A federation of ten Greco-Roman city-states primarily situated east and south of the Sea of Galilee. The Decapolis was established by Pompey in 64 BC during the course of his invasion of Syria and Judea. It was to serve as a league for trade and defense.

According to Pliny the Elder (AD 23–79), the cities were Scythopolis (Bet She’an), Hippos (Suseih), Gadara (Umm Qais), Pella (Tabaqat Fahl), Philadelphia (Amman), Gerasa (Jerash), Dion (Adun), Kanatha (Kanawat), Damascus, and Raphana (Abila). Of these, only Scythopolis, biblical Beth Shan (1 Sam. 31:10–12), was west of the Jordan.

The Decapolis cities were populated not by Jews but rather by Greeks, who had begun settling in the region during the intertestamental period. Hellenistic culture and practices prevailed, creating ongoing friction, conflict, and unease with the Jews in the area. The Greeks were offended by the Jewish practice of circumcision. In turn, the Jews found the Greeks’ culturally normative homosexual behavior, religious idolatry, and swine herding repugnant.

Decapolites were among those who followed Jesus (Matt. 4:25). His healing of the deaf man by use of his own saliva also took place in this region (Mark 7:31–37). Although it is not explicitly mentioned, the Decapolis could be the “distant country” (“distant region” is a better translation) of the prodigal son (Luke 15:13–16).

However, Jesus’ most significant encounter in the Decapolis is his healing of the Gadarene demoniac (Matt. 8:28–34; Mark 5:1–20; Luke 8:26–39). The place name for this miracle differs among the Gospel writers, with textual variants occurring in all three accounts. Mark and Luke refer to it as “Gerasa,” one of the Decapolis cities with excellent name recognition, while Matthew indicates “Gadara,” a smaller city nearer the Galilee coast. Some manuscripts also identify “Gergesa,” an insignificant town near Gadara that is very near the kind of steep coastline featured in the account. It has been suggested that Matthew may have been a native of the Decapolis and therefore had better command of the geographic details.

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

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

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

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

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

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

The word “palsy” is a shorter form of “paralysis.” Jesus and the apostles cured many afflicted by paralysis (Matt. 4:24; 8:5–13; 9:2–7; Mark 2:3–11; Luke 5:18; 7:2–10; John 5:5–7; Acts 8:7; 9:34). Affecting the motor centers of the brain or spinal cord, paralysis is characterized by the extreme loss of the power of motion. It is always serious, usually irreversible, and generally sudden in onset.

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

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

Origins

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

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

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

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

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

First-Century Synagogues

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

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

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

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

The Synagogue in the Bible

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

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

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

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

Ben-Ammi was the son of Abraham’s nephew Lot and the younger of Lot’s two daughters (Gen. 19:36–38). He is represented as the ancestor of the Ammonites, a Transjordanian people who were a perennial threat to Israel from the wilderness period through to David’s reign.

The nation of Ammon was located east of the Jordan, just north of the Dead Sea. Its capital was Rabbah, and it bordered Gad to the west, the half-tribe of Manasseh to the northwest, and Moab to the south (see also Deut. 3:16). Much of the source of their contention was over the fertile land of Gilead, which encompassed the Jordan River and bordered Ephraim, the western tribe of Manasseh, Benjamin, and Judah.

The exodus and the period of the judges. According to the biblical record, while moving to enter Canaan, Moses and the Israelites avoided Amman (Rabbah) and marched through Sihon instead (Num. 21:24–35). Later the Israelites were told explicitly not to attack the Ammonites, for that territory was given to the descendants of Lot (Deut. 2:19, 37).

The first conflict between the Ammonites and the Israelites is recorded in Judg. 3:13, where the Moabite king Eglon was allied with the Ammonites (and the Amalekites) against Ehud. In Judg. 10:6–7 the Israelites are punished for their idolatry by being put under the thumb of the Philistines and the Ammonites. Jephthah led the Gileadites against the Ammonites, who had provoked them to battle. This story is perhaps better known with respect to Jephthah’s fateful oath to Yahweh to offer up as a burnt offering whatever came out of his door if Yahweh would give him victory over the Ammonites (Judg. 11). It was his daughter who came out to meet him. In Judg. 12 the Ephraimites voiced their displeasure at not having been asked to join in the battle, so they came to Jephthah, threatening to burn his house down. Jephthah responded that he did call but they did not come. A battle ensued between them, which sparked the famous shibboleth/sibboleth incident, in which Jephthah’s forces could identify Ephraimite opponents by their inability to pronounce the sh.

The monarchy. During the early monarchic period, the Ammonite king Nahash besieged Jabesh of Gilead. Rather than negotiate, the Ammonites demanded that the right eye of every Jabeshite male be put out. They appealed to Saul for help, who came and slaughtered many and scattered the rest (1 Sam. 11:1–11). Saul’s act was remembered kindly when, after his death at the hand of the Philistines, the men of Jabesh brought back the bodies of Saul and his sons, burned them, buried the remains, and fasted for seven days (31:11–13). In 1 Sam. 12:12 Samuel refers to the Nahash incident as the impetus for the Israelites’ desire to be ruled by a king.

In 2 Sam. 10–12 David conquers the Am­mon­ite capital of Rabbah, under the rule of Hanun son of Nahash (see also 1 Chron. 19:1–20:3). This is the context in which David’s affair with Bathsheba took place (2 Sam. 11–12). Uriah, her husband, was killed while attacking Rabbah. During the revolt by his son Absalom, David was given material aid from several sources, one of which was “Shobi son of Nahash from Rabbah of the Ammonites” (2 Sam. 17:27).

Solomon’s marriages to foreign wives included Ammonites (1 Kings 11:1). As a result, Solomon followed the foreign gods, including “Molek the detestable god of the Ammonites” (11:5). It is not mentioned how many Ammonite wives Solomon had, but one of them, Naamah, was the mother of Rehoboam, the first king of Judah during the divided kingdom (14:31).

The divided kingdom. Later, during the divided monarchy, the Ammonites appear again. Ammon, Moab, and Edom formed a coalition against Jehoshaphat king of Judah (2 Chron. 20:1–30). Jehoshaphat was victorious with God’s assistance. Likewise, during the reign of Jehoiakim king of Judah, a coalition of Babylonian, Aramean, Moabite, and Ammonite forces attacked him, although this time it was at God’s direction because “he did evil in the eyes of the Lord, just as his predecessors had done” (2 Kings 23:36–24:6). According to 2 Chron. 26:8; 27:5, the Ammonites had earlier brought tribute to Uzziah and his son Josiah.

The Ammonites appear on the scene again just before the fall of Judah. During the reign of Zedekiah, a coalition of several nations including Ammon was thwarted by God through Nebuchadnezzar of Babylon (Jer. 27:1–7).

The exilic and postexilic periods. Am­mon­ite opposition to Judah continued. According to Jer. 41:10, 15, governor Gedaliah’s assassin found refuge among the Ammonites. Later, under Nehemiah, the Ammonites actively resisted the rebuilding of Jerusalem (Neh. 4:1–3). In the postbiblical period, the Ammonites are mentioned as those among whom Jason, who slaughtered his fellow citizens, was given refuge (1 Macc. 4:26; 5:7).

In addition to the historical books, the Ammonites are mentioned numerous times in the prophetic books. Isaiah predicts that Ephraim and Judah will together “swoop down” and subject Edom, Moab, and the Ammonites (11:14). Jeremiah prophesies against them at some length (49:1–6), mainly because of the worship of Molek, although God will “restore the fortunes of the Ammonites” (v. 6). Likewise, Ezekiel prophesies the destruction of Ammon (21:28–32; 25:1–7, 10).

Eventually, Rabbah became a shell of its former self (see Jer. 25:5) and was rebuilt by Ptolemy II Philadelphus (285–246 BC), who renamed the city “Philadelphia.” It became a city of the Decapolis (a group of ten Greek cities [see Matt. 4:25; Mark 5:20; 7:31]).

Ben-Ammi was the son of Abraham’s nephew Lot and the younger of Lot’s two daughters (Gen. 19:36–38). He is represented as the ancestor of the Ammonites, a Transjordanian people who were a perennial threat to Israel from the wilderness period through to David’s reign.

The nation of Ammon was located east of the Jordan, just north of the Dead Sea. Its capital was Rabbah, and it bordered Gad to the west, the half-tribe of Manasseh to the northwest, and Moab to the south (see also Deut. 3:16). Much of the source of their contention was over the fertile land of Gilead, which encompassed the Jordan River and bordered Ephraim, the western tribe of Manasseh, Benjamin, and Judah.

The exodus and the period of the judges. According to the biblical record, while moving to enter Canaan, Moses and the Israelites avoided Amman (Rabbah) and marched through Sihon instead (Num. 21:24–35). Later the Israelites were told explicitly not to attack the Ammonites, for that territory was given to the descendants of Lot (Deut. 2:19, 37).

