A fishing town located on the northwest shore of the Sea of Galilee (Matt. 4:13). Capernaum is referred to in Luke 4:31 as a polis (“city” or “town”), so it must have been larger than a typical “village.” The town was on an important trade route and was a center for commerce in Galilee. In Capernaum, Jesus called Levi (Matthew) from his “tax booth,” probably a customs station for goods in transit (Mark 2:13–17; Matt. 9:9–13; Luke 5:27–32). There may also have been a military garrison in Capernaum, since the town’s synagogue was built by a certain centurion whose servant Jesus healed (Matt. 8:8–13; Luke 7:1–10).

Capernaum served as Jesus’ base of operations during his Galilean ministry. In Mark’s Gospel, Jesus’ teaching and healing ministry begins there (Mark 1:21–34), and this is where he returned “home” after itinerant ministry around Galilee (Matt. 9:1; Mark 2:1; 9:33). Although Peter and Andrew were originally from Bethsaida (John 1:44), they lived in Capernaum, and their fishing business was located there. It was here that Jesus healed Peter’s mother-in-law (Mark 1:29–31) and a paralyzed man whose friends lowered him through a hole in the roof (2:1–12). Jesus later pronounced judgment against the town, together with Chorazin and Bethsaida, because of the people’s unbelief despite the miracles they had seen (Matt. 11:23–24; Luke 10:15). Archaeologists have discovered a first-century home under a fifth-century church in Capernaum. Christian inscriptions in the home indicate that it was venerated by Christians, suggesting to many scholars that this was Peter’s residence.

The Gospels list demon possession among the maladies that Jesus and his disciples (and later the apostles) cured (e.g., Matt. 4:24). While the NT does not offer an explicit theory of demon possession or an account of how it differs from illnesses with nondemonic causes, the Gospels are rich in descriptions of the suffering of the demon-possessed. Demons caused muteness (Matt. 9:32–33; Luke 11:14), blindness (Matt. 12:22), and seizures (Matt. 17:15; Luke 4:35; 9:42), as well as symptoms that moderns associate with various forms of mental illness, including strange verbal outbursts (Matt. 8:28–34; Luke 4:34). The story of the Gerasene demoniac is especially troubling (Luke 8:26–39 pars.). The demoniac (or demoniacs, according to Matt. 8:28) wore no clothes, lived outside his city among the tombs, howled, cut himself with stones, and shouted under the control of the demons. He was able to break chains that were placed on his body as restraints. Many demoniacs who appear in the Gospels are men, but demon possession also affected women (Matt. 15:22–28). The Gospels do not describe the onset of demon possession.

In addition to these descriptions of demon possession, the recorded perceptions of Jesus’ contemporaries offer insight into how it was understood in antiquity. Some thought that John the Baptist was demon-possessed (Matt. 11:18; Luke 7:33) because he “came neither eating nor drinking”—that is, he adhered to an extreme ascetic diet and lifestyle. Jesus was thought to derive his power to cast out demons from collusion with Beelzebul (Mark 3:22). In the Gospel of John, in contrast to the Synoptic Gospels, Jesus’ ability to heal leads his contemporaries to the opposite conclusion, that he is not demon-possessed (John 10:20–21). Instead, the charge of demon possession in the Gospel of John stems from the perception that Jesus’ religious teachings were unorthodox (John 8:48–52). Paul also correlates heresy with demonic influence (1 Tim. 4:1).

It is important to note that in the NT, demon possession is almost always portrayed as a terrible affliction. The idea of harnessing the power of a demon for one’s own benefit, which was widespread in antiquity and the Middle Ages, is not a major focus in the NT, though it is reflected in the story of the girl who was possessed by a fortune-telling spirit (Acts 16:16) and in cases in which Jesus’ contemporaries attributed (falsely) his healing power to demonic possession.

The Gospels list demon possession among the maladies that Jesus and his disciples (and later the apostles) cured (e.g., Matt. 4:24). While the NT does not offer an explicit theory of demon possession or an account of how it differs from illnesses with nondemonic causes, the Gospels are rich in descriptions of the suffering of the demon-possessed. Demons caused muteness (Matt. 9:32–33; Luke 11:14), blindness (Matt. 12:22), and seizures (Matt. 17:15; Luke 4:35; 9:42), as well as symptoms that moderns associate with various forms of mental illness, including strange verbal outbursts (Matt. 8:28–34; Luke 4:34). The story of the Gerasene demoniac is especially troubling (Luke 8:26–39 pars.). The demoniac (or demoniacs, according to Matt. 8:28) wore no clothes, lived outside his city among the tombs, howled, cut himself with stones, and shouted under the control of the demons. He was able to break chains that were placed on his body as restraints. Many demoniacs who appear in the Gospels are men, but demon possession also affected women (Matt. 15:22–28). The Gospels do not describe the onset of demon possession.

In addition to these descriptions of demon possession, the recorded perceptions of Jesus’ contemporaries offer insight into how it was understood in antiquity. Some thought that John the Baptist was demon-possessed (Matt. 11:18; Luke 7:33) because he “came neither eating nor drinking”—that is, he adhered to an extreme ascetic diet and lifestyle. Jesus was thought to derive his power to cast out demons from collusion with Beelzebul (Mark 3:22). In the Gospel of John, in contrast to the Synoptic Gospels, Jesus’ ability to heal leads his contemporaries to the opposite conclusion, that he is not demon-possessed (John 10:20–21). Instead, the charge of demon possession in the Gospel of John stems from the perception that Jesus’ religious teachings were unorthodox (John 8:48–52). Paul also correlates heresy with demonic influence (1 Tim. 4:1).

It is important to note that in the NT, demon possession is almost always portrayed as a terrible affliction. The idea of harnessing the power of a demon for one’s own benefit, which was widespread in antiquity and the Middle Ages, is not a major focus in the NT, though it is reflected in the story of the girl who was possessed by a fortune-telling spirit (Acts 16:16) and in cases in which Jesus’ contemporaries attributed (falsely) his healing power to demonic possession.

In Christian theology, doctrine is the synthesis of Christian teaching, especially as set forth in its various related themes. The early disciples frequently referred to the teachings of Christ and to the teachings of the apostles and the church. These were memorized, compiled, and passed through the generations in the church (2 Tim. 2). As early as Acts 2 reference is made to the teaching of the apostles and the devotion of the church to it. By the second century, a body of teaching had crystallized into a doctrinal treatise called the Didache. Doctrinal teaching as a set structure is especially emphasized in the Pastoral Epistles, such that it has caused some to conjecture a later date and early catholic outlook for those letters. Regardless of the validity of this postulation, these letters evidence an early doctrinal and confessional outlook within the church.

This was, of course, nothing new, since the Israelites had a body of teaching that they had passed on through the generations: the law, both written and oral. For the Israelites, the law, both written and oral, was memorized, taught, interpreted, and heeded through all of society. The church simply followed suit in forming its teachings.

In the NT two words, didachē and didaskalia, are commonly translated “teaching” and in some cases are rendered by some translations as “doctrine.” The term didachē appears more widely throughout the NT, whereas didaskalia is used largely in the Pastoral Epistles (referring to both the content and the act of teaching). The term didaskalia is sometimes used with the term logos when the latter indicates sound speech (Titus 2:7–8) and words of the faith (1 Tim. 4:6). In fact, in one verse in the Pastoral Epistles all three terms are used together as “the faithful word,” “in accordance with the teaching,” and “in sound doctrine” (Titus 1:9 NASB).

The first body of teaching for the church is the teaching of Jesus (Matt. 7:28), such as that found in the Sermon on the Mount, where Jesus notes the ethic of his messiahship and his followers. The teaching of Jesus, which is authoritative (Mark 1:22, 27), and confrontational (Mark 12:38), is an astonishing answer to the religious leaders (Matt. 22:33; cf. Luke 4:32). Jesus notes the vanity of teaching the human commandments as if they were the doctrine from God (Mark 7:7). When questioned, Jesus sets forth his teaching as from the Father (John 7:16–17). The chief priests seek to destroy both Jesus and his followers because of the teaching (Mark 11:18; John 18:19; Acts 5:28). On Cyprus the proconsul is astonished at the doctrine of Christ taught by Paul (Acts 13:12), and in Athens Paul’s teaching about Christ is new and unusual to those of the Areopagus (Acts 17:18–20).

For Paul, doctrine is fundamental for believers. He notes the commitment to the teaching of Christ after conversion as normative for the Roman believers (Rom. 6:17), and he instructs further that they keep an eye out for those who cause division and hinder adherence to sound doctrine (Rom. 16:17). In fact, God has given gifted people to the body for building up the saints to avoid such doctrinal problems (Eph. 4:12–14). Further, a straightforward expression of teaching has priority over gifts such as tongues (1 Cor. 14:6, 26). Paul also points out that the Colossian heresy is the doctrine of human beings rather than that of God (Col. 2:22).

In the Pastoral Epistles the injunction from Paul to Timothy is that he be nourished on and persevere in sound doctrine (1 Tim. 4:6, 16) and set forth doctrine in preaching (1 Tim. 4:13 [along with public reading of Scripture]; 2 Tim. 4:2). All this is certainly fitting for Timothy, as he has followed the teaching of Paul (2 Tim. 3:10). The injunction to Titus is to hold to the word and to the sound doctrine and teaching as he corrects the church (Titus 1:9). Those who are servants are encouraged to show honesty and good faith, so that the teaching of the Savior will be respected (Titus 2:10). It is clear for Paul that Scripture is the basis of doctrine (2 Tim. 3:16). This doctrine (teaching) will be tolerated by few; as a whole, sound doctrine will be rejected in favor of a message more palatable to human interest (2 Tim. 4:3). The task of the servant of God is to stand against heterodox teaching (1 Tim. 1:3; 6:3). Heterodoxy leads to heteropraxy (1 Tim. 1:10). Paul notes the doctrine of demons, false teaching that is ultimately based in satanic teaching (1 Tim. 4:1).

The injunction of the writer to the Hebrews is that they are not to submit to strange teachings, which deny grace (13:9). This accords with the book’s argument as a whole. For John, staying in the doctrine of Christ is salvific, but going outside it is not (2 John 9). John’s readers are not to receive those who pervert the doctrine of Christ (2 John 10).

In the book of Revelation, Jesus warns the church at Pergamum about the false teaching of Balaam (2:14) and that of the Nicolaitans (2:15). The church at Thyatira is likewise warned to shun the teachings of the false prophetess known as “Jezebel” (2:20, 24).

A transliteration of the Greek word synagōgē, meaning “gathering, assembly, meeting.” In English, the word “synagogue” refers either to a Jewish congregation or to the place where that congregation meets. Synagogues of the biblical era functioned as both religious and civic centers for the Jewish community.

Origins

The origin of synagogues is uncertain. The earliest archaeological evidence is from Egypt in the third century BC, consisting of inscriptions and a papyrus letter. The oldest architectural find is from the island of Delos in the Aegean Sea, although whether this was constructed as a synagogue or redesigned into one is unknown, as is whether it was Jewish or Samaritan. The oldest structures yet found in Israel consist of two rooms at Qumran and the synagogue at Gamla, which date from the late first century BC. In Capernaum, the basalt synagogue was built by a Gentile centurion for the community in the first century AD (Luke 7:1–5).

By that time, synagogues were well attested in Israel, elsewhere in the Roman Empire, and in Egypt (Matt. 4:23; Luke 4:44; Acts 9:2; 17:10, 16–17; 18:8, 19). Synagogues were found wherever there were communities of Jews, in cities and rural areas alike. Especially in Diaspora settings or remote locations, they were the heart of Jewish life. Several hypotheses have been suggested to account for their apparently sudden appearance.

Some believe that synagogues were developed during the Babylonian captivity as the response of the exile community to the destruction of their temple and sacrificial system. Despite these enormous losses, the Jews still had the Torah, and from that point forward worship and prayer based on the reading and studying of the Scriptures, which could be done locally, began to gain ascendancy. Critics of this idea, however, point out that while it makes sense, there is no direct evidence to support it.

Others think that the spread of Hellenism in the second century BC precipitated a crisis of identity among Jews. For example, 1 Maccabees reports with distress that some Jews had abandoned the covenant and teamed with the Hellenists, even going so far as to build a Greek-style gymnasium in Jerusalem (1:11–15). Thus, the thought is that synagogues were a form of resistance to the overwhelming and perversely appealing cultural changes of the day.

More recently, it has been suggested that synagogues were the gradual successors to functions that had previously taken place at city gates. First-century synagogues served a wide range of functions for the community. Throughout Israel’s prior history, however, these same activities—assembly, legal, social, educational, and religious—had taken place at the city gate (Deut. 12:15; 2 Sam. 15:2; 2 Kings 23:8; Neh. 8:1–8). The Gamla synagogue sits against the east city wall next to a probable gate, and its location could be evidence of the slow development of the synagogue as city gates changed from multipurpose facilities to portals of ingress and egress.

First-Century Synagogues

First-century synagogues served as integrated centers supporting Jewish life. Regular communal reading and exposition of Scripture, including teaching and discussion of the law and transmission of its complex associated traditions (Luke 4:16; Acts 13:14–15), occurred there. Although formal liturgical rites evolved after the destruction of the temple in AD 70, synagogues were places of prayer in the first century (Matt. 6:5). Synagogues also served as courtrooms and places where crimes were punished (Acts 22:19), as well as locations for common meals and festivals (see Acts 6:2).

Synagogues were administered by local community leaders, including a president and a board (Acts 13:15). Synagogue leaders named in the NT include Jairus (Mark 5:22; Luke 8:41), Crispus (Acts 18:8), and Sosthenes (Acts 18:17). The role of the leader was to preside over services, to rule as the judge in court cases, to represent the community, and often to act as a patron. The board served in an advisory role and assisted with teaching. A scribe maintained community records and taught.

Congregations included Pharisees, who advocated strict adherence to the law, although they were chided by Jesus for their false piety (Luke 11:42–44). Women participated in the synagogue along with the men, and in some cases they were financial donors (cf. Luke 8:3). God-fearing Gentiles were welcomed (Acts 17:17). In Jerusalem, synagogues included both Hebrews and Jews from the Diaspora (Acts 6:1, 9).

A synagogue could be a designated room in a house or a discrete building. Most of the better archaeological evidence is later than the first century and reveals more clearly religious intentionality in design than may have been characteristic earlier. This evidence includes the door facing Jerusalem, artistic temple motifs, a niche for the Torah scrolls, and perimeter bench seating around an open central hall.

The Synagogue in the Bible

Since synagogues were institutions with a documented history no earlier than the third century BC, they are not mentioned in the OT. The Greek word from which the English one is derived does appear frequently in the LXX, but always with a general reference to a gathering, assembly, or meeting.

Rabbinic history (but not Scripture) makes reference to the “Great Synagogue,” meaning a group of men who transmitted traditions from the prophets to the earliest named rabbinic teachers. It is loosely based on Neh. 8–10, which describes the prayers and actions of the Jewish leaders who had returned from exile.

Synagogues frequently were locations of the teaching and healing ministry of Jesus. He began preaching the kingdom of God, teaching, and performing healing miracles in Galilean synagogues (Matt. 4:23; 9:35; 12:9; 13:54; Mark 1:21–29, 39; 3:1; 6:2; Luke 4:15–38, 44; 6:6–11; 13:10–17; John 6:59; 18:20). Later, the apostle Paul customarily initiated his mission work in the local synagogue at each of his destinations (Acts 9:19–20; 13:5, 14–15; 14:1; 17:1, 10, 17; 18:1–8; 19:8).

The last (and, from a twenty-first-century perspective, most controversial) use of the word “synagogue” in Scripture is the difficult phrase “synagogue of Satan” (Rev. 2:9; 3:9), which must be read in its context. This was written in response to the significant persecution in Asia Minor of the churches at Smyrna and Philadelphia by Jews who were in collusion with the Roman authorities. They were falsely accusing Jewish and Gentile Christian believers, creating unspeakable suffering for them. This phrase, intended to encourage Christian perseverance, implies that the churches in view represented true Israel, while their accusers were false Jews. Similar language was used by the covenant-keeping community in Qumran when, in the DSS, it referred to apostate Jews as a “congregation of Belial” and an “assembly of hypocrites” (1QHa 10:22; 15:34).

Understanding many aspects of education in Israel during OT times and, to a lesser extent, into the NT period is extraordinarily difficult. Many studies draw quite specific conclusions based on very slender evidence and inferences drawn from supposed parallels with neighboring societies, inferences themselves beset by uncertainties. Therefore, conclusions are necessarily tentative at many points. Furthermore, it is reasonable to expect that things did not remain constant through history, and that what can be reliably discerned for one period may not accurately reflect the situation in other times.

Education encompasses several areas of life in the biblical world. Aside from academic education (relating to literacy and numeracy), there was moral and religious education, military education, and vocational training. These are not all distinct; those whose vocation lay in diplomatic circles or within the royal court as scribes would have received academic education, while those living in the country and working a farm would have had little opportunity to access such knowledge.

Old Testament

Settings for education. There were three primary arenas of education in OT times: home, school, and temple.

Home. The most important setting for education in OT times was the home (Deut. 4:9; 6:7; 11:19). Both parents were expected to play a role in a child’s education (Prov. 1:8; 6:20; 23:22; 31:1). Sons generally were trained in their father’s vocation, and such training took the form of an apprenticeship (1 Sam. 16:11; 2 Kings 4:18); girls learned from their mothers as they undertook their work on a daily basis (Exod. 35:25–26; 2 Sam. 13:8).

In part, the extent of home education is tied to the question of the extent of formal schooling in ancient Israel. As noted below, the nature and extent of schools is unclear, and if (as the evidence seems to suggest) schools were virtually nonexistent outside the royal court, then the home ultimately would have been the locus of any academic education received by children and the source of any widespread literacy and numeracy in the community. The frequent use of father/son language in Proverbs, however, need not imply an exclusively familial context for the instruction contained therein, as there is evidence from Egypt that such language was used between teacher and student.

School. The existence, nature, and extent of schools in OT times is extensively debated and ultimately uncertain. The first explicit reference to a school is found in the second century BC in Sir. 51:23. The virtual silence of the OT on the topic may reflect either that schools were absent in ancient Israel or that their existence was somehow of little interest and so warranted little reflection by biblical authors. In any case, it is likely that some form of school for scribes and those training to work in government existed in the vicinity of the royal court, as they did in Mesopotamia and Egypt. These did not form a comprehensive national schooling system for young children but were more specifically targeted to the few individuals who aimed to become scribes or advisers.

Outside the Bible there exist a number of inscriptions that could suggest the existence of schools in Israel prior to the exile. These include abecedaries (lists of the letters of the alphabet written out, usually as practice exercises or as examples), words written out several times, lists of month names, and possible exercises in reading foreign languages, among others.

There is also extensive evidence of schools in Egypt, Mesopotamia, and probably also Ugarit from an early date (cf. Acts 7:22). Whether their existence supports the existence of schools in Israel is unclear. Egypt and Mesopotamia had large and complex bureaucracies necessary to administer their kingdoms, and they employed writing systems far more difficult to master than Hebrew. In addition, mathematical texts reflect a concern with numeracy within the schools of these kingdoms, for which there is no clear evidence in ancient Israel.

The sages and scribes appear to be the primary source for the material supposedly employed in schools. Ecclesiastes 12:9 identifies one of the tasks of the sages as teaching the people, and some claim that Proverbs functioned as a textbook within a school setting. Indeed, Prov. 4:5; 17:16 speak of the “buying” (Heb. qanah) of knowledge, interpreted by some as a reference to teachers paid for providing tuition. Again, the context in which such tuition may have taken place is uncertain.

Temple. Priests were also involved in some teaching (1 Sam. 2:21, 26). According to 2 Chron. 17:7–9, King Jehoshaphat sent five officials, nine Levites, and two priests to teach the people of Judah from the Book of the Law, a point that stresses both the importance of the task and the probable failure of the home setting to adequately convey this instruction, at least by the late fifth century BC.

Types of education. In OT times four types of education can be discerned: moral and religious, academic, vocational, and military.

Moral and religious education. The Bible stresses the importance of moral and religious education above all other forms (Exod. 10:2; 12:26; 13:8; Deut. 4:9; 6:7, 20–21; 32:7, 46).

Academic education. The extent of literacy and numeracy in ancient Israel is difficult to ascertain. Rudimentary numeracy almost certainly was widespread and learned within the home and in the course of vocational training when necessary. Many among the population also appear to have been at least capable of reading and writing names or other simple texts (Deut. 6:9; 11:20; Judg. 8:14).

Vocational training. Most commonly, boys followed in their father’s vocation and thus learned through observation and participation. Under some circumstances, however, children served apprenticeships under the tutelage of others, such as was apparently the case for prophetic schools (2 Kings 2:7; 4:38; 6:1–2; Amos 7:14–15).

Military training. There are clear indications that kings recruited mercenaries to form the most important part of their army (e.g., 1 Sam. 22:2; 25:13). These mercenaries were paid and likely had received some formal training, but the nature of that training is nowhere explained. In addition to these elite forces, all able-bodied men apparently were considered eligible for military service when the need arose (2 Chron. 25:5). So, for example, the elite troops were responsible for staging the attack (2 Sam. 11:14–17; 12:26), while the remainder of the army served as reinforcements where necessary (2 Sam. 12:29). The use of chariots (under David and Solomon) would have required some training, as would the wielding of various weapons (swords, spears, bows, and slings). Ultimately, however, there are only allusions to such training (e.g., Judg. 3:2; 2 Sam. 22:35).

Educational methods. Throughout the ancient Near East there is evidence that corporal punishment played a significant role in education. There is a somewhat comical text from Mesopotamia that relates a day in the life of a student who receives physical punishment for virtually everything he does. Similarly, the book of Proverbs highlights the importance of discipline in raising and training children (e.g., 13:24; 22:15; 29:15, 17). Nonetheless, Proverbs uses “the rod” as a means to signify discipline as a whole without necessarily endorsing corporal punishment as the only or even the primary means of discipline. This is apparent because Proverbs contrasts the rod not with other, lesser forms of discipline but rather with no discipline at all. Thus, although there is evidence that corporal punishment was used extensively (and probably excessively [see Sir. 30]), Proverbs endorses a more nuanced approach to disciplining children.

Academic, religious, and moral education also involved the use of various techniques that facilitated learning. These included the use of poetry or poetic couplets (common in wisdom literature and in psalms), numerical sayings (e.g., Ps. 62:11; Prov. 6:16), and acrostics, as well as the celebration of feasts and memorials at various times throughout the year.

New Testament

Greco-Roman education. Greek education developed from about the fourth century BC and spread throughout the Mediterranean region, adopted with minor modification by the Romans. The curriculum was dominated by sports and a focus on literacy, with little place given to religious education (although philosophy was taught and did bear some religious traits). Education in the Greco-Roman world was expensive, and its provision was a parental responsibility, which tended to restrict formal education to the elite.

At about the age of fifteen, boys could move from elementary schooling to the gymnasium, where they received intellectual and physical training. Some in the Corinthian church may have received such an education, a possibility raised by Paul’s terminology in 1 Corinthians that reflects educational language: his claim to be father of the Corinthian household (4:14–21); sporting imagery (esp. 9:24–27); language of nursing and nature (3:1–4); agricultural imagery (3:5–9); his threat to come with a rod (4:21), which could be related to the rod of correction; the term grammateus (1:20), which may refer to the gymnasium instructor; reference to writing (4:6); and talk of removing the marks of circumcision (7:18).

Education in Israel. One Jewish tradition states that in AD 63 the high priest Joshua ben Gamla decreed that every town should appoint a schoolteacher for the education of children of six or seven years of age. This, together with the existence of Sirach’s school more than two centuries earlier, indicates that some form of schooling existed within Israel in the first century AD.

Although some Jews throughout the ancient world received a standard Hellenistic education, others reacted against the influence of Hellenism and sought to educate their children within the Scriptures and Jewish tradition. The DSS refer to the importance placed on study of the Torah (1QS 6:6–7). There were also rabbinic schools that focused on such teaching.

By NT times, synagogues were well established. Although determining precisely what took place within the synagogues is difficult, indications are that the focus on Scripture and its exposition played an important role in teaching both its importance and the appropriate way to interpret it. Teaching, however, was not confined to synagogues or the temple, as is amply demonstrated by the frequency with which Jesus is described as teaching in a variety of settings. Nonetheless, the temple itself did appear to serve as a center for religious education, as is reflected in the account of the twelve-year-old Jesus’ interactions with the teachers at the temple (Luke 2:41–51). Jesus’ own teaching was remarkable, however, in that it was delivered with authority (Matt. 7:29; Mark 1:22; Luke 4:32).

