Leprosy

Leprosy (צָרִעִת, tsara'äth, a smiting, because supposed to be a direct visitation of heaven; Gr. λέπρα, so called from its scaliness, hence English "leper," etc.), a name that was given by the Greek physicians to a scaly disease of the skin. During the Dark Ages it was indiscriminately applied to all chronic diseases of the skin, and more particularly to elephantiasis, to which latter, however, it does not bear a complete resemblance. Hence prevailed the greatest discrepancy and confusion in the descriptions that authors gave of the disease, until Dr. Willan restored to the term lepra its original significations. In the Scriptures it is applied to a foul cutaneous disease, the description of which, as well as the regulations consecrated therewith, are given in Le 13; Le 14 (comp. also Ex 4:6-7; Nu 12:10-15; 2Sa 3:29; 2Ki 5:27; 2Ki 7:3; 2Ki 15:5; Mt 8:2; Mt 10:8, etc.). In the discussion of this subject we base our article upon the most recent scientific and archeological distinctions, compared with the present Oriental usages.

I. Scriptural and Talmudical Statements. —

(I.) Leprosy in Human Beings. —

"Leprosy." topical outline.

1. Cases and Symptomns of Biblical Leprosy. — Le 13:2-44, which descrilbes this distemper as laying hold of man, gives six different circumstances under which it may develop itself. They are as follows:

(1.) The first circumstance mentioned in Le 13:2-6 is that it may develop itself without any apparent cause. Hence it is enjoined that if any one should notice a rising or swelling (שאת), an eruption or scab (ספחת), or a glossy pimple (בהרת) in the skin of his flesh, which may terminate in leprosy (צרעת ), he is at once to be taken to the priest, who is to examine it and pronounce it leprosy, and the man unclean, if it exhibits these two symptoms, viz. a, the hair of the affected spot changed from its natural black color to white; and, b, the spot deeper than the general level of the skin of the body (ver. 2, 3). But if these two symptoms do not appear in the bright pimple, the priest is to shut him up for seven days, examine him again on the seventh day, and if the disease appears to have made no progress during this time, he is to remand the patient for another seven days (ver. 4, 5), and then, if on inspecting it again he finds that the bright spot has grown darker (כהה), and that it has not spread on the skin, he is to pronounce it a simple scab (ספחת מספחת), and the person clean after washing his garments (ver. 6). If, however, the pustule spreads over the skin after it has been pronounced a simple scab and the individual clean, the priest is to declare it leprosy, and the patient unclean (ver. 7, 8). It is thus evident that the symptoms which indicated scriptural leprosy, as the Mishna rightly remarks (Negaim, 3:3), are bright pimples, a little depressed, turning the hair white, and spreading over the skin.

Bible concordance for LEPROSY.

As the description of these symptoms is very concise, and requires to be specified more minutely for practical purposes, the spiritual guides of Israel defined them as follows: Both the bright pimple (בהרת) and the swelling spot (שאת), when indicative of leprosy, assume respectively one of two colors, a principal or a subordinate one. The principal color of the bright pimple is as white as snow (עזת כשלג), and the subordinate resembles plaster on the wall (כסיד ההיכל); whilst the principal color of the rising spot is like that of an eggshell (כקרום בצה), and the secondary one resembles white wool (כצמר לבן, Negaim, 1:1); so that if the affected spot in the skin is inferior in whiteness to the film of an egg it is not leprosy, but simply a gathering (Maimonides, On Leprosy, 1:1). Any one may examine the disease, except the patient himself or his relatives, but the priest alone can decide whether it is leprosy or not, and accordingly pronounce the patient unclean or clean, because De 21:5 declares that the priest must decide cases of litigation and disease. But though the priest only can pronounce the decision, even if he be a child or a fool, yet he must act upon the advice of a learned layman in those matters (Negaim, 3:1; Maimonides, l. c., 9:1, 2). If the priest is blind of one eye, or is weak-sighted, he is disqualified for examining the distemper (Mishna, l. c., 2:3). The inspection must not take place on the Sabbath, nor early in the morning, nor in the middle of the day, nor in the evening, nor on cloudy days, because the color of the skin cannot properly be ascertained in these hours of the day; but in the third, fourth, fifth, seventh, eighth, or ninth hour (Negayim, 2:2); and the same priest who inspected it at first must examine it again at the end of the second seven days, as another one could not tell whether it has spread. If he should die in the interim, or be taken ill, another one may examine him, but not pronounce him unclean (Maimonides, On Leprosy, 9:4). There must be at least two hairs white at the root and in the body of the bright spot before the patient can be declared unclean (Maimonides, 1. c., 2:1). If a bridegroom is seized with this distemper he must be left alone during the nuptial week (Negayim, 3:2).

(2.) The second case is of leprosy reappearing after it has been cured (Le 13:9-17), where a somewhat different treatment is enjoined. If a person who has once been healed of this disease is brought again to the priest, and if the latter finds a white rising in the skin (לבנה שאת), which has changed the hair into white and contains live flesh (בשר חי), he is forthwith to recognize therein the reappearance of the old malady, and declare the patient unclean without any quarantine whatever, since the case is so evident that it requires no trial (ver. 9-11). There were, however, two phases of this returned distemper which exempted the patient from uncleanness. If the leprosy suddenly covered the whole body so that the patient became perfectly white, in which case there could be no appearance of live flesh (ver. 12, 13), or if the whiteness, after having once diminished and allowed live flesh to appear, covers again the whole body, then the patient was clean (ver. 14-17). This, most probably, was regarded as indicative of the crisis, as the whole evil matter thus brought to the surface formed itself into a scale which dried and peeled off. The only other feature which this case represents besides the symptoms already described is that leprosy at times also spread over the whole skin and rendered it perfectly white. As to the live flesh (בשר חי), the Sept., the Chaldee, the Mishna, and the Jewish rabbins, in accordance with ancient tradition, take it to denote soundflesh, or a spot in the flesh assuming the appearance of life after it had been paled by the whiteness overspreading the whole surface. The size of this spot of live flesh which renders the patient unclean must, according to tradition, be at least that of a lentil (Maimonides, 1. c., 3:1-3).