The first conflict between the Ammonites and the Israelites is recorded in Judg. 3:13, where the Moabite king Eglon was allied with the Ammonites (and the Amalekites) against Ehud. In Judg. 10:6–7 the Israelites are punished for their idolatry by being put under the thumb of the Philistines and the Ammonites. Jephthah led the Gileadites against the Ammonites, who had provoked them to battle. This story is perhaps better known with respect to Jephthah’s fateful oath to Yahweh to offer up as a burnt offering whatever came out of his door if Yahweh would give him victory over the Ammonites (Judg. 11). It was his daughter who came out to meet him. In Judg. 12 the Ephraimites voiced their displeasure at not having been asked to join in the battle, so they came to Jephthah, threatening to burn his house down. Jephthah responded that he did call but they did not come. A battle ensued between them, which sparked the famous shibboleth/sibboleth incident, in which Jephthah’s forces could identify Ephraimite opponents by their inability to pronounce the sh.

The monarchy. During the early monarchic period, the Ammonite king Nahash besieged Jabesh of Gilead. Rather than negotiate, the Ammonites demanded that the right eye of every Jabeshite male be put out. They appealed to Saul for help, who came and slaughtered many and scattered the rest (1 Sam. 11:1–11). Saul’s act was remembered kindly when, after his death at the hand of the Philistines, the men of Jabesh brought back the bodies of Saul and his sons, burned them, buried the remains, and fasted for seven days (31:11–13). In 1 Sam. 12:12 Samuel refers to the Nahash incident as the impetus for the Israelites’ desire to be ruled by a king.

In 2 Sam. 10–12 David conquers the Am­mon­ite capital of Rabbah, under the rule of Hanun son of Nahash (see also 1 Chron. 19:1–20:3). This is the context in which David’s affair with Bathsheba took place (2 Sam. 11–12). Uriah, her husband, was killed while attacking Rabbah. During the revolt by his son Absalom, David was given material aid from several sources, one of which was “Shobi son of Nahash from Rabbah of the Ammonites” (2 Sam. 17:27).

Solomon’s marriages to foreign wives included Ammonites (1 Kings 11:1). As a result, Solomon followed the foreign gods, including “Molek the detestable god of the Ammonites” (11:5). It is not mentioned how many Ammonite wives Solomon had, but one of them, Naamah, was the mother of Rehoboam, the first king of Judah during the divided kingdom (14:31).

The divided kingdom. Later, during the divided monarchy, the Ammonites appear again. Ammon, Moab, and Edom formed a coalition against Jehoshaphat king of Judah (2 Chron. 20:1–30). Jehoshaphat was victorious with God’s assistance. Likewise, during the reign of Jehoiakim king of Judah, a coalition of Babylonian, Aramean, Moabite, and Ammonite forces attacked him, although this time it was at God’s direction because “he did evil in the eyes of the Lord, just as his predecessors had done” (2 Kings 23:36–24:6). According to 2 Chron. 26:8; 27:5, the Ammonites had earlier brought tribute to Uzziah and his son Josiah.

The Ammonites appear on the scene again just before the fall of Judah. During the reign of Zedekiah, a coalition of several nations including Ammon was thwarted by God through Nebuchadnezzar of Babylon (Jer. 27:1–7).

The exilic and postexilic periods. Am­mon­ite opposition to Judah continued. According to Jer. 41:10, 15, governor Gedaliah’s assassin found refuge among the Ammonites. Later, under Nehemiah, the Ammonites actively resisted the rebuilding of Jerusalem (Neh. 4:1–3). In the postbiblical period, the Ammonites are mentioned as those among whom Jason, who slaughtered his fellow citizens, was given refuge (1 Macc. 4:26; 5:7).

In addition to the historical books, the Ammonites are mentioned numerous times in the prophetic books. Isaiah predicts that Ephraim and Judah will together “swoop down” and subject Edom, Moab, and the Ammonites (11:14). Jeremiah prophesies against them at some length (49:1–6), mainly because of the worship of Molek, although God will “restore the fortunes of the Ammonites” (v. 6). Likewise, Ezekiel prophesies the destruction of Ammon (21:28–32; 25:1–7, 10).

Eventually, Rabbah became a shell of its former self (see Jer. 25:5) and was rebuilt by Ptolemy II Philadelphus (285–246 BC), who renamed the city “Philadelphia.” It became a city of the Decapolis (a group of ten Greek cities [see Matt. 4:25; Mark 5:20; 7:31]).

(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).

Evangelism is the proclamation of the “evangel” (Gk. euangelion), the good news, of Jesus Christ. The content of the evangel includes Jesus’ birth, which was announced as good news to Zechariah by the angel Gabriel (Luke 1:19) and by the angels to the shepherds (Luke 2:10). The good news speaks of the reality of Jesus’ resurrection (Acts 17:18), is described as a message of grace (Acts 20:24) and reconciliation to God through the sacrificed body of Christ (Col. 1:22–23), and includes the expectation of a day of divine judgment (Rom. 2:16). Paul preached the gospel (from Old English gōdspel, “good news”) message, which he claimed had its origin with God, not humans (Gal. 1:11–12). He summarizes this message in 1 Cor. 15:3b–5: “that Christ died for our sins according to the Scriptures, that he was buried, that he was raised on the third day according to the Scriptures, and that he appeared to Cephas, and then to the Twelve.” The introduction to the Gospel of Mark (1:1) may indicate that this written gospel could serve evangelistic purposes.

Evangelistic efforts in the New Testament. Numerous figures throughout the NT participated in evangelistic endeavors. John the Baptist’s preaching about the coming Messiah is described as evangelism (Luke 3:18). Evangelism was a characteristic activity of Jesus’ own ministry (Matt. 4:23; 9:35; Mark 1:14; Luke 20:1), which focused on proclaiming the advent of the kingdom of God (Luke 4:43; 8:1) and at times was targeted toward the poor (Matt. 11:5; Luke 4:18; 7:22). Jesus commanded those who follow him to engage in evangelism. He sent out the twelve apostles for evangelistic purposes (Luke 9:2), and he issued the Great Commission to this end (Matt. 28:18–20).

The missionary enterprise recorded in Acts demonstrates the efforts of the earliest Christians to spread the gospel. The apostles in Jerusalem (Acts 5:42) proclaimed the gospel in spite of great opposition and persecution, and believers who were scattered outside Jerusalem because of persecution spread the gospel in new locales (8:4). Philip evangelized Samaritans and an Ethiopian (8:12, 35). The ministry of Paul and Barnabas is characterized as preaching the good news (14:7, 15, 21; 15:35; 16:10; 17:18). Philip, one of the seven chosen to distribute food (6:5), was given the name “the Evangelist” (21:8). Timothy, additionally, is said to be Paul’s fellow worker in evangelism (1 Thess. 3:2; cf. 2 Tim. 4:5).

Evangelism was a central part of Paul’s ministry (Rom. 1:9; 1 Cor. 1:17; 15:1–2; Eph. 6:19; 1 Thess. 2:2, 9). He indicated an explicit interest in sharing the gospel with Gentiles (Rom. 15:16; Gal. 1:16; 2:7; Eph. 3:8) and with those who had never heard it (Rom. 15:20; 2 Cor. 10:16), and he expressed a desire to preach the gospel at Rome (Rom. 1:15). Paul wrote of the necessity of evangelism in order for people to be saved (Rom. 10:15), and he preached the gospel message free of charge (1 Cor. 9:16, 18; 2 Cor. 11:7). He listed the role of the evangelist in the church along with apostles, prophets, pastors, and teachers (Eph. 4:11).

Goal and methods of evangelism. Evangelism’s goal is to spread the gospel across ethnic and religious boundaries until it reaches all nations (Mark 13:10; Col. 1:23). To this end, Acts details an intentional effort by the earliest Christians to share the gospel with those who came from both Jewish and non-Jewish backgrounds. Acts 8:25 records Peter and John’s evangelistic efforts in Samaritan villages, and Acts 15:7 identifies Peter as an evangelist to Gentiles. An outreach specifically to Gentiles is chronicled in Acts 11:20, and Paul’s intentional program of traveling from city to city further contributes to this goal (Rom. 15:19).

The evangelists recorded in the NT demonstrate a range of methods and approaches to sharing the good news. They often began with a point of contact from the religious worldview of their audience. For instance, Philip used Scripture as a starting point in speaking with an individual who was familiar with some portion of it (Acts 8:35). Similarly, when addressing Jews, Paul preached Jesus as the fulfillment of various OT Scriptures (Acts 13:32–41), but when preaching the gospel to the Greeks in Athens, he acknowledged their religiosity and their previous worship of one called “an unknown God” (17:22–23). Evangelists sought opportunities to gain an audience, and Paul even took advantage of an illness to stay with the Galatians and share the gospel with them (Gal. 4:13). Finally, much of the evangelistic work in the early church was coupled with miraculous signs and wonders, which served to authenticate the message being proclaimed (Rom. 15:19; 1 Thess. 1:5).

(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).

In the NT the most common word used for “minister” is diakonos (e.g., 2 Cor. 3:6), and for “ministry,” diakonia (e.g., 1 Cor. 16:15 [NIV: “service”]). These words function as umbrella terms for NT writers to describe the whole range of ministries performed by the church. They can describe either a special ministry performed by an official functionary (1 Cor. 3:5) or one performed by any believer (Rev. 2:19). In the early church, ministry was based not on institutional hierarchies but on services performed (1 Tim. 3:1–13).

