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

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

A commander of one hundred soldiers (a “century”) in a Roman legion, with various tactical and logistical duties, including management of supplies and leadership in battle. Having the best training and most experience in battle, the sixty centurions of each legion served as the backbone of the Roman army. Centurions in the Bible include the centurion who, according to Jesus, had more faith than anyone in Israel (Matt. 8:5–13; Luke 7:2–9); Cornelius the generous God-fearer and supporter of the Jewish people of Caesarea Maritima (Acts 10); the centurion in charge of the soldiers at Jesus’ crucifixion (Matt. 27:54; Mark 15:39, 44–45; Luke 23:47); and the various named and unnamed centurions throughout Acts (see Acts 22–27).

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

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

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

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

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

(1) Renamed “Israel” by God (Gen. 32:28), he was the son of Isaac and Rebekah and was the father of twelve sons, whose descendants became the twelve tribes. Half the book of Genesis (25:19–49:33) narrates his story and that of his sons. The middle chapters of Genesis focus on his struggles with his brother, Esau, and with his uncle Laban, and the later chapters focus on his children Dinah, Judah, and particularly Joseph during his time in Egypt.

According to the Genesis narrative, Jacob’s mother, Rebekah, was barren, but God heard Isaac’s prayer, and she gave birth to twins, Esau the older and Jacob the younger (25:21–26). He was named “Jacob,” which means “supplanter,” because he gripped Esau’s heel during their birth. Isaac favored Esau, but Jacob was, so to speak, a “mama’s boy” (25:27–28). Jacob supplanted Esau twice, initially when Esau sold Jacob his birthright as firstborn son for some stew and later when Jacob pretended to be Esau, tricking his elderly father into giving him Esau’s blessing (25:29–34; 27:1–29). After the second incident, Esau swore to kill his brother, so Jacob fled to Harran, where his uncle Laban lived (27:41–28:5).

En route to Harran, Jacob had a dream of a stairway to heaven, and God spoke to him, repeating the Abrahamic promise of land, blessing, many descendants, and divine presence (28:10–22). He named the place “Bethel” (“house of God”) and made a vow to God. Upon his arrival in Harran, he fell in love with Laban’s younger daughter, Rachel, and agreed to work seven years to marry her (29:9–30). When the wedding night came, Laban replaced Rachel with her older sister, Leah, and somehow Jacob did not notice until the next day. Jacob then agreed to work seven more years for both daughters.

The text records the births of Jacob’s thirteen children (29:31–30:24). Since Jacob loved Rachel more than her sister, God blessed Leah with four sons (Reuben, Simeon, Levi, and Judah), while Rachel remained barren. Following the precedent set by Sarah with Hagar, Rachel offered to Jacob her maidservant Bilhah, who gave birth to two more sons (Dan and Naphtali). Leah then offered her maidservant Zilpah, with whom Jacob fathered two more sons (Gad and Asher). Leah gave birth to two more sons (Issachar and Zebulun) and one daughter (Dinah). Finally, God opened Rachel’s womb, and she gave birth to Jacob’s last sons, Joseph and Benjamin, but she died when the latter was born (35:16–19).

Jacob ended up working for Laban a total of twenty years, during which God blessed both of them. God eventually told Jacob to return to the land of his ancestors, but Jacob did not tell Laban because he was worried that Laban would not allow Jacob to take his daughters to a distant land. Laban pursued Jacob, and eventually they made a covenant of peace (31:22–55).

After departing from Laban, Jacob received word that Esau was coming to meet him with four hundred men (32:1–6). Jacob was fearful and prayed for deliverance from his brother, reminding God of the promise to give him descendants as numerous as “the sand of the sea” (32:7–12). Jacob spent the night alone, and his prayers were answered in an unusual way in the form of a wrestler whom the text describes as both human and divine (32:22–32). The wrestler could not defeat Jacob, but he did put Jacob’s hip out of joint. The wrestler asked Jacob his name, but he had the authority to change it to “Israel” (“wrestles with God”). Jacob named the site “Peniel” (“face of God”) because he survived his face-to-face meeting with God. The next day, Jacob and Esau met not as foes but as friends, and Jacob told Esau that meeting him was like seeing the face of God (33:1–11).

The family crises that characterized Jacob’s life continued in Canaan. His daughter Dinah was raped by the Canaanite Shechem, so her older brothers Simeon and Levi retaliated and killed all the males of his city (chap. 34). After Jacob’s favorite son, Joseph, told his brothers about his two dreams in which their sheaves and stars bowed down to him, they sold him into slavery and told Jacob that a wild animal had killed Joseph, prompting Jacob to mourn for many days (chap. 37). Over twenty years later, during a famine in Canaan, Jacob learned that Egypt had grain, so he sent ten of his sons (but not Benjamin) there to purchase grain (42:1–5). When they arrived, the brothers did not recognize the official in charge of grain storage, Joseph, and bowed to him, fulfilling his dreams (42:6–9). When all eleven of the brothers later returned for more food, Joseph orchestrated a test to see if they would allow his younger brother, Benjamin, also to be enslaved, but when Judah sacrificially offered to be enslaved instead, Joseph broke down, revealed his identity, and wept (43:1–45:15).

Joseph told his brothers to bring Jacob and their families to Egypt because the famine would continue for five more years. Joseph rode his chariot out to the land of Goshen to be reunited with his father (46:28–34). In Egypt, Jacob blessed Pharaoh (47:7–10) and Joseph’s two sons, Ephraim and Manasseh (chap. 48), and also uttered his final testament, involving blessings and curses on his twelve sons (49:1–28). He died in Egypt at the age of 147, but Joseph buried him in Canaan (47:28; 49:29–50:14).

Jacob is mentioned throughout the OT as a forefather to the nation of Israel (Exod. 2:24; 3:16; Deut. 1:8; 2 Kings 13:23) as well as in Psalms and prophetic literature as a synonym for the nation Israel (Pss. 22:23; 105:23; Isa. 41:8; Jer. 2:4). In the NT, he appears in the genealogies of Jesus (Matt. 1:2; Luke 3:34), alongside Abraham and Isaac (Matt. 8:11; Acts 3:13), and among the heroes of faith (Heb. 11:9, 20–21).

(2) The father of Joseph, who was the husband of Mary the mother of Jesus (Matt. 1:15–16).

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).

Although the events narrated in the NT took place during a time of peace in the Roman Empire, Roman soldiers were a fixture in Judea, and they appear in a number of stories: the centurion whose servant Jesus healed (Matt. 8:5–13; Luke 7:1–10); the soldiers who tortured and executed Jesus (Matt. 27; Mark 15; Luke 23; John 19) and guarded his tomb (Matt. 28:4); the God-fearing centurion Cornelius (Acts 10); and the Roman garrison in Jerusalem (Acts 21:27–40). Soldiers also guarded prisoners (Acts 12:1–10; 23; 27:1–2, 31–32, 42–44; 28:16). In several places Paul writes of Christian workers as soldiers (1 Cor. 9:7; Eph. 6:10–17; Phil. 2:25; 2 Tim. 2:3–4; Philem. 1:2).

OT law considered the loss of a tooth or an eye equally serious (Exod. 21:24, 27; Lev. 24:20; Deut. 19:21; Matt. 5:38–39). Perfect, clean, white teeth are a mark of beauty (Song 4:2; 6:6). When nations or people destroy, it is with sharp teeth (Deut. 32:24 [NIV: “fangs”]; Job 29:17; 41:14; Ps. 57:4; Prov. 30:14; Joel 1:6). The psalmist calls upon Yahweh “to break the teeth” of the wicked (Pss. 3:7; 58:6). Hell, described as a place of “weeping and gnashing of teeth” (Matt. 8:12; 13:42; 22:13; 24:51; 25:30; Luke 13:28), graphically pictures the suffering reserved for those outside the kingdom of God.

The historical origins of Christianity need to be set against Jewish history, beliefs, and culture in Palestine and the eastern Mediterranean, but they also need to be set in the context of the wider Greco-Roman world that was dominated politically and militarily by the Roman Empire.

From Republic to Empire

Rome began as a city-state but soon became a transcontinental empire reaching over parts of Europe, Africa, and Asia. Rome emerged as the most dominant force in the Mediterranean after it defeated Carthage in the Second Punic War (218–201 BC). Thereafter, Rome began to expand its control and power over the various Hellenistic city-states in the east, including Macedonia, Illyria, and Asia Minor. By the mid-first century AD, Rome had also conquered or annexed Syria, Palestine, Egypt, Cyrene, Gaul, Spain, North Africa, and Armenia.

The transition from the Roman Republic to the Roman Empire took place under the Roman emperors beginning with Julius Caesar (100–44 BC), who, after crossing the Rubicon and defeating Pompey, was proclaimed dictator perpetuus (“dictator for life”). The period after Julius Caesar’s assassination (44 BC) was a time of political upheaval as Rome was marred by a series of civil wars. The first was between Octavius and Antony against Caesar’s assassins Brutus and Cassius. This climaxed in the Battle of Philippi (42 BC), which the former allies of Julius Caesar won. The second was between Octavius and Antony, where Antony and Cleopatra were defeated at the Battle of Actium in 31 BC, leaving Octavius as the undisputed leader of Rome.

