Provision for the extremely needy. Alms provide what is essential to human survival: food, clothing, and shelter (1 Tim. 6:8). Of the three main expressions of Jewish and early Christian piety, which included prayer and fasting (Matt. 6:1–18), giving to the destitute, literally “the practicing of mercy,” was the most highly prized and appears to have been broadly practiced (Tob. 12:8; 2 Clem. 16:4). The rabbis eventually legislated against extreme almsgiving, fixing the limit at 20 percent of one’s assets (b. Ketub. 50a; cf. 1 Cor. 13:3). The inherent element of mercy suggests that the needy are not necessarily deserving of the gift. Jesus grounded the practice in mindfulness of God’s mercy toward those blessed with surplus (Matt. 5:7) but warned against giving for public recognition (6:1–4). Beggars would gather around the temple, appealing to the charity of pilgrims (Acts 3:1–10). The early church took the initiative to care for the destitute, particularly orphans and widows, a practice that James, the brother of Jesus, impressed upon Paul to maintain in the non-Jewish wing of the church—something the apostle was happy to do, even collecting money for the needy in Jerusalem (Gal. 2:10; 2 Cor. 9:1–5 [cf. James 1:27]). A communal fund was collected in the local synagogue (m. Pe’ah 8:7). Trumpets were blown on days of fasting as a reminder (b. Ber. 6b; b. Sanh. 35a; cf. Matt. 6:2). The early church directed most of its giving to the poor (Tertullian, Apol. 39.6).

A gate of Herod’s temple where John and Peter healed a lame man (Acts 3:2, 10; NIV: “gate called Beautiful”). This name is used only in the NT, and so its identification and location must be surmised by other names for it. Two temple gates known from other historical sources are the likely candidates for the Beautiful Gate: the Golden Gate or the Nicanor Gate. Josephus describes a beautiful gate located in the east of the temple, known to this day as the Golden Gate. The Nicanor Gate is probably the gate described in the book of Acts. Its construction was funded by a wealthy Alexandrian Jew. It is located either on the east side of the court of women leading from the court of the Gentiles or on the western side of the court of women at the entrance to that court.

A controlled point of entry into an otherwise enclosed area such as a city (Gen. 34:24; Ps. 122:2; Acts 9:24), camp (Exod. 32:26–27), tabernacle court (Exod. 35:17), palace (2 Kings 11:19), temple area (Jer. 36:10; Ezek. 40), prison (Acts 12:10), or house (Acts 10:17).

In the OT, the city gate has a central role in that city’s military, economic, judicial, political, and religious aspects of life. A key component of the defense system of a city, the gate consists of doors fortified with bars (Judg. 16:3; Ps. 107:16; Nah. 3:13) and keeps invading armies out while also serving as the point of departure and return for the city’s army (2 Sam. 18:4; cf. God the warrior entering in Ps. 24:7–8). The gate also may serve as the location where news of the battle is delivered (1 Sam. 4:18; 2 Sam. 18:24). The destruction of the city gate usually means the destruction of the city (Isa. 24:12).

In the economic life of the city, the gate functions as a place of commerce (Gen. 23; 2 Kings 7:1) and music (Lam. 5:14). At the entrance to the city gate, the city elders assembled daily to hear cases and render judgment (Job 29:7; Prov. 24:7). Along with the elders, there might be additional witnesses (Ruth 4:1–11; Ps. 69:12). For criminal cases, the gate may also be the location where punishment is enacted (Deut. 17:5; 22:24). Thus, the gate is to be a place where all people can come to obtain justice (2 Sam. 15:2–4; Isa. 29:21; Amos 5:15). The gate may hold a seat reserved for the king (2 Sam. 19:8) as well as the king’s officials (Esther 2:19–21; 3:2–3). The city gate might also contain shrines to various gods (2 Kings 23:8; cf. Acts 14:13).

A city may have more than one gate (Jer. 17:19), each having a different name. For example, when Nehemiah sets out to rebuild the wall and gates of Jerusalem, there is mention of the Valley Gate, the Dung Gate, and the Fountain Gate (Neh. 2:11–17) as well as the Sheep Gate (3:1) and the Jeshanah Gate (3:6).

Some references to gates refer to those of the temple area (Ezek. 44; 46; Pss. 100:4; 118:19–20). In Ezek. 48 the temple area is to have twelve gates, each named after a tribe of Israel (Ezek. 48:30–35; cf. Rev. 21:12–25). The prophet Jeremiah proclaims the word of the Lord from both the city gate(s) (Jer. 17:19–27) and the temple gate(s) (7:1–4).

In the NT, Jesus raises the dead son of a widow at the town gate (Luke 7:11–17) and heals a lame man near the Sheep Gate (John 5:1–15). Peter heals a crippled man near the temple gate (Acts 3:1–10). Jesus mentions gates in his teaching, including a call to enter through the narrow gate of life (Matt. 7:13–14), and his parable of the sheep and the gate, in which Jesus refers to himself as the gate (John 10:1–18). See also City Gates.

The precise and consistent division of time into hours, minutes, and seconds is a feature of modern life first made possible by the widespread use of mechanical clocks in the late Middle Ages. Biblical texts reflect an earlier situation in which timekeeping was primarily a matter of celestial observation. NT references to “hours” fall into two broad categories: first, timekeeping by means of numbered hours; and second, the use of the word “hour” in the sense of “moment,” a short, indefinite period of time (e.g., Matt. 8:13; John 16:2), as the hour was the basic unit of measurable time (see Rev. 9:15).

Jesus observed that the day was divided into twelve hours (John 11:9). Jesus was crucified at the third hour (9 a.m.); it was dark from the sixth hour (noon) until the ninth hour (3 p.m.), at which point Jesus died (Matt. 27:45–46; Mark 15:25, 33; Luke 23:44; John 19:14). In one parable, a landowner hired workers at the third, sixth, ninth, and eleventh hours (Matt. 20:3–12). The book of Acts also reports events occurring at the third, sixth, and ninth hours (Acts 2:15; 3:1; 10:3, 9). Such passages suggest that actual reckoning was often less precise even than the twelve-hour scheme permitted, and that the day was more roughly divided into four parts of three hours each. The Gospel of John provides the most precise time indications, mentioning the tenth hour (4 p.m. [John 1:39]) and the seventh hour (1 p.m. [John 4:52]). One text names an “hour of dinner” (Luke 14:17; see also 22:14), and another indicates that the ninth hour (3 p.m.) was an “hour of prayer” (Acts 3:1; see also 10:30).

The night was divided into three or four “watches,” of which the NT mentions the second, third (Luke 12:38), and fourth (Matt. 14:25; Mark 6:48). The OT mentions nocturnal watches (Pss. 63:6; 90:4; 119:148; Lam. 2:19), including in military contexts (Exod. 14:24; Judg. 7:19; 1 Sam. 11:11), from which the term with the sense of standing guard is derived. The OT watches are not numbered, but are referred to as “middle” or “last.” The system of watches did not preclude the counting of hours during the night, as in Acts 23:23, which refers to the third hour of the night (9 p.m.).

In addition to the numbered hours of the day, the hour is also used to measure the passage of time, as in Acts 19:34, where a crowd riots for two hours (see also Matt. 26:40; Luke 22:59; Acts 5:7; Rev. 17:12). One text refers to a half-hour period (Rev. 8:1).

Numerous texts refer to hours of future trial (Matt. 10:19; Rev. 3:10), including an eschatological or “last hour” (e.g., Mark 13:32; 1 John 2:18). The suffering and death of Jesus is also referred to as his “hour” (e.g., Mark 14:35; 14:41; John 12:23, 27).

Pieces of metal stamped with a particular impression, used as a medium of exchange. From time immemorial people used animals, grain, or other commodities to barter (Hos. 3:2), pay taxes (1 Sam. 8:15), or as a measure of wealth (Job 1:3). Substituting smaller, more easily handled pieces of precious metal had obvious advantages. Gradually people used precious metal such as silver or gold along with commodities (Gen. 20:14–16) and then in place of them (37:28) as a means of payment. Such metal had been refined, but it could have been in most any form (rings, bars, ingots, dust) as long as it weighed the appropriate amount. Local and international standards developed to regulate the weights, and later the concept grew in popularity to use standard, authorized, clearly stamped pieces of precious metal—coins.

Old Testament. Minting of coins may have begun as far back as the late eighth century BC, and it gradually spread throughout the known world. The first coins apparently were made in Asia Minor using electrum, a natural alloy of gold and silver.

When the Persians took over much of the ancient Near East in the sixth century BC, the use of coins spread, and Persian coins came to the land of the Bible. At the end of the Hebrew Bible there is mention of large quantities of Persian coins called “darics” (1 Chron. 29:7; Ezra 8:27), also translated as “drachmas” (NASB) or “drams” (KJV) (Ezra 2:69; Neh. 7:70–72). These darics were stamped with the likeness of Darius the Great (521–486 BC) and were minted from gold and occasionally silver. At about the same time, silver tetradrachmas (four-drachma coins) from Athens made their way to the western shores of the Mediterranean. Local imitations of this coin were stamped with “YHD” to represent the province of Judah.

New Testament. Coins appear dozens of times in the NT; some have Hellenistic roots, while others come from the periods of Hasmonean or Roman rule.

For several centuries after Alexander the Great conquered the ancient Near East (fourth century BC), coins with the images of Alexander or his Seleucid or Ptolemaic successors were circulated in Judea. In particular, silver shekels from the Phoenician port cities of Tyre and Sidon enjoyed wide usage for a long time. Also called a “stater,” the shekel or four-drachma coin recovered by Peter from the fish’s mouth (Matt. 17:27) may have been such a Tyrian coin. Many or all of the thirty silver coins that the chief priests gave Judas for betraying Jesus (Matt. 26:15; 27:3) probably were Tyrian shekels as well, since this coin came to be the accepted currency at the temple in Jerusalem and the priests would have had a good supply of them.