The ministry of Jesus. The church’s mind-set flows out of the way in which Jesus understood his ministry. He described his ministry pattern as that of serving (Matt. 20:28; Mark 10:45; John 13:4–17). Thus, he called his disciples to follow a model of leadership in the new community that did not elevate them above others (Matt. 20:20–28; 23:8–12; cf. 1 Pet. 5:3).

Jesus’ ministry provides the paradigm for the ministry of the church. The NT writers describe the threefold ministry of Jesus as preaching, teaching, and healing (Matt. 4:23; 9:35; Mark 1:14, 21–22, 39; Acts 10:36–38). The disciples carried on the earthly ministry of Jesus by the power of the Spirit. They too engaged in preaching, teaching, and healing (Matt. 10:7–8; 28:19–20).

The ministry of the church. The church, because it is the body of Christ, continues these ministry responsibilities. In 1 Pet. 4:10–11 is a summary of the overarching ministries of the church, which include speaking the words of God and serving. As a priesthood of believers (Exod. 19:4–6; 1 Pet. 2:5, 9; Rev. 1:5–6), individual members took responsibility for fulfilling the various tasks of service. Thus, all Christians are called to minister (Rom. 15:27; Philem. 13; 1 Pet. 2:16). Even when a member strayed, it was another believer’s responsibility to confront that wayward person and, if necessary, involve others in the body to help (Matt. 18:15–20).

Although ministry was the responsibility of all believers, there were those with special expertise whom Christ and the church set apart for particular leadership roles (Eph. 4:11–12). Christ set apart Apollos and Paul for special ministries (1 Cor. 3:5; Eph. 3:7). The church called on special functionaries to carry out specific ministries. For example, the early church appointed seven individuals to serve tables (Acts 6:2). They appointed certain ones to carry the relief fund collected for the Jerusalem Christians (2 Cor. 8:19, 23). As special functionaries, Paul, Apollos, Timothy, Titus, the elders, as well as others accepted the responsibility of teaching and preaching and healing for the whole church.

All the ministries of the church, whether performed by believers in general or by some specially appointed functionary, were based on gifts received from God (Rom. 12:1–8; 1 Cor. 12:4–26). God gave individuals the abilities necessary to perform works of service (Acts 20:24; Eph. 4:11; Col. 4:17; 1 Tim. 1:12; 1 Pet. 4:11). The NT, however, makes it clear that when it comes to one’s relationship and spiritual status before God, all Christians are equal. Yet in equality there is diversity of gifts and talents. Paul identifies some gifts given to individuals for special positions: apostles, prophets, evangelists, pastors, and teachers (Eph. 4:11). The description here is of special ministry roles that Christ calls certain individuals to fulfill based on the gifts given to them. The ones fulfilling these roles did not do all the ministry of the church but rather equipped the rest of the body to do ministry (Eph. 4:12–13). No one can boast in the gifts given to him or her because those gifts were given for ministry to others (1 Cor. 4:7). Thus, gifts lead to service, and in turn service results in leadership.

It becomes the responsibility of those who lead to equip others for ministry. When others are equipped for ministry, they in turn minister and edify the whole body (Eph. 4:15–16; 2 Tim. 2:1–2). The goal of all ministry, according to Paul, is to build up a community of believers until all reach maturity in Christ (Rom. 15:15–17; 1 Cor. 3:5–4:5; Eph. 4:12–16; 1 Thess. 2:19–20).

In the NT the most common word used for “minister” is diakonos (e.g., 2 Cor. 3:6), and for “ministry,” diakonia (e.g., 1 Cor. 16:15 [NIV: “service”]). These words function as umbrella terms for NT writers to describe the whole range of ministries performed by the church. They can describe either a special ministry performed by an official functionary (1 Cor. 3:5) or one performed by any believer (Rev. 2:19). In the early church, ministry was based not on institutional hierarchies but on services performed (1 Tim. 3:1–13).

The ministry of Jesus. The church’s mind-set flows out of the way in which Jesus understood his ministry. He described his ministry pattern as that of serving (Matt. 20:28; Mark 10:45; John 13:4–17). Thus, he called his disciples to follow a model of leadership in the new community that did not elevate them above others (Matt. 20:20–28; 23:8–12; cf. 1 Pet. 5:3).

Jesus’ ministry provides the paradigm for the ministry of the church. The NT writers describe the threefold ministry of Jesus as preaching, teaching, and healing (Matt. 4:23; 9:35; Mark 1:14, 21–22, 39; Acts 10:36–38). The disciples carried on the earthly ministry of Jesus by the power of the Spirit. They too engaged in preaching, teaching, and healing (Matt. 10:7–8; 28:19–20).

The ministry of the church. The church, because it is the body of Christ, continues these ministry responsibilities. In 1 Pet. 4:10–11 is a summary of the overarching ministries of the church, which include speaking the words of God and serving. As a priesthood of believers (Exod. 19:4–6; 1 Pet. 2:5, 9; Rev. 1:5–6), individual members took responsibility for fulfilling the various tasks of service. Thus, all Christians are called to minister (Rom. 15:27; Philem. 13; 1 Pet. 2:16). Even when a member strayed, it was another believer’s responsibility to confront that wayward person and, if necessary, involve others in the body to help (Matt. 18:15–20).

Although ministry was the responsibility of all believers, there were those with special expertise whom Christ and the church set apart for particular leadership roles (Eph. 4:11–12). Christ set apart Apollos and Paul for special ministries (1 Cor. 3:5; Eph. 3:7). The church called on special functionaries to carry out specific ministries. For example, the early church appointed seven individuals to serve tables (Acts 6:2). They appointed certain ones to carry the relief fund collected for the Jerusalem Christians (2 Cor. 8:19, 23). As special functionaries, Paul, Apollos, Timothy, Titus, the elders, as well as others accepted the responsibility of teaching and preaching and healing for the whole church.

All the ministries of the church, whether performed by believers in general or by some specially appointed functionary, were based on gifts received from God (Rom. 12:1–8; 1 Cor. 12:4–26). God gave individuals the abilities necessary to perform works of service (Acts 20:24; Eph. 4:11; Col. 4:17; 1 Tim. 1:12; 1 Pet. 4:11). The NT, however, makes it clear that when it comes to one’s relationship and spiritual status before God, all Christians are equal. Yet in equality there is diversity of gifts and talents. Paul identifies some gifts given to individuals for special positions: apostles, prophets, evangelists, pastors, and teachers (Eph. 4:11). The description here is of special ministry roles that Christ calls certain individuals to fulfill based on the gifts given to them. The ones fulfilling these roles did not do all the ministry of the church but rather equipped the rest of the body to do ministry (Eph. 4:12–13). No one can boast in the gifts given to him or her because those gifts were given for ministry to others (1 Cor. 4:7). Thus, gifts lead to service, and in turn service results in leadership.

It becomes the responsibility of those who lead to equip others for ministry. When others are equipped for ministry, they in turn minister and edify the whole body (Eph. 4:15–16; 2 Tim. 2:1–2). The goal of all ministry, according to Paul, is to build up a community of believers until all reach maturity in Christ (Rom. 15:15–17; 1 Cor. 3:5–4:5; Eph. 4:12–16; 1 Thess. 2:19–20).

Because Scripture sees all things as providentially arranged and sustained by God’s sovereign power at all times (Heb. 1:3), miracles are not aberrations in an otherwise closed and mechanical universe. Nor are miracles raw demonstrations of divinity designed to overcome prejudice or unbelief and to convince people of the existence of God (Mark 8:11–12). Still less are they clever conjuring tricks involving some kind of deception that can be otherwise explained on a purely scientific basis. Rather, God in his infinite wisdom sometimes does unusual and extraordinary things to call attention to himself and his activity. Miracles are divinely ordained acts of God that dramatically alert us to the presence of his glory and power and advance his saving purposes in redemptive history.

Terminology

The biblical writers describe miracles with various terms, such as “signs,” “wonders,” and “miracles” (or “powers”), which can carry various connotations. As the word “sign” suggests, divine miracles are significant and should cause us to think more deeply about God in a way that goes beyond mere amazement or curiosity (Exod. 4:30–31; John 2:11). Not all of God’s signs are miraculous. Some are given as part of his ordering of the natural world (Gen. 1:14) or as an encouragement to faith that God will do as he has said (e.g., the rainbow in Gen. 9:8–17; the blood of the Passover lamb in Exod. 12:13). (See also Sign.)

Often coupled with signs are “wonders” (Jer. 32:21; John 4:48; 2 Cor. 12:12). If the depiction of miracles as “signs” indicates an appeal to the intellect, that of “wonders” points to the emotions. Miracles evoke astonishment and awe at the one who did them.

The NT word “miracle” carries the meaning of power and therefore points to the supernatural source of these events (Luke 10:13; Acts 8:13).

