Chs. 13, 14. The Treatment of Leprosy

The word leprosy is now used to denote a malignant disease which in the Middle Ages swept over Europe and the British Isles. Traces of this visitation are found in the leper houses which were built in England. At present the disease is the subject of special treatment in Norway, but it is prevalent in India and elsewhere in the East and in parts of the Pacific Ocean. Many travellers have described the pitiable condition of the modern lepers, and the heroic action of Father Damien at the leper settlement of Molokai, Hawaii (†1889) in devoting his life to the alleviation of their sufferings has drawn public attention to the continued existence of this malady, but in by far the majority of cases these accounts of lepers and their sufferings are read with interest mainly because of the prominent position assigned to the treatment of leprosy in these chapters, and other references to lepers in both the Old and New Testaments. References are often made in the Bible to other diseases, but none are described with such particularity as that which is called leprosy. The symptoms here described refer to the earlier stages of the leprosy, if indeed that name be the right one. The Art. Leprosy in Enc. Bib. 111. (by Creighton) says, however, ‘it may be doubted whether anyone would ever have discovered true leprosy in these chapters but for the translation [of the Heb. word] in LXX. and Vulgate’ (quoted by Kennedy), Lev. ad loc. (Cent. Bible).

For translation of portions of the Talmudic treatise Negâim, which deals with leprosy, see Jos. Barclay’s Talmud, pp. 267 ff., and cp. the Midrashic commentaries Siphra (on Lev.) and Mechilta (on Exodus): see also the Art. Leprosy (A. Macalister) in HDB.

Leprosy in man (Leviticus 13:2-46)

Appearances in the skin which should be shewn to the priest (2–8)

2. a rising, or a scab, or a bright spot] Of the three words thus translated, the first is a common Heb. word for ‘lifting up,’ but employed in these chs. only in the sense of a swelling in or under the skin; the second (ṣappaḥath) occurs only here and Leviticus 14:56, the form miṣpaḥath from the same root only in Leviticus 13:6-8; the third is from a root signifying ‘to be bright or clear,’ and is used only in these chs. They all seem to denote an appearance like that of an angry-looking boil.

the plague of leprosy] rather a plague.

plague] lit. ‘a stroke’ (plaga; cp. a ‘stroke’ of paralysis), which also represents the sense of the Heb. word nega‘, which gives its name to the treatise Negâim. The leper was rejected as ‘smitten of God.’ See introd. note on ch. 14.

3. The distinctive marks of leprosy are—the hair, which is generally very dark among Jews, turns while, and the swelling appears deep-seated; in that case the priest is at once to declare the man unclean.

4. If any of the symptoms are not found, the man is to be shut up seven days and again examined.

5. If the plague (i.e. the rising described in Leviticus 13:2) has not spread (the Heb. verb occurs only in chs. 13, 14), he is to be shut up another seven days, and if the spot then appears dull (the Heb. word in this sense is confined to the two chs.; it is applied to the eye becoming dim through age, 1 Samuel 3:2), and there is no sign of its spreading, the priest shall pronounce him clean.

7. after that he hath shewn himself to the priest for his cleansing] i.e. in order to be declared clean. Three inspections by the priest are ordered with a week’s interval between each. If during either week the rising spreads, the priest shall pronounce him unclean.

It will be noticed that the word ‘plague’ is used to denote the rising or scab which is a mark of the leprosy, and also the person afflicted (in Leviticus 13:4; Leviticus 13:12-13; Leviticus 13:17 him that hath is not in the Heb.), as well as the disease itself in the phrase ‘the plague of leprosy.’

9–17. The first part of this section is obscure; most modern commentators explain Leviticus 13:9-11 as referring to another form of leprosy in which the rising described in Leviticus 13:10 appears without any of the premonitory symptoms of Leviticus 13:2; if in addition to the white hair (already mentioned in Leviticus 13:3) there is ‘quick raw flesh’ (Leviticus 13:10) in the rising, this is a sure sign of leprosy, and the man must be declared unclean at once without waiting for any further examination. By ‘quick raw flesh’ (Heb. ‘the rawness of raw flesh,’ or lit. ‘the quickness of quick flesh’) is understood an appearance like that of raw meat. The Heb. words for ‘raw flesh’ [bâsâr ḥay] are used of raw meat in 1 Samuel 2:15; Prof. Macalister describes it as ‘red granulation tissue’ (HDB. iii. 96a). The words ‘old leprosy’ must then mean a leprosy of long standing which has not manifested itself in the preliminary stages, but, when first noticed, shews this definite indication of the disease. It is possible that these verses may include the case when the first symptoms described in Leviticus 13:2 have been either unobserved or concealed.

Another explanation of Leviticus 13:9-11 is that they describe a fresh outbreak in one who has been pronounced clean, or who has been cured of a previous attack. The traditional interpretation of ‘quick raw flesh’ (the quickening of living flesh, A. V. mg.) is ‘sound flesh.’ The appearance of this sound flesh in a rising was, in the opinion of the rabbis, evidence that an old leprosy had developed fresh activity.