After the Hellenistic rulers lost control of Judea during the rebellion led by the Maccabean or Hasmonean family in the second century BC, the Jews could mint their own coins for the first time. The honor of producing the first Jewish coin apparently goes to John Hyrcanus I (134–104 BC), son of Simon and nephew of Judas Maccabeus. Simon’s modest bronze lepton (pl. lepta), or prutah, has an inscription on one side and two cornucopias and a pomegranate on the other. Use of such agricultural symbols apparently fulfilled two purposes: it portrayed the fertility of the land that God had given his people, and it helped the Jews avoid depicting people on coins, as the Greeks and later the Romans would do. During this period devout Jews avoided such images in order to help fulfill the second commandment (Exod. 20:4), to avoid graven images. Hyrcanus I’s son Alexander Jannaeus (103–76 BC) minted great quantities of different types of bronze lepta, still often found in excavations in Israel today. These coins remained in circulation for many years, probably through the ministry of Jesus. Thus, the two small coins for which Jesus commended the widow for donating to the temple treasury (Mark 12:42; Luke 21:2) may well have been lepta of Alexander Jannaeus. The tiny lepton, typically smaller than a dime and worth only 1/400 of a shekel, also appears in Luke 12:59.

It is also possible that the aforementioned lepta were not minted by Alexander Jannaeus, since later rulers, including the Jewish king Herod the Great (40–4 BC), also minted large numbers of similar small bronze coins. Though not known for his piety, Herod continued to avoid human representations on his coins. For the most part, so did his sons and the later Roman procurators (including Pontius Pilate [governed AD 26–36]), who ruled Judea before the revolt in AD 66.

Other Roman coins, such as the silver denarius (pl. denarii) minted outside Judea, clearly did not avoid human representation, however. Jesus’ request for a coin with Caesar’s image and inscription (Matt. 22:15–22) refers to the denarius. The denarius in Jesus’ day could have portrayed the emperor Tiberius (r. AD 14–37) or even Augustus (r. 27 BC–AD 14), whose coins were probably still in circulation. The silver denarius came to represent the daily wage of a common laborer, as clearly shown in the parable of laborers (Matt. 20:1–16). The denarius also appears in many other passages, although modern translators sometimes use a more interpretive expression (“two silver coins” for “two denarii” in Luke 10:35; “a year’s wages” for “three hundred denarii” in Mark 14:5).

Although many of the references discussed above contain specific terms that can be identified with coins known from history, others cannot. General terms meaning “coins” or “pieces of money” sometimes appear, as when Jesus scattered the coins of the money changers (John 2:15), or the rather common term for silver that appears frequently and is often translated as “money” (Matt. 28:12; Luke 9:3) or “silver” (Acts 3:6; 1 Pet. 1:18) as well as “silver coins” (Matt. 27:3 GW).

In the first century, Nazareth was a small village in the extreme southerly part of lower Galilee, midway between the Sea of Galilee and the Mediterranean Sea. It was near Gath Hepher, the birthplace of Jonah the prophet to the Gentiles (2 Kings 14:25), and Sepphoris, one of the three largest cities in the region. Not far was the Via Maris, the great highway joining Mesopotamia to Egypt and ultimately the trading network that linked India, China, central Asia, the Near East, and the Mediterranean. The village was perched 1,150 feet above sea level, overlooking the Jezreel Valley, with several terraces for agriculture cut into the mountain. A Nazarene could look south across the grand Plain of Esdraelon, west to Mount Carmel on the Mediterranean coast, east to nearby Mount Tabor, and north to snowcapped Mount Hermon. The community, whose population may have averaged around five hundred, subsisted from agriculture. Capital resources included almonds, pomegranates, dates, oil, and wine. (Excavations have located vaulted cells for wine and oil storage, as well as wine presses and storage jar vessels.) Nazareth appears to have been uninhabited from the eighth to the second centuries BC, until it was resettled during the reign of John Hyrcanus (134–104 BC), probably by a Davidic clan of army veterans. The claim that Jesus’ adoptive father, Joseph, was a descendant of David and a resident of Nazareth is therefore plausible (Matt. 1:20; Luke 2:4–5). Today, Nazareth is the largest Arab city in Israel.

Although Jesus’ ministry was unsuccessful in Nazareth, he and his followers were called “Nazarenes” (Mark 1:24; 10:47; John 18:5, 7; Acts 2:22; 3:6; 24:5). Descendants of Jesus’ family continued to live in the area for centuries. The epithet “Nazarene” probably was intended as a slur. Nathanael is unimpressed by Jesus’ origin in Nazareth (John 1:46). The village is not mentioned in the OT. Some even doubted its existence, until 1962, when the place name “Nazareth” was discovered on a synagogue inscription in Caesarea Maritima.

In the first century, Nazareth was a small village in the extreme southerly part of lower Galilee, midway between the Sea of Galilee and the Mediterranean Sea. It was near Gath Hepher, the birthplace of Jonah the prophet to the Gentiles (2 Kings 14:25), and Sepphoris, one of the three largest cities in the region. Not far was the Via Maris, the great highway joining Mesopotamia to Egypt and ultimately the trading network that linked India, China, central Asia, the Near East, and the Mediterranean. The village was perched 1,150 feet above sea level, overlooking the Jezreel Valley, with several terraces for agriculture cut into the mountain. A Nazarene could look south across the grand Plain of Esdraelon, west to Mount Carmel on the Mediterranean coast, east to nearby Mount Tabor, and north to snowcapped Mount Hermon. The community, whose population may have averaged around five hundred, subsisted from agriculture. Capital resources included almonds, pomegranates, dates, oil, and wine. (Excavations have located vaulted cells for wine and oil storage, as well as wine presses and storage jar vessels.) Nazareth appears to have been uninhabited from the eighth to the second centuries BC, until it was resettled during the reign of John Hyrcanus (134–104 BC), probably by a Davidic clan of army veterans. The claim that Jesus’ adoptive father, Joseph, was a descendant of David and a resident of Nazareth is therefore plausible (Matt. 1:20; Luke 2:4–5). Today, Nazareth is the largest Arab city in Israel.

Although Jesus’ ministry was unsuccessful in Nazareth, he and his followers were called “Nazarenes” (Mark 1:24; 10:47; John 18:5, 7; Acts 2:22; 3:6; 24:5). Descendants of Jesus’ family continued to live in the area for centuries. The epithet “Nazarene” probably was intended as a slur. Nathanael is unimpressed by Jesus’ origin in Nazareth (John 1:46). The village is not mentioned in the OT. Some even doubted its existence, until 1962, when the place name “Nazareth” was discovered on a synagogue inscription in Caesarea Maritima.

Simon Peter is the best-known and the most colorful of Jesus’ twelve disciples. The name “Peter” means “rock” in Greek. In some biblical texts, he is also called “Cephas,” which is the Aramaic word for “rock” (see esp. John 1:42). Despite the ups and downs of Peter’s spiritual life, God was able to use him as the foundational apostle for the establishment of the NT church. Peter first met Jesus immediately after Jesus’ baptism, when Peter’s brother, Andrew, heard John the Baptist’s identification of Jesus as the Lamb of God (John 1:35). In classic missionary style, “the first thing Andrew did was to find his brother Simon and tell him, ‘We have found the Messiah’ ” (John 1:41). Peter’s official call to ministry took place later, when he was fishing on the Sea of Galilee and Jesus issued the well-known invitation “Come, follow me, . . . and I will send you out to fish for people” (Matt. 4:19).

Peter was the chief spokesman for the disciples at Caesarea Philippi when Jesus asked them, “Who do people say the Son of Man is?” (Matt. 16:13). Peter responded, “You are the Messiah, the Son of the living God,” an insight given him by God the Father (16:16–17). Jesus promised him, “I tell you that you are Peter [petros], and on this rock [petra] I will build my church, and the gates of Hades will not overcome it” (16:18). Yet Peter almost immediately became a “stumbling block” to Jesus when he chided Jesus for saying that he must go to Jerusalem and suffer many things and be killed (16:21–22). Another major failure by Peter came with his threefold denial of Jesus after Jesus had warned him, “This very night, before the rooster crows, you will disown me three times” (Matt. 26:34). Fortunately, there were tears of repentance, and Peter was forgiven and restored after Jesus’ threefold question (“Do you love me?” [John 21:15–19]).

Jesus’ death and resurrection, as well as the giving of the Holy Spirit on the day of Pentecost, had stabilizing effects on Peter. After Jesus’ ascension, Peter exercised primary leadership among the other disciples during the upper room prayer meetings and the choosing of the replacement for Judas (Acts 1). Peter clearly was the public spokesman for the apostles on the day of Pentecost and a key player in the establishment of the church in Jerusalem (Acts 2–5), in receiving the first Samaritan converts (Acts 8:14–25), and in receiving Cornelius as the first Gentile convert (Acts 10–11). Following Peter’s miraculous deliverance from prison in Acts 12, he essentially disappears from recorded history. By the time of the Jerusalem council (Acts 15), Peter reappeared briefly, but by this time he had been replaced by James as the leader of the Jerusalem church. Peter apparently continued to live as a missionary (1 Cor. 9:5), specifically “to the circumcised” (Gal. 2:7–8), for the rest of his life. Yet Peter was still human, and on one occasion Paul gave him a stinging rebuke (Gal. 2:11–21).

During his travels, Peter undoubtedly visited the recipients of his later letter 1 Peter (and possibly 2 Peter) in north central Asia Minor (the regions of “Pontus, Galatia, Cappadocia, Asia and Bithynia” [1 Pet. 1:1]), possibly Corinth (1 Cor. 1:12; 3:22), and, at least by the end of his life, Rome itself. According to tradition, he was put to death by Nero between AD 64 and 68, apparently by being crucified upside down (cf. John 21:18–19). Peter’s life is a vivid illustration of the Christian’s fight for faith, God’s gracious provision, and Jesus’ intercession on his behalf (“I have prayed for you, Simon, that your faith may not fail” [Luke 22:32]).

This book, commonly referred to simply as Acts, is the sequel to the Gospel of Luke and records the exciting history of the first three decades of the early church. The book begins with the ascension of Jesus, followed by his sending of the Holy Spirit, and ends with the gospel message being proclaimed by Paul as a prisoner in the capital city of the Roman Empire. In the pages in between, the reader is introduced to the key people, places, and events of this strategic and crucial time of Christian history. The book of Acts provides insightful and inspiring reading. It forms the backdrop for understanding much of the NT (especially Paul’s letters), and it provides important models for the contemporary church.

Historical Background

In order to understand the book of Acts, one must become familiar with its historical background. This includes understanding the book’s authorship, recipients, and setting. In terms of authorship, the book technically is anonymous; however, there are good reasons for holding to church history’s traditional view that its author is Luke. This tradition dates back to the early second century and is supported by internal evidence. This evidence further reveals that Luke was a physician and close companion of the apostle Paul (in fact, Luke was actually with Paul for some of the events that he records in Acts; see the “we” passages, found in 16:10–17; 20:5–15; 21:8–18; 27:1–28:16). Luke was well educated, well traveled, and familiar with both the Jewish and the Greco-​Roman worlds. He was a Hellenistic God-fearer and a Christian. He was also familiar with the Jewish Scriptures, Greco-Roman rhetoric, and ancient histories, thus making him the perfect candidate to write an accurate history of early Christianity.