Miracles in the Bible

Old Testament. In the OT, miracles are not evenly distributed but rather are found in greater number during times of great redemptive significance, such as the exodus and the conquest of Canaan. Miracles were performed also during periods of apostasy, such as in the days of the ninth-century prophets Elijah and Elisha. Common to both of these eras is the powerful demonstration of the superiority of God over pagan deities (Exod. 7–12; 1 Kings 18:20–40).

New Testament. In the NT, miracles often are acts of compassion, but more significantly they attest the exalted status of Jesus of Nazareth (Acts 2:22) and the saving power of his word (Heb. 2:3–4). In the Synoptic Gospels, they reveal the coming of God’s kingdom and the conquest of Satan’s dominion (Matt. 8:16–17; 12:22–30; Mark 3:27). They point to the person of Jesus as the promised Messiah of OT Scripture (Matt. 4:23; 11:4–6). John shows a preference for the word “signs,” and his Gospel is structured around them (John 20:30–31). According to John, the signs that Jesus performed were such that only the one who stood in a unique relationship to the Father as the Son of God could do them.

Miracles and faith. Just as entrenched skepticism is injurious to faith, so too is naive credulity, for although signs and wonders witness to God, false prophets also perform them “to deceive, if possible, even the elect” (Matt. 24:24). Christians are to exercise discernment and not be led astray by such impostors (Matt. 7:15–20).

The relationship between miracles and faith is not as straightforward as sometimes supposed. Miracles do not necessarily produce faith, nor does faith necessarily produce miracles. Miracles were intended to bring about the faith that leads to eternal life (John 20:31), but not all who witnessed them believed (John 10:32). Additionally, Jesus regarded a faith that rested only on the miracle itself as precarious (Mark 8:11–13; John 2:23–25; 4:48), though better than no faith at all (John 10:38). Faith that saves must ultimately find its grounding in the person of Jesus as the Son of God.

It is also clear that although Jesus always encouraged faith in those who came to him for help (Mark 9:23), and that he deliberately limited his miraculous powers in the presence of unbelief (Mark 6:5), many of his miracles were performed on those who did not or could not exercise faith (Matt. 12:22; Mark 1:23–28; 5:1–20; Luke 14:1–4).

The fact that Jesus performed miracles was never an issue; rather, his opponents disputed the source of his power (Mark 3:22). Arguments about his identity were to be settled by appeal not to miracles but to the word of God (Matt. 22:41–46).

The function of miracles. Miracle accounts function in a symbolic and prophetic manner. Hence, the cursing of the fig tree was prophetic of the coming judgment (Mark 11:12–21). The unusual two-stage healing of the blind man of Bethsaida symbolized Peter’s incomplete understanding of Jesus’ messiahship (Mark 8:22–33).

The miraculous element of Jesus’ ministry carries an eschatological significance, pointing to the order of things in the age to come. For example, the nature miracles (Mark 4:35–41) look forward to the redemption of creation itself, which is presently subject to frustration and decay (Rom. 8:20–21); the healing miracles point to a day when disease and deformity will be abolished (Rev. 21:4); and miracles in which the dead are raised to life anticipate a time when death itself will be no more (Rev. 20:14; 21:4). From this perspective, the miracles are a gracious foretaste of a far more glorious future.

Terminology

The word “Palestine” is derived from the name of one of the Sea Peoples (Heb. pelishtim) who migrated to the southern coastal region of the Fertile Crescent from one or more of the coastal regions of the Mediterranean (see Philistines).

The word “Palestine” has at times been used to refer to an area as small as this southwestern coastal region (functioning at times as a synonym for “Philistia”) and as large as the land on both sides of the Jordan River, including the Negev in the south.

Most English versions of the Bible do not mention “Palestine,” although in the KJV the Hebrew word peleshet (usually rendered “Philistia” or “Philistines”) is translated as “Palestina” in Exod. 15:14; Isa. 14:29, 31 and as “Palestine” in Joel 3:4.

Other designations of this region within the Scripture include “Canaan” (Gen. 10:19; Josh. 22:9), “the land” (Gen. 13:17; Josh. 2:1), “the land of Canaan” (Gen. 17:8; Num. 13:2), “the land of the Hebrews” (Gen. 40:15), “the land . . . promised on oath” (Gen. 50:24; Deut. 6:23), in various combinations and order “the land of the Canaanites, Hittites, Amorites, Hivites, Periz-zites, Jebusites, and Girgashites” (Exod. 3:17; 13:5; 23:23), “the Lord’s land” (Josh. 22:19), “the land of Israel” (1 Sam. 13:19; Ezek. 47:18), and “Trans-Euphrates,” which was “beyond the river” from the perspective of those in Persia (Ezra 4:10; Neh. 2:7). Compare also “the tribes of Israel” (2 Sam. 24:2; Ezek. 47:13), “Israel and Judah” (2 Sam. 5:5; 2 Chron. 30:6), and “from Dan to Beersheba” (Judg. 20:1; 1 Kings 4:25).

In the NT, this territory is usually designated by reference to the provinces of Judea and Galilee (Matt. 2:22; John 7:1), which sometimes are mentioned with the Decapolis (Matt. 4:25) and Samaria (Acts 9:31; cf. Luke 3:1).

Boundaries and Size

Boundaries. Palestine is in the southwestern portion of the Fertile Crescent (i.e., western Iraq, Syria, Lebanon, Jordan, and Israel). It is located northeast of the Nile River basin and west-southwest of the basins of the Tigris and Euphrates rivers.

Generally speaking, it is bounded by Lebanon to the north, the Mediterranean Sea (= the Sea, the Great Sea, or the western sea) on the west, Wadi el-Arish (= the river of Egypt, the Wadi of Egypt) in the southwest, the Sinai Peninsula in the south, and the Transjordan in the east (Gen. 15:18; Num. 34:3–7, 11–12; Deut. 1:7; 11:24; 34:2; Josh. 1:4; 11:16; 2 Kings 24:7). When the Transjordan is considered part of Palestine (cf. Deut. 34:1), the eastern boundary is the Syrian (Syro-Arabian) Desert. In several biblical texts the northeast boundary of this region is “the great river, the Euphrates” (Gen. 15:18; Deut. 1:7; 11:24; Josh. 1:4; 1 Chron. 5:9; cf. 2 Sam. 8:3).

Size. Because of fluidity in the use of the term “Palestine,” it is difficult to speak precisely of the land area designated by it. Palestine west of the Jordan River is about six thousand square miles, similar to the land area of the state of Hawaii.

A description of “the whole land” viewed by Moses included both the Negev and Gilead, part of the Transjordan (Deut. 34:1–3). In the OT, the Negev is regularly included as one of the regions of the land on the west side of the Jordan (Deut. 1:7; Josh. 10:40; 11:16; Jer. 17:26). The unity of the land on both sides of the Jordan is reflected in texts that focus on Israel’s inheritance of land (Deut. 3:12–17), cities of refuge (Num. 35:14; Josh. 20:7–8), and military victories (Josh. 12:1–8; 24:8–13).

The land area of Palestine increases considerably if one includes these areas, for the Transjordan region is about 4,000 square miles, while the Negev is about 4,600 square miles.

Topographical Regions

Frequent seismic activity, the rising and falling of the landmass, and deposits from the inundation and withdrawal of seas produced seven topographical regions current in Palestine.

Coastal plain. The coastal plain is the fertile terrain bordering the Mediterranean, though the coastline itself consists of beaches, sand dunes, wetlands, and rock cliffs.

The southern portion of the coastal plain was once inhabited by the Philistines (with the coastal cities of Gaza, Ashkelon, and Ashdod). Moving north of the Yarkon River, we pass through the marshy Plain of Sharon and the Dor Plain. In the north, hills rise near Carmel and extend west to the central highlands. North of the Carmel range lie the Acco Plain, the Asher Plain, and the coastlands of Phoenicia (including Tyre and Sidon).

Hill country. The hill country is located between, and runs parallel to, the coastal plain on the west and the Jordan Valley on the east. The hills, ridges, plateaus, and valleys of the hill country are the setting for most of the OT narratives.

The hill country is bisected by the Jezreel Valley, which runs east-west from the Jordan Valley to the Bay of Acco (Haifa Bay), north of Carmel.

The hill country south of the Jezreel Valley is called “the central highlands,” which consist of the rough and rocky hills of Samaria in the north (such as Mount Gerizim and Mount Ebal) and the more arid (and, historically, less populated) Judean hill country in the south. The highest hills of this area exceed three thousand feet.

In Scripture the southern hill country (or portions of it) is called “the hill country of Judah/Judea” (Josh. 11:21; Luke 1:39) and “the hill country of Bethel” (Josh. 16:1; 1 Sam. 13:2), while the northern (Samarian) hill country (or portions of it) is called “the hill country of Israel” (Josh. 11:21), “the hill country of Naphtali” (Josh. 20:7), and, most frequently, “the hill country of Ephraim” (Josh. 17:15; Judg. 2:9; 1 Kings 4:8).

The hill country north of the Jezreel Valley consists of two parts, Lower and Upper Galilee, divided by the fault through which runs Wadi esh-Shaghur. Lower Galilee has fertile basins and hills about two thousand feet above sea level. Farther north is Upper Galilee, with hills averaging about three thousand feet. It forms a transition to the mountains of Lebanon, which lie to the north.