Education in the church. Paul highlights one of the prerequisites for being an overseer of a church as the ability to teach, stressing the importance of the NT church as a place of learning (1 Tim. 3:2; 2 Tim. 2:2, 24). This teaching involved a familiarity with right doctrine in order to avoid being led astray, an exemplary life that modeled godly behavior for all to see, and the maturity required to apply discipline when necessary.

Cities, towns, and villages were essential parts of a common civilization pattern shared by the ancient Near East and the Bible. Towns and cities were designed to provide the basic needs of security, shelter, and sustenance to enable their populations to engage in a variety of social, economic, religious, and political activities.

The urban picture of the biblical world is complicated by several factors. The first is the large span of time covered in the Bible. The urban chronology of Scripture begins at the moment of the first attempt at city building (Gen. 4:17) and ends with the revelation of the new Jerusalem, the city of God (Rev. 3:12; 21:2).

Moreover, the Bible is not concerned with providing a detailed commentary on the expansion of city and urban life. It is true that several of the great cities of the ancient Near East and the Greco-Roman world are mentioned in the pages of the Bible; however, many of the religious, social, economic, and political factors involved in the development of urban life are not identified or discussed. The archaeological record often suggests a more complex picture.

In addition, a wide variety of terms are used broadly and interchangeably in the Scriptures to describe settlement patterns and socio-urban structures. For example, the specific differences between a city, a town, and a village are not clearly identified in the biblical text. Normally, a city had a fortified wall or other type of defensive enclosure, while a town or village did not.

Furthermore, city status was not necessarily determined by size. Ancient cities were much smaller. During the reign of Solomon, Jerusalem covered about thirty-three acres. But by the time of Jesus it measured nearly two hundred acres. Jericho, the oldest city in Palestine, was no larger than ten acres. The archaeological record suggests that Jericho was occupied by at least 7000 BC. Hazor, one of the largest cities in the upper Galilee, covered 175 acres. The dimensions of Palestinian cities were minuscule compared to the great pagan cities such as Nineveh, Babylon, and Rome.

Archaeological Evidence

Archaeological evidence suggests that some of the chief concerns of city building remained constant over time. Cities were planted along main highways or trade routes. Often a city sat at important crossroads or intersections. An adequate water supply was necessary, as were raw materials for shelter and industry. The site had to be easy to defend and surrounded by adjacent agricultural land sufficient to sustain the population. All cities in the ancient Near East built walls and city gates. Most featured an acropolis or citadel and a working system of city streets. Many cities contained a sanctuary or high place where individuals could worship.

At least four major phases of urbanization in Palestine occurred during the biblical period.

Early Bronze Age II (3000–2700 BC). Although Jericho and other cities had their origin in the Chalcolithic period, the Early Bronze Age produced a significant expansion of urban life. Cities in this period included Megiddo, Ai, Gezer, Arad, Jericho, and others. Larger sites protected by fortifications with gates are characteristic of this period. Temples, fortified citadels, and residential houses were found arranged along streets and thoroughfares inside the city. The water supply became a community concern, and steps were taken to conserve runoff water into large reservoirs or cisterns. Such urban planning presupposes a social hierarchy in the differentiation of labor and need. Farmers, craftsmen, and traders, as well as priests and rulers, worked and lived side by side in the city.

Middle Bronze Age IIB (1750–1650 BC). In the second wave of urbanization, the Canaanites refortified and rebuilt older settlements such as Dan, Hazor, Megiddo, and Shechem. Other sites, such as Bethel and Beth Shemesh, were established as new settlements. Distinctive walls, fortifications, gates, and cultic architecture characterized this period. Mud-brick was a common construction material. Larger city-states controlled agricultural resources and ruled numerous villages and settlements within their immediate vicinity. These city-states often joined together in political alliances. Cuneiform documents from Mari and Hazor provide a glimpse into the social, cultural, and political life in the cities of this period. This wave of urbanization began to decline by the Late Bronze Age.

Iron Age II (1000–586 BC). Early Iron Age settlements developed alongside the declining Late Bronze cities as rough camps, simple enclosures, and villages in the highlands of Palestine. Later, during the monarchial period, some of the villages and cities expanded into full urban centers, following royal hierarchical and administrative blueprints. Cities contained administrative buildings, enhanced fortifications and gates, new water systems, and planned street systems offering systematic drainage. Housing generally followed a typical pattern. Stone became the construction material of choice. Both the united monarchy and the divided kingdoms of Israel and Judah established royal cities, administrative centers, fortified border cities, and fortresses. Urban life gravitated toward the upkeep of a central religious and economic royal administration.

Roman period. As a champion of all things Hellenic, Alexander the Great introduced the Greek city, or polis, into the oriental culture of the Levant. This new type of city, with its theaters, gymnasia, statues, and colonnades, served as a beacon of Greek civilization. Such cities attracted Greek settlers, traders, and local natives (Acts 18:1–3, 18–28; Rom. 16:3–5; 1 Cor. 16:19). The Greek agora (marketplace) replaced the Palestinian city gate as the center of trade and commerce. Sepphoris and the towns of the Decapolis were examples of this type of city in Palestine. The Romans imitated the Hellenistic city plan but emphasized one main north-south thoroughfare (cardo) and east-west streets. Building activity in Palestine flourished under Herod the Great (37–4 BC). He rebuilt, expanded, and renamed many Palestinian sites, such as Caesarea, Sebaste, and the Tower of Antonia in Jerusalem. Herod radically changed the landscape of Jerusalem, rebuilding there on a massive scale not only the palace but also the temple.

Old Testament

The common Hebrew word for “city,” ’ir, occurs 1,093 times in the OT. English versions normally translate the word as “city,” but sometimes “town” is used. The same term is found outside the Bible in one of the Lachish letters and as a cognate in several Semitic languages. The etymology of ’ir is not clear, but it may be related to the Sumerian word for “city,” uru. The word may have originally designated a fortified or protected place.

In the OT, ’ir can be applied to a wide range of settlements, including villages, towns, and capital cities regardless of size or location. For example, Deut. 3:5 speaks of cities fortified with high walls, gates, and bars in the same sentence with “rural towns” or “country settlements” [NIV: “unwalled villages”]. On the other hand, a distinction is made between a “walled city” and a “village” in Lev. 25:29, 31. In Num. 13:19 Moses specifically charges the spies with the task of determining whether the Canaanite cities are fortified or more like camps. Cities given to the Levites in Num. 35:1–8 also included the surrounding pasturelands connected with them. A number of times the OT speaks of the fields associated with a city or village (Lev. 25:34; Josh. 21:12; Neh. 11:25, 30).

Cities were also given special designations or names. Cities of refuge are so designated to provide protection for individuals who have committed accidental manslaughter (Num. 35:11; Josh. 20:2; 1 Chron. 6:57). Jericho was called “the City of Palms” (Deut. 34:3; 2 Chron. 28:15). Jerusalem was known as “the City of David” (1 Kings 3:1; 2 Chron. 5:2), “Zion” (Isa. 33:20; Zech. 8:3; Heb. 12:22), and “the holy city” (Isa. 52:1; Rev. 21:1).

Two other Hebrew terms are often translated “city.” The noun qeret occurs only five times in biblical poetry (Job 29:7; Prov. 8:3; 9:3, 14; 11:11). The noun qiryah is found twenty-nine times. It is sometimes translated “town” in the NIV (Deut. 2:36; Job 39:7; Isa. 25:2; Jer. 49:25; Hos. 7:12). The etymology of either word is uncertain, but both may be derived from qir (“wall”). In many cases qiryah functions as a synonym of ’ir.

In Deut. 2:36 and 3:4 qiryah is used to designate the towns taken by the Israelites in Transjordan. Heshbon is identified in Num. 21:28 as the “town” (qiryah; NIV: “city”) of Sihon. The word qiryah is also found in the names of several towns, such as Kiriath Jearim (Josh. 15:9) and Kiriath Sepher (Josh. 15:15). Hebron was originally Kiriath Arba (Gen. 23:2; 35:27), and Balaam rode to Kiriath Huzoth (Num. 22:39). Shaveh Kiriathaim (Gen. 14:5) and Kiriathaim (Num. 32:37) contain a form of qiryah.

Smaller communities were called “villages” or “settlements” (Gen. 25:16; Lev. 25:31; Deut. 2:23). Some of these were connected to a larger city or provincial center. The book of Joshua commonly speaks of a city or town and “its villages” (Josh. 13–19; cf. 1 Chron. 6:26). In addition, the Hebrew phrase “daughters of” (i.e., settlements) is frequently used to identify smaller villages under the jurisdiction of a larger city and dependent upon it (Num. 21:25, 32; 32:42; Josh. 15:45, 47; Neh. 11:25–31).

New Testament

The Greek word polis occurs 163 times in the NT and is translated as “town” or “city.” Several sites are called polis: Nazareth (Matt. 2:23), Capernaum (Luke 4:31), Arimathea (Luke 23:51), Bethlehem (John 7:42), and others. Jerusalem is called “the holy city” (Matt. 4:5; cf. Rev. 3:12), “the city of the Great King” (Matt. 5:35), and “the city of the living God” (Heb. 12:22). During his ministry, Jesus preached in the towns of Galilee (Matt. 11:1) and Samaria (Matt. 10:5). In the book of Acts, Paul served as an evangelist to the Greek and Roman cities in the Mediterranean world.

Cities, towns, and villages were essential parts of a common civilization pattern shared by the ancient Near East and the Bible. Towns and cities were designed to provide the basic needs of security, shelter, and sustenance to enable their populations to engage in a variety of social, economic, religious, and political activities.

The urban picture of the biblical world is complicated by several factors. The first is the large span of time covered in the Bible. The urban chronology of Scripture begins at the moment of the first attempt at city building (Gen. 4:17) and ends with the revelation of the new Jerusalem, the city of God (Rev. 3:12; 21:2).

Moreover, the Bible is not concerned with providing a detailed commentary on the expansion of city and urban life. It is true that several of the great cities of the ancient Near East and the Greco-Roman world are mentioned in the pages of the Bible; however, many of the religious, social, economic, and political factors involved in the development of urban life are not identified or discussed. The archaeological record often suggests a more complex picture.

In addition, a wide variety of terms are used broadly and interchangeably in the Scriptures to describe settlement patterns and socio-urban structures. For example, the specific differences between a city, a town, and a village are not clearly identified in the biblical text. Normally, a city had a fortified wall or other type of defensive enclosure, while a town or village did not.

Furthermore, city status was not necessarily determined by size. Ancient cities were much smaller. During the reign of Solomon, Jerusalem covered about thirty-three acres. But by the time of Jesus it measured nearly two hundred acres. Jericho, the oldest city in Palestine, was no larger than ten acres. The archaeological record suggests that Jericho was occupied by at least 7000 BC. Hazor, one of the largest cities in the upper Galilee, covered 175 acres. The dimensions of Palestinian cities were minuscule compared to the great pagan cities such as Nineveh, Babylon, and Rome.

Archaeological Evidence

Archaeological evidence suggests that some of the chief concerns of city building remained constant over time. Cities were planted along main highways or trade routes. Often a city sat at important crossroads or intersections. An adequate water supply was necessary, as were raw materials for shelter and industry. The site had to be easy to defend and surrounded by adjacent agricultural land sufficient to sustain the population. All cities in the ancient Near East built walls and city gates. Most featured an acropolis or citadel and a working system of city streets. Many cities contained a sanctuary or high place where individuals could worship.

At least four major phases of urbanization in Palestine occurred during the biblical period.

Early Bronze Age II (3000–2700 BC). Although Jericho and other cities had their origin in the Chalcolithic period, the Early Bronze Age produced a significant expansion of urban life. Cities in this period included Megiddo, Ai, Gezer, Arad, Jericho, and others. Larger sites protected by fortifications with gates are characteristic of this period. Temples, fortified citadels, and residential houses were found arranged along streets and thoroughfares inside the city. The water supply became a community concern, and steps were taken to conserve runoff water into large reservoirs or cisterns. Such urban planning presupposes a social hierarchy in the differentiation of labor and need. Farmers, craftsmen, and traders, as well as priests and rulers, worked and lived side by side in the city.

Middle Bronze Age IIB (1750–1650 BC). In the second wave of urbanization, the Canaanites refortified and rebuilt older settlements such as Dan, Hazor, Megiddo, and Shechem. Other sites, such as Bethel and Beth Shemesh, were established as new settlements. Distinctive walls, fortifications, gates, and cultic architecture characterized this period. Mud-brick was a common construction material. Larger city-states controlled agricultural resources and ruled numerous villages and settlements within their immediate vicinity. These city-states often joined together in political alliances. Cuneiform documents from Mari and Hazor provide a glimpse into the social, cultural, and political life in the cities of this period. This wave of urbanization began to decline by the Late Bronze Age.

Iron Age II (1000–586 BC). Early Iron Age settlements developed alongside the declining Late Bronze cities as rough camps, simple enclosures, and villages in the highlands of Palestine. Later, during the monarchial period, some of the villages and cities expanded into full urban centers, following royal hierarchical and administrative blueprints. Cities contained administrative buildings, enhanced fortifications and gates, new water systems, and planned street systems offering systematic drainage. Housing generally followed a typical pattern. Stone became the construction material of choice. Both the united monarchy and the divided kingdoms of Israel and Judah established royal cities, administrative centers, fortified border cities, and fortresses. Urban life gravitated toward the upkeep of a central religious and economic royal administration.

Roman period. As a champion of all things Hellenic, Alexander the Great introduced the Greek city, or polis, into the oriental culture of the Levant. This new type of city, with its theaters, gymnasia, statues, and colonnades, served as a beacon of Greek civilization. Such cities attracted Greek settlers, traders, and local natives (Acts 18:1–3, 18–28; Rom. 16:3–5; 1 Cor. 16:19). The Greek agora (marketplace) replaced the Palestinian city gate as the center of trade and commerce. Sepphoris and the towns of the Decapolis were examples of this type of city in Palestine. The Romans imitated the Hellenistic city plan but emphasized one main north-south thoroughfare (cardo) and east-west streets. Building activity in Palestine flourished under Herod the Great (37–4 BC). He rebuilt, expanded, and renamed many Palestinian sites, such as Caesarea, Sebaste, and the Tower of Antonia in Jerusalem. Herod radically changed the landscape of Jerusalem, rebuilding there on a massive scale not only the palace but also the temple.

Old Testament

The common Hebrew word for “city,” ’ir, occurs 1,093 times in the OT. English versions normally translate the word as “city,” but sometimes “town” is used. The same term is found outside the Bible in one of the Lachish letters and as a cognate in several Semitic languages. The etymology of ’ir is not clear, but it may be related to the Sumerian word for “city,” uru. The word may have originally designated a fortified or protected place.

In the OT, ’ir can be applied to a wide range of settlements, including villages, towns, and capital cities regardless of size or location. For example, Deut. 3:5 speaks of cities fortified with high walls, gates, and bars in the same sentence with “rural towns” or “country settlements” [NIV: “unwalled villages”]. On the other hand, a distinction is made between a “walled city” and a “village” in Lev. 25:29, 31. In Num. 13:19 Moses specifically charges the spies with the task of determining whether the Canaanite cities are fortified or more like camps. Cities given to the Levites in Num. 35:1–8 also included the surrounding pasturelands connected with them. A number of times the OT speaks of the fields associated with a city or village (Lev. 25:34; Josh. 21:12; Neh. 11:25, 30).

Cities were also given special designations or names. Cities of refuge are so designated to provide protection for individuals who have committed accidental manslaughter (Num. 35:11; Josh. 20:2; 1 Chron. 6:57). Jericho was called “the City of Palms” (Deut. 34:3; 2 Chron. 28:15). Jerusalem was known as “the City of David” (1 Kings 3:1; 2 Chron. 5:2), “Zion” (Isa. 33:20; Zech. 8:3; Heb. 12:22), and “the holy city” (Isa. 52:1; Rev. 21:1).

Two other Hebrew terms are often translated “city.” The noun qeret occurs only five times in biblical poetry (Job 29:7; Prov. 8:3; 9:3, 14; 11:11). The noun qiryah is found twenty-nine times. It is sometimes translated “town” in the NIV (Deut. 2:36; Job 39:7; Isa. 25:2; Jer. 49:25; Hos. 7:12). The etymology of either word is uncertain, but both may be derived from qir (“wall”). In many cases qiryah functions as a synonym of ’ir.

In Deut. 2:36 and 3:4 qiryah is used to designate the towns taken by the Israelites in Transjordan. Heshbon is identified in Num. 21:28 as the “town” (qiryah; NIV: “city”) of Sihon. The word qiryah is also found in the names of several towns, such as Kiriath Jearim (Josh. 15:9) and Kiriath Sepher (Josh. 15:15). Hebron was originally Kiriath Arba (Gen. 23:2; 35:27), and Balaam rode to Kiriath Huzoth (Num. 22:39). Shaveh Kiriathaim (Gen. 14:5) and Kiriathaim (Num. 32:37) contain a form of qiryah.

Smaller communities were called “villages” or “settlements” (Gen. 25:16; Lev. 25:31; Deut. 2:23). Some of these were connected to a larger city or provincial center. The book of Joshua commonly speaks of a city or town and “its villages” (Josh. 13–19; cf. 1 Chron. 6:26). In addition, the Hebrew phrase “daughters of” (i.e., settlements) is frequently used to identify smaller villages under the jurisdiction of a larger city and dependent upon it (Num. 21:25, 32; 32:42; Josh. 15:45, 47; Neh. 11:25–31).

New Testament

The Greek word polis occurs 163 times in the NT and is translated as “town” or “city.” Several sites are called polis: Nazareth (Matt. 2:23), Capernaum (Luke 4:31), Arimathea (Luke 23:51), Bethlehem (John 7:42), and others. Jerusalem is called “the holy city” (Matt. 4:5; cf. Rev. 3:12), “the city of the Great King” (Matt. 5:35), and “the city of the living God” (Heb. 12:22). During his ministry, Jesus preached in the towns of Galilee (Matt. 11:1) and Samaria (Matt. 10:5). In the book of Acts, Paul served as an evangelist to the Greek and Roman cities in the Mediterranean world.

(Disabilities; Disability; Deformity; Deformities; Sickness] The Bible often speaks of health, healing, disease, and illness. Good health was a sign of God’s favor, and healing was also the work of God and his divinely empowered agents. These agents included the prophets (1 Kings 17:8–23; 2 Kings 5:1–15), the apostles (Acts 3:1–10), and the messiah (Mal. 4:2). The divine prerogative of Jesus was to heal (Mark 1:32; 6:56; Matt. 4:23; 8:16; 15:30; 21:14; Luke 6:10, 17–19), and miraculous healings were a sign of his messianic office (Luke 7:20–23). Disease, on the other hand, was regarded as a sign of God’s disfavor. Within a covenantal context, God could send disease to punish the sinner (Exod. 4:11; 32:35).

The Bible assigns a wide variety of names to various diseases and their symptoms. These terms are nontechnical and generally descriptive. Some are uncertain in meaning. In most cases they describe the symptoms of the disease, not the disease itself. Diagnosis often was based on incomplete observation and nonclinical examination. The Bible also presupposes supernatural intervention in the life of a person. Healing occurred when God’s agents touched individuals, cast out demons, and resurrected the dead.

Ancient Near Eastern Influences

In the ancient Near East the knowledge of disease and medicine was precritical. Bacteria and viruses were virtually unknown. Mesopotamian literature contains many references to medicine, physicians, and medical practice. Minerals, salts, herbs, and other botanicals were used to make up treatments. Babylonian physicians also administered prescriptions accompanied by incantations. Disease was considered to be the result of a violation of a taboo or possession by a demon. The Code of Hammurabi (1750 BC) includes laws regulating the practice of medicine and surgery by physicians. In Egypt medicine and healing were connected to the gods. Tomb paintings and several papyrus documents describe the developing state of Egyptian medicine, pharmacy, and surgery.

Greek physicians admired and sought to learn the skills of the Egyptians. However, the early Greek doctor Hippocrates (460–370 BC), called the “Father of Medicine,” is credited with being the first physician to reject the belief that supernatural or divine forces cause illness. He argued that disease is the result of environmental factors, diet, and living habits, not a punishment imposed by the gods.

It is clear that the biblical world shared with the ancient Near East the same types of maladies common to tropical or subtropical climates. These include malaria, tropical fevers, dysentery, and sunstroke. The tendency of the hot climate to produce frequent droughts and famine certainly contributed to similar types of diseases throughout the Fertile Crescent. Additionally, it must be remembered that Palestine was a land bridge between the Mesopotamian and Egyptian worlds. Migrations carry not only goods and products, but also parasites, communicable disease, and epidemics.

Biblical Concept of Disease

The religious tradition of the Hebrews repudiated the magical or demonic origin of disease. Hence, moral, ethical, and spiritual factors regulated disease and illness. This was true for the individual as well as the community. The Hebrews, like the Egyptians, also recognized that much sickness arose from the individual’s relationship to the physical environment. Great stress was placed on hygiene and preventive medicine.

Pentateuchal legislation offered seven covenantal principles designed to prevent the possibility of disease and sickness: (1) Sabbath observance for humans, animals, and the land, which enforced regular periods of rest (Gen. 2:3); (2) dietary regulations, which divided food into efficient categories of clean and unclean (Lev. 11); (3) circumcision, which carried physical benefits as well as religious and moral implications (Gen. 17:9; circumcision is the only example of Hebrew surgery); (4) laws governing sexual relationships and health, including a list of forbidden degrees of marital relationships (Lev. 18–20); (5) provisions for individual sexual hygiene (Lev. 15); (6) stipulations for cleanliness and bodily purification (Lev. 14:2; 15:2); (7) sanitary and hygienic regulations for camp life (Num. 31:19; Deut. 23:12).

In NT times magical charms and incantations were used along with folk remedies in an effort to cure disease. Jesus repudiated these means. He also suggested that sickness and disease were not direct punishments for sin (John 9:2). In the Sermon on the Mount (Matt. 5–7), Jesus confirmed that the ethical and religious standards of the new covenant promoted the total health of the community and the individual.

Circulatory Diseases

Nabal most likely suffered a cerebrovascular accident or stroke (1 Sam. 25:36–38). After a heavy bout of drinking, his heart “died” (KJV; NIV: “failed”), and he became paralyzed, lapsed into a coma, and died ten days later. Psalm 137:5–6 may contain a clinical example of the symptoms of stroke. The psalmist wrote, “If I forget you, Jerusalem, may my right hand forget its skill. May my tongue cling to the roof of my mouth if I do not remember you.” This description points to a paralysis of the right side of the body (right hemiplegia) and the loss of speech (motor aphasia) that result from a stroke on the left side of the brain. Basically, the exiled psalmist is wishing upon himself the effects of a stroke if he held anything other than Jerusalem as his highest priority. Some have considered the collapse of Uzzah when he reached out to stabilize the ark of the covenant (2 Sam. 6:6–7) to be the consequence of an apoplectic seizure. But since no actual paralysis was described and death occurred immediately, this seems unlikely. It is more probable that God struck him down with an aortic aneurism or a coronary thrombosis.

Paralysis

A possible case of paralysis may be described in the shriveled (atrophic) hand of Jeroboam I (1 Kings 13:4–6). In an angry outburst Jeroboam ordered the arrest of a prophet who condemned the altar at Bethel. When Jeroboam stretched out his hand, it “shriveled up, so that he could not pull it back.” Several complicated diagnoses have been offered to explain the “withered” hand, but it is possibly an example of cataplexy, a sudden loss of muscle power following a strong emotional stimulus. After intercession by the man of God, and the subsiding of the emotional outburst, the arm was restored.

The threat against the faithless shepherd of God’s people (Zech. 11:17), which included a withered arm and blindness in the right eye, may refer to a form of paralysis known as tabes dorsalis, or locomotor ataxia. Knifelike pains in the extremities and blindness characterize this disease.

Paralysis is frequently mentioned in the NT (Matt. 8:6; 9:2, 6; 12:10; Mark 2:3–5, 9, 10; 3:1, 3, 5; Luke 5:18, 24; 6:6; John 5:3; Acts 9:33; Heb. 12:12). The exact diagnosis for each of these cases remains uncertain.

The physician Luke’s use of the Greek medical term paralelymenos (Luke 5:18, 24) suggests that some of these cases were caused by chronic organic disease. Others clearly were congenital (Acts 3:2; cf. 14:8). It is not necessary to rationalize the origin of these examples of paralysis as hysteria or pretense. The NT writers regarded the healing of these individuals by Jesus and the apostles as miraculous.