Octavius was given the honorific name “Augustus” by the senate. His reign (31 BC–AD 14) marked a period of consolidation, reorganization, and renewal of the Roman Empire. Augustus embarked on an empire-wide policy of fiscal rationalization, developed a constitutional settlement for Rome, centralized his military authority over the various provinces, and had Julius Caesar deified. Writers and artists of the era heralded Augustus’s reign as a time of unprecedented peace and security—peace from civil war and security from the Germanic tribes in the north and the Parthian Empire in the east. Worship of the emperor became more frequent especially in the Roman East, although Augustus did not permit it in Rome. What is most significant about Augustus is that it is with his reign that the Roman Empire essentially began. He was the emperor at the time of Jesus’ birth (Luke 2:1). It was under Trajan (AD 98–117), however, that the Roman Empire expanded to its largest area, encompassing parts of Britain and Persia.

Emperors (AD 14–98)

Tiberius, Augustus’s adopted heir, reigned in the years AD 14–37. He was a highly successful military general, but as emperor he was remembered as being gloomy and melancholic. Tiberius even went into a self-imposed exile for a time, leaving the praetorian prefect Sejanus in charge until Tiberius finally had him executed for treason. It was during the reign of Tiberius that Jesus conducted his ministry in Palestine.

Tiberius was succeeded by his adopted grandson Caligula, who reigned in the years AD 37–41. Caligula was the son of the popular Roman general Germanicus, who died in Antioch in AD 19. Historical sources are not favorably disposed toward Caligula, who was remembered as a malevolent tyrant given to self-aggrandizement and sexual perversity. In AD 39/40 Caligula departed from imperial policy that permitted emperor worship in the east and veneration of deceased emperors in Rome, and he often appeared dressed as a god in public and demanded worship as a living god. During this time he deposed Herod Antipas, the tetrarch of Galilee and Perea, on suspicion of consorting with Parthia (Josephus, Ant. 18.7). Caligula also ordered that his statue be placed in the holy of holies in the Jerusalem temple (Philo, Embassy 203). Petronius, the governor of Syria, knowing that such an act would lead to civil war, refused to comply and appealed to Caligula to reverse the order. In response, Caligula sent an order to Petronius that he commit suicide. Fortunately, news of Caligula’s assassination by a conspiracy involving the praetorian guard and senators reached Petronius first.

Claudius, Caligula’s uncle, reigned in the years AD 41–54, and his rule was defined by numerous public works, a reordering of the judicial system, a torrid series of marriages, the conquest of Britain, and a number of attempted coups by the Roman senate. In AD 49 he expelled the Jews from Rome because of disputes about a certain “Chrestus,” probably Christ (cf. Acts 18:2). No one is sure whether Claudius was murdered or died of old age, but he remained a sharp contrast to the brutal excesses of Caligula and Nero.

Nero, the stepson of Claudius, reigned in the years AD 54–68. The early period of his rule was marked by cultural endeavors and diplomatic efforts. The later years were, in contrast, distinguished by tyranny and self-aggrandizement. There was a Jewish revolt against Rome in Judea (AD 66–70) during Nero’s reign, and Vespasian was sent to pacify the territory. According to ancient sources, Nero accused Christians of starting the fire of Rome in AD 64 and subjected them to the cruelest of punishments, including crucifixion, being thrown to wild animals, and even being burned alive. It probably was during this time that the apostles Peter and Paul were martyred in Rome. Nero eventually was declared a public enemy by the Roman senate, and he committed suicide before he could be captured in AD 68. There arose a “Nero redivivus” legend, whereby many hoped or feared that Nero had not died in AD 68 but had fled to Parthia and would return to Rome in order to destroy it (Sib. Or. 4.119–124; 5.137–141, 361–396), and this arguably stands behind the imagery of Rev. 13:3; 17:8–11.

The suicide of Nero left a power vacuum in Rome, and AD 69 saw no less than four emperors ascend the throne: Galba, Otho, Vitellius, and finally Vespasian. Galba was governor of Hispania Tarraconensis and was invited to become emperor by the senate, but he was killed by the praetorian guard after they were bribed by the praetor Otho. Otho himself committed suicide after his forces were defeated by Vitellius, the commander of the legions on the Rhine. Vitellius became emperor, but he was fiscally irresponsible and murdered many of his rivals. The legions in the Danube, Egypt, Syria, and Judea had declared Vespasian emperor and marched on Rome. Vespasian controlled the grain supplies to Rome from Egypt and had a superior force. Vitellius’s forces were defeated at Bedriacum, and Vitellius went into hiding but eventually was killed in Rome. Vespasian was declared emperor by the senate, and so began the Flavian dynasty, which restored order after the chaos of civil war.

The Flavians ruled in the years AD 69–96. Vespasian (r. AD 69–79) consolidated the empire after its year of strife and instituted new taxes, such as the fiscus judaicus, a war reparation tax placed on all Jews and paid to the temple of Jupiter in lieu of the Jerusalem temple tax. Vespasian was succeeded by his sons Titus (r. AD 79–81) and Domitian (r. AD 81–96). When Vespasian sailed to Rome from Judea, Titus was left in charge of the siege of Jerusalem, which he completed and celebrated in a triumph in Rome in AD 72. This triumph is memorialized in the Arch of Titus, which depicts Roman soldiers bringing the vessels of the temple to Rome as part of the booty taken. Later Roman writers regarded Domitian as a malevolent and malicious tyrant (e.g., Tacitus, Suetonius), but this probably is an exaggeration caused partly by a desire to highlight the greatness of succeeding emperors such as Nerva and Trajan. It probably was during the reign of Domitian that some Christians in Asia Minor were being persecuted for their failure to worship the emperor, as depicted in the book of Revelation.

Table 7. Roman Emperors (31 BC–AD 117)

31 BC-AD 14 – Augustus

AD 14-37 – Tiberius

AD 37-41 – Caligula

AD 41-54 – Claudius

AD 54-68 – Nero

AD 68-69 – Galba

AD 69 – Otho

AD 69 – Vitellius

AD 69-79 – Vespasian

AD 79-81 – Titus

AD 81-96 – Domitian

AD 96-98 – Nerva

AD 98-117 – Trajan

Military

Military expeditions expanded Rome’s control of foreign territories and safeguarded its borders from incursion, most threateningly from the Germanic tribes east of the Rhine River and north of the Danube River and from the Parthian (= Neo-Persian) Empire east of the Euphrates River. A Roman legion consisted of around six thousand men, including cavalry. Under Tiberius, there were twenty-five legions stationed across the empire: eight on the Rhine, three in Spain, two in Egypt, four in Syria, two in Africa, and six in the Danube region. In terms of command structures, the legions were under the control of certain regional commands by men of consular rank, including two on the Rhine, one in Spain, one in Syria, and three in the Balkans (Tacitus, Ann. 4.5). These were among the most powerful persons outside the ruling family and could be kingmakers or contenders during times of civil war. A legion was divided into ten cohorts and commanded by a legate, usually of senatorial rank. Units of one hundred were commanded by centurions, and service in the legions was set at between twenty and twenty-five years. Upon recruitment, the soldier swore an oath of loyalty to the emperor (sacramentum) that was renewed annually. During times of peace, Roman soldiers could perform a number of civil tasks relating to taxation, building projects, and policing.

Centurions are mentioned several times in the NT (e.g., Matt. 8:5; Mark 15:39; Acts 10:1; 21:32; 27:1). There is a mention of a “legion” of demons that oppressed the Gerasene demoniac (Mark 5:9), and Jesus refers to the possibility of the Father sending him “legions” of angels (Matt. 26:53). Military terminology is very apparent in Paul’s letters, where he refers to fighting armor (Rom. 13:11–13; 2 Cor. 6:7; Eph. 6:10–18), compares commitment to Christ to military service (2 Tim. 2:4), refers to his coworkers as “soldiers” or “fellow soldiers” (Phil. 2:25; Philem. 2; 2 Tim. 2:3), and likens ministerial remuneration to a soldier being paid his salarium (1 Cor. 9:7).

Culture and Religion

One of the primary reasons for Rome’s rise and dominance, militarily and culturally, was its capacity to absorb other peoples and even other gods into its constituency and pantheon. Its constantly growing pantheon, application of the rule of law, and superior military force made Rome what it was: a melting pot of all cultures and a Romanizer of other cultures.

Roman society was heavily stratified, but social mobility, upward and downward, was possible. Wealth, marriage, education, and military exploits were the primary means to social advancement. The senatorial class represented the wealthy nobility of Rome and provided the primary cohort of civil and military administrators. The equestrian class (or “knights,” as they are sometimes called) were a larger group of less wealthy Roman citizens. Decurions were members of civil councils in provincial cities who often acted as magistrates and were leaders of local communities. The plebeians represented the general citizenry of Rome, who, until the time of Tiberius, had some power in electing officials. Finally, there were freedmen, who were ex-slaves usually in a relationship with their former master, and also slaves, who were regarded as little more than property.

The ancient Roman religions focused on the numen, the somewhat impersonal divine power associated with certain localities. From the third century BC, Greek deities were assimilated and Romanized, so that Zeus became Jupiter, and Vesta was identified as Hestia. The Capitoline Hill was crowned with a temple that was dedicated around 500 BC to Jupiter, Minerva, and Juno. These were the principal gods of Rome, although others were added to the pantheon as the Romans conquered other peoples and adopted their gods. Other gods also received greater honor, such as the goddess Pax, the personification of peace (based on the Greek goddess Eirene); Vespasian built and dedicated a temple in her honor in Rome in AD 75. The Roman emperor was the Pontifex Maximus and supreme high priest of Rome and the empire. In the mid- to late first century AD, the fastest-growing religion was the imperial cult, the worship of (usually) deceased Roman emperors. This cult became popular in the eastern Mediterranean cities, where worship of rulers was commonplace, but was regarded with indifference in Rome.

