“Author of life” is a title applied to Jesus by Peter in Acts 3:15 (KJV: “Prince of life”), where he uses it ironically to highlight that people had killed the one who was the source of life. Elsewhere, the Greek word behind “author” (archēgos) is translated as “prince,” “leader,” “captain,” or “pioneer” (Acts 5:31; Heb. 2:10; 12:2).

A person of uncertain or questionable parentage (used figuratively in Zech. 9:6 to speak of foreigners as “a mongrel people” [NIV, NRSV]). Bastards were excluded from the assembly of the Lord, even to the tenth generation of descendants (Deut. 23:2 KJV, RSV). They were therefore marginalized and often considered to be under divine condemnation (1 En. 10:9). The unusual circumstances behind Jesus’ birth perhaps made him vulnerable to this accusation (Mark 6:3; John 8:41), which opponents of Christianity made later (Origen, Cels. 1.28, 32; Gos. Thom. 105). The author of Hebrews appropriates the concept to explain why God disciplines his legitimate children (Heb. 12:8).

Chastening sometimes refers to the discipline of a parent to a child. Parents are to chasten their children (Deut. 21:18), “for in that there is hope” (Prov. 19:18). However, the most frequent and significant biblical references are to God’s discipline of his own spiritual children. In Heb. 12 the author encourages his readers not to “grow weary and lose heart” (v. 3), because “the Lord disciplines the one he loves” (v. 6); rather, this discipline should be a reminder that God is treating them as children (v. 7). Furthermore, if people respect their human fathers for administering discipline, “How much more should we submit to the Father of our spirits and live!” (v. 9). Certainly, “No discipline seems pleasant at the time, but painful. Later on, however, it produces a harvest of righteousness and peace for those who have been trained by it” (v. 11). God’s lesson is that “those whom I love I rebuke and discipline” (Rev. 3:19), and that we can trust that God knows what he is doing when allowing difficulties in our lives.

Chastening sometimes refers to the discipline of a parent to a child. Parents are to chasten their children (Deut. 21:18), “for in that there is hope” (Prov. 19:18). However, the most frequent and significant biblical references are to God’s discipline of his own spiritual children. In Heb. 12 the author encourages his readers not to “grow weary and lose heart” (v. 3), because “the Lord disciplines the one he loves” (v. 6); rather, this discipline should be a reminder that God is treating them as children (v. 7). Furthermore, if people respect their human fathers for administering discipline, “How much more should we submit to the Father of our spirits and live!” (v. 9). Certainly, “No discipline seems pleasant at the time, but painful. Later on, however, it produces a harvest of righteousness and peace for those who have been trained by it” (v. 11). God’s lesson is that “those whom I love I rebuke and discipline” (Rev. 3:19), and that we can trust that God knows what he is doing when allowing difficulties in our lives.

Types of Crosses

A cross is an upright wooden beam or post on which persons were either tied or nailed as a means of torture and execution. A cross could have several different shapes. The earliest was not a cross at all but rather a simple stake or pole on which persons were impaled. This simple stake evolved over time into more elaborate shapes with the addition of a crossbeam that was secured to the upright stake. The Latin cross was shaped like a t and was the type most commonly used by the Romans. Jesus was crucified probably on a Latin cross, which allowed for a convenient place for a sign (called a titlos in John 19:19) to be placed above his head (Matt. 27:37 pars.). Another form of cross, now referred to as a St. Anthony’s cross, was shaped like a T, with the crossbeam affixed at the top of the upright beam. A cross shaped like an X, having a crisscross pattern, is also known as a St. Andrew’s cross. Tradition holds that the apostle Peter was crucified upside down on this type of cross. A cross shaped like a +, the Greek cross, has the crossbeam in the center.

Crucifixion in Ancient Times

In ancient times, crucifixion was a method of execution used by many peoples, including the Assyrians, the Phoenicians, the Babylonians, the Persians, the Medes, and the Greeks. Historically, crucifixion’s barbaric predecessor was impalement. Victims often were beheaded first, and then their lifeless bodies were forced onto a large stake or spike (Gen. 40:19; 1 Sam. 31:9–10). Impalement originally was more about triumph and exposure than execution (Deut. 21:22–23; Josh. 8:29; 10:26; 2 Sam. 4:12; 21:9–10). But the Assyrians impaled their enemies by sticking them, still alive, onto pointed stakes, thus utilizing impalement as a method of execution. The book of Esther probably reflects the practice of impalement in the Persian period by describing how the king’s officials were executed (2:23; 5:14; KJV: “hanged”). In these verses, the Hebrew word that some English versions translate as “gallows” (’ets) actually means “tree,” and a noose for hanging was not used in Persia during this period. Impalement became a common form of execution.

Impalement as a means of execution eventually gave way to crucifixion. Crucifixion was especially prized by the Phoenicians, whose normal methods of execution—drowning, immersion in boiling oil, impalement, stoning, and burning—were seen as too quick and easy. Wanting their victims to suffer longer, they used crucifixion, a more severe form of execution. The Greeks also crucified victims on a stake or a cross. Alexander the Great crucified two thousand inhabitants of Tyre along the shoreline when he captured the city in 332 BC.

There is no evidence that ancient Israel fastened people to a stake or a cross as a method of execution. Instead, stoning was the preferred method of execution in Israel and was commanded by the law (Lev. 20:2; Deut. 22:24). The law did, however, permit the public display of an offender’s body “on a tree” or a “pole” after being executed (Deut. 21:22). The same expression is used in the book of Acts to describe Jesus’ crucifixion (5:30; 10:39; 13:29). In contrast to pagan nations that would leave a corpse hanging on a cross until the flesh either rotted away or was devoured by vultures, Israel was commanded to take the body down, not letting it remain on the tree overnight (Deut. 21:23). This explains why the Jews were so adamant that Jesus’ body be taken down before the Sabbath commenced at sunset (John 19:31). Being hung on a tree was especially abhorrent to Israel because it reflected God’s curse upon the offender (Deut. 21:23). Jesus was accursed by God as he hung on the cross, bearing the sins of the world (Gal. 3:13).

Crucifixion in New Testament Times

Not long before the Romans took over Palestine, the Jewish ruler Alexander Jannaeus crucified about eight hundred Pharisees who opposed him in 86 BC. This gruesome event was out of character for the Jewish nation and was frowned upon by the Jews of the day as well as by the later Jewish historian Josephus. But it was the Romans who perfected crucifixion as a means of torture and execution. The Romans called crucifixion “slaves’ punishment” because it was intended for the lowest members of society. It became the preferred method of execution for political crimes such as desertion, spying, rebellion, and insurrection. Roman crucifixion was common in NT times and extended well into the fourth century AD. The emperor Constantine converted to Christianity in AD 312 and abolished crucifixion altogether. The cross became a symbol of Christian sacrifice instead of a barbarous method of torture and execution.

Roman Crucifixion

Crucifixion was a barbaric method of torture and execution whereby a victim was either nailed or tied to a wooden cross and left to die a long, agonizing death. It often was reserved for the most offensive criminals, such as thieves (Matt. 27:38), murderers, insurrectionists (Mark 15:7), and other political rebels. Disobedient slaves commonly were crucified. Crucifixion was so demeaning that Roman citizens were exempt and could be crucified only by direct decree of the emperor. Crucifixion also was used as a triumphant sign in times of war as victors demonstrated their conquests by hoisting their enemies upon crosses for all to see. It was viewed as a public symbol of strength and intimidation. Adding insult to injury, executioners stripped their victims and crucified them alongside busy roads and in public places where onlookers could gaze in horror.

Criminals often were flogged severely before crucifixion in a pseudo-compassionate effort to speed up the death process experienced on the cross (John 19:1). The victim was stripped, tied to a post, and then brutally beaten by several Roman torturers using whips with sharp pieces of bone or metal at the ends of the lashes. Such floggings were said to leave the victim’s bones and entrails exposed. The torturers did not stop until they either exhausted themselves or were called off by their commanding officers.

After the flogging, the offender was forced to carry the crossbeam, often weighing seventy-five to one hundred pounds, on his or her shoulders to the crucifixion site (John 19:17). The main upright beam, standing seven to nine feet tall, remained at the site of crucifixion and was used repeatedly. The victim was then laid down with arms stretched out across the beam and usually tied into position. Once the victim’s arms were secured by ropes, a soldier searched for the “hollow spot” in the wrist located just above the flexion area near the carpal bones. The metacarpal bones of the palms were too weak to support the weight of the body on the cross, so the wrist was a stronger alternative. However, the use of ropes to support the arms made the choice of little consequence. Either location was acceptable. A hammer was used to drive five-inch nails through both wrists, affixing the victim to the crossbeam. It was customary to offer the victim a narcotic cocktail to help ease the pain of crucifixion. Jesus refused this drink (Matt. 27:34; Mark 15:23).

After the victim’s arms were nailed to the crossbeam, it was hoisted up and secured to the upright post. This alone was very hard on the fatigued body of the victim, who already had lost a considerable amount of blood. This quick, upward motion caused orthostatic hypotension—very low blood pressure caused by a rapid vertical shift in body position. The victim’s blood pressure would drop to half of normal, while the pulse rate doubled. Victims frequently fainted due to the rush of blood away from the head during this upward motion. This motion probably is the imagery behind Jesus’ “lifted up” sayings (John 3:14; 8:28; 12:32). Jesus was quite literally lifted up onto the cross.

Next came the nailing of the feet. The Romans had several different ways of nailing the feet to the cross. Roman soldiers were notorious for twisting and contorting victims into odd positions while nailing them to the cross. Sometimes a victim’s legs were stretched downward, feet crossed, and one nail driven through both. A support block typically was placed behind the victim to support the weight of the body on the cross. A heel bone of a crucified man named “Yehohanan” (John) was discovered in an ossuary north of Jerusalem in 1968. A single nail had been driven through the side of the heel. Either the body was twisted so that the nail was driven through both heels, the right above the left, or each heel was nailed to opposite sides of the upright beam causing the victim to straddle the cross. A piece of wood was held against the heel before the nail was driven in, to act as a washer, preventing the foot from tearing free. The ossuary’s inscription describes Yehohanan as “the one hanged with knees apart.” Once nailed to the cross, the victim often suffered for several hours, even days, exposed to the hot sun as well as the insults of those passing by on the busy road (cf. Matt. 27:39; Mark 15:29; Luke 23:35; John 19:20). Extreme thirst was brought on by massive blood loss and exposure to the elements (John 19:28).

Because death could take several hours, it sometimes was hastened by a crushing blow to the legs with a club. Victims were unable to push their bodies upward to gasp for air or to keep their blood circulating. This final blow to the legs also caused intense pain and usually was enough to throw the body into shock, with death following soon afterward. Jesus was already dead when the soldiers approached to break his legs (John 19:32–33). This fulfilled what was written in the Scriptures: “Not one of his bones will be broken” (John 19:36; cf. Exod. 12:46; Num. 9:12; Ps. 34:20). Instead of breaking Jesus’ legs, a soldier thrust a spear into his side, which brought forth a sudden flow of blood and water, indicating that he was truly dead (John 19:34). This too was to fulfill Scripture: “They will look on the one they have pierced” (John 19:37; cf. Zech. 12:10). Bodies often were left on the crosses to be eaten by scavenging birds such as vultures. The Jews demanded that the bodies of Jesus and the two thieves crucified with him be taken down before the Sabbath that began that evening (John 19:31).

Physical Death by Crucifixion

Death by crucifixion resulted from a combination of factors. The most obvious was massive blood loss. With the nails being driven through the extensive artery systems of the wrists and feet, the victim lost a lot of blood. The severe flogging before being crucified also played a role and took its toll on the body. Blood loss also led to a depletion of oxygen supply to the vital tissues. Major organs failed due to lack of oxygenation. Another factor leading to death was suffocation or asphyxiation. The weight of the body hanging on the cross was too great for the tendons and muscles in the arms, so the victims were unable to hold themselves up in order to take in deep breaths. The victim’s upper body continued to sink lower until the lungs became too compressed and unable to take in large volumes of air. Victims could force themselves upward to gasp air by using their legs, but this was extremely painful. Preventing the victim from pushing upward in order to breathe was another reason for breaking the legs. The victim slowly suffocated for hours.

The ultimate cause of death was an eventual heart rupture due to massive blood loss and lack of oxygenation. As the pulse raced and blood pressure increased, the heart eventually burst due to the stress. This helps explain the reference to the “sudden flow of blood and water” in John 19:34. In the case of heart rupture, the right side of the heart still has some blood left in it while the sac that surrounds the heart, the pericardium, fills with water. The soldier’s spear pierced this sac and the heart, causing both blood and water to flow out.

The Meaning of Jesus’ Crucifixion

The OT teaches that it is blood that makes atonement for sin (Lev. 17:11). Just as sacrificial lambs shed their blood on the altar for the sins of Israel, Jesus shed his blood on the cross for the sins of the world (John 1:29). The crucifixion of Jesus was the greatest atoning event in history. His blood, which provided the means for a new covenant, was poured out for many on the cross (Matt. 26:28). The cross, as gruesome as it was, was the means through which Christ died “for our sins” (Gal. 1:4). Jesus freely scorned the shame of the cross so that we might be reconciled to God by his shed blood (Col. 1:20; Heb. 12:2).

Jesus also bore the curse of God in our place when he died on the cross. The one who hangs on a tree is divinely cursed (Deut. 21:23). God’s curse is a curse upon sin, death, and fallenness. Jesus took God’s curse upon himself in order to redeem us from that curse (Gal. 3:13).

Jesus demonstrated the humble nature of his mission and ministry by his obedience to death, even death on the cross (Phil. 2:8). For Jesus the cross was not simply his martyrdom, as if he simply died for a worthy cause; it was the pinnacle example of obedience and love in the Bible. Jesus called his followers to take up a cross and follow his example of selfless sacrifice (Matt. 16:24). Jesus’ cross is a symbol of his love, obedience, and selflessness.

Most of all, the cross reveals the unconditional love of God, who offered his Son as the atoning sacrifice for sin (John 3:16; 1 John 4:10). The brutal cross reveals the beautiful love of Jesus, who willingly laid down his life (1 John 3:16).

In the Bible, “discipline” can refer, positively, to training that instills wisdom in an individual (sometimes translated “instruction”) and, negatively, to punishment or correction of groups or individuals (sometimes translated “chastisement”). Discipline comes from God or from humans, especially from parents to their children. Biblical references to discipline in the Bible occur largely in several clusters, especially in Lev. 26:14–46; Deuteronomy (4:36; 8:5; 11:2; 21:18; 22:18); Job (4:3; 5:17; 20:3; 33:16; 36:10); Psalms (throughout); Proverbs (throughout); Jeremiah (2:19; 5:3; 6:8; 7:28; 10:8, 24; 17:23; 30:11, 14; 31:18; 32:33; 35:13; 46:28); and in the NT, in Heb. 12:5–11. Elsewhere, the language of discipline occurs to a limited extent in Isa. 8:11; 26:16; 28:22, 26; Ezek. 5:15; Hos. 5:2; 7:15; 10:10; Zeph. 3:2, 7; and in the NT, in 1 Cor. 11:32; Eph. 6:4; 2 Tim. 2:16; Rev. 3:19. Most of the OT passages cited above can be described as pertaining to the themes of wisdom (citations of Proverbs and Job) and covenant (citations of Deuteronomy, Jeremiah, Hosea).

Divine discipline. OT wisdom and poetry affirm that it is a blessing to be disciplined by God, even in the negative sense of chastisement (e.g., Job 5:17; Ps. 94:12; Prov. 3:11). This surprising attitude is no doubt due to the close connection between God’s chastening of humans and his covenant relationship with them. Indeed, the prophetic threat of divine discipline often comes in response to the covenant unfaithfulness of God’s people, and such discipline is intended to correct human sin so that the covenant relationship can ultimately be restored (cf. Lev. 16:18–28 with the final resolution of the situation in Lev. 26:40–45, whereby chastisement effects repentance and reconciliation). The author of Hebrews quotes Prov. 3:11–12, reminding his readers that “the Lord disciplines the one he loves” (12:6). As Jeremiah mocks the silliness of worshiping vain idols that are no more than “a scarecrow in a cucumber field” (Jer. 10:5), he points out that unlike the living God of Israel, idols lack the power to administer discipline or instruction (10:8).

