In all pagan cultures of the ancient Near East, illness was thought to be due to an infestation of the body with evil spirits, and the physician-priest’s function was to cleanse the body of these evil influences by means of various magical devices such as incantations and amulets. Such a view could arise only on pagan soil, because pagan man divided his entire universe between primordial good and evil forces, upon which even his gods were dependent. Illness was always ultimately due to these evil forces.
The healing arts were in the hands of the priests in pagan society, because they were thought to know the most about how to go about appeasing the wrath of the gods and the forces responsible for illness. Since the gods themselves could be evil, illness did not necessarily imply that the patient was a sinner, as the disease might be due to the whim of a wicked or irritated god. Pagan man did not worship his deities because he thought they were righteous, but because he knew they were more powerful, and consequently had to be kept happy at all times if lowly man was also to be kept happy.
The Israelite conception of monotheism brought about a complete revolution in the Hebrew’s attitude toward medicine, as it did to almost everything else. The Bible pictures its one God as at once both omnipotent and perfect. Once this was postulated, however, the Bible was stuck with the most burning question of all, and one which was no problem in pagan theology - the problem of evil. How was it possible that the just and perfect God, whom the Israelite worshipped not only because He was all-powerful but also because He was the epitome of goodness and righteousness, could allow so much evil (of which illness is just one type) to exist in the world that He created?
The Bible’s answer is: Man brought evil into the world by using the free will God granted him to sin. The natural consequence of this theology, which is repeated and amplified in different ways on almost every page of the Hebrew Bible, was that evil, including disease, was a direct punishment for human iniquity, and that a sick person must perforce be a sinner. Furthermore, all attempts to heal the sick person by magical means were useless; first, because the Bible prohibits the use of magic as an idolatrous practice; second, because magic could not be effective against a divinely-ordained punishment. Not once in the entire Hebrew Bible is an illness cured by driving out evil spirits, getting rid of demons, or by incantations and amulets.
One might wonder how a physician had any place at all in ancient Israel. The only recourse against illness would logically be to somehow get God to change His mind and cure the disease; and the way to accomplish this would obviously be by righteous acts and prayer, certainly not by the use of herbs or other medicinals to confute a divinely-ordained punishment.
But here the Bible contradicted popular Israelite practice. It was impossible to stop the sick from using whatever natural means were thought efficacious in an attempt to cure himself, and men who had knowledge of these means became physicians, practicing in the face of mixed feelings on the part of official Israelite religion. An uneasy compromise was effected which allowed physicians to practice so long as they did not make use of any magical idolatrous healing methods, but their activities were frowned upon nevertheless. King Asa of Judah is said to have died because “In his illness he sought not the Lord, but the physicians” (II Chron. 16:12-13).
Still further evidence of the fact that the Bible prefers its sick to be cured by God or His direct messengers, the prophets, rather than by physicians, is the prominence given to the many stories about the miraculous cures achieved by the prophets, such as Moses, Elijah, Elisha, and Isaiah, while there is not even one story of a cure brought about by an ordinary physician in the entire Hebrew Bible. Since the Bible considers the prophets, rather than the priests, to be God’s messengers, unlike the situation in pagan religions, the priests in ancient Israel never functioned as healers and were not considered physicians. They did occasionally diagnose disease, but they never treated it.
Despite this negative attitude towards them, the physicians continued to flourish, as they obviously filled a real need. As the centuries passed and the battle against idolatry within Israel itself became completely won, a more tolerant attitude is evident. The apocryphal book of Ben-Sira (Ecclesiasticus, Chapter 38, c. 190 B.C.E.) furnishes us with a lengthy passage on the subject of physicians, the first such passage in any Hebrew book, which beautifully illustrates the more positive attitude Judaism in the early Hellenistic period showed the physician assigning to both him and God their proper places in healing the sick.
Let us now consider a disease discussed in our parasha: Tsaraat. The skin was the only organ of the body which was visible, and so were its diseases. This fact alone gave it tremendous importance in biblical thought. The ancient Israelite associated his own spiritual and physical health with the state of his skin. If an Israelite was so unfortunate as to be stricken with tsaraat (the biblical leprosy), this was considered a sign of divine punishment and he was banished from the camp. The leper, stricken with a cutaneous disease, was considered to be like a man who had gone into the grave while still alive (cf. Numbers 12:12). Such was the importance attributed by biblical man to a skin disease.