Religions and philosophies from all over the known world eventually made their way to Rome. Egyptian rites and religions gained followings, Mithraism acquired currency within the ranks of the military and among public servants, Judaism entered Rome probably with the Hasmonean delegation sent there around 139 BC, and Christianity came to Rome probably during the late 30s and early 40s of the first century AD through Jewish pilgrims visiting the east and through Judean immigration to Rome. Many Roman intellectuals lamented the fact that so many foreign superstitions had found their way to Rome, and that Roman peoples found them more attractive than their own state religion. Roman religion was largely controlled by the state through a set calendar and the appointment of priests and vestal virgins. It was practiced in public and in the home. As such, religious life was very much intertwined with social and political life. Roman religion engendered the need for its citizens to act with pietas, the honoring of one’s obligations to the gods, and with religio, which designated appropriate scruples and rites in the presence of the gods.

Summary

The birth of the church and the growth of Christianity took place within the wider social, religious, and cultural context of the Greco-Roman world. The politics and power of the Roman Empire provide the backdrop for the birth of Jesus (Luke 2:1), and since Rome was considered to be the center of the world, it was necessary that Paul himself testify to Jesus Christ there (Acts 19:21). The history, literature, and cultural background of Rome form an important background to the NT and should be studied along with the history and literature of Judaism during the time of Jesus and the apostles. Although the Romans were the primary threat to the survival of Christians in the ancient world, after the conversion of Constantine in the fourth century AD, they became the primary means by which Christianity spread to the rest of Europe and western Asia. See also Roman Law.

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

The common experience/sharing of something with someone else. In the NT, the most common Greek word group to express this idea has the root koin- (“common”), with the cognate verb koinōneō, noun koinōnia, and adjective koinos. But the concept of fellowship extends well beyond this single word family and finds expression in a variety of different contexts.

Fellowship between the Members of the Trinity

The Gospel of John makes several claims about the fellowship that the members of the Trinity have experienced with each other from all eternity. Jesus claims, “I and the Father are one” (10:30) and “It is the Father, living in me, who is doing his work” (14:10). Regarding the Holy Spirit, Jesus says, “He will glorify me because it is from me that he will receive what he will make known to you. All that belongs to the Father is mine” (16:14–15). The Son has even shared in the Father’s glory from before the creation of the world (17:5). Within the unity of the Godhead, the individual members experience perfect fellowship as they share in the fullness of deity.

Fellowship between Jesus and Outcasts

During his earthly ministry, Jesus modeled God’s love for the marginalized by associating with them. Such fellowship often took the form of sharing meals with outcasts such as tax collectors and sinners (Mark 2:15–17; Luke 5:29–32; 7:36–50; 19:1–10), a practice that provoked sharp criticism from the Pharisees (Luke 15:1–2). In Luke 15:3–32, Jesus tells three parables in response to such criticism. These parables indicate that his fellowship with sinners demonstrates God’s love for the lost and the joy that comes from restored fellowship with God. Such table fellowship served as a foretaste of the eschatological messianic banquet, when all of God’s people (Jew and Gentile alike) will eat together in the kingdom of God as the fellowship of the forgiven (Matt. 8:11; Luke 13:29–30; Rev. 19:6–9).

Fellowship between Believers and God

The close and intimate fellowship that the members of the Trinity experience with one another is something that Jesus prays for his people to experience themselves (John 17:20–26). He asks that believers “may be one, Father, just as you are in me and I am in you. May they also be in us so that the world may believe that you have sent me” (17:21). Just as the Father is in Jesus and Jesus is in the Father, believers are described as being in both the Father and the Son. The stated purpose for such fellowship is twofold: that the world may know and believe that the Father has sent the Son, and that the Father loves believers even as he has loved the Son (17:21, 23). Central to this fellowship between God and believers is the sharing of the glory that the Father and the Son experience (17:22). Jesus expresses similar truths in John 15:1–11 when he speaks of himself as the true vine and his followers as the branches who must remain in him because “apart from me you can do nothing” (v. 5).

Although fellowship with God is something that Christ has purchased for his people through his death and resurrection, it can be broken by sin in the believer’s life: “If we claim to have fellowship with him and yet walk in the darkness, we lie and do not live out the truth” (1 John 1:6). When sin does break a believer’s fellowship with God, we are reassured, “If we confess our sins, he is faithful and just and will forgive us our sins and purify us from all unrighteousness” (1:9). This restoration of fellowship is based on the work of Jesus to plead our case before the Father (2:1).

Paul frequently speaks of the believer’s fellowship with Christ, even though he rarely uses the word “fellowship” to speak of this reality. It is God who calls the believer into fellowship with Christ (1 Cor. 1:9), but such fellowship involves both the “power of his resurrection and participation in his sufferings, becoming like him in his death” (Phil. 3:10). When believers celebrate the Lord’s Supper, they are participating in the body and blood of Christ (1 Cor. 10:16–17). Far more frequently, Paul expresses the concept of fellowship with Christ by his use of the phrase “with Christ.” Believers have been crucified, buried, raised, clothed, and seated in the heavenly realms with Christ (Rom. 6:4–9; 2 Cor. 13:4; Gal. 2:20–21; Eph. 2:5–6; Col. 2:12–13; 3:1–4). They also share in the inheritance that Christ has received from the Father (Rom. 8:16–17) and one day will reign with him (2 Tim. 2:12).

Fellowship between Believers and Others

The fellowship that believers have with one another is an extension of their fellowship with God. John wrote, “We proclaim to you what we have seen and heard, so that you also may have fellowship with us. And our fellowship is with the Father and with his Son, Jesus Christ” (1 John 1:3). Just as walking in darkness falsifies a believer’s claim to fellowship with God, so also walking in the light is necessary for fellowship with other believers (1:6–7). Paul strikes a similar note when he says, “Do not be yoked together with unbelievers. For what do righteousness and wickedness have in common? Or what fellowship can light have with darkness? What harmony is there between Christ and Belial? Or what does a believer have in common with an unbeliever?” (2 Cor. 6:14–15). The point is not to avoid all contact with unbelievers (cf. 1 Cor. 5:9–10), but rather that the believer is so fundamentally identified with Christ that to identify with unbelievers should be avoided.

Because they are joined to Christ by faith, believers share a wide variety of experiences and blessings with each other. In the broadest sense, they share in the gospel and its blessings (1 Cor. 9:23; Phil. 1:5–7; Philem. 6; 2 Pet. 1:4), especially the Spirit (2 Cor. 13:13–14; Phil. 2:1). But the most common shared experience is suffering. When believers suffer because of their identification with Christ, they are said to share in Christ’s suffering (Phil. 3:10; 1 Pet. 4:13). In addition to this vertical element, there is a horizontal aspect. Because believers are united in one body (1 Cor. 12:12–13; Eph. 4:4–6), when one believer suffers, the entire body shares in that suffering (2 Cor. 1:7; Heb. 10:33; Rev. 1:9).

From the earliest days of the church, believers found very tangible ways to demonstrate that their fellowship was rooted in their common faith in Jesus. Immediately after Pentecost, “they devoted themselves to the apostles’ teaching and to fellowship, to the breaking of bread and to prayer. . . . All the believers were together and had everything in common” (Acts 2:42–44). This common experience led believers to voluntarily sell their possessions and share with any who had a need (2:45; 4:32). This meeting of very practical needs was motivated by a common experience of God’s abundant generosity in freely giving his Son (Rom. 8:32). The self-sacrificial sharing of resources became a staple of the early church (Rom. 12:13; Gal. 6:6; 1 Tim. 6:18) and provided an opportunity for Paul to demonstrate the unity of the church when he collected money from Gentile churches to alleviate the suffering of Jewish Christians in Judea (Rom. 15:26–27; 2 Cor. 8–9).

Conclusion

Biblical fellowship is not merely close association with other believers. The NT emphasizes what believers share in Christ rather than whom they share it with. True biblical fellowship between believers is an outworking of their fellowship with God through the gospel.

The place where the lost are assigned by God to eternal punishment of both body and soul (Matt. 10:28). This agony of eternal torment in hell is the greatest of all possible tragedies.

At times, there is confusion about this topic, since the English word “hell” is used in different ways in our English Bibles. Sometimes it is used to translate the Hebrew word she’ol or the Greek word hadēs, which refer generally to the place of the departed dead. Other times it is used more properly to translate the Aramaic-derived Greek word geenna, which refers to the place of the eternal punishment of the wicked following the final judgment. This second usage will be the focus of this present study.

This topic of the afterlife unfolded only gradually in Scripture. “Gehenna” originally referred to the Valley of Hinnom near Jerusalem, the location of the notorious sacrificial offerings of children by fire to the god Molek by Ahaz (2 Chron. 28:3) and Manasseh (2 Chron. 33:6). Later, the meaning of this term was extended to the place of fiery punishment in general. Still later, the geographic location of this place of punishment was shifted to under the earth, but the idea of fiery torment continued. By NT times, the Pharisees clearly believed in the punishment of the wicked in the afterlife.

It is primarily in the teachings of Jesus that the reality of a place of eternal punishment comes into clear focus. Jesus describes hell as involving unquenchable fire (Matt. 18:8–9; Mark 9:42–43, 48), a place where the worm does not die (Mark 9:48). Jesus also pictures the extreme anguish of those who suffer the ultimate punishment of being “thrown outside, into the darkness, where there will be weeping and gnashing of teeth” (Matt. 8:12).