The specific recipient of Acts is Theophilus (1:1). Theophilus could be characterized as a relatively new believer of high social status, a person educated in Greco-Roman rhetoric and history, and one who possessed the financial means to promote and publish Luke’s work (both the Gospel of Luke and Acts). It is probable that in some way Theophilus served as a bridge to a wider readership. It seems likely that Theophilus was Luke’s ideal reader (i.e., an influential Greco-Roman of high social standing).

The specific setting of Acts is difficult to determine; however, it seems clear that the book was written during a time of crisis for the church. This crisis involved persecution and slander of Christians by both Jews and Gentiles. Both groups were trying to persuade public opinion against Christianity, including the opinion of Greco-Roman authorities. The persecution and slander were taking their toll on the church, and many Christians were demoralized and struggling to remain faithful as witnesses of Jesus. Christianity needed someone to write a response to this crisis. This response had to do three things: (1) accurately relate the history of the church to influential Greco-Romans of high social status; (2) show that Christianity was an ancient religion (ancient religions were considered to be legitimate by Roman authorities) and an asset to the Roman Empire, not a threat; (3) legitimize Christianity over against Judaism. The author of this reponse had to be someone who was respected both inside and outside of the Christian faith community, who knew the church’s history well, and who was educated in Greco-Roman rhetoric. What better authorial candidate than Luke? Finally, the church also needed a person of high social status and financial means to help publish and promote the work; thus, Theophilus was chosen.

Purpose

The book of Acts was written for a variety of purposes. These include apologetics, legitimization, discipleship, and witness to salvation. The apologetic purpose of Acts focuses on how Christianity could be recognized as an ancient, honorable, and officially protected religion in the Roman Empire. Although Judaism had the status of religio licita (legal religion) with Roman authorities for most of the first century, Christianity encountered serious problems in this respect. Acts itself reveals a substantial amount of such evidence in this regard. For example, 16:20–21 shows that at Philippi, Paul and Silas were charged with disturbing the peace by advocating unlawful customs. In Thessalonica, the missionaries were accused of defying Caesar by promoting another king named “Jesus” (17:7). At Corinth, the charge was that of persuading the people toward unlawful worship (18:13). Later in Acts, Paul was charged by the Jewish priestly leaders with being part of an unacceptable sect that was stirring up riots in Jewish communities (24:5–9). In 28:22, when Paul addressed the Roman Jews, they responded by saying that “people everywhere are talking against this sect [Christianity].” Such accusations, accompanied by the fact that Christianity’s founder had been crucified by Roman authorities, made it difficult for the Christians to gain credibility. Christianity’s precarious position with Rome was further exacerbated by a strong Jewish campaign to separate from Christians and to label them as sectarian. This strategy certainly intended for Christianity to be viewed by Rome as religio illicita (illegal or forbidden religion). Thus, Luke writes Acts to defend Christianity by showing that it is not a replacement of Judaism, but rather its legitimate continuation. Therefore, it should be accepted by the Roman authorities as a legal religion just as Judaism was accepted.

Luke’s apologetic message also appears to be directed inwardly, to a struggling church. This inward focus leads to Luke’s next main purpose: legitimization of the Christian faith for its adherents. As part of his defense, Luke intends to equip the church in the midst of an identity crisis due to the constant threats of illegitimacy. This explains Luke’s strategy of retelling the story of the church’s origins so that followers of Christ would understand their true position from God’s perspective. Thus, Luke verifies four things: (1) the Jewish Scriptures prophesied a coming messiah, and Jesus matched these prophecies; (2) the resurrection was foretold in Scripture and verified by eyewitnesses; (3) it was God’s plan all along for Gentiles to be included in God’s redemptive work; (4) Jews who rejected Jesus were acting in the same way their ancestors did; therefore, believers should not be surprised by their negative reaction to Jesus. Luke uses stories such as the one in Acts 2:41–47 to verify that salvation was genuinely being accomplished in the church and that Christians were experiencing the fulfillment of God’s ancient promises to Israel. Luke’s writing is intended to encourage his contemporary church members to remain faithful in their service and witness for the Lord. He reminds them that they are the true (legitimate) “people of God” and that God’s Spirit will help them prevail and will give them abundant life even in the midst of hardship and persecution.

Another key purpose of the book of Acts is to foster discipleship. The prologues of both Luke’s Gospel and Acts verify that Luke is writing to provide instruction and teaching for Theophilus (see Luke 1:1–4; Acts 1:1–2). Part of this instruction reveals that the ascension of Jesus was not the end of his relationship with the world, but rather a new beginning. Jesus’ departure did not mean abandonment; in fact, it meant just the opposite. Jesus verifies his continuing presence and work in the world after his departure just as he had lived and worked before. In other words, the same Spirit who directed the ministry of Jesus is now going to direct the ministry of Jesus’ followers. The rest of the book of Acts provides instruction (with many personal examples) on how Christ can fulfill the ministry of believers through the power and direction of the Holy Spirit. Luke’s discipleship teaching includes helping believers learn how to experience and follow God’s Spirit (chap. 2), to boldly witness for Christ in the midst of persecution (chaps. 3–4, 8, 14, 16–17, 19–28), to sacrificially share resources with other Christians in need (chaps. 2, 4, 11), to resolve disputes within the church (chaps. 6, 15), and to take the gospel message of salvation to all people (chaps. 2, 11, 13–28).

The book of Acts places great emphasis on the message of salvation and the responsibility given to believers to share this salvific message with all people. This salvation-witness concept is clearly one of Luke’s key purposes for the book of Acts. The Pentecost event of Acts 2 initiates the theme of salvation for all people and thus sets the agenda for the rest of the book. In this passage, various Jews from many nations hear the good news in their own tongue, which suggests that this news is for peoples of all tongues and nations yet for Jews first. The rest of Acts continues this theme of the universal scope of salvation. Luke makes it clear that this salvation crosses all geographical, ethnic, and social boundaries. In Acts, Luke is bridging the gap between Jesus’ earthly ministry and a later generation of Christ followers who are to take the gospel to a much wider geographical area with even greater ethnic diversity. The message of salvation should be joined with Luke’s emphasis on witness. The centrality of the theme of witness in Acts is verified by Jesus’ words right before the ascension: “And you will be my witnesses in Jerusalem, and in all Judea and Samaria, and to the ends of the earth” (1:8). The book of Acts tells the story of how the early church received and obeyed the command of Jesus to bear witness of him to the ends of the earth.

Literary Features

These key purposes of Acts are expounded through some distinctive literary features found in the book. One such literary feature is that the book of Acts was written in a literary genre called “apologetic historiography.” This genre can be defined as the story of a subgroup of people told by a member of the group who explains the group’s traditions and history while using Greco-Roman literary features. A good example of this literary genre is Josephus’s Jewish Antiquities. Josephus tells the story of the Jews to Greco-Roman readers in hopes that they will better understand Jewish history and traditions and will accept the Jews in the larger Greco-Roman world. This appears to be exactly what Luke is doing in the book of Acts for Christians. However, Luke is not giving a defense of a particular ethnic group; rather, he is defending a multicultural people who transcend ethnic and geographical boundaries. In fact, this is a key part of Luke’s message. Throughout Acts, Luke is trying to explain why his religion is one that crosses ethnic boundaries and is a universal religion inclusive of all ethnicities. As Luke tells the story of Christianity, he is careful to utilize Hellenistic literary features in order to connect with his primary audience. Evidence of these Hellenistic literary features in the book of Acts includes a narrative style illustrating the history through the personal experiences of key characters (Acts tells the history of the early church through characters such as Peter and Paul), the frequent use of speeches, personal observation of at least part of the narrative while maintaining anonymity of authorship (the “we” passages of Acts), and the frequent use of summaries to guide the narrative (Acts contains three major summaries [2:42–47; 4:32–37; 5:12–16] and a number of minor summaries [6:7; 9:31; 12:24; 16:5; 19:20; 28:31]).

Outline and Survey

Acts can be outlined according to Jesus’ final words, recorded in 1:8: “You will receive power when the Holy Spirit comes on you; and you will be my witnesses in Jerusalem, and in all Judea and Samaria, and to the ends of the earth.”

I. Witnesses in Jerusalem (1:1–8:3) II. Witnesses in Judea and Samaria (8:4–12:25) III. Witnesses to the Ends of the Earth (13:1–28:31)

I. Witnesses in Jerusalem (Acts 1:1–8:3). Immediately following his ascension, Jesus tells his followers to return to Jerusalem and wait for the coming of the Holy Spirit. They promptly obey, and after ten days of waiting, the disciples are dramatically filled with the Holy Spirit and begin to share the gospel with those around them. This event occurs at the Jewish Pentecost festival, which was attended by Jews and Jewish proselytes from throughout the Roman Empire. After the Spirit comes at Pentecost, Peter boldly preaches to the crowds, and over three thousand people respond with saving faith (2:41).

Luke next provides an exciting summary of the Spirit-led life within the early church. This life is characterized by the early believers’ participation together in the sharing of worship activities, material possessions, and spiritual blessings (2:42–47). This summary is followed by several dramatic healing miracles accomplished through Peter and the subsequent arrest of Christian leaders by Jewish religious authorities. Instead of squelching the Christian movement, however, these arrests only enhance the spiritual revival and its accompanying miracles. This revival is characterized by extreme generosity and unity within the early church (4:32–37).

The revival joy, however, is marred by the deceitful actions of Ananias and Sapphira, who lie to the church and to the Holy Spirit and are judged by God with immediate death (5:1–11). This story proves that God will go to extreme lengths to protect the unity of his church. Following more persecution and miracles, the disciples choose seven men to oversee distribution of food to Hellenistic widows who have been neglected in daily food distributions (6:1–7). One of these leaders, Stephen, is arrested and brought before the Sanhedrin. Stephen testifies boldly before the Jewish leaders and is promptly executed by stoning (chap. 7). This execution is endorsed by Saul, a zealous Pharisee who begins to lead fierce persecution against the church in Jerusalem (8:1–3).