In addition to this positive view of divine discipline, there is a prominent but complementary strand of thought that involves imploring the Lord for relief from deserved divine discipline: “Lord, do not rebuke me in your anger or discipline me in your wrath” (Pss. 6:1; 38:1). Here is a recognition that while God’s discipline proceeds from his love, it is not a thing to be considered lightly or embraced flippantly.

Human parental discipline. Given the importance of discipline in the education of children, it is not surprising that the theme is well developed in wisdom literature (Proverbs and Job), where issues of parenting are prominent. The opening words of the book of Proverbs assert the value of the proverbs “to teach people wisdom and discipline,” among other things (1:2 NLT). Discipline is paired with wisdom in another of the book’s best-known passages: “Fear of the Lord is the foundation of true knowledge, but fools despise wisdom and discipline” (1:7 NLT; see also 12:1; 23:23). In addition to divine discipline (see above), Proverbs speaks of the discipline administered by parents, warning that “a fool spurns a parent’s discipline” (15:5), admonishing children to heed “a father’s instruction” (4:1), and urging parents, “Discipline your children, for in that there is hope; do not be a willing party to their death” (19:18). Discipline can sometimes take the form of physical punishment, as in 23:13: “Do not withhold discipline from a child; if you punish them with the rod, they will not die” (see also 13:24; 22:15). In Proverbs discipline is construed both positively, as when it is paired with wisdom or knowledge (23:12), and negatively, as in 15:10: “Stern discipline awaits anyone who leaves the path.”

Proverbs often equates listening to discipline with life, and spurning discipline with death. In the law of Deut. 21:18–21, this equation is more than a figure of speech: the son who rejects discipline from his parents is to be stoned to death by the elders of his town. The congruity between divine and human parental discipline is well illustrated in Deut. 8:5: “Know then in your heart that as a man disciplines his son, so the Lord your God disciplines you.” Similarly, the author of Hebrews teaches, “Endure hardship as discipline; God is treating you as his children. For what children are not disciplined by their father?” (12:7). And the writer of Ephesians urges fathers, “Do not provoke your children to anger, but bring them up in the discipline [paideia] and instruction of the Lord” (6:4 NRSV).

To discipline the mind or to exert the body with rigorous physical activity. In the Greco-Roman world, the typical person worked from sunrise to noon, after which many would go to the local bathhouse to exercise in the palaestra. (Greek students spent half of their education engaged in sports.) Activities included wrestling, boxing, and running (see 1 Cor. 9:24–26; Gal. 5:7). The NT uses the concept metaphorically for training in the Christian way (1 Tim. 4:7–8; Heb. 5:14; 12:11; cf. 2 Pet. 2:14) but also finds value in disciplining the body to curb the insatiability of passion (1 Cor. 7:9; 9:27).

The empowering of another in belief or course of action (1 Thess. 2:3; 1 Tim. 4:13; Heb. 12:5). The concept overlaps semantically with encouragement, the lifting of another’s spirit (Acts 9:31; Phil. 2:1; 2 Cor. 1:4–7) and appeal (2 Cor. 8:4). Jews congregated regularly in synagogues to hear a reading from the Law and the Prophets, which then was applied to their immediate lives by a competent teacher as “a word of exhortation” or sermon (Acts 13:15; see Luke 4:16–21). Preaching weekly from an authoritative text for community formation appears to be a uniquely Jewish phenomenon in the Greco-Roman world. This practice continues in the church. The author of Hebrews describes his text as a “word of exhortation” (13:22). The Holy Spirit illumined the fuller sense of Scripture as a witness to Jesus Christ and also communicated directly to believers through prophetic utterances (Rom. 12:6; 1 Cor. 14:3).

The harvest was a major event on the yearly calendar of Israel’s agrarian society (Lev. 25:11; Judg. 15:1; Ruth 1:22; 2 Sam. 21:9–10). Life was dependent on the harvest. As a result, God set certain rules with respect to the harvest to help the Israelites keep proper priorities. Every seven years and every fiftieth year, the people were to give the land a rest (Exod. 23:10; Lev. 25:20–22). The people were to rest on the Sabbath, even during the harvesttime (Exod. 34:21). Some portions of crops were to be left in the field so that the poor might have food (Lev. 19:9; 23:22; Deut. 24:21). The people were to acknowledge God as the source of the harvest by offering the first of the produce (Lev. 23:10). Celebrating the harvest was commanded (Exod. 23:16; Deut. 16:15; Isa. 9:3). Planning for the harvest was a mark of wisdom (Prov. 6:8; 10:5; 20:4). Even as a good harvest was the blessing of God (Ps. 67:6; Isa. 62:9), so a bad harvest was a curse from God and the plight of a fool (1 Sam. 12:17; Job 5:5; Prov. 26:1; Isa. 18:4–5; Jer. 8:13, 20; Joel 3:12; Mic. 6:15). Failure to acknowledge God for the harvest was a sin (Jer. 5:24).

The harvest is often used in Scripture as an analogy. The prophets talk about the negative harvest of idolatry (Isa. 17:11). Israel is called the firstfruits of God’s harvest (Jer. 2:3). Hosea uses the idea of harvest to indicate that God’s people have a future (Hos. 6:11). In the Gospels, the harvest is used as an analogy for those needing to hear the good news (Matt. 9:37–38), for the end times (Matt. 13:24–30; Rev. 14:15), and for a lesson about unfaithful leadership (Matt. 21:33–46; 25:24). In the remainder of the NT, the harvest analogy usually refers to Christian growth and salvation (Rom. 1:13; 1 Cor. 9:10–11; 2 Cor. 9:10; Gal. 6:9; Heb. 12:11; James 3:18).

Holiness is an attribute of God and of all that is fit for association with him. God alone is intrinsically holy (Rev. 15:4). God the Father is holy (John 17:11), as is the Son (Acts 3:14), while “Holy” is the characteristic designation of God’s Spirit (Ps. 51:11; Matt. 1:18). God’s name is holy (Luke 1:49), as are his arm (Ps. 98:1), ways (Ps. 77:13), and words (Ps. 105:42).

With reference to God himself, holiness may indicate something like his uniqueness, and it is associated with attributes such as his glory (Isa. 6:3), righteousness (Isa. 5:16), and jealousy—that is, his proper concern for his reputation (Josh. 24:19).

God’s dwelling place is in heaven (Ps. 20:6), and “holy” functions in some contexts as a virtual equivalent for heavenly (11:4). God’s throne is holy (47:8), and the angels who surround it are “holy ones” (89:5; cf. Mark 8:38).

A corollary of God’s holiness is that he must be treated as holy (Lev. 22:32)—that is, honored (Lev. 10:3), worshiped (Ps. 96:9), and feared (Isa. 8:13).

While “holy” is sometimes said to mean “set apart,” this does not appear to be its core meaning, though it is an associated notion (Lev. 20:26; Heb. 7:26). Holiness, as applied to people and things, is a relational concept. They are (explicitly or implicitly) holy “to the Lord” (Exod. 28:36), never “from” something.

The symbolic representation of God’s heavenly palace, the tabernacle (Exod. 40:9), and later the temple (1 Chron. 29:3), and everything associated with them, are holy and the means whereby God’s people in the OT may symbolically be brought near to God. For God to share his presence with anything or anyone else, these too must be holy (Lev. 11:44–45; Heb. 12:14).

The OT system of worship involved the distinction between unclean and clean, and between common and holy, and the means of effecting a transition to a state of cleanness or holiness (Lev. 10:10). People, places, and items may be made holy by a process of consecration or sanctification, whether simply by God’s purifying presence (Exod. 3:5) or by ritual acts (Exod. 19:10; 29:36).

Holiness may be an attribute of places marked by God’s presence (Exod. 3:5; Ps. 43:3). Likewise, particular times, especially the Sabbath day (Exod. 20:8), are declared holy.

God’s faithful people are described as holy (Exod. 19:6; 1 Pet. 2:9). In the OT, this is true of the whole people of God at one level, and of particular individuals at another. Thus, kings (Ps. 16:10), prophets (2 Kings 4:9), and in particular priests (Lev. 21:7) are declared to be holy. While the OT witnesses to some tension between the collective holiness of Israel and the particular holiness of its designated leaders (Num. 16:3), the latter were intended to act as models and facilitators of Israel’s holiness.

The prophet Zechariah envisions a time when the distinctions between holy and common will be meaningless (Zech. 14:20–21). While vestiges of the symbolic language of holiness remain in the NT (e.g., the “holy city” in Matt. 27:53), after the death and resurrection of Christ the NT no longer operates with the symbolic holiness of the OT. Rather, this language is appropriated to explain what true holiness entails in the lives of God’s people (Rom. 12:1; Eph. 2:21). All Christians are holy (“saints” [Gk. hagioi] means “holy ones” [e.g., Rom. 1:7]), including in some sense the members of a believer’s family (1 Cor. 7:14). The holiness of God’s people is both definitive, by virtue of the saving work of Christ (Heb. 13:12), and progressive, by eliciting, and empowering through his Holy Spirit, holy and righteous living (Rom. 6:19; 1 Thess. 4:7–8). Both divine initiative and human activity with regard to holiness may be seen in texts such as Lev. 20:8; Heb. 10:14. The objective of Christian discipline is that we might share God’s holiness (Heb. 12:10).

Hebrews uses the word archēgos in highlighting Jesus as the “pioneer” of salvation and faith (Heb. 2:10; 12:2; NASB: “author”). The same Greek term is used in the phrase “author of life” in Acts 3:15 and is translated as “Prince” in Acts 5:31. See also Author, Author of Life.

Affliction is a condition of physical, mental, or spiritual distress, or the cause of suffering. Afflictions may be a variety of temporal, physical sufferings, such as infertility (Gen. 25:32; 1 Sam. 1:11), injustice and toil (Gen. 31:42), slavery (Exod. 1:12; 3:7, 17; 4:31; Deut. 26:6–7; Neh. 9:9), military oppression (Judg. 2:18; 10:18), loss (Ruth 1:21), displacement and mocking (2 Sam. 16:12), disease and disorders (Mark 3:10; 5:29, 34; Luke 7:21; John 5:4; Acts 28:8), and famine (Acts 7:11). Affliction may be mental or spiritual, arising from the prospects or effects of physical afflictions, feeling the futility of life (Eccles. 1:13), or concern for others in their afflictions (Isa. 63:9; 2 Cor. 2:4).

There are several different causes and reasons for affliction, but there is no simple formula for determining the cause of one’s afflictions, as Job reminds us. Clearly, Job is blameless (Job 1:1, 8; 2:3), but his friends carry on wrongly in their assumptions that his sins are to blame. The agents of affliction include God (2 Kings 17:20; Nah. 1:12), Satan and/or demons (Job 1:12; Acts 5:16), other people (Judg. 10:8; 2 Thess. 1:6), oneself (1 Kings 18:28), or the general condition of life (Job 5:7).

The reasons for affliction also vary. One reason might be called “no reason,” in that “man is born to trouble as surely as sparks fly upward” (Job 5:7). Troubles, afflictions, and sorrow just happen. In retrospect, this is a condition of living in a cursed world (Gen. 3). But this is a general consequence for the whole human race, not a punishment directed at a specific sin. The widespread afflictions of the curse appear random. In various forms they prevent us from turning to easy living as a refuge from broken relationships and therefore force us to look elsewhere. The intent is that we look to God (see Hos. 5:15). Multiple specific reasons, however, may lie behind any particular affliction. They include punishment for sin (Deut. 29:22), often to induce repentance leading to restoration (Hos. 5:15; Zech. 10:9; 1 Cor. 11:30). Affliction may be dealt out by people as they sin against others (1 Sam. 1:7; 2 Sam. 16:12; 2 Thess. 1:6). One’s own choices may have natural consequences (Prov. 11:24; 13:20; 19:9, 15; 22:3), or consequences come due to a lack of leadership (Zech. 10:2). Some result from being associated with those going through afflictions (Num. 14:28–35; 1 Kings 2:26), suffering afflictions due to following Christ (Matt. 13:21; John 15:18–20; Acts 20:23), or feeling empathy for the afflicted (2 Cor. 2:4). Other afflictions are given as training, prevention, or refining (Isa. 48:10; Rom. 5:3–5; 2 Cor. 12:7; Heb. 12:5–13). Suffering affliction may also be substitutionary, on behalf of others (Isa. 53:4–7; and the substitutionary atonement of Christ generally).

In response to others’ afflictions, we are called to sympathy, compassion, comfort, and justice. Appropriate responses to our own afflictions range from patient endurance for the cause of Christ (James 5:11) to lamenting (the psalms and Christ’s example, Matt. 27:46).

“Author of life” is a title applied to Jesus by Peter in Acts 3:15 (KJV: “Prince of life”), where he uses it ironically to highlight that people had killed the one who was the source of life. Elsewhere, the Greek word behind “author” (archēgos) is translated as “prince,” “leader,” “captain,” or “pioneer” (Acts 5:31; Heb. 2:10; 12:2).

Types of Crosses

A cross is an upright wooden beam or post on which persons were either tied or nailed as a means of torture and execution. A cross could have several different shapes. The earliest was not a cross at all but rather a simple stake or pole on which persons were impaled. This simple stake evolved over time into more elaborate shapes with the addition of a crossbeam that was secured to the upright stake. The Latin cross was shaped like a t and was the type most commonly used by the Romans. Jesus was crucified probably on a Latin cross, which allowed for a convenient place for a sign (called a titlos in John 19:19) to be placed above his head (Matt. 27:37 pars.). Another form of cross, now referred to as a St. Anthony’s cross, was shaped like a T, with the crossbeam affixed at the top of the upright beam. A cross shaped like an X, having a crisscross pattern, is also known as a St. Andrew’s cross. Tradition holds that the apostle Peter was crucified upside down on this type of cross. A cross shaped like a +, the Greek cross, has the crossbeam in the center.

Crucifixion in Ancient Times

In ancient times, crucifixion was a method of execution used by many peoples, including the Assyrians, the Phoenicians, the Babylonians, the Persians, the Medes, and the Greeks. Historically, crucifixion’s barbaric predecessor was impalement. Victims often were beheaded first, and then their lifeless bodies were forced onto a large stake or spike (Gen. 40:19; 1 Sam. 31:9–10). Impalement originally was more about triumph and exposure than execution (Deut. 21:22–23; Josh. 8:29; 10:26; 2 Sam. 4:12; 21:9–10). But the Assyrians impaled their enemies by sticking them, still alive, onto pointed stakes, thus utilizing impalement as a method of execution. The book of Esther probably reflects the practice of impalement in the Persian period by describing how the king’s officials were executed (2:23; 5:14; KJV: “hanged”). In these verses, the Hebrew word that some English versions translate as “gallows” (’ets) actually means “tree,” and a noose for hanging was not used in Persia during this period. Impalement became a common form of execution.

Impalement as a means of execution eventually gave way to crucifixion. Crucifixion was especially prized by the Phoenicians, whose normal methods of execution—drowning, immersion in boiling oil, impalement, stoning, and burning—were seen as too quick and easy. Wanting their victims to suffer longer, they used crucifixion, a more severe form of execution. The Greeks also crucified victims on a stake or a cross. Alexander the Great crucified two thousand inhabitants of Tyre along the shoreline when he captured the city in 332 BC.