Mental Illness and Brain Disorders

Cases of mental disease are generally described in the Bible by noting the symptoms produced by the disorder. The particular cause of a mental illness in the NT is often blamed on an unknown evil spirit or spirits (Luke 8:2). Such spirits, however, were subject to God’s control and operated only within the boundaries allowed by him (1 Sam. 16:14–16, 23; 18:10; 19:9). Accordingly, in the OT “madness” and “confusion of mind” were regarded as consequences of covenantal disobedience (Deut. 28:28, 34).

It has been argued that King Saul displayed early indications of personality disorder. Symptoms included pride, self-aggrandizement (1 Sam. 11:6; 13:12; 15:9, 19), and ecstatic behavior (10:11–12). A rapid deterioration in Saul’s character transpired after David was anointed and became more popular (16:14; 18:10–11). Since Saul demonstrated fear, jealousy, a sense of persecution, and homicidal tendencies, some scholars argue that he suffered from paranoid schizophrenia.

Nebuchadnezzar suffered a rare form of monomania in which he lived like a wild beast in the field eating grass (Dan. 4:33). David, in order to save his own life, feigned insanity or perhaps epilepsy before the Philistine king Achish (1 Sam. 21:12–15).

In the NT, individuals with mental disorders went about naked, mutilated themselves, lived in tombs (Mark 5:2), and exhibited violent behavior (Matt. 8:28). Such mental disorientation was often linked to demon possession. Examples include the Syrophoenician’s child (Matt. 15:22; Mark 7:25), the demoniacs at Gerasa (Matt. 8:28; Mark 5:2; Luke 8:27) and Capernaum (Mark 1:23; Luke 4:33), a blind and mute demoniac (Matt. 12:22; Luke 11:14), and a fortune-telling slave girl (Acts 16:16). While such behavior is clinically suggestive of paranoid schizophrenia or other mental disorders, the mind-controlling influence of some extraneous negative force cannot be ruled out.

Epilepsy (grand mal) causes the afflicted person to fall to the ground, foam at the mouth, and clench or grind the teeth (Matt. 17:15; Mark 9:17–18; Luke 9:39). The description of Saul falling to the ground in an ecstatic state (1 Sam. 19:23–24) and Balaam falling with open eyes may be indicative of an epileptic seizure. In the NT, Jesus healed many who suffered from epilepsy (Matt. 4:24; 17:14–18; Mark 9:17–18; Luke 9:38–42). Some scholars have linked the light seen by Paul on the road to Damascus with the aura that some epileptics experience prior to a seizure. His subsequent blindness has also been attributed to the epileptic disturbance of the circulation of the blood in the brain.

Childhood Diseases

The cause of the death of the widow’s son at Zarephath is unknown (1 Kings 17:17–22). The death of the Shunammite woman’s son has been attributed to sunstroke (2 Kings 4:18–37), although a headache is the only symptom recorded (v. 19). In both cases there is too little evidence to present an accurate diagnosis.

In the first case, the boy at Zarephath stopped breathing (1 Kings 17:17). This may leave the door open to argue that Elijah resuscitated the child. However, in the second case, the text clearly states that the Shunammite boy died (2 Kings 4:20), implying a resurrection.

Infectious and Communicable Diseases

Fever and other calamities are listed among the punishments for covenantal infidelity (Deut. 28:22). Three different types of fever may be intentionally described here: “fever,” “inflammation,” and “scorching heat” (ESV: “fiery heat”). Fever is also mentioned frequently in the NT (Matt. 8:15; Mark 1:30–31; Luke 4:38–39; John 4:52; Acts 28:8). Both Jesus and Paul healed individuals who had a fever. A number of these fevers were likely caused by malaria, since the disease was known to be endemic to the Jordan Valley and other marshy areas in Palestine.

Several epidemics in which numerous people died of pestilence or plague are mentioned in the OT (Exod. 11:1; 12:13; Num. 14:37; Zech. 14:12). The fifth plague of Egypt (Exod. 9:3–6) has been attributed to Jordan Rift Valley fever, which is spread by flies. Bubonic plague has been blamed for the malady that struck the Philistines (1 Sam. 5–6). However, it may have been the result of a severe form of tropical dysentery. Acute bacillary dysentery contracted in the military camp may also have been responsible for the epidemic that killed a large number of the Assyrian army (2 Kings 19:35).

Parasitic Diseases

Some scholars have repeatedly argued that the “fiery serpents” (NIV: “venomous snakes”) encountered by Moses and the children of Israel (Num. 21:6–9) were in reality an infestation of the parasitic guinea worm (Dracunculus medinensis). Microscopic fleas ingested in drinking water carry the larvae of this slender nematode into the body. The larvae move from the digestive tract to the skin. The adult worm, which may grow to a length of several feet, discharges its eggs into an ulcer on the skin. Death of the host occurs because of the resulting infection of the skin ulcers.

After the conquest of Jericho, Joshua cursed the individual who would endeavor to rebuild the city (Josh. 6:26). Later, Hiel of Bethel attempted to rebuild the city and lost two of his sons as a result of the curse (1 Kings 16:34). Elisha was then asked to purify the bad water at Jericho in order to allow a new settlement (2 Kings 2:19). Elisha obliged by throwing salt into the spring and thereby making the water potable (2:20–22). Recent archaeological study has discovered the remains of certain snails in the mud-bricks used to construct Jericho in the Bronze Age. These types of snails are now known to serve as intermediate hosts for the flatworm parasite that can cause schistosomiasis. The Schistosoma haematobium trematode infects the urinary tract and the bladder. It is possible that this type of parasite was responsible for the death of Hiel’s two sons.

In NT times, Herod Agrippa apparently died of the complications of a parasitic disease, perhaps being infested by the larvae of flies (myiasis) in the bowels. Luke mentions that he was “eaten by worms” (skōlēkobrōtos [Acts 12:23]). The father of Publius also suffered from dysentery (Acts 28:8).

Physical Deformities and Abnormalities

Individuals with deformities were disqualified from priestly service (Lev. 21:18–20). The list included lameness, limb damage, and dwarfism. The deformities mentioned here might have been congenital or acquired. Mephibosheth was dropped by his nurse (2 Sam. 4:4) and perhaps suffered damage to the spinal cord. Jacob possibly sustained injury to an intervertebral disk (Gen. 32:32) causing a deformity and a limp. The woman who was “bent over” (Luke 13:10–17) might have suffered from an abnormality of the spine similar to scoliosis. It is difficult to ascertain the origin of the “shriveled hand” of the unnamed individual healed by Jesus (Matt. 12:10–13; Mark 3:1–5; Luke 6:6–10). It could be congenital in character or a paralysis caused by any number of factors.

Diseases and Disabilities of the Eyes and Ears

Physical blindness is mentioned several times in the Bible. Blindness excluded one from serving as a priest (Lev. 21:18, 20). Blindness and deafness, however, were disabilities requiring special care from the community (Lev. 19:14; Deut. 27:18). The “weak eyes” of Leah may refer to an eye condition (Gen. 29:17).

Blindness in the biblical world was caused by various factors. Leviticus 26:16 speaks of a fever that destroys the eyes. Flies probably were responsible for much of the conjunctivitis found in children. John 9:1 mentions congenital blindness, which Jesus cured using mud made from spittle and dirt (John 9:6). In Mark 8:22–26 Jesus healed a blind man by spitting in his eye and laying hands on him (cf. Matt. 20:34 with Mark 10:52).

Congenital deafness would also be associated with mutism and speech defects because a child learning to speak depends on imitation and mimicry. Jesus healed a man who was deaf and could barely talk (Mark 7:32–37). The man’s inability to say much possibly pointed to a loss of hearing early in life.

Skin Conditions

Various skin and hair abnormalities are described in the Bible. Some made the individual unclean (Lev. 13:30; 14:54). The OT speaks of “the boils of Egypt” (Deut. 28:27; cf. Exod. 9:9). Skin ailments included tumors, festering sores, boils, infections, and the itch (Deut. 28:27, 35; Isa. 3:7). Job complained of a litany of ailments: broken and festering skin (7:5), multiple wounds (9:17), black peeling skin and fever (30:30), gnawing bone pain (2:5; 19:20; 30:17), insomnia (7:3–4), and wasting away (33:21). These symptoms have been diagnosed as indications of yaws or eczema. A poultice made of figs cured Hezekiah’s boil (2 Kings 20:7).

Leprosy was once thought to be a common problem in the biblical world. Leprosy (Hansen’s disease) is a slow, progressive chronic infectious disease caused by a bacterium. Symptoms include loss of sensation and loss of parts of the body. Evidence for this type of disease in Palestine is rare. Uzziah may have had a true case of Hansen’s disease. He was quarantined until the day he died (2 Chron. 26:21).

Scholars now suggest that the symptoms of the disease described in the Bible do not fit this pattern and thus do not signify leprosy (Hansen’s disease) as it is known today. Instead, the word that English versions translate as “leprosy” (Heb. root tsr’) probably refers to different types of infectious skin disease, often characterized by a long-standing, patchy skin condition associated with peeling or flakiness and redness of skin. Evidence points more toward psoriasis, fungal infections, or dermatitis.

This disease could appear in humans (Lev. 14:2), on buildings (14:34), and on clothing (14:55). It was not limited to the extremities but could occur on the head (14:42–44). It could run its course quickly (13:5–8). It made the individual ceremonially unclean, but it was also curable (Lev. 14:3; 2 Kings 5:1–27). Individuals with the disease were not necessarily shunned (2 Kings 7; Matt. 26:6 // Mark 14:3). Moses (Exod. 4:6), Miriam (Num. 12:10), and Naaman experienced this type of skin disease (2 Kings 5:1–27). Jesus healed many suffering from skin ailments (Matt. 8:2–3; Mark 1:40–42; Luke 5:12–13), including the ten “men who had leprosy” (Luke 17:12–14).

Ailments of an Unknown Nature

Some cases in the Bible present insufficient evidence for scholars to render a clear diagnosis. King Asa suffered a disease in his feet (2 Chron. 16:12). However, in the OT the Hebrew expression for “feet” is sometimes used euphemistically for the sexual organs (Judg. 3:24 KJV). Because of this, the exact nature of the disease is ambiguous. Jehoram was afflicted with “an incurable disease of the bowels” (2 Chron. 21:18–19). Other unknown ailments factor in the deaths of the firstborn son of David and Bathsheba (2 Sam. 12:15), of Jeroboam’s son in infancy (1 Kings 14:17), of Elisha (2 Kings 13:14), and of Ezekiel’s wife (Ezek. 24:16).

(Disabilities; Disability; Deformity; Deformities; Sickness] The Bible often speaks of health, healing, disease, and illness. Good health was a sign of God’s favor, and healing was also the work of God and his divinely empowered agents. These agents included the prophets (1 Kings 17:8–23; 2 Kings 5:1–15), the apostles (Acts 3:1–10), and the messiah (Mal. 4:2). The divine prerogative of Jesus was to heal (Mark 1:32; 6:56; Matt. 4:23; 8:16; 15:30; 21:14; Luke 6:10, 17–19), and miraculous healings were a sign of his messianic office (Luke 7:20–23). Disease, on the other hand, was regarded as a sign of God’s disfavor. Within a covenantal context, God could send disease to punish the sinner (Exod. 4:11; 32:35).

The Bible assigns a wide variety of names to various diseases and their symptoms. These terms are nontechnical and generally descriptive. Some are uncertain in meaning. In most cases they describe the symptoms of the disease, not the disease itself. Diagnosis often was based on incomplete observation and nonclinical examination. The Bible also presupposes supernatural intervention in the life of a person. Healing occurred when God’s agents touched individuals, cast out demons, and resurrected the dead.

Ancient Near Eastern Influences

In the ancient Near East the knowledge of disease and medicine was precritical. Bacteria and viruses were virtually unknown. Mesopotamian literature contains many references to medicine, physicians, and medical practice. Minerals, salts, herbs, and other botanicals were used to make up treatments. Babylonian physicians also administered prescriptions accompanied by incantations. Disease was considered to be the result of a violation of a taboo or possession by a demon. The Code of Hammurabi (1750 BC) includes laws regulating the practice of medicine and surgery by physicians. In Egypt medicine and healing were connected to the gods. Tomb paintings and several papyrus documents describe the developing state of Egyptian medicine, pharmacy, and surgery.

Greek physicians admired and sought to learn the skills of the Egyptians. However, the early Greek doctor Hippocrates (460–370 BC), called the “Father of Medicine,” is credited with being the first physician to reject the belief that supernatural or divine forces cause illness. He argued that disease is the result of environmental factors, diet, and living habits, not a punishment imposed by the gods.

It is clear that the biblical world shared with the ancient Near East the same types of maladies common to tropical or subtropical climates. These include malaria, tropical fevers, dysentery, and sunstroke. The tendency of the hot climate to produce frequent droughts and famine certainly contributed to similar types of diseases throughout the Fertile Crescent. Additionally, it must be remembered that Palestine was a land bridge between the Mesopotamian and Egyptian worlds. Migrations carry not only goods and products, but also parasites, communicable disease, and epidemics.

Biblical Concept of Disease

The religious tradition of the Hebrews repudiated the magical or demonic origin of disease. Hence, moral, ethical, and spiritual factors regulated disease and illness. This was true for the individual as well as the community. The Hebrews, like the Egyptians, also recognized that much sickness arose from the individual’s relationship to the physical environment. Great stress was placed on hygiene and preventive medicine.

Pentateuchal legislation offered seven covenantal principles designed to prevent the possibility of disease and sickness: (1) Sabbath observance for humans, animals, and the land, which enforced regular periods of rest (Gen. 2:3); (2) dietary regulations, which divided food into efficient categories of clean and unclean (Lev. 11); (3) circumcision, which carried physical benefits as well as religious and moral implications (Gen. 17:9; circumcision is the only example of Hebrew surgery); (4) laws governing sexual relationships and health, including a list of forbidden degrees of marital relationships (Lev. 18–20); (5) provisions for individual sexual hygiene (Lev. 15); (6) stipulations for cleanliness and bodily purification (Lev. 14:2; 15:2); (7) sanitary and hygienic regulations for camp life (Num. 31:19; Deut. 23:12).

In NT times magical charms and incantations were used along with folk remedies in an effort to cure disease. Jesus repudiated these means. He also suggested that sickness and disease were not direct punishments for sin (John 9:2). In the Sermon on the Mount (Matt. 5–7), Jesus confirmed that the ethical and religious standards of the new covenant promoted the total health of the community and the individual.

Circulatory Diseases

Nabal most likely suffered a cerebrovascular accident or stroke (1 Sam. 25:36–38). After a heavy bout of drinking, his heart “died” (KJV; NIV: “failed”), and he became paralyzed, lapsed into a coma, and died ten days later. Psalm 137:5–6 may contain a clinical example of the symptoms of stroke. The psalmist wrote, “If I forget you, Jerusalem, may my right hand forget its skill. May my tongue cling to the roof of my mouth if I do not remember you.” This description points to a paralysis of the right side of the body (right hemiplegia) and the loss of speech (motor aphasia) that result from a stroke on the left side of the brain. Basically, the exiled psalmist is wishing upon himself the effects of a stroke if he held anything other than Jerusalem as his highest priority. Some have considered the collapse of Uzzah when he reached out to stabilize the ark of the covenant (2 Sam. 6:6–7) to be the consequence of an apoplectic seizure. But since no actual paralysis was described and death occurred immediately, this seems unlikely. It is more probable that God struck him down with an aortic aneurism or a coronary thrombosis.

Paralysis

A possible case of paralysis may be described in the shriveled (atrophic) hand of Jeroboam I (1 Kings 13:4–6). In an angry outburst Jeroboam ordered the arrest of a prophet who condemned the altar at Bethel. When Jeroboam stretched out his hand, it “shriveled up, so that he could not pull it back.” Several complicated diagnoses have been offered to explain the “withered” hand, but it is possibly an example of cataplexy, a sudden loss of muscle power following a strong emotional stimulus. After intercession by the man of God, and the subsiding of the emotional outburst, the arm was restored.

The threat against the faithless shepherd of God’s people (Zech. 11:17), which included a withered arm and blindness in the right eye, may refer to a form of paralysis known as tabes dorsalis, or locomotor ataxia. Knifelike pains in the extremities and blindness characterize this disease.

Paralysis is frequently mentioned in the NT (Matt. 8:6; 9:2, 6; 12:10; Mark 2:3–5, 9, 10; 3:1, 3, 5; Luke 5:18, 24; 6:6; John 5:3; Acts 9:33; Heb. 12:12). The exact diagnosis for each of these cases remains uncertain.

The physician Luke’s use of the Greek medical term paralelymenos (Luke 5:18, 24) suggests that some of these cases were caused by chronic organic disease. Others clearly were congenital (Acts 3:2; cf. 14:8). It is not necessary to rationalize the origin of these examples of paralysis as hysteria or pretense. The NT writers regarded the healing of these individuals by Jesus and the apostles as miraculous.

Mental Illness and Brain Disorders

Cases of mental disease are generally described in the Bible by noting the symptoms produced by the disorder. The particular cause of a mental illness in the NT is often blamed on an unknown evil spirit or spirits (Luke 8:2). Such spirits, however, were subject to God’s control and operated only within the boundaries allowed by him (1 Sam. 16:14–16, 23; 18:10; 19:9). Accordingly, in the OT “madness” and “confusion of mind” were regarded as consequences of covenantal disobedience (Deut. 28:28, 34).

It has been argued that King Saul displayed early indications of personality disorder. Symptoms included pride, self-aggrandizement (1 Sam. 11:6; 13:12; 15:9, 19), and ecstatic behavior (10:11–12). A rapid deterioration in Saul’s character transpired after David was anointed and became more popular (16:14; 18:10–11). Since Saul demonstrated fear, jealousy, a sense of persecution, and homicidal tendencies, some scholars argue that he suffered from paranoid schizophrenia.

Nebuchadnezzar suffered a rare form of monomania in which he lived like a wild beast in the field eating grass (Dan. 4:33). David, in order to save his own life, feigned insanity or perhaps epilepsy before the Philistine king Achish (1 Sam. 21:12–15).

In the NT, individuals with mental disorders went about naked, mutilated themselves, lived in tombs (Mark 5:2), and exhibited violent behavior (Matt. 8:28). Such mental disorientation was often linked to demon possession. Examples include the Syrophoenician’s child (Matt. 15:22; Mark 7:25), the demoniacs at Gerasa (Matt. 8:28; Mark 5:2; Luke 8:27) and Capernaum (Mark 1:23; Luke 4:33), a blind and mute demoniac (Matt. 12:22; Luke 11:14), and a fortune-telling slave girl (Acts 16:16). While such behavior is clinically suggestive of paranoid schizophrenia or other mental disorders, the mind-controlling influence of some extraneous negative force cannot be ruled out.

Epilepsy (grand mal) causes the afflicted person to fall to the ground, foam at the mouth, and clench or grind the teeth (Matt. 17:15; Mark 9:17–18; Luke 9:39). The description of Saul falling to the ground in an ecstatic state (1 Sam. 19:23–24) and Balaam falling with open eyes may be indicative of an epileptic seizure. In the NT, Jesus healed many who suffered from epilepsy (Matt. 4:24; 17:14–18; Mark 9:17–18; Luke 9:38–42). Some scholars have linked the light seen by Paul on the road to Damascus with the aura that some epileptics experience prior to a seizure. His subsequent blindness has also been attributed to the epileptic disturbance of the circulation of the blood in the brain.

Childhood Diseases

The cause of the death of the widow’s son at Zarephath is unknown (1 Kings 17:17–22). The death of the Shunammite woman’s son has been attributed to sunstroke (2 Kings 4:18–37), although a headache is the only symptom recorded (v. 19). In both cases there is too little evidence to present an accurate diagnosis.

In the first case, the boy at Zarephath stopped breathing (1 Kings 17:17). This may leave the door open to argue that Elijah resuscitated the child. However, in the second case, the text clearly states that the Shunammite boy died (2 Kings 4:20), implying a resurrection.

Infectious and Communicable Diseases

Fever and other calamities are listed among the punishments for covenantal infidelity (Deut. 28:22). Three different types of fever may be intentionally described here: “fever,” “inflammation,” and “scorching heat” (ESV: “fiery heat”). Fever is also mentioned frequently in the NT (Matt. 8:15; Mark 1:30–31; Luke 4:38–39; John 4:52; Acts 28:8). Both Jesus and Paul healed individuals who had a fever. A number of these fevers were likely caused by malaria, since the disease was known to be endemic to the Jordan Valley and other marshy areas in Palestine.

Several epidemics in which numerous people died of pestilence or plague are mentioned in the OT (Exod. 11:1; 12:13; Num. 14:37; Zech. 14:12). The fifth plague of Egypt (Exod. 9:3–6) has been attributed to Jordan Rift Valley fever, which is spread by flies. Bubonic plague has been blamed for the malady that struck the Philistines (1 Sam. 5–6). However, it may have been the result of a severe form of tropical dysentery. Acute bacillary dysentery contracted in the military camp may also have been responsible for the epidemic that killed a large number of the Assyrian army (2 Kings 19:35).

Parasitic Diseases

Some scholars have repeatedly argued that the “fiery serpents” (NIV: “venomous snakes”) encountered by Moses and the children of Israel (Num. 21:6–9) were in reality an infestation of the parasitic guinea worm (Dracunculus medinensis). Microscopic fleas ingested in drinking water carry the larvae of this slender nematode into the body. The larvae move from the digestive tract to the skin. The adult worm, which may grow to a length of several feet, discharges its eggs into an ulcer on the skin. Death of the host occurs because of the resulting infection of the skin ulcers.

After the conquest of Jericho, Joshua cursed the individual who would endeavor to rebuild the city (Josh. 6:26). Later, Hiel of Bethel attempted to rebuild the city and lost two of his sons as a result of the curse (1 Kings 16:34). Elisha was then asked to purify the bad water at Jericho in order to allow a new settlement (2 Kings 2:19). Elisha obliged by throwing salt into the spring and thereby making the water potable (2:20–22). Recent archaeological study has discovered the remains of certain snails in the mud-bricks used to construct Jericho in the Bronze Age. These types of snails are now known to serve as intermediate hosts for the flatworm parasite that can cause schistosomiasis. The Schistosoma haematobium trematode infects the urinary tract and the bladder. It is possible that this type of parasite was responsible for the death of Hiel’s two sons.

In NT times, Herod Agrippa apparently died of the complications of a parasitic disease, perhaps being infested by the larvae of flies (myiasis) in the bowels. Luke mentions that he was “eaten by worms” (skōlēkobrōtos [Acts 12:23]). The father of Publius also suffered from dysentery (Acts 28:8).

Physical Deformities and Abnormalities

Individuals with deformities were disqualified from priestly service (Lev. 21:18–20). The list included lameness, limb damage, and dwarfism. The deformities mentioned here might have been congenital or acquired. Mephibosheth was dropped by his nurse (2 Sam. 4:4) and perhaps suffered damage to the spinal cord. Jacob possibly sustained injury to an intervertebral disk (Gen. 32:32) causing a deformity and a limp. The woman who was “bent over” (Luke 13:10–17) might have suffered from an abnormality of the spine similar to scoliosis. It is difficult to ascertain the origin of the “shriveled hand” of the unnamed individual healed by Jesus (Matt. 12:10–13; Mark 3:1–5; Luke 6:6–10). It could be congenital in character or a paralysis caused by any number of factors.

Diseases and Disabilities of the Eyes and Ears

Physical blindness is mentioned several times in the Bible. Blindness excluded one from serving as a priest (Lev. 21:18, 20). Blindness and deafness, however, were disabilities requiring special care from the community (Lev. 19:14; Deut. 27:18). The “weak eyes” of Leah may refer to an eye condition (Gen. 29:17).

Blindness in the biblical world was caused by various factors. Leviticus 26:16 speaks of a fever that destroys the eyes. Flies probably were responsible for much of the conjunctivitis found in children. John 9:1 mentions congenital blindness, which Jesus cured using mud made from spittle and dirt (John 9:6). In Mark 8:22–26 Jesus healed a blind man by spitting in his eye and laying hands on him (cf. Matt. 20:34 with Mark 10:52).

Congenital deafness would also be associated with mutism and speech defects because a child learning to speak depends on imitation and mimicry. Jesus healed a man who was deaf and could barely talk (Mark 7:32–37). The man’s inability to say much possibly pointed to a loss of hearing early in life.

Skin Conditions

Various skin and hair abnormalities are described in the Bible. Some made the individual unclean (Lev. 13:30; 14:54). The OT speaks of “the boils of Egypt” (Deut. 28:27; cf. Exod. 9:9). Skin ailments included tumors, festering sores, boils, infections, and the itch (Deut. 28:27, 35; Isa. 3:7). Job complained of a litany of ailments: broken and festering skin (7:5), multiple wounds (9:17), black peeling skin and fever (30:30), gnawing bone pain (2:5; 19:20; 30:17), insomnia (7:3–4), and wasting away (33:21). These symptoms have been diagnosed as indications of yaws or eczema. A poultice made of figs cured Hezekiah’s boil (2 Kings 20:7).