The idea of a severe eternal punishment for the lost is also taught by the apostles. At the return of Christ, those living outside a proper relationship with God will experience sudden destruction (1 Thess. 5:3) when the angels will come “in blazing fire” and “punish those who do not know God and do not obey the gospel of our Lord Jesus” (2 Thess. 1:6–9). The author of Hebrews speaks of the “fearful expectation of judgment and of raging fire that will consume the enemies of God” (Heb. 10:27). Revelation describes how “the smoke of their torment will rise for ever and ever” (Rev. 14:11), and how the ungodly will be cast into “the fiery lake of burning sulfur” (21:8).

One significant controversy related to this topic is annihilation or conditional immortality (taught by, e.g., Seventh-Day Adventists and Jehovah’s Witnesses), where the lost cease to exist, either immediately following death or after a limited period of punishment. Appeals for this view are found in the language applied to the wicked such as “death” (Rom. 6:23; James 5:20), “destruction” (Matt. 7:13; 10:28), and “perishing” (John 3:16). Yet other Scriptures speak of the place of punishment as being where “the worms that eat them will not die, the fire that burns them will not be quenched” (Isa. 66:24), and where “God’s wrath remains on them [present tense]” (John 3:36), and as being “everlasting,” “eternal,” or “for ever” (Isa. 33:14; Matt. 18:8; 25:46; 2 Thess. 1:9; Rev. 20:10). Historic orthodoxy has generally maintained that the bliss of the redeemed and the punishment of the unsaved will continue for all eternity.

Another controversy involves universalism, the belief that ultimately all will be saved following death, possibly after a period of punishment. Yet this view, as attractive as it might be to human nature, falls short of the teachings of Scripture about “the coming wrath” for the ungodly (Matt. 3:7). The Roman Catholic belief in purgatory and the practice of praying for the dead represent other denials of the standard position that one’s eternal destiny is inevitably fixed at the time of death.

Another question involves how literally or figuratively to take the language of unquenchable fire and worms that do not die (Mark 9:48). Will the fire be the same as the fire that we know on earth? And will there be literal worms? It is best to conclude simply that such punishment will be the worst that we can possibly imagine. Jesus clearly and emphatically warns about the dangers of hell as the greatest of all tragedies, characterized by “weeping and gnashing of teeth” (an expression found seven times in the Gospels).

There is also the question of whether there will be degrees of punishment in hell. In Mark 12:40 Jesus implies that there will be degrees of punishment, telling of hypocrites who will receive greater condemnation, and in Luke 12:47–48 speaking of some who will “be beaten with many blows,” whereas others who have less knowledge of their master’s will will “be beaten with few blows.” The underlying principle both in the degrees of reward in glory and in the degrees of punishment in hell is this: “From everyone who has been given much, much will be demanded; and from the one who has been entrusted with much, much more will be asked” (Luke 12:48).

The practice of receiving strangers in order to offer provision and protection was an important concept in many of the cultures throughout the time period of both Testaments.

Hospitality first appears in Abraham’s care of the strangers who visit him in Gen. 18. The strangers in turn reveal God’s imminent fulfillment of his promise to provide a child to Abraham and Sarah. Thus, they return the good favor and kindness that they have received, which is the expected pattern of mutual goodwill that characterizes hospitality.

The unusual hospitality of Rebekah in offering water for Abraham’s servant’s camels distinguishes her as the wife whom God had appointed for Isaac (Gen. 24:1–49).

Part of the sin of Sodom and Gomorrah is that the men violate hospitality norms by demanding that the visiting angels have sex with them, which is in deep contrast to Lot’s attempt to welcome and protect the visitors (Gen. 19:1–9; see also Ezek. 16:49–50).

A conviction of the people of Israel is that God is their host in the promised land (Lev. 25:23). Jesus frequently is the beneficiary of the hospitality of others in the Gospels, and he sends out his disciples relying on it (Luke 9:1–4; 10:1–9). The messianic banquet is a theme of Jesus’ teaching on the kingdom of God (Matt. 8:11; 22:1–14; Luke 14:16–24). Hospitality is also commanded to be an aspect of early Christian communities, and it is a spiritual gift (Rom. 12:8, 13; Heb. 13:2; 1 Pet. 4:9).

Laying hands on someone/something has two literal uses and two with symbolic significance. (1) Literally, to take something (e.g., Exod. 22:8–11; Esther 9:10–16; Matt. 26:51; Luke 9:62) or someone—that is, to make an arrest (e.g., Neh. 13:21; Matt. 26:50; Mark 14:46; Luke 20:19; 21:12; 22:53; John 7:30, 44; Acts 4:3; 5:18; 12:1; 21:27). (2) Literally, to lay hands on persons (or things) so as to hurt or destroy them (e.g., Gen. 22:12; 37:22; 1 Sam. 22:17; 24:5–13; 26:9–23; Job 1:12; 9:33; Isa. 11:14; Jer. 15:6; Ezek. 39:21). (3) Laying a hand over one’s mouth as a symbolic gesture of amazement (Mic. 7:16) or humility (Job 40:4). (4) A gesture to symbolize the transfer of something from one person to another. Transfer symbolism applications include the transfer of representative identity in sacrificing (e.g., Exod. 29:10–19; Lev. 1:4; 16:21; Num. 8:10–12; 2 Chron. 29:23–24), of authority in commissioning (ordination) (e.g., Num. 27:18–23; Deut. 34:9; Acts 6:6; 13:3), of blessing (e.g., Gen. 48:13–20; Matt. 19:13–15), of life and health (e.g., Matt. 8:3, 15; 9:18, 25, 29; 20:34; Mark 6:5; 7:32–33; 8:22–26; 16:18; Luke 4:40; 7:14; 13:13; 22:51; Acts 8:17; 9:12, 17; 28:8), and of the Holy Spirit and spiritual gifting (Acts 8:17–19; 9:17; 19:6; 1 Tim. 4:14; 2 Tim. 1:6).

Three additional things should be noted about this transfer symbolism. First, the laying on of hands is symbolic rather than purely causative. This is evidenced when Jesus and the apostles credit faith, and not mere touch, for healings (e.g., Matt. 9:22, 29–30; Luke 17:19; Acts 3:12–16; 14:9; cf. Matt. 13:58), when healings occur from a distance (e.g., Matt. 8:5–13; 15:21–28; John 4:46–54) and/or with no apparent touch involved (e.g., Matt. 8:28–34; 9:1–8, 32–33; 12:22; 17:14–21; Mark 1:23–28; Luke 17:11–19; John 5:1–9; 11:1–44; Acts 5:15; 9:32–35, 40–41; 14:8–10; 16:18), when the Holy Spirit comes upon people without touch (e.g., Acts 10:44–45), and when Peter strongly rebukes Simon Magus for assuming that the Holy Spirit is dispensed by mere touch (Acts 8:17–24).

Second, the early church used the laying on of hands for commissioning church workers (Acts 6:6), missionaries (Acts 13:3), and elders (Acts 14:23 [the Greek word used for “appointing,” cheirotoneō, is derived from the words for “extend,” teinō, and “hand,” cheir; cf. 2 Cor. 8:19). Since the act was conducted by apostles (Acts 6:6), by prophets and teachers (Acts 13:1–3), by Paul and Barnabas (Acts 14:23; 2 Tim. 1:6), and by church elders (1 Tim. 4:14), we may conclude that the early church had no established hierarchy for ordination.

Third, the NT has some guidelines for commissioning Christian workers (cf. Heb. 6:2). Church leaders have weighty responsibilities (Acts 20:28; 1 Tim. 3:1–13; 5:17; Titus 1:5–9; 1 Pet. 5:1–4), so it is not surprising that a church elder/overseer must not be a recent convert (1 Tim. 3:6) or hastily ordained (1 Tim. 5:22), and that a deacon must first be tested (1 Tim. 3:10).

(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).

Behind the English translation “mercy” lie diverse biblical words in Hebrew (khesed, khanan, rakham) and in Greek (charis, eleos, oiktirmos, splanchnon). These words are also translated as “love,” “compassion,” “grace,” “favor,” “kindness,” “loving-kindness,” and so on, depending on context. Hence, a conceptual approach to the meaning of “mercy” is best.

God’s Mercy

Mercy as part of God’s character. Mercy is a distinguishing characteristic of the nature of God. God is called “the Father of mercies” (2 Cor. 1:3 NRSV [NIV: “Father of compassion”]). God is “rich in mercy” (Eph. 2:4; cf. 2 Sam. 24:14; Dan. 9:9). God’s mercy was demonstrated in his covenantal faithfulness to his people (1 Kings 8:23–24; Mic. 7:18–20). God redeemed the oppressed Israelites from slavery under Pharaoh because of his mercy, which was stirred when he heard their groaning and cry for help. Here, the rekindling of God’s mercy toward the Israelites was depicted in terms of remembering his covenant with Abraham, Isaac, and Jacob (Exod. 2:23–25). Mercy is a manifestation of God’s faithfulness to his covenant. Hence, God’s mercy to his covenant people never ceases (Pss. 119:132; 103:17).

God has absolute sovereignty in electing the people to whom he wills to show mercy. A classic expression appears in Exod. 33:19: “I will have mercy on whom I will have mercy, and I will have compassion on whom I will have compassion.” Paul quoted this to explain God’s sovereignty in electing Jacob as the recipient of God’s mercy (Rom. 9:13–15). God’s mercy cannot be acquired by human effort or desire (Rom. 9:16). God even ordered the Israelites to show no mercy to the Canaanites because of their corruption and idolatry (Deut. 7:2).