The Shephelah (“lowland” or “piedmont”) is the region of gentle and rolling hills between five hundred and one thousand feet above sea level between the Judean hill country and the coastal plain. These hills formerly were covered with sycamore trees and provided Judeans with protection against an attack from the west.

Jezreel Valley. The Jezreel Valley is often equated with the Plain of Esdraelon, though some distinguish the fault basin (Esdraelon) from the rift valley (Jezreel).

On its west side, this fertile plain begins north of Carmel at the coast, moving east to the Jordan Valley. The central highlands lie to the north (Galilee) and south (Samaria) of this plain.

The fertile soil of this low-lying basin was valued for farming. Traders and armies regularly passed through this great plain, and it was often the place of military conflict (cf. Judg. 6:33; 1 Sam. 29:1, 11; Hos. 1:5).

Jordan Valley. The Jordan Valley (also known as the Jordan Rift Valley or the Dead Sea Rift) begins near the base of Mount Hermon in the north (9,232 feet). Moving south, the rift continues to the Hula Valley, through which the Jordan River flows to the Sea of Galilee (Sea of Gennesaret, Lake Kinnereth). The Sea of Galilee is about twelve miles long and five miles wide, located within an area of hills and valleys.

The Jordan River meanders south, flowing through a deep gorge and falling three thousand feet before coming to the Dead Sea (also called “the Sea of the Arabah” [Deut. 4:49; Josh. 3:16] and “the Salt Sea” [Num. 34:3, 12; Josh. 15:2, 5 ESV, NASB]), the lowest place on earth. At its lowest point, the Dead Sea is more than 2,600 feet below sea level.

The Jordan Valley rises as one continues south from the Dead Sea (forty-eight miles long and eight miles wide) through the arid Arabah (cf. Isa. 33:9; Zech. 14:10) to the Gulf of Aqaba.

The term “Arabah” is generally used to refer to the extension of the rift south of the Dead Sea, though at one time in the history of ancient Israel it referred to a region that included the Jordan Valley between the Sea of Galilee and the Dead Sea, on both the east (Deut. 3:17; Josh. 12:1–3) and the west (Deut. 11:30; Josh. 11:2; Ezek. 47:8) sides of the Jordan River.

Transjordan. The Transjordan region is located east of the Jordan Valley and west of the Syrian (Syro-Arabian) Desert. Three major rivers run across this region, each moving from east to west. The Yarmouk (Yarmuk) and the Jabbok (Zarqa) rivers empty into the Jordan River, while the Arnon River (Wadi el-Mujib) flows into the Dead Sea.

In ancient Israel, regions of the Transjordan, from north to south, included Bashan (Karnaim), north of the Yarmuk River; Gilead, south of the Yarmuk; Ammon, the region of modern-day Amman, southeast of Gilead; Moab, south of the Arnon River; and Edom, south of Wadi el-Hesa (Zered River [cf. Num. 21:12; Deut. 2:13–14]).

The capture of the territory belonging to Sihon between the Jabbok and the Arnon rivers was a significant event in the history of ancient Israel (Num. 21:24; Josh. 12:1–2).

Although the Transjordan is often excluded from “Palestine,” there were times in biblical history when the land on both sides of the Jordan was considered a unit. For example, “the other half of Manasseh, the Reubenites and the Gadites” received their tribal inheritance east of the Jordan (cf. Josh. 13:8–32). They inhabited Bashan, Gilead, and the land of the Amorites (cf. Deut. 3:12–17; 34:1; Judg. 20:1).

According to 2 Sam. 8, David established control over Moab (vv. 2, 12), the Beqaa Valley (“along the Euphrates River” [v. 3 GW]), Aram (v. 6; vv. 12–13 MT), Ammon and Amalek (v. 12), and Edom (v. 14; vv. 12–13 LXX, Syriac; cf. 1 Chron. 18:2–13).

In Scripture, the central Transjordan hill country is sometimes called “the hill country of Gilead” (Gen. 31:21, 23, 25; Deut. 3:12). The southern elevated region in Edom is called “the hill country of Seir” (Gen. 36:8–9; Deut. 2:5).

Negev. The Negev (Negeb) is shaped like an inverted triangle with its peak at the southern city of Eilat (Elath) near the biblical Ezion Geber (cf. 1 Kings 9:26). It is bounded on the north by the Judean hill country, on the west by Sinai, and on the east by the Arabah Valley (which lies along the rift south of the Dead Sea).

The Negev is an extremely dry area, with the most rain found in the northern (twelve inches annually) and western (ten inches annually) sections, and the least in the Arabah Valley (two inches annually). It is a place of sand dunes, rocky desert, and brown hills that increase in height as one moves toward Sinai.

Although the Negev is described as “a land of hardship and distress, of lions and lionesses, of adders and darting snakes” (Isa. 30:6), it was also a place of wells and springs, in addition to cities and towns such as Beersheba (Josh. 15:21–32; 2 Sam. 24:7).

Sinai peninsula. The Sinai peninsula is about twenty-three thousand square miles. It consists primarily of plains, plateaus, and hills (the highest of which is Jebel Yiallaq, at 3,656 feet), with a coastline along the Mediterranean of 145 miles.

The longest river in the region is the Wadi el-Arish, which runs 155 miles northward from central Sinai to the Mediterranean.

Israel’s activities in the Desert of Sinai are often mentioned in the Pentateuch (e.g., Exod. 19:1–2; Num. 1:1; 9:5).

The Desert of Sinai is distinguished from the Desert of Sin (Exod. 16:1) and the Desert of Paran (Num. 10:12). Other arid areas within the Sinai Peninsula include the Desert of Zin (Num. 34:3), the Desert of Shur (Exod. 15:22), and the Desert of Etham (Num. 33:8).

Climate

The climate of Palestine consists of a dry and hot season from June to August and a wet season from mid-October to mid-April. It is common for the wet season to consist of two distinct periods of heavy rain, one at the beginning and one toward the end of this period (cf. “spring and autumn rains” [Deut. 11:14; Joel 2:23; James 5:7]).

Two transitional seasons of about six weeks each bridge the wet and the dry seasons. One occurs between early September and the end of October, the other between early April and the middle of June.

Average temperatures throughout the region range from 46.5–55 degrees (Fahrenheit) in January (both the coldest and the wettest month in Palestine) to 71.5–93 degrees in August.

Most rainfall in Palestine occurs as cyclonic storm systems (about twenty-five each year) bring warm air from North Africa eastward over the Mediterranean, clashing with cooler air from Europe and Asia. As clouds move over the land, precipitation falls heaviest on the west side of the hills, leaving the east side of the hills with less rain.

Typically, rainfall is heaviest in the northern areas of Palestine, the regions closest to the Mediterranean, and in the Transjordan. The area around the Dead Sea is extremely dry, with evaporation exceeding precipitation. In contrast, the northern highlands have forty inches of annual rainfall.

In Palestine, precipitation can also take the form of both snow (cf. 2 Sam. 23:20; Prov. 25:13) and, in a significant way, dew (cf. Judg. 6:37–40; Song 5:2). Dew provides moisture for agriculture especially in the coastal plain, the central highlands, and the Jezreel Valley.

During the transitional seasons, desiccating winds (sometimes called sirocco winds) bring warm desert air from the east (and at times from the south), raising the temperature and lowering the relative humidity throughout Palestine. These winds often bring fine dust from the desert. The effects are most onerous in the Jordan Valley. References to an east wind in Scripture are common (Gen. 41:6; Hos. 13:15; Jon. 4:8; see also “south wind” in Job 37:17; Luke 12:55).

Roads

Two major highways passed through Palestine: “the Way of the Sea,” or Via Maris (cf. Isa. 9:1; Matt. 4:15), and “the King’s Highway” (cf. Num. 20:17; 21:22).

The Way of the Sea moved north from Egypt through the coastal plain, heading east through the Jezreel Valley. From this point it branched out in three directions: northwest through Phoenicia, north toward Damascus, and east to join with the King’s Highway.

The King’s Highway was a Transjordanian route passing from the Gulf of Aqaba in the south (cf. Deut. 2:8) through Edom, Moab, Gilead, and Bashan to Damascus in the north.

Merchants and armies used these highways to pass through Palestine, while local traffic often used east-west roads to move throughout the area.

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

A city that during NT times was located in the Decapolis region of Syria, two miles east of the Jordan River in what is the modern nation of Jordan. Pella is not mentioned explicitly in the Gospels, but it was in close proximity to several of the other cities of the Decapolis where Jesus and his disciples traveled and ministered (Matt. 4:24–25; 8:28–34; Mark 5:1–20; 7:31–37; Luke 8:26–39). Some of these Gospel accounts emphasize the strong Gentile presence in the region, though Jews resided there as well. Eusebius and Epiphanius, two Christian authors of the fourth century AD, state that some of those from the Jewish Christian community at Jerusalem fled to Pella around the time of the Jewish war of AD 66–73.