Leprosy was once thought to be a common problem in the biblical world. Leprosy (Hansen’s disease) is a slow, progressive chronic infectious disease caused by a bacterium. Symptoms include loss of sensation and loss of parts of the body. Evidence for this type of disease in Palestine is rare. Uzziah may have had a true case of Hansen’s disease. He was quarantined until the day he died (2 Chron. 26:21).

Scholars now suggest that the symptoms of the disease described in the Bible do not fit this pattern and thus do not signify leprosy (Hansen’s disease) as it is known today. Instead, the word that English versions translate as “leprosy” (Heb. root tsr’) probably refers to different types of infectious skin disease, often characterized by a long-standing, patchy skin condition associated with peeling or flakiness and redness of skin. Evidence points more toward psoriasis, fungal infections, or dermatitis.

This disease could appear in humans (Lev. 14:2), on buildings (14:34), and on clothing (14:55). It was not limited to the extremities but could occur on the head (14:42–44). It could run its course quickly (13:5–8). It made the individual ceremonially unclean, but it was also curable (Lev. 14:3; 2 Kings 5:1–27). Individuals with the disease were not necessarily shunned (2 Kings 7; Matt. 26:6 // Mark 14:3). Moses (Exod. 4:6), Miriam (Num. 12:10), and Naaman experienced this type of skin disease (2 Kings 5:1–27). Jesus healed many suffering from skin ailments (Matt. 8:2–3; Mark 1:40–42; Luke 5:12–13), including the ten “men who had leprosy” (Luke 17:12–14).

Ailments of an Unknown Nature

Some cases in the Bible present insufficient evidence for scholars to render a clear diagnosis. King Asa suffered a disease in his feet (2 Chron. 16:12). However, in the OT the Hebrew expression for “feet” is sometimes used euphemistically for the sexual organs (Judg. 3:24 KJV). Because of this, the exact nature of the disease is ambiguous. Jehoram was afflicted with “an incurable disease of the bowels” (2 Chron. 21:18–19). Other unknown ailments factor in the deaths of the firstborn son of David and Bathsheba (2 Sam. 12:15), of Jeroboam’s son in infancy (1 Kings 14:17), of Elisha (2 Kings 13:14), and of Ezekiel’s wife (Ezek. 24:16).

(Disabilities; Disability; Deformity; Deformities; Sickness] The Bible often speaks of health, healing, disease, and illness. Good health was a sign of God’s favor, and healing was also the work of God and his divinely empowered agents. These agents included the prophets (1 Kings 17:8–23; 2 Kings 5:1–15), the apostles (Acts 3:1–10), and the messiah (Mal. 4:2). The divine prerogative of Jesus was to heal (Mark 1:32; 6:56; Matt. 4:23; 8:16; 15:30; 21:14; Luke 6:10, 17–19), and miraculous healings were a sign of his messianic office (Luke 7:20–23). Disease, on the other hand, was regarded as a sign of God’s disfavor. Within a covenantal context, God could send disease to punish the sinner (Exod. 4:11; 32:35).

The Bible assigns a wide variety of names to various diseases and their symptoms. These terms are nontechnical and generally descriptive. Some are uncertain in meaning. In most cases they describe the symptoms of the disease, not the disease itself. Diagnosis often was based on incomplete observation and nonclinical examination. The Bible also presupposes supernatural intervention in the life of a person. Healing occurred when God’s agents touched individuals, cast out demons, and resurrected the dead.

Ancient Near Eastern Influences

In the ancient Near East the knowledge of disease and medicine was precritical. Bacteria and viruses were virtually unknown. Mesopotamian literature contains many references to medicine, physicians, and medical practice. Minerals, salts, herbs, and other botanicals were used to make up treatments. Babylonian physicians also administered prescriptions accompanied by incantations. Disease was considered to be the result of a violation of a taboo or possession by a demon. The Code of Hammurabi (1750 BC) includes laws regulating the practice of medicine and surgery by physicians. In Egypt medicine and healing were connected to the gods. Tomb paintings and several papyrus documents describe the developing state of Egyptian medicine, pharmacy, and surgery.

Greek physicians admired and sought to learn the skills of the Egyptians. However, the early Greek doctor Hippocrates (460–370 BC), called the “Father of Medicine,” is credited with being the first physician to reject the belief that supernatural or divine forces cause illness. He argued that disease is the result of environmental factors, diet, and living habits, not a punishment imposed by the gods.

It is clear that the biblical world shared with the ancient Near East the same types of maladies common to tropical or subtropical climates. These include malaria, tropical fevers, dysentery, and sunstroke. The tendency of the hot climate to produce frequent droughts and famine certainly contributed to similar types of diseases throughout the Fertile Crescent. Additionally, it must be remembered that Palestine was a land bridge between the Mesopotamian and Egyptian worlds. Migrations carry not only goods and products, but also parasites, communicable disease, and epidemics.

Biblical Concept of Disease

The religious tradition of the Hebrews repudiated the magical or demonic origin of disease. Hence, moral, ethical, and spiritual factors regulated disease and illness. This was true for the individual as well as the community. The Hebrews, like the Egyptians, also recognized that much sickness arose from the individual’s relationship to the physical environment. Great stress was placed on hygiene and preventive medicine.

Pentateuchal legislation offered seven covenantal principles designed to prevent the possibility of disease and sickness: (1) Sabbath observance for humans, animals, and the land, which enforced regular periods of rest (Gen. 2:3); (2) dietary regulations, which divided food into efficient categories of clean and unclean (Lev. 11); (3) circumcision, which carried physical benefits as well as religious and moral implications (Gen. 17:9; circumcision is the only example of Hebrew surgery); (4) laws governing sexual relationships and health, including a list of forbidden degrees of marital relationships (Lev. 18–20); (5) provisions for individual sexual hygiene (Lev. 15); (6) stipulations for cleanliness and bodily purification (Lev. 14:2; 15:2); (7) sanitary and hygienic regulations for camp life (Num. 31:19; Deut. 23:12).

In NT times magical charms and incantations were used along with folk remedies in an effort to cure disease. Jesus repudiated these means. He also suggested that sickness and disease were not direct punishments for sin (John 9:2). In the Sermon on the Mount (Matt. 5–7), Jesus confirmed that the ethical and religious standards of the new covenant promoted the total health of the community and the individual.

Circulatory Diseases

Nabal most likely suffered a cerebrovascular accident or stroke (1 Sam. 25:36–38). After a heavy bout of drinking, his heart “died” (KJV; NIV: “failed”), and he became paralyzed, lapsed into a coma, and died ten days later. Psalm 137:5–6 may contain a clinical example of the symptoms of stroke. The psalmist wrote, “If I forget you, Jerusalem, may my right hand forget its skill. May my tongue cling to the roof of my mouth if I do not remember you.” This description points to a paralysis of the right side of the body (right hemiplegia) and the loss of speech (motor aphasia) that result from a stroke on the left side of the brain. Basically, the exiled psalmist is wishing upon himself the effects of a stroke if he held anything other than Jerusalem as his highest priority. Some have considered the collapse of Uzzah when he reached out to stabilize the ark of the covenant (2 Sam. 6:6–7) to be the consequence of an apoplectic seizure. But since no actual paralysis was described and death occurred immediately, this seems unlikely. It is more probable that God struck him down with an aortic aneurism or a coronary thrombosis.

Paralysis

A possible case of paralysis may be described in the shriveled (atrophic) hand of Jeroboam I (1 Kings 13:4–6). In an angry outburst Jeroboam ordered the arrest of a prophet who condemned the altar at Bethel. When Jeroboam stretched out his hand, it “shriveled up, so that he could not pull it back.” Several complicated diagnoses have been offered to explain the “withered” hand, but it is possibly an example of cataplexy, a sudden loss of muscle power following a strong emotional stimulus. After intercession by the man of God, and the subsiding of the emotional outburst, the arm was restored.

The threat against the faithless shepherd of God’s people (Zech. 11:17), which included a withered arm and blindness in the right eye, may refer to a form of paralysis known as tabes dorsalis, or locomotor ataxia. Knifelike pains in the extremities and blindness characterize this disease.

Paralysis is frequently mentioned in the NT (Matt. 8:6; 9:2, 6; 12:10; Mark 2:3–5, 9, 10; 3:1, 3, 5; Luke 5:18, 24; 6:6; John 5:3; Acts 9:33; Heb. 12:12). The exact diagnosis for each of these cases remains uncertain.

The physician Luke’s use of the Greek medical term paralelymenos (Luke 5:18, 24) suggests that some of these cases were caused by chronic organic disease. Others clearly were congenital (Acts 3:2; cf. 14:8). It is not necessary to rationalize the origin of these examples of paralysis as hysteria or pretense. The NT writers regarded the healing of these individuals by Jesus and the apostles as miraculous.

Mental Illness and Brain Disorders

Cases of mental disease are generally described in the Bible by noting the symptoms produced by the disorder. The particular cause of a mental illness in the NT is often blamed on an unknown evil spirit or spirits (Luke 8:2). Such spirits, however, were subject to God’s control and operated only within the boundaries allowed by him (1 Sam. 16:14–16, 23; 18:10; 19:9). Accordingly, in the OT “madness” and “confusion of mind” were regarded as consequences of covenantal disobedience (Deut. 28:28, 34).

It has been argued that King Saul displayed early indications of personality disorder. Symptoms included pride, self-aggrandizement (1 Sam. 11:6; 13:12; 15:9, 19), and ecstatic behavior (10:11–12). A rapid deterioration in Saul’s character transpired after David was anointed and became more popular (16:14; 18:10–11). Since Saul demonstrated fear, jealousy, a sense of persecution, and homicidal tendencies, some scholars argue that he suffered from paranoid schizophrenia.

Nebuchadnezzar suffered a rare form of monomania in which he lived like a wild beast in the field eating grass (Dan. 4:33). David, in order to save his own life, feigned insanity or perhaps epilepsy before the Philistine king Achish (1 Sam. 21:12–15).

In the NT, individuals with mental disorders went about naked, mutilated themselves, lived in tombs (Mark 5:2), and exhibited violent behavior (Matt. 8:28). Such mental disorientation was often linked to demon possession. Examples include the Syrophoenician’s child (Matt. 15:22; Mark 7:25), the demoniacs at Gerasa (Matt. 8:28; Mark 5:2; Luke 8:27) and Capernaum (Mark 1:23; Luke 4:33), a blind and mute demoniac (Matt. 12:22; Luke 11:14), and a fortune-telling slave girl (Acts 16:16). While such behavior is clinically suggestive of paranoid schizophrenia or other mental disorders, the mind-controlling influence of some extraneous negative force cannot be ruled out.

Epilepsy (grand mal) causes the afflicted person to fall to the ground, foam at the mouth, and clench or grind the teeth (Matt. 17:15; Mark 9:17–18; Luke 9:39). The description of Saul falling to the ground in an ecstatic state (1 Sam. 19:23–24) and Balaam falling with open eyes may be indicative of an epileptic seizure. In the NT, Jesus healed many who suffered from epilepsy (Matt. 4:24; 17:14–18; Mark 9:17–18; Luke 9:38–42). Some scholars have linked the light seen by Paul on the road to Damascus with the aura that some epileptics experience prior to a seizure. His subsequent blindness has also been attributed to the epileptic disturbance of the circulation of the blood in the brain.

Childhood Diseases

The cause of the death of the widow’s son at Zarephath is unknown (1 Kings 17:17–22). The death of the Shunammite woman’s son has been attributed to sunstroke (2 Kings 4:18–37), although a headache is the only symptom recorded (v. 19). In both cases there is too little evidence to present an accurate diagnosis.

In the first case, the boy at Zarephath stopped breathing (1 Kings 17:17). This may leave the door open to argue that Elijah resuscitated the child. However, in the second case, the text clearly states that the Shunammite boy died (2 Kings 4:20), implying a resurrection.

Infectious and Communicable Diseases

Fever and other calamities are listed among the punishments for covenantal infidelity (Deut. 28:22). Three different types of fever may be intentionally described here: “fever,” “inflammation,” and “scorching heat” (ESV: “fiery heat”). Fever is also mentioned frequently in the NT (Matt. 8:15; Mark 1:30–31; Luke 4:38–39; John 4:52; Acts 28:8). Both Jesus and Paul healed individuals who had a fever. A number of these fevers were likely caused by malaria, since the disease was known to be endemic to the Jordan Valley and other marshy areas in Palestine.

Several epidemics in which numerous people died of pestilence or plague are mentioned in the OT (Exod. 11:1; 12:13; Num. 14:37; Zech. 14:12). The fifth plague of Egypt (Exod. 9:3–6) has been attributed to Jordan Rift Valley fever, which is spread by flies. Bubonic plague has been blamed for the malady that struck the Philistines (1 Sam. 5–6). However, it may have been the result of a severe form of tropical dysentery. Acute bacillary dysentery contracted in the military camp may also have been responsible for the epidemic that killed a large number of the Assyrian army (2 Kings 19:35).

Parasitic Diseases

Some scholars have repeatedly argued that the “fiery serpents” (NIV: “venomous snakes”) encountered by Moses and the children of Israel (Num. 21:6–9) were in reality an infestation of the parasitic guinea worm (Dracunculus medinensis). Microscopic fleas ingested in drinking water carry the larvae of this slender nematode into the body. The larvae move from the digestive tract to the skin. The adult worm, which may grow to a length of several feet, discharges its eggs into an ulcer on the skin. Death of the host occurs because of the resulting infection of the skin ulcers.

After the conquest of Jericho, Joshua cursed the individual who would endeavor to rebuild the city (Josh. 6:26). Later, Hiel of Bethel attempted to rebuild the city and lost two of his sons as a result of the curse (1 Kings 16:34). Elisha was then asked to purify the bad water at Jericho in order to allow a new settlement (2 Kings 2:19). Elisha obliged by throwing salt into the spring and thereby making the water potable (2:20–22). Recent archaeological study has discovered the remains of certain snails in the mud-bricks used to construct Jericho in the Bronze Age. These types of snails are now known to serve as intermediate hosts for the flatworm parasite that can cause schistosomiasis. The Schistosoma haematobium trematode infects the urinary tract and the bladder. It is possible that this type of parasite was responsible for the death of Hiel’s two sons.

In NT times, Herod Agrippa apparently died of the complications of a parasitic disease, perhaps being infested by the larvae of flies (myiasis) in the bowels. Luke mentions that he was “eaten by worms” (skōlēkobrōtos [Acts 12:23]). The father of Publius also suffered from dysentery (Acts 28:8).

Physical Deformities and Abnormalities

Individuals with deformities were disqualified from priestly service (Lev. 21:18–20). The list included lameness, limb damage, and dwarfism. The deformities mentioned here might have been congenital or acquired. Mephibosheth was dropped by his nurse (2 Sam. 4:4) and perhaps suffered damage to the spinal cord. Jacob possibly sustained injury to an intervertebral disk (Gen. 32:32) causing a deformity and a limp. The woman who was “bent over” (Luke 13:10–17) might have suffered from an abnormality of the spine similar to scoliosis. It is difficult to ascertain the origin of the “shriveled hand” of the unnamed individual healed by Jesus (Matt. 12:10–13; Mark 3:1–5; Luke 6:6–10). It could be congenital in character or a paralysis caused by any number of factors.

Diseases and Disabilities of the Eyes and Ears

Physical blindness is mentioned several times in the Bible. Blindness excluded one from serving as a priest (Lev. 21:18, 20). Blindness and deafness, however, were disabilities requiring special care from the community (Lev. 19:14; Deut. 27:18). The “weak eyes” of Leah may refer to an eye condition (Gen. 29:17).

Blindness in the biblical world was caused by various factors. Leviticus 26:16 speaks of a fever that destroys the eyes. Flies probably were responsible for much of the conjunctivitis found in children. John 9:1 mentions congenital blindness, which Jesus cured using mud made from spittle and dirt (John 9:6). In Mark 8:22–26 Jesus healed a blind man by spitting in his eye and laying hands on him (cf. Matt. 20:34 with Mark 10:52).

Congenital deafness would also be associated with mutism and speech defects because a child learning to speak depends on imitation and mimicry. Jesus healed a man who was deaf and could barely talk (Mark 7:32–37). The man’s inability to say much possibly pointed to a loss of hearing early in life.

Skin Conditions

Various skin and hair abnormalities are described in the Bible. Some made the individual unclean (Lev. 13:30; 14:54). The OT speaks of “the boils of Egypt” (Deut. 28:27; cf. Exod. 9:9). Skin ailments included tumors, festering sores, boils, infections, and the itch (Deut. 28:27, 35; Isa. 3:7). Job complained of a litany of ailments: broken and festering skin (7:5), multiple wounds (9:17), black peeling skin and fever (30:30), gnawing bone pain (2:5; 19:20; 30:17), insomnia (7:3–4), and wasting away (33:21). These symptoms have been diagnosed as indications of yaws or eczema. A poultice made of figs cured Hezekiah’s boil (2 Kings 20:7).

Leprosy was once thought to be a common problem in the biblical world. Leprosy (Hansen’s disease) is a slow, progressive chronic infectious disease caused by a bacterium. Symptoms include loss of sensation and loss of parts of the body. Evidence for this type of disease in Palestine is rare. Uzziah may have had a true case of Hansen’s disease. He was quarantined until the day he died (2 Chron. 26:21).

Scholars now suggest that the symptoms of the disease described in the Bible do not fit this pattern and thus do not signify leprosy (Hansen’s disease) as it is known today. Instead, the word that English versions translate as “leprosy” (Heb. root tsr’) probably refers to different types of infectious skin disease, often characterized by a long-standing, patchy skin condition associated with peeling or flakiness and redness of skin. Evidence points more toward psoriasis, fungal infections, or dermatitis.

This disease could appear in humans (Lev. 14:2), on buildings (14:34), and on clothing (14:55). It was not limited to the extremities but could occur on the head (14:42–44). It could run its course quickly (13:5–8). It made the individual ceremonially unclean, but it was also curable (Lev. 14:3; 2 Kings 5:1–27). Individuals with the disease were not necessarily shunned (2 Kings 7; Matt. 26:6 // Mark 14:3). Moses (Exod. 4:6), Miriam (Num. 12:10), and Naaman experienced this type of skin disease (2 Kings 5:1–27). Jesus healed many suffering from skin ailments (Matt. 8:2–3; Mark 1:40–42; Luke 5:12–13), including the ten “men who had leprosy” (Luke 17:12–14).

Ailments of an Unknown Nature

Some cases in the Bible present insufficient evidence for scholars to render a clear diagnosis. King Asa suffered a disease in his feet (2 Chron. 16:12). However, in the OT the Hebrew expression for “feet” is sometimes used euphemistically for the sexual organs (Judg. 3:24 KJV). Because of this, the exact nature of the disease is ambiguous. Jehoram was afflicted with “an incurable disease of the bowels” (2 Chron. 21:18–19). Other unknown ailments factor in the deaths of the firstborn son of David and Bathsheba (2 Sam. 12:15), of Jeroboam’s son in infancy (1 Kings 14:17), of Elisha (2 Kings 13:14), and of Ezekiel’s wife (Ezek. 24:16).

Understanding many aspects of education in Israel during OT times and, to a lesser extent, into the NT period is extraordinarily difficult. Many studies draw quite specific conclusions based on very slender evidence and inferences drawn from supposed parallels with neighboring societies, inferences themselves beset by uncertainties. Therefore, conclusions are necessarily tentative at many points. Furthermore, it is reasonable to expect that things did not remain constant through history, and that what can be reliably discerned for one period may not accurately reflect the situation in other times.

Education encompasses several areas of life in the biblical world. Aside from academic education (relating to literacy and numeracy), there was moral and religious education, military education, and vocational training. These are not all distinct; those whose vocation lay in diplomatic circles or within the royal court as scribes would have received academic education, while those living in the country and working a farm would have had little opportunity to access such knowledge.

Old Testament

Settings for education. There were three primary arenas of education in OT times: home, school, and temple.

Home. The most important setting for education in OT times was the home (Deut. 4:9; 6:7; 11:19). Both parents were expected to play a role in a child’s education (Prov. 1:8; 6:20; 23:22; 31:1). Sons generally were trained in their father’s vocation, and such training took the form of an apprenticeship (1 Sam. 16:11; 2 Kings 4:18); girls learned from their mothers as they undertook their work on a daily basis (Exod. 35:25–26; 2 Sam. 13:8).

In part, the extent of home education is tied to the question of the extent of formal schooling in ancient Israel. As noted below, the nature and extent of schools is unclear, and if (as the evidence seems to suggest) schools were virtually nonexistent outside the royal court, then the home ultimately would have been the locus of any academic education received by children and the source of any widespread literacy and numeracy in the community. The frequent use of father/son language in Proverbs, however, need not imply an exclusively familial context for the instruction contained therein, as there is evidence from Egypt that such language was used between teacher and student.

School. The existence, nature, and extent of schools in OT times is extensively debated and ultimately uncertain. The first explicit reference to a school is found in the second century BC in Sir. 51:23. The virtual silence of the OT on the topic may reflect either that schools were absent in ancient Israel or that their existence was somehow of little interest and so warranted little reflection by biblical authors. In any case, it is likely that some form of school for scribes and those training to work in government existed in the vicinity of the royal court, as they did in Mesopotamia and Egypt. These did not form a comprehensive national schooling system for young children but were more specifically targeted to the few individuals who aimed to become scribes or advisers.

Outside the Bible there exist a number of inscriptions that could suggest the existence of schools in Israel prior to the exile. These include abecedaries (lists of the letters of the alphabet written out, usually as practice exercises or as examples), words written out several times, lists of month names, and possible exercises in reading foreign languages, among others.

There is also extensive evidence of schools in Egypt, Mesopotamia, and probably also Ugarit from an early date (cf. Acts 7:22). Whether their existence supports the existence of schools in Israel is unclear. Egypt and Mesopotamia had large and complex bureaucracies necessary to administer their kingdoms, and they employed writing systems far more difficult to master than Hebrew. In addition, mathematical texts reflect a concern with numeracy within the schools of these kingdoms, for which there is no clear evidence in ancient Israel.

The sages and scribes appear to be the primary source for the material supposedly employed in schools. Ecclesiastes 12:9 identifies one of the tasks of the sages as teaching the people, and some claim that Proverbs functioned as a textbook within a school setting. Indeed, Prov. 4:5; 17:16 speak of the “buying” (Heb. qanah) of knowledge, interpreted by some as a reference to teachers paid for providing tuition. Again, the context in which such tuition may have taken place is uncertain.

Temple. Priests were also involved in some teaching (1 Sam. 2:21, 26). According to 2 Chron. 17:7–9, King Jehoshaphat sent five officials, nine Levites, and two priests to teach the people of Judah from the Book of the Law, a point that stresses both the importance of the task and the probable failure of the home setting to adequately convey this instruction, at least by the late fifth century BC.

Types of education. In OT times four types of education can be discerned: moral and religious, academic, vocational, and military.

Moral and religious education. The Bible stresses the importance of moral and religious education above all other forms (Exod. 10:2; 12:26; 13:8; Deut. 4:9; 6:7, 20–21; 32:7, 46).

Academic education. The extent of literacy and numeracy in ancient Israel is difficult to ascertain. Rudimentary numeracy almost certainly was widespread and learned within the home and in the course of vocational training when necessary. Many among the population also appear to have been at least capable of reading and writing names or other simple texts (Deut. 6:9; 11:20; Judg. 8:14).

Vocational training. Most commonly, boys followed in their father’s vocation and thus learned through observation and participation. Under some circumstances, however, children served apprenticeships under the tutelage of others, such as was apparently the case for prophetic schools (2 Kings 2:7; 4:38; 6:1–2; Amos 7:14–15).

Military training. There are clear indications that kings recruited mercenaries to form the most important part of their army (e.g., 1 Sam. 22:2; 25:13). These mercenaries were paid and likely had received some formal training, but the nature of that training is nowhere explained. In addition to these elite forces, all able-bodied men apparently were considered eligible for military service when the need arose (2 Chron. 25:5). So, for example, the elite troops were responsible for staging the attack (2 Sam. 11:14–17; 12:26), while the remainder of the army served as reinforcements where necessary (2 Sam. 12:29). The use of chariots (under David and Solomon) would have required some training, as would the wielding of various weapons (swords, spears, bows, and slings). Ultimately, however, there are only allusions to such training (e.g., Judg. 3:2; 2 Sam. 22:35).