Diverse images are used to describe God’s mercy. God is compared to a loving father who has compassion on his children (Jer. 31:20; Mal. 3:17). “As a father has compassion on his children, so the Lord has compassion on those who fear him; for he knows how we are formed, he remembers that we are dust” (Ps. 103:13–14). God’s compassion is also compared to that of a nursing mother who feeds her baby at her breast (Isa. 49:15). The images of the loving father and the loving mother reflect closely the heart of God’s mercy toward his chosen people. God is especially merciful to the needy, the weak, the afflicted, and the oppressed (Exod. 2:23–24; Ps. 123:2–3; Isa. 49:13; Heb. 4:16). God is called “a father to the fatherless” and “a defender of widows” (Ps. 68:5). Sinners appeal for God’s mercy when they request forgiveness (Ps. 51:1). “Have mercy on me” is a common form of expression when the psalmist entreats God for his forgiveness (Pss. 41:4, 10; 51:1). God’s mercy is also shown in his act of salvation and blessing (Exod. 15:13; Deut. 13:17–18; Judg. 2:18; Eph. 2:4–5).

God’s mercy in redemptive history. Redemptive history is a successive demonstration of God’s mercy toward his chosen people. It was because of God’s mercy that he took the initiative to save fallen human beings (Gen. 3:15). Death was the due penalty for Adam and Eve (Gen. 2:17), but God preached the good news of mercy that the descendant of the woman would someday crush the head of the serpent. In Rev. 20:2 that ancient serpent in the garden of Eden is identified as “the devil, or Satan,” whose head was crushed by Jesus Christ on the cross and is bound by the coming Messiah “for a thousand years” and will be “thrown into the lake of burning sulfur” (Rev. 20:2, 10). In spite of God’s judgment on Cain, the first murderer, God showed mercy by putting a mark on him so that no one would kill him (Gen. 4:15). As the psalmist later confesses, God proves himself as the merciful God who “does not treat us as our sins deserve or repay us according to our iniquities” (Ps. 103:10).

Noah and his family were saved from the judgment of the flood because of God’s special mercy toward them (Gen. 6:8). Immediately after God confused the languages of human beings because of their challenge to him (Gen. 11:1–9), God showed mercy on Abram, “a wandering Aramean” (Deut. 26:5), and designated him to be the father of his chosen people (Gen. 12:1–3). Jacob’s election originated solely from God’s mercy, as Paul pointed out by quoting Scripture: “Jacob I loved, but Esau I hated” (Rom. 9:13). The exodus is also the clearest evidence of God’s demonstration of mercy toward his chosen people (Exod. 2:23–25). They were saved not by their own righteousness but rather by God’s mercy on the covenant people, who suffered under the bondage of Pharaoh’s slavery. God’s mercy reached its climax when he sent his only Son, Jesus Christ, to save sinners (Rom. 5:8). It is because of God’s mercy that we are saved, not because of our righteousness (Titus 3:5).

Christ’s Mercy

Jesus Christ lived a life full of mercy. He is, in a sense, the bodily manifestation of God’s mercy. Jesus expressed deep mercy whenever he saw the sick and the lost. The writers of the Gospels describe Jesus’ demonstrations of mercy when he healed the blind, the lame, the deaf, the leprous, the demon-possessed, and the dead (Matt. 9:36; 14:14; 20:34; Mark 1:41; 5:19; 6:34; 8:2; Luke 7:13; John 11:33). Jesus especially had compassion on the crowds, who did not have a spiritual leader, and he compared them to “sheep without a shepherd” (Matt. 9:36).

Jesus’ ministry of healing and evangelism was motivated by his deep mercy and compassion toward people in physical and spiritual need (Luke 4:16–21; cf. Isa. 61:1–2). Whenever the sick appealed to his mercy, Jesus never refused to dispense it to them (Matt. 15:22; 17:14–18). For example, he healed the two blind men who entreated his mercy (Matt. 20:30–34). When a leper, kneeling before him, entreated his mercy, Jesus touched him (risking his own uncleanness according to the law) and healed him (Matt. 8:2–3). When a centurion asked for Jesus’ mercy on his sick servant, he was willing to go and heal the sick man (Matt. 8:5–13). Jesus’ mercy was aroused especially when he saw people crying for the dead, and even he shed tears (John 11:33–35). When Jesus saw a widow crying for her dead son during a funeral procession, he comforted and had compassion on her and made her son alive (Luke 7:12–15).

According to Heb. 2:17–18, Jesus became “a merciful and faithful high priest” to make atonement for the sins of his people. He is also compared to the high priest who is able to sympathize with our weaknesses because he “has been tempted in every way, just as we are” (Heb. 4:15). His high priestly work on earth was highlighted in terms of his ministry of mercy toward his people. Like God’s mercy, Jesus’ mercy was shown in his actions of salvation (Luke 19:10; Eph. 5:2; 1 Tim. 1:14–16; Titus 3:4–7), of blessing (Mark 10:13–16), and of forgiveness (Mark 2:10; Luke 23:34). Paul’s personal experience led him to confess, “He saved us, not because of righteous things we had done, but because of his mercy” (Titus 3:5). Jesus’ character of mercy was most vividly manifested on the cross when he prayed for the forgiveness of the crucifying soldiers and the cursing crowds (Luke 23:33–37).

Human Response to God’s Mercy

What is the proper response to God’s mercy and compassion? God expects believers to show the same kind of mercy toward other people. One of the best examples is the parable of the unmerciful servant (Matt. 18:23–35). The central focus of this parable is on the unmerciful servant, to whom a tremendous mercy is shown by the king, but who refuses to show a little mercy to his fellow servant. The parable concludes with the king’s statement that no mercy will be shown to those who do not show mercy and forgiveness to others. Hence, a forgiving attitude is a must for believers, who have received immeasurable mercy from God when he forgave their sins at the time of repentance. The Lord’s Prayer also includes the believer’s forgiveness of others as being inseparably linked to the request for forgiveness from God (Matt. 6:12). Jesus affirms this idea in a subsequent statement: “For if you forgive other people when they sin against you, your heavenly Father will also forgive you. But if you do not forgive others their sins, your Father will not forgive your sins” (6:14–15).

Mercy is one of the eight blessings in the Beatitudes: “Blessed are the merciful, for they will be shown mercy” (Matt. 5:7). Jesus’ response to the critical Pharisees reveals that our merciful life should precede our religious life (9:13). According to the parable of the good Samaritan (Luke 10:25–37), the true neighbor is the one who shows mercy to the afflicted. Its conclusion, “Go and do likewise” (10:37), requires believers to show mercy to their suffering neighbors. At the last judgment the righteous are characterized by their lives of showing mercy to the hungry, the thirsty, the stranger, the unclothed, the sick, and the imprisoned (Matt. 25:37–40). In Luke 6:36, Jesus summarizes the law of mercy: “Be merciful, just as your Father is merciful.” According to James, “judgment without mercy will be shown to anyone who has not been merciful”; however, “mercy triumphs over judgment” (James 2:12–13). And according to the prophets, a merciless life is characteristic of godless people (Isa. 13:18; Jer. 6:23; 21:7; 50:42; Amos 1:11–12).

It is by God’s mercy that believers can persevere during the time of suffering (2 Cor. 4:1). Their prayer is the channel through which they draw God’s mercy. Hence, the writer of Hebrews exhorts believers to “approach God’s throne of grace with confidence, so that we may receive mercy” (Heb. 4:16).

A town in Egypt near the location of a 1945 archaeological discovery in which numerous gnostic Christian texts were found, including works such as the Gospel of Thomas, the Apocryphon of James, the Gospel of Truth, the Gospel of Philip, the Dialogue of the Savior, the Apocalypse of Peter, and many others. Nag Hammadi is located over three hundred miles south of Cairo along the Nile River. A group of Egyptian peasants found thirteen papyrus manuscripts at the base of a cliff, and they contained a total of over fifty different works. Nearly all of these writings are gnostic Christian in nature, though a few, such as Plato’s Republic, are not. The manuscripts, dated to the fourth century AD, are written in Coptic (an Egyptian language, written using an adapted Greek alphabet) and are in codex (book) form. They are currently housed in the Coptic Museum in Cairo.

Gnosticism

Commonly referred to as the Nag Hammadi Library, this group of texts has shed a great deal of light on the early Christian gnostic movements that were present during the second through fourth centuries AD and beyond. While some early church fathers provided commentary and criticism of gnosticism in their own works, the Nag Hammadi discovery has provided the opportunity to see firsthand the writings and thought of this movement, which was branded heretical by many of the earliest Christian leaders.

The term “gnosticism” derives from the Greek word for “knowledge” (gnōsis). Gnostics, then, were those who placed an emphasis on knowledge, often of a secret or hidden nature. Saving knowledge, according to gnostic belief systems, comes by revelation from a transcendent realm. This revelation typically is available through a revealer who comes to show people the true knowledge of God and self, the two of which are often intertwined, since gnostics consider the true self to be of divine origin. Salvation of the self includes returning to the divine world from which it came. Therefore, in Christian versions of gnosticism Jesus is portrayed as the revealer of this hidden knowledge needed for salvation, the returning of the self to its divine origin. The gnostic movement was not confined to Christianity, as gnostics quite often adapted their myths to make them compatible with other religions with which they came into contact.

