted by rats through infected fleas that they carry on their bodies, the fleas transferring to man for livelihood after the rat host dies of the disease. The disease causes the lymph nodes of the groin and armpits to enlarge to the size of walnuts. These enlarged nodes are known as buboes (Heb. ‘ŏphālîm, meaning “mounds”)—“emerods” (kjv), “hemorrhoids” (mlb, nasb), “tumors” (niv, rsv). This outbreak of bubonic plague was attributed to “rats that are destroying the country” (1Sam.6.5). The LXX more vividly says: “In the midst of the land thereof mice were brought forth, and there was a great and deadly destruction in the city...and the land swarmed with mice.” The Hebrew word ‘akhbār doubtless refers to rats as well as mice; no other word for rat occurs in the Bible, though rats evidently existed in the land, since archaeologists have found rat skeletons. Worthy of note is the ancient’s recognition that plague broke out in dwellings (cf. Ps.91.10), followed lines of communication, and was transmitted by rats.

2. Pneumonic plague is transmitted by droplet spray from the mouth. The first case in an epidemic apparently arises from a case of bubonic plague that has been complicated by plague pneumonia. Untreated pneumonic plague is always fatal. The victim goes to bed apparently well and is found dead by morning. It appears very likely that it was either bubonic or pneumonic plague or both that destroyed Sennacherib’s army (2Kgs.19.35) when 185,000 men were all “dead bodies” by early morning.

B. Consumption (Heb. shaḥepheth, “wasting disease”) doubtless included tuberculosis, malaria, typhoid fever, typhus fever, dysentery, chronic diarrhea, and cholera. These diseases are contagious and are sometimes referred to as “pestilences,” being especially prevalent under circumstances of impaired nutrition and crowding such as are encountered in the siege of a city, e.g., Deut.28.21-Deut.28.22; Jer.21.6-Jer.21.7, Jer.21.9.

1. Tuberculosis occurs in acute or chronic form, more commonly the latter. Under the living conditions of OT days, it probably not only attacked the lungs (common form in America today), but also the bones and joints (common in underdeveloped lands today). “Crookback,” e.g., extreme hunchback of Lev.21.20, may result from tuberculosis of the spinal vertebrae or less commonly from severe back injury. Tuberculosis anywhere in the body may produce fever, defective nutrition with underweight, or discharge of infectious pus (referred to as an “issue” in Leviticus). The disease may produce chronic invalidism or death if the disease process is not arrested.

2. Typhoid fever and typhus fever both give rise to similar symptoms of steady fever and delirium lasting for a matter of weeks, often fatal. Typhoid fever is transmitted through contamination in water and contamination that flies carry to food and drink. Typhus fever is transmitted to humans by lice that have fed on infected human beings.

3. Malaria is believed to be the great fever with which Peter’s mother-in-law was stricken. The “fever” (kjv “burning ague”) of Lev.26.16 and the “extreme burning” (kjv) of Deut.28.22 were probably malaria. Transmitted by certain species of mosquito, malaria is responsible for much chronic illness. A chill followed by fever often subsides in a few hours only to recur more severely some hours later, continuing intermittently thereafter. Death may follow if the disease is not treated.

4. Diarrhea, dysentery, and cholera, caused by microorganisms taken into the body in contaminated food or drink, were doubtless prevalent in OT times. They are characterized by frequent watery bowel movements, often by vomiting and fever, and if protracted, by weakness and prostration. Publius’s father’s illness (Acts.28.8) is probably rightly translated by NIV as “fever and dysentery,” a diarrhea associated with painful spasms of the bowel, ulceration, and infection, either amoebic or bacillary, giving rise to blood and pus in the excreta. As to cholera, it is fatal in half of the cases when modern treatment is not utilized.

III. Diseases Caused by Worms and Snakes.

1. Intestinal roundworm infection (ascariasis) is a common disease today in lands where sanitation is poor, and is believed to have been responsible for Herod Agrippa I’s death (Acts.12.21-Acts.12.23). The pinkish yellow roundworm, Ascaris lumbricoides, is about ten to sixteen inches (twenty-six to forty-one cm.) long and one-fifth of an inch (one-half cm.) in diameter. Aggregated worms sometimes form a tight ball with their interlocking bodies so as to obstruct the intestine, producing severe pain and copious vomiting of worms. If the obstruction is not promptly relieved by surgery, death may ensue. The roundworm does not chew and devour, but feeds on the nutrient fluids in the bowel and may work its way through diseased portions of the bowel as though it had eaten a hole through it. Josephus’s account of Herod’s death is highly suggestive of the intestinal obstruction produced by these worms.