Educational methods. Throughout the ancient Near East there is evidence that corporal punishment played a significant role in education. There is a somewhat comical text from Mesopotamia that relates a day in the life of a student who receives physical punishment for virtually everything he does. Similarly, the book of Proverbs highlights the importance of discipline in raising and training children (e.g., 13:24; 22:15; 29:15, 17). Nonetheless, Proverbs uses “the rod” as a means to signify discipline as a whole without necessarily endorsing corporal punishment as the only or even the primary means of discipline. This is apparent because Proverbs contrasts the rod not with other, lesser forms of discipline but rather with no discipline at all. Thus, although there is evidence that corporal punishment was used extensively (and probably excessively [see Sir. 30]), Proverbs endorses a more nuanced approach to disciplining children.

Academic, religious, and moral education also involved the use of various techniques that facilitated learning. These included the use of poetry or poetic couplets (common in wisdom literature and in psalms), numerical sayings (e.g., Ps. 62:11; Prov. 6:16), and acrostics, as well as the celebration of feasts and memorials at various times throughout the year.

New Testament

Greco-Roman education. Greek education developed from about the fourth century BC and spread throughout the Mediterranean region, adopted with minor modification by the Romans. The curriculum was dominated by sports and a focus on literacy, with little place given to religious education (although philosophy was taught and did bear some religious traits). Education in the Greco-Roman world was expensive, and its provision was a parental responsibility, which tended to restrict formal education to the elite.

At about the age of fifteen, boys could move from elementary schooling to the gymnasium, where they received intellectual and physical training. Some in the Corinthian church may have received such an education, a possibility raised by Paul’s terminology in 1 Corinthians that reflects educational language: his claim to be father of the Corinthian household (4:14–21); sporting imagery (esp. 9:24–27); language of nursing and nature (3:1–4); agricultural imagery (3:5–9); his threat to come with a rod (4:21), which could be related to the rod of correction; the term grammateus (1:20), which may refer to the gymnasium instructor; reference to writing (4:6); and talk of removing the marks of circumcision (7:18).

Education in Israel. One Jewish tradition states that in AD 63 the high priest Joshua ben Gamla decreed that every town should appoint a schoolteacher for the education of children of six or seven years of age. This, together with the existence of Sirach’s school more than two centuries earlier, indicates that some form of schooling existed within Israel in the first century AD.

Although some Jews throughout the ancient world received a standard Hellenistic education, others reacted against the influence of Hellenism and sought to educate their children within the Scriptures and Jewish tradition. The DSS refer to the importance placed on study of the Torah (1QS 6:6–7). There were also rabbinic schools that focused on such teaching.

By NT times, synagogues were well established. Although determining precisely what took place within the synagogues is difficult, indications are that the focus on Scripture and its exposition played an important role in teaching both its importance and the appropriate way to interpret it. Teaching, however, was not confined to synagogues or the temple, as is amply demonstrated by the frequency with which Jesus is described as teaching in a variety of settings. Nonetheless, the temple itself did appear to serve as a center for religious education, as is reflected in the account of the twelve-year-old Jesus’ interactions with the teachers at the temple (Luke 2:41–51). Jesus’ own teaching was remarkable, however, in that it was delivered with authority (Matt. 7:29; Mark 1:22; Luke 4:32).

Education in the church. Paul highlights one of the prerequisites for being an overseer of a church as the ability to teach, stressing the importance of the NT church as a place of learning (1 Tim. 3:2; 2 Tim. 2:2, 24). This teaching involved a familiarity with right doctrine in order to avoid being led astray, an exemplary life that modeled godly behavior for all to see, and the maturity required to apply discipline when necessary.

In the Hebrew Bible several different words can be translated as “instruction.” In Exod. 24:12 God informs Moses that the laws and commands given to him on the mountain are for Israel’s instruction (yarah), instruction (dabar) given at the feet of God (Deut. 33:3). Indeed, Job 22:22 concedes that instruction (torah) proceeds from God’s mouth, while Nehemiah reminds God of his promises to the people of Israel when he refers to the instructions (dabar) given to Moses for repentance (Neh. 1:8). When the priests fail to give “true instruction,” they let the people go astray, inviting God’s wrath (Mal. 2:1–10). Similarly, failure to observe divine instruction (musar) elicits God’s condemnation (Ps. 50:17).

But the biblical book that bills itself as the instruction manual is Proverbs (part of the poetic section in the OT known as the Ketubim, the Writings), which is presented in the form of parental instruction (musar) to a child (1:8; 4:1; 13:1; 19:27), given in a royal setting (1:1) or a school. The book of Proverbs has been compared to similar Egyptian writings (The Instruction of Amenemope; The Maxims of Ptahhotep) and Sumerian wisdom as well as an Aramaic proverbial writing, Ahiqar.

While Proverbs, like its Egyptian and Mesopotamian counterparts, dispenses advice on how to successfully negotiate life, a distinct element of the biblical book is the setting of wisdom as inextricably bound to the “fear of the Lord” (1:7; 9:10). In Proverbs, instruction is also dispensed by the persona “Lady Wisdom” (chap. 8), whose advice, in contrast to that of the “loose” woman, leads to knowledge, wisdom, and life.

Jesus was known for his authoritative teaching of the law, which in the Synoptic Gospels is dominated by his use of parables for instruction (Matt. 7:29; Mark 1:22; Luke 4:32, 36). Accepting Jesus Christ entails discarding any false teaching and embracing the instruction (logos) of Jesus (1 Tim. 6:3–4; Heb. 6:2). Anyone who disregards this instruction is to be avoided and not socialized with (2 Thess. 3:14).

Instruction (didachē) in the Pauline writings is presumed to be a gift of the Holy Spirit (1 Cor. 14:6, 26) that is to be managed by the one so gifted for the benefit of the community of believers. It is to be shared in and out of season (2 Tim. 4:2). Such giftedness is also to be understood as entitling the instructor to support by the church (Gal. 6:6). Indeed, the Thessalonians are warned that failure to heed apostolic instruction (logos) is tantamount to disobeying God (1 Thess. 4:8; 2 Thess. 3:14). On the other hand, reminiscent of the Proverbs, parental instruction (nouthesia) should encourage rather than exasperate the child (Eph. 6:4). See also Education.

In the Hebrew Bible several different words can be translated as “instruction.” In Exod. 24:12 God informs Moses that the laws and commands given to him on the mountain are for Israel’s instruction (yarah), instruction (dabar) given at the feet of God (Deut. 33:3). Indeed, Job 22:22 concedes that instruction (torah) proceeds from God’s mouth, while Nehemiah reminds God of his promises to the people of Israel when he refers to the instructions (dabar) given to Moses for repentance (Neh. 1:8). When the priests fail to give “true instruction,” they let the people go astray, inviting God’s wrath (Mal. 2:1–10). Similarly, failure to observe divine instruction (musar) elicits God’s condemnation (Ps. 50:17).

But the biblical book that bills itself as the instruction manual is Proverbs (part of the poetic section in the OT known as the Ketubim, the Writings), which is presented in the form of parental instruction (musar) to a child (1:8; 4:1; 13:1; 19:27), given in a royal setting (1:1) or a school. The book of Proverbs has been compared to similar Egyptian writings (The Instruction of Amenemope; The Maxims of Ptahhotep) and Sumerian wisdom as well as an Aramaic proverbial writing, Ahiqar.

While Proverbs, like its Egyptian and Mesopotamian counterparts, dispenses advice on how to successfully negotiate life, a distinct element of the biblical book is the setting of wisdom as inextricably bound to the “fear of the Lord” (1:7; 9:10). In Proverbs, instruction is also dispensed by the persona “Lady Wisdom” (chap. 8), whose advice, in contrast to that of the “loose” woman, leads to knowledge, wisdom, and life.

Jesus was known for his authoritative teaching of the law, which in the Synoptic Gospels is dominated by his use of parables for instruction (Matt. 7:29; Mark 1:22; Luke 4:32, 36). Accepting Jesus Christ entails discarding any false teaching and embracing the instruction (logos) of Jesus (1 Tim. 6:3–4; Heb. 6:2). Anyone who disregards this instruction is to be avoided and not socialized with (2 Thess. 3:14).

Instruction (didachē) in the Pauline writings is presumed to be a gift of the Holy Spirit (1 Cor. 14:6, 26) that is to be managed by the one so gifted for the benefit of the community of believers. It is to be shared in and out of season (2 Tim. 4:2). Such giftedness is also to be understood as entitling the instructor to support by the church (Gal. 6:6). Indeed, the Thessalonians are warned that failure to heed apostolic instruction (logos) is tantamount to disobeying God (1 Thess. 4:8; 2 Thess. 3:14). On the other hand, reminiscent of the Proverbs, parental instruction (nouthesia) should encourage rather than exasperate the child (Eph. 6:4). See also Education.

(Disabilities; Disability; Deformity; Deformities; Sickness] The Bible often speaks of health, healing, disease, and illness. Good health was a sign of God’s favor, and healing was also the work of God and his divinely empowered agents. These agents included the prophets (1 Kings 17:8–23; 2 Kings 5:1–15), the apostles (Acts 3:1–10), and the messiah (Mal. 4:2). The divine prerogative of Jesus was to heal (Mark 1:32; 6:56; Matt. 4:23; 8:16; 15:30; 21:14; Luke 6:10, 17–19), and miraculous healings were a sign of his messianic office (Luke 7:20–23). Disease, on the other hand, was regarded as a sign of God’s disfavor. Within a covenantal context, God could send disease to punish the sinner (Exod. 4:11; 32:35).

The Bible assigns a wide variety of names to various diseases and their symptoms. These terms are nontechnical and generally descriptive. Some are uncertain in meaning. In most cases they describe the symptoms of the disease, not the disease itself. Diagnosis often was based on incomplete observation and nonclinical examination. The Bible also presupposes supernatural intervention in the life of a person. Healing occurred when God’s agents touched individuals, cast out demons, and resurrected the dead.

Ancient Near Eastern Influences

In the ancient Near East the knowledge of disease and medicine was precritical. Bacteria and viruses were virtually unknown. Mesopotamian literature contains many references to medicine, physicians, and medical practice. Minerals, salts, herbs, and other botanicals were used to make up treatments. Babylonian physicians also administered prescriptions accompanied by incantations. Disease was considered to be the result of a violation of a taboo or possession by a demon. The Code of Hammurabi (1750 BC) includes laws regulating the practice of medicine and surgery by physicians. In Egypt medicine and healing were connected to the gods. Tomb paintings and several papyrus documents describe the developing state of Egyptian medicine, pharmacy, and surgery.

Greek physicians admired and sought to learn the skills of the Egyptians. However, the early Greek doctor Hippocrates (460–370 BC), called the “Father of Medicine,” is credited with being the first physician to reject the belief that supernatural or divine forces cause illness. He argued that disease is the result of environmental factors, diet, and living habits, not a punishment imposed by the gods.

It is clear that the biblical world shared with the ancient Near East the same types of maladies common to tropical or subtropical climates. These include malaria, tropical fevers, dysentery, and sunstroke. The tendency of the hot climate to produce frequent droughts and famine certainly contributed to similar types of diseases throughout the Fertile Crescent. Additionally, it must be remembered that Palestine was a land bridge between the Mesopotamian and Egyptian worlds. Migrations carry not only goods and products, but also parasites, communicable disease, and epidemics.

Biblical Concept of Disease

The religious tradition of the Hebrews repudiated the magical or demonic origin of disease. Hence, moral, ethical, and spiritual factors regulated disease and illness. This was true for the individual as well as the community. The Hebrews, like the Egyptians, also recognized that much sickness arose from the individual’s relationship to the physical environment. Great stress was placed on hygiene and preventive medicine.

Pentateuchal legislation offered seven covenantal principles designed to prevent the possibility of disease and sickness: (1) Sabbath observance for humans, animals, and the land, which enforced regular periods of rest (Gen. 2:3); (2) dietary regulations, which divided food into efficient categories of clean and unclean (Lev. 11); (3) circumcision, which carried physical benefits as well as religious and moral implications (Gen. 17:9; circumcision is the only example of Hebrew surgery); (4) laws governing sexual relationships and health, including a list of forbidden degrees of marital relationships (Lev. 18–20); (5) provisions for individual sexual hygiene (Lev. 15); (6) stipulations for cleanliness and bodily purification (Lev. 14:2; 15:2); (7) sanitary and hygienic regulations for camp life (Num. 31:19; Deut. 23:12).

In NT times magical charms and incantations were used along with folk remedies in an effort to cure disease. Jesus repudiated these means. He also suggested that sickness and disease were not direct punishments for sin (John 9:2). In the Sermon on the Mount (Matt. 5–7), Jesus confirmed that the ethical and religious standards of the new covenant promoted the total health of the community and the individual.

Circulatory Diseases

Nabal most likely suffered a cerebrovascular accident or stroke (1 Sam. 25:36–38). After a heavy bout of drinking, his heart “died” (KJV; NIV: “failed”), and he became paralyzed, lapsed into a coma, and died ten days later. Psalm 137:5–6 may contain a clinical example of the symptoms of stroke. The psalmist wrote, “If I forget you, Jerusalem, may my right hand forget its skill. May my tongue cling to the roof of my mouth if I do not remember you.” This description points to a paralysis of the right side of the body (right hemiplegia) and the loss of speech (motor aphasia) that result from a stroke on the left side of the brain. Basically, the exiled psalmist is wishing upon himself the effects of a stroke if he held anything other than Jerusalem as his highest priority. Some have considered the collapse of Uzzah when he reached out to stabilize the ark of the covenant (2 Sam. 6:6–7) to be the consequence of an apoplectic seizure. But since no actual paralysis was described and death occurred immediately, this seems unlikely. It is more probable that God struck him down with an aortic aneurism or a coronary thrombosis.

Paralysis

A possible case of paralysis may be described in the shriveled (atrophic) hand of Jeroboam I (1 Kings 13:4–6). In an angry outburst Jeroboam ordered the arrest of a prophet who condemned the altar at Bethel. When Jeroboam stretched out his hand, it “shriveled up, so that he could not pull it back.” Several complicated diagnoses have been offered to explain the “withered” hand, but it is possibly an example of cataplexy, a sudden loss of muscle power following a strong emotional stimulus. After intercession by the man of God, and the subsiding of the emotional outburst, the arm was restored.

The threat against the faithless shepherd of God’s people (Zech. 11:17), which included a withered arm and blindness in the right eye, may refer to a form of paralysis known as tabes dorsalis, or locomotor ataxia. Knifelike pains in the extremities and blindness characterize this disease.

Paralysis is frequently mentioned in the NT (Matt. 8:6; 9:2, 6; 12:10; Mark 2:3–5, 9, 10; 3:1, 3, 5; Luke 5:18, 24; 6:6; John 5:3; Acts 9:33; Heb. 12:12). The exact diagnosis for each of these cases remains uncertain.

The physician Luke’s use of the Greek medical term paralelymenos (Luke 5:18, 24) suggests that some of these cases were caused by chronic organic disease. Others clearly were congenital (Acts 3:2; cf. 14:8). It is not necessary to rationalize the origin of these examples of paralysis as hysteria or pretense. The NT writers regarded the healing of these individuals by Jesus and the apostles as miraculous.

Mental Illness and Brain Disorders

Cases of mental disease are generally described in the Bible by noting the symptoms produced by the disorder. The particular cause of a mental illness in the NT is often blamed on an unknown evil spirit or spirits (Luke 8:2). Such spirits, however, were subject to God’s control and operated only within the boundaries allowed by him (1 Sam. 16:14–16, 23; 18:10; 19:9). Accordingly, in the OT “madness” and “confusion of mind” were regarded as consequences of covenantal disobedience (Deut. 28:28, 34).

It has been argued that King Saul displayed early indications of personality disorder. Symptoms included pride, self-aggrandizement (1 Sam. 11:6; 13:12; 15:9, 19), and ecstatic behavior (10:11–12). A rapid deterioration in Saul’s character transpired after David was anointed and became more popular (16:14; 18:10–11). Since Saul demonstrated fear, jealousy, a sense of persecution, and homicidal tendencies, some scholars argue that he suffered from paranoid schizophrenia.

Nebuchadnezzar suffered a rare form of monomania in which he lived like a wild beast in the field eating grass (Dan. 4:33). David, in order to save his own life, feigned insanity or perhaps epilepsy before the Philistine king Achish (1 Sam. 21:12–15).

In the NT, individuals with mental disorders went about naked, mutilated themselves, lived in tombs (Mark 5:2), and exhibited violent behavior (Matt. 8:28). Such mental disorientation was often linked to demon possession. Examples include the Syrophoenician’s child (Matt. 15:22; Mark 7:25), the demoniacs at Gerasa (Matt. 8:28; Mark 5:2; Luke 8:27) and Capernaum (Mark 1:23; Luke 4:33), a blind and mute demoniac (Matt. 12:22; Luke 11:14), and a fortune-telling slave girl (Acts 16:16). While such behavior is clinically suggestive of paranoid schizophrenia or other mental disorders, the mind-controlling influence of some extraneous negative force cannot be ruled out.

Epilepsy (grand mal) causes the afflicted person to fall to the ground, foam at the mouth, and clench or grind the teeth (Matt. 17:15; Mark 9:17–18; Luke 9:39). The description of Saul falling to the ground in an ecstatic state (1 Sam. 19:23–24) and Balaam falling with open eyes may be indicative of an epileptic seizure. In the NT, Jesus healed many who suffered from epilepsy (Matt. 4:24; 17:14–18; Mark 9:17–18; Luke 9:38–42). Some scholars have linked the light seen by Paul on the road to Damascus with the aura that some epileptics experience prior to a seizure. His subsequent blindness has also been attributed to the epileptic disturbance of the circulation of the blood in the brain.

Childhood Diseases

The cause of the death of the widow’s son at Zarephath is unknown (1 Kings 17:17–22). The death of the Shunammite woman’s son has been attributed to sunstroke (2 Kings 4:18–37), although a headache is the only symptom recorded (v. 19). In both cases there is too little evidence to present an accurate diagnosis.

In the first case, the boy at Zarephath stopped breathing (1 Kings 17:17). This may leave the door open to argue that Elijah resuscitated the child. However, in the second case, the text clearly states that the Shunammite boy died (2 Kings 4:20), implying a resurrection.

Infectious and Communicable Diseases

Fever and other calamities are listed among the punishments for covenantal infidelity (Deut. 28:22). Three different types of fever may be intentionally described here: “fever,” “inflammation,” and “scorching heat” (ESV: “fiery heat”). Fever is also mentioned frequently in the NT (Matt. 8:15; Mark 1:30–31; Luke 4:38–39; John 4:52; Acts 28:8). Both Jesus and Paul healed individuals who had a fever. A number of these fevers were likely caused by malaria, since the disease was known to be endemic to the Jordan Valley and other marshy areas in Palestine.

Several epidemics in which numerous people died of pestilence or plague are mentioned in the OT (Exod. 11:1; 12:13; Num. 14:37; Zech. 14:12). The fifth plague of Egypt (Exod. 9:3–6) has been attributed to Jordan Rift Valley fever, which is spread by flies. Bubonic plague has been blamed for the malady that struck the Philistines (1 Sam. 5–6). However, it may have been the result of a severe form of tropical dysentery. Acute bacillary dysentery contracted in the military camp may also have been responsible for the epidemic that killed a large number of the Assyrian army (2 Kings 19:35).

Parasitic Diseases

Some scholars have repeatedly argued that the “fiery serpents” (NIV: “venomous snakes”) encountered by Moses and the children of Israel (Num. 21:6–9) were in reality an infestation of the parasitic guinea worm (Dracunculus medinensis). Microscopic fleas ingested in drinking water carry the larvae of this slender nematode into the body. The larvae move from the digestive tract to the skin. The adult worm, which may grow to a length of several feet, discharges its eggs into an ulcer on the skin. Death of the host occurs because of the resulting infection of the skin ulcers.

After the conquest of Jericho, Joshua cursed the individual who would endeavor to rebuild the city (Josh. 6:26). Later, Hiel of Bethel attempted to rebuild the city and lost two of his sons as a result of the curse (1 Kings 16:34). Elisha was then asked to purify the bad water at Jericho in order to allow a new settlement (2 Kings 2:19). Elisha obliged by throwing salt into the spring and thereby making the water potable (2:20–22). Recent archaeological study has discovered the remains of certain snails in the mud-bricks used to construct Jericho in the Bronze Age. These types of snails are now known to serve as intermediate hosts for the flatworm parasite that can cause schistosomiasis. The Schistosoma haematobium trematode infects the urinary tract and the bladder. It is possible that this type of parasite was responsible for the death of Hiel’s two sons.

In NT times, Herod Agrippa apparently died of the complications of a parasitic disease, perhaps being infested by the larvae of flies (myiasis) in the bowels. Luke mentions that he was “eaten by worms” (skōlēkobrōtos [Acts 12:23]). The father of Publius also suffered from dysentery (Acts 28:8).

Physical Deformities and Abnormalities

Individuals with deformities were disqualified from priestly service (Lev. 21:18–20). The list included lameness, limb damage, and dwarfism. The deformities mentioned here might have been congenital or acquired. Mephibosheth was dropped by his nurse (2 Sam. 4:4) and perhaps suffered damage to the spinal cord. Jacob possibly sustained injury to an intervertebral disk (Gen. 32:32) causing a deformity and a limp. The woman who was “bent over” (Luke 13:10–17) might have suffered from an abnormality of the spine similar to scoliosis. It is difficult to ascertain the origin of the “shriveled hand” of the unnamed individual healed by Jesus (Matt. 12:10–13; Mark 3:1–5; Luke 6:6–10). It could be congenital in character or a paralysis caused by any number of factors.

Diseases and Disabilities of the Eyes and Ears

Physical blindness is mentioned several times in the Bible. Blindness excluded one from serving as a priest (Lev. 21:18, 20). Blindness and deafness, however, were disabilities requiring special care from the community (Lev. 19:14; Deut. 27:18). The “weak eyes” of Leah may refer to an eye condition (Gen. 29:17).

Blindness in the biblical world was caused by various factors. Leviticus 26:16 speaks of a fever that destroys the eyes. Flies probably were responsible for much of the conjunctivitis found in children. John 9:1 mentions congenital blindness, which Jesus cured using mud made from spittle and dirt (John 9:6). In Mark 8:22–26 Jesus healed a blind man by spitting in his eye and laying hands on him (cf. Matt. 20:34 with Mark 10:52).

Congenital deafness would also be associated with mutism and speech defects because a child learning to speak depends on imitation and mimicry. Jesus healed a man who was deaf and could barely talk (Mark 7:32–37). The man’s inability to say much possibly pointed to a loss of hearing early in life.

Skin Conditions

Various skin and hair abnormalities are described in the Bible. Some made the individual unclean (Lev. 13:30; 14:54). The OT speaks of “the boils of Egypt” (Deut. 28:27; cf. Exod. 9:9). Skin ailments included tumors, festering sores, boils, infections, and the itch (Deut. 28:27, 35; Isa. 3:7). Job complained of a litany of ailments: broken and festering skin (7:5), multiple wounds (9:17), black peeling skin and fever (30:30), gnawing bone pain (2:5; 19:20; 30:17), insomnia (7:3–4), and wasting away (33:21). These symptoms have been diagnosed as indications of yaws or eczema. A poultice made of figs cured Hezekiah’s boil (2 Kings 20:7).

Leprosy was once thought to be a common problem in the biblical world. Leprosy (Hansen’s disease) is a slow, progressive chronic infectious disease caused by a bacterium. Symptoms include loss of sensation and loss of parts of the body. Evidence for this type of disease in Palestine is rare. Uzziah may have had a true case of Hansen’s disease. He was quarantined until the day he died (2 Chron. 26:21).

Scholars now suggest that the symptoms of the disease described in the Bible do not fit this pattern and thus do not signify leprosy (Hansen’s disease) as it is known today. Instead, the word that English versions translate as “leprosy” (Heb. root tsr’) probably refers to different types of infectious skin disease, often characterized by a long-standing, patchy skin condition associated with peeling or flakiness and redness of skin. Evidence points more toward psoriasis, fungal infections, or dermatitis.

This disease could appear in humans (Lev. 14:2), on buildings (14:34), and on clothing (14:55). It was not limited to the extremities but could occur on the head (14:42–44). It could run its course quickly (13:5–8). It made the individual ceremonially unclean, but it was also curable (Lev. 14:3; 2 Kings 5:1–27). Individuals with the disease were not necessarily shunned (2 Kings 7; Matt. 26:6 // Mark 14:3). Moses (Exod. 4:6), Miriam (Num. 12:10), and Naaman experienced this type of skin disease (2 Kings 5:1–27). Jesus healed many suffering from skin ailments (Matt. 8:2–3; Mark 1:40–42; Luke 5:12–13), including the ten “men who had leprosy” (Luke 17:12–14).