The Gospel of Thomas

Among the writings found at Nag Hammadi, the Gospel of Thomas is the best known. It contains a collection of 114 sayings attributed to Jesus. Unlike the NT Gospels, the Gospel of Thomas contains no narrative material; Jesus performs no miracles or healings, none of his travels are described, and there is no passion or resurrection story. Instead, it contains only a list of Jesus’ sayings, with the occasional reply or question from his disciples. This has led some to conclude that the Gospel of Thomas is similar in genre to the hypothetical Q document, which may have been a source for the Gospel of Matthew and the Gospel of Luke. However, even Q allegedly includes some narrative material (e.g., Matt. 4:1–11 // Luke 4:1–13; Matt. 8:5–13 // Luke 7:1–10).

Many of the sayings in the Gospel of Thomas have parallels in the NT Gospels, including the following:

Jesus said, “Often you have desired to hear these sayings that I am speaking to you, and you have no one else from whom to hear them. There will be days when you will seek me and you will not find me.” (Gos. Thom. 38; cf. John 7:32–36)

Jesus said, “Whoever blasphemes against the Father will be forgiven, and whoever blasphemes against the Son will be forgiven, but whoever blasphemes against the Holy Spirit will not be forgiven, either on earth or in heaven.” (Gos. Thom. 44; cf. Matt. 12:31–32; Mark 3:28–30; Luke 12:10)

Jesus said, “Show me the stone which the builders have rejected. That one is the corner-stone.” (Gos. Thom. 66; cf. Mark 12:10–11)

Because of these similarities, the question has arisen concerning the relationship between the Gospel of Thomas and the NT Gospels. Some have suggested that, in fact, the Gospel of Thomas is the earliest of all the Gospels. This claim has been rejected by the overwhelming majority of scholars, who have instead concluded that the Gospel of Thomas reflects a later development of the sayings of Jesus that have been largely shaped out of a desire to reflect gnostic ideas. The strong gnostic theology prevalent in the Gospel of Thomas is on display in, for example, sayings 83 and 84:

Jesus said, “Images are visible to people, but the light within them is hidden in the image of the Father’s light. He will be disclosed, but his image is hidden by his light.”

Jesus said, “When you see your likeness, you are happy. But when you see your images that came into being before you and that neither die nor become visible, how much you will have to bear!” (Gos. Thom. 83–84)

Apocryphal Gospels and Apocalypses

Other apocryphal Gospels are among the works found at Nag Hammadi. The Gospel of Truth is not of the Gospel genre per se, but rather its title reflects the text’s claim to be telling the “good news” of the salvific work of Jesus, albeit from the perspective of early gnosticism. The Gospel of Philip is concerned primarily with the issue of sacraments within a gnostic understanding of human existence after physical death. In the Gospel of Mary there is a dialogue between the risen Jesus and his disciples, which is followed by Mary Magdalene receiving a special revelation from the Savior.

In addition to Gospels, the Nag Hammadi texts include several apocalypses, including the Apocalypse of Paul, the First Apocalypse of James and the Second Apocalypse of James, the Apocalypse of Adam, and the Apocalypse of Peter. These generally purport to give an account of a revelation seen by a well-known figure, especially an apostle (e.g., Peter, James, Paul). None of these works are considered to be accounts of the actual apostles; rather, they were written pseudonymously.

In modern cosmology, “outer space” refers to the vast expanse of the universe that lies beyond the earth’s atmosphere. Within the Bible, the sky and anything beyond it—including the space traversed by the sun, the moon, and the stars, as well as the cosmic region in which the divine court exists—are referred to by the term “heaven(s)” (Heb. shamayim; Gk. ouranos [sg.], ouranoi [pl.]). The abode of the sun, the moon, and the stars is most naturally equated with the modern concept of outer space, but the equation is somewhat artificial because the ancient conception of this region was comprehensively different from the modern understanding. For example, there is little indication that the Bible’s ancient audience would have understood that the stars populating the heavens are significantly larger than the earth and are many light-years distant. Such ideas had no significant bearing on the more important information that the writers of the Bible sought to convey. By way of contrast, biblical authors wrote according to commonly held notions of the structure of the universe (without offering explicit judgment about their veracity) in order to make theological points clear to their audience.

By the time of the NT, there apparently were a variety of views of the structure of the heavens. Some held that there was just one heaven, others three, five, or seven. Typically, the highest heaven was the special abode of God.

No expression equivalent to “outer space” exists in the Bible, and the closest parallel lies in references not to space beyond the earth’s atmosphere but to uninhabited wilderness (e.g., Ps. 55:7) or even to a place of judgment and punishment (Matt. 8:12). This highlights the difference between the conceptual worlds of the original settings of the biblical texts and those of their modern readers.

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

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

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

Ancient Near Eastern Influences

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

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

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

Biblical Concept of Disease

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

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

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

Circulatory Diseases

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

Paralysis

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

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

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

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

Mental Illness and Brain Disorders

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

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

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

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

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

Childhood Diseases

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

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

Infectious and Communicable Diseases

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

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

Parasitic Diseases

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

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

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

Physical Deformities and Abnormalities

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

Diseases and Disabilities of the Eyes and Ears

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

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

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

Skin Conditions

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

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

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

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

Ailments of an Unknown Nature

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

The historical origins of Christianity need to be set against Jewish history, beliefs, and culture in Palestine and the eastern Mediterranean, but they also need to be set in the context of the wider Greco-Roman world that was dominated politically and militarily by the Roman Empire.

From Republic to Empire

Rome began as a city-state but soon became a transcontinental empire reaching over parts of Europe, Africa, and Asia. Rome emerged as the most dominant force in the Mediterranean after it defeated Carthage in the Second Punic War (218–201 BC). Thereafter, Rome began to expand its control and power over the various Hellenistic city-states in the east, including Macedonia, Illyria, and Asia Minor. By the mid-first century AD, Rome had also conquered or annexed Syria, Palestine, Egypt, Cyrene, Gaul, Spain, North Africa, and Armenia.

The transition from the Roman Republic to the Roman Empire took place under the Roman emperors beginning with Julius Caesar (100–44 BC), who, after crossing the Rubicon and defeating Pompey, was proclaimed dictator perpetuus (“dictator for life”). The period after Julius Caesar’s assassination (44 BC) was a time of political upheaval as Rome was marred by a series of civil wars. The first was between Octavius and Antony against Caesar’s assassins Brutus and Cassius. This climaxed in the Battle of Philippi (42 BC), which the former allies of Julius Caesar won. The second was between Octavius and Antony, where Antony and Cleopatra were defeated at the Battle of Actium in 31 BC, leaving Octavius as the undisputed leader of Rome.

Octavius was given the honorific name “Augustus” by the senate. His reign (31 BC–AD 14) marked a period of consolidation, reorganization, and renewal of the Roman Empire. Augustus embarked on an empire-wide policy of fiscal rationalization, developed a constitutional settlement for Rome, centralized his military authority over the various provinces, and had Julius Caesar deified. Writers and artists of the era heralded Augustus’s reign as a time of unprecedented peace and security—peace from civil war and security from the Germanic tribes in the north and the Parthian Empire in the east. Worship of the emperor became more frequent especially in the Roman East, although Augustus did not permit it in Rome. What is most significant about Augustus is that it is with his reign that the Roman Empire essentially began. He was the emperor at the time of Jesus’ birth (Luke 2:1). It was under Trajan (AD 98–117), however, that the Roman Empire expanded to its largest area, encompassing parts of Britain and Persia.

Emperors (AD 14–98)

Tiberius, Augustus’s adopted heir, reigned in the years AD 14–37. He was a highly successful military general, but as emperor he was remembered as being gloomy and melancholic. Tiberius even went into a self-imposed exile for a time, leaving the praetorian prefect Sejanus in charge until Tiberius finally had him executed for treason. It was during the reign of Tiberius that Jesus conducted his ministry in Palestine.

Tiberius was succeeded by his adopted grandson Caligula, who reigned in the years AD 37–41. Caligula was the son of the popular Roman general Germanicus, who died in Antioch in AD 19. Historical sources are not favorably disposed toward Caligula, who was remembered as a malevolent tyrant given to self-aggrandizement and sexual perversity. In AD 39/40 Caligula departed from imperial policy that permitted emperor worship in the east and veneration of deceased emperors in Rome, and he often appeared dressed as a god in public and demanded worship as a living god. During this time he deposed Herod Antipas, the tetrarch of Galilee and Perea, on suspicion of consorting with Parthia (Josephus, Ant. 18.7). Caligula also ordered that his statue be placed in the holy of holies in the Jerusalem temple (Philo, Embassy 203). Petronius, the governor of Syria, knowing that such an act would lead to civil war, refused to comply and appealed to Caligula to reverse the order. In response, Caligula sent an order to Petronius that he commit suicide. Fortunately, news of Caligula’s assassination by a conspiracy involving the praetorian guard and senators reached Petronius first.

Claudius, Caligula’s uncle, reigned in the years AD 41–54, and his rule was defined by numerous public works, a reordering of the judicial system, a torrid series of marriages, the conquest of Britain, and a number of attempted coups by the Roman senate. In AD 49 he expelled the Jews from Rome because of disputes about a certain “Chrestus,” probably Christ (cf. Acts 18:2). No one is sure whether Claudius was murdered or died of old age, but he remained a sharp contrast to the brutal excesses of Caligula and Nero.