Definition of leprosy

(3.) The third case is of leprosy developing itself from an inflammation (שחין) or a burn (מכות אש), which is to be recognized by the same symptoms (Le 13:18-28). Hence, when these suspicious signs were discernible in that part of the skin which was healed of an inflammation, the patient was to go to the priest, who was at once to pronounce it leprosy developed from an inflammation, if the symptoms were unmistakable (ver. 19, 20). If the priest found these marks, he remanded the patient for seven days (ver. 21), and if the disorder spread over the skin during the time the patient was declared leprous and unclean (ver. 22); but if it remained in the same condition, he pronounced it the cicatrix of the inflammation (צרהת השחין ) and the patient clean (ver. 23). The same rules applied to the suspicious appearance of a burn (ver. 24-28). According to the Hebrew canons, שהין is defined inflammation arising from "an injury received from the stroke of wood or a stone, or from hot olive husks, or the hot Tiberian water, or from anything, the heat of which does not come from fire, whilst מכות denotes a burn from live coals, hot ashes, or from any heat which proceeds from fire" (Negaim,, 9:1; Maimonides, On Leprosy, v. 1). It will be seen that there is a difference in the treatment of the suspicious symptoms in (1.) and (3.). In the former instance, where there is no apparent cause for the symptoms, the suspected invalid has to undergo two remands of seven days before his case can be decided; whilst in the latter, where the inflammation or the burn visibly supplies the reason for this suspicion, he is only remanded for one week, at the end of which his case is finally determined.

(4.) The fourth case is leprosy on the head or chin (Le 13:29-37), which is to be recognized by the affected spot being deeper than the general level of the skin, and by the hair thereon having become thin and yellowish. When these symptoms exist, the priest is to pronounce it a scall (נתק), which is head or chin leprosy, and declare the patient unclean (ver. 30). But if this disorder on the head or chin does not exhibit these symptoms, the patient is to be remanded for seven days, when the priest is again to examine it, and if he finds that it has neither spread nor exhibits the required criteria, he is to order the patient to cut off all the hair of his head or chin, except that which grows on the afflicted spot itself, and remand him for another week, and then pronounce him clean if it continues in the same state at the expiration of this period (ver. 31-34); and if it spreads after he has been pronounced clean, the priest is forthwith to declare him unclean without looking for any yellow hair (ver. 35,36). The Jewish canons define נתק by "an affection on the head or chin which causes the hair on these affected parts to fall off by the roots, so that the place of the hair is quite bare" (Maimonides, On Leprosy, 8:1). The condition of the hair, constituting one of the leprous symptoms, is described as follows: "דק is small or short, but if it be long, though it is yellow as gold, it is no sign of uncleanness. Two yellow and short hairs, whether close to one another or far from each other, whether in the center of the nethek or on the edge thereof, no matter whether the nethek precedes the yellow hair or the yellow hair the nethek, are symptoms of uncleanness" (Maimonides. 1. c., 8:5). The manner of shaving is thus described: "The hair round the scall is all shaved off except two hairs which are close to it, so that it might be known thereby whether it spread" (Negaim, 10:5).

(5.) The fifth case is leprosy which shows itself in white polished spots, and is not regarded as unclean (Le 13:38-39). It is called bohak (בֹּהק ', from בָּהִק, to be white), or, as the Sept. has it, ἀλφός, vitiligo alba, white scurf.

(6.) The sixth case is of leprosy either at the back or in the front of the head (Le 13:40-44). When a man loses his hair either at the back or in the front of his head, it is a simple case of baldness, and he is clean (ver. 40.41). But if a whitish red spot forms itself on the bald place at the back or in the front of the head, then it is leprosy, which is to be recognized by the fact that the swelling or scab on the spot has the appearance of leprosy in the skin of the body; and the priest is to declare the man's head leprous and unclean (ver. 42-44). Though there is only one symptom mentioned whereby head leprosy is to be recognized, and nothing is said about remanding the patient if the distemper should appear doubtful, as in the other cases of leprosy, yet the ancient rabbins inferred from the remark, "It is like leprosy in the skin of the flesh," that all the criteria specified in the latter are implied in the former. Hence the Hebrew canons submit that "there are two symptoms which render baldness in the front or at the back of the head unclean, viz. live or sound flesh, and spreading; the patient is also shut up for them two weeks, because it is said of them that 'they are land therefore must be treated like leprosy in the skin of the flesh' "(Le 13:43). Of course, the fact that the distemper in this instance develops itself on baldness, precludes white hair being among the criteria indicating uncleanness. The manner in which the patient in question is declared unclean by two symptoms and in two weeks is as follows: "If live or sound flesh is found in the bright spot on the baldness at the back or in the front of the head, he is pronounced unclean; if there is no live flesh he is shut up and examined at the end of the week, and if live flesh has developed itself, and it has spread, he is declared unclean, and if not he is shut up for another week. If it has spread during this time, or engendered live flesh, he is declared unclean, and if not he is pronounced clean. He is also pronounced unclean if it spreads or engenders sound flesh after he has been declared clean" (Negaim, 10:10; Maimonides, On Leprosy, 5:9,10).