The words of Leviticus 13:7, ‘after that he hath shewn himself to the priest for his cleansing,’ are by some considered as referring to the third of the inspections prescribed in Leviticus 13:2-6. It has been observed that the suspected person at the first and second inspection must either be pronounced unclean, or shut up for further enquiry, and he cannot be pronounced clean till the third examination. Then Leviticus 13:7-8 would refer to the reappearance of leprous symptoms after a man had been pronounced clean by the priest, and Leviticus 13:9-11 would supply further rules for such cases.

The case when the whole body is turned white (12–17)

A form of skin disease which is not infectious seems to be here indicated. A white efflorescence spreads over the whole body, which after a time peels off, and the skin resumes a healthy appearance. The presence of the raw flesh indicates disease (Leviticus 13:14-15), but as soon as the whole surface becomes white, the priest shall pronounce him clean.

Leprosy developing in the place of an old boil or a burn (18–28)

The distinguishing marks of leprosy are similar to those already indicated; it would seem that in these cases they are more easily recognised, for only one shutting up for seven days is required. The Heb. word (shĕḥîn) for ‘boil’ is used of Hezekiah (2 Kings 20:7) and Job (Job 2:7); also for ‘the botch (boil R.V.) of Egypt’ (Deuteronomy 28:17). As Egypt was notorious for malignant skin diseases, this expression may denote some form of leprosy.

23. the scar of the boil] The Heb. for ‘scar’ occurs only here and in Leviticus 13:28. It is from a root signifying ‘to burn,’ which is found in Ezekiel 20:47 (Heb. 21:3), ‘all faces … shall be burnt.’

Leprosy in the hair of the head or face (29–37)

The treatment is similar to that in the preceding cases, but two periods of confinement are prescribed, and the hair is to be shaven after the first seven days.

30. yellow thin hair] The Heb. word for ‘yellow’ is used only here and in Leviticus 13:32; Leviticus 13:36.

a scall] a dry scall A.V.; the Heb. word néthek is used only in this section, and denotes ‘what one is inclined to scratch or tear away’ (Oxf. Lex.).

33. It is enjoined in the Mishna (Tal. Bab. Neg. x. § 5) that two hairs on each side of the scall should be left so that the priest might judge whether the disease had spread.

White spots in the skin (38, 39)

These, if they are dull, and not of the character described in Leviticus 13:3, are a ‘tetter’ (freckled spot A.V.), a skin disease which is not of a leprous character. The Heb. word bohaḳ (only in Leviticus 13:39) is still used by the Arabs to denote this kind of eruption.

Baldness in the back or front part of the head (40–44)

This is not in itself a sign of uncleanness, but if in either part a reddish white plague (white reddish sore A. V.) appears, he must be seen by the priest. The word ‘bald’ in Leviticus 13:40 means bald at the back of the head, as distinguished from forehead bald in Leviticus 13:41.

43. as the appearance of leprosy] The criterion of white hair is absent, but the other tests of leprosy already mentioned are sufficient to determine whether the outbreak is leprous. According to tradition, two periods of seclusion were necessary as in Leviticus 13:2-6 and in Leviticus 13:29-37.

45. his clothes shall be rent] not the usual Heb. word, but one used only here and in Leviticus 10:6, Leviticus 21:10; Jewish tradition exempted women from rending their clothes. The actions of the leper here prescribed are those of a mourner; rending the garments, and letting the hair go loose (cp. Leviticus 10:6, Leviticus 21:10; Ezekiel 24:17), covering the upper lip (cp. Ezekiel 24:17; Ezekiel 24:22; Micah 3:7), crying, Unclean (Lamentations 4:15). The leper was regarded as one dead; Miriam is so described (Numbers 12:12) and Josephus refers to lepers as ‘in no way differing from the dead’ (Ant. iii. 11. 3). Cp. mediaeval rites relating to lepers in HDB. iii. 98 b.

The office from the Sarum Manual used at the seclusion of a leper may be found in R. M. Clay’s Mediaeval Hospitals, pp. 273 ff.

Rules for treatment of leprous persons (45, 46)

Leprosy in garments (47–59)

The nature of these spots in clothing is not clear. It is generally supposed that they are caused by mildew or moth (see Art. Leprosy, HDB.); another suggestion is that the clothing had been worn by a leprous person, but this is not stated in the text. The materials of the garments are either wool, linen, or skin.

48. whether it be in warp, or woof] The LXX. and other versions translate thus; another suggestion is that different ways of working up the material are meant (so R.V. mg.).

51. a fretting leprosy] i.e. malignant.

55. it is a fret, whether the bareness be within or without] The Heb. word for ‘fret’ occurs only here, and probably means a depression in the surface caused by the material being eaten away. The Heb. words which follow are those used for baldness in the back or front of the head in Leviticus 13:40-41. They are used here to denote the back or front of the garment, the inside or outside. The word ‘fret’ has nothing in common with ‘fretting’ in Leviticus 13:51.

56, 57. If after washing, the colour is dim, the affected part is to be torn out, and if any further sign of infection is found, the garment must be burnt.

58. The garment which after washing (Leviticus 13:54) shews no further sign of the plague, is to be washed again, and then declared clean.