II. Witnesses in Judea and Samaria (Acts 8:4–12:25). Saul’s persecution forces many of the early church believers to leave Jerusalem. These believers scatter throughout the surrounding areas of Judea and Samaria. As they scatter, however, they continue to preach the gospel (8:4). Philip preaches in Samaria and performs many miraculous signs, producing a spiritual revival in the region. Hearing about this, the apostles send Peter and John to Samaria to minister to the Samaritans (8:18–25), thus confirming the cross-cultural nature of the gospel (Samaritans traditionally were hated by the Jews). Next Luke tells of Philip’s evangelizing of an Ethiopian eunuch (8:26–40).

Following the Ethiopian’s belief in Jesus, the narrative tells of Saul’s dramatic conversion while traveling to Damascus to persecute Christians there (9:1–19). Saul’s dramatic turnaround is met with suspicion by the other disciples, but eventually he is accepted by the believers with the help of Barnabas (9:27–30). Next Peter travels to the Judean countryside and heals the paralytic Aeneas and raises Dorcas from the dead (9:32–42). These miracles produce an exciting spiritual revival in the region. Following this, God gives Peter a vision to go to the coastal city of Caesarea in order to minister to Cornelius, a Roman army officer. Cornelius is a God-fearer, and through Peter’s witness he responds to the gospel message and receives the Holy Spirit (chap. 10). Peter explains his actions with Cornelius to his concerned Jewish companions and verifies that God has indeed included the Gentiles in his plan of salvation (11:1–18).

This verification is followed by the report of what is happening in the church at Antioch, where Jews begin to share the gospel with larger groups of Gentiles (11:19–21). This cross-cultural evangelism produces a spiritual revival in Antioch, causing the Jerusalem church to send Barnabas to the large Syrian city to investigate (11:22–30). Barnabas confirms that God is indeed at work in Antioch and invites Saul to come and help him disciple the new Gentile believers (11:25–26). Next Luke reports more persecution breaking out against Christians in Jerusalem, resulting in the arrest of James and Peter by King Herod. James is executed, but Peter miraculously escapes from prison with the help of an angel (12:1–19), and the church continues to increase, spreading throughout the Roman Empire.

III. Witnesses to the ends of the earth (Acts 13:1–28:31). Starting with chapter 13, the narrative shifts its focus from the ministry of Peter to that of Paul (formerly Saul). The church at Antioch begins to take center stage over the church at Jerusalem. This church commissions Paul and Barnabas and sends them off on their first missionary journey, accompanied by Bar­na­bas’s cousin John Mark. The missionaries first sail to Cyprus, where they preach in synagogues and encounter a Jewish sorcerer, Bar-Jesus. Next they sail to Pamphylia, thus crossing into Asia Minor, and preach the gospel in Pisidian Antioch, Iconium, Lystra, and Derbe (this area was known as part of the region of Galatia). In these cities, God provides numerous miracles, and the missionaries experience a great response to the gospel as well as much persecution because of the gospel. On one occasion, Paul is actually stoned and left for dead (14:19–20).

Unfazed, Paul and his team boldly continue their mission. Eventually, they retrace their steps, strengthen the churches that they have started, and sail back to Syrian Antioch, where they give an exciting report to the church (14:26–28). Following this report, Luke tells of an important meeting of church leaders in Jerusalem. The subject of the meeting involves whether or not the new Gentile Christians should be required to follow the Jewish laws and customs. After debating the issue, the leaders side with Paul, determining that the Gentiles should not be burdened with Jewish laws and traditions, but simply must live moral lives and not eat food that has been sacrificed to idols (chap. 15).

Following this meeting, Paul and Barnabas decide to make a second missionary journey. Unfortunately, the two missionaries get into a dispute over whether to take John Mark with them again. The argument is such that the missionaries decide to separate, and Paul chooses a new partner, Silas. They travel by land back to Galatia. Barnabas takes John Mark and sails to Cyprus. Paul and Silas return to Derbe and Lystra and then make their way to Macedonia and Greece. They spend significant time in Philippi, Thessalonica, and Corinth before returning to Caesarea and Antioch (chaps. 16–18). Following his return, Paul makes a third missionary journey, revisiting churches in Galatia and Phrygia and staying in Ephesus for three years before visiting Macedonia and Greece for a second time.

Paul concludes his third missionary journey with a trip to Jerusalem, where he is falsely accused of bringing a Gentile into the temple. This accusation creates a riot, and Paul is rescued by Roman soldiers, who arrest him and transfer him to a prison in Caesarea, where he spends two years awaiting trial under the rule of Felix and Festus (23:34–25:22). Paul eventually exercises his right as a Roman citizen to have his case heard by the emperor. He is sent to Rome by boat and is shipwrecked on the island of Malta. Eventually he makes his way to the capital city, where he is placed under house arrest. While in Rome, Paul maintains a rented house and is free to receive visitors and write letters. In fact, it is thought that Paul penned his “prison letters” during this time of house arrest (Ephesians, Philippians, Colossians, Philemon). The narrative of Acts ends with Paul ministering boldly in Rome while awaiting his trial.

Acts and the Contemporary Church

The book of Acts provides a model for today’s church on numerous topics. These include understanding the role of the Holy Spirit, practicing community life within the church, dealing with hardship and persecution, overcoming social injustices, and carrying out missions.

Acts reveals that the key issue for Christians is learning to experience and follow God’s Holy Spirit, who enables believers to be bold in their witness for Christ, generous in their physical and spiritual support of each other, and effective in their ministries. Acts consistently reveals that one’s joy, power, and purpose come from the Holy Spirit. According to Acts, learning to follow and depend upon God’s Holy Spirit is the key to having a healthy church.

Acts also shows that the Holy Spirit produces a unique community life characterized by worship, generosity, blessing, and unity. Luke calls this Spirit-led common life koinōnia, which is explained and illustrated in the first five chapters of Acts (see esp. 2:42–47). It should be the desire and goal of every church to re-create this koinōnia community first experienced by the primitive church in Acts.

In addition to its koinōnia, the book of Acts serves as a model for the church in overcoming persecution and hardship. The narrative of Acts consistently reveals the sovereign power of God in overcoming opposition. The early church found great joy and growth in the midst of hardship and persecution, and today’s church can do the same.

Another important example for the church provided by Acts is in the area of social justice. Luke’s primitive church consistently removed ethnic prejudices, eliminated social hierarchy and status within the church, and elevated the role of women. Acts provides inspiration and guidance for today’s church in facing these same social issues.

In addition to overcoming social injustices, the church in Acts provides an excellent example of mission ministry. These believers consistently revealed God’s heart for the nations and made it a priority to share the gospel with all people everywhere. Acts’ emphasis on the universal nature of the gospel, the responsibility of individual Christians to witness for Christ, and the importance of planting new churches and discipling new believers sets a pattern for today’s church in the area of missions.

These examples should serve to inspire and guide the contemporary church as it seeks to follow and experience the Holy Spirit, who is so powerfully revealed in the book of Acts.

A Greek form of the common Hebrew name “Hananiah.” (1) A member of the Jerusalem church whose death was followed by that of his wife, Sapphira, as a result of holding back part of their possessions (Acts 5:1–11). Peter rebuked Ananias and Sapphira’s deception as lying to or testing “the Holy Spirit” (vv. 3, 5). This incident is best understood against the background of Acts 2–4, which describes as closely related being “filled with the Holy Spirit” (2:4; 4:31), the spread of the gospel (2:40; 4:4), and the communal sharing of possessions (2:44–45; 4:32–37).

(2) A disciple at Damascus who helped restore Saul’s eyesight and baptized him in accordance with the Lord’s direction in a vision (Acts 9). In Acts 22:12 Paul describes Ananias as “a devout observer of the law and highly respected by all the Jews living [at Damascus].” He was the one who informed Paul of his calling as a witness for Jesus to all people (22:12–15).

(3) A high priest in Jerusalem during AD 47–58. He presided over the interrogation of Paul at the Sanhedrin of Jerusalem (Acts 23:1–10) and testified against Paul before Felix (24:1). His character is well illustrated in his command to strike Paul on the mouth, upon which Paul calls him a “whitewashed wall” and sees him unfit for the high priesthood (23:2–5). Being a pro-Roman figure, Ananias was assassinated by the Zealots in AD 66.

Simon Peter is the best-known and the most colorful of Jesus’ twelve disciples. The name “Peter” means “rock” in Greek. In some biblical texts, he is also called “Cephas,” which is the Aramaic word for “rock” (see esp. John 1:42). Despite the ups and downs of Peter’s spiritual life, God was able to use him as the foundational apostle for the establishment of the NT church. Peter first met Jesus immediately after Jesus’ baptism, when Peter’s brother, Andrew, heard John the Baptist’s identification of Jesus as the Lamb of God (John 1:35). In classic missionary style, “the first thing Andrew did was to find his brother Simon and tell him, ‘We have found the Messiah’ ” (John 1:41). Peter’s official call to ministry took place later, when he was fishing on the Sea of Galilee and Jesus issued the well-known invitation “Come, follow me, . . . and I will send you out to fish for people” (Matt. 4:19).

Peter was the chief spokesman for the disciples at Caesarea Philippi when Jesus asked them, “Who do people say the Son of Man is?” (Matt. 16:13). Peter responded, “You are the Messiah, the Son of the living God,” an insight given him by God the Father (16:16–17). Jesus promised him, “I tell you that you are Peter [petros], and on this rock [petra] I will build my church, and the gates of Hades will not overcome it” (16:18). Yet Peter almost immediately became a “stumbling block” to Jesus when he chided Jesus for saying that he must go to Jerusalem and suffer many things and be killed (16:21–22). Another major failure by Peter came with his threefold denial of Jesus after Jesus had warned him, “This very night, before the rooster crows, you will disown me three times” (Matt. 26:34). Fortunately, there were tears of repentance, and Peter was forgiven and restored after Jesus’ threefold question (“Do you love me?” [John 21:15–19]).

Jesus’ death and resurrection, as well as the giving of the Holy Spirit on the day of Pentecost, had stabilizing effects on Peter. After Jesus’ ascension, Peter exercised primary leadership among the other disciples during the upper room prayer meetings and the choosing of the replacement for Judas (Acts 1). Peter clearly was the public spokesman for the apostles on the day of Pentecost and a key player in the establishment of the church in Jerusalem (Acts 2–5), in receiving the first Samaritan converts (Acts 8:14–25), and in receiving Cornelius as the first Gentile convert (Acts 10–11). Following Peter’s miraculous deliverance from prison in Acts 12, he essentially disappears from recorded history. By the time of the Jerusalem council (Acts 15), Peter reappeared briefly, but by this time he had been replaced by James as the leader of the Jerusalem church. Peter apparently continued to live as a missionary (1 Cor. 9:5), specifically “to the circumcised” (Gal. 2:7–8), for the rest of his life. Yet Peter was still human, and on one occasion Paul gave him a stinging rebuke (Gal. 2:11–21).