Ailments of an Unknown Nature

Some cases in the Bible present insufficient evidence for scholars to render a clear diagnosis. King Asa suffered a disease in his feet (2 Chron. 16:12). However, in the OT the Hebrew expression for “feet” is sometimes used euphemistically for the sexual organs (Judg. 3:24 KJV). Because of this, the exact nature of the disease is ambiguous. Jehoram was afflicted with “an incurable disease of the bowels” (2 Chron. 21:18–19). Other unknown ailments factor in the deaths of the firstborn son of David and Bathsheba (2 Sam. 12:15), of Jeroboam’s son in infancy (1 Kings 14:17), of Elisha (2 Kings 13:14), and of Ezekiel’s wife (Ezek. 24:16).

(Disabilities; Disability; Deformity; Deformities; Sickness] The Bible often speaks of health, healing, disease, and illness. Good health was a sign of God’s favor, and healing was also the work of God and his divinely empowered agents. These agents included the prophets (1 Kings 17:8–23; 2 Kings 5:1–15), the apostles (Acts 3:1–10), and the messiah (Mal. 4:2). The divine prerogative of Jesus was to heal (Mark 1:32; 6:56; Matt. 4:23; 8:16; 15:30; 21:14; Luke 6:10, 17–19), and miraculous healings were a sign of his messianic office (Luke 7:20–23). Disease, on the other hand, was regarded as a sign of God’s disfavor. Within a covenantal context, God could send disease to punish the sinner (Exod. 4:11; 32:35).

The Bible assigns a wide variety of names to various diseases and their symptoms. These terms are nontechnical and generally descriptive. Some are uncertain in meaning. In most cases they describe the symptoms of the disease, not the disease itself. Diagnosis often was based on incomplete observation and nonclinical examination. The Bible also presupposes supernatural intervention in the life of a person. Healing occurred when God’s agents touched individuals, cast out demons, and resurrected the dead.

Ancient Near Eastern Influences

In the ancient Near East the knowledge of disease and medicine was precritical. Bacteria and viruses were virtually unknown. Mesopotamian literature contains many references to medicine, physicians, and medical practice. Minerals, salts, herbs, and other botanicals were used to make up treatments. Babylonian physicians also administered prescriptions accompanied by incantations. Disease was considered to be the result of a violation of a taboo or possession by a demon. The Code of Hammurabi (1750 BC) includes laws regulating the practice of medicine and surgery by physicians. In Egypt medicine and healing were connected to the gods. Tomb paintings and several papyrus documents describe the developing state of Egyptian medicine, pharmacy, and surgery.

Greek physicians admired and sought to learn the skills of the Egyptians. However, the early Greek doctor Hippocrates (460–370 BC), called the “Father of Medicine,” is credited with being the first physician to reject the belief that supernatural or divine forces cause illness. He argued that disease is the result of environmental factors, diet, and living habits, not a punishment imposed by the gods.

It is clear that the biblical world shared with the ancient Near East the same types of maladies common to tropical or subtropical climates. These include malaria, tropical fevers, dysentery, and sunstroke. The tendency of the hot climate to produce frequent droughts and famine certainly contributed to similar types of diseases throughout the Fertile Crescent. Additionally, it must be remembered that Palestine was a land bridge between the Mesopotamian and Egyptian worlds. Migrations carry not only goods and products, but also parasites, communicable disease, and epidemics.

Biblical Concept of Disease

The religious tradition of the Hebrews repudiated the magical or demonic origin of disease. Hence, moral, ethical, and spiritual factors regulated disease and illness. This was true for the individual as well as the community. The Hebrews, like the Egyptians, also recognized that much sickness arose from the individual’s relationship to the physical environment. Great stress was placed on hygiene and preventive medicine.

Pentateuchal legislation offered seven covenantal principles designed to prevent the possibility of disease and sickness: (1) Sabbath observance for humans, animals, and the land, which enforced regular periods of rest (Gen. 2:3); (2) dietary regulations, which divided food into efficient categories of clean and unclean (Lev. 11); (3) circumcision, which carried physical benefits as well as religious and moral implications (Gen. 17:9; circumcision is the only example of Hebrew surgery); (4) laws governing sexual relationships and health, including a list of forbidden degrees of marital relationships (Lev. 18–20); (5) provisions for individual sexual hygiene (Lev. 15); (6) stipulations for cleanliness and bodily purification (Lev. 14:2; 15:2); (7) sanitary and hygienic regulations for camp life (Num. 31:19; Deut. 23:12).

In NT times magical charms and incantations were used along with folk remedies in an effort to cure disease. Jesus repudiated these means. He also suggested that sickness and disease were not direct punishments for sin (John 9:2). In the Sermon on the Mount (Matt. 5–7), Jesus confirmed that the ethical and religious standards of the new covenant promoted the total health of the community and the individual.

Circulatory Diseases

Nabal most likely suffered a cerebrovascular accident or stroke (1 Sam. 25:36–38). After a heavy bout of drinking, his heart “died” (KJV; NIV: “failed”), and he became paralyzed, lapsed into a coma, and died ten days later. Psalm 137:5–6 may contain a clinical example of the symptoms of stroke. The psalmist wrote, “If I forget you, Jerusalem, may my right hand forget its skill. May my tongue cling to the roof of my mouth if I do not remember you.” This description points to a paralysis of the right side of the body (right hemiplegia) and the loss of speech (motor aphasia) that result from a stroke on the left side of the brain. Basically, the exiled psalmist is wishing upon himself the effects of a stroke if he held anything other than Jerusalem as his highest priority. Some have considered the collapse of Uzzah when he reached out to stabilize the ark of the covenant (2 Sam. 6:6–7) to be the consequence of an apoplectic seizure. But since no actual paralysis was described and death occurred immediately, this seems unlikely. It is more probable that God struck him down with an aortic aneurism or a coronary thrombosis.

Paralysis

A possible case of paralysis may be described in the shriveled (atrophic) hand of Jeroboam I (1 Kings 13:4–6). In an angry outburst Jeroboam ordered the arrest of a prophet who condemned the altar at Bethel. When Jeroboam stretched out his hand, it “shriveled up, so that he could not pull it back.” Several complicated diagnoses have been offered to explain the “withered” hand, but it is possibly an example of cataplexy, a sudden loss of muscle power following a strong emotional stimulus. After intercession by the man of God, and the subsiding of the emotional outburst, the arm was restored.

The threat against the faithless shepherd of God’s people (Zech. 11:17), which included a withered arm and blindness in the right eye, may refer to a form of paralysis known as tabes dorsalis, or locomotor ataxia. Knifelike pains in the extremities and blindness characterize this disease.

Paralysis is frequently mentioned in the NT (Matt. 8:6; 9:2, 6; 12:10; Mark 2:3–5, 9, 10; 3:1, 3, 5; Luke 5:18, 24; 6:6; John 5:3; Acts 9:33; Heb. 12:12). The exact diagnosis for each of these cases remains uncertain.

The physician Luke’s use of the Greek medical term paralelymenos (Luke 5:18, 24) suggests that some of these cases were caused by chronic organic disease. Others clearly were congenital (Acts 3:2; cf. 14:8). It is not necessary to rationalize the origin of these examples of paralysis as hysteria or pretense. The NT writers regarded the healing of these individuals by Jesus and the apostles as miraculous.

Mental Illness and Brain Disorders

Cases of mental disease are generally described in the Bible by noting the symptoms produced by the disorder. The particular cause of a mental illness in the NT is often blamed on an unknown evil spirit or spirits (Luke 8:2). Such spirits, however, were subject to God’s control and operated only within the boundaries allowed by him (1 Sam. 16:14–16, 23; 18:10; 19:9). Accordingly, in the OT “madness” and “confusion of mind” were regarded as consequences of covenantal disobedience (Deut. 28:28, 34).

It has been argued that King Saul displayed early indications of personality disorder. Symptoms included pride, self-aggrandizement (1 Sam. 11:6; 13:12; 15:9, 19), and ecstatic behavior (10:11–12). A rapid deterioration in Saul’s character transpired after David was anointed and became more popular (16:14; 18:10–11). Since Saul demonstrated fear, jealousy, a sense of persecution, and homicidal tendencies, some scholars argue that he suffered from paranoid schizophrenia.

Nebuchadnezzar suffered a rare form of monomania in which he lived like a wild beast in the field eating grass (Dan. 4:33). David, in order to save his own life, feigned insanity or perhaps epilepsy before the Philistine king Achish (1 Sam. 21:12–15).

In the NT, individuals with mental disorders went about naked, mutilated themselves, lived in tombs (Mark 5:2), and exhibited violent behavior (Matt. 8:28). Such mental disorientation was often linked to demon possession. Examples include the Syrophoenician’s child (Matt. 15:22; Mark 7:25), the demoniacs at Gerasa (Matt. 8:28; Mark 5:2; Luke 8:27) and Capernaum (Mark 1:23; Luke 4:33), a blind and mute demoniac (Matt. 12:22; Luke 11:14), and a fortune-telling slave girl (Acts 16:16). While such behavior is clinically suggestive of paranoid schizophrenia or other mental disorders, the mind-controlling influence of some extraneous negative force cannot be ruled out.

Epilepsy (grand mal) causes the afflicted person to fall to the ground, foam at the mouth, and clench or grind the teeth (Matt. 17:15; Mark 9:17–18; Luke 9:39). The description of Saul falling to the ground in an ecstatic state (1 Sam. 19:23–24) and Balaam falling with open eyes may be indicative of an epileptic seizure. In the NT, Jesus healed many who suffered from epilepsy (Matt. 4:24; 17:14–18; Mark 9:17–18; Luke 9:38–42). Some scholars have linked the light seen by Paul on the road to Damascus with the aura that some epileptics experience prior to a seizure. His subsequent blindness has also been attributed to the epileptic disturbance of the circulation of the blood in the brain.

Childhood Diseases

The cause of the death of the widow’s son at Zarephath is unknown (1 Kings 17:17–22). The death of the Shunammite woman’s son has been attributed to sunstroke (2 Kings 4:18–37), although a headache is the only symptom recorded (v. 19). In both cases there is too little evidence to present an accurate diagnosis.

In the first case, the boy at Zarephath stopped breathing (1 Kings 17:17). This may leave the door open to argue that Elijah resuscitated the child. However, in the second case, the text clearly states that the Shunammite boy died (2 Kings 4:20), implying a resurrection.

Infectious and Communicable Diseases

Fever and other calamities are listed among the punishments for covenantal infidelity (Deut. 28:22). Three different types of fever may be intentionally described here: “fever,” “inflammation,” and “scorching heat” (ESV: “fiery heat”). Fever is also mentioned frequently in the NT (Matt. 8:15; Mark 1:30–31; Luke 4:38–39; John 4:52; Acts 28:8). Both Jesus and Paul healed individuals who had a fever. A number of these fevers were likely caused by malaria, since the disease was known to be endemic to the Jordan Valley and other marshy areas in Palestine.

Several epidemics in which numerous people died of pestilence or plague are mentioned in the OT (Exod. 11:1; 12:13; Num. 14:37; Zech. 14:12). The fifth plague of Egypt (Exod. 9:3–6) has been attributed to Jordan Rift Valley fever, which is spread by flies. Bubonic plague has been blamed for the malady that struck the Philistines (1 Sam. 5–6). However, it may have been the result of a severe form of tropical dysentery. Acute bacillary dysentery contracted in the military camp may also have been responsible for the epidemic that killed a large number of the Assyrian army (2 Kings 19:35).

Parasitic Diseases

Some scholars have repeatedly argued that the “fiery serpents” (NIV: “venomous snakes”) encountered by Moses and the children of Israel (Num. 21:6–9) were in reality an infestation of the parasitic guinea worm (Dracunculus medinensis). Microscopic fleas ingested in drinking water carry the larvae of this slender nematode into the body. The larvae move from the digestive tract to the skin. The adult worm, which may grow to a length of several feet, discharges its eggs into an ulcer on the skin. Death of the host occurs because of the resulting infection of the skin ulcers.

After the conquest of Jericho, Joshua cursed the individual who would endeavor to rebuild the city (Josh. 6:26). Later, Hiel of Bethel attempted to rebuild the city and lost two of his sons as a result of the curse (1 Kings 16:34). Elisha was then asked to purify the bad water at Jericho in order to allow a new settlement (2 Kings 2:19). Elisha obliged by throwing salt into the spring and thereby making the water potable (2:20–22). Recent archaeological study has discovered the remains of certain snails in the mud-bricks used to construct Jericho in the Bronze Age. These types of snails are now known to serve as intermediate hosts for the flatworm parasite that can cause schistosomiasis. The Schistosoma haematobium trematode infects the urinary tract and the bladder. It is possible that this type of parasite was responsible for the death of Hiel’s two sons.

In NT times, Herod Agrippa apparently died of the complications of a parasitic disease, perhaps being infested by the larvae of flies (myiasis) in the bowels. Luke mentions that he was “eaten by worms” (skōlēkobrōtos [Acts 12:23]). The father of Publius also suffered from dysentery (Acts 28:8).

Physical Deformities and Abnormalities

Individuals with deformities were disqualified from priestly service (Lev. 21:18–20). The list included lameness, limb damage, and dwarfism. The deformities mentioned here might have been congenital or acquired. Mephibosheth was dropped by his nurse (2 Sam. 4:4) and perhaps suffered damage to the spinal cord. Jacob possibly sustained injury to an intervertebral disk (Gen. 32:32) causing a deformity and a limp. The woman who was “bent over” (Luke 13:10–17) might have suffered from an abnormality of the spine similar to scoliosis. It is difficult to ascertain the origin of the “shriveled hand” of the unnamed individual healed by Jesus (Matt. 12:10–13; Mark 3:1–5; Luke 6:6–10). It could be congenital in character or a paralysis caused by any number of factors.

Diseases and Disabilities of the Eyes and Ears

Physical blindness is mentioned several times in the Bible. Blindness excluded one from serving as a priest (Lev. 21:18, 20). Blindness and deafness, however, were disabilities requiring special care from the community (Lev. 19:14; Deut. 27:18). The “weak eyes” of Leah may refer to an eye condition (Gen. 29:17).

Blindness in the biblical world was caused by various factors. Leviticus 26:16 speaks of a fever that destroys the eyes. Flies probably were responsible for much of the conjunctivitis found in children. John 9:1 mentions congenital blindness, which Jesus cured using mud made from spittle and dirt (John 9:6). In Mark 8:22–26 Jesus healed a blind man by spitting in his eye and laying hands on him (cf. Matt. 20:34 with Mark 10:52).

Congenital deafness would also be associated with mutism and speech defects because a child learning to speak depends on imitation and mimicry. Jesus healed a man who was deaf and could barely talk (Mark 7:32–37). The man’s inability to say much possibly pointed to a loss of hearing early in life.

Skin Conditions

Various skin and hair abnormalities are described in the Bible. Some made the individual unclean (Lev. 13:30; 14:54). The OT speaks of “the boils of Egypt” (Deut. 28:27; cf. Exod. 9:9). Skin ailments included tumors, festering sores, boils, infections, and the itch (Deut. 28:27, 35; Isa. 3:7). Job complained of a litany of ailments: broken and festering skin (7:5), multiple wounds (9:17), black peeling skin and fever (30:30), gnawing bone pain (2:5; 19:20; 30:17), insomnia (7:3–4), and wasting away (33:21). These symptoms have been diagnosed as indications of yaws or eczema. A poultice made of figs cured Hezekiah’s boil (2 Kings 20:7).

Leprosy was once thought to be a common problem in the biblical world. Leprosy (Hansen’s disease) is a slow, progressive chronic infectious disease caused by a bacterium. Symptoms include loss of sensation and loss of parts of the body. Evidence for this type of disease in Palestine is rare. Uzziah may have had a true case of Hansen’s disease. He was quarantined until the day he died (2 Chron. 26:21).

Scholars now suggest that the symptoms of the disease described in the Bible do not fit this pattern and thus do not signify leprosy (Hansen’s disease) as it is known today. Instead, the word that English versions translate as “leprosy” (Heb. root tsr’) probably refers to different types of infectious skin disease, often characterized by a long-standing, patchy skin condition associated with peeling or flakiness and redness of skin. Evidence points more toward psoriasis, fungal infections, or dermatitis.

This disease could appear in humans (Lev. 14:2), on buildings (14:34), and on clothing (14:55). It was not limited to the extremities but could occur on the head (14:42–44). It could run its course quickly (13:5–8). It made the individual ceremonially unclean, but it was also curable (Lev. 14:3; 2 Kings 5:1–27). Individuals with the disease were not necessarily shunned (2 Kings 7; Matt. 26:6 // Mark 14:3). Moses (Exod. 4:6), Miriam (Num. 12:10), and Naaman experienced this type of skin disease (2 Kings 5:1–27). Jesus healed many suffering from skin ailments (Matt. 8:2–3; Mark 1:40–42; Luke 5:12–13), including the ten “men who had leprosy” (Luke 17:12–14).

Ailments of an Unknown Nature

Some cases in the Bible present insufficient evidence for scholars to render a clear diagnosis. King Asa suffered a disease in his feet (2 Chron. 16:12). However, in the OT the Hebrew expression for “feet” is sometimes used euphemistically for the sexual organs (Judg. 3:24 KJV). Because of this, the exact nature of the disease is ambiguous. Jehoram was afflicted with “an incurable disease of the bowels” (2 Chron. 21:18–19). Other unknown ailments factor in the deaths of the firstborn son of David and Bathsheba (2 Sam. 12:15), of Jeroboam’s son in infancy (1 Kings 14:17), of Elisha (2 Kings 13:14), and of Ezekiel’s wife (Ezek. 24:16).

(Disabilities; Disability; Deformity; Deformities; Sickness] The Bible often speaks of health, healing, disease, and illness. Good health was a sign of God’s favor, and healing was also the work of God and his divinely empowered agents. These agents included the prophets (1 Kings 17:8–23; 2 Kings 5:1–15), the apostles (Acts 3:1–10), and the messiah (Mal. 4:2). The divine prerogative of Jesus was to heal (Mark 1:32; 6:56; Matt. 4:23; 8:16; 15:30; 21:14; Luke 6:10, 17–19), and miraculous healings were a sign of his messianic office (Luke 7:20–23). Disease, on the other hand, was regarded as a sign of God’s disfavor. Within a covenantal context, God could send disease to punish the sinner (Exod. 4:11; 32:35).

The Bible assigns a wide variety of names to various diseases and their symptoms. These terms are nontechnical and generally descriptive. Some are uncertain in meaning. In most cases they describe the symptoms of the disease, not the disease itself. Diagnosis often was based on incomplete observation and nonclinical examination. The Bible also presupposes supernatural intervention in the life of a person. Healing occurred when God’s agents touched individuals, cast out demons, and resurrected the dead.

Ancient Near Eastern Influences

In the ancient Near East the knowledge of disease and medicine was precritical. Bacteria and viruses were virtually unknown. Mesopotamian literature contains many references to medicine, physicians, and medical practice. Minerals, salts, herbs, and other botanicals were used to make up treatments. Babylonian physicians also administered prescriptions accompanied by incantations. Disease was considered to be the result of a violation of a taboo or possession by a demon. The Code of Hammurabi (1750 BC) includes laws regulating the practice of medicine and surgery by physicians. In Egypt medicine and healing were connected to the gods. Tomb paintings and several papyrus documents describe the developing state of Egyptian medicine, pharmacy, and surgery.

Greek physicians admired and sought to learn the skills of the Egyptians. However, the early Greek doctor Hippocrates (460–370 BC), called the “Father of Medicine,” is credited with being the first physician to reject the belief that supernatural or divine forces cause illness. He argued that disease is the result of environmental factors, diet, and living habits, not a punishment imposed by the gods.

It is clear that the biblical world shared with the ancient Near East the same types of maladies common to tropical or subtropical climates. These include malaria, tropical fevers, dysentery, and sunstroke. The tendency of the hot climate to produce frequent droughts and famine certainly contributed to similar types of diseases throughout the Fertile Crescent. Additionally, it must be remembered that Palestine was a land bridge between the Mesopotamian and Egyptian worlds. Migrations carry not only goods and products, but also parasites, communicable disease, and epidemics.

Biblical Concept of Disease

The religious tradition of the Hebrews repudiated the magical or demonic origin of disease. Hence, moral, ethical, and spiritual factors regulated disease and illness. This was true for the individual as well as the community. The Hebrews, like the Egyptians, also recognized that much sickness arose from the individual’s relationship to the physical environment. Great stress was placed on hygiene and preventive medicine.

Pentateuchal legislation offered seven covenantal principles designed to prevent the possibility of disease and sickness: (1) Sabbath observance for humans, animals, and the land, which enforced regular periods of rest (Gen. 2:3); (2) dietary regulations, which divided food into efficient categories of clean and unclean (Lev. 11); (3) circumcision, which carried physical benefits as well as religious and moral implications (Gen. 17:9; circumcision is the only example of Hebrew surgery); (4) laws governing sexual relationships and health, including a list of forbidden degrees of marital relationships (Lev. 18–20); (5) provisions for individual sexual hygiene (Lev. 15); (6) stipulations for cleanliness and bodily purification (Lev. 14:2; 15:2); (7) sanitary and hygienic regulations for camp life (Num. 31:19; Deut. 23:12).

In NT times magical charms and incantations were used along with folk remedies in an effort to cure disease. Jesus repudiated these means. He also suggested that sickness and disease were not direct punishments for sin (John 9:2). In the Sermon on the Mount (Matt. 5–7), Jesus confirmed that the ethical and religious standards of the new covenant promoted the total health of the community and the individual.

Circulatory Diseases

Nabal most likely suffered a cerebrovascular accident or stroke (1 Sam. 25:36–38). After a heavy bout of drinking, his heart “died” (KJV; NIV: “failed”), and he became paralyzed, lapsed into a coma, and died ten days later. Psalm 137:5–6 may contain a clinical example of the symptoms of stroke. The psalmist wrote, “If I forget you, Jerusalem, may my right hand forget its skill. May my tongue cling to the roof of my mouth if I do not remember you.” This description points to a paralysis of the right side of the body (right hemiplegia) and the loss of speech (motor aphasia) that result from a stroke on the left side of the brain. Basically, the exiled psalmist is wishing upon himself the effects of a stroke if he held anything other than Jerusalem as his highest priority. Some have considered the collapse of Uzzah when he reached out to stabilize the ark of the covenant (2 Sam. 6:6–7) to be the consequence of an apoplectic seizure. But since no actual paralysis was described and death occurred immediately, this seems unlikely. It is more probable that God struck him down with an aortic aneurism or a coronary thrombosis.

Paralysis

A possible case of paralysis may be described in the shriveled (atrophic) hand of Jeroboam I (1 Kings 13:4–6). In an angry outburst Jeroboam ordered the arrest of a prophet who condemned the altar at Bethel. When Jeroboam stretched out his hand, it “shriveled up, so that he could not pull it back.” Several complicated diagnoses have been offered to explain the “withered” hand, but it is possibly an example of cataplexy, a sudden loss of muscle power following a strong emotional stimulus. After intercession by the man of God, and the subsiding of the emotional outburst, the arm was restored.

The threat against the faithless shepherd of God’s people (Zech. 11:17), which included a withered arm and blindness in the right eye, may refer to a form of paralysis known as tabes dorsalis, or locomotor ataxia. Knifelike pains in the extremities and blindness characterize this disease.

Paralysis is frequently mentioned in the NT (Matt. 8:6; 9:2, 6; 12:10; Mark 2:3–5, 9, 10; 3:1, 3, 5; Luke 5:18, 24; 6:6; John 5:3; Acts 9:33; Heb. 12:12). The exact diagnosis for each of these cases remains uncertain.

The physician Luke’s use of the Greek medical term paralelymenos (Luke 5:18, 24) suggests that some of these cases were caused by chronic organic disease. Others clearly were congenital (Acts 3:2; cf. 14:8). It is not necessary to rationalize the origin of these examples of paralysis as hysteria or pretense. The NT writers regarded the healing of these individuals by Jesus and the apostles as miraculous.

Mental Illness and Brain Disorders

Cases of mental disease are generally described in the Bible by noting the symptoms produced by the disorder. The particular cause of a mental illness in the NT is often blamed on an unknown evil spirit or spirits (Luke 8:2). Such spirits, however, were subject to God’s control and operated only within the boundaries allowed by him (1 Sam. 16:14–16, 23; 18:10; 19:9). Accordingly, in the OT “madness” and “confusion of mind” were regarded as consequences of covenantal disobedience (Deut. 28:28, 34).