2. Regulations about the Conduct and Purification of leprous Men. — Lepers were to rend their garments, let the hair of their head hang down disheveled, cover themselves up to the upper lip, like mourners, and warn off every one whom they happened to meet by calling out "Unclean! unclean!" since they defiled every one and everything they touched. For this reason they were also obliged to live in exclusion outside the camp or city (Le 13:45-46; Nu 5:1-4; Nu 12:10-15; 2Ki 7:3, etc.). "The very entrance of a leper into a house," according to the Jewish canons, "renders everything in it unclean" (Negaim., 12:11; Kelim, 1:4). "If he stands under a tree and a clean man passes by, he renders him unclean. In the synagogue which he wishes to attend they are obliged to make him a separate compartment, ten handbreadths high and four cubits long and broad; he has to be the first to go in, and the last to leave the synagogue" (Negaim, 12:12; Maimonides, On Leprosy, 10:12); and if he transgressed the prescribed boundaries he was to receive forty stripes (Pesachim, 67, at). All this only applies to those who had been pronounced lepers by the priest, but not to those who were on quarantine (Negaim, 1:7). The rabbinic law also exempts women from the obligation to rend their garments and let the hair of their head fall down (Sota, 3:8). It is therefore no wonder that the Jews regarded leprosy as a living death (comp. Josephus, Ant. 3:11, 8, and the well-known rabbinic saying מצורע חשוב כמת), and as an awful punishment from the Lord (2Ki 5:7; 2Ch 26:20), which they wished all their mortal enemies (2Sa 3:29: 2Ki 5:27).

The healed leper had to pass through two stages of purification before he could be received back into the community. As soon as the distemper disappeared he sent for the priest, who had to go outside the camp or town to convince himself of the fact. Thereupon the priest ordered two clean and live birds, a piece of cedar wood, crimson wool, and hyssop; killed one bird over a vessel containining spring water, so that the blood might run into it, tied together the hyssop and the cedar wood with the crimson wool, put about them the tops of the wings and the tip of the tail of the living bird, dipped all the four in the blood and water which were in the vessel, then sprinkled the hand of the healed leper seven times, let the bird loose, and pronounced the restored man clean (Le 14:1; Le 7; Negtaime, 12:1). The healed leper was then to wash his garments, cut off all his hair, be immersed, and return to the camp or city, but remain outside his house seven days, which the Mishina (Negailm, 14:2), the Chaldee Paraphrase, Maimonides (On Leprosy, 11:1), etc., rightly regard as a euphemism for exclusion from connubial intercourse during that time (ver. 8), in order that he might not contract impurity (comp. Le 15:18). With this ended the first stage of purification. According to the Jewish canons, the birds are to be "free, and not caged," or sparrows; the piece of cedar wood is to be "a cubit long, and a quarter of the foot of the bed thick;" the crimson wool is to be a shekel's weight, i.e. 320 grains of barley; the hyssop must at least be a handbreadth in size, and is neither to be the so- called Greek, nor ornamental, nor Roman, nor wild hyssop, nor have any name whatever; the vessel must be an earthen one, and new; and the dead bird must be buried in a hole dug before their eyes (Negaim, 14:1-6; Maimonides, On Leprosy, 11:1).

The second stage of purification began on the seventh day, when the leper had again to cut off the hair of his head, his beard, eyebrows, etc., wash his garments, and be immersed (Le 14:9). On the eighth day he had to bring two he-lambs without blemish, one ewe-lamb a year old, three tenths of an ephah of fine flour mixed with oil, and one log of oil; the one he-lamb is to be a trespass-offering, and the other, with the ewe-lamb, a burnt and a sin-offering; but if the man was poor he was to bring two turtle-doves, or two young pigeons, for a sin-offering and a burnt-offering, instead of a he-lamb and a ewe-lamb (ver. 10, 11, 21). With these offerings the priest conducted the healed leper before the presence of the Lord. What the offerer had to do, and how the priest acted when going through these ceremonies, cannot be better described than in the following graphic language of the Jewish tradition. "The priest approaches the trespass- offering, lays both his hands on it, and kills it, when two priests catch its blood, one into a vessel, and the other in his hand; the one who caught it into the vessel sprinkles it against the wall of the altar, the other goes to the leper, who, having been immersed in the leper's chamber [which is in the women's court], is waiting [outside the court of Israel, or the men's court, opposite the eastern door] in the porch of Nicanor [with his face to the west]. He then puts his head into [the court of Israel], and the priest puts some of the blood upon the tip of his right ear; he next puts in his right hand, and the priest puts some blood upon the thumb thereof; and, lastly, puts in his right ear, and the priest puts some blood on the toe thereof. The: priest then takes some of the log of oil and puts it into, the left hand of his fellow-priest, or into his own left hand, dips the finger of his right hand in it, and sprinkles it seven times towards the holy of holies, dipping his finger every time he sprinkles it; whereupon he goes to the leper, puts oil on those parts of his body on which he had previously put blood [i.e. the tip of the ear, the thumb, and the toe], as it is written, 'on the place of the blood of the trespass-offering' [Le 14:28], and what remains of the oil in the hand of the priest he puts on the head of him who is to be cleansed, for an atonement" (Negaim, 14:8-10; Maimonides, Michoth Mechosrei Kepora, 4). It is in accordance with this prerogative of the priest, who alone could pronounce the leper clean and readmit him into the congregation, that Christ commanded the leper whom he had healed to show himself to this functionary (Mt 8:2, etc.).

(II.) Leprous Garments and Vessels. — Leprosy in garments and vessels is indicated by two symptoms, green or reddish spots, and spreading. If a green or reddish spot shows itself in a woolen or linen garment, or in a leather vessel, it is indicative of leprosy, and must be shown to the priest, who is to shut it up for a week. If, on inspecting it at the end of this time, he finds that the spot has spread, he is to pronounce it inveterate leprosy (צרעת ממארת), and unclean, and burn it (Le 13:47-52); if it has not spread he is to have it washed, and shut it up for another week, and if its appearance has then not changed, he is to pronounce it unclean and burn it, though it has not spread, since the distemper rankles in the front or at the back of the material (ver. 53-55). But if, after washing it, the priest sees that the spot has become weaker, he is to cut it out of the material; if it reappears in any part thereof, then it is a developed distemper, and the whole of it must be burned; and if it vanishes after washing, it must be washed a second time, and is clean (ver. 56-59). The Jewish canons define the color green to be like that of herbs, and red like that of fair crimson, and take this enactment literally as referring strictly to wool of sheep and flax, but not to hemp and other materials. A material made of camel's hair and sheep's wool is not rendered unclean by leprosy if the camel's hair preponderate, but is unclean when the sheep's wool preponderates, or when both are equal, and this also applies to mixtures of flax and hemp. Dyed skins and garments are not rendered unclean by leprosy; nor are vessels so if made of skins of aquatic animals exposed to leprous uncleanness (Negaim, 11:2,3; Maimonides, ut sup. 11:1; 12:10; 13:1-3).