2. The Guinea worm, Dracunculus medinensis, formerly called the serpent or dragon worm, has probably been known longer than any other human parasite. It is still found in interior Arabia and the adjacent Red Sea coast. Some regard it as the fiery serpent of Num.21.1-Num.21.35. The infection enters the human body through drinking water containing Cyclops (a water insect one-fiftieth of an inch [.05 cm.] long) infected with tiny Guinea worm larvae. In about one year the female worm attains a length of three feet (one m.), being one-fifteenth inch (.17 cm.) in diameter, usually maturing under the skin of the leg or arm. A blister is raised in the skin through which a huge brood of tiny larvae are extruded. This area itches and burns intensely. Death may result from internal complications or severe secondary infection, particularly if the worm is broken. The ancient and modern treatment consists in hastening the extrusion of larvae with cold water followed by gradual extraction of the worm. This is done by winding the worm around a stick of wood without breaking it, taking a turn or two of the stick each day. Complete removal takes about three weeks. The implication is that Moses with his brass model of the Guinea worm twisted around a wooden stick taught the Israelites how to extract the worm.

3. The snake-bite that Paul received was doubtless inflicted by a venomous snake of the pit-viper type. Experts today stress that the bite of a venomous snake is not poisonous unless it is accompanied by envenomation, the latter failing to take place if the contents of the poison sac located at the base of the snake’s hollow fangs have just previously been completely squeezed out, or if the sac is ineffectively squeezed when the snake strikes. Note that envenomation apparently did not take place in Acts.28.3, Acts.28.6. The snake, enraged by the fire, probably repeatedly struck at surrounding objects and exhausted all its venom before fastening itself to Paul’s hand. This is a frequent occurrence and makes for difficulty in assessing the degree of envenomation and evaluating the efficacy of one snake-bite treatment as compared with another. When envenomation with pit-viper venom takes place, the tissues may quickly swell to three or four times their normal size in the region of the bite.

IV. Diseases of the Eyes.

1. Epidemic blindness, described in 2Kgs.6.18, when a whole army was struck with blindness, is not the rarity that some may imagine. The writer, while a missionary in China, was in close contact with an army contingent that was decimated with blindness in a few days. Gonorrhea of the sexual organs had been occurring sporadically. Suddenly this same gonorrhea germ in the midst of unsanitary conditions changed its propensities to produce acute blinding inflammation of the eyes in violent epidemic form, spreading from eye to eye like wildfire, which is one of the recognized potentialities of this germ. Many of the soldiers were permanently blinded. The army troops that had been the most feared for their cruel depredations were suddenly rendered powerless, and the condition of the men was pitiful as one saw them trying to grope their way about, the totally blind being led about by the partially blind.

2. Infirmity (Gal.4.13, niv “illness”) of the apostle Paul, which he described as a “a thorn in my flesh,” is considered by many authorities to have been trachoma, an infectious eye disease. Early in the disease there is often acute inflammation of the eyelids, which makes the lids feel like sandpaper. This frequently spreads on to the bulb of the eye, especially the cornea, the transparent part of the bulb, which becomes red and inflamed. At this state, infection with other germs is often added. Pus seeps out over the lid margins, forming a tough, crusting scab as it dries and unites with the greasy secretion of the glands of the lid margin.

It is possible that Paul’s blindness encountered on the Damascus road was of this type. For three days the secretion was evidently so severe that it formed incrustations at the lid margins such as to glue and mat together the lashes of the lids, so that the eyelids could not be parted. At the end of this time we are told he saw again after scabs (Gr. lepides, which Hobart says is the medical term for particles or scaly substance thrown off from the body) fell (the Greek word was also used by Hippocrates, “the falling off of the scab, caused by burning in a medical operation, from the eyelid”) from his eyes. Later Paul seemingly was afflicted with chronic trachoma as might well be expected. (a) He failed to recognize the high priest (Acts.23.2-Acts.23.5). (b) The Galatians offered their good eyes for his (Gal.4.13-Gal.4.15). (c) He wrote with “large letters” (Gal.6.11). (d) He used a secretary.