The Greek name for the region east of the Jordan River and Samaria, south of the Decapolis (modern Jordan). In the NT it is referred to as peran tou Iordanou (“beyond the Jordan” or “the region across the Jordan”) (Matt. 4:25; 19:1; Mark 3:8; 10:1). Galilean Jews often detoured through Perea when traveling to Judea in order to avoid Samaria (John 4:3–4, 9). It was part of the kingdom of Herod the Great, apportioned to his son Herod Antipas, who also ruled Galilee as a client king of the Roman Empire in Jesus’ time. Herod’s fortress in Machaerus (southern Perea) is the probable location of John the Baptist’s imprisonment and beheading (Mark 6:17–28). Jesus traveled through Perea (Matt. 19–20) to arrive in Jerusalem for his Passion Week.

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

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

Origins

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

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

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

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

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

First-Century Synagogues

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

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

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

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

The Synagogue in the Bible

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

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

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

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

The Sermon on the Mount is the inaugural sermon of Jesus in Matthew’s Gospel (5:1–7:29), which sets out Jesus’ kingdom program for the people of God. Whether this was a single sermon delivered on one occasion or Matthew’s compilation of Jesus’ teaching is uncertain. Luke’s Gospel has a similar sermon (6:17–49), which may or may not be the same event (sometimes called the “Sermon on the Plain” because of v. 17, although this may simply be a “level place” on the same hill that Matthew describes).

Luke’s account is similar to Matthew’s on several points: same beatitudes regarding the poor, the hungry, and the persecuted; same teaching of loving enemies, turning the other cheek, not judging, the Golden Rule; same illustrations of removing a speck from the eye, good trees producing good fruit, wise man building a house on the rock. Of course, there are many differences in Luke’s version: woes pronounced upon the rich, the satiated, and the honored; the importance of giving; warning the blind who lead the blind; how students become teachers. In Luke, Jesus delivers his sermon to the twelve disciples just chosen as well as directly to a larger crowd (Luke 6:12–20), “Blessed are you . . .” In Matthew, Jesus addresses the crowd (including the disciples) gathered around him because of the miracles he has performed (Matt. 4:24–5:1)—note the third person, “Blessed are the poor in spirit . . .” Finally, Matthew’s account has more unique material than Luke’s: beatitudes regarding the pure in heart, peacemakers, and mourners; questions about the righteousness of scribes and Pharisees; the importance of obeying the Law and the Prophets; teachings regarding murder, adultery, divorce, revenge, swearing oaths, giving alms, prayer, fasting, worry; illustrations of salt and light, dogs and pigs, fish and stones, narrow and wide gates, wolves in sheep’s clothing. That Matthew begins the story of Jesus’ earthly ministry with this sermon is significant: he wants his readers to see Jesus as the rabbi who knows more about the kingdom of heaven than any scribe or Pharisee.

The Beatitudes

With the first words of the sermon, commonly known as the Beatitudes, Jesus challenges the conventional wisdom that the poor, the hungry, and the meek are cursed. Instead, Jesus claims that his hearers are blessed (these poor, hungry, and meek Galileans) because the kingdom of heaven comes to those who need God. Not surprisingly, these subversive ideas are couched in paradoxes: the poor are kingdom rich; the hungry are satisfied with righteousness; the meek inherit the land of promise; the bereaved are comforted; the persecuted find joy in their tribulations. They are pure-hearted; they are peacemakers. These are the kind of people Jesus calls “the salt of the earth” (Matt. 5:13). They are “the light of the world” (v. 14) because they reveal the glorious work of God in their lives. They are what the kingdom of heaven looks like on earth.

All of this may sound like the opposite of what was taught in the Torah, where it was said that material blessings are a sign of divine favor for the obedient, and sickness and death come to those who disobey God (Deut. 30:1–20). But Jesus claims that he is not ignoring the Law and the Prophets. Instead, he intends to keep the Law and the Prophets better than anyone, especially the scribes and the Pharisees, whom Jesus accuses of abrogating the law because they have missed the heart of the commandments (Matt. 5:17–20; cf. 23:23–24).

Love God and Neighbor

The Sermon on the Mount appears to be an exposition of two great commandments emphasized by Jesus: love God (6:1–34; Deut. 6:5) and love your neighbor (5:21–48; Lev. 19:18). In particular, Jesus challenges the experts of the law—the scribes and the Pharisees—in regard to their righteousness.

Do the experts keep the law when it comes to loving your neighbor? They say, “You shall not murder” (quoting the Decalogue) and “Anyone who murders will be subject to judgment” (quoting their tradition). But according to Jesus, they break the commandment and their tradition when they call someone a “fool.” Their indignation is not righteous; in fact, it condemns them to hell and prevents them from worshiping God (5:21–26). They say, “You shall not commit adultery” (again quoting the Decalogue) and “Whoever divorces his wife, let him give her a certificate of dismissal” (quoting Deut. 24). But Jesus believes that the commandment is broken when a man lusts for a woman; so he advises men to take drastic measures in dealing with eyes and hands, the instruments of lust (5:27–30). He even accuses husbands of practicing and promoting serial adultery when they abuse women by treating them as objects, trying to justify their selfish behavior by appealing to the provision of divorce in the law of Moses (5:31–32). The scribes and Pharisees also swear oaths to cover false vows (5:33–37). They hate their neighbors when they seek revenge against their enemies, desiring only to help their friends (5:38–47). Instead, Jesus teaches that when it comes to the kingdom of heaven, children of God must replicate the qualities of their heavenly Father (5:48): defying injustice (unrighteousness) through love, self-sacrifice, and mercy (turning the other cheek, giving away clothing, helping enemies, praying for persecutors). When it comes to loving your neighbor, this righteousness is picture perfect.

Certainly the scribes and the Pharisees cannot be accused of not loving God, for their standards of holiness are considered the highest of all. Yet according to Jesus, their acts of holiness are not for God’s benefit but for their own (6:1). When they give to the poor, it is an ostentatious display designed for social approval (6:2–4). When they pray, it is for human eyes, not God’s ears (6:5). When they fast, they want everyone to know about it (6:16). Jesus, on the other hand, believes that acts of holiness are for God’s eyes only. Give in secret; pray in private; fast in disguise (6:3–4, 6–13, 17–18). In this way, a person is storing up treasures in heaven. Those who seek human approval get their rewards on earth, where treasures are temporal (6:1–2, 5, 16, 19–21). Indeed, slaves of mammon worry about things that do not last (money, food, clothing). Those who seek the kingdom of heaven, on the other hand, are anxious for nothing. They serve the master who feeds sparrows and clothes fields of grass with flowers (6:24–34). God knows what kingdom seekers need before they ask, which is why they pray for the kingdom to come, for the will of God to be done on earth as it is in heaven (6:8–13). Rather than judging others, kingdom seekers forgive their debtors (7:1–5). They are delivered from the evil one because they make requests to a Father who gives only good gifts (7:7–11). Kingdom seekers treat others as they themselves want to be treated because they know that the Law and the Prophets are summed up in these two commandments: love God and love your neighbor (7:12).

The Narrow Gate

The sermon ends with an invitation. Two gates stand before Jesus’ listeners. One is wide, and many enter this way—a broad path that leads to destruction. It is the way of the Pharisees and the scribes. The other gate is narrow, and few enter this way, even though it leads to life—the way of righteousness, according to Jesus (7:13–14). There are two kinds of prophets, two kinds of trees, two kinds of builders (7:15–27). False prophets make bad trees; those who listen to them are fools. True prophets produce good fruit; those who listen to them are wise persons who build their lives on the rock of Jesus’ words—a Sermon on the Mount.

The stretch of land east of the Jordan River extending from Mount Hermon in the north to the Gulf of Aqaba in the south, including the biblical areas of Bashan, Gilead, Ammon, Moab, and Edom. The area is roughly that of the modern country of Jordan. The word “Transjordan” is not found in the Bible but is derived from variations of the Hebrew ’eber hayyarden (e.g., Deut. 1:1) and the Greek peran tou Iordanou (e.g., Matt. 4:25). The NIV variously translates these phrases as “east of the Jordan,” “across the Jordan,” “beyond the Jordan,” “near the Jordan,” “along the Jordan,” and “on the other side of the Jordan.” Occasionally these phrases also refer to the area west of the Jordan.

Description

Transjordan is a high plateau that in general rises in height from north to south, although Mount Hermon, as part of the Anti-Lebanon range, does mark the highest point of elevation at 9,230 feet above sea level. The plateau, bounded by the Sea of Galilee, the Jordan Rift Valley, the Dead Sea, and the Arabah in the west and the desert to the east, is intersected by numerous streams running east to west that have cut deep gorges as they run toward the Jordan. A main trade route, known as the King’s Highway, ran through Transjordan in biblical times, connecting the Gulf of Aqaba and western Arabia with Damascus in the north (Num. 20:17; 21:22).