(III.) Leprous Houses. — Leprosy in houses is indicated by the same three symptoms, viz. spots of a deep green or reddish hue, depressed beyond the general level, and spreading (Le 14:33-48). On its appearance the priest was at once to be sent for, and the house cleared of everything before his arrival. If, on inspecting it, he found the first two symptoms in the walls, viz. a green or red spot in the wall, and depressed, he shut the house up for seven days (ver. 34-38), inspected it again on the seventh day, and if the distemper spread in the wall he had the affected stones taken out, the inside of the house scraped all round, the stones, dust, etc., cast into an unclean place without the city, and other stones and plaster put on the wall (ver. 39-42). If, after all this, the spot reappeared and spread, he pronounced it inveterate leprosy, and unclean, had the house pulled down, and the stones, timber, plaster, etc., cast into an unclean place without the city, declared every one unclean, till evening, who had entered it, and ordered every one who had either slept or eaten in it to wash his garments (ver. 43-47).

As to the purification of the houses which have been cured of leprosy, the process is the same as that of healed men, except that in the case of man the priest sprinkles seven times upon his hand, while in that of the house he sprinkles seven times on the upper door-post without. Of course the sacrifices which the leprous man had to bring in his second stage of purification are precluded in the case of the house (Maimonides, On Leprosy, 15:8).

3. Prevalence, Contagion, and Curableness of Leprosy. — Though the malicious story of Manetho that the Egyptians expelled the Jews because they were afflicted with leprosy (Josephus, Ap. 1:26), which is repeated by Tacitus (lib. v, c. 3), is rejected by modern historians and critics as a fabrication, yet Michaelis (Laws of Moses, art. 209), Thomson (The Land and the Book, p. 652), and others still maintain that this disease was "extremely prevalent among the Israelites." Against this, however, is to be urged that, 1. The very fact that such strict examination was enjoined, and that every one who had a pimple, spot, or boil was shut up, shows that leprosy could not have been so widespread, inasmuch as it would require the imprisonment of the great mass of the people. 2. In cautioning the people against the evil of leprosy, and urging on them to keep strictly to the directions of the priest, Moses adds, "Remember what the Lord thy God did to Miriam on the way when you came out of Egypt" (De 24:9). Now allusion to a single instance which occurred on the way from Egypt, and which, therefore, was an old case, naturally implies that leprosy was of rare occurrence among the Jews, else there would have been no necessity to adduce a by-gone case; and, 3. Wherever leprosy is spoken of in later books of the Bible, which does not often take place, it is only of isolated cases (2Ki 7:3; 2Ki 15:5), and the regulations are strictly carried out, and the men are shut up so that even the king himself formed no exception (2Ki 15:5).

That the disease was not contagious is evident from the regulations themselves. The priests had to be in constant and close contact with lepers, had to examine and handle them; the leper who was entirely covered was pronounced clean (Le 13:12-13); and the priest himself commanded that all things in a leprous house should be taken out before he entered it, in order that they might not be pronounced unclean, and that they might be used again (Le 14:36), which most unquestionably implies that there was no fear of contagion. This is, moreover, corroborated by the ancient Jewish canons, which were made by those very men who had personally to deal with this distemper, and according to which a leprous minor, a heathen, and a proselyte, as well as leprous garments, and houses of non-Israelites, do not render any one unclean; nor does a bridegroom, who is seized with this malady during the nuptial week, defile any one during the first seven days of his marriage (comp. Negaim,

3:1, 2; 7:1; 11:1; 12:1; Maimonides, On Leprosy, 6:1; 7:1, etc.). These canons would be utterly inexplicable on the hypothesis that the distemper in question was contagious. The enactments, therefore, about the exclusion of the leper from society, and about defilement, were not dictated by sanitary caution, but had their root in the moral and ceremonial law, like the enactments about the separation and uncleanness of menstruous women, of those who had an issue or touched the dead, which are joined with leprosy. Being regarded as a punishment for sin, which God himself inflicted upon the disobedient (Ex 15:26; Le 14:35), this loathsome disease, with the peculiar rites connected therewith, was especially selected as a typical representation of the pollution of sin, in which light the Jews always viewed it. Thus we are told that "leprosy comes upon man for seven, ten, or eleven things: for idolatry, profaning the name of God, unchastity, theft, slander, false witness, false judgment, perjury, infringing the borders of a neighbor, devising malicious plans, or creating discord between brothers" (Erachin, 16, 17; Baba Bathra, 164; Aboth de R. Nathan, 9; Midrash Rabba on Leviticus 14). "Cedar wood and hyssop, the highest and the lowest, give the leper purity. Why these? Because pride was the cause of the distemper, which cannot be cured till man becomes humble, and keeps himself as low as hyssop" (Midrash Rabba, Koheleth, p. 104).

As to the curableness of the disease, this is unquestionably implied in the minute regulations about the sacrifices and conduct of those who were restored to health. Besides, in the case of Miriam, we find that shutting her up for seven days cured her of leprosy (Nu 12:11-13).

II. Identity of the Biblical Leprosy with the modern Distemper bearing this Name. — It would be useless to discuss the different disorders which have been palmed upon the Mosaic description of leprosy. A careful classification and discrimination is necessary.