Severe chronic trachoma commonly produces scarring of the eyelids with incurving of the cartilage of the eyelid called entropion that makes the lashes poke into and rub back and forth on the cornea, resulting in a frosted appearance, impaired vision, and blindness if unrelieved. This condition comprises a literal thorn in the flesh of the eye. It is often encountered by medical missionaries in underdeveloped lands today. Modern surgery performed on these eyelids produces outcurving of the lids, the offending eyelashes either removed or transplanted. Without surgery the only recourse is to pluck out the lashes one by one, but this affords only transient relief since the lash soon reappears as a sharp, stiff stubble that even more effectively sticks into the cornea like a thorn.

V. Nervous and Mental Diseases.

While terminology and explanations of the causes of emotional and mental diseases have varied greatly through the centuries, there is clear insight in the Scriptures concerning the relationship between the emotional state and physical disease (psychosomatic medicine). This is exemplified in Prov.17.22: “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” The cheerful heart can resolve excessive emotional tension in a manner superior to that of any tranquilizer. In contrast, some forms of arthritis occur on an emotional basis, the outcome of a “crushed spirit,” whereby the bones are seemingly dried of joint lubrication.

Both Elijah and Jonah were men who lapsed into states of extreme nervous exhaustion, often referred to as neurasthenia, a common condition amid the tension of modern days. God’s method of dealing with this condition as outlined in 1Kgs.19.1-1Kgs.19.21 and in Jonah is a model for modern psychiatric therapy. In the case of Epaphroditus (Phil.2.25-Phil.2.30) there is clear recognition then as today of the role played by pressure of work and anxiety as he endeavored to accomplish a colossal task unaided by those who should have been his helpers. No doubt there was physical illness superimposed on the emotional tension in his case, often true in modern times as well. In addition, there are mental diseases that are recognized as disease entities just as distinctive as appendicitis or pneumonia. The general term used in KJV for those so afflicted is “lunatic,” though formerly this term referred to epilepsy as well as insanity because of a supposed relationship to the phases of the moon. As today, legal responsibility for actions was regarded as tempered by proof of mental incompetence. Hence we find David escaping from Achish by pretending “insanity” (1Sam.21.13-1Sam.21.15). Perhaps he was even imitating some of Saul’s actions. The modern psychiatrist would diagnose Saul’s state as manic-depressive insanity, with its periods of black melancholy, flashes of homicidal violence, and deeply rooted delusion that people were plotting against him, characteristically ending in Saul’s suicide. Nebuchadnezzar is considered by Short to have been a victim of paranoia, a delusional form of insanity well known to medical science.

VI. Miscellaneous Medical Disorders and Therapy.

1. The woman’s issue of blood (niv “bleeding”) of twelve years’ duration (Luke.8.43-Luke.8.44) was doubtless excessive menstrual flow, a fairly common condition. In its severe form, it is commonly due to fibroid tumors in the womb encroaching on the lining of the womb. A flow of blood with large clots occurs, depleting the body of blood and causing severe anemia. The modern remedy usually used in this condition is removal of the tumor from the womb or removal of the womb (hysterectomy). This surgery obviously was not available in NT times so that it is quite understandable that all this woman’s living was spent on unsuccessful medical care.

2. In connection with Jesus’ agony in Gethsemane, we read that “his sweat was like drops of blood falling to the ground” (Luke.22.44). Some have thought that this refers to actual blood-tinged sweat. Short tends to take this point of view despite his confession that this phenomenon must be very rare and is not well authenticated. Rather it seems that the emphasis here is to be put on the word “like,” referring to the size and weight of the drops of sweat. It should be recalled that this occurred at night. Jesus’ enemies carried lanterns and torches, but evidently he had neither. The color of the sweat was therefore unobservable. In the quiet of the garden the heavy drip of large drops of sweat was probably heard and not seen by the disciples particularly as Jesus came to arouse them from sleep. The word “drops“ (Gr. thromboi) when used in connection with blood usually means “clots.” It may be that the simile here includes that idea; i.e., the drops of sweat sounded like blood clots falling on the ground.