The area of Bashan, with mountains to the north, is largely a fertile plain known in the OT for its well-fed cattle and large oak trees (Ps. 22:12; Isa. 2:13; Ezek. 27:6). South of Bashan, between the Yarmuk and the Jabbok (modern Nahr ez-Zerqa) rivers, the hills of Gilead rise to more than three thousand feet and were known for their rich pastureland (Num. 32:1). Although Gilead’s boundaries are defined here as between the Yarmuk and the Jabbok, it should be noted that in the OT “Gilead” occasionally referred to a region extending beyond these two rivers. This larger area is also roughly equivalent to the district called “Perea” by the first-century AD Jewish historian Josephus. South of Gilead, between the Jabbok and the Arnon (modern Seil el-Mojib) rivers lay the country of Ammon, although the political borders of this region were also somewhat fluid. Between the Arnon River and the Zered River (probably modern Wadi el-Hesa) lay the country of Moab, with a well-watered plateau rising to about 3,200 feet. This area was highly suitable for raising sheep (2 Kings 3:4). From the Zered River southward to the Gulf of Aqaba, the mountains of Edom rise to about 5,500 feet above sea level.

History

Biblical mention of Transjordan begins in Gen. 13, when Lot saw the fertile valley of the Jordan and chose to settle in Sodom. Although Sodom’s exact location is unknown, it may have been near the Dead Sea. Similarly, the battle of five kings against Kedorlaomer and his allies, which took place in the Valley of Siddim, may have been located near the south end of the Dead Sea (Gen. 14). Later, Jacob’s flight from Laban took him to the hill country of Gilead and eventually to the bank of the Jabbok River, where he wrestled with the angel (Gen. 31:22–25; 32:22–32).

Transjordan took center stage in the events following Israel’s exodus from Egypt. When the Israelites left Kadesh Barnea in Sinai, Moses requested passage through Edom on the King’s Highway, but the Edomite king refused (Num. 20:14–21). So the Israelites took a more easterly route, along the edge of the desert bordering Transjordan, thus bypassing both Edom and Moab (Num. 21). When they reached the Arnon River and attempted to rejoin the King’s Highway, Sihon king of the Amorites refused them passage and engaged them in battle, only to lose his territory to the Israelites (Num. 21:21–32). The Israelites continued farther north to Bashan, where they fought successfully against Og king of Bashan and claimed his land as well (Num. 21:33–35). When Balak king of Moab heard news of Israel’s victories, he feared for his own country and hired Balaam to curse Israel. However, by God’s prompting, Balaam blessed Israel and cursed Moab instead (Num. 22–23).

Before Israel crossed the Jordan to enter Canaan, the tribes of Reuben and Gad, which owned large numbers of livestock and were impressed by the rich pastureland of Gilead, requested that the land east of the Jordan be given to them (Num. 32:1–5). Thus, Reuben took possession of Ammon north of the Arnon River (Josh. 13:15–23), Gad’s tribe settled the northern parts of Ammon into Gilead (13:24–28), and the half-tribe of Manasseh settled in the hills of Gilead northward through Bashan (13:29–31).

Despite the Israelites’ victories over Sihon and Og and their settlement of Transjordan, hostilities continued between Israel and the remaining inhabitants of the land. Jephthah, for example, a Gileadite, fought successfully against the Ammonites, who wanted their land returned to them (Judg. 11:1–34). Saul also successfully fought the Ammonites when they threatened the town of Jabesh Gilead (1 Sam. 11:1–14). Saul’s courage won the gratitude of the town’s inhabitants, and it was they who later recovered Saul’s body from Beth Shan after the Philistines killed him (1 Sam. 31:7–13). During David’s reign, Israel’s territory was expanded throughout Transjordan from Damascus in the north and through Edom in the south (2 Sam. 8:1–14).

Solomon’s reign and the period of the divided kingdom saw ongoing struggles for control over the regions of Transjordan. Damascus, for example, gained independence during Solomon’s reign (1 Kings 11:23–25), and later Hazael of Syria (r. 842–806 BC) extended the Aramean Empire through Bashan and into Gilead (2 Kings 10:32–33). Later Jehoash and Jeroboam II of Israel were able to recapture this territory (2 Kings 13:25; 14:28). And when Ahab of Israel died, Mesha of Moab, who had been paying tribute to Israel, rebelled. This rebellion prompted Jehoram of Israel to invade and attempt to reassert control over Moab, but he was unsuccessful (2 Kings 3).

In 733/732 BC the Assyrian king Tiglath-pileser III annexed the northern parts of Trans-jor-dan, while Ammon, Moab, and Edom remained semiautonomous, likely paying tribute. The Babylonian and Persian empires also extended throughout Transjordan.

During the Hellenistic and Roman periods (332 BC–AD 324), Transjordan was controlled by the Ptolemies (c. 333–198 BC), the Seleucids (c. 198–153 BC), the Hasmoneans (c. 153–63 BC), and then the Romans. This era saw the emergence of the Decapolis, a confederation of ten cities settled by Greeks, nine of which were located east of the Jordan. The Romans continued dominance through the Byzantine period (AD 324–638).

The region of Transjordan is mentioned a few times in the NT in connection with Jesus’ ministry. The Gospels note that Jesus’ travels took him across the Jordan (Matt. 19:1–2; Mark 10:1), and that among the crowds who followed him were many from the Decapolis and beyond the Jordan (Matt. 4:25; Mark 3:8). Although the location of his healing of the demoniac is uncertain, in the country of either the Gadarenes (Matt. 8:28) or the Gerasenes (Mark 5:1; Luke 8:26), it was in the Decapolis region that the healed man proclaimed what Jesus had done for him (Mark 5:20).

A “type” (from Gk. typos) can be defined as a biblical event, person, or institution that serves as an example or pattern for events, persons, or institutions in the later OT or in the NT. Typology is based on the assumption that there is a pattern in God’s work in the OT and in the NT that forms a promise-fulfillment relationship. In the OT there are shadows of things that will be more fully revealed in the NT. Thus, the OT flows into the NT as part of a continuous story of salvation history. What is promised in the OT is fulfilled in the NT. This can be accomplished through prophetic word or through prophetic action/event. The use of prophetic action/event to predict or foreshadow future actions/events involves typology. Typology is part of the promise-fulfillment scheme that connects the two Testaments.

A number of biblical interpreters note that three primary characteristics of types can be identified. First, there must be some notable point of resemblance or analogy between the type and its antitype. Second, there must be evidence that the type was appointed by God to represent the thing typified. Here one must avoid the two extremes of, on the one hand, saying that a type is a type only when the Scripture explicitly calls it such, and, on the other hand, of finding a type “behind every tree.” Third, a type should prefigure something in the future. Thus, antitypes in the NT must present truth more fully realized than in the OT.

Typological interpretation of the OT is different from allegorizing a text. The former restricts itself to the meaning intended by the original author, whereas the latter reads things into the OT passage (usually in connection with messianic prophecy) not initially intended. On the other hand, it should be noted that the OT authors may not always have fully comprehended the long-range fulfillment of their prophecies. Thus, for example, Ps. 22 reveals King David’s trials and tribulations that are later viewed by NT authors as applicable to the crucifixion of Christ (e.g., the quotation of Ps. 22:18 in John 19:24 regarding the soldiers casting lots for Jesus’ clothes). David probably did not envision his situation as predictive of the sufferings of the coming Christ. But the Holy Spirit did, and he allowed the Gospel authors to make the connection. Thus, typology is a special form of biblical prophecy, which Jesus seemed to use extensively. Hence, the type is found in the OT, and its antitype occurs in the NT.

More particularly, Jesus seemed to perceive himself as the antitype to all three of the aforementioned possible types. First, Jesus fulfilled in himself persons in the OT who were types. Thus, Jesus is the ultimate David, Solomon, Elijah, Elisha, Jonah, the heavenly Son of Man of Dan. 7, and the Suffering Servant of Isa. 52:13–53:12. Second, with regard to famous OT events, Jesus reenacted the new exodus and passed the test in the new wilderness wanderings (Matt. 4:1–11 pars.), and then he proclaimed a new law from the mountain, as did Moses (Matt. 5–7). Third, Jesus revised or replaced OT institutions such as the sacrificial system and the feasts of Yahweh (most notably Passover) at his death, and at his resurrection he became the new temple of God.

The NT continues Jesus’ typological interpretation of the OT, seeing in him the supreme antitype of OT symbolism. Thus, for example, Paul sees Christ as the second Adam (Rom. 5:12–21), whose church is the new Israel, the eschatological people of God (1 Cor. 10:1–13). Matthew perceives Jesus to be the new Moses (Matt. 1–10). Note the following comparisons:

Moses, the Old Testament Type vs. Jesus, Matthew’s Antitype to Moses:

Moses was born to deliver his people. Jesus was born to save his people.

Pharoah tried to kill the infant Moses. Herod tried to kill the infant Jesus.

Moses was “baptized” in the exodus. Jesus was baptized in the new “exodus.”

Moses was tempted in the wilderness. Jesus was tempted in the wildnerness.

Moses performed ten plagues. Jesus performed ten miracles.

Moses received the law on the mount. Jesus gave a new law on the mount.

Luke understands Jesus to be the new David (Luke 1:32). Hebrews asserts that Jesus has inaugurated the new covenant (chap. 8), the true priesthood (chaps. 7–8; 10), whose death is the fulfillment and replacement of the sacrificial system of the OT (chaps. 9–10). But perhaps the most extensive usage of typology in the NT occurs in Rev. 21–22 (cf. Rev. 19), where the new creation is the antitype of the old creation of Gen. 1–3 (see table 10).