It has been argued that King Saul displayed early indications of personality disorder. Symptoms included pride, self-aggrandizement (1 Sam. 11:6; 13:12; 15:9, 19), and ecstatic behavior (10:11–12). A rapid deterioration in Saul’s character transpired after David was anointed and became more popular (16:14; 18:10–11). Since Saul demonstrated fear, jealousy, a sense of persecution, and homicidal tendencies, some scholars argue that he suffered from paranoid schizophrenia.

Nebuchadnezzar suffered a rare form of monomania in which he lived like a wild beast in the field eating grass (Dan. 4:33). David, in order to save his own life, feigned insanity or perhaps epilepsy before the Philistine king Achish (1 Sam. 21:12–15).

In the NT, individuals with mental disorders went about naked, mutilated themselves, lived in tombs (Mark 5:2), and exhibited violent behavior (Matt. 8:28). Such mental disorientation was often linked to demon possession. Examples include the Syrophoenician’s child (Matt. 15:22; Mark 7:25), the demoniacs at Gerasa (Matt. 8:28; Mark 5:2; Luke 8:27) and Capernaum (Mark 1:23; Luke 4:33), a blind and mute demoniac (Matt. 12:22; Luke 11:14), and a fortune-telling slave girl (Acts 16:16). While such behavior is clinically suggestive of paranoid schizophrenia or other mental disorders, the mind-controlling influence of some extraneous negative force cannot be ruled out.

Epilepsy (grand mal) causes the afflicted person to fall to the ground, foam at the mouth, and clench or grind the teeth (Matt. 17:15; Mark 9:17–18; Luke 9:39). The description of Saul falling to the ground in an ecstatic state (1 Sam. 19:23–24) and Balaam falling with open eyes may be indicative of an epileptic seizure. In the NT, Jesus healed many who suffered from epilepsy (Matt. 4:24; 17:14–18; Mark 9:17–18; Luke 9:38–42). Some scholars have linked the light seen by Paul on the road to Damascus with the aura that some epileptics experience prior to a seizure. His subsequent blindness has also been attributed to the epileptic disturbance of the circulation of the blood in the brain.

Childhood Diseases

The cause of the death of the widow’s son at Zarephath is unknown (1 Kings 17:17–22). The death of the Shunammite woman’s son has been attributed to sunstroke (2 Kings 4:18–37), although a headache is the only symptom recorded (v. 19). In both cases there is too little evidence to present an accurate diagnosis.

In the first case, the boy at Zarephath stopped breathing (1 Kings 17:17). This may leave the door open to argue that Elijah resuscitated the child. However, in the second case, the text clearly states that the Shunammite boy died (2 Kings 4:20), implying a resurrection.

Infectious and Communicable Diseases

Fever and other calamities are listed among the punishments for covenantal infidelity (Deut. 28:22). Three different types of fever may be intentionally described here: “fever,” “inflammation,” and “scorching heat” (ESV: “fiery heat”). Fever is also mentioned frequently in the NT (Matt. 8:15; Mark 1:30–31; Luke 4:38–39; John 4:52; Acts 28:8). Both Jesus and Paul healed individuals who had a fever. A number of these fevers were likely caused by malaria, since the disease was known to be endemic to the Jordan Valley and other marshy areas in Palestine.

Several epidemics in which numerous people died of pestilence or plague are mentioned in the OT (Exod. 11:1; 12:13; Num. 14:37; Zech. 14:12). The fifth plague of Egypt (Exod. 9:3–6) has been attributed to Jordan Rift Valley fever, which is spread by flies. Bubonic plague has been blamed for the malady that struck the Philistines (1 Sam. 5–6). However, it may have been the result of a severe form of tropical dysentery. Acute bacillary dysentery contracted in the military camp may also have been responsible for the epidemic that killed a large number of the Assyrian army (2 Kings 19:35).

Parasitic Diseases

Some scholars have repeatedly argued that the “fiery serpents” (NIV: “venomous snakes”) encountered by Moses and the children of Israel (Num. 21:6–9) were in reality an infestation of the parasitic guinea worm (Dracunculus medinensis). Microscopic fleas ingested in drinking water carry the larvae of this slender nematode into the body. The larvae move from the digestive tract to the skin. The adult worm, which may grow to a length of several feet, discharges its eggs into an ulcer on the skin. Death of the host occurs because of the resulting infection of the skin ulcers.

After the conquest of Jericho, Joshua cursed the individual who would endeavor to rebuild the city (Josh. 6:26). Later, Hiel of Bethel attempted to rebuild the city and lost two of his sons as a result of the curse (1 Kings 16:34). Elisha was then asked to purify the bad water at Jericho in order to allow a new settlement (2 Kings 2:19). Elisha obliged by throwing salt into the spring and thereby making the water potable (2:20–22). Recent archaeological study has discovered the remains of certain snails in the mud-bricks used to construct Jericho in the Bronze Age. These types of snails are now known to serve as intermediate hosts for the flatworm parasite that can cause schistosomiasis. The Schistosoma haematobium trematode infects the urinary tract and the bladder. It is possible that this type of parasite was responsible for the death of Hiel’s two sons.

In NT times, Herod Agrippa apparently died of the complications of a parasitic disease, perhaps being infested by the larvae of flies (myiasis) in the bowels. Luke mentions that he was “eaten by worms” (skōlēkobrōtos [Acts 12:23]). The father of Publius also suffered from dysentery (Acts 28:8).

Physical Deformities and Abnormalities

Individuals with deformities were disqualified from priestly service (Lev. 21:18–20). The list included lameness, limb damage, and dwarfism. The deformities mentioned here might have been congenital or acquired. Mephibosheth was dropped by his nurse (2 Sam. 4:4) and perhaps suffered damage to the spinal cord. Jacob possibly sustained injury to an intervertebral disk (Gen. 32:32) causing a deformity and a limp. The woman who was “bent over” (Luke 13:10–17) might have suffered from an abnormality of the spine similar to scoliosis. It is difficult to ascertain the origin of the “shriveled hand” of the unnamed individual healed by Jesus (Matt. 12:10–13; Mark 3:1–5; Luke 6:6–10). It could be congenital in character or a paralysis caused by any number of factors.

Diseases and Disabilities of the Eyes and Ears

Physical blindness is mentioned several times in the Bible. Blindness excluded one from serving as a priest (Lev. 21:18, 20). Blindness and deafness, however, were disabilities requiring special care from the community (Lev. 19:14; Deut. 27:18). The “weak eyes” of Leah may refer to an eye condition (Gen. 29:17).

Blindness in the biblical world was caused by various factors. Leviticus 26:16 speaks of a fever that destroys the eyes. Flies probably were responsible for much of the conjunctivitis found in children. John 9:1 mentions congenital blindness, which Jesus cured using mud made from spittle and dirt (John 9:6). In Mark 8:22–26 Jesus healed a blind man by spitting in his eye and laying hands on him (cf. Matt. 20:34 with Mark 10:52).

Congenital deafness would also be associated with mutism and speech defects because a child learning to speak depends on imitation and mimicry. Jesus healed a man who was deaf and could barely talk (Mark 7:32–37). The man’s inability to say much possibly pointed to a loss of hearing early in life.

Skin Conditions

Various skin and hair abnormalities are described in the Bible. Some made the individual unclean (Lev. 13:30; 14:54). The OT speaks of “the boils of Egypt” (Deut. 28:27; cf. Exod. 9:9). Skin ailments included tumors, festering sores, boils, infections, and the itch (Deut. 28:27, 35; Isa. 3:7). Job complained of a litany of ailments: broken and festering skin (7:5), multiple wounds (9:17), black peeling skin and fever (30:30), gnawing bone pain (2:5; 19:20; 30:17), insomnia (7:3–4), and wasting away (33:21). These symptoms have been diagnosed as indications of yaws or eczema. A poultice made of figs cured Hezekiah’s boil (2 Kings 20:7).

Leprosy was once thought to be a common problem in the biblical world. Leprosy (Hansen’s disease) is a slow, progressive chronic infectious disease caused by a bacterium. Symptoms include loss of sensation and loss of parts of the body. Evidence for this type of disease in Palestine is rare. Uzziah may have had a true case of Hansen’s disease. He was quarantined until the day he died (2 Chron. 26:21).

Scholars now suggest that the symptoms of the disease described in the Bible do not fit this pattern and thus do not signify leprosy (Hansen’s disease) as it is known today. Instead, the word that English versions translate as “leprosy” (Heb. root tsr’) probably refers to different types of infectious skin disease, often characterized by a long-standing, patchy skin condition associated with peeling or flakiness and redness of skin. Evidence points more toward psoriasis, fungal infections, or dermatitis.

This disease could appear in humans (Lev. 14:2), on buildings (14:34), and on clothing (14:55). It was not limited to the extremities but could occur on the head (14:42–44). It could run its course quickly (13:5–8). It made the individual ceremonially unclean, but it was also curable (Lev. 14:3; 2 Kings 5:1–27). Individuals with the disease were not necessarily shunned (2 Kings 7; Matt. 26:6 // Mark 14:3). Moses (Exod. 4:6), Miriam (Num. 12:10), and Naaman experienced this type of skin disease (2 Kings 5:1–27). Jesus healed many suffering from skin ailments (Matt. 8:2–3; Mark 1:40–42; Luke 5:12–13), including the ten “men who had leprosy” (Luke 17:12–14).

Ailments of an Unknown Nature

Some cases in the Bible present insufficient evidence for scholars to render a clear diagnosis. King Asa suffered a disease in his feet (2 Chron. 16:12). However, in the OT the Hebrew expression for “feet” is sometimes used euphemistically for the sexual organs (Judg. 3:24 KJV). Because of this, the exact nature of the disease is ambiguous. Jehoram was afflicted with “an incurable disease of the bowels” (2 Chron. 21:18–19). Other unknown ailments factor in the deaths of the firstborn son of David and Bathsheba (2 Sam. 12:15), of Jeroboam’s son in infancy (1 Kings 14:17), of Elisha (2 Kings 13:14), and of Ezekiel’s wife (Ezek. 24:16).

A transliteration of the Greek word synagōgē, meaning “gathering, assembly, meeting.” In English, the word “synagogue” refers either to a Jewish congregation or to the place where that congregation meets. Synagogues of the biblical era functioned as both religious and civic centers for the Jewish community.

Origins

The origin of synagogues is uncertain. The earliest archaeological evidence is from Egypt in the third century BC, consisting of inscriptions and a papyrus letter. The oldest architectural find is from the island of Delos in the Aegean Sea, although whether this was constructed as a synagogue or redesigned into one is unknown, as is whether it was Jewish or Samaritan. The oldest structures yet found in Israel consist of two rooms at Qumran and the synagogue at Gamla, which date from the late first century BC. In Capernaum, the basalt synagogue was built by a Gentile centurion for the community in the first century AD (Luke 7:1–5).

By that time, synagogues were well attested in Israel, elsewhere in the Roman Empire, and in Egypt (Matt. 4:23; Luke 4:44; Acts 9:2; 17:10, 16–17; 18:8, 19). Synagogues were found wherever there were communities of Jews, in cities and rural areas alike. Especially in Diaspora settings or remote locations, they were the heart of Jewish life. Several hypotheses have been suggested to account for their apparently sudden appearance.

Some believe that synagogues were developed during the Babylonian captivity as the response of the exile community to the destruction of their temple and sacrificial system. Despite these enormous losses, the Jews still had the Torah, and from that point forward worship and prayer based on the reading and studying of the Scriptures, which could be done locally, began to gain ascendancy. Critics of this idea, however, point out that while it makes sense, there is no direct evidence to support it.

Others think that the spread of Hellenism in the second century BC precipitated a crisis of identity among Jews. For example, 1 Maccabees reports with distress that some Jews had abandoned the covenant and teamed with the Hellenists, even going so far as to build a Greek-style gymnasium in Jerusalem (1:11–15). Thus, the thought is that synagogues were a form of resistance to the overwhelming and perversely appealing cultural changes of the day.

More recently, it has been suggested that synagogues were the gradual successors to functions that had previously taken place at city gates. First-century synagogues served a wide range of functions for the community. Throughout Israel’s prior history, however, these same activities—assembly, legal, social, educational, and religious—had taken place at the city gate (Deut. 12:15; 2 Sam. 15:2; 2 Kings 23:8; Neh. 8:1–8). The Gamla synagogue sits against the east city wall next to a probable gate, and its location could be evidence of the slow development of the synagogue as city gates changed from multipurpose facilities to portals of ingress and egress.

First-Century Synagogues

First-century synagogues served as integrated centers supporting Jewish life. Regular communal reading and exposition of Scripture, including teaching and discussion of the law and transmission of its complex associated traditions (Luke 4:16; Acts 13:14–15), occurred there. Although formal liturgical rites evolved after the destruction of the temple in AD 70, synagogues were places of prayer in the first century (Matt. 6:5). Synagogues also served as courtrooms and places where crimes were punished (Acts 22:19), as well as locations for common meals and festivals (see Acts 6:2).

Synagogues were administered by local community leaders, including a president and a board (Acts 13:15). Synagogue leaders named in the NT include Jairus (Mark 5:22; Luke 8:41), Crispus (Acts 18:8), and Sosthenes (Acts 18:17). The role of the leader was to preside over services, to rule as the judge in court cases, to represent the community, and often to act as a patron. The board served in an advisory role and assisted with teaching. A scribe maintained community records and taught.

Congregations included Pharisees, who advocated strict adherence to the law, although they were chided by Jesus for their false piety (Luke 11:42–44). Women participated in the synagogue along with the men, and in some cases they were financial donors (cf. Luke 8:3). God-fearing Gentiles were welcomed (Acts 17:17). In Jerusalem, synagogues included both Hebrews and Jews from the Diaspora (Acts 6:1, 9).

A synagogue could be a designated room in a house or a discrete building. Most of the better archaeological evidence is later than the first century and reveals more clearly religious intentionality in design than may have been characteristic earlier. This evidence includes the door facing Jerusalem, artistic temple motifs, a niche for the Torah scrolls, and perimeter bench seating around an open central hall.

The Synagogue in the Bible

Since synagogues were institutions with a documented history no earlier than the third century BC, they are not mentioned in the OT. The Greek word from which the English one is derived does appear frequently in the LXX, but always with a general reference to a gathering, assembly, or meeting.

Rabbinic history (but not Scripture) makes reference to the “Great Synagogue,” meaning a group of men who transmitted traditions from the prophets to the earliest named rabbinic teachers. It is loosely based on Neh. 8–10, which describes the prayers and actions of the Jewish leaders who had returned from exile.

Synagogues frequently were locations of the teaching and healing ministry of Jesus. He began preaching the kingdom of God, teaching, and performing healing miracles in Galilean synagogues (Matt. 4:23; 9:35; 12:9; 13:54; Mark 1:21–29, 39; 3:1; 6:2; Luke 4:15–38, 44; 6:6–11; 13:10–17; John 6:59; 18:20). Later, the apostle Paul customarily initiated his mission work in the local synagogue at each of his destinations (Acts 9:19–20; 13:5, 14–15; 14:1; 17:1, 10, 17; 18:1–8; 19:8).

The last (and, from a twenty-first-century perspective, most controversial) use of the word “synagogue” in Scripture is the difficult phrase “synagogue of Satan” (Rev. 2:9; 3:9), which must be read in its context. This was written in response to the significant persecution in Asia Minor of the churches at Smyrna and Philadelphia by Jews who were in collusion with the Roman authorities. They were falsely accusing Jewish and Gentile Christian believers, creating unspeakable suffering for them. This phrase, intended to encourage Christian perseverance, implies that the churches in view represented true Israel, while their accusers were false Jews. Similar language was used by the covenant-keeping community in Qumran when, in the DSS, it referred to apostate Jews as a “congregation of Belial” and an “assembly of hypocrites” (1QHa 10:22; 15:34).

(Disabilities; Disability; Deformity; Deformities; Sickness] The Bible often speaks of health, healing, disease, and illness. Good health was a sign of God’s favor, and healing was also the work of God and his divinely empowered agents. These agents included the prophets (1 Kings 17:8–23; 2 Kings 5:1–15), the apostles (Acts 3:1–10), and the messiah (Mal. 4:2). The divine prerogative of Jesus was to heal (Mark 1:32; 6:56; Matt. 4:23; 8:16; 15:30; 21:14; Luke 6:10, 17–19), and miraculous healings were a sign of his messianic office (Luke 7:20–23). Disease, on the other hand, was regarded as a sign of God’s disfavor. Within a covenantal context, God could send disease to punish the sinner (Exod. 4:11; 32:35).

The Bible assigns a wide variety of names to various diseases and their symptoms. These terms are nontechnical and generally descriptive. Some are uncertain in meaning. In most cases they describe the symptoms of the disease, not the disease itself. Diagnosis often was based on incomplete observation and nonclinical examination. The Bible also presupposes supernatural intervention in the life of a person. Healing occurred when God’s agents touched individuals, cast out demons, and resurrected the dead.

Ancient Near Eastern Influences

In the ancient Near East the knowledge of disease and medicine was precritical. Bacteria and viruses were virtually unknown. Mesopotamian literature contains many references to medicine, physicians, and medical practice. Minerals, salts, herbs, and other botanicals were used to make up treatments. Babylonian physicians also administered prescriptions accompanied by incantations. Disease was considered to be the result of a violation of a taboo or possession by a demon. The Code of Hammurabi (1750 BC) includes laws regulating the practice of medicine and surgery by physicians. In Egypt medicine and healing were connected to the gods. Tomb paintings and several papyrus documents describe the developing state of Egyptian medicine, pharmacy, and surgery.

Greek physicians admired and sought to learn the skills of the Egyptians. However, the early Greek doctor Hippocrates (460–370 BC), called the “Father of Medicine,” is credited with being the first physician to reject the belief that supernatural or divine forces cause illness. He argued that disease is the result of environmental factors, diet, and living habits, not a punishment imposed by the gods.

It is clear that the biblical world shared with the ancient Near East the same types of maladies common to tropical or subtropical climates. These include malaria, tropical fevers, dysentery, and sunstroke. The tendency of the hot climate to produce frequent droughts and famine certainly contributed to similar types of diseases throughout the Fertile Crescent. Additionally, it must be remembered that Palestine was a land bridge between the Mesopotamian and Egyptian worlds. Migrations carry not only goods and products, but also parasites, communicable disease, and epidemics.

Biblical Concept of Disease

The religious tradition of the Hebrews repudiated the magical or demonic origin of disease. Hence, moral, ethical, and spiritual factors regulated disease and illness. This was true for the individual as well as the community. The Hebrews, like the Egyptians, also recognized that much sickness arose from the individual’s relationship to the physical environment. Great stress was placed on hygiene and preventive medicine.

Pentateuchal legislation offered seven covenantal principles designed to prevent the possibility of disease and sickness: (1) Sabbath observance for humans, animals, and the land, which enforced regular periods of rest (Gen. 2:3); (2) dietary regulations, which divided food into efficient categories of clean and unclean (Lev. 11); (3) circumcision, which carried physical benefits as well as religious and moral implications (Gen. 17:9; circumcision is the only example of Hebrew surgery); (4) laws governing sexual relationships and health, including a list of forbidden degrees of marital relationships (Lev. 18–20); (5) provisions for individual sexual hygiene (Lev. 15); (6) stipulations for cleanliness and bodily purification (Lev. 14:2; 15:2); (7) sanitary and hygienic regulations for camp life (Num. 31:19; Deut. 23:12).

In NT times magical charms and incantations were used along with folk remedies in an effort to cure disease. Jesus repudiated these means. He also suggested that sickness and disease were not direct punishments for sin (John 9:2). In the Sermon on the Mount (Matt. 5–7), Jesus confirmed that the ethical and religious standards of the new covenant promoted the total health of the community and the individual.

Circulatory Diseases

Nabal most likely suffered a cerebrovascular accident or stroke (1 Sam. 25:36–38). After a heavy bout of drinking, his heart “died” (KJV; NIV: “failed”), and he became paralyzed, lapsed into a coma, and died ten days later. Psalm 137:5–6 may contain a clinical example of the symptoms of stroke. The psalmist wrote, “If I forget you, Jerusalem, may my right hand forget its skill. May my tongue cling to the roof of my mouth if I do not remember you.” This description points to a paralysis of the right side of the body (right hemiplegia) and the loss of speech (motor aphasia) that result from a stroke on the left side of the brain. Basically, the exiled psalmist is wishing upon himself the effects of a stroke if he held anything other than Jerusalem as his highest priority. Some have considered the collapse of Uzzah when he reached out to stabilize the ark of the covenant (2 Sam. 6:6–7) to be the consequence of an apoplectic seizure. But since no actual paralysis was described and death occurred immediately, this seems unlikely. It is more probable that God struck him down with an aortic aneurism or a coronary thrombosis.

Paralysis

A possible case of paralysis may be described in the shriveled (atrophic) hand of Jeroboam I (1 Kings 13:4–6). In an angry outburst Jeroboam ordered the arrest of a prophet who condemned the altar at Bethel. When Jeroboam stretched out his hand, it “shriveled up, so that he could not pull it back.” Several complicated diagnoses have been offered to explain the “withered” hand, but it is possibly an example of cataplexy, a sudden loss of muscle power following a strong emotional stimulus. After intercession by the man of God, and the subsiding of the emotional outburst, the arm was restored.

The threat against the faithless shepherd of God’s people (Zech. 11:17), which included a withered arm and blindness in the right eye, may refer to a form of paralysis known as tabes dorsalis, or locomotor ataxia. Knifelike pains in the extremities and blindness characterize this disease.

Paralysis is frequently mentioned in the NT (Matt. 8:6; 9:2, 6; 12:10; Mark 2:3–5, 9, 10; 3:1, 3, 5; Luke 5:18, 24; 6:6; John 5:3; Acts 9:33; Heb. 12:12). The exact diagnosis for each of these cases remains uncertain.

The physician Luke’s use of the Greek medical term paralelymenos (Luke 5:18, 24) suggests that some of these cases were caused by chronic organic disease. Others clearly were congenital (Acts 3:2; cf. 14:8). It is not necessary to rationalize the origin of these examples of paralysis as hysteria or pretense. The NT writers regarded the healing of these individuals by Jesus and the apostles as miraculous.

Mental Illness and Brain Disorders

Cases of mental disease are generally described in the Bible by noting the symptoms produced by the disorder. The particular cause of a mental illness in the NT is often blamed on an unknown evil spirit or spirits (Luke 8:2). Such spirits, however, were subject to God’s control and operated only within the boundaries allowed by him (1 Sam. 16:14–16, 23; 18:10; 19:9). Accordingly, in the OT “madness” and “confusion of mind” were regarded as consequences of covenantal disobedience (Deut. 28:28, 34).

It has been argued that King Saul displayed early indications of personality disorder. Symptoms included pride, self-aggrandizement (1 Sam. 11:6; 13:12; 15:9, 19), and ecstatic behavior (10:11–12). A rapid deterioration in Saul’s character transpired after David was anointed and became more popular (16:14; 18:10–11). Since Saul demonstrated fear, jealousy, a sense of persecution, and homicidal tendencies, some scholars argue that he suffered from paranoid schizophrenia.

Nebuchadnezzar suffered a rare form of monomania in which he lived like a wild beast in the field eating grass (Dan. 4:33). David, in order to save his own life, feigned insanity or perhaps epilepsy before the Philistine king Achish (1 Sam. 21:12–15).

In the NT, individuals with mental disorders went about naked, mutilated themselves, lived in tombs (Mark 5:2), and exhibited violent behavior (Matt. 8:28). Such mental disorientation was often linked to demon possession. Examples include the Syrophoenician’s child (Matt. 15:22; Mark 7:25), the demoniacs at Gerasa (Matt. 8:28; Mark 5:2; Luke 8:27) and Capernaum (Mark 1:23; Luke 4:33), a blind and mute demoniac (Matt. 12:22; Luke 11:14), and a fortune-telling slave girl (Acts 16:16). While such behavior is clinically suggestive of paranoid schizophrenia or other mental disorders, the mind-controlling influence of some extraneous negative force cannot be ruled out.

Epilepsy (grand mal) causes the afflicted person to fall to the ground, foam at the mouth, and clench or grind the teeth (Matt. 17:15; Mark 9:17–18; Luke 9:39). The description of Saul falling to the ground in an ecstatic state (1 Sam. 19:23–24) and Balaam falling with open eyes may be indicative of an epileptic seizure. In the NT, Jesus healed many who suffered from epilepsy (Matt. 4:24; 17:14–18; Mark 9:17–18; Luke 9:38–42). Some scholars have linked the light seen by Paul on the road to Damascus with the aura that some epileptics experience prior to a seizure. His subsequent blindness has also been attributed to the epileptic disturbance of the circulation of the blood in the brain.