3. Timothy was admonished to shun profane babblings because “their teaching will spread like gangrene” (2Tim.2.17). Gangrene means local death of the tissues. Common forms of gangrene are: (a) gas gangrene, a rapidly fatal type caused by a spreading gas-forming germ in muscles after recent injury; (b) diabetic gangrene, a “dry” gangrene that spreads less rapidly caused by circulatory impairment associated with uncontrolled diabetes; (c) septic gangrene that spreads from the edges of infected ulcers.

4. Dropsy (Luke.14.2), in modern medical language called edema, is a condition in which the tissues retain too much fluid. It may be caused by heart disease, kidney disease, or local infection, and may terminate fatally.

5. Dwarfism is referred to in Lev.21.20. One may have been dwarfed through tuberculosis or injury of the spine, but deficiency of thyroid function such as is found in cretinism is also a likely cause. In the latter condition there is also usually mental deficiency and this gives added reason for not permitting such an individual to participate in priestly service. Cretinism today responds well to thyroid extract therapy if administered early in life.

6. As to orthopedic conditions, reference is made to the maimed (those whose bodies are deprived of a part) and the halt (those who limp in walking because of lameness from a disabled lower extremity). The latter may be due to a fracture that has healed in an unfavorable position or it may be due to atrophy (wasting) of the muscles. Atrophy of a hand is referred to as a “shriveled” hand in Luke.6.6 (kjv “withered”). Atrophy usually results from palsy or paralysis (synonymous terms), a condition characterized by loss of control of movement of muscles through disease or destruction of nerves or nervous tissue.

7. Muteness, i.e., inability to speak, may arise from deafness since one will naturally find it difficult to reproduce unheard sounds. It also may arise from hemorrhage (apoplexy) or thrombosis (clotting) in relation to the blood vessels of one or more of the speech centers of the brain. Often a marked degree of recovery takes place in these instances of so-called stroke as the clotted blood is gradually absorbed from the affected area. Such may have happened to Zacharias (Luke.1.20-Luke.1.22, Luke.1.64), whereas Nabal (1Sam.25.36-1Sam.25.38) evidently experienced a fatal stroke.

8. Frequent instances of unspecified sickness occur throughout the biblical record. Some of the these cases of sickness did not experience divine healing. For example, Paul informs us, “I left Trophimus sick in Miletus” (2Tim.4.20). Also Paul tells us that three times he prayed for the removal of his thorn in the flesh; he was answered not by removal of his infirmity but by being given more grace (2Cor.12.8-2Cor.12.10). Therefore, the Bible does not teach that all Christians are entitled to divine healing by virtue of being Christians.

James urges that the church elders be called to pray for the sick. He also directs that they “anoint him with oil in the name of the Lord” (Jas.5.14). The latter has perhaps wrongfully been assumed to refer to a church ritual. Bauer’s Greek Lexicon states that the Greek verb aleiphō, used for “anointing,” commonly referred to rubbing oil on the skin as a household remedy. It would seem to be James’s meaning that the sick one is not only to be prayed for but the commonly accepted remedies are also to be applied as an indication of compassionate concern. Jesus’ disciples made similar use of the application of oil to the sick (Mark.6.13).

Bibliography: A. R. Short, The Bible and Modern Medicine, 1953; W. K. Hobart, Medical Language of Luke, 1954; P. B. Beeson and W. McDermott, Textbook of Medicine, 1971; S. G. Browne, Leprosy in the Bible, 1974; F. MacNutt, The Power to Heal, 1977.——PEA

International Standard Bible Encyclopedia (1915)

di-zez’, di-zez’-iz (chalah, choli; nosos): Palestine, from its position and physical conditions, ought to be a healthy country. That it is not so depends on the unsanitary conditions in which the people live and the absence of any attempts to check the introduction or development of zymotic diseases. The number of marshes or pools is fairly small, and the use of active measures to destroy the larvae of mosquitos might easily diminish or abolish the malarial fevers which now prevail all over the country.

The freeing of Ismailieh and Port Said from these pests is an object-lesson in sanitation. When one examines the conditions of life in towns and villages all over the country, the evidences of the ravages of these fevers and their sequelae appear on every hand as they affect all ages from infancy to middle age, and one meets but few individuals of extreme old age. The absence of any adequate system of drainage and the pollution of the water supplies are also factors of great importance in preserving this unhealthiness.

Alex. Macalister