Table 10. New Creation Typology in Revelation 21–22

Sinful people are scattered (Gen. 1-3). God’s people unite to sing his praises (Rev. 21-22; cf. 19:6-7).

The “marriage” of Adam and Eve takes place in the garden (Gen. 1-3). The marriage of the second Adam and his bride, the church has come (Rev. 21-22; cf. 19:7, 21:2, 9).

God is abandoned by sinful people (Gen. 1-3). God’s people (new Jerusalem, bride of Christ) are made ready for God; marriage of the Lamb. (Rev. 21-22; cf. 19:7-8, 21:2, 9-21).

Exclusion from bounty of Eden (Gen. 1-3). Invitation to marriage supper of Lamb (Rev. 21-22; cf. 19:9).

Satan introduces sin into world (Gen. 1-3). Satan and sin are judged (Rev. 21-22; cf. 19:11-21, 20:7-10).

The serpent deceives humankind (Gen. 1-3). The ancient serpent is bound “to keep him from deceiving the nations (Rev. 21-22; cf. 20:2-3).

God gives humans dominion over the earth (Gen. 1-3). God’s people will reign with him forever (Rev. 21-22; cf. 20:4, 6, 22:5).

People rebel against the true God, resulting in physical and spiritual death (Gen. 1-3). God’s people risk death to worship the true God and thus experience life (Rev. 21-22; cf. 20:4-6).

Sinful people are sent away from life (Gen. 1-3). God’s people have their names written in the book of life (Rev. 20:4-6, 15; 21:6, 27).

Death enters the world (Gen. 1-3). Death is put to death (Rev. 20:14; 21:4).

God creates the first heaven and earth, eventually cursed by sin (Gen. 1-3). God creates a new heaven and earth, where sin is nowhere to be found (Rev. 21:1)/

Water symbolizes chaos (Gen. 1-3). There is no longer any sea (Rev. 21:1).

Sin brings pain and tears (Gen. 1-3). God comforts his people and removes crying and pain (Rev. 21:4).

Sinful humanity is cursed with wandering (exile) (Gen. 1-3). God’s people are given a permanent home (Rev. 21:3).

Community is forfeited (Gen. 1-3). Genuine community is experienced (Rev. 21-22; cf. 21:3, 7).

Sinful people are banished from the presence of God (Gen. 1-3). God lives among his people (Rev. 21:3, 7, 22; 22:4).

Creation begins to grow old and die (Gen. 1-3). All things are made new (Rev. 21:5).

Water is used to destroy wicked humanity (Gen. 1-3). God quenches thirst with water from the spring of life (Rev. 21:6; 22:1).

“In the beginning, God…” (Gen. 1-3). “I am the Alpha and the Omega, the beginning and the end.” (Rev. 21:6).

Sinful humanity suffers a wandering exile in the land (Gen. 1-3). God gives his children an inheritance (Rev. 21:7).

Sin enters the world (Gen. 1-3). Sin is banished from God’s city (Rev. 21:8, 27; 22:15).

Sinful humanity is separated from the presence of the holy God (Gen. 1-3). God’s people experience God’s holiness (cubed city = holy of holies) (Rev. 21:15-21).

God creates light and separates it from darkness (Gen. 1-3). No more night or natural light; God himself is the source of light (Rev. 21:23; 22:5)

Languages of sinful humanity are confused (Gen. 1-3). God’s people is a multicultural people (Rev. 21:24, 26; 22:2).

Sinful people are sent away from the garden (Gen. 1-3). The new heaven/earth includes a garden (Rev. 22:2).

Sinful people are forbidden to eat from the tree of life (Gen. 1-3). God’s people may eat freely from the tree of life (Rev. 22:2, 14).

Sin results in spiritual sickness (Gen. 1-3). God heals the nations (Rev. 22:2).

Sinful people are cursed (Gen. 1-3). The curse is removed from redeemed humanity, and people become a blessing (Rev. 22:3).

Sinful people refuse to serve/obey God (Gen. 1-3). God’s people serve him (Rev. 22:3).

Sinful people are ashamed in God’s presence (Gen. 1-3). God’s people will “see his face” (Rev. 22:4).

Because Scripture sees all things as providentially arranged and sustained by God’s sovereign power at all times (Heb. 1:3), miracles are not aberrations in an otherwise closed and mechanical universe. Nor are miracles raw demonstrations of divinity designed to overcome prejudice or unbelief and to convince people of the existence of God (Mark 8:11–12). Still less are they clever conjuring tricks involving some kind of deception that can be otherwise explained on a purely scientific basis. Rather, God in his infinite wisdom sometimes does unusual and extraordinary things to call attention to himself and his activity. Miracles are divinely ordained acts of God that dramatically alert us to the presence of his glory and power and advance his saving purposes in redemptive history.

Terminology

The biblical writers describe miracles with various terms, such as “signs,” “wonders,” and “miracles” (or “powers”), which can carry various connotations. As the word “sign” suggests, divine miracles are significant and should cause us to think more deeply about God in a way that goes beyond mere amazement or curiosity (Exod. 4:30–31; John 2:11). Not all of God’s signs are miraculous. Some are given as part of his ordering of the natural world (Gen. 1:14) or as an encouragement to faith that God will do as he has said (e.g., the rainbow in Gen. 9:8–17; the blood of the Passover lamb in Exod. 12:13). (See also Sign.)

Often coupled with signs are “wonders” (Jer. 32:21; John 4:48; 2 Cor. 12:12). If the depiction of miracles as “signs” indicates an appeal to the intellect, that of “wonders” points to the emotions. Miracles evoke astonishment and awe at the one who did them.

The NT word “miracle” carries the meaning of power and therefore points to the supernatural source of these events (Luke 10:13; Acts 8:13).

Miracles in the Bible

Old Testament. In the OT, miracles are not evenly distributed but rather are found in greater number during times of great redemptive significance, such as the exodus and the conquest of Canaan. Miracles were performed also during periods of apostasy, such as in the days of the ninth-century prophets Elijah and Elisha. Common to both of these eras is the powerful demonstration of the superiority of God over pagan deities (Exod. 7–12; 1 Kings 18:20–40).

New Testament. In the NT, miracles often are acts of compassion, but more significantly they attest the exalted status of Jesus of Nazareth (Acts 2:22) and the saving power of his word (Heb. 2:3–4). In the Synoptic Gospels, they reveal the coming of God’s kingdom and the conquest of Satan’s dominion (Matt. 8:16–17; 12:22–30; Mark 3:27). They point to the person of Jesus as the promised Messiah of OT Scripture (Matt. 4:23; 11:4–6). John shows a preference for the word “signs,” and his Gospel is structured around them (John 20:30–31). According to John, the signs that Jesus performed were such that only the one who stood in a unique relationship to the Father as the Son of God could do them.

Miracles and faith. Just as entrenched skepticism is injurious to faith, so too is naive credulity, for although signs and wonders witness to God, false prophets also perform them “to deceive, if possible, even the elect” (Matt. 24:24). Christians are to exercise discernment and not be led astray by such impostors (Matt. 7:15–20).

The relationship between miracles and faith is not as straightforward as sometimes supposed. Miracles do not necessarily produce faith, nor does faith necessarily produce miracles. Miracles were intended to bring about the faith that leads to eternal life (John 20:31), but not all who witnessed them believed (John 10:32). Additionally, Jesus regarded a faith that rested only on the miracle itself as precarious (Mark 8:11–13; John 2:23–25; 4:48), though better than no faith at all (John 10:38). Faith that saves must ultimately find its grounding in the person of Jesus as the Son of God.

It is also clear that although Jesus always encouraged faith in those who came to him for help (Mark 9:23), and that he deliberately limited his miraculous powers in the presence of unbelief (Mark 6:5), many of his miracles were performed on those who did not or could not exercise faith (Matt. 12:22; Mark 1:23–28; 5:1–20; Luke 14:1–4).

The fact that Jesus performed miracles was never an issue; rather, his opponents disputed the source of his power (Mark 3:22). Arguments about his identity were to be settled by appeal not to miracles but to the word of God (Matt. 22:41–46).

The function of miracles. Miracle accounts function in a symbolic and prophetic manner. Hence, the cursing of the fig tree was prophetic of the coming judgment (Mark 11:12–21). The unusual two-stage healing of the blind man of Bethsaida symbolized Peter’s incomplete understanding of Jesus’ messiahship (Mark 8:22–33).

The miraculous element of Jesus’ ministry carries an eschatological significance, pointing to the order of things in the age to come. For example, the nature miracles (Mark 4:35–41) look forward to the redemption of creation itself, which is presently subject to frustration and decay (Rom. 8:20–21); the healing miracles point to a day when disease and deformity will be abolished (Rev. 21:4); and miracles in which the dead are raised to life anticipate a time when death itself will be no more (Rev. 20:14; 21:4). From this perspective, the miracles are a gracious foretaste of a far more glorious future.