1. The Greeks distinguished three species of lepra, the specific names of which were ἀλφος, λευκή, and μέλας which may be rendered the vitiligo, the white and the black. Now, on turning to the Mosaic account, we also find three species mentioned, which were all included under the generic term of בִּהֶרֶת, bahereth, or "bright spot" (Le 13:2-4,18-28). The first is called בֹּהִק, bhak, which signifies "brightness," but in a subordinate degree (Le 13:39). This species did not render a person unclean. The second was called לבָנָה בִּהֶרֶת, bahereth lebandh. or a bright white baherleth. The characteristic marks of the bahe'eth lebandh mentioned by Moses are a glossy white and spreading scale upon an elevated base, the elevation depressed in the middle, the hair on the patches participating in the whiteness, and the patches themselves perpetually increasing. This was evidently the true leprosy, probably corresponding to the white of the Greeks and the vulgaris of modern science. The third was בִּהֶרֶת כּהָה, bahereth khadh, or dusky bahereth, spreading in the skin. It has been thought to correspond with the black leprosy of the Greeks and the nigricans of Dr. Willan. These last two were also called צָרִעִת , tsardath (i.e. proper leprosy), and rendered a person unclean. There are some other slight affections mentioned by name in Leviticus (chap. 13), which the priest was required to distinguish from leprosy, such as שׂאֵת, seeth; שָׁפָל, shaphdl; תּפק, nethek; שׁחַין -, shechen, i.e. "elevation," "depressed," etc.; and to each of these Dr. Good (Study of Med. 5:590) has assigned a modern systematic name. But, as it is useless to attempt to recognize a disease otherwise than by a description of its symptoms, we can have no object in discussing his interpretation of these terms. We therefore recognize but two species of real leprosy.

(I.) Proper Leprosy. — This is the kind specifically denominated בִּהֶרֶת, bahereth, whether white or black, but usually called white leprosy, by the Arabs barras; a disease not unfrequent among the Hebrews (2Ki 5:27; Ex 4:6; Nu 12:10), and often called lepra Mosaica. It was regarded by them as a divine infliction (hence its Heb. name צָרִעִת, tsardath, a stroke i.e. of God), and in several instances we find it such, as in the case of Miriam (Nu 12:10), Gehazi (2Ki 5:27), and Uzziah (2Ch 26:16-23), from which and other indications it appears to have been considered hereditary, and incurable by human means (comp. 2Sa 3:29; 2Ki 5:7). From De 24:8, it appears to have been well-known in Egypt as a dreadful disease (comp. Description de l'Egypte, 13:159 sq.). The distinctive marks given by Moses to indicate this disease (Leviticus 13) are, a depression of the surface and whiteness or yellowness of the hair in the spot (ver. 3, 20, 25, 30), or a spreading of the scaliness (ver. 8, 22, 27, 36), or raw flesh in it (ver. 10, 14), or a white-reddish sore (ver. 43).

The disease, as it is known at the present day, commences by an eruption of small reddish spots slightly raised above the level of the skin. and grouped in a circle. These spots are soon covered by a very thin, semitransparent scale or epidermis, of a whitish color, and very smooth, which in a little time falls off, and leaves the skin beneath red and uneven. As the circles increase in diameter, the skin recovers its healthy appearance towards the center; fresh scales are formed, which are now thicker, and superimposed one above the other, especially at the edges, so that the center of the scale appears to be depressed. The scales are of a grayish- white color, and have something of a micaceous or pearly lustre. The circles are generally of the size of a shilling or half crown, but they have been known to attain half a foot in diameter. The disease generally affects the knees and elbows, but sometimes it extends over the whole body, in which case the circles become confluent. It does not at all affect the general health, and the only inconvenience it causes the patient is a slight itching when the skin is heated; or, in inveterate cases, when the skin about the joints is much thickened, it may in some degree impede the free motion of the limbs. It is common to both sexes, to almost all ages, and all ranks of society. It is not in the least infectious, but. it is always difficult to be cured, and in old persons, when it is of long standing, may be pronounced incurable. It is commonly met with in all parts of Europe, and occasionally in America. Its systematic name is Lepra vulgaris.

Moses prescribes no natural remedy for the cure of leprosy (Leviticus 13). He requires only that the diseased person should show himself to the priest, and that the priest should judge of his leprosy; if it appeared to be a real leprosy, he separated the leper from the company of mankind (Le 13:45-46; comp. Nu 5:2; Nu 12:10,14; 2Ki 7:3; 2Ki 15:5; Josephus, Apion, 1:31; Ant. 3:11,3; Wars, 5:5,6; see Wetstein, N. t. 1:175; Lightfoot, Hor. Heb. p. 861; Withob, Opusc. p. 169 sq.). Although the laws in the Mosaic code respecting this disease are exceedingly rigid (see Michaelis, Orient. Bibl. 17:19 sq.; Medic. hermeneuet. Untersuch. p. 240 sq.), it is by no means clear that the leprosy was contagious. The fear or disgust which was felt towards such a peculiar disease might be a sufficient cause for such severe enactments. All intercourse with society, however, was not cut off (Mt 8:2; Lu 5:12; Lu 17:12), and even contact with a leper did not necessarily impart uncleanness (Lu 17:12). They were even admitted to the synagogue (Lightfoot, Hor. Heb. p. 862). Similar liberties are still allowed them among the Arabians (Niebuhr, Beschr. p. 136); so that we are probably to regard the statements of travelers respecting the utter exclusion of modern lepers in the East as relating to those affected with entirely a different disease, the elephantiasis. In Leviticus 14 are detailed particular ceremonies and offerings (compare Mt 8:4) to be officially observed by the priest on behalf of a leper restored to health and purity. See D. C. Lutz, De duab. avtib. purgationi leprosi destinatis earundenzque mysterio, Hal. 1737; Bihr, Symbol. 2:512 sq.; Baumgarten, Commnent. I, 2:170 sq.; Talmud, tract Negaim, 6:3; Otho, Lex. Rabb. p. 365 sq.; Rhenferd, in Meuschen, N.T. Talmud. p. 1057.