The most important dermatologic disease in the Bible is tsaraat, popularly translated as leprosy. It has been recognized by scholars for many decades that the biblical disease “leprosy” is, for many reasons, really not leprosy at all The disease, as described in the book Leviticus, not only affects people, but also clothes and houses. This immediately eliminates the possibility of its being present-day leprosy, and also rules out diseases such as psoriasis and syphilis (Leviticus 13:47-59; 14:33-54).
It has been widely assumed that the banishment of the ‘leper’ from the camp was for purposes of quarantine, and that the Bible was aware of the epidemic nature of this disease and was attempting to control it by epidemiologic measures. This notion illustrates the danger of attempting to see modern concepts in ancient practices. That the purpose of the banishment was not to stop the spread of the disease and that the Bible did not consider the disease to be contagious can be easily proven by the simple fact that the Bible decreed that if the disease became so widespread that it covered the entire body, the “leper” was then considered pure and could return to the camp and mingle freely with the populace like any other Israelite (Leviticus 13 12-13). Actually, the reason for the biblical treatment of the “leper” is easily understood in the light of our above discussion of the Hebrew conception of disease. Tsaraat, like all other diseases, was considered divinely ordained punishment for sin, and the Bible makes it quite clear what sins are involved - slander, tale-bearing, infringing on the rights of one’s neighbour, and fraud - clearly crimes committed by one man against another.
Once we appreciate the fact that the Bible considers “leprosy” a punishment for crimes committed by a man against his fellowman, it is not at all difficult to understand its treatment of such a man. The first lesion of the disease would already be evidence to the priest that the man was a tale-bearer and a slanderer. The appropriate punishment for one who so sins against other human beings was to banish him from the camp so that he could have no contact with other people. If, however, his entire body became covered with the disease there was no need to take such extreme measures to prevent his coming into contact with other people, as everyone would immediately recognize him as having been stricken because of his crimes and shun him.
Further evidence is provided by the fact that when “lepers” died with their disease, they were buried in a special cemetery, away from the other graves (II Chron. 26:23). Even kings were not exempt from this punishment.
The custom is fairly easy to understand if we assume that the banishment of the “leper” was a punishment, as the allotment of a separate cemetery to “lepers” would serve to remind the Israelites of the vengeance exacted from slanderers and talebearers of the worst kind, who persisted in their sin and so prevented the disease from taking its natural course and healing spontaneously. However, if we assume that the banishment of live “lepers” was for purposes of quarantine, what possible purpose could there be in separating dead “lepers” from the other dead? Still more evidence that the banishment of the “leper” from the camp was for purposes of punishment rather than quarantine is the commandment that the “leper” dishevel his hair and tear his clothes, both signs of degradation, while calling out to every person he sees “Unclean, unclean!” meaning that he was unclean, banished, and degraded because he committed the moral evils listed above.
We have seen the Bible’s attitude towards medicine in general and dermatology in particular is determined, as is practically every other normative view in the Bible, by its basic theological outlook. Disease was no longer thought to be a curse brought about by evil spirits, but a punishment for sin, inflicted by the omnipotent and perfect God; Therefore, cure was possible only if the sinner cleansed himself of sin and achieved a divine decision to effect it, usually by means of God’s prophets, never by physicians, whose efforts were frowned upon. The skin, being the most obvious organ affected by disease, had tremendous importance in the eyes of biblical man, and its diseases are consequently discussed in great detail. Vestiges of the attitude of the Bible towards skin disease are encountered by the practicing dermatologist even today.
Dr. Yehudi Felman, a New York dermatologist, is doing graduate work in Semitics at Columbia University.
YAVNEH STUDIES IN PARASHAT HASHAVUA, edited by Joel B. Wolowelsky, was a 1969-72 project of YAVNEH: THE RELIGIOUS JEWISH STUDENTS ASSOCIATION. The bios here are as they were at the time of the original publication. For a history of YAVNEH, see Benny Kraut, The Greening of American Orthodox Judaism: Yavneh in the 1960s (Cincinnti: Hebrew Union College Press, 2011).