During his travels, Peter undoubtedly visited the recipients of his later letter 1 Peter (and possibly 2 Peter) in north central Asia Minor (the regions of “Pontus, Galatia, Cappadocia, Asia and Bithynia” [1 Pet. 1:1]), possibly Corinth (1 Cor. 1:12; 3:22), and, at least by the end of his life, Rome itself. According to tradition, he was put to death by Nero between AD 64 and 68, apparently by being crucified upside down (cf. John 21:18–19). Peter’s life is a vivid illustration of the Christian’s fight for faith, God’s gracious provision, and Jesus’ intercession on his behalf (“I have prayed for you, Simon, that your faith may not fail” [Luke 22:32]).

Terminology

The NT word for “church” is ekklēsia, which means “gathering, assembly, congregation.” In classical Greek the term was used almost exclusively for political gatherings. In particular, in Athens the word signified the assembling of the citizens for the purpose of conducting the affairs of the city. Moreover, ekklēsia referred only to the actual meeting, not to the citizens themselves. When the people were not assembled, they were not considered to be the ekklēsia. The NT records three instances of this secular usage of the term (Acts 19:32, 39, 41).

The most important background for the Christian use of the term is the LXX (Greek translation of the Hebrew Scriptures, dated c. 250 BC), which uses the word in a religious sense about one hundred times, almost always as a translation of the Hebrew word qahal. While qahal does not indicate a secular gathering (in contrast to ’edah, the typical Hebrew word for Israel’s religious gathering, translated by Greek synagōgē), it does denote Israel’s sacred meetings. This is especially the case in Deuteronomy, where qahal is linked with the covenant.

In the NT, ekklēsia is used to refer to the community of God’s people 109 times (out of 114 occurrences of the term). Although the word occurs in only two Gospel passages (Matt. 16:18; 18:17), it is of special importance in Acts (23 times) and the Pauline writings (46 times). It is found 20 times in Revelation and in isolated instances in James and Hebrews. Three general conclusions can be drawn from this usage. First, ekklēsia (in both the singular and the plural) applies predominantly to a local assembly of those who profess faith in and allegiance to Christ. Second, ekklēsia designates the universal church (Acts 8:3; 9:31; 1 Cor. 12:28; 15:9; especially in the later Pauline letters: Eph. 1:22–23; Col. 1:18). Third, the ekklēsia is God’s congregation (1 Cor. 1:2; 2 Cor. 1:1).

The Nature of the Church

The nature of the church is too broad to be exhausted in the meaning of one word. To capture its significance, the NT authors utilize a rich array of metaphorical descriptions. Nevertheless, there are those metaphors that seem to dominate the biblical pictures of the church, five of which call for comment: the people of God, the kingdom of God, the eschatological temple of God, the bride of Christ, and the body of Christ.

The people of God. Essentially, the concept of the people of God can be summed up in the covenantal phrase: “I will be their God, and they will be my people” (see Exod. 6:6–7; 19:5; Lev. 26:9–14; Jer. 7:23; 30:22; 32:37–40; Ezek. 11:19–20; 36:22–28; Acts 15:14; 2 Cor. 6:16; Heb. 8:10–12; Rev. 21:3). Thus, the people of God are those in both the OT and the NT eras who responded to God by faith and whose spiritual origin rests exclusively in God’s grace.

To speak of the one people of God transcending the eras of the OT and the NT necessarily raises the question of the relationship between the church and Israel. Modern interpreters prefer not to polarize the matter into an either/or issue. Rather, they talk about the church and Israel in terms of there being both continuity and discontinuity between them.

Continuity between the church and Israel. Two ideas establish the fact that the church and Israel are portrayed in the Bible as being in a continuous relationship. First, in the OT the church was present in Israel in some sense. Acts 7:38 suggests this connection when, alluding to Deut. 9:10, it speaks of the church (ekklēsia) in the wilderness. The same idea is probably to be inferred from the intimate association noted earlier existing between the words ekklēsia and qahal, especially when the latter is qualified by the phrase “of God.” Furthermore, if the church is viewed in some NT passages as preexistent, then one finds therein the prototype of the creation of Israel (see Exod. 25:40; Acts 7:44; Gal. 4:26; Heb. 12:22; Rev. 21:11; cf. Eph. 1:3–14).

Second, Israel in some sense is present in the church in the NT. The many OT names for Israel applied to the church in the NT establish that fact. Some of those are “Israel” (Gal. 6:15–16; Eph. 2:12; Heb. 8:8–10; Rev. 2:14), “a chosen people” (1 Pet. 2:9), “the circumcision” (Rom. 2:28–29; Phil. 3:3; Col. 2:11), “Abraham’s seed” (Rom. 4:16; Gal. 3:29), “the remnant” (Rom. 9:27; 11:5–7), “the elect” (Rom. 11:28; Eph. 1:4), “the flock” (Acts 20:28; Heb. 13:20; 1 Pet. 5:2), and “priesthood” (1 Pet. 2:9; Rev. 1:6; 5:10).

Discontinuity between the church and Israel. The church, however, is not totally identical with Israel; discontinuity also characterizes the relationship. The church, according to the NT, is the eschatological (end-time) Israel incorporated in Jesus Christ and, as such, is a progression beyond historical Israel (1 Cor. 10:11; 2 Cor. 5:14–21). Indeed, significant discontinuity is introduced by the fact that the church includes Gentiles as members of Israel, without requiring them to convert to Judaism first. Gentiles enter as Gentiles. However, a caveat must be issued at this point. Although the church is a progression beyond Israel, it does not seem to be the permanent replacement of Israel (see Rom. 9–11, esp. 11:25–27).

The kingdom of God. Many scholars have maintained that the life, death, and resurrection of Jesus inaugurated the kingdom of God, producing the overlapping of the two ages. The kingdom has already dawned but is not yet complete. The first aspect pertains to Jesus’ first coming, and the second aspect relates to his second coming. In other words, the age to come has broken into this age, and now the two exist simultaneously. This background is crucial in ascertaining the relationship between the church and the kingdom of God, because the church also exists in the tension that results from the overlapping of the two ages. Accordingly, one may define the church as the foreshadowing of the kingdom. Two ideas flow from this definition: first, the church is related to the kingdom of God; second, the church is not equal to the kingdom of God.

The church and the kingdom of God are related. Not until after the resurrection of Jesus does the NT speak with regularity about the church. However, there are early signs of the church in the teaching and ministry of Jesus, in both general and specific ways. In general, Jesus anticipated the later official formation of the church in that he gathered to himself the twelve disciples, who constituted the beginnings of eschatological Israel—in effect, the remnant. More specifically, Jesus explicitly referred to the church in two passages: Matt. 16:18–19; 18:17. In the first passage Jesus promised that he would build his church despite satanic opposition, thus assuring the ultimate success of his mission. The notion of the church overcoming the forces of evil coincides with the idea that the kingdom of God will prevail over its enemies and bespeaks the intimate association between the church and the kingdom. The second passage relates to the future organization of the church, not unlike the Jewish synagogue practices of Jesus’ day.

The church and the kingdom of God are not identical. As intimately related as the church and the kingdom of God are, the NT does not equate the two, as is evident in the fact that the early Christians preached the kingdom, not the church (Acts 8:12; 19:8; 20:25; 28:23, 31). The NT identifies the church as the people of the kingdom (e.g., Rev. 5:10), not the kingdom itself. Moreover, the church is the instrument of the kingdom. This is especially clear from Matt. 16:18–19, where the preaching of Peter and the church become the keys to opening up the kingdom of God to all who would enter.

The eschatological temple of God. Both the OT and Judaism anticipated the rebuilding of the temple in the future kingdom of God (e.g., Ezek. 40–48; Hag. 2:1–9; 1 En. 90:29; 91:3; Jub. 1:17, 29). Jesus hinted that he was going to build such a structure (Matt. 16:18; Mark 14:58; John 2:19–22). Pentecost witnessed to the beginning of the fulfillment of that dream in that when the Spirit inhabited the church, the eschatological temple was formed (Acts 2:16–36). Other NT writers also perceived that the presence of the Spirit in the Christian community constituted the new temple of God (1 Cor. 3:16–17; 2 Cor. 6:14–7:1; Eph. 2:19–22; see also Gal. 4:21–31; 1 Pet. 2:4–10). How­ever, that the eschatological temple is not yet complete is evident in the preceding passages, especially in their emphasis on the need for the church to grow toward maturity in Christ, which will be fully accomplished only at the parousia (second coming of Christ). In the meantime, Christians, as priests of God, are to perform their sacrificial service to the glory of God (Rom. 12:1–2; Heb. 13:15; 1 Pet. 2:4–10).

The bride of Christ. The image of marriage is applied to God and Israel in the OT (see Isa. 54:5–6; 62:5; Hos. 2:7). Similar imagery is applied to Christ and the church in the NT. Christ, the bridegroom, has sacrificially and lovingly chosen the church to be his bride (Eph. 5:25–27). Her responsibility during the betrothal period is to be faithful to him (2 Cor. 11:2; Eph. 5:24). At the parousia the official wedding ceremony will take place, and with it the eternal union of Christ and his wife will be actualized (Rev. 19:7–9; 21:1–2).

The body of Christ. The body of Christ as a metaphor for the church is unique to the Pauline literature and constitutes one of the most significant concepts therein (Rom. 12:4–5; 1 Cor. 12:12–27; Eph. 4:7–16; Col. 1:18). The primary purpose of the metaphor is to demonstrate the interrelatedness of diversity and unity within the church, especially with reference to spiritual gifts. The body of Christ is the last Adam (1 Cor. 15:45), the new humanity of the end time that has appeared in history. However, Paul’s usage of the image, like the metaphor of the new temple, indicates that the church, as the body of Christ, still has a long way to go spiritually. It is not yet complete.

Sacraments

At the heart of the expression of the church’s faith are the sacraments of baptism and the Lord’s Supper. The former symbolizes entrance into the church, while the latter provides spiritual sustenance for the church.