There is no evidence that ancient Israel fastened people to a stake or a cross as a method of execution. Instead, stoning was the preferred method of execution in Israel and was commanded by the law (Lev. 20:2; Deut. 22:24). The law did, however, permit the public display of an offender’s body “on a tree” or a “pole” after being executed (Deut. 21:22). The same expression is used in the book of Acts to describe Jesus’ crucifixion (5:30; 10:39; 13:29). In contrast to pagan nations that would leave a corpse hanging on a cross until the flesh either rotted away or was devoured by vultures, Israel was commanded to take the body down, not letting it remain on the tree overnight (Deut. 21:23). This explains why the Jews were so adamant that Jesus’ body be taken down before the Sabbath commenced at sunset (John 19:31). Being hung on a tree was especially abhorrent to Israel because it reflected God’s curse upon the offender (Deut. 21:23). Jesus was accursed by God as he hung on the cross, bearing the sins of the world (Gal. 3:13).

Crucifixion in New Testament Times

Not long before the Romans took over Palestine, the Jewish ruler Alexander Jannaeus crucified about eight hundred Pharisees who opposed him in 86 BC. This gruesome event was out of character for the Jewish nation and was frowned upon by the Jews of the day as well as by the later Jewish historian Josephus. But it was the Romans who perfected crucifixion as a means of torture and execution. The Romans called crucifixion “slaves’ punishment” because it was intended for the lowest members of society. It became the preferred method of execution for political crimes such as desertion, spying, rebellion, and insurrection. Roman crucifixion was common in NT times and extended well into the fourth century AD. The emperor Constantine converted to Christianity in AD 312 and abolished crucifixion altogether. The cross became a symbol of Christian sacrifice instead of a barbarous method of torture and execution.

Roman Crucifixion

Crucifixion was a barbaric method of torture and execution whereby a victim was either nailed or tied to a wooden cross and left to die a long, agonizing death. It often was reserved for the most offensive criminals, such as thieves (Matt. 27:38), murderers, insurrectionists (Mark 15:7), and other political rebels. Disobedient slaves commonly were crucified. Crucifixion was so demeaning that Roman citizens were exempt and could be crucified only by direct decree of the emperor. Crucifixion also was used as a triumphant sign in times of war as victors demonstrated their conquests by hoisting their enemies upon crosses for all to see. It was viewed as a public symbol of strength and intimidation. Adding insult to injury, executioners stripped their victims and crucified them alongside busy roads and in public places where onlookers could gaze in horror.

Criminals often were flogged severely before crucifixion in a pseudo-compassionate effort to speed up the death process experienced on the cross (John 19:1). The victim was stripped, tied to a post, and then brutally beaten by several Roman torturers using whips with sharp pieces of bone or metal at the ends of the lashes. Such floggings were said to leave the victim’s bones and entrails exposed. The torturers did not stop until they either exhausted themselves or were called off by their commanding officers.

After the flogging, the offender was forced to carry the crossbeam, often weighing seventy-five to one hundred pounds, on his or her shoulders to the crucifixion site (John 19:17). The main upright beam, standing seven to nine feet tall, remained at the site of crucifixion and was used repeatedly. The victim was then laid down with arms stretched out across the beam and usually tied into position. Once the victim’s arms were secured by ropes, a soldier searched for the “hollow spot” in the wrist located just above the flexion area near the carpal bones. The metacarpal bones of the palms were too weak to support the weight of the body on the cross, so the wrist was a stronger alternative. However, the use of ropes to support the arms made the choice of little consequence. Either location was acceptable. A hammer was used to drive five-inch nails through both wrists, affixing the victim to the crossbeam. It was customary to offer the victim a narcotic cocktail to help ease the pain of crucifixion. Jesus refused this drink (Matt. 27:34; Mark 15:23).

After the victim’s arms were nailed to the crossbeam, it was hoisted up and secured to the upright post. This alone was very hard on the fatigued body of the victim, who already had lost a considerable amount of blood. This quick, upward motion caused orthostatic hypotension—very low blood pressure caused by a rapid vertical shift in body position. The victim’s blood pressure would drop to half of normal, while the pulse rate doubled. Victims frequently fainted due to the rush of blood away from the head during this upward motion. This motion probably is the imagery behind Jesus’ “lifted up” sayings (John 3:14; 8:28; 12:32). Jesus was quite literally lifted up onto the cross.

Next came the nailing of the feet. The Romans had several different ways of nailing the feet to the cross. Roman soldiers were notorious for twisting and contorting victims into odd positions while nailing them to the cross. Sometimes a victim’s legs were stretched downward, feet crossed, and one nail driven through both. A support block typically was placed behind the victim to support the weight of the body on the cross. A heel bone of a crucified man named “Yehohanan” (John) was discovered in an ossuary north of Jerusalem in 1968. A single nail had been driven through the side of the heel. Either the body was twisted so that the nail was driven through both heels, the right above the left, or each heel was nailed to opposite sides of the upright beam causing the victim to straddle the cross. A piece of wood was held against the heel before the nail was driven in, to act as a washer, preventing the foot from tearing free. The ossuary’s inscription describes Yehohanan as “the one hanged with knees apart.” Once nailed to the cross, the victim often suffered for several hours, even days, exposed to the hot sun as well as the insults of those passing by on the busy road (cf. Matt. 27:39; Mark 15:29; Luke 23:35; John 19:20). Extreme thirst was brought on by massive blood loss and exposure to the elements (John 19:28).

Because death could take several hours, it sometimes was hastened by a crushing blow to the legs with a club. Victims were unable to push their bodies upward to gasp for air or to keep their blood circulating. This final blow to the legs also caused intense pain and usually was enough to throw the body into shock, with death following soon afterward. Jesus was already dead when the soldiers approached to break his legs (John 19:32–33). This fulfilled what was written in the Scriptures: “Not one of his bones will be broken” (John 19:36; cf. Exod. 12:46; Num. 9:12; Ps. 34:20). Instead of breaking Jesus’ legs, a soldier thrust a spear into his side, which brought forth a sudden flow of blood and water, indicating that he was truly dead (John 19:34). This too was to fulfill Scripture: “They will look on the one they have pierced” (John 19:37; cf. Zech. 12:10). Bodies often were left on the crosses to be eaten by scavenging birds such as vultures. The Jews demanded that the bodies of Jesus and the two thieves crucified with him be taken down before the Sabbath that began that evening (John 19:31).

Physical Death by Crucifixion

Death by crucifixion resulted from a combination of factors. The most obvious was massive blood loss. With the nails being driven through the extensive artery systems of the wrists and feet, the victim lost a lot of blood. The severe flogging before being crucified also played a role and took its toll on the body. Blood loss also led to a depletion of oxygen supply to the vital tissues. Major organs failed due to lack of oxygenation. Another factor leading to death was suffocation or asphyxiation. The weight of the body hanging on the cross was too great for the tendons and muscles in the arms, so the victims were unable to hold themselves up in order to take in deep breaths. The victim’s upper body continued to sink lower until the lungs became too compressed and unable to take in large volumes of air. Victims could force themselves upward to gasp air by using their legs, but this was extremely painful. Preventing the victim from pushing upward in order to breathe was another reason for breaking the legs. The victim slowly suffocated for hours.

The ultimate cause of death was an eventual heart rupture due to massive blood loss and lack of oxygenation. As the pulse raced and blood pressure increased, the heart eventually burst due to the stress. This helps explain the reference to the “sudden flow of blood and water” in John 19:34. In the case of heart rupture, the right side of the heart still has some blood left in it while the sac that surrounds the heart, the pericardium, fills with water. The soldier’s spear pierced this sac and the heart, causing both blood and water to flow out.

The Meaning of Jesus’ Crucifixion

The OT teaches that it is blood that makes atonement for sin (Lev. 17:11). Just as sacrificial lambs shed their blood on the altar for the sins of Israel, Jesus shed his blood on the cross for the sins of the world (John 1:29). The crucifixion of Jesus was the greatest atoning event in history. His blood, which provided the means for a new covenant, was poured out for many on the cross (Matt. 26:28). The cross, as gruesome as it was, was the means through which Christ died “for our sins” (Gal. 1:4). Jesus freely scorned the shame of the cross so that we might be reconciled to God by his shed blood (Col. 1:20; Heb. 12:2).

Jesus also bore the curse of God in our place when he died on the cross. The one who hangs on a tree is divinely cursed (Deut. 21:23). God’s curse is a curse upon sin, death, and fallenness. Jesus took God’s curse upon himself in order to redeem us from that curse (Gal. 3:13).

Jesus demonstrated the humble nature of his mission and ministry by his obedience to death, even death on the cross (Phil. 2:8). For Jesus the cross was not simply his martyrdom, as if he simply died for a worthy cause; it was the pinnacle example of obedience and love in the Bible. Jesus called his followers to take up a cross and follow his example of selfless sacrifice (Matt. 16:24). Jesus’ cross is a symbol of his love, obedience, and selflessness.

Most of all, the cross reveals the unconditional love of God, who offered his Son as the atoning sacrifice for sin (John 3:16; 1 John 4:10). The brutal cross reveals the beautiful love of Jesus, who willingly laid down his life (1 John 3:16).

Types of Crosses

A cross is an upright wooden beam or post on which persons were either tied or nailed as a means of torture and execution. A cross could have several different shapes. The earliest was not a cross at all but rather a simple stake or pole on which persons were impaled. This simple stake evolved over time into more elaborate shapes with the addition of a crossbeam that was secured to the upright stake. The Latin cross was shaped like a t and was the type most commonly used by the Romans. Jesus was crucified probably on a Latin cross, which allowed for a convenient place for a sign (called a titlos in John 19:19) to be placed above his head (Matt. 27:37 pars.). Another form of cross, now referred to as a St. Anthony’s cross, was shaped like a T, with the crossbeam affixed at the top of the upright beam. A cross shaped like an X, having a crisscross pattern, is also known as a St. Andrew’s cross. Tradition holds that the apostle Peter was crucified upside down on this type of cross. A cross shaped like a +, the Greek cross, has the crossbeam in the center.

Crucifixion in Ancient Times

In ancient times, crucifixion was a method of execution used by many peoples, including the Assyrians, the Phoenicians, the Babylonians, the Persians, the Medes, and the Greeks. Historically, crucifixion’s barbaric predecessor was impalement. Victims often were beheaded first, and then their lifeless bodies were forced onto a large stake or spike (Gen. 40:19; 1 Sam. 31:9–10). Impalement originally was more about triumph and exposure than execution (Deut. 21:22–23; Josh. 8:29; 10:26; 2 Sam. 4:12; 21:9–10). But the Assyrians impaled their enemies by sticking them, still alive, onto pointed stakes, thus utilizing impalement as a method of execution. The book of Esther probably reflects the practice of impalement in the Persian period by describing how the king’s officials were executed (2:23; 5:14; KJV: “hanged”). In these verses, the Hebrew word that some English versions translate as “gallows” (’ets) actually means “tree,” and a noose for hanging was not used in Persia during this period. Impalement became a common form of execution.

Impalement as a means of execution eventually gave way to crucifixion. Crucifixion was especially prized by the Phoenicians, whose normal methods of execution—drowning, immersion in boiling oil, impalement, stoning, and burning—were seen as too quick and easy. Wanting their victims to suffer longer, they used crucifixion, a more severe form of execution. The Greeks also crucified victims on a stake or a cross. Alexander the Great crucified two thousand inhabitants of Tyre along the shoreline when he captured the city in 332 BC.

There is no evidence that ancient Israel fastened people to a stake or a cross as a method of execution. Instead, stoning was the preferred method of execution in Israel and was commanded by the law (Lev. 20:2; Deut. 22:24). The law did, however, permit the public display of an offender’s body “on a tree” or a “pole” after being executed (Deut. 21:22). The same expression is used in the book of Acts to describe Jesus’ crucifixion (5:30; 10:39; 13:29). In contrast to pagan nations that would leave a corpse hanging on a cross until the flesh either rotted away or was devoured by vultures, Israel was commanded to take the body down, not letting it remain on the tree overnight (Deut. 21:23). This explains why the Jews were so adamant that Jesus’ body be taken down before the Sabbath commenced at sunset (John 19:31). Being hung on a tree was especially abhorrent to Israel because it reflected God’s curse upon the offender (Deut. 21:23). Jesus was accursed by God as he hung on the cross, bearing the sins of the world (Gal. 3:13).

Crucifixion in New Testament Times

Not long before the Romans took over Palestine, the Jewish ruler Alexander Jannaeus crucified about eight hundred Pharisees who opposed him in 86 BC. This gruesome event was out of character for the Jewish nation and was frowned upon by the Jews of the day as well as by the later Jewish historian Josephus. But it was the Romans who perfected crucifixion as a means of torture and execution. The Romans called crucifixion “slaves’ punishment” because it was intended for the lowest members of society. It became the preferred method of execution for political crimes such as desertion, spying, rebellion, and insurrection. Roman crucifixion was common in NT times and extended well into the fourth century AD. The emperor Constantine converted to Christianity in AD 312 and abolished crucifixion altogether. The cross became a symbol of Christian sacrifice instead of a barbarous method of torture and execution.

Roman Crucifixion

Crucifixion was a barbaric method of torture and execution whereby a victim was either nailed or tied to a wooden cross and left to die a long, agonizing death. It often was reserved for the most offensive criminals, such as thieves (Matt. 27:38), murderers, insurrectionists (Mark 15:7), and other political rebels. Disobedient slaves commonly were crucified. Crucifixion was so demeaning that Roman citizens were exempt and could be crucified only by direct decree of the emperor. Crucifixion also was used as a triumphant sign in times of war as victors demonstrated their conquests by hoisting their enemies upon crosses for all to see. It was viewed as a public symbol of strength and intimidation. Adding insult to injury, executioners stripped their victims and crucified them alongside busy roads and in public places where onlookers could gaze in horror.

Criminals often were flogged severely before crucifixion in a pseudo-compassionate effort to speed up the death process experienced on the cross (John 19:1). The victim was stripped, tied to a post, and then brutally beaten by several Roman torturers using whips with sharp pieces of bone or metal at the ends of the lashes. Such floggings were said to leave the victim’s bones and entrails exposed. The torturers did not stop until they either exhausted themselves or were called off by their commanding officers.

After the flogging, the offender was forced to carry the crossbeam, often weighing seventy-five to one hundred pounds, on his or her shoulders to the crucifixion site (John 19:17). The main upright beam, standing seven to nine feet tall, remained at the site of crucifixion and was used repeatedly. The victim was then laid down with arms stretched out across the beam and usually tied into position. Once the victim’s arms were secured by ropes, a soldier searched for the “hollow spot” in the wrist located just above the flexion area near the carpal bones. The metacarpal bones of the palms were too weak to support the weight of the body on the cross, so the wrist was a stronger alternative. However, the use of ropes to support the arms made the choice of little consequence. Either location was acceptable. A hammer was used to drive five-inch nails through both wrists, affixing the victim to the crossbeam. It was customary to offer the victim a narcotic cocktail to help ease the pain of crucifixion. Jesus refused this drink (Matt. 27:34; Mark 15:23).

After the victim’s arms were nailed to the crossbeam, it was hoisted up and secured to the upright post. This alone was very hard on the fatigued body of the victim, who already had lost a considerable amount of blood. This quick, upward motion caused orthostatic hypotension—very low blood pressure caused by a rapid vertical shift in body position. The victim’s blood pressure would drop to half of normal, while the pulse rate doubled. Victims frequently fainted due to the rush of blood away from the head during this upward motion. This motion probably is the imagery behind Jesus’ “lifted up” sayings (John 3:14; 8:28; 12:32). Jesus was quite literally lifted up onto the cross.

Next came the nailing of the feet. The Romans had several different ways of nailing the feet to the cross. Roman soldiers were notorious for twisting and contorting victims into odd positions while nailing them to the cross. Sometimes a victim’s legs were stretched downward, feet crossed, and one nail driven through both. A support block typically was placed behind the victim to support the weight of the body on the cross. A heel bone of a crucified man named “Yehohanan” (John) was discovered in an ossuary north of Jerusalem in 1968. A single nail had been driven through the side of the heel. Either the body was twisted so that the nail was driven through both heels, the right above the left, or each heel was nailed to opposite sides of the upright beam causing the victim to straddle the cross. A piece of wood was held against the heel before the nail was driven in, to act as a washer, preventing the foot from tearing free. The ossuary’s inscription describes Yehohanan as “the one hanged with knees apart.” Once nailed to the cross, the victim often suffered for several hours, even days, exposed to the hot sun as well as the insults of those passing by on the busy road (cf. Matt. 27:39; Mark 15:29; Luke 23:35; John 19:20). Extreme thirst was brought on by massive blood loss and exposure to the elements (John 19:28).

Because death could take several hours, it sometimes was hastened by a crushing blow to the legs with a club. Victims were unable to push their bodies upward to gasp for air or to keep their blood circulating. This final blow to the legs also caused intense pain and usually was enough to throw the body into shock, with death following soon afterward. Jesus was already dead when the soldiers approached to break his legs (John 19:32–33). This fulfilled what was written in the Scriptures: “Not one of his bones will be broken” (John 19:36; cf. Exod. 12:46; Num. 9:12; Ps. 34:20). Instead of breaking Jesus’ legs, a soldier thrust a spear into his side, which brought forth a sudden flow of blood and water, indicating that he was truly dead (John 19:34). This too was to fulfill Scripture: “They will look on the one they have pierced” (John 19:37; cf. Zech. 12:10). Bodies often were left on the crosses to be eaten by scavenging birds such as vultures. The Jews demanded that the bodies of Jesus and the two thieves crucified with him be taken down before the Sabbath that began that evening (John 19:31).

Physical Death by Crucifixion

Death by crucifixion resulted from a combination of factors. The most obvious was massive blood loss. With the nails being driven through the extensive artery systems of the wrists and feet, the victim lost a lot of blood. The severe flogging before being crucified also played a role and took its toll on the body. Blood loss also led to a depletion of oxygen supply to the vital tissues. Major organs failed due to lack of oxygenation. Another factor leading to death was suffocation or asphyxiation. The weight of the body hanging on the cross was too great for the tendons and muscles in the arms, so the victims were unable to hold themselves up in order to take in deep breaths. The victim’s upper body continued to sink lower until the lungs became too compressed and unable to take in large volumes of air. Victims could force themselves upward to gasp air by using their legs, but this was extremely painful. Preventing the victim from pushing upward in order to breathe was another reason for breaking the legs. The victim slowly suffocated for hours.

The ultimate cause of death was an eventual heart rupture due to massive blood loss and lack of oxygenation. As the pulse raced and blood pressure increased, the heart eventually burst due to the stress. This helps explain the reference to the “sudden flow of blood and water” in John 19:34. In the case of heart rupture, the right side of the heart still has some blood left in it while the sac that surrounds the heart, the pericardium, fills with water. The soldier’s spear pierced this sac and the heart, causing both blood and water to flow out.

The Meaning of Jesus’ Crucifixion

The OT teaches that it is blood that makes atonement for sin (Lev. 17:11). Just as sacrificial lambs shed their blood on the altar for the sins of Israel, Jesus shed his blood on the cross for the sins of the world (John 1:29). The crucifixion of Jesus was the greatest atoning event in history. His blood, which provided the means for a new covenant, was poured out for many on the cross (Matt. 26:28). The cross, as gruesome as it was, was the means through which Christ died “for our sins” (Gal. 1:4). Jesus freely scorned the shame of the cross so that we might be reconciled to God by his shed blood (Col. 1:20; Heb. 12:2).

Jesus also bore the curse of God in our place when he died on the cross. The one who hangs on a tree is divinely cursed (Deut. 21:23). God’s curse is a curse upon sin, death, and fallenness. Jesus took God’s curse upon himself in order to redeem us from that curse (Gal. 3:13).

Jesus demonstrated the humble nature of his mission and ministry by his obedience to death, even death on the cross (Phil. 2:8). For Jesus the cross was not simply his martyrdom, as if he simply died for a worthy cause; it was the pinnacle example of obedience and love in the Bible. Jesus called his followers to take up a cross and follow his example of selfless sacrifice (Matt. 16:24). Jesus’ cross is a symbol of his love, obedience, and selflessness.

Most of all, the cross reveals the unconditional love of God, who offered his Son as the atoning sacrifice for sin (John 3:16; 1 John 4:10). The brutal cross reveals the beautiful love of Jesus, who willingly laid down his life (1 John 3:16).

Types of Crosses

A cross is an upright wooden beam or post on which persons were either tied or nailed as a means of torture and execution. A cross could have several different shapes. The earliest was not a cross at all but rather a simple stake or pole on which persons were impaled. This simple stake evolved over time into more elaborate shapes with the addition of a crossbeam that was secured to the upright stake. The Latin cross was shaped like a t and was the type most commonly used by the Romans. Jesus was crucified probably on a Latin cross, which allowed for a convenient place for a sign (called a titlos in John 19:19) to be placed above his head (Matt. 27:37 pars.). Another form of cross, now referred to as a St. Anthony’s cross, was shaped like a T, with the crossbeam affixed at the top of the upright beam. A cross shaped like an X, having a crisscross pattern, is also known as a St. Andrew’s cross. Tradition holds that the apostle Peter was crucified upside down on this type of cross. A cross shaped like a +, the Greek cross, has the crossbeam in the center.

Crucifixion in Ancient Times

In ancient times, crucifixion was a method of execution used by many peoples, including the Assyrians, the Phoenicians, the Babylonians, the Persians, the Medes, and the Greeks. Historically, crucifixion’s barbaric predecessor was impalement. Victims often were beheaded first, and then their lifeless bodies were forced onto a large stake or spike (Gen. 40:19; 1 Sam. 31:9–10). Impalement originally was more about triumph and exposure than execution (Deut. 21:22–23; Josh. 8:29; 10:26; 2 Sam. 4:12; 21:9–10). But the Assyrians impaled their enemies by sticking them, still alive, onto pointed stakes, thus utilizing impalement as a method of execution. The book of Esther probably reflects the practice of impalement in the Persian period by describing how the king’s officials were executed (2:23; 5:14; KJV: “hanged”). In these verses, the Hebrew word that some English versions translate as “gallows” (’ets) actually means “tree,” and a noose for hanging was not used in Persia during this period. Impalement became a common form of execution.

Impalement as a means of execution eventually gave way to crucifixion. Crucifixion was especially prized by the Phoenicians, whose normal methods of execution—drowning, immersion in boiling oil, impalement, stoning, and burning—were seen as too quick and easy. Wanting their victims to suffer longer, they used crucifixion, a more severe form of execution. The Greeks also crucified victims on a stake or a cross. Alexander the Great crucified two thousand inhabitants of Tyre along the shoreline when he captured the city in 332 BC.

There is no evidence that ancient Israel fastened people to a stake or a cross as a method of execution. Instead, stoning was the preferred method of execution in Israel and was commanded by the law (Lev. 20:2; Deut. 22:24). The law did, however, permit the public display of an offender’s body “on a tree” or a “pole” after being executed (Deut. 21:22). The same expression is used in the book of Acts to describe Jesus’ crucifixion (5:30; 10:39; 13:29). In contrast to pagan nations that would leave a corpse hanging on a cross until the flesh either rotted away or was devoured by vultures, Israel was commanded to take the body down, not letting it remain on the tree overnight (Deut. 21:23). This explains why the Jews were so adamant that Jesus’ body be taken down before the Sabbath commenced at sunset (John 19:31). Being hung on a tree was especially abhorrent to Israel because it reflected God’s curse upon the offender (Deut. 21:23). Jesus was accursed by God as he hung on the cross, bearing the sins of the world (Gal. 3:13).

Crucifixion in New Testament Times

Not long before the Romans took over Palestine, the Jewish ruler Alexander Jannaeus crucified about eight hundred Pharisees who opposed him in 86 BC. This gruesome event was out of character for the Jewish nation and was frowned upon by the Jews of the day as well as by the later Jewish historian Josephus. But it was the Romans who perfected crucifixion as a means of torture and execution. The Romans called crucifixion “slaves’ punishment” because it was intended for the lowest members of society. It became the preferred method of execution for political crimes such as desertion, spying, rebellion, and insurrection. Roman crucifixion was common in NT times and extended well into the fourth century AD. The emperor Constantine converted to Christianity in AD 312 and abolished crucifixion altogether. The cross became a symbol of Christian sacrifice instead of a barbarous method of torture and execution.

Roman Crucifixion

Crucifixion was a barbaric method of torture and execution whereby a victim was either nailed or tied to a wooden cross and left to die a long, agonizing death. It often was reserved for the most offensive criminals, such as thieves (Matt. 27:38), murderers, insurrectionists (Mark 15:7), and other political rebels. Disobedient slaves commonly were crucified. Crucifixion was so demeaning that Roman citizens were exempt and could be crucified only by direct decree of the emperor. Crucifixion also was used as a triumphant sign in times of war as victors demonstrated their conquests by hoisting their enemies upon crosses for all to see. It was viewed as a public symbol of strength and intimidation. Adding insult to injury, executioners stripped their victims and crucified them alongside busy roads and in public places where onlookers could gaze in horror.

Criminals often were flogged severely before crucifixion in a pseudo-compassionate effort to speed up the death process experienced on the cross (John 19:1). The victim was stripped, tied to a post, and then brutally beaten by several Roman torturers using whips with sharp pieces of bone or metal at the ends of the lashes. Such floggings were said to leave the victim’s bones and entrails exposed. The torturers did not stop until they either exhausted themselves or were called off by their commanding officers.

After the flogging, the offender was forced to carry the crossbeam, often weighing seventy-five to one hundred pounds, on his or her shoulders to the crucifixion site (John 19:17). The main upright beam, standing seven to nine feet tall, remained at the site of crucifixion and was used repeatedly. The victim was then laid down with arms stretched out across the beam and usually tied into position. Once the victim’s arms were secured by ropes, a soldier searched for the “hollow spot” in the wrist located just above the flexion area near the carpal bones. The metacarpal bones of the palms were too weak to support the weight of the body on the cross, so the wrist was a stronger alternative. However, the use of ropes to support the arms made the choice of little consequence. Either location was acceptable. A hammer was used to drive five-inch nails through both wrists, affixing the victim to the crossbeam. It was customary to offer the victim a narcotic cocktail to help ease the pain of crucifixion. Jesus refused this drink (Matt. 27:34; Mark 15:23).

After the victim’s arms were nailed to the crossbeam, it was hoisted up and secured to the upright post. This alone was very hard on the fatigued body of the victim, who already had lost a considerable amount of blood. This quick, upward motion caused orthostatic hypotension—very low blood pressure caused by a rapid vertical shift in body position. The victim’s blood pressure would drop to half of normal, while the pulse rate doubled. Victims frequently fainted due to the rush of blood away from the head during this upward motion. This motion probably is the imagery behind Jesus’ “lifted up” sayings (John 3:14; 8:28; 12:32). Jesus was quite literally lifted up onto the cross.

Next came the nailing of the feet. The Romans had several different ways of nailing the feet to the cross. Roman soldiers were notorious for twisting and contorting victims into odd positions while nailing them to the cross. Sometimes a victim’s legs were stretched downward, feet crossed, and one nail driven through both. A support block typically was placed behind the victim to support the weight of the body on the cross. A heel bone of a crucified man named “Yehohanan” (John) was discovered in an ossuary north of Jerusalem in 1968. A single nail had been driven through the side of the heel. Either the body was twisted so that the nail was driven through both heels, the right above the left, or each heel was nailed to opposite sides of the upright beam causing the victim to straddle the cross. A piece of wood was held against the heel before the nail was driven in, to act as a washer, preventing the foot from tearing free. The ossuary’s inscription describes Yehohanan as “the one hanged with knees apart.” Once nailed to the cross, the victim often suffered for several hours, even days, exposed to the hot sun as well as the insults of those passing by on the busy road (cf. Matt. 27:39; Mark 15:29; Luke 23:35; John 19:20). Extreme thirst was brought on by massive blood loss and exposure to the elements (John 19:28).

Because death could take several hours, it sometimes was hastened by a crushing blow to the legs with a club. Victims were unable to push their bodies upward to gasp for air or to keep their blood circulating. This final blow to the legs also caused intense pain and usually was enough to throw the body into shock, with death following soon afterward. Jesus was already dead when the soldiers approached to break his legs (John 19:32–33). This fulfilled what was written in the Scriptures: “Not one of his bones will be broken” (John 19:36; cf. Exod. 12:46; Num. 9:12; Ps. 34:20). Instead of breaking Jesus’ legs, a soldier thrust a spear into his side, which brought forth a sudden flow of blood and water, indicating that he was truly dead (John 19:34). This too was to fulfill Scripture: “They will look on the one they have pierced” (John 19:37; cf. Zech. 12:10). Bodies often were left on the crosses to be eaten by scavenging birds such as vultures. The Jews demanded that the bodies of Jesus and the two thieves crucified with him be taken down before the Sabbath that began that evening (John 19:31).

Physical Death by Crucifixion

Death by crucifixion resulted from a combination of factors. The most obvious was massive blood loss. With the nails being driven through the extensive artery systems of the wrists and feet, the victim lost a lot of blood. The severe flogging before being crucified also played a role and took its toll on the body. Blood loss also led to a depletion of oxygen supply to the vital tissues. Major organs failed due to lack of oxygenation. Another factor leading to death was suffocation or asphyxiation. The weight of the body hanging on the cross was too great for the tendons and muscles in the arms, so the victims were unable to hold themselves up in order to take in deep breaths. The victim’s upper body continued to sink lower until the lungs became too compressed and unable to take in large volumes of air. Victims could force themselves upward to gasp air by using their legs, but this was extremely painful. Preventing the victim from pushing upward in order to breathe was another reason for breaking the legs. The victim slowly suffocated for hours.

The ultimate cause of death was an eventual heart rupture due to massive blood loss and lack of oxygenation. As the pulse raced and blood pressure increased, the heart eventually burst due to the stress. This helps explain the reference to the “sudden flow of blood and water” in John 19:34. In the case of heart rupture, the right side of the heart still has some blood left in it while the sac that surrounds the heart, the pericardium, fills with water. The soldier’s spear pierced this sac and the heart, causing both blood and water to flow out.

The Meaning of Jesus’ Crucifixion

The OT teaches that it is blood that makes atonement for sin (Lev. 17:11). Just as sacrificial lambs shed their blood on the altar for the sins of Israel, Jesus shed his blood on the cross for the sins of the world (John 1:29). The crucifixion of Jesus was the greatest atoning event in history. His blood, which provided the means for a new covenant, was poured out for many on the cross (Matt. 26:28). The cross, as gruesome as it was, was the means through which Christ died “for our sins” (Gal. 1:4). Jesus freely scorned the shame of the cross so that we might be reconciled to God by his shed blood (Col. 1:20; Heb. 12:2).

Jesus also bore the curse of God in our place when he died on the cross. The one who hangs on a tree is divinely cursed (Deut. 21:23). God’s curse is a curse upon sin, death, and fallenness. Jesus took God’s curse upon himself in order to redeem us from that curse (Gal. 3:13).

Jesus demonstrated the humble nature of his mission and ministry by his obedience to death, even death on the cross (Phil. 2:8). For Jesus the cross was not simply his martyrdom, as if he simply died for a worthy cause; it was the pinnacle example of obedience and love in the Bible. Jesus called his followers to take up a cross and follow his example of selfless sacrifice (Matt. 16:24). Jesus’ cross is a symbol of his love, obedience, and selflessness.

Most of all, the cross reveals the unconditional love of God, who offered his Son as the atoning sacrifice for sin (John 3:16; 1 John 4:10). The brutal cross reveals the beautiful love of Jesus, who willingly laid down his life (1 John 3:16).

(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).

(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).

The Bible contains two kinds of statements related to proper conduct. Some of them describe the nature of God, the sort of world he created, and what he has done for particular groups of people. It also contains statements telling us what we ought to do, both as creatures of this God and, in some instances, as the unique beneficiaries of his redemptive activity. Consequently, the Bible sets forth a moral viewpoint or ethical system, supported by reasons that justify its content and urgency. The writers of Scripture were not moral philosophers, outlining their position in technical detail; nevertheless, they intended to reveal what pleases our God and Savior, so that the saints are “thoroughly equipped for every good work” (2 Tim. 3:16–17). The Bible, therefore, is the foundational resource for moral discernment, the definitive statement of what Christians must do and who they must become.

The Sources of Moral Knowledge

Scripture identifies two sources of moral knowledge. First, all human beings have the law of God “written on their hearts” (Rom. 2:15). We have a conscience, a God-given awareness of right and wrong that acquits or convicts us, depending on how we respond to it. The fall of humankind has damaged this source of knowledge, and our consciences can become “seared” through chronic disobedience and doctrinal treason (1 Tim. 4:2). We do not, therefore, see infallibly what our duties are. Nevertheless, the apostle Paul argues that every human being knows enough of God’s law—and indeed, enough about his nature as God—to eliminate every defense on judgment day (Rom. 1:18–20). No one will be able to say to God in that hour, “I had no idea who you were and no hint of what you expected of me.”

Second, as noted above, we have the Bible as a source of knowledge, this one being fully adequate and sufficiently clear to guide our choices. Knowing Scripture is necessary for Christian ethics because it offers a high-definition view of what conscience can (even in its best moments) scarcely grasp. The Bible proclaims not only what the church must do, often in straightforward, concrete terms, but also (at least, in many cases) why God’s will has its particular content and why obedience is an emergency, not a safely deferred, improvement project. The Bible does not, and really could not, answer every ethical question put to it in unambiguous detail. New technologies and cultural shifts have created dilemmas unimagined in the first century or any previous age. But the church can be assured that a faithful reading of and response to Scripture will, by the grace of God, please him even today, whatever our particular circumstances.

The Logic of Biblical Morality

The moral teaching of Scripture has an identifiable structure consisting of duties and final objectives. When we obey God’s commandments, which is our duty, his ultimate goals or objectives in creating us are realized. In this sense, biblical morality is complete and informative compared to systems derived from other worldviews. It explains what life is all about, but also what we must do from day to day. This entire picture emerges from Scripture because its theological statements are always practically applied and never presented with merely theoretical interest.

The objectives of biblical morality. The objectives of an ethical system are its final ends or purposes: the results that obedience is supposed to yield. In the Bible, two objectives have this ultimate significance, one being the anticipated side effect of the other.

To glorify God. The biblical writers proclaim the spectacular goodness of God. He is maximally excellent in all ways as the Creator, including wisdom, power, justice, and love. He is the holy God who, almost in spite of that fact, loves us and gave his Son, Jesus, to suffer for our sins so that we might live eternally in his presence. In these respects, God stands alone, not simply in experience but necessarily so. No one ever has, and no one ever could, be like him. Thus, the final objective of all human striving must be to glorify this God—to know him, to praise him, and to value what he values. Our actions must testify to his excellence, honoring him and encouraging others to do likewise. Obedience treasures what God treasures, shuns what he abhors, and allows his power to work in our lives, causing us to live in unity with our fellow believers. These patterns of behavior define what it means to glorify God.

To be happy in God’s presence. The second goal or objective of biblical morality is to be happy in ways that are proper for God’s creatures. In this sense, the Christian system of ethics differs from moral theories that either reject happiness altogether, viewing it as an unworthy goal, or else reduce it to a merely practical necessity—that is, we sinners need our incentives. On the contrary, the God of Scripture plainly desires our happiness and often presents himself as the final source of it when calling his people to obedience. This tendency follows from the perfect goodness of God and his freedom in creating all things. He did not have to make anything else, but he did so; and because he has no needs, his purposes must have been selfless rather than selfish. He created in order to give rather than to get, and the very best he desires for any of us is the happiness that results from our glorifying him together, as one body in Christ. Likewise, then, biblical morality differs from ethical systems that make human happiness an intrinsic good, so that any means to it is acceptable. God wants us to be happy, but our happiness must come from bringing him glory. All other forms of happiness are deceptive and transitory. The heavenly scenes of the book of Revelation show the church what happiness God has in store for them if they overcome the trials of this life (so, e.g., Rev. 4–5; 7; 21–22; cf. 1 Cor. 2:9; Heb. 12:2).

The means of biblical morality. Not surprisingly, the Bible also shows us how to glorify God—how to reflect his majesty in our daily lives, how to praise him, and how to value what he values. Within the whole of this teaching, several major themes can be discerned, five leading examples of which appear below, allowing some overlap between them.

Trusting in God’s promises. Biblical faith is the confidence that God will do for us what he has promised. We believe that he can and will meet our needs and not allow us to endure pointless suffering. When we trust him, we proclaim his greatness and acknowledge our own dependence upon him. Both Rom. 4 and Heb. 11 make this point in ways that reflect upon OT history with an application to the present Christian life. The gospel is a promise concerning the death, burial, and resurrection of Christ; and faith assures us that God will reckon these events to our account. Conversely, we often violate God’s commandments because we doubt that he will give us what we need when we need it (so, e.g., Abraham’s capitulation to Sarah in Gen. 16, with its corresponding negative results).

Keeping holiness and impurity separated. God is the all-powerful, all-knowing, morally perfect Creator of the universe. All things depend on him for their existence, and he is extreme both in his commitment to justice and his desire to love. Consequently, God’s creatures encounter him as “holy,” as the ominously transcendent or dangerously perfect deity. He stands alone, apart from everything else, and life in his presence cannot entail business as usual. The shorthand way of expressing this duty is to say that we ourselves must be holy, as he is holy, by shunning all forms of impurity. In this way, for example, the ancient Israelites prepared themselves to enter Yahweh’s presence and gave him public honor (Lev. 11:44; 19:2; Ps. 24:3–4; Isa. 6:1–5; cf. 1 Pet. 1:15–16).

In Scripture, the distinction between the pure and the impure, or the holy and the unholy, is sometimes intrinsic and sometimes pedagogical. Breaking any of the Ten Commandments makes one intrinsically impure. It is always evil, everywhere, for anyone to have other gods, make idols, and disrespect parents. It is evil to lie, steal, and murder. Even breaking the Sabbath is wrong if it expresses unbelief in God’s ability and willingness to provide. But some lines between purity and impurity—or, in other cases, just between the sacred and the common—seem to be drawn by God for instructional purposes only. They do not separate good from evil as such, but they compel the Israelites to “practice Yahweh’s presence” by honoring boundaries imposed on domestic life. It is not evil to eat pork, but doing that is forbidden in the OT and permitted in the NT (Lev. 11:7; Mark 7:19). It is not evil to wear blended cloth, but doing that is forbidden in the OT and passed over in the NT (Lev. 19:19). Therefore, as suggested, Levitical rules of this kind must have had some instrumental purpose, serving an objective beyond themselves. They impose the holiness of Yahweh on everyday choices, as the Holy Spirit now presses the claims of God upon his church. This separation of impurity and holiness is, in any case, a constant theme in the OT, and it carries over into the NT as well, where it informs the question “What must I do to be saved?” (cf. Acts 16:30).

Imitating God/Christ. The biblical writers also construe the moral life as an imitation of God and/or Christ, especially when the virtues of mercy, humility, and endurance are at stake. In the OT, Yahweh’s behavior toward people becomes the standard for Israel’s own conduct. So, for example, he says, “But let the one who boasts boast about this: that they have the understanding to know me, that I am the Lord, who exercises kindness, justice and righteousness on earth, for in these I delight” (Jer. 9:24). In the NT, similar inferences appear, as when Jesus says, “Blessed are the peacemakers, for they will be called children of God” (Matt. 5:9), the son being one who follows in his father’s footsteps. We must love our enemies, so that we may be “children of (our) Father in heaven” (Matt. 5:44–45). We must “be perfect,” as he is perfect (Matt. 5:48). Jesus commands his disciples to wash one another’s feet, after his own example (John 13:14–15). They must love each other as he has loved them (John 15:12). The new commandment to love one another, following the Lord’s example, puts on display his character and their own relationship to him (13:34–35). Jesus prays that his disciples will be “one,” just as the Father and the Son are one (17:22). Paul’s hymn in Phil. 2:5–11 serves this purpose: we must imitate the humility that surrendered all, even to the point of crucifixion. Hebrews 12:1–2 holds up Christ as one who “for the joy set before him endured the cross, scorning its shame,” resulting in his glory.

Living out our unique identity. Scripture defines the moral ideal for all persons, whoever they are, because its perspective is not relativistic. Murder, idolatry, and lying are not wrong for some and right for others. Nevertheless, most of the Bible’s moral teaching has a target audience, so that it often contains inferences to this effect: “You shall do X (or doing X is urgent for you), either (a) because you belong to God in a special way or (b) because he has done this special thing for you.” In the OT, the target audience is Israel; in the NT, the corresponding group is the church. In both Testaments, however, the same ethical particularism operates, thereby giving the moral exhortations of Paul and Peter, to cite two clear examples, a recognizably “Jewish” structure or theme.

The linkage between gift and task, or supernatural identity and behavior, is the basic structure of the Sinai covenant itself. The text moves from prologue, “I am the Lord your God, who brought you out of Egypt,” to moral exhortation, beginning with, “You shall have no other gods before me” (Exod. 20:1–3; Deut. 5:6–7). Echoes of this prologue also occur frequently in the OT as motive clauses. God will say, in effect, “You shall do X, for I am the Lord your God,” or “You shall not do Y, for I am the Lord your God who brought you out of Egypt.” In some cases, the motive clause identifies the people themselves, as in, “For you are a people holy to the Lord your God. The Lord your God has chosen you out of all the peoples on the face of the earth to be his people, his treasured possession” (Deut. 7:6). Or again, “You are the children of the Lord your God. Do not cut yourselves or shave the front of your heads for the dead, for you are a people holy to the Lord your God. Out of all the peoples on the face of the earth, the Lord has chosen you to be his treasured possession” (Deut. 14:1–2). In some cases, God refers to the people’s unique condition to shame them, as in, “When Israel was a child, I loved him, and out of Egypt I called my son. But the more they were called, the more they went away from me” (Hos. 11:1–2). Loyalty was especially urgent, given Israel’s experience of God’s particular love.

In the NT, the mandate to live out one’s special identity appears often, especially (though not exclusively) in the writings of Paul and Peter. In Rom. 6 those who have been emancipated from sin must resist its waning influence. In Rom. 8 those who are under the Holy Spirit’s new management must walk in accordance with him and shun the mind-set of the flesh. The Corinthians have become an unleavened batch of dough; therefore, they must “Get rid of the old yeast,” which tolerates extraordinary sin (1 Cor. 5). The members of Christ’s one body are to function as one new humanity (1 Cor. 12:12–31). If the Galatians live by the Spirit, they must also walk by the Spirit (Gal. 5:25). Peter tells his readers to love one another because they have been “born again” of “imperishable seed” (1 Pet. 1:22–23). They are a “chosen race,” a “royal priesthood,” and a “holy nation”; therefore, they must proclaim his excellence and abstain from carnal passions (1 Pet. 2:9–11). Jesus himself says that because he is the vine and we are the branches, we must abide in him (John 15:1–11). In all these cases, the target audience has a special relationship to God that imposes on them corresponding duties or priorities, so that they reflect his holiness, value what he values, and attain the goals that he has set before them.

Living in unity with one another. The first sin separated God from humankind and damaged all other relationships (Gen. 3). From that point onward, Adam and Eve would live in tension (Gen. 3:16), and their son Cain kills his brother Abel (Gen. 4:8). Disunity results from sin; and in some cases, God scatters sinners as judgment on their wickedness (e.g., Gen. 11:1–9; 1 Kings 11). It is “good and pleasant” when “God’s people live together in unity” (Ps. 133:1), and obedience to OT teaching would make them do so. Nevertheless, sin stands between Yahweh and his people, and it stands between one Israelite and another. Disunity, in all these dimensions, is the unfinished business of the OT story.

The NT presents unity as both an effect and a duty (or a gift and a task) of the new life in Christ. We are one in Christ, and we must live in unity of fellowship with one another. Jews and Gentiles—indeed, people from all walks of life—become one body, a new kind of people, defined by relationships that are “thicker than blood,” so to speak, as blood is thicker than water. Paul, as the apostle to the Gentiles, enforces this theme throughout his letters, so that his exhortations concentrate on the church, in the first instance, rather than the individual. Christians must display the social virtues of love and humility, resisting selfish ambition and pride, both of which separate believer from believer and each from the head of the church, who is Christ. Romans and Ephesians make a positive case for Christian unity among Jews and Gentiles, while Philippians (perhaps, in a broader sense, also Galatians and Colossians) confronts a divisive tendency. The essential vice denounced in 1–2 Corinthians is arrogant grandstanding, which rejects Paul’s “message of the cross” (1 Cor. 1:18) and subdivides the church into cults of personality. Worldly forces are centrifugal, leading us away from one another and into competition for influence, wealth, and public honor. In contrast, the Holy Spirit’s force is centripetal, creating unity where no one would expect it and leading each person to self-sacrifice so that others in the body of Christ might be built up in him.

The Bible contains little information about nonathletic games, but archaeology has revealed numerous types of board games and children’s games in Egypt, Mesopotamia, and Canaan. Although actual game pieces and dice have been found, information concerning the rules of the games is lacking. The Hebrew Bible does not describe anything like Greek or Roman games, but the NT makes numerous references to athletic competitions.

Greek games originated with funeral rites that commemorated heroes. The Iliad provides the earliest reference to Greek games as it describes games sponsored by Achilles in memory of Patroklos. The games became an integral part of Greek culture, honored the Greek gods, and were an essential element in a Greek education. Games were held at hundreds of local festivals across the Mediterranean, but the four Panhellenic games were the most prestigious. The games were accompanied by a sacred truce and held in sanctuaries. The Greeks trained and competed in the nude. Initially, running was the only competition, but by the second century AD Pausanius enumerated twenty-four contests, all of which were individual competitions. The specific contests varied from place to place, but the main events included running, chariot racing, long jumping, javelin throwing, discus throwing (2 Macc. 4:14), wrestling, boxing (1 Cor. 9:26), and the pankration, which was a form of all-out fighting. Some of the games included musical competitions. The prize, a wreath, was awarded only for first prize, and the winner of all four Panhellenic games was the periodonikēs. The victor returned home to a hero’s welcome, fame, and gifts. Some examples of cheating and bribery have survived, and those caught were fined.

The Olympic games, established in 776 BC, were the oldest and most prestigious of the Panhellenic games. They were held every four years in the sanctuary complex of Zeus in Olympia. The stadium was typically about 600 feet long, but Olympia’s was the longest, at about 630 feet, because of the tradition that Heracles had laid out the course. The remaining Panhellenic games were established about two hundred years later, in the sixth century BC. The Pythian games were held at the sanctuary of Apollo in Delphi. The Nemean games were held at the sanctuary of Zeus in Argos. The Isthmian games were administered by Corinth at the sanctuary of Poseidon.

The Romans preferred gladiatorial games and wild-game hunts over Greek games. Nevertheless, Romans were allowed to participate in the Panhellenic games. In fact, the emperors Tiberius and Nero participated. The Roman games were wildly popular with the people. By the second century AD, 135 days of games were held each year in Rome. The Circus Maximus was the largest venue, allowing up to two hundred thousand spectators to attend the chariot races. The Colosseum, the largest amphitheater in the Roman Empire, was built in AD 80, financed with spoils taken during the First Jewish Revolt. It held fifty thousand spectators for the gladiatorial games. Prisoners of war, slaves, and criminals condemned to die were forced to fight as gladiators and face wild beasts. Gladiatorial games were held throughout the empire. Herod the Great threw condemned criminals to wild animals in his amphitheater near Jerusalem in order to delight the spectators (Josephus, Ant. 15.273–75). Paul refers to fighting wild beasts in Ephesus (1 Cor. 15:32), though this is likely a metaphor for his spiritual opponents. Roman-style games honored Rome and became a symbol of loyalty to the Roman Empire.

Jewish views toward Greek and Roman games varied. Some Jews, especially those in the Diaspora, embraced the games as spectators and participants (2 Macc. 4:9–14). During the reign of Antiochus IV, some Jewish youth participated in the gymnasium in Jerusalem. They even underwent surgery to cover the signs of their circumcision (1 Macc. 1:12–15). Herod the Great built amphitheaters, stadiums, and hippodromes throughout his kingdom, and Philo of Alexandria frequented the games. However, the authors of 1–2 Maccabees criticize the priests for neglecting their duties by attending the games. Furthermore, the religious association of the games led many conservative Jews to oppose the games.

Because Paul and his audiences were familiar with Greek and Roman games, he drew upon them as analogies to the Christian life. During Paul’s eighteen-month ministry in Corinth, the nearby Isthmian games were played. Through references to training and competition, Paul demonstrates the need to be disciplined, focused, determined as an athlete (1 Cor. 9:24–27; 2 Tim. 4:7; cf. Heb. 12:1). In contrast to the wreath won by Greek athletes, Christians strive for an eternal prize and a crown of righteousness (1 Cor. 9:27; Phil. 3:14; 2 Tim. 4:7–8).

In the Bible, gestures are made with either parts of the body or items, such as clothing and rings, directly connected to the body. For this reason, it makes sense to classify biblical gestures in relation to the different body parts that are identified with the gestures. It is, however, challenging to know where to draw a line on classifying a gesture. For example, a devious person is described in Prov. 6:13 as one “who winks maliciously with his eye, signals with his feet and motions with his fingers.” It is unclear whether this is a single gesture or multiple ones, and whether all signify different things or the same thing.

Head

Gestures that relate to the head range from simple head motions to semiviolent acts such as hair pulling. Simple head motions include lifting of one’s head in honor (Gen. 40:13), bowing one’s head in mourning (Ps. 35:14), tossing one’s head in mockery and derision (2 Kings 19:21), and shaking one’s head as insult (Ps. 22:7; Mark 15:29).

A common action is the shaving of the head, which can be for purification (Lev. 14:8–9; Num. 6:9; 8:7 [includes all body hair]), mourning (Deut. 21:11–13; Job 1:20; Isa. 15:2; Jer. 16:6; 47:5; 48:37; Ezek. 27:31; Amos 8:10; Mic. 1:16), remorse (Jer. 41:5), or shaming (Jer. 2:16). However, priests are forbidden from shaving their heads even in mourning (Lev. 21:5; Ezek. 44:20), while the high priest is to wear a turban on his head during sacrificial duties (Exod. 29:6).

Anointing of the head is done when a priest or king is installed (Exod. 29:7; Ps. 23:5) or simply as a sign of God’s goodness and blessing on a person (Eccles. 9:8). Blessing may also involve placing a hand on the head of the person being blessed (Gen. 48:14–18; Exod. 29:19), while the same gesture on the head of sacrificial animals is a symbolic means of transferring sin (Lev. 3:2, 8, 13; 4:4, 15, 24, 29, 33; 8:18, 22).

In the OT, a woman’s head can be shaved in mourning (Deut. 21:12–13; cf. Jer. 47:5), but in the NT, a shaved head can be a cause for disgrace (1 Cor. 11:5–6).

Face. Facial gestures range from expressions to actions such as touching or covering the face. A face can be downcast in anger (Gen. 4:5–6) or bowed to the ground in honor (Gen. 48:12), in dejection (Josh. 7:6), in humility (Ruth 2:10), in worship (2 Chron. 20:18; Ps. 138:2), in subjection, supplication, reverence (1 Sam. 20:41; 25:41; 28:14; 2 Sam. 14:4, 22; 18:28; 24:20; 1 Kings 1:23; 1 Chron. 21:20), or in dread (e.g., Moses before Yahweh [Exod. 3:6]).

The face can be covered or veiled as an indication of uncleanness (Lev. 13:45), in grief/mourning (2 Sam. 19:4; Ezek. 24:17), in resignation (1 Kings 19:13), with intent to deceive in adultery (Job 24:15), or in horror of judgment (Esther 7:8; Ezek. 12:6, 12). It can also be buried in the dust in remorse (Lam. 3:29).

God can be described as hiding or turning away his face against wickedness and evil (Deut. 31:18; 32:20; Ps. 34:16; Isa. 8:17; Jer. 33:5; Ezek. 7:22; 15:7; 20:46; 21:2) or in an act of withholding blessings (Job 13:15; Pss. 10:1; 13:1; 27:9; 30:7; 34:16; Isa. 54:8; 59:2; 64:7). God can also turn his face toward a place in judgment (Ezek. 4:3, 7; 6:2). In 1 Sam. 5:3–4 the idol of the Philistine god Dagon falls facedown before the ark of the covenant, apparently overpowered by Yahweh.

Acts of humiliation or dishonor can involve spitting in the face (Num. 12:14; Deut. 25:9; Job 17:6; 30:10; Isa. 50:6), slapping the face (1 Kings 22:24; 2 Chron. 18:23; Job 16:10; Lam. 3:30; Mic. 5:1), pulling a skirt up over someone’s face in shaming judgment (Jer. 13:26; Nah. 3:5), and hooking and dragging someone by the nose (2 Kings 19:28). Although being struck on the cheek is humiliating, Jesus instructs his disciples to “turn the other cheek” as a sign of resistance to violence (Matt. 5:39; Luke 6:29).

One can lift one’s face in worship (2 Kings 20:2; Job 22:26; Isa. 38:2) or in confidence (Job 11:15) and can fail to lift it in shame and disgrace (Ezra 9:6). Although the shaving of beards in mourning is common practice (Ezra 9:3; Isa. 15:2; Jer. 41:5; 48:37), the forced shaving of beards is an act of shaming and insulting (2 Sam. 10:4; 1 Chron. 19:4–5; Isa. 7:20; 50:6).

Eyes. Winking the eye is perceived as an evil, deceptive, or malicious act (Ps. 35:19; Prov. 6:13; 16:30). Eyes can be lifted up in worship and expectation (Pss. 121:1; 123:1).

Mouth. Pursed lips can characterize an evil person (Prov. 16:30), while a hand can be clapped over the mouth in awe and submission (Job 21:5; 40:4). Psalm 72:9 looks to the righteous king before whom the desert tribes will bow and whose “enemies lick the dust” in defeat.

Ears. An Israelite slave for life is to have a hole punched through his or her earlobe, held against a doorpost, with an awl (Exod. 21:6; Deut. 15:17). Blood is sprinkled on the lobe of the right ear for purification (Exod. 29:20; Lev. 8:23–24; 14:17), while supplication can be described as asking for the turning of an ear (2 Kings 19:16; Ps. 31:2). Turning one’s ear signifies paying attention or taking something to heart (Ps. 49:4; Prov. 4:20; 5:13).

Neck. The neck can be adorned (Song 1:10) as a sign of pride and honor (Gen. 41:42; Judg. 5:30; Prov. 1:9; Ezek. 16:11) or outstretched in arrogance (Ps. 75:5 TNIV: “Do not lift your horns against heaven; do not speak with outstretched neck”). Jeremiah put a yoke on his neck as a prophetic sign of the approaching Babylonian conquest (Jer. 27–28). While putting someone’s neck in a yoke is an act of triumphal conquest (Ps. 105:18), stepping on the neck of a subdued enemy is an act of subjugation and humiliation (Josh. 10:24).

Body

Nakedness in public is considered shameful (Gen. 9:22–23; Nah. 3:5; Rev. 3:18), so that it is sometimes pictured as part of divine judgment (Deut. 28:48; Isa. 47:2–3; Lam. 1:8; Mic. 1:11) or as a sign of promiscuity (Isa. 57:8; Ezek. 16:36). An unkempt body can be a sign of mourning, as it is for Mephibosheth (2 Sam. 19:24). A certain kind of body covering is a sign of marriage proposal or protection (Ezek. 16:8; 23:18; Hos. 2:9). Body dismembering, even in war, is an act of humiliation (2 Sam. 4:12).

Chest. In self-mortification, one can pound one’s chest in mourning (Ezek. 21:12) or in remorse (Jer. 31:19; Luke 18:13). The breasts of sacrificial animals are waved before God as a “wave offering” before being eaten (Exod. 29:26; Lev. 7:30; Num. 6:20).

Hand, arm. Hand gestures include motions such as lifting hands in worship, clapping hands in joy, and clapping a hand over one’s mouth in awe. The expression “outstretched arm” (Exod. 6:6; Deut. 4:34; 5:15; 7:19; 9:29; 11:2; 26:8; 1 Kings 8:42; 2 Kings 17:36; 2 Chron. 6:32; Ps. 136:12; Jer. 21:5; 27:5; 32:17, 21; Ezek. 20:33–34) indicates power, might, strength. It is often used of God to indicate his ability to defeat powerful armies and enemies. God is implored by the psalmist to lift his hand and act for the sake of the righteous (Ps. 10:12).

Since the right hand is the hand of power, the act of sitting at the right hand indicates being favored (1 Kings 2:19; Ps. 110:1; Matt. 22:44; Mark 12:36; Luke 20:43; Acts 2:35; Heb. 1:3; 8:1; 10:12; 12:2; 1 Pet. 3:22). When taking an oath, one places a hand under the thigh/crotch (Gen. 24:2; 47:29), most likely the right hand (see Gen. 48:14, 17–18; Lev. 8:23; 14:14).

Clapping the hands can be a sign of awe (Ezek. 6:11), malice, or remorse (25:6), while a bared arm can be a sign of judgment (4:7). Job claps his hand over his mouth in awe of God and in submission and repentance (Job 40:4–5).

Hands can be lifted in worship (1 Kings 8:22; 1 Tim. 2:8), to beseech (Ps. 28:2), to protect and bless (Ps. 10:12), in an oath (Deut. 32:40), or to harm (Exod. 24:11; 1 Sam. 24:6, 10; 2 Sam.1:14; 18:12).

Pilate washes his hands to proclaim his innocence over the death of Jesus (Matt. 27:24), while 1 Pet. 5:6 urges believers to humble themselves “under God’s mighty hand,” so that in due time they will be lifted up.

Buttocks. Exposure of the buttocks can serve as a humiliating insult and provocation, as happens to David’s men (2 Sam. 10:4; 1 Chron. 19:4) and Egyptian and Cushite captives (Isa. 20:4).

Leg. The leg or thigh is often a euphemism for the male reproductive organs, so that putting one’s hand under a thigh in oath (Gen. 24:2; 47:29) may involve actually grabbing the genitalia. Animal thighs are waved to God in offering before being consumed (Lev. 9:21; 10:14; Num. 6:20), while oaths administered to uncover adultery cause a guilty woman’s thighs to waste (Num. 5:2–27).

The most common gesture involving the knee is bowing, in worship or reverence (Deut. 33:3; Isa. 45:23; Rom. 11:4; 14:11; Phil. 2:10), in defeat (2 Sam. 22:40; Ps. 18:38; Isa. 60:14), in distress (Ps. 57:6), or in respect (1 Kings 1:31). In what seems to be a somewhat awkward position, Elijah puts his face between his knees in prayer (1 Kings 18:42).

Feet. Gestures involving the feet are probably the most common gestures in the Bible. Feet can be washed in hospitality (Gen. 18:4; 19:2; 24:32; 43:24; 1 Sam. 25:41), in ablution (Exod. 30:19, 21; 40:31), or in supplication (1 Sam. 25:41). Feet can be bathed in oil as a blessing (Deut. 33:24), uncovered in marriage proposals (Ezek. 16:8; cf. Ruth 3:4, 7), and stamped in remorse (Ezek. 25:6), and sandals can be removed from them in honor (Exod. 3:1–10) or disgrace (Deut. 25:9). The heavenly seraphs cover their feet in supplication before the throne of God (Isa. 6:2), while the feet of humans can signal deception (Prov. 6:13).

Enemies can be placed under one’s feet in subjugation (1 Kings 5:3; Pss. 8:6; 18:39; 45:5; 47:3; 110:1; Mal. 4:3; Rom. 16:20), have their feet shackled or ensnared (Job 13:27; 33:11; Pss. 25:15; 105:18), and be forced to lick the feet of victors in humiliation and defeat (Isa. 49:23). The righteous will bathe their feet in the blood of their enemies in revenge (Pss. 58:10; 68:23).

Those overwhelmed can grovel at the feet of the powerful (2 Kings 4:27, 37; Esther 8:3; Matt. 28:9; Mark 5:33; 7:25; Acts 10:25), while those emboldened can rise to their feet in confidence (Ezek. 2:1–2; 3:24; Dan. 8:18).

In the NT, dust can be shaken off one’s feet as an indication of divine judgment (Matt. 10:14; Mark 6:11; Luke 9:5), even as lying at a person’s feet is a recognition of authority/submission (Matt. 15:30; Mark 5:33; Luke 8:28, 35, 41, 47; 10:39; 17:16; Acts 4:37; 5:2). A woman publicly washes Jesus’ feet with her tears, wipes them with her hair, and kisses and perfumes them in what seems an act of love and repentance; but Jesus indicates that she has prepared his body for burial (Luke 7:38–46; John 11:2; 12:3). Jesus washes his disciples’ feet as instruction on servanthood and discipleship (John 13:5–14).

Fingers, Toes. Different fingers seem to have different roles assigned them. A finger sprinkles blood in cleansing (Lev. 4:6, 17, 25, 30, 34; 8:15; 9:9; 14:16; 16:14, 19; Num. 19:4), while blood on the tip of the right thumb and on the right big toe is for cleansing (Exod. 29:20; Lev. 8:23–24; 14:17, 25, 28).

One wears a signet ring as a sign of power (Esther 3:10) or a gesture of restoration and forgiveness (Luke 15:22). But fingers can also motion in deception (Prov. 6:13) or point in blame (Isa. 58:9). Jesus writes with his finger on the ground, apparently as a gesture of indifference to those pointing accusing fingers (John 8:6).

Clothes and Shoes

Garments. Garments attain significance as they are related to specific emotions. Wearing sackcloth and ashes in mourning is common (Gen. 37:34; Ezek. 7:18; 2 Sam. 3:31), while ripping garments in mourning is also frequently attested (Gen. 37:34; 44:13; Lev. 10:6; 21:10; Josh. 7:6; 2 Sam. 1:11; 3:31; 13:31; 1 Kings 21:27; 2 Kings 2:12; 19:1; Esther 4:1; Isa. 32:11; 37:1; Jer. 41:5).

Ripping someone’s clothing to expose nakedness (Ezek. 16:39; 2 Sam. 10:4) or pulling a person’s skirts up over the face (Jer. 13:26) is an act of shaming or insulting. But tearing one’s clothes off can be a sign of fury (Matt. 26:65). Persons with defiling diseases are expected to warn off others by wearing torn clothes and shouting, “Unclean! Unclean!” (Lev. 13:45).

By laying their clothes at Saul’s feet, the crowd may be acknowledging his authority in the stoning of Stephen (Acts 7:58).

Sandals. A woman can remove a man’s sandal in contempt (Deut. 25:5–10), while a sandal can be removed by a kinsman-redeemer to indicate giving up a right or as a transfer of property (Ruth 4:7–8). A sandal can also be removed in mourning (Ezek. 24:17) or be cast over a piece of land to claim ownership (Pss. 60:8; 108:9).

Prophetic Gestures

Prophetic gestures in the OT are mostly concerned with the call to repentance and approaching judgments upon failure to heed the warning. Jeremiah puts a yoke on his neck (Jer. 27–28; cf. Deut. 28:48), Ezekiel cooks with dung (Ezek. 4:12) and sleeps on his left side for 390 days and then on his right side for 40 days (4:5–6), Isaiah strips off his clothing (Isa. 20:2–3; 32:11), and Hosea marries an unfaithful wife (Hos. 1:1–3).

In the NT, Jesus cleanses the temple as an act of symbolic judgment (Matt. 21:12; Mark 11:15; John 2:15). He also breaks bread and drinks wine (Matt. 26:26; Mark 14:22; Luke 22:19; 24:30, 35; Acts 2:46; 20:11; 27:35; 1 Cor. 11:24–25) and washes his disciples’ feet (John 13:1–13), thereby establishing symbolic Christian practices.

The Letter to the Hebrews and the Letter to the Romans constitute the two great pillars of theology in the NT. Hebrews brings a high Christology and increases Christian understanding of Christ’s role as priest and pioneer of faith. From this book, deductions can be made regarding the early church’s understanding of OT interpretation and its view of typology.

Hebrews ends like a letter, but it does not begin like one. In particular, it lacks the names of the writer and the recipients. From the content, though, it is evident that this work is meant for a certain audience, familiar with the author. The author shows a loving pastoral concern for his readers, teaching them, exhorting them, and rebuking them when necessary. He gives them models of faith to encourage them and instructs them to encourage one another. The author describes the work as “my word of exhortation” (13:22). The book is often identified as a sermon.

Author

The letter is, strictly speaking, anonymous. No author is mentioned, and few clues as to his identity exist. He is known by his readers (13:19) and has a pastor’s heart for them (6:9). He and his audience are second-generation Christians; that is, they did not hear Jesus during his ministry but rather are dependent upon those who did (2:3). He is a companion of Timothy (13:23) and thus possibly in the circle of Paul. The letter shows that he has great organizational and rhetorical skills; he is intelligent and well educated; his writing indicates that he is likely from a Greek-speaking culture and is a converted Hellenistic Jew familiar with the Greek version of the OT. And he is a creative theologian with perspectives found nowhere else in the NT.

Early church tradition offers no name for the author. The letter’s later attribution to the apostle Paul probably granted it the authority necessary for canonicity, though problems with that view were readily apparent. The Greek is unlike Paul’s, and the rhetoric and theology are much different as well. The themes present in Hebrews are of only tangential interest to Paul. All the Pauline Epistles bear his self-identification, because he felt that his status as an apostle added authority to his words. And Paul did not consider himself to be a second-generation Christian, since he had seen the Lord himself (Gal. 1:12). Although the Catholic and Eastern Churches continue to ascribe the work to Paul, the Protestant Church has almost completely abandoned that idea.

In the absence of a known author, almost every name in the NT has been suggested, including Apollos, Barnabas, Luke, and Silas. While each name has merits and problems, too little is known to prove or disprove any prospective author. Yet, even without Pauline or other known authorship, the book maintains its authority.

Audience

The original readers almost certainly were a house church, part of a network of churches in an urban setting, likely either Jerusalem or Rome, with Rome being slightly preferred. The recipients were a specific group rather than the church at large as in the General Epistles (James, 1–2 Peter, 1–3 John, Jude); the author knew their circumstances (Heb. 10:32; 12:4; 13:17, 24). They were Jewish Christians who, possibly because of persecution, were in danger of drifting back into the Judaism they had left (see 10:32–39). The letter was written probably in the late 60s, as evidenced by the fact that there is no mention of the temple’s destruction, which occurred in AD 70. Given the reasoning of the author, it is quite hard to imagine that he would not mention this event were he writing after that date.

Themes

Hebrews presents two main themes. The first is faith and perseverance, especially in the face of persecution. Jesus is the pioneer of salvation through suffering (2:10) and can help those being tempted (2:18); he has been faithful to the one who appointed him (3:2) as the Son over God’s house (3:6), which is Christians who hold firmly to their confidence and hope (3:6). Christians share in Christ, if they hold their convictions firmly to the end (3:14). This is possible because Jesus is the great high priest, having ascended into heaven (4:14). A person falling away, not holding firmly, cannot be brought back again to repentance (6:4–6). Jesus has sacrificed himself once for all (7:27). Christians must hold unswervingly to the hope they profess, for the one who promised is faithful (10:23). Those who do will be richly rewarded (10:35–36).

Role models of faith are portrayed in chapter 11, the so-called Faith Chapter. The author presents Abel, Enoch, Noah, Abraham, Isaac, Jacob, Joseph, and other OT figures as examples of living by faith. These serve as a “cloud of witnesses,” demanding “perseverance [in] the race marked out” for Christians (12:1). Jesus is the “pioneer and perfecter” of faith, enduring the cross and shame (12:2). Christians should endure hardship as discipline (12:7), which will produce a “harvest of righteousness” (12:11).

The second theme is the superiority of Christ, presented in a series of escalating comparisons between Jesus and every aspect of Judaism. The Son is a superior revelation from God (1:1–2). He is superior to the angels (1:4–14) and even to Moses (3:2–6). The Son’s Melchizedekian priesthood is superior to the Levitical priesthood (7:1–25). The new covenant brought by the Son is superior to the Mosaic covenant (8:6–13); the Son’s sacrifice is superior to the sacrifices offered under the Mosaic law (9:1–10:18).

Theology

The author brings his unique perspective to the work of Christ—his special roles as both high priest and sacrifice. Because Jesus lives forever, he has a permanent priesthood (7:24), which is not a function of his ancestry but rather is “on the basis of the power of an indestructible life” (7:16). He meets the requirements of a priest, being “holy, blameless, pure, set apart from sinners, exalted above the heavens” (7:26). He is a “priest forever, in the order of Melchizedek” (7:17, quoting Ps. 110:4). Melchizedek is a once-mentioned figure from Gen. 14:18. He was the king of Salem, a “priest of God Most High.” Abraham, and by extension Levi, paid him a tithe and received a blessing from him. Therefore, Melchizedek is superior to Levi, and his priestly order is superior to Levi’s. This priesthood, in fact, replaces the Levitical priesthood because the earlier priesthood could not produce perfection (Heb. 7:11), being “weak and useless” (7:18).

The Levitical priests had offered their sacrifices repeatedly, year after year, first for their own sins, then for those of the people. They had used the blood of bulls and goats to cleanse the tabernacle and accessories, because without the shedding of blood there can be no forgiveness of sin (9:22). There had been many priests, as death claimed each one. The priests, in all their weaknesses, had been appointed by the law. The sanctuary in which they serve is a “copy and shadow” of what is in heaven (8:5).

In contrast to the Levitical high priest, Jesus sits at “the right hand of the throne of the Majesty in heaven” (8:1) and serves in the true tabernacle not made by human hands. He has been appointed not by the law but by the oath of God, which came after the law. He has no need to offer sacrifices day after day; his sacrifice was “once for all” (7:27), coming at the culmination of the ages to do away with sin (9:26). In fact, the repeated nature of the Levitical sacrifices serves as proof of their ineffectiveness. Had they been effective, they would have ceased. But “it is impossible for the blood of bulls and goats to take away sins” (10:4), even when offered in accordance with the law (10:8). The worshipers had been left with the same guilty consciences. Christ had “entered the Most Holy Place once for all by his own blood” and obtained eternal redemption for all believers (9:12), sprinkling their hearts to cleanse them from guilty consciences (10:22)

Because of this, Christ is the mediator of the new covenant, prophesied in Jer. 31:31, which is superior to the Mosaic covenant. The first covenant has been made obsolete and will soon disappear (Heb. 8:13), as the new covenant is “established on better promises” (8:6). The tabernacle had been designed to demonstrate that there was no way into the most holy place for anyone but the high priest. Now, the blood of Jesus has opened a way through the curtain, allowing believers to “draw near to God with a sincere heart and with the full assurance of faith” (10:22).

Exhortations

Hebrews consists of theology interspersed with exhortations to the readers to persevere in the face of persecution, not to drift away from their new faith. These hortatory passages also serve as warnings. Because the new covenant is superior to the old one, its violation carries proportional penalties: since every violation of the old covenant had been met with its just punishment, “how shall we escape if we ignore so great a salvation?” (2:3). Believers must encourage one another, so that no one becomes “hardened by sin’s deceitfulness” (3:13). As recipients of new access to God, Christians must hold unswervingly to the hope, because God is faithful. This new access has completely replaced the old; there is no sacrifice remaining to forgive deliberate sinning. As those rejecting the law of Moses had died without mercy, those insulting the Spirit of grace will be punished more severely (10:29). Christians should consider “him who endured such opposition” so as not to “grow weary and lose heart” (12:3).

The author rebukes his readers for being lazy: “We have much to say about this, but it is hard to make it clear to you because you no longer try to understand” (5:11); but he patiently moves on beyond elementary teaching to teaching of Christian maturity (6:1). He warns them sternly that there is no reverse gear: those who have entered the sphere of Christian faith cannot fall away and then reenter at will; apostates would be “crucifying the Son of God all over again” (6:6). But then he softens the rebuke as a pastor: “Even though we speak like this, dear friends, we are convinced of better things in your case— the things that have to do with salvation” (6:9).

The author also shows great interest in the Sabbath rest promised to Moses. Those who had disobeyed were denied the rest (3:18), but the promise of entering his rest still stands (4:1). In fact, the Sabbath rest that remains is superior, or else it would not still be offered (4:8), and Christians must make every effort to enter that rest so that no one will perish (4:11).

Outline

The Letter to the Hebrews is very organized yet difficult to outline, owing to the manner in which the author handles his transitional material. The main theological argument (the superiority of the Son) is presented as a series of overlapping and interlocked comparisons interspersed with pastoral exhortations to perseverance. The connection between sections is often a keyword used in one section and then picked up and expanded in the next.

I. Introduction (1:1–4)

II. The Son Is Superior to the Angels (1:5–14)

III. Warning: Do Not Reject the Word Spoken through God’s Son (2:1–4)

IV. Jesus Is the Perfect Pioneer of Salvation because of His Suffering (2:5–18)

V. The Son Is Superior to Moses (3:1–19)

VI. The Sabbath Rest Is Still Available and Is Superior to the OT Rest (4:1–13)

VII. The Son Is a Superior High Priest (4:14–5:10)

VIII. Rebuke: You Are Still Spiritual Children (5:11–6:3)

IX. Warning: There Is No Return to the Former Covenant (6:4–12)

X. Jesus Completes the Oath God Gave Abraham (6:13–20)

XI. Jesus Is a Priest of Melchizedek’s Order, Superior to Levi’s Priesthood (7:1–25)

XII. The Priestly Function of Jesus Is Superior to That of the OT Priest (7:26–8:6)

XIII. The New Covenant of Jesus Is Superior to the Mosaic Covenant (8:7–13)

XIV. The Tabernacle of the New Covenant Is Superior to the Old (9:1–7)

XV. The Sacrifice of Christ Is Superior to the OT Sacrifices (9:8–10:20)

XVI. Exhortation to Persevere (10:21–39)

XVII. Faith Models (11:1–40)

XVIII. Exhortation to Righteous Living (12:1–13:17)

XIX. Closing Personal Greetings (13:18–25)

(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 type of training, generally referred to in the NIV as “discipline” (Prov. 3:11–12; 15:5; Heb. 12:5, 7, 10). For children, it encompasses the cultivation of the mind and morals, which includes essential corrections, reproofs, punishment, and restraint that exhibits godly character toward Christian growth (Eph. 6:4). For adults, Scripture has a role in this “training in righteousness” (2 Tim. 3:16). Even as earthly fathers discipline their children, God “disciplines the one he loves” (Heb. 12:6). Disciplinary sufferings are a demonstration of sonship (Heb. 12:5–11). Nurturing is also a type of care that can be shown to plants, akin to the proper care of children (Ps. 144:12).

(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).

The Bible contains little information about nonathletic games, but archaeology has revealed numerous types of board games and children’s games in Egypt, Mesopotamia, and Canaan. Although actual game pieces and dice have been found, information concerning the rules of the games is lacking. The Hebrew Bible does not describe anything like Greek or Roman games, but the NT makes numerous references to athletic competitions.

Greek games originated with funeral rites that commemorated heroes. The Iliad provides the earliest reference to Greek games as it describes games sponsored by Achilles in memory of Patroklos. The games became an integral part of Greek culture, honored the Greek gods, and were an essential element in a Greek education. Games were held at hundreds of local festivals across the Mediterranean, but the four Panhellenic games were the most prestigious. The games were accompanied by a sacred truce and held in sanctuaries. The Greeks trained and competed in the nude. Initially, running was the only competition, but by the second century AD Pausanius enumerated twenty-four contests, all of which were individual competitions. The specific contests varied from place to place, but the main events included running, chariot racing, long jumping, javelin throwing, discus throwing (2 Macc. 4:14), wrestling, boxing (1 Cor. 9:26), and the pankration, which was a form of all-out fighting. Some of the games included musical competitions. The prize, a wreath, was awarded only for first prize, and the winner of all four Panhellenic games was the periodonikēs. The victor returned home to a hero’s welcome, fame, and gifts. Some examples of cheating and bribery have survived, and those caught were fined.

The Olympic games, established in 776 BC, were the oldest and most prestigious of the Panhellenic games. They were held every four years in the sanctuary complex of Zeus in Olympia. The stadium was typically about 600 feet long, but Olympia’s was the longest, at about 630 feet, because of the tradition that Heracles had laid out the course. The remaining Panhellenic games were established about two hundred years later, in the sixth century BC. The Pythian games were held at the sanctuary of Apollo in Delphi. The Nemean games were held at the sanctuary of Zeus in Argos. The Isthmian games were administered by Corinth at the sanctuary of Poseidon.

The Romans preferred gladiatorial games and wild-game hunts over Greek games. Nevertheless, Romans were allowed to participate in the Panhellenic games. In fact, the emperors Tiberius and Nero participated. The Roman games were wildly popular with the people. By the second century AD, 135 days of games were held each year in Rome. The Circus Maximus was the largest venue, allowing up to two hundred thousand spectators to attend the chariot races. The Colosseum, the largest amphitheater in the Roman Empire, was built in AD 80, financed with spoils taken during the First Jewish Revolt. It held fifty thousand spectators for the gladiatorial games. Prisoners of war, slaves, and criminals condemned to die were forced to fight as gladiators and face wild beasts. Gladiatorial games were held throughout the empire. Herod the Great threw condemned criminals to wild animals in his amphitheater near Jerusalem in order to delight the spectators (Josephus, Ant. 15.273–75). Paul refers to fighting wild beasts in Ephesus (1 Cor. 15:32), though this is likely a metaphor for his spiritual opponents. Roman-style games honored Rome and became a symbol of loyalty to the Roman Empire.

Jewish views toward Greek and Roman games varied. Some Jews, especially those in the Diaspora, embraced the games as spectators and participants (2 Macc. 4:9–14). During the reign of Antiochus IV, some Jewish youth participated in the gymnasium in Jerusalem. They even underwent surgery to cover the signs of their circumcision (1 Macc. 1:12–15). Herod the Great built amphitheaters, stadiums, and hippodromes throughout his kingdom, and Philo of Alexandria frequented the games. However, the authors of 1–2 Maccabees criticize the priests for neglecting their duties by attending the games. Furthermore, the religious association of the games led many conservative Jews to oppose the games.

Because Paul and his audiences were familiar with Greek and Roman games, he drew upon them as analogies to the Christian life. During Paul’s eighteen-month ministry in Corinth, the nearby Isthmian games were played. Through references to training and competition, Paul demonstrates the need to be disciplined, focused, determined as an athlete (1 Cor. 9:24–27; 2 Tim. 4:7; cf. Heb. 12:1). In contrast to the wreath won by Greek athletes, Christians strive for an eternal prize and a crown of righteousness (1 Cor. 9:27; Phil. 3:14; 2 Tim. 4:7–8).

“Author of life” is a title applied to Jesus by Peter in Acts 3:15 (KJV: “Prince of life”), where he uses it ironically to highlight that people had killed the one who was the source of life. Elsewhere, the Greek word behind “author” (archēgos) is translated as “prince,” “leader,” “captain,” or “pioneer” (Acts 5:31; Heb. 2:10; 12:2).

(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).

Although athletic competition was found across the ancient world, sports receive little to no attention in the OT. Be it archery (1 Sam. 20:20), chariotry (1 Kings 9:22), slinging (1 Chron. 12:2), or running (1 Kings 1:5), no instance occurs in a demonstrably athletic context but rather refers to military activity. This likely includes Jacob’s wrestling with a divine stranger (Gen. 32:24; see too Abner’s challenge to Joab’s men in 2 Sam. 2:14, where a physical competition among some soldiers eventually breaks into combat). Athletic imagery seems to be used in Jer. 12:5, where God reasons with Jeremiah using racing metaphors (see also the mention of a ball in Isa. 22:18, which may have athletic connotations).

With the conquest of Palestine by Alexander the Great in 332 BC, Hellenistic customs began to influence the native Jewish population, including an affinity for sports. Antiochus IV Epiphanes (r. 175–164 BC) introduced Jerusalem’s first gymnasium, a Greek cultural center that held many athletic events. Athletes in Greek society competed naked, and events always honored pagan deities. Because of this and the reminder of foreign occupation, many Jews despised the gymnasium. But Greco-Roman athletics still pervaded the culture, as evidenced in the NT. Paul and the author of Hebrews are the only NT authors to refer to sports. The best example is Paul’s use of imagery from running, boxing, and athletic discipline when writing to the church at Corinth, the city of the famed Isthmian games (1 Cor. 9:24–27). Paul refers to running no less than five more times in his letters (Gal. 2:2; 5:7; Phil. 2:16; 3:12–14; 2 Tim. 4:7–8). The author of Hebrews also uses running imagery in Heb. 12:1–2.

The act of yielding or consenting to the authority of another, voluntarily or involuntarily; personal deference, compliance, or humility toward another; to become subject to. Submission incorporates obedience, and in certain usages the terms are synonymous. However, “obedience” indicates compliance with directions or guidance, while “submission” describes one’s subservient posture toward another. Submission within a formalized hierarchy is subordination—for example, Jesus’ relationship to the Father.

Scripture presents submission in two ways: as the translation of a number of specific Hebrew and Greek terms that convey an aspect of the concept, and as a general portrait of relationships—for example, patriarchs and prophets before the Lord, or demons toward Jesus. Sometimes, the presentation is negative, as in a refusal to submit.

In the OT, the use of the word “submission” (or its derivatives) in the major English versions is primarily a function of translator preference. In fact, Gen. 16:9, the angel’s instructions to Hagar, is the sole instance where “submit” is broadly agreed to be the best translation of the underlying Hebrew. Elsewhere, the NIV and at least one other version use forms of “submission” to interpretively translate Hebrew expressions meaning the following: “become a slave to” (Gen. 49:15); “serve” (2 Chron. 30:8); “have a relationship with” (Job 22:21); “quickly stretch out hands” (Ps. 68:31); “give over to” (Ps. 81:11); and “give the hand to” (Lam. 5:6).

In the NT, “submission” (along with its derivatives and, often, “to be subject to”) appears only in Luke and the epistles, and it translates forms of four different Greek roots.

1. Dogmatizō appears once: “Why . . . do you submit to rules?” (Col. 2:20). It includes the aspect of obligation to something that has been decreed.

2. Hypeikō appears once: “Obey your leaders and submit to them” (Heb. 13:17 NASB, NRSV). Here, obedience is specifically distinguished from submission.

3. Hypotagē appears four times as “submission.” In Gal. 2:5; 1 Tim. 2:11; 3:4 it indicates the main understanding: subordinate posturing toward superiors; in 2 Cor. 9:13, however, it refers to obedience to a decree, in this case confession of the gospel.

4. Hypotassō is by far the most significant root. It appears almost forty times in the NT; about half of these occurrences can be translated using a form of “submission” (or “to be subject to”). It is used to convey the subordination of children to parents (Luke 2:51); demons to the seventy-two missionaries (Luke 10:17, 20); sinners to God’s law or righteousness (Rom. 8:7; 10:3); people to governing authorities (Rom. 13:1, 5; Titus 3:1; 1 Pet. 2:13); believers to one another (1 Cor. 16:16; Eph. 5:21); wives to husbands (1 Cor. 14:34; Eph. 5:22, 24; Col. 3:18; Titus 2:5; 1 Pet. 3:1, 5); slaves to masters (Titus 2:9; 1 Pet. 2:18); angels, authorities, and powers to Jesus (1 Pet. 3:22); believers to God (Heb. 12:9; James 4:7); younger men to elders (1 Pet. 5:5).

A few additional uses of “submission” in some translations have other primary meanings: “turn in for inspection” (Gal. 2:2 NASB); “reverence” (Heb. 5:7 NIV, NRSV); and “open-mindedness” (James 3:17 NIV).

Vivid portraits of submission conveying the concept without invoking the specific vocabulary include Abraham’s submission to God (Gen. 12:1–4; 17:1–27; 21:4; 22:1–19); Moses at the burning bush (Exod. 3:1–4:17); Joshua toward God (Josh. 24:29); prophets toward God (1 Sam. 3:10; Isa. 6:8; Hos. 1:1–3); Jesus’ submission to the Father (Matt. 26:39, 42, 44; Mark 14:35–36, 39; Luke 2:49; 22:42); Paul’s submission to Jesus (Rom. 1:1; Titus 1:1); believers doing the will of the Father (Matt. 12:50; 21:28–32); the prodigal son toward his father (Luke 15:18, 21); believers toward Jesus (John 12:26; 14:21, 23–24; 15:10); husbands and wives toward each other (1 Cor. 7:3–5; 11:11); believers humble before one another (Rom. 12:10; Phil. 2:3–4); and the bowing of every knee to Jesus (Phil. 2:10–13).

The act of yielding or consenting to the authority of another, voluntarily or involuntarily; personal deference, compliance, or humility toward another; to become subject to. Submission incorporates obedience, and in certain usages the terms are synonymous. However, “obedience” indicates compliance with directions or guidance, while “submission” describes one’s subservient posture toward another. Submission within a formalized hierarchy is subordination—for example, Jesus’ relationship to the Father.

Scripture presents submission in two ways: as the translation of a number of specific Hebrew and Greek terms that convey an aspect of the concept, and as a general portrait of relationships—for example, patriarchs and prophets before the Lord, or demons toward Jesus. Sometimes, the presentation is negative, as in a refusal to submit.

In the OT, the use of the word “submission” (or its derivatives) in the major English versions is primarily a function of translator preference. In fact, Gen. 16:9, the angel’s instructions to Hagar, is the sole instance where “submit” is broadly agreed to be the best translation of the underlying Hebrew. Elsewhere, the NIV and at least one other version use forms of “submission” to interpretively translate Hebrew expressions meaning the following: “become a slave to” (Gen. 49:15); “serve” (2 Chron. 30:8); “have a relationship with” (Job 22:21); “quickly stretch out hands” (Ps. 68:31); “give over to” (Ps. 81:11); and “give the hand to” (Lam. 5:6).

In the NT, “submission” (along with its derivatives and, often, “to be subject to”) appears only in Luke and the epistles, and it translates forms of four different Greek roots.

1. Dogmatizō appears once: “Why . . . do you submit to rules?” (Col. 2:20). It includes the aspect of obligation to something that has been decreed.

2. Hypeikō appears once: “Obey your leaders and submit to them” (Heb. 13:17 NASB, NRSV). Here, obedience is specifically distinguished from submission.

3. Hypotagē appears four times as “submission.” In Gal. 2:5; 1 Tim. 2:11; 3:4 it indicates the main understanding: subordinate posturing toward superiors; in 2 Cor. 9:13, however, it refers to obedience to a decree, in this case confession of the gospel.

4. Hypotassō is by far the most significant root. It appears almost forty times in the NT; about half of these occurrences can be translated using a form of “submission” (or “to be subject to”). It is used to convey the subordination of children to parents (Luke 2:51); demons to the seventy-two missionaries (Luke 10:17, 20); sinners to God’s law or righteousness (Rom. 8:7; 10:3); people to governing authorities (Rom. 13:1, 5; Titus 3:1; 1 Pet. 2:13); believers to one another (1 Cor. 16:16; Eph. 5:21); wives to husbands (1 Cor. 14:34; Eph. 5:22, 24; Col. 3:18; Titus 2:5; 1 Pet. 3:1, 5); slaves to masters (Titus 2:9; 1 Pet. 2:18); angels, authorities, and powers to Jesus (1 Pet. 3:22); believers to God (Heb. 12:9; James 4:7); younger men to elders (1 Pet. 5:5).

A few additional uses of “submission” in some translations have other primary meanings: “turn in for inspection” (Gal. 2:2 NASB); “reverence” (Heb. 5:7 NIV, NRSV); and “open-mindedness” (James 3:17 NIV).

Vivid portraits of submission conveying the concept without invoking the specific vocabulary include Abraham’s submission to God (Gen. 12:1–4; 17:1–27; 21:4; 22:1–19); Moses at the burning bush (Exod. 3:1–4:17); Joshua toward God (Josh. 24:29); prophets toward God (1 Sam. 3:10; Isa. 6:8; Hos. 1:1–3); Jesus’ submission to the Father (Matt. 26:39, 42, 44; Mark 14:35–36, 39; Luke 2:49; 22:42); Paul’s submission to Jesus (Rom. 1:1; Titus 1:1); believers doing the will of the Father (Matt. 12:50; 21:28–32); the prodigal son toward his father (Luke 15:18, 21); believers toward Jesus (John 12:26; 14:21, 23–24; 15:10); husbands and wives toward each other (1 Cor. 7:3–5; 11:11); believers humble before one another (Rom. 12:10; Phil. 2:3–4); and the bowing of every knee to Jesus (Phil. 2:10–13).

The Bible has much to say about suffering. While in the OT suffering is regularly an indication of divine displeasure (Lev. 26:16–36; Deut. 28:20–68; Ps. 44:10–12; Isa. 1:25; cf. Heb. 10:26–31), in the NT it becomes the means by which blessing comes to humanity.

The Bible often shows that sinfulness results in suffering (Gen. 2:17; 6:5–7; Exod. 32:33; 2 Sam. 12:13–18; Rom. 1:18; 1 Cor. 11:27–30). Job’s friends mistakenly assume that he has suffered because of disobedience (Job 4:7–9; 8:3–4, 20; 11:6). Job passionately defends himself (12:4; 23:10), and in the final chapter of the book God commends Job and condemns his friends for their accusations (42:7–8; cf. 1:1, 22; 2:10). The writer makes clear that suffering is not necessarily evidence of sinfulness. Like Job’s friends, Jesus’ disciples assume that blindness is an indication of sinfulness (John 9:1–2). Jesus rejects this simplistic notion of retributive suffering (John 9:3, 6–7; cf. Luke 13:1–5).

The prayers of suffering people are expressed in the sixteen communal and thirty-seven individual laments in the book of Psalms. Within the laments the writers describe their problems, express feelings, make requests, ask questions (“How long, Lord?” [13:1]; “Why have you forsaken me?” [22:1]), and lodge complaints against God (“My eyes fail, looking for my God [69:3]), enemies (“You have made us an object of derision to our neighbors, and our enemies mock us” [80:6]), and even themselves (“I am a worm and not a man” [22:6]).

The NT writers reveal that Jesus’ suffering was prophesied in the OT (Mark 9:12; 14:21; Luke 18:31–32; 24:46; Acts 3:18; 17:3; 26:22–23; 1 Pet. 1:11; referring to OT texts such as Ps. 22; Isa. 52:13–53:12; Zech. 13:7). The Lord Jesus is presented as the answer to human suffering: (1) Through the incarnation, God’s Son personally experienced human suffering (Phil. 2:6–8; Heb. 2:9; 5:8). (2) Through his suffering, Christ paid the price for sin (Rom. 4:25; 3:25–26), so that believers are set free from sin (Rom. 6:6, 18, 22) and helped in temptation (Heb. 2:18). (3) Christ Jesus intercedes for his suffering followers (Rom. 8:34–35). (4) Christ is the example in suffering (1 Pet. 2:21; 4:1; cf. Phil. 3:10; 2 Cor. 1:5; 4:10; 1 Pet. 4:13), and though he died once for sins (Heb. 10:12), he continues to suffer as his church suffers (Acts 9:4–5). (5) Christ provides hope of resurrection (Rom. 6:5; 1 Cor. 15:20–26; Phil. 3:10–11) and a future life without suffering or death (Rev. 21:4).

There are many NT examples of suffering believers (John 15:20–21; Acts 4:3; 5:18; 7:57–60; 8:1–3; 12:1–5; 14:19; 16:22–24; 18:17; 2 Cor. 6:4–5, 8–10; Heb. 10:32; 1 Pet. 5:9; Rev. 2:10). Suffering is part of God’s plan for his people (Acts 9:16; 1 Thess. 3:2–4) and is part of what it means to be a follower of Christ Jesus (Acts 14:22; Rom. 8:17; Phil. 1:29; 1 Pet. 2:21; 4:12).

The NT writers repeatedly mention the benefits of suffering, for it has become part of God’s work of redemption. The suffering of believers accompanies the proclamation and advancement of the gospel (Acts 5:41–42; 9:15–16; 2 Cor. 4:10–11; 6:2–10; Phil. 1:12, 27–29; 1 Thess. 2:14–16; 2 Tim. 1:8; 4:5) and results in salvation (Matt. 10:22; 2 Cor. 1:6; 1 Thess. 2:16; 2 Tim. 2:10; Heb. 10:39), faith (Heb. 10:32–34, 38–39; 1 Pet. 1:7), the kingdom of God (Acts 14:22), resurrection from the dead (Phil. 3:10–11), and the crown of life (Rev. 2:10). It is an essential part of the development toward Christian maturity (Rom. 5:3–4; 2 Cor. 4:11; Heb. 12:4; James 1:3–4; 1 Pet. 1:7; 4:1).

Suffering is associated with knowing Christ (Phil. 3:10); daily inward renewal (2 Cor. 4:16); purity, understanding, patience, kindness, sincere love, truthful speech, the power of God (2 Cor. 4:4–10); comfort and endurance (2 Cor. 1:6); obedience (Heb. 5:8); blessing (1 Pet. 3:14; 4:14); glory (Rom. 8:17; 2 Cor. 4:17); and joy (Matt. 5:12; Acts 5:41; 2 Cor. 6:10; 12:10; James 1:2; 1 Pet. 1:6; 4:13). Other positive results of Christian suffering include perseverance (Rom. 5:3; James 1:3), character and hope (Rom. 5:4), strength (2 Cor. 12:10), and maturity and completeness (James 1:4). Present suffering is light and momentary when compared to future glory (Matt. 5:10–12; Acts 14:22; Rom. 8:18; 2 Cor. 4:17; Heb. 10:34–36; 1 Pet. 1:5–7; 4:12–13).

Throughout the Bible, believers are instructed to help those who suffer. The OT law provides principles for assisting the poor, the disadvantaged, and the oppressed (Exod. 20:10; 21:2; 23:11; Lev. 19:13, 34; 25:10, 35; Deut. 14:28–29; 15:1–2; 24:19–21). Jesus regularly taught his followers to help the poor (Matt. 5:42; 6:3; 19:21; 25:34–36; Luke 4:18; 12:33; 14:13, 21). It is believers’ responsibility to show mercy (Matt. 5:7; 9:13), be generous (Rom. 12:8; 2 Cor. 8:7; 1 Tim. 6:18), mourn with mourners (Rom. 12:15), carry other’s burdens (Gal. 6:1–2), and visit prisoners (Matt. 25:36, 43). See also Servant of the Lord.