(II.) Elephantiasis. — This more severe form of cutaneous, or, rather, scrofulous disease has been confounded with leprosy, from which it is essentially different. It is usually called tubercular leprosy (Lepra nodosa, Celsus, Med. 3:25), and has generally been thought to be the disease with which Job was afflicted (שׁחין רִע, Job 2:7; comp. De 28:35). SEE JOBS DISEASE. It has been thought to be alluded to by the term "botch of Egypt" (שׁהין מַצרִיַם, De 28:27), where it is said to have been endemic (Pliny, 26:5; Lucret. 6:1112 sq.; comp. Aretaeus, Cappad. morb. diut. 2:13, see Ainslie, in the Transactions of the Asiatic Society, 1:282 sq.). The Greeks gave the name of elephantiasis to this disease because the skin of the person affected with it was thought to resemble that of an elephant, in dark color, ruggedness, and insensibility, or, as some have thought, because the foot, after the loss of the toes, when the hollow of the sole is filled up and the ankle enlarged, resembles the foot of an elephant. The Arabs called it Judhâm, which means "mutilation," "amputation," in reference to the loss of the smaller members. They have, however, also described another disease, and a very different one from elephantiasis, to which they gave the name of Da'l fil, which means literally morbus elephas. The disease to which they applied this name is called by modern writers the tumid Barbadoes leg, and consists in a thickening of the skin and subcutaneous tissues of the leg, but presents nothing resembling the tubercles of elephantiasis. Now the Latin translators from the Arabic, finding that the same name existed both in the Greek and Arabic, translated Da'l fil by elephantiasis, and thus confounded the Barbadoes leg with the Arabic Judham, while this latter, which was in reality elephantiasis, they rendered by the Greek term lepra. See Kleyer, in Miscell. nat. curios. 1683, p. 8; Bartholin. Morb. Bibl. 100:7; Michaelis, Finleit. ins A. T. 1:58 sq.; Reinhard, Bibelkrank. 3:52.

Elephantiasis first of all makes its appearance by spots of a reddish, yellowish, or livid hue, irregularly disseminated over the skin and slightly raised above its surface. These spots are glossy, and appear oily, or as if they were covered with varnish. After they have remained in this way for a longer or shorter time, they are succeeded by an eruption of tubercles. These are soft, roundish tumors, varying in size from that of a pea to that of an olive, and are of a reddish or livid color. They are principally developed on the face and ears, but in the course of years extend over the whole body. The face becomes frightfully deformed; the forehead is traversed by deep lines and covered with numerous tubercles; the eyebrows become bald, swelled, furrowed by oblique lines, and covered with nipple- like elevations; the eyelashes fall out, and the eyes assume a fixed and staring look; the lips are enormously thickened and shining; the beard falls out; the chin and ears are enlarged and beset with tubercles: the lobe and alae of the nose are frightfully enlarged and deformed; the nostrils irregularly dilated, internally constricted, and excoriated; the voice is hoarse and nasal, and the breath intolerably fetid. After some time, generally after some years, many of the tubercles ulcerate, and the matter which exudes from them dries to crusts of a brownish or blackish color; but this process seldom terminates in cicatrization. The extremities are affected in the same way as the face. The hollow of the foot is swelled out, so that the sole becomes flat; the sensibility of the skin is greatly impaired, and in the hands and feet, often entirely lost; the joints of the toes ulcerate and fall off one after the other; insupportable fetor exhales from the whole body. The patient's general health is not affected for a considerable time, and his sufferings are not always of the same intensity as his external deformity. Often, however, his nights are sleepless or disturbed by frightful dreams; he becomes morose and melancholy; he shuns the sight of the healthy because he feels what an object of disgust he is to them, and life becomes a loathsome burden to him; or he falls into a state of apathy, and, after many years of such an existence, he sinks either from exhaustion or from the supervention of internal disease.

About the period of the Crusades elephantiasis spread itself like an epidemic over all Europe, even as far north as the Faroe Islands; and henceforth, owing to the above-named mistakes, every one became familiar with leprosy under the form of the terrible disease that has just been described. Leper or lazar-houses abounded everywhere: as many as 2000 are said to have existed in France alone. In the leper hospital in Edinburgh the inmates begged for the general community-sitting for the purpose at the door of the hospital. They were obliged to warn those approaching them of the presence of an infected fellow-mortal by using a wood rattle or clapper. The infected in European countries were obliged to enter leper hospitals, and were considered legally and politically dead. The Church, taking the same view of it, performed over them the solemn ceremonies for the burial of the dead — the priest closing the ceremony by throwing upon them a shovelful of earth. The disease was considered to be contagious possibly only on account of the belief that was entertained respecting its identity with Jewish leprosy, and the strictest regulations were enacted for secluding the diseased from society. Towards the commencement of the 17th century the disease gradually disappeared from Europe, and is now mostly confined to intertropical countries. It existed in Faroe as late as 1676, and in the Shetland Islands in 1736, long after it had ceased in the southern parts of Great Britain. This fearful disease made its appearance in the island of Guadaloupe in the year 1730, introduced by negroes from Africa, producing great consternation among the inhabitants. In Europe it is now principally confined to Norway, where the last census gave 2000 cases. It visits occasionally some of the sea-port localities of Spain. It has made its appearance in the most different climates, from Iceland through the temperate regions to the and plains of Arabia — in moist and dry localities. It still exists in Palestine and Egypt — the latter its most familiar home, although Dr. Kitto thinks not in such numerous instances as in former ages. The physical causes of the malady are uncertain. The best authors of the present day who have had an opportunity of observing the disease do not consider it to be contagious. There seems, however, to be little doubt as to its being hereditary. See Good's Study of Medicine, 3:421; Rayer, Malachi de la Peau, 2:296; Simpson, On the Lepers and Leperhouses of Scotland and England, in Edinb. Medical and Surgical Journal, Jan. 1, 1842; J. Gieslesen, De elephantiasi Norvegica (Havn. 1785); Michael. U. orient Bibl. 4:168 sq.; B. Haubold, Vitiliginis leprosce rarioris historia c. epicrisi (Lips. 1821); C. J. Hille, Rarmioris norbi clephantiasi partiali sienilis histor. (Lips. 1828); Rosenbaum, in the Hall. Encyklop. 33:254 sq.

Elephantiasis, or the leprosy of the Middle Ages, is the disease from which most of the prevalent notions concerning leprosy have been derived, and to which the notices of lepers contained in modern books of travels exclusively refer. It is doubtful whether any of the lepers cured by Christ (Mt 8:3; Mr 1:42; Luke v. 12, 13) were of this class. In nearly all Oriental towns persons of this description are met with, excluded from intercourse with the rest of the community, and usually confined to a separate quarter of the town. Dr. Robinson says, with reference to Jerusalem, "Within the Zion Gate, a little towards the right, are some miserable hovels, inhabited by persons called lepers. Whether their disease is or is not the leprosy of Scripture I am unable to affirm; the symptoms described to us were similar to those of elephantiasis. At any rate, they are pitiable objects, and miserable outcasts from society. They all live here together, and inter-marry only with each other. The children are said to be healthy until the age of puberty or later, when the disease makes its appearance in a finger, on the nose, or in some like part of the body, and gradually increases as long as the victim survives. They were said often to live to the age of forty or fifty years" (Bib. Res. 1:359). With reference to their presence elsewhere, he remarks, "There are said to be leprous persons at Nablûs (Shechem) as well as at Jerusalem, but we did not here meet with them" (ib. 3:113 note). On the reputed site of the house of Naaman, at Damascus, stands at the present day a hospital filled with unfortunate patients, the victims affected like him with leprosy. SEE PLAGUE.

2. That the Mosaic cases of true leprosy were confined to the former of these two dreadful forms of disease is evident. The reason why this kind of cutaneous distemper alone was taken cognizance of by the law doubtless was because the other was too well marked and obvious to require any diagnostic particularization. With the scriptural symptoms before us, let us compare the most recent description of modern leprosy of the malignant type given by an eye-witness who examined this subject: "The scab comes on by degrees, in different parts of the body; the hair falls from the head and eyebrows; the nails loosen, decay, and drop off; joint after joint of the fingers and toes shrink up, and slowly fall away; the gums are absorbed, and the teeth disappear; the nose, the eyes, the tongue, and the palate are slowly consumed; and, finally, the wretched victim shrinks into the earth and disappears, while medicine has no power to stay the ravages of this fell disease, or even to mitigate sensibly its tortures" (Thomson, Land and Book, p. 653, etc.); and again, "Sauntering down the Jaffa road, on my approach to the Holy City, in a kind of dreamy maze, I was startled out of my reverie by the sudden apparition of a crowd of beggars, sans eyes, sans nose, sans hair, sans everything. They held up towards me their handless arms, unearthly sounds gurgled through throats without palates" (ibid. p.

651). We merely ask by what rules of interpretation can we deduce from the Biblical leprosy, which is described as consisting in a rising scab, or bright spot deeper than the general level of the skin, and spreading, sometimes exhibiting live flesh, and which is non-contagious and curable, that loathsome and appalling malady described by Dr. Thomson and others?

3. As to the leprosy of garments, vessels, and houses, the ancient Jewish tradition is that "leprosy of garments and houses was not to be found in the world generally, but was a sign and a miracle in Israel to guard them against an evil tongue" (Maimonides, On Leprosy, 16:10). Some have thought garments worn by leprous patients intended. The discharges of the diseased skin absorbed into the apparel would, if infection were possible, probably convey disease, and it is known to be highly dangerous in some cases to allow clothes which have so imbibed the discharges of an ulcer to be worn again. The words of Jude, ver. 23, may seem to countenance this, "Hating even the garment spotted by the flesh." But, 1st, no mention of infection occurs; 2d, no connection of the leprous garment with a leprous human wearer is hinted at; 3d, this would not help us to account for a leprosy of stone walls and plaster. Thus Dr. Mead (ut sq).) speaks at any rate plausibly of the leprosy of garments, but becomes unreasonable when he extends his explanation to that of walls. There is more probability in the idea of Sommer (Bibl. Abhandlugen, 1:224) that what is meant are the fusting-stains occasioned by damp and want of air, and which, when confirmed, cause the cloth to moulder and fall to pieces. Michaelis thought that wool from sheep which had died of a particular disease might fret into holes, and exhibit an appearance like that described in Le 13:47,59 (Michaelis, art. 211, 3:290, 291). But woolen cloth is far from being the only material mentioned; nay, there is even some reason to think that the words rendered in the A.V. "warp" and "woof" are not those distinct parts of the texture, but distinct materials. Linen, however, and leather are distinctly particularized, and the latter not only as regards garments, but "anything (lit. vessel) made of skin" — for instance, bottles. This classing of garments and house-walls with the human epidermis as leprous has moved the mirth of some and the wonder of others. Yet modern science has established what goes far to vindicate the Mosaic classification as more philosophical than such cavils. It is now known that there are some skin- diseases which originate in an acarus, and others which proceed from a fungus. In these we may probably find the solution of the paradox. The analogy between the insect which frets the human skin and that which frets the garment that covers it, between the fungous growth that lines the crevices of the epidermis and that which creeps in the interstices of masonry, is close enough for the purposes of a ceremonial law, to which it is essential that there should be an arbitrary element intermingled with provisions manifestly reasonable. Michaelis (ibid. art. 211:3:293-9) has suggested a nitrous efflorescence on the surface of the stone, produced by saltpetre, or rather an acid containing it, and issuing in red spots, and cites the example of a house in Lubeck; he mentions, also, exfoliation of the stone from other causes; but probably these appearances would not be developed without a greater degree of damp than is common in Palestine and Arabia. It is manifest, also, that a disease in the human subject caused by an acarus or a fungus would be certainly contagious, since the propagative cause could be transferred from person to person. Some physicians, indeed, assert that only such skin-diseases are contagious. Hence, perhaps, arose a further reason for marking, even in their analogues among lifeless substances, the strictness with which forms of disease so arising were to be shunned.

Whatever the nature of the disorder might be, there can be no doubt, as Baumgarten has remarked (Comm. 2:175), that in the house respect was had to its possessor, since when it came to be in a good condition a cleansing or purification quite analogous to the man's was prescribed. He was thus taught to see in his external environments a sign of what was or might be internal. The later Jews appear to have had some idea of this, though others viewed it differently. Some rabbins say that God sent this plague for the good of the Israelites into certain houses, that, they being pulled down, the treasure which the Amorites had hidden there might be discovered (Patrick on Le 14:34). But "there is good reason," adds the learned prelate, "from these words ['I put the plague of leprosy upon a house], to think that this plague was a supernatural stroke. Thus Aberbanel understands it: 'When he saith "I put the plague," it shows that this thing was not natural, but proceeded from the special providence and pleasure of the blessed God.' So the author of Sepher Cosri (pt. 2, § 58): God inflicted the plague of leprosy upon houses and garments as a punishment for lesser sins, and when men continued still to multiply transgressions, then it invaded their bodies. Maimonides will have this to be the punishment of an evil tongue, i.e. detractions and calumny, which began in the walls of the offender's house, and went no farther, but vanished if he repented of his sin; but if he persisted in his rebellious courses, it proceeded to his household stuff; and if he still went on, invaded his garments, and at last his body" (More Nebochim, pt. 3, cap. 47).

Finally, as to the moral design of all these enactments. Every leper was a living sermon, a loud admonition to keep unspotted from the world. The exclusion of lepers from the camp, from the holy city, conveyed figuratively the same lesson as is done in the New Testament passages (Re 21:27; Eph 5:5)...It is only when we take this view of the leprosy that we account for the fact that just this disease so frequently occurs as the theocratic punishment of sin. The image of sin is best suited for reflecting it: he who is a sinner before God is represented as a sinner in the eyes of man also, by the circumstance that he must exhibit before men the image of sin. God took care that ordinarily the image and the thing itself were perfectly coincident, although, no doubt, there were exceptions" (Hengstenberg, Christol. on Jer 31:39). SEE UNCLEANNESS.

Literature. — Besides the above notices and canons on leprosy given in the Mischna, tract Negaim; also by Maimonides, Yod Ha-Chezaka Hilchoth Mechosse Kapara, cap. 4, and Hilchoth Tamath Tsoraoth; and by Rashi and Rashbarn, Commentar. on Le 13; Le 14; see, among modern writers, Mead, Medica Sacra, in his Medical Works (Edinb. 1765), 3:160, etc.; Michaelis, Laws of Moses (Lond. 1814), 3:257-305; Mason Good, The Study of Medicine (Lond. 1825), v. 585 sq.; Schilling, De lepra Commentationes (Lugd. Bat. 1778); Hensler, Vorn abendlandischen Aussatze im Mittelalter (Hamb. 1790); Jahn, Biblische A rchaologie (Vienna, 1818), I, 2:355 sq.; Bahr, Symbolik des Mosaischen Cultus (Heidelb. 1830), 2:459 sq., 512 sq.; Sommer, Biblische Abhacndlungen, vol. 1 (Bonn, 1846); Pruner, Die Krankheiten des Orients (Erlang. 1847), p. 163 sq.; Trusen, Die Sitten, Gebrauche und Kranklheiten der A lten Hebr. (Bresl. 1833); Saalschütz, Das Mosaische Recht (Berlin, 1853), 1:217 sq.; Keil, Handbuch der Biblischen A rchaologie (Frankfort-on-the- Main, 1858), 1:270 sq., 288 sq.; Bonorden, Lepra squamosa (Hal. 1795); Lutz, De avibus purgat. leprosi (Hal.1757); Withof, De leprosariis vet. Hebrueorum (Duisb. 1756); Murray, Historia leprce (Gott. 1749); J. Thomas, De lepra Grcecor. et Judaeor. (Basil. 1708); Norberg, De lepra A rabums (Lond. 1796); Hilary, Observ. on the Diseases of Barbadoes (Lond. 1759), p. 326 sq.; Sprengel, Pathol. 3:794-835; Frank, De curandis honzin. morbis, I, 2:476; Schnurrer, in the Halle Encyklop.

6:451 sq.; Rust, Handb. d. Chirurg. 2:581 sq.; Roussille-Chamseru. Recherches sur ie veritable. Caractere de la Lepre des Hebreux, and Relation Chirurg. de l'Armee de l'Orient (Paris, 1804); Cazenave and Schedel, A breg Pratique des Maladies de la Peau; Aretaeus, Maorb. Chron. 2:13; Fracastorius, De Morbis Contagiosis; Johannes Manardus, Epist. Medic. 7:2, and to 4:3, 3, § 1 Avicenna, De Medic. v. 28, § 19; also Dr. Sim in the North American Chirurgical Review, Sept. 1859, p. 876: Hecker, Die Elephantiasis oder Lepra Arabica (Lehr, 1858); also the monographs cited by Volbeding, Index, p. 42; and by Hase, Leben Jesu, p. 137. The ancient authorities are Hippocrates, Prophetica, lib. 12, ap. fin.; Galen, Explicati Linguaruam Hippocratis, and De Art. Curat. lib. 2; Celsus, De Medic. 5:28, § 19. SEE DISEASE.

 
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