Baptism. Baptism symbolizes the sinner’s entrance into the church. Three observations emerge from the biblical treatment of this sacrament. First, the OT intimated baptism, especially in its association of repentance of sin with ablutions (Num.19:18–22; Ps. 51:7; Ezek. 36:25; cf. John 3:5). Second, the baptism of John anticipated Christian baptism. John administered a baptism of repentance in expectation of the baptism of the Spirit and fire that the Messiah would exercise (Matt. 3:11 // Luke 3:16). Those who accept Jesus as Messiah experience the baptism of fire and judgment (which may be an allusion to undergoing the great tribulation/messianic woes that lead into the messianic kingdom). Third, the early church practiced baptism in imitation of the Lord Jesus (Matt. 3:13–17 // Mark 1:9–11 // Luke 3:21–22; see also John 1:32–34; cf. Matt. 28:19; Acts 2:38; 8:16; Rom. 6:3–6; 1 Cor. 1:13–15; Gal. 3:27; Titus 3:5; 1 Pet. 3:21). These passages demonstrate some further truths about baptism: baptism is intimately related to faith in God; baptism identifies the person with the death and resurrection of Jesus; baptism incorporates the person into the community of believers.

Lord’s Supper. The other biblical sacrament is the Lord’s Supper. This rite symbolizes Christ’s spiritual nourishment of his church as it celebrates the sacred meal. Two basic points emerge from the biblical data concerning the Lord’s Supper. First, it was instituted by Christ (Matt. 26:26–29; Mark 14:22–25; Luke 22:15–20; 1 Cor. 11:23–25), probably as an adaptation of the Passover meal. If that is the case, then, Jesus will have introduced two changes into the Passover seder: he replaced the unleavened bread with a reference to his body being given for us on the cross; he replaced the cup of redemption with a reference to his shed blood on the cross, the basis of the new covenant. Second, the early church practiced the Lord’s Supper probably weekly, in conjunction with the love feast (see 1 Cor. 11:18–22; cf. Jude 12). A twofold meaning is attached to the Lord’s Supper by the NT authors. First, it involves participation in Christ’s salvation (Luke 22:19; 1 Cor. 11:24–25), and in two ways: participating in the Lord’s Supper looks back to the death of Jesus, in which the believer now shares; participating in the Lord’s Supper looks forward to Christ’s return, the culmination point of the believer’s salvation. Second, the Lord’s Supper involves identification with the body of Christ, the community of faith (1 Cor. 10:16–17; 11:27–33).

Worship

The ultimate purpose of the church is to worship God through Christ and in the power of the Holy Spirit (see, e.g., Rev. 4–5). The early church first worshiped in the Jerusalem temple (Acts 2:46; 3:1; 5:42) as well as in the synagogue (Acts 22:19; cf. John 9:22; James 2:2). At the same time, and into the near future, believers met in homes for worship (Acts 1:13; 2:46; 5:42; cf. Rom. 16:15; Col. 4:15; Philem. 2; 2 John 10; 3 John 1, 6). Although many Jewish Christians no doubt continued to worship God on the Sabbath, the established time for the church’s worship came to be Sunday, the day of Jesus’ resurrection (Acts 20:7; Rev. 1:10). The early church most probably patterned its order of worship after the synagogue service: praise in prayer (Acts 2:42, 47; 3:1; 1 Thess. 1:2; 5:17) and in song (1 Cor. 14:26; Phil. 2:6–11; Col. 1:15–20), the expounding of Scripture (Acts 2:42; 6:4; Col. 4:16; 1 Thess. 2:13; 1 Tim. 4:13), and almsgiving to the needy (Acts 2:44–45; 1 Cor. 16:1–2; 2 Cor. 8–9; James 2:15–17).

Service and Organization

Five observations emerge from the NT regarding the service and organization of the early church. First, the ministry of the church centers on its usage of spiritual gifts, which are given to believers by God’s grace and for his glory as well as for the good of others (Rom. 12:3; Eph. 4:7–16). Second, every believer possesses a gift of the Spirit (1 Cor. 12:7; Eph. 4:7). Third, it is through the diversity of the gifts that the body of Christ matures and is unified (Rom. 12:4; 1 Cor. 12:12–31; Eph. 4:17–18). Fourth, although there was organized leadership in the NT church, including elders (1 Tim. 3:1–7 [also called “pastors” and “bishops”; see Acts 20:17, 28; 1 Pet. 5:1–4]) and deacons (1 Tim. 3:8–13), there does not seem to have been a gap between the “clergy” and the “laity” in the church of the first century; rather, those with the gift of leadership are called to equip all the saints for the work of the ministry (Eph. 4:7–16). Fifth, spiritual gifts are to be exercised in love (1 Cor. 13).

Pieces of metal stamped with a particular impression, used as a medium of exchange. From time immemorial people used animals, grain, or other commodities to barter (Hos. 3:2), pay taxes (1 Sam. 8:15), or as a measure of wealth (Job 1:3). Substituting smaller, more easily handled pieces of precious metal had obvious advantages. Gradually people used precious metal such as silver or gold along with commodities (Gen. 20:14–16) and then in place of them (37:28) as a means of payment. Such metal had been refined, but it could have been in most any form (rings, bars, ingots, dust) as long as it weighed the appropriate amount. Local and international standards developed to regulate the weights, and later the concept grew in popularity to use standard, authorized, clearly stamped pieces of precious metal—coins.

Old Testament. Minting of coins may have begun as far back as the late eighth century BC, and it gradually spread throughout the known world. The first coins apparently were made in Asia Minor using electrum, a natural alloy of gold and silver.

When the Persians took over much of the ancient Near East in the sixth century BC, the use of coins spread, and Persian coins came to the land of the Bible. At the end of the Hebrew Bible there is mention of large quantities of Persian coins called “darics” (1 Chron. 29:7; Ezra 8:27), also translated as “drachmas” (NASB) or “drams” (KJV) (Ezra 2:69; Neh. 7:70–72). These darics were stamped with the likeness of Darius the Great (521–486 BC) and were minted from gold and occasionally silver. At about the same time, silver tetradrachmas (four-drachma coins) from Athens made their way to the western shores of the Mediterranean. Local imitations of this coin were stamped with “YHD” to represent the province of Judah.

New Testament. Coins appear dozens of times in the NT; some have Hellenistic roots, while others come from the periods of Hasmonean or Roman rule.

For several centuries after Alexander the Great conquered the ancient Near East (fourth century BC), coins with the images of Alexander or his Seleucid or Ptolemaic successors were circulated in Judea. In particular, silver shekels from the Phoenician port cities of Tyre and Sidon enjoyed wide usage for a long time. Also called a “stater,” the shekel or four-drachma coin recovered by Peter from the fish’s mouth (Matt. 17:27) may have been such a Tyrian coin. Many or all of the thirty silver coins that the chief priests gave Judas for betraying Jesus (Matt. 26:15; 27:3) probably were Tyrian shekels as well, since this coin came to be the accepted currency at the temple in Jerusalem and the priests would have had a good supply of them.

After the Hellenistic rulers lost control of Judea during the rebellion led by the Maccabean or Hasmonean family in the second century BC, the Jews could mint their own coins for the first time. The honor of producing the first Jewish coin apparently goes to John Hyrcanus I (134–104 BC), son of Simon and nephew of Judas Maccabeus. Simon’s modest bronze lepton (pl. lepta), or prutah, has an inscription on one side and two cornucopias and a pomegranate on the other. Use of such agricultural symbols apparently fulfilled two purposes: it portrayed the fertility of the land that God had given his people, and it helped the Jews avoid depicting people on coins, as the Greeks and later the Romans would do. During this period devout Jews avoided such images in order to help fulfill the second commandment (Exod. 20:4), to avoid graven images. Hyrcanus I’s son Alexander Jannaeus (103–76 BC) minted great quantities of different types of bronze lepta, still often found in excavations in Israel today. These coins remained in circulation for many years, probably through the ministry of Jesus. Thus, the two small coins for which Jesus commended the widow for donating to the temple treasury (Mark 12:42; Luke 21:2) may well have been lepta of Alexander Jannaeus. The tiny lepton, typically smaller than a dime and worth only 1/400 of a shekel, also appears in Luke 12:59.

It is also possible that the aforementioned lepta were not minted by Alexander Jannaeus, since later rulers, including the Jewish king Herod the Great (40–4 BC), also minted large numbers of similar small bronze coins. Though not known for his piety, Herod continued to avoid human representations on his coins. For the most part, so did his sons and the later Roman procurators (including Pontius Pilate [governed AD 26–36]), who ruled Judea before the revolt in AD 66.

Other Roman coins, such as the silver denarius (pl. denarii) minted outside Judea, clearly did not avoid human representation, however. Jesus’ request for a coin with Caesar’s image and inscription (Matt. 22:15–22) refers to the denarius. The denarius in Jesus’ day could have portrayed the emperor Tiberius (r. AD 14–37) or even Augustus (r. 27 BC–AD 14), whose coins were probably still in circulation. The silver denarius came to represent the daily wage of a common laborer, as clearly shown in the parable of laborers (Matt. 20:1–16). The denarius also appears in many other passages, although modern translators sometimes use a more interpretive expression (“two silver coins” for “two denarii” in Luke 10:35; “a year’s wages” for “three hundred denarii” in Mark 14:5).

Although many of the references discussed above contain specific terms that can be identified with coins known from history, others cannot. General terms meaning “coins” or “pieces of money” sometimes appear, as when Jesus scattered the coins of the money changers (John 2:15), or the rather common term for silver that appears frequently and is often translated as “money” (Matt. 28:12; Luke 9:3) or “silver” (Acts 3:6; 1 Pet. 1:18) as well as “silver coins” (Matt. 27:3 GW).

(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 gates of Jerusalem and the temple have varied throughout history. Gates usually were given names that represented their function, activity, or the direction of travel. Most of what we know of gates during OT times is derived from Nehemiah’s inspection and description of the destroyed city.

Jerusalem contained several gates during the OT period. On the eastern wall was the Fountain Gate. Just south of this gate was the Potsherd Gate, later becoming the Dung Gate. On the southwest corner was the Valley Gate. On the northern wall were the Ephraim Gate (later called “Middle Gate”) and possibly the Fish Gate.

Gates that were either associated with or near the temple were the Muster Gate, Horse Gate, Gate of the Guard, and the Water Gate (possibly also called “East Gate”), the temple gate facing the north, New Gate, Horse Gate, and the upper Benjamin Gate (also Sheep Gate?).

Josephus recounts ten gates associated with the temple: four each on the north and south and two on the east. The gate that led to the court of the women may have been the Beautiful Gate (Acts 3:2), and the gate between the court of the women and the court of Israel probably was the Nicanor Gate. The Todi Gate was on the north; the Coponius Gate (Barclay’s Gate), Wilson’s Arch, and Warren’s Gate were on the west. The south side of the Temple Mount had two large gates: the Double Gate and the Triple Gate. Josephus mentions only two city gates: the Gate of the Essenes and the Gennath Gate.