Nero, the stepson of Claudius, reigned in the years AD 54–68. The early period of his rule was marked by cultural endeavors and diplomatic efforts. The later years were, in contrast, distinguished by tyranny and self-aggrandizement. There was a Jewish revolt against Rome in Judea (AD 66–70) during Nero’s reign, and Vespasian was sent to pacify the territory. According to ancient sources, Nero accused Christians of starting the fire of Rome in AD 64 and subjected them to the cruelest of punishments, including crucifixion, being thrown to wild animals, and even being burned alive. It probably was during this time that the apostles Peter and Paul were martyred in Rome. Nero eventually was declared a public enemy by the Roman senate, and he committed suicide before he could be captured in AD 68. There arose a “Nero redivivus” legend, whereby many hoped or feared that Nero had not died in AD 68 but had fled to Parthia and would return to Rome in order to destroy it (Sib. Or. 4.119–124; 5.137–141, 361–396), and this arguably stands behind the imagery of Rev. 13:3; 17:8–11.

The suicide of Nero left a power vacuum in Rome, and AD 69 saw no less than four emperors ascend the throne: Galba, Otho, Vitellius, and finally Vespasian. Galba was governor of Hispania Tarraconensis and was invited to become emperor by the senate, but he was killed by the praetorian guard after they were bribed by the praetor Otho. Otho himself committed suicide after his forces were defeated by Vitellius, the commander of the legions on the Rhine. Vitellius became emperor, but he was fiscally irresponsible and murdered many of his rivals. The legions in the Danube, Egypt, Syria, and Judea had declared Vespasian emperor and marched on Rome. Vespasian controlled the grain supplies to Rome from Egypt and had a superior force. Vitellius’s forces were defeated at Bedriacum, and Vitellius went into hiding but eventually was killed in Rome. Vespasian was declared emperor by the senate, and so began the Flavian dynasty, which restored order after the chaos of civil war.

The Flavians ruled in the years AD 69–96. Vespasian (r. AD 69–79) consolidated the empire after its year of strife and instituted new taxes, such as the fiscus judaicus, a war reparation tax placed on all Jews and paid to the temple of Jupiter in lieu of the Jerusalem temple tax. Vespasian was succeeded by his sons Titus (r. AD 79–81) and Domitian (r. AD 81–96). When Vespasian sailed to Rome from Judea, Titus was left in charge of the siege of Jerusalem, which he completed and celebrated in a triumph in Rome in AD 72. This triumph is memorialized in the Arch of Titus, which depicts Roman soldiers bringing the vessels of the temple to Rome as part of the booty taken. Later Roman writers regarded Domitian as a malevolent and malicious tyrant (e.g., Tacitus, Suetonius), but this probably is an exaggeration caused partly by a desire to highlight the greatness of succeeding emperors such as Nerva and Trajan. It probably was during the reign of Domitian that some Christians in Asia Minor were being persecuted for their failure to worship the emperor, as depicted in the book of Revelation.

Table 7. Roman Emperors (31 BC–AD 117)

31 BC-AD 14 – Augustus

AD 14-37 – Tiberius

AD 37-41 – Caligula

AD 41-54 – Claudius

AD 54-68 – Nero

AD 68-69 – Galba

AD 69 – Otho

AD 69 – Vitellius

AD 69-79 – Vespasian

AD 79-81 – Titus

AD 81-96 – Domitian

AD 96-98 – Nerva

AD 98-117 – Trajan

Military

Military expeditions expanded Rome’s control of foreign territories and safeguarded its borders from incursion, most threateningly from the Germanic tribes east of the Rhine River and north of the Danube River and from the Parthian (= Neo-Persian) Empire east of the Euphrates River. A Roman legion consisted of around six thousand men, including cavalry. Under Tiberius, there were twenty-five legions stationed across the empire: eight on the Rhine, three in Spain, two in Egypt, four in Syria, two in Africa, and six in the Danube region. In terms of command structures, the legions were under the control of certain regional commands by men of consular rank, including two on the Rhine, one in Spain, one in Syria, and three in the Balkans (Tacitus, Ann. 4.5). These were among the most powerful persons outside the ruling family and could be kingmakers or contenders during times of civil war. A legion was divided into ten cohorts and commanded by a legate, usually of senatorial rank. Units of one hundred were commanded by centurions, and service in the legions was set at between twenty and twenty-five years. Upon recruitment, the soldier swore an oath of loyalty to the emperor (sacramentum) that was renewed annually. During times of peace, Roman soldiers could perform a number of civil tasks relating to taxation, building projects, and policing.

Centurions are mentioned several times in the NT (e.g., Matt. 8:5; Mark 15:39; Acts 10:1; 21:32; 27:1). There is a mention of a “legion” of demons that oppressed the Gerasene demoniac (Mark 5:9), and Jesus refers to the possibility of the Father sending him “legions” of angels (Matt. 26:53). Military terminology is very apparent in Paul’s letters, where he refers to fighting armor (Rom. 13:11–13; 2 Cor. 6:7; Eph. 6:10–18), compares commitment to Christ to military service (2 Tim. 2:4), refers to his coworkers as “soldiers” or “fellow soldiers” (Phil. 2:25; Philem. 2; 2 Tim. 2:3), and likens ministerial remuneration to a soldier being paid his salarium (1 Cor. 9:7).

Culture and Religion

One of the primary reasons for Rome’s rise and dominance, militarily and culturally, was its capacity to absorb other peoples and even other gods into its constituency and pantheon. Its constantly growing pantheon, application of the rule of law, and superior military force made Rome what it was: a melting pot of all cultures and a Romanizer of other cultures.

Roman society was heavily stratified, but social mobility, upward and downward, was possible. Wealth, marriage, education, and military exploits were the primary means to social advancement. The senatorial class represented the wealthy nobility of Rome and provided the primary cohort of civil and military administrators. The equestrian class (or “knights,” as they are sometimes called) were a larger group of less wealthy Roman citizens. Decurions were members of civil councils in provincial cities who often acted as magistrates and were leaders of local communities. The plebeians represented the general citizenry of Rome, who, until the time of Tiberius, had some power in electing officials. Finally, there were freedmen, who were ex-slaves usually in a relationship with their former master, and also slaves, who were regarded as little more than property.

The ancient Roman religions focused on the numen, the somewhat impersonal divine power associated with certain localities. From the third century BC, Greek deities were assimilated and Romanized, so that Zeus became Jupiter, and Vesta was identified as Hestia. The Capitoline Hill was crowned with a temple that was dedicated around 500 BC to Jupiter, Minerva, and Juno. These were the principal gods of Rome, although others were added to the pantheon as the Romans conquered other peoples and adopted their gods. Other gods also received greater honor, such as the goddess Pax, the personification of peace (based on the Greek goddess Eirene); Vespasian built and dedicated a temple in her honor in Rome in AD 75. The Roman emperor was the Pontifex Maximus and supreme high priest of Rome and the empire. In the mid- to late first century AD, the fastest-growing religion was the imperial cult, the worship of (usually) deceased Roman emperors. This cult became popular in the eastern Mediterranean cities, where worship of rulers was commonplace, but was regarded with indifference in Rome.

Religions and philosophies from all over the known world eventually made their way to Rome. Egyptian rites and religions gained followings, Mithraism acquired currency within the ranks of the military and among public servants, Judaism entered Rome probably with the Hasmonean delegation sent there around 139 BC, and Christianity came to Rome probably during the late 30s and early 40s of the first century AD through Jewish pilgrims visiting the east and through Judean immigration to Rome. Many Roman intellectuals lamented the fact that so many foreign superstitions had found their way to Rome, and that Roman peoples found them more attractive than their own state religion. Roman religion was largely controlled by the state through a set calendar and the appointment of priests and vestal virgins. It was practiced in public and in the home. As such, religious life was very much intertwined with social and political life. Roman religion engendered the need for its citizens to act with pietas, the honoring of one’s obligations to the gods, and with religio, which designated appropriate scruples and rites in the presence of the gods.

Summary

The birth of the church and the growth of Christianity took place within the wider social, religious, and cultural context of the Greco-Roman world. The politics and power of the Roman Empire provide the backdrop for the birth of Jesus (Luke 2:1), and since Rome was considered to be the center of the world, it was necessary that Paul himself testify to Jesus Christ there (Acts 19:21). The history, literature, and cultural background of Rome form an important background to the NT and should be studied along with the history and literature of Judaism during the time of Jesus and the apostles. Although the Romans were the primary threat to the survival of Christians in the ancient world, after the conversion of Constantine in the fourth century AD, they became the primary means by which Christianity spread to the rest of Europe and western Asia. See also Roman Law.

The historical origins of Christianity need to be set against Jewish history, beliefs, and culture in Palestine and the eastern Mediterranean, but they also need to be set in the context of the wider Greco-Roman world that was dominated politically and militarily by the Roman Empire.

From Republic to Empire

Rome began as a city-state but soon became a transcontinental empire reaching over parts of Europe, Africa, and Asia. Rome emerged as the most dominant force in the Mediterranean after it defeated Carthage in the Second Punic War (218–201 BC). Thereafter, Rome began to expand its control and power over the various Hellenistic city-states in the east, including Macedonia, Illyria, and Asia Minor. By the mid-first century AD, Rome had also conquered or annexed Syria, Palestine, Egypt, Cyrene, Gaul, Spain, North Africa, and Armenia.

The transition from the Roman Republic to the Roman Empire took place under the Roman emperors beginning with Julius Caesar (100–44 BC), who, after crossing the Rubicon and defeating Pompey, was proclaimed dictator perpetuus (“dictator for life”). The period after Julius Caesar’s assassination (44 BC) was a time of political upheaval as Rome was marred by a series of civil wars. The first was between Octavius and Antony against Caesar’s assassins Brutus and Cassius. This climaxed in the Battle of Philippi (42 BC), which the former allies of Julius Caesar won. The second was between Octavius and Antony, where Antony and Cleopatra were defeated at the Battle of Actium in 31 BC, leaving Octavius as the undisputed leader of Rome.