Childhood Diseases

The cause of the death of the widow’s son at Zarephath is unknown (1 Kings 17:17–22). The death of the Shunammite woman’s son has been attributed to sunstroke (2 Kings 4:18–37), although a headache is the only symptom recorded (v. 19). In both cases there is too little evidence to present an accurate diagnosis.

In the first case, the boy at Zarephath stopped breathing (1 Kings 17:17). This may leave the door open to argue that Elijah resuscitated the child. However, in the second case, the text clearly states that the Shunammite boy died (2 Kings 4:20), implying a resurrection.

Infectious and Communicable Diseases

Fever and other calamities are listed among the punishments for covenantal infidelity (Deut. 28:22). Three different types of fever may be intentionally described here: “fever,” “inflammation,” and “scorching heat” (ESV: “fiery heat”). Fever is also mentioned frequently in the NT (Matt. 8:15; Mark 1:30–31; Luke 4:38–39; John 4:52; Acts 28:8). Both Jesus and Paul healed individuals who had a fever. A number of these fevers were likely caused by malaria, since the disease was known to be endemic to the Jordan Valley and other marshy areas in Palestine.

Several epidemics in which numerous people died of pestilence or plague are mentioned in the OT (Exod. 11:1; 12:13; Num. 14:37; Zech. 14:12). The fifth plague of Egypt (Exod. 9:3–6) has been attributed to Jordan Rift Valley fever, which is spread by flies. Bubonic plague has been blamed for the malady that struck the Philistines (1 Sam. 5–6). However, it may have been the result of a severe form of tropical dysentery. Acute bacillary dysentery contracted in the military camp may also have been responsible for the epidemic that killed a large number of the Assyrian army (2 Kings 19:35).

Parasitic Diseases

Some scholars have repeatedly argued that the “fiery serpents” (NIV: “venomous snakes”) encountered by Moses and the children of Israel (Num. 21:6–9) were in reality an infestation of the parasitic guinea worm (Dracunculus medinensis). Microscopic fleas ingested in drinking water carry the larvae of this slender nematode into the body. The larvae move from the digestive tract to the skin. The adult worm, which may grow to a length of several feet, discharges its eggs into an ulcer on the skin. Death of the host occurs because of the resulting infection of the skin ulcers.

After the conquest of Jericho, Joshua cursed the individual who would endeavor to rebuild the city (Josh. 6:26). Later, Hiel of Bethel attempted to rebuild the city and lost two of his sons as a result of the curse (1 Kings 16:34). Elisha was then asked to purify the bad water at Jericho in order to allow a new settlement (2 Kings 2:19). Elisha obliged by throwing salt into the spring and thereby making the water potable (2:20–22). Recent archaeological study has discovered the remains of certain snails in the mud-bricks used to construct Jericho in the Bronze Age. These types of snails are now known to serve as intermediate hosts for the flatworm parasite that can cause schistosomiasis. The Schistosoma haematobium trematode infects the urinary tract and the bladder. It is possible that this type of parasite was responsible for the death of Hiel’s two sons.

In NT times, Herod Agrippa apparently died of the complications of a parasitic disease, perhaps being infested by the larvae of flies (myiasis) in the bowels. Luke mentions that he was “eaten by worms” (skōlēkobrōtos [Acts 12:23]). The father of Publius also suffered from dysentery (Acts 28:8).

Physical Deformities and Abnormalities

Individuals with deformities were disqualified from priestly service (Lev. 21:18–20). The list included lameness, limb damage, and dwarfism. The deformities mentioned here might have been congenital or acquired. Mephibosheth was dropped by his nurse (2 Sam. 4:4) and perhaps suffered damage to the spinal cord. Jacob possibly sustained injury to an intervertebral disk (Gen. 32:32) causing a deformity and a limp. The woman who was “bent over” (Luke 13:10–17) might have suffered from an abnormality of the spine similar to scoliosis. It is difficult to ascertain the origin of the “shriveled hand” of the unnamed individual healed by Jesus (Matt. 12:10–13; Mark 3:1–5; Luke 6:6–10). It could be congenital in character or a paralysis caused by any number of factors.

Diseases and Disabilities of the Eyes and Ears

Physical blindness is mentioned several times in the Bible. Blindness excluded one from serving as a priest (Lev. 21:18, 20). Blindness and deafness, however, were disabilities requiring special care from the community (Lev. 19:14; Deut. 27:18). The “weak eyes” of Leah may refer to an eye condition (Gen. 29:17).

Blindness in the biblical world was caused by various factors. Leviticus 26:16 speaks of a fever that destroys the eyes. Flies probably were responsible for much of the conjunctivitis found in children. John 9:1 mentions congenital blindness, which Jesus cured using mud made from spittle and dirt (John 9:6). In Mark 8:22–26 Jesus healed a blind man by spitting in his eye and laying hands on him (cf. Matt. 20:34 with Mark 10:52).

Congenital deafness would also be associated with mutism and speech defects because a child learning to speak depends on imitation and mimicry. Jesus healed a man who was deaf and could barely talk (Mark 7:32–37). The man’s inability to say much possibly pointed to a loss of hearing early in life.

Skin Conditions

Various skin and hair abnormalities are described in the Bible. Some made the individual unclean (Lev. 13:30; 14:54). The OT speaks of “the boils of Egypt” (Deut. 28:27; cf. Exod. 9:9). Skin ailments included tumors, festering sores, boils, infections, and the itch (Deut. 28:27, 35; Isa. 3:7). Job complained of a litany of ailments: broken and festering skin (7:5), multiple wounds (9:17), black peeling skin and fever (30:30), gnawing bone pain (2:5; 19:20; 30:17), insomnia (7:3–4), and wasting away (33:21). These symptoms have been diagnosed as indications of yaws or eczema. A poultice made of figs cured Hezekiah’s boil (2 Kings 20:7).

Leprosy was once thought to be a common problem in the biblical world. Leprosy (Hansen’s disease) is a slow, progressive chronic infectious disease caused by a bacterium. Symptoms include loss of sensation and loss of parts of the body. Evidence for this type of disease in Palestine is rare. Uzziah may have had a true case of Hansen’s disease. He was quarantined until the day he died (2 Chron. 26:21).

Scholars now suggest that the symptoms of the disease described in the Bible do not fit this pattern and thus do not signify leprosy (Hansen’s disease) as it is known today. Instead, the word that English versions translate as “leprosy” (Heb. root tsr’) probably refers to different types of infectious skin disease, often characterized by a long-standing, patchy skin condition associated with peeling or flakiness and redness of skin. Evidence points more toward psoriasis, fungal infections, or dermatitis.

This disease could appear in humans (Lev. 14:2), on buildings (14:34), and on clothing (14:55). It was not limited to the extremities but could occur on the head (14:42–44). It could run its course quickly (13:5–8). It made the individual ceremonially unclean, but it was also curable (Lev. 14:3; 2 Kings 5:1–27). Individuals with the disease were not necessarily shunned (2 Kings 7; Matt. 26:6 // Mark 14:3). Moses (Exod. 4:6), Miriam (Num. 12:10), and Naaman experienced this type of skin disease (2 Kings 5:1–27). Jesus healed many suffering from skin ailments (Matt. 8:2–3; Mark 1:40–42; Luke 5:12–13), including the ten “men who had leprosy” (Luke 17:12–14).

Ailments of an Unknown Nature

Some cases in the Bible present insufficient evidence for scholars to render a clear diagnosis. King Asa suffered a disease in his feet (2 Chron. 16:12). However, in the OT the Hebrew expression for “feet” is sometimes used euphemistically for the sexual organs (Judg. 3:24 KJV). Because of this, the exact nature of the disease is ambiguous. Jehoram was afflicted with “an incurable disease of the bowels” (2 Chron. 21:18–19). Other unknown ailments factor in the deaths of the firstborn son of David and Bathsheba (2 Sam. 12:15), of Jeroboam’s son in infancy (1 Kings 14:17), of Elisha (2 Kings 13:14), and of Ezekiel’s wife (Ezek. 24:16).

(Disabilities; Disability; Deformity; Deformities; Sickness] The Bible often speaks of health, healing, disease, and illness. Good health was a sign of God’s favor, and healing was also the work of God and his divinely empowered agents. These agents included the prophets (1 Kings 17:8–23; 2 Kings 5:1–15), the apostles (Acts 3:1–10), and the messiah (Mal. 4:2). The divine prerogative of Jesus was to heal (Mark 1:32; 6:56; Matt. 4:23; 8:16; 15:30; 21:14; Luke 6:10, 17–19), and miraculous healings were a sign of his messianic office (Luke 7:20–23). Disease, on the other hand, was regarded as a sign of God’s disfavor. Within a covenantal context, God could send disease to punish the sinner (Exod. 4:11; 32:35).

The Bible assigns a wide variety of names to various diseases and their symptoms. These terms are nontechnical and generally descriptive. Some are uncertain in meaning. In most cases they describe the symptoms of the disease, not the disease itself. Diagnosis often was based on incomplete observation and nonclinical examination. The Bible also presupposes supernatural intervention in the life of a person. Healing occurred when God’s agents touched individuals, cast out demons, and resurrected the dead.

Ancient Near Eastern Influences

In the ancient Near East the knowledge of disease and medicine was precritical. Bacteria and viruses were virtually unknown. Mesopotamian literature contains many references to medicine, physicians, and medical practice. Minerals, salts, herbs, and other botanicals were used to make up treatments. Babylonian physicians also administered prescriptions accompanied by incantations. Disease was considered to be the result of a violation of a taboo or possession by a demon. The Code of Hammurabi (1750 BC) includes laws regulating the practice of medicine and surgery by physicians. In Egypt medicine and healing were connected to the gods. Tomb paintings and several papyrus documents describe the developing state of Egyptian medicine, pharmacy, and surgery.

Greek physicians admired and sought to learn the skills of the Egyptians. However, the early Greek doctor Hippocrates (460–370 BC), called the “Father of Medicine,” is credited with being the first physician to reject the belief that supernatural or divine forces cause illness. He argued that disease is the result of environmental factors, diet, and living habits, not a punishment imposed by the gods.

It is clear that the biblical world shared with the ancient Near East the same types of maladies common to tropical or subtropical climates. These include malaria, tropical fevers, dysentery, and sunstroke. The tendency of the hot climate to produce frequent droughts and famine certainly contributed to similar types of diseases throughout the Fertile Crescent. Additionally, it must be remembered that Palestine was a land bridge between the Mesopotamian and Egyptian worlds. Migrations carry not only goods and products, but also parasites, communicable disease, and epidemics.

Biblical Concept of Disease

The religious tradition of the Hebrews repudiated the magical or demonic origin of disease. Hence, moral, ethical, and spiritual factors regulated disease and illness. This was true for the individual as well as the community. The Hebrews, like the Egyptians, also recognized that much sickness arose from the individual’s relationship to the physical environment. Great stress was placed on hygiene and preventive medicine.

Pentateuchal legislation offered seven covenantal principles designed to prevent the possibility of disease and sickness: (1) Sabbath observance for humans, animals, and the land, which enforced regular periods of rest (Gen. 2:3); (2) dietary regulations, which divided food into efficient categories of clean and unclean (Lev. 11); (3) circumcision, which carried physical benefits as well as religious and moral implications (Gen. 17:9; circumcision is the only example of Hebrew surgery); (4) laws governing sexual relationships and health, including a list of forbidden degrees of marital relationships (Lev. 18–20); (5) provisions for individual sexual hygiene (Lev. 15); (6) stipulations for cleanliness and bodily purification (Lev. 14:2; 15:2); (7) sanitary and hygienic regulations for camp life (Num. 31:19; Deut. 23:12).

In NT times magical charms and incantations were used along with folk remedies in an effort to cure disease. Jesus repudiated these means. He also suggested that sickness and disease were not direct punishments for sin (John 9:2). In the Sermon on the Mount (Matt. 5–7), Jesus confirmed that the ethical and religious standards of the new covenant promoted the total health of the community and the individual.

Circulatory Diseases

Nabal most likely suffered a cerebrovascular accident or stroke (1 Sam. 25:36–38). After a heavy bout of drinking, his heart “died” (KJV; NIV: “failed”), and he became paralyzed, lapsed into a coma, and died ten days later. Psalm 137:5–6 may contain a clinical example of the symptoms of stroke. The psalmist wrote, “If I forget you, Jerusalem, may my right hand forget its skill. May my tongue cling to the roof of my mouth if I do not remember you.” This description points to a paralysis of the right side of the body (right hemiplegia) and the loss of speech (motor aphasia) that result from a stroke on the left side of the brain. Basically, the exiled psalmist is wishing upon himself the effects of a stroke if he held anything other than Jerusalem as his highest priority. Some have considered the collapse of Uzzah when he reached out to stabilize the ark of the covenant (2 Sam. 6:6–7) to be the consequence of an apoplectic seizure. But since no actual paralysis was described and death occurred immediately, this seems unlikely. It is more probable that God struck him down with an aortic aneurism or a coronary thrombosis.

Paralysis

A possible case of paralysis may be described in the shriveled (atrophic) hand of Jeroboam I (1 Kings 13:4–6). In an angry outburst Jeroboam ordered the arrest of a prophet who condemned the altar at Bethel. When Jeroboam stretched out his hand, it “shriveled up, so that he could not pull it back.” Several complicated diagnoses have been offered to explain the “withered” hand, but it is possibly an example of cataplexy, a sudden loss of muscle power following a strong emotional stimulus. After intercession by the man of God, and the subsiding of the emotional outburst, the arm was restored.

The threat against the faithless shepherd of God’s people (Zech. 11:17), which included a withered arm and blindness in the right eye, may refer to a form of paralysis known as tabes dorsalis, or locomotor ataxia. Knifelike pains in the extremities and blindness characterize this disease.

Paralysis is frequently mentioned in the NT (Matt. 8:6; 9:2, 6; 12:10; Mark 2:3–5, 9, 10; 3:1, 3, 5; Luke 5:18, 24; 6:6; John 5:3; Acts 9:33; Heb. 12:12). The exact diagnosis for each of these cases remains uncertain.

The physician Luke’s use of the Greek medical term paralelymenos (Luke 5:18, 24) suggests that some of these cases were caused by chronic organic disease. Others clearly were congenital (Acts 3:2; cf. 14:8). It is not necessary to rationalize the origin of these examples of paralysis as hysteria or pretense. The NT writers regarded the healing of these individuals by Jesus and the apostles as miraculous.

Mental Illness and Brain Disorders

Cases of mental disease are generally described in the Bible by noting the symptoms produced by the disorder. The particular cause of a mental illness in the NT is often blamed on an unknown evil spirit or spirits (Luke 8:2). Such spirits, however, were subject to God’s control and operated only within the boundaries allowed by him (1 Sam. 16:14–16, 23; 18:10; 19:9). Accordingly, in the OT “madness” and “confusion of mind” were regarded as consequences of covenantal disobedience (Deut. 28:28, 34).

It has been argued that King Saul displayed early indications of personality disorder. Symptoms included pride, self-aggrandizement (1 Sam. 11:6; 13:12; 15:9, 19), and ecstatic behavior (10:11–12). A rapid deterioration in Saul’s character transpired after David was anointed and became more popular (16:14; 18:10–11). Since Saul demonstrated fear, jealousy, a sense of persecution, and homicidal tendencies, some scholars argue that he suffered from paranoid schizophrenia.

Nebuchadnezzar suffered a rare form of monomania in which he lived like a wild beast in the field eating grass (Dan. 4:33). David, in order to save his own life, feigned insanity or perhaps epilepsy before the Philistine king Achish (1 Sam. 21:12–15).

In the NT, individuals with mental disorders went about naked, mutilated themselves, lived in tombs (Mark 5:2), and exhibited violent behavior (Matt. 8:28). Such mental disorientation was often linked to demon possession. Examples include the Syrophoenician’s child (Matt. 15:22; Mark 7:25), the demoniacs at Gerasa (Matt. 8:28; Mark 5:2; Luke 8:27) and Capernaum (Mark 1:23; Luke 4:33), a blind and mute demoniac (Matt. 12:22; Luke 11:14), and a fortune-telling slave girl (Acts 16:16). While such behavior is clinically suggestive of paranoid schizophrenia or other mental disorders, the mind-controlling influence of some extraneous negative force cannot be ruled out.

Epilepsy (grand mal) causes the afflicted person to fall to the ground, foam at the mouth, and clench or grind the teeth (Matt. 17:15; Mark 9:17–18; Luke 9:39). The description of Saul falling to the ground in an ecstatic state (1 Sam. 19:23–24) and Balaam falling with open eyes may be indicative of an epileptic seizure. In the NT, Jesus healed many who suffered from epilepsy (Matt. 4:24; 17:14–18; Mark 9:17–18; Luke 9:38–42). Some scholars have linked the light seen by Paul on the road to Damascus with the aura that some epileptics experience prior to a seizure. His subsequent blindness has also been attributed to the epileptic disturbance of the circulation of the blood in the brain.

Childhood Diseases

The cause of the death of the widow’s son at Zarephath is unknown (1 Kings 17:17–22). The death of the Shunammite woman’s son has been attributed to sunstroke (2 Kings 4:18–37), although a headache is the only symptom recorded (v. 19). In both cases there is too little evidence to present an accurate diagnosis.

In the first case, the boy at Zarephath stopped breathing (1 Kings 17:17). This may leave the door open to argue that Elijah resuscitated the child. However, in the second case, the text clearly states that the Shunammite boy died (2 Kings 4:20), implying a resurrection.

Infectious and Communicable Diseases

Fever and other calamities are listed among the punishments for covenantal infidelity (Deut. 28:22). Three different types of fever may be intentionally described here: “fever,” “inflammation,” and “scorching heat” (ESV: “fiery heat”). Fever is also mentioned frequently in the NT (Matt. 8:15; Mark 1:30–31; Luke 4:38–39; John 4:52; Acts 28:8). Both Jesus and Paul healed individuals who had a fever. A number of these fevers were likely caused by malaria, since the disease was known to be endemic to the Jordan Valley and other marshy areas in Palestine.

Several epidemics in which numerous people died of pestilence or plague are mentioned in the OT (Exod. 11:1; 12:13; Num. 14:37; Zech. 14:12). The fifth plague of Egypt (Exod. 9:3–6) has been attributed to Jordan Rift Valley fever, which is spread by flies. Bubonic plague has been blamed for the malady that struck the Philistines (1 Sam. 5–6). However, it may have been the result of a severe form of tropical dysentery. Acute bacillary dysentery contracted in the military camp may also have been responsible for the epidemic that killed a large number of the Assyrian army (2 Kings 19:35).

Parasitic Diseases

Some scholars have repeatedly argued that the “fiery serpents” (NIV: “venomous snakes”) encountered by Moses and the children of Israel (Num. 21:6–9) were in reality an infestation of the parasitic guinea worm (Dracunculus medinensis). Microscopic fleas ingested in drinking water carry the larvae of this slender nematode into the body. The larvae move from the digestive tract to the skin. The adult worm, which may grow to a length of several feet, discharges its eggs into an ulcer on the skin. Death of the host occurs because of the resulting infection of the skin ulcers.

After the conquest of Jericho, Joshua cursed the individual who would endeavor to rebuild the city (Josh. 6:26). Later, Hiel of Bethel attempted to rebuild the city and lost two of his sons as a result of the curse (1 Kings 16:34). Elisha was then asked to purify the bad water at Jericho in order to allow a new settlement (2 Kings 2:19). Elisha obliged by throwing salt into the spring and thereby making the water potable (2:20–22). Recent archaeological study has discovered the remains of certain snails in the mud-bricks used to construct Jericho in the Bronze Age. These types of snails are now known to serve as intermediate hosts for the flatworm parasite that can cause schistosomiasis. The Schistosoma haematobium trematode infects the urinary tract and the bladder. It is possible that this type of parasite was responsible for the death of Hiel’s two sons.

In NT times, Herod Agrippa apparently died of the complications of a parasitic disease, perhaps being infested by the larvae of flies (myiasis) in the bowels. Luke mentions that he was “eaten by worms” (skōlēkobrōtos [Acts 12:23]). The father of Publius also suffered from dysentery (Acts 28:8).

Physical Deformities and Abnormalities

Individuals with deformities were disqualified from priestly service (Lev. 21:18–20). The list included lameness, limb damage, and dwarfism. The deformities mentioned here might have been congenital or acquired. Mephibosheth was dropped by his nurse (2 Sam. 4:4) and perhaps suffered damage to the spinal cord. Jacob possibly sustained injury to an intervertebral disk (Gen. 32:32) causing a deformity and a limp. The woman who was “bent over” (Luke 13:10–17) might have suffered from an abnormality of the spine similar to scoliosis. It is difficult to ascertain the origin of the “shriveled hand” of the unnamed individual healed by Jesus (Matt. 12:10–13; Mark 3:1–5; Luke 6:6–10). It could be congenital in character or a paralysis caused by any number of factors.

Diseases and Disabilities of the Eyes and Ears

Physical blindness is mentioned several times in the Bible. Blindness excluded one from serving as a priest (Lev. 21:18, 20). Blindness and deafness, however, were disabilities requiring special care from the community (Lev. 19:14; Deut. 27:18). The “weak eyes” of Leah may refer to an eye condition (Gen. 29:17).

Blindness in the biblical world was caused by various factors. Leviticus 26:16 speaks of a fever that destroys the eyes. Flies probably were responsible for much of the conjunctivitis found in children. John 9:1 mentions congenital blindness, which Jesus cured using mud made from spittle and dirt (John 9:6). In Mark 8:22–26 Jesus healed a blind man by spitting in his eye and laying hands on him (cf. Matt. 20:34 with Mark 10:52).

Congenital deafness would also be associated with mutism and speech defects because a child learning to speak depends on imitation and mimicry. Jesus healed a man who was deaf and could barely talk (Mark 7:32–37). The man’s inability to say much possibly pointed to a loss of hearing early in life.

Skin Conditions

Various skin and hair abnormalities are described in the Bible. Some made the individual unclean (Lev. 13:30; 14:54). The OT speaks of “the boils of Egypt” (Deut. 28:27; cf. Exod. 9:9). Skin ailments included tumors, festering sores, boils, infections, and the itch (Deut. 28:27, 35; Isa. 3:7). Job complained of a litany of ailments: broken and festering skin (7:5), multiple wounds (9:17), black peeling skin and fever (30:30), gnawing bone pain (2:5; 19:20; 30:17), insomnia (7:3–4), and wasting away (33:21). These symptoms have been diagnosed as indications of yaws or eczema. A poultice made of figs cured Hezekiah’s boil (2 Kings 20:7).

Leprosy was once thought to be a common problem in the biblical world. Leprosy (Hansen’s disease) is a slow, progressive chronic infectious disease caused by a bacterium. Symptoms include loss of sensation and loss of parts of the body. Evidence for this type of disease in Palestine is rare. Uzziah may have had a true case of Hansen’s disease. He was quarantined until the day he died (2 Chron. 26:21).

Scholars now suggest that the symptoms of the disease described in the Bible do not fit this pattern and thus do not signify leprosy (Hansen’s disease) as it is known today. Instead, the word that English versions translate as “leprosy” (Heb. root tsr’) probably refers to different types of infectious skin disease, often characterized by a long-standing, patchy skin condition associated with peeling or flakiness and redness of skin. Evidence points more toward psoriasis, fungal infections, or dermatitis.

This disease could appear in humans (Lev. 14:2), on buildings (14:34), and on clothing (14:55). It was not limited to the extremities but could occur on the head (14:42–44). It could run its course quickly (13:5–8). It made the individual ceremonially unclean, but it was also curable (Lev. 14:3; 2 Kings 5:1–27). Individuals with the disease were not necessarily shunned (2 Kings 7; Matt. 26:6 // Mark 14:3). Moses (Exod. 4:6), Miriam (Num. 12:10), and Naaman experienced this type of skin disease (2 Kings 5:1–27). Jesus healed many suffering from skin ailments (Matt. 8:2–3; Mark 1:40–42; Luke 5:12–13), including the ten “men who had leprosy” (Luke 17:12–14).

Ailments of an Unknown Nature

Some cases in the Bible present insufficient evidence for scholars to render a clear diagnosis. King Asa suffered a disease in his feet (2 Chron. 16:12). However, in the OT the Hebrew expression for “feet” is sometimes used euphemistically for the sexual organs (Judg. 3:24 KJV). Because of this, the exact nature of the disease is ambiguous. Jehoram was afflicted with “an incurable disease of the bowels” (2 Chron. 21:18–19). Other unknown ailments factor in the deaths of the firstborn son of David and Bathsheba (2 Sam. 12:15), of Jeroboam’s son in infancy (1 Kings 14:17), of Elisha (2 Kings 13:14), and of Ezekiel’s wife (Ezek. 24:16).