The gates of Jerusalem and the temple have varied throughout history. Gates usually were given names that represented their function, activity, or the direction of travel. Most of what we know of gates during OT times is derived from Nehemiah’s inspection and description of the destroyed city.

Jerusalem contained several gates during the OT period. On the eastern wall was the Fountain Gate. Just south of this gate was the Potsherd Gate, later becoming the Dung Gate. On the southwest corner was the Valley Gate. On the northern wall were the Ephraim Gate (later called “Middle Gate”) and possibly the Fish Gate.

Gates that were either associated with or near the temple were the Muster Gate, Horse Gate, Gate of the Guard, and the Water Gate (possibly also called “East Gate”), the temple gate facing the north, New Gate, Horse Gate, and the upper Benjamin Gate (also Sheep Gate?).

Josephus recounts ten gates associated with the temple: four each on the north and south and two on the east. The gate that led to the court of the women may have been the Beautiful Gate (Acts 3:2), and the gate between the court of the women and the court of Israel probably was the Nicanor Gate. The Todi Gate was on the north; the Coponius Gate (Barclay’s Gate), Wilson’s Arch, and Warren’s Gate were on the west. The south side of the Temple Mount had two large gates: the Double Gate and the Triple Gate. Josephus mentions only two city gates: the Gate of the Essenes and the Gennath Gate.

The keys of the kingdom picture the power and authority entrusted to Simon Peter by Jesus immediately after Peter’s confession of faith (Matt. 16:16). Jesus responded, “I tell you that you are Peter [petros], and on this rock [petra] I will build my church, and the gates of Hades will not overcome it” (Matt. 16:18). It is at this point that Jesus tells Peter, “I will give you the keys of the kingdom of heaven; whatever you bind on earth will be bound in heaven, and whatever you loose on earth will be loosed in heaven” (16:19). Roman Catholics have understood these keys, along with this symbolism of loosing and binding, to refer to a special authority in the forgiveness of sins and in the practices of penance and absolution given to the apostle Peter, and by extension to the institution of the papacy as his spiritual heir. Protestants have often understood this power as involving the apostles in general, or perhaps even the entire church (see 18:18).

The symbolism of keys is normally used in the Bible to refer to a means of entry. Jesus is addressing Peter in particular in Matt. 16:19, not the apostles as a whole, since the “you” is singular in the Greek text. Perhaps the best way to understand this phrase is to interpret it in its original context of something that Peter was to do in the initial establishment of the NT church. Significantly, Peter is given an unparalleled initiatory role in the spread of the gospel. Peter is the one who takes on leadership in the upper room prayer meeting in Acts 1 and also in the process of finding another apostle to replace Judas Iscariot. Peter is the spokesman for the apostles on the day of Pentecost (Acts 2) as well as in the subsequent events involving the Jerusalem church (Acts 3–5). Peter (along with John) goes down to Samaria to examine the new believers in Samaria and to be the human channel through which they would receive the Spirit (Acts 8:14–17). Peter is the one who is entrusted by God with reaching out to Cornelius, the first Gentile convert (Acts 10–11). At every step along the way, Peter is the one whom God used to open the door to new groups of people in the spread of the gospel.

The Letter of James has been hailed as possibly the earliest, most Jewish, and most practical of all NT letters. James 3:13 aptly communicates the book’s theme: “Who is wise and understanding among you? Let them show it by their good life, by deeds done in humility that comes from wisdom.” The terms “wise” and “wisdom” occur five times in the book (1:5; 3:13 [2×], 15, 17). Hence, the author instructed his readers on leading a life of faith that was characterized by a wisdom expressed through speech and actions (2:12).

Literary Features

The author’s employment of picturesque, concrete language has close affinities to OT wisdom literature and reflects Jesus’ teaching in the Sermon on the Mount.

James 1:2 – Matthew 5:10-12

James 1:4 – Matthew 5:48

James 1:5; 5:15 – Matthew 7:7-12

James 1:9 – Matthew 5:3

James 1:20 – Matthew 5:22

James 1:22 – Matthew 7:21

James 2:5 – Matthew 5:3

James 2:13 – Matthew 5:7; 6:14-15

James 2:14-16 – Matthew 7:21-23

James 3:12 – Matthew 7:16

James 3:17-18 – Matthew 5:9

James 4:4 – Matthew 6:24

James 4:10 – Matthew 5:3-4

James 4:11 – Matthew 7:1-2

James 5:2 – Matthew 6:19

James 5:10 – Matthew 5:12

James 5:12 – Matthew 5:33-37

Like the OT wisdom literature, the teaching in James has a strongly practical orientation. Although the book contains some lengthier paragraphs, much of it consists of sequential admonishments and ethical maxims that in some cases are only loosely related to one another. The sentences generally are short and direct. There are fifty-four verbs in the imperative. Connection between sentences is sometimes created through repeated words. Yet the overall topic of practical faith and wisdom links these exhortations together.

Background and Occasion

After the death of Stephen, many disciples were scattered into the regions of Judea and Samaria (Acts 7:54–8:3). In Acts 11:19 the narrator notes, “Now those who had been scattered by the persecution that broke out when Stephen was killed traveled as far as Phoenicia, Cyprus and Antioch, spreading the word only among Jews.” James may have written this letter to instruct and comfort those scattered believers, as he addressed his letter to “the twelve tribes dispersed abroad” (1:1 NET). These Jewish Christians no longer had direct contact with the apostles in Jerusalem and needed to be instructed and admonished in their tribulations. Apparently, the rich were taking advantage of them (2:6; 5:1–6), and their trials had led to worldliness, rash words, and strained relationships (2:1; 4:1, 11; 5:9). In view of persecution, some may have been tempted to hide their faith (5:10–11). James exhorted them to demonstrate a lifestyle that would reflect their faith.

James’s View on Works and Salvation

Some readers of this letter have observed a seeming contradiction between James’s call for good works and Paul’s insistence on salvation by grace through faith apart from works (cf. James 2:14–26 with Eph. 2:8–10). The discussion is complicated by James’s argument that a faith without works cannot “save” and by his observation that Abraham was justified by what he did, not by faith alone (James 2:14, 20–24). Paul, by contrast, maintains that Abraham was justified exclusively by faith (Rom. 4:1–3).

Referring rhetorically to people who claim to have faith but have no deeds, James asks, “Can such faith save them?” (2:14). That is, can the kind of faith that results in no works be genuine? The expected answer is no. The kind of faith that produces no works cannot be genuine faith; rather, it is “dead” (2:17, 26) and “useless” (2:20). This kind of faith is “by itself,” meaning that it produces no lasting fruit (2:17). James’s point is that genuine faith will produce good works in the believer’s life. By way of contrast, a mere profession is not necessarily an indication of genuine faith. Even demons believe in God, but they are not saved; the kind of belief that they exhibit is merely an acknowledgment of God’s existence (2:19).

According to James, Abraham was justified not in the sense of first being declared righteous, but rather in the sense that his faith was demonstrated as genuine when he offered up Isaac (2:21). Paul, on the other hand, argues that salvation is obtained not through works but rather by faith alone. He quotes Gen. 15:6 to show that Abraham trusted God and was declared righteous several years before he offered up Isaac (Rom. 4:3).

According to Paul, Abraham was justified (declared righteous) before God when he believed God’s promise (Gen. 15:6), but for James, he was justified in the sense of giving observable proof of salvation through his obedience to God. Whereas Paul refers to the point and means of positional salvation, James refers to a subsequent event that confirmed that Abraham was justified.

I. Faith

A. Paul (Romans 4:1-3):

1. Is personal trust in God

2. Justifies one before God

3. Is not proof of Salvation

B. James (2:14-26)

1. Is a mere claim if there is no resulting fruit

II. Works

A. Paul (Romans 4:1-3):

1. Precede salvation

2. Attempt to merit salvation

3. Cannot justify before God

B. James (2:14-26)

1. Follow conversion

2. Are evidence of salvation

3. Confirm one’s salvation

It is important to keep in mind that each author wrote with a different purpose. Paul wrote against Judaizers, who taught that a man had to be circumcised and keep the OT law to be saved. James was warning against a mere profession of faith that leads to self-deception (1:22). John Calvin correctly expressed the biblical teaching that faith alone saves, but that kind of faith does not remain alone; it produces good works (cf. Rom. 3:21–6:14; Eph. 2:8–10; Titus 2:11–14; 3:4–7).

Authorship

The author identifies himself as “James, a servant of God and of the Lord Jesus Christ” (1:1). The NT mentions five persons having the name “James”: (1) James the son of Zebedee and the brother of John (Matt. 4:21); (2) James the son of Alphaeus (Matt. 10:3); (3) James “the younger” (Mark 15:40); (4) James the father of the apostle Judas (not Judas Iscariot; Luke 6:16); and (5) James the brother of Jesus (Matt. 13:55; Mark 6:3; Gal. 1:19).

James the brother of John was executed by Herod Agrippa I, who died in AD 44 (Acts 12:2). Since the Letter of James probably was written after this date, the brother of John could not have written it. Neither James the son of Alphaeus, James the younger, nor James the father of Judas was as prominent in the early church as the writer of this letter, who simply identified himself and assumed that his readers would know him (1:1). James the son of Alphaeus is mentioned for the last time in Acts 1:13, and nothing is known of James the father of Judas apart from the listing of his name in Luke 6:15; Acts 1:13. (It is uncertain whether James the younger should be identified with one of the other four or is a separate figure.) Thus, it is unlikely that any of them wrote the book. James the brother of Jesus is most likely the author of this letter.

James the Brother of the Lord

At the beginning of Jesus’ ministry, James, as well as his brothers Joses (Joseph), Judas, and Simon, did not believe that Jesus was the Messiah (Matt. 13:55; Mark 6:3; John 7:5). However, they came to believe in him after the resurrection (Acts 1:14; 1 Cor. 15:7). Paul called James, along with Peter and John, the “pillars” of the church (Gal. 2:9). James does not claim to be an apostle in this letter; however, he is identified as one in Gal. 1:19. But there the term “apostle” probably refers to a group of leading disciples outside the Twelve (cf. Acts 14:4, 14; 1 Cor. 15:7; Gal. 2:9). Since the author of this letter employed many imperatives, his readers clearly accepted his authority. James, the brother of Jesus, who also became a key leader of the church in Jerusalem, possessed such authority (Acts 12:17; 15:13, 19; 21:18; Gal. 1:18–19; 2:9).

Date

Some scholars hold that the Letter of James was written around AD 62, while others argue that James wrote this letter sometime in AD 45–50. Those who favor the earlier dates point out that the Jewish character of this letter fits with this period when the church was mainly Jewish, based on the following criteria: (1) There is no mention of Gentile Christians in the letter. (2) The author does not refer to the teachings of the Judaizers. If the letter had been written at a later date, we would expect the author to address the issue of circumcision among Christians. (3) The mention of “teachers” (3:1) and “elders” (5:14) as the leaders in the church reflects the structure of the primitive church. (4) The word “meeting” in 2:2 is the same Greek word as for “synagogue.” It describes the gathering place of the early church. This implies a time when the congregation was still primarily Jewish (Acts 1–7).

Outline

I. Introduction (1:1)

II. The Wise Christian Is Patient in Trials (1:2–18)

A. How the Christian should face trials (1:2–12)

B. The source of temptations (1:13–18)

III. The Wise Christian Is a Practical Doer of the Word (1:19–2:26)

A. Hearers and doers of the word (1:19–25)

B. True religion (1:26–27)

C. Prejudice in the church (2:1–13)

D. Faith that works (2:14–26)

IV. The Wise Christian Masters the Tongue (3:1–18)

A. The power of the tongue (3:1–12)

B. The wisdom from above (3:13–18)

V. The Wise Christian Seeks Peace in Relationships (4:1–17)

A. The cause of quarrels (4:1–3)

B. Warning against worldliness (4:4–10)

C. Warning against slander (4:11–12)

D. Warning against boasting and self-sufficiency (4:13–17)

VI. The Wise Christian Is Patient and Prays When Facing Difficulties (5:1–20)

A. Warning to the rich (5:1–6)

B. Exhortation to patience (5:7–12)

C. The power of prayer (5:13–18)

D. The benefit of correcting those in error (5:19–20)

(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).

Pieces of metal stamped with a particular impression, used as a medium of exchange. From time immemorial people used animals, grain, or other commodities to barter (Hos. 3:2), pay taxes (1 Sam. 8:15), or as a measure of wealth (Job 1:3). Substituting smaller, more easily handled pieces of precious metal had obvious advantages. Gradually people used precious metal such as silver or gold along with commodities (Gen. 20:14–16) and then in place of them (37:28) as a means of payment. Such metal had been refined, but it could have been in most any form (rings, bars, ingots, dust) as long as it weighed the appropriate amount. Local and international standards developed to regulate the weights, and later the concept grew in popularity to use standard, authorized, clearly stamped pieces of precious metal—coins.

Old Testament. Minting of coins may have begun as far back as the late eighth century BC, and it gradually spread throughout the known world. The first coins apparently were made in Asia Minor using electrum, a natural alloy of gold and silver.

When the Persians took over much of the ancient Near East in the sixth century BC, the use of coins spread, and Persian coins came to the land of the Bible. At the end of the Hebrew Bible there is mention of large quantities of Persian coins called “darics” (1 Chron. 29:7; Ezra 8:27), also translated as “drachmas” (NASB) or “drams” (KJV) (Ezra 2:69; Neh. 7:70–72). These darics were stamped with the likeness of Darius the Great (521–486 BC) and were minted from gold and occasionally silver. At about the same time, silver tetradrachmas (four-drachma coins) from Athens made their way to the western shores of the Mediterranean. Local imitations of this coin were stamped with “YHD” to represent the province of Judah.

New Testament. Coins appear dozens of times in the NT; some have Hellenistic roots, while others come from the periods of Hasmonean or Roman rule.

For several centuries after Alexander the Great conquered the ancient Near East (fourth century BC), coins with the images of Alexander or his Seleucid or Ptolemaic successors were circulated in Judea. In particular, silver shekels from the Phoenician port cities of Tyre and Sidon enjoyed wide usage for a long time. Also called a “stater,” the shekel or four-drachma coin recovered by Peter from the fish’s mouth (Matt. 17:27) may have been such a Tyrian coin. Many or all of the thirty silver coins that the chief priests gave Judas for betraying Jesus (Matt. 26:15; 27:3) probably were Tyrian shekels as well, since this coin came to be the accepted currency at the temple in Jerusalem and the priests would have had a good supply of them.

After the Hellenistic rulers lost control of Judea during the rebellion led by the Maccabean or Hasmonean family in the second century BC, the Jews could mint their own coins for the first time. The honor of producing the first Jewish coin apparently goes to John Hyrcanus I (134–104 BC), son of Simon and nephew of Judas Maccabeus. Simon’s modest bronze lepton (pl. lepta), or prutah, has an inscription on one side and two cornucopias and a pomegranate on the other. Use of such agricultural symbols apparently fulfilled two purposes: it portrayed the fertility of the land that God had given his people, and it helped the Jews avoid depicting people on coins, as the Greeks and later the Romans would do. During this period devout Jews avoided such images in order to help fulfill the second commandment (Exod. 20:4), to avoid graven images. Hyrcanus I’s son Alexander Jannaeus (103–76 BC) minted great quantities of different types of bronze lepta, still often found in excavations in Israel today. These coins remained in circulation for many years, probably through the ministry of Jesus. Thus, the two small coins for which Jesus commended the widow for donating to the temple treasury (Mark 12:42; Luke 21:2) may well have been lepta of Alexander Jannaeus. The tiny lepton, typically smaller than a dime and worth only 1/400 of a shekel, also appears in Luke 12:59.

It is also possible that the aforementioned lepta were not minted by Alexander Jannaeus, since later rulers, including the Jewish king Herod the Great (40–4 BC), also minted large numbers of similar small bronze coins. Though not known for his piety, Herod continued to avoid human representations on his coins. For the most part, so did his sons and the later Roman procurators (including Pontius Pilate [governed AD 26–36]), who ruled Judea before the revolt in AD 66.

Other Roman coins, such as the silver denarius (pl. denarii) minted outside Judea, clearly did not avoid human representation, however. Jesus’ request for a coin with Caesar’s image and inscription (Matt. 22:15–22) refers to the denarius. The denarius in Jesus’ day could have portrayed the emperor Tiberius (r. AD 14–37) or even Augustus (r. 27 BC–AD 14), whose coins were probably still in circulation. The silver denarius came to represent the daily wage of a common laborer, as clearly shown in the parable of laborers (Matt. 20:1–16). The denarius also appears in many other passages, although modern translators sometimes use a more interpretive expression (“two silver coins” for “two denarii” in Luke 10:35; “a year’s wages” for “three hundred denarii” in Mark 14:5).

Although many of the references discussed above contain specific terms that can be identified with coins known from history, others cannot. General terms meaning “coins” or “pieces of money” sometimes appear, as when Jesus scattered the coins of the money changers (John 2:15), or the rather common term for silver that appears frequently and is often translated as “money” (Matt. 28:12; Luke 9:3) or “silver” (Acts 3:6; 1 Pet. 1:18) as well as “silver coins” (Matt. 27:3 GW).

(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).

Simon Peter is the best-known and the most colorful of Jesus’ twelve disciples. The name “Peter” means “rock” in Greek. In some biblical texts, he is also called “Cephas,” which is the Aramaic word for “rock” (see esp. John 1:42). Despite the ups and downs of Peter’s spiritual life, God was able to use him as the foundational apostle for the establishment of the NT church. Peter first met Jesus immediately after Jesus’ baptism, when Peter’s brother, Andrew, heard John the Baptist’s identification of Jesus as the Lamb of God (John 1:35). In classic missionary style, “the first thing Andrew did was to find his brother Simon and tell him, ‘We have found the Messiah’ ” (John 1:41). Peter’s official call to ministry took place later, when he was fishing on the Sea of Galilee and Jesus issued the well-known invitation “Come, follow me, . . . and I will send you out to fish for people” (Matt. 4:19).

Peter was the chief spokesman for the disciples at Caesarea Philippi when Jesus asked them, “Who do people say the Son of Man is?” (Matt. 16:13). Peter responded, “You are the Messiah, the Son of the living God,” an insight given him by God the Father (16:16–17). Jesus promised him, “I tell you that you are Peter [petros], and on this rock [petra] I will build my church, and the gates of Hades will not overcome it” (16:18). Yet Peter almost immediately became a “stumbling block” to Jesus when he chided Jesus for saying that he must go to Jerusalem and suffer many things and be killed (16:21–22). Another major failure by Peter came with his threefold denial of Jesus after Jesus had warned him, “This very night, before the rooster crows, you will disown me three times” (Matt. 26:34). Fortunately, there were tears of repentance, and Peter was forgiven and restored after Jesus’ threefold question (“Do you love me?” [John 21:15–19]).

Jesus’ death and resurrection, as well as the giving of the Holy Spirit on the day of Pentecost, had stabilizing effects on Peter. After Jesus’ ascension, Peter exercised primary leadership among the other disciples during the upper room prayer meetings and the choosing of the replacement for Judas (Acts 1). Peter clearly was the public spokesman for the apostles on the day of Pentecost and a key player in the establishment of the church in Jerusalem (Acts 2–5), in receiving the first Samaritan converts (Acts 8:14–25), and in receiving Cornelius as the first Gentile convert (Acts 10–11). Following Peter’s miraculous deliverance from prison in Acts 12, he essentially disappears from recorded history. By the time of the Jerusalem council (Acts 15), Peter reappeared briefly, but by this time he had been replaced by James as the leader of the Jerusalem church. Peter apparently continued to live as a missionary (1 Cor. 9:5), specifically “to the circumcised” (Gal. 2:7–8), for the rest of his life. Yet Peter was still human, and on one occasion Paul gave him a stinging rebuke (Gal. 2:11–21).

During his travels, Peter undoubtedly visited the recipients of his later letter 1 Peter (and possibly 2 Peter) in north central Asia Minor (the regions of “Pontus, Galatia, Cappadocia, Asia and Bithynia” [1 Pet. 1:1]), possibly Corinth (1 Cor. 1:12; 3:22), and, at least by the end of his life, Rome itself. According to tradition, he was put to death by Nero between AD 64 and 68, apparently by being crucified upside down (cf. John 21:18–19). Peter’s life is a vivid illustration of the Christian’s fight for faith, God’s gracious provision, and Jesus’ intercession on his behalf (“I have prayed for you, Simon, that your faith may not fail” [Luke 22:32]).