Octavius was given the honorific name “Augustus” by the senate. His reign (31 BC–AD 14) marked a period of consolidation, reorganization, and renewal of the Roman Empire. Augustus embarked on an empire-wide policy of fiscal rationalization, developed a constitutional settlement for Rome, centralized his military authority over the various provinces, and had Julius Caesar deified. Writers and artists of the era heralded Augustus’s reign as a time of unprecedented peace and security—peace from civil war and security from the Germanic tribes in the north and the Parthian Empire in the east. Worship of the emperor became more frequent especially in the Roman East, although Augustus did not permit it in Rome. What is most significant about Augustus is that it is with his reign that the Roman Empire essentially began. He was the emperor at the time of Jesus’ birth (Luke 2:1). It was under Trajan (AD 98–117), however, that the Roman Empire expanded to its largest area, encompassing parts of Britain and Persia.

Emperors (AD 14–98)

Tiberius, Augustus’s adopted heir, reigned in the years AD 14–37. He was a highly successful military general, but as emperor he was remembered as being gloomy and melancholic. Tiberius even went into a self-imposed exile for a time, leaving the praetorian prefect Sejanus in charge until Tiberius finally had him executed for treason. It was during the reign of Tiberius that Jesus conducted his ministry in Palestine.

Tiberius was succeeded by his adopted grandson Caligula, who reigned in the years AD 37–41. Caligula was the son of the popular Roman general Germanicus, who died in Antioch in AD 19. Historical sources are not favorably disposed toward Caligula, who was remembered as a malevolent tyrant given to self-aggrandizement and sexual perversity. In AD 39/40 Caligula departed from imperial policy that permitted emperor worship in the east and veneration of deceased emperors in Rome, and he often appeared dressed as a god in public and demanded worship as a living god. During this time he deposed Herod Antipas, the tetrarch of Galilee and Perea, on suspicion of consorting with Parthia (Josephus, Ant. 18.7). Caligula also ordered that his statue be placed in the holy of holies in the Jerusalem temple (Philo, Embassy 203). Petronius, the governor of Syria, knowing that such an act would lead to civil war, refused to comply and appealed to Caligula to reverse the order. In response, Caligula sent an order to Petronius that he commit suicide. Fortunately, news of Caligula’s assassination by a conspiracy involving the praetorian guard and senators reached Petronius first.

Claudius, Caligula’s uncle, reigned in the years AD 41–54, and his rule was defined by numerous public works, a reordering of the judicial system, a torrid series of marriages, the conquest of Britain, and a number of attempted coups by the Roman senate. In AD 49 he expelled the Jews from Rome because of disputes about a certain “Chrestus,” probably Christ (cf. Acts 18:2). No one is sure whether Claudius was murdered or died of old age, but he remained a sharp contrast to the brutal excesses of Caligula and Nero.

Nero, the stepson of Claudius, reigned in the years AD 54–68. The early period of his rule was marked by cultural endeavors and diplomatic efforts. The later years were, in contrast, distinguished by tyranny and self-aggrandizement. There was a Jewish revolt against Rome in Judea (AD 66–70) during Nero’s reign, and Vespasian was sent to pacify the territory. According to ancient sources, Nero accused Christians of starting the fire of Rome in AD 64 and subjected them to the cruelest of punishments, including crucifixion, being thrown to wild animals, and even being burned alive. It probably was during this time that the apostles Peter and Paul were martyred in Rome. Nero eventually was declared a public enemy by the Roman senate, and he committed suicide before he could be captured in AD 68. There arose a “Nero redivivus” legend, whereby many hoped or feared that Nero had not died in AD 68 but had fled to Parthia and would return to Rome in order to destroy it (Sib. Or. 4.119–124; 5.137–141, 361–396), and this arguably stands behind the imagery of Rev. 13:3; 17:8–11.

The suicide of Nero left a power vacuum in Rome, and AD 69 saw no less than four emperors ascend the throne: Galba, Otho, Vitellius, and finally Vespasian. Galba was governor of Hispania Tarraconensis and was invited to become emperor by the senate, but he was killed by the praetorian guard after they were bribed by the praetor Otho. Otho himself committed suicide after his forces were defeated by Vitellius, the commander of the legions on the Rhine. Vitellius became emperor, but he was fiscally irresponsible and murdered many of his rivals. The legions in the Danube, Egypt, Syria, and Judea had declared Vespasian emperor and marched on Rome. Vespasian controlled the grain supplies to Rome from Egypt and had a superior force. Vitellius’s forces were defeated at Bedriacum, and Vitellius went into hiding but eventually was killed in Rome. Vespasian was declared emperor by the senate, and so began the Flavian dynasty, which restored order after the chaos of civil war.

The Flavians ruled in the years AD 69–96. Vespasian (r. AD 69–79) consolidated the empire after its year of strife and instituted new taxes, such as the fiscus judaicus, a war reparation tax placed on all Jews and paid to the temple of Jupiter in lieu of the Jerusalem temple tax. Vespasian was succeeded by his sons Titus (r. AD 79–81) and Domitian (r. AD 81–96). When Vespasian sailed to Rome from Judea, Titus was left in charge of the siege of Jerusalem, which he completed and celebrated in a triumph in Rome in AD 72. This triumph is memorialized in the Arch of Titus, which depicts Roman soldiers bringing the vessels of the temple to Rome as part of the booty taken. Later Roman writers regarded Domitian as a malevolent and malicious tyrant (e.g., Tacitus, Suetonius), but this probably is an exaggeration caused partly by a desire to highlight the greatness of succeeding emperors such as Nerva and Trajan. It probably was during the reign of Domitian that some Christians in Asia Minor were being persecuted for their failure to worship the emperor, as depicted in the book of Revelation.

Table 7. Roman Emperors (31 BC–AD 117)

31 BC-AD 14 – Augustus

AD 14-37 – Tiberius

AD 37-41 – Caligula

AD 41-54 – Claudius

AD 54-68 – Nero

AD 68-69 – Galba

AD 69 – Otho

AD 69 – Vitellius

AD 69-79 – Vespasian

AD 79-81 – Titus

AD 81-96 – Domitian

AD 96-98 – Nerva

AD 98-117 – Trajan

Military

Military expeditions expanded Rome’s control of foreign territories and safeguarded its borders from incursion, most threateningly from the Germanic tribes east of the Rhine River and north of the Danube River and from the Parthian (= Neo-Persian) Empire east of the Euphrates River. A Roman legion consisted of around six thousand men, including cavalry. Under Tiberius, there were twenty-five legions stationed across the empire: eight on the Rhine, three in Spain, two in Egypt, four in Syria, two in Africa, and six in the Danube region. In terms of command structures, the legions were under the control of certain regional commands by men of consular rank, including two on the Rhine, one in Spain, one in Syria, and three in the Balkans (Tacitus, Ann. 4.5). These were among the most powerful persons outside the ruling family and could be kingmakers or contenders during times of civil war. A legion was divided into ten cohorts and commanded by a legate, usually of senatorial rank. Units of one hundred were commanded by centurions, and service in the legions was set at between twenty and twenty-five years. Upon recruitment, the soldier swore an oath of loyalty to the emperor (sacramentum) that was renewed annually. During times of peace, Roman soldiers could perform a number of civil tasks relating to taxation, building projects, and policing.

Centurions are mentioned several times in the NT (e.g., Matt. 8:5; Mark 15:39; Acts 10:1; 21:32; 27:1). There is a mention of a “legion” of demons that oppressed the Gerasene demoniac (Mark 5:9), and Jesus refers to the possibility of the Father sending him “legions” of angels (Matt. 26:53). Military terminology is very apparent in Paul’s letters, where he refers to fighting armor (Rom. 13:11–13; 2 Cor. 6:7; Eph. 6:10–18), compares commitment to Christ to military service (2 Tim. 2:4), refers to his coworkers as “soldiers” or “fellow soldiers” (Phil. 2:25; Philem. 2; 2 Tim. 2:3), and likens ministerial remuneration to a soldier being paid his salarium (1 Cor. 9:7).

Culture and Religion

One of the primary reasons for Rome’s rise and dominance, militarily and culturally, was its capacity to absorb other peoples and even other gods into its constituency and pantheon. Its constantly growing pantheon, application of the rule of law, and superior military force made Rome what it was: a melting pot of all cultures and a Romanizer of other cultures.

Roman society was heavily stratified, but social mobility, upward and downward, was possible. Wealth, marriage, education, and military exploits were the primary means to social advancement. The senatorial class represented the wealthy nobility of Rome and provided the primary cohort of civil and military administrators. The equestrian class (or “knights,” as they are sometimes called) were a larger group of less wealthy Roman citizens. Decurions were members of civil councils in provincial cities who often acted as magistrates and were leaders of local communities. The plebeians represented the general citizenry of Rome, who, until the time of Tiberius, had some power in electing officials. Finally, there were freedmen, who were ex-slaves usually in a relationship with their former master, and also slaves, who were regarded as little more than property.

The ancient Roman religions focused on the numen, the somewhat impersonal divine power associated with certain localities. From the third century BC, Greek deities were assimilated and Romanized, so that Zeus became Jupiter, and Vesta was identified as Hestia. The Capitoline Hill was crