The Great Physician XX: Not All Leprosy Is The Same

So now I kind of get into the original reason I started looking into the comparison between the Old Testament Law of Moses and modern medicine. Leviticus 13 and leprosy. There is a lot to go over and it will take a while to work through. I'll keep it as short as possible in the next three posts. Simply put, not all leprosy is leprosy as we understand it today.

Chapter 13 of the book of Leviticus contains the fullest account in the Bible of leprosy (in the broad sense).  Chapter 13 is literally a diagnostic checklist to enable the identification of the symptoms and signs of different types of leprosy/skin lesions. It also offers treatment and guidance for dealing with what is diagnosed.

I will note outright that this chapter raises questions about leprosy and skin conditions which are difficult to answer. They might even be unanswerable.  I will also borrow from the Septuagint and New Testament idea of leprosy or lepra / λέπρα also to try and extrapolate answers. Why? Because it is the Jewish translators of the Septuagint LXX that chose to transliterate the Hebrew word to lepra / λέπρα or leprosy not more modern translators. IT matters because the Greek lepra / λέπρα can be equivocal or ambiguous or vague. Far and away not all of these references to leprosy are the dreaded Glephantiasis Graecorum or Hansen’s disease.

The Dictionary of Classic Hebrew seems to implies that the root of the word used as leprosy in Leviticus 13 means specifically ‘to be afflicted with a rash’ (1). Quite a few Hebrew dictionaries tell us that tzaraath צרעת was unpleasant, affected the skin and possibly occurred suddenly ‘like a blow’; but it also affected fabrics and structures/buildings alike.  As stated before, its diagnosis and treatment primarily involved priests not physicians and it is unsurprising, therefore, that remedial measures were non-medicinal sacrifice(s). (2) Milgrom translated tzaraath as scale-disease (3) The justification of a skin disease noted by nearly all authors over many years has been a single verse from Leviticus 13:2 which specifically mentions scales/rash that turns into Leprosy.

“The LORD spoke to Moses and Aaron, saying, when a person has on the skin of his body a swelling or an eruption or a spot, and it turns into a case of leprous disease on the skin of his body, then he shall be brought to Aaron the priest or to one of his sons the priests… Leviticus 13:1-2

What should also be noted is Leviticus 13 was stated not to Israel but to Moses and Aaron only. I suggest that is because of the potential for an alarmist type misdiagnosis causing the tribes to panic in reaction. Not only did God attempt to quarantine the disease, he quarantined the information so not to cause a panic of thousands perhaps millions of people.

Leviticus 13:2-17 Symptoms and Signs

These verses mark out a list of symptoms and signs that characterize and also the appropriate actions to be taken by the priest when diagnosing and thereafter. Therefore, based on a reading of this passage it quickly becomes clear that leprosy in the Biblical sense is not so much a specifically identified disease as it is more a group of visible symptoms and outward bodily signs that qualify and quantify it as belonging to one of the impurities mentioned elsewhere in the law. Unfortunately, the wordage is at time very imprecise and hard to quantify in modern terminology. Verse 2 seems to refer to skin lesions. It says, “The skin of his skin” or “the skin of his body…”.

The Septuagint (LXX) transliterates specific Hebrew wordage in Leviticus 13:2. The words in question I focus on are the lumping together of three types of lesions together: οὐλη σημασίας τηλαυγὴς.  Both Liddell and Scott’s Lexicon (4) and Bauer’s Lexicon (5) define οὐλη quite specifically as a ‘wound scarred over’.  The noun σημασίας is defined as ‘an indication’ or ‘a mark’ and τηλαυγὴς as ‘conspicuous from afar by its shining whiteness’. Therefore here we do not have an inflammatory lesion glowing red but an area of white scarring.  This suggests an old lesion that has healed. If we turn to non-biblical Greek sources, Hippocrates reinforces the idea of scarring in an account of a child born with an omphalocoele (6) which became ulcerated so…

‘…the navel did not form a scar’  or … ὁ ὀμφαλὸς οὐ μάλα οὐλὴ ἐγεγονει (Hippocrates, Epidemics IV, 171) (6)

What I can tell with certainty from this is one thing. This disease is neither modern leprosy named Hansen’s Disease or Elephantiasis Graecorum the name given in Hellenic times to the disease (probably the same as Hansen’s disease. For me to speculate beyond this is going beyond the scope of the text. I would therefore be performing eisegesis and reading things into Bible that are not stated there.

(1) Clines, ed., Dictionary of Classical Hebrew. (DCH)

(2) Poorthuis and Schwartz, Purity and Holiness: the Heritage of Leviticus;  Knohl, The Sanctuary of Silence.

(3) Milgrom, Leviticus, a New Translation with Introduction and Commentary;  Sawyer, "A Note on the etymology of sara'at."

(4) Liddell and Scott, Greek English Lexicon

(5) Bauer et al., A Greek-English lexicon of the New Testament and other early Christian literature.

(6) Hippocrates et al., Hippocrates.Vol VII, p 128. An omphalocoele is a herniation of the gut at the umbilicus resulting from incomplete closure of the latter by scarring, during foetal development. Omphalocoeles become secondarily infected and show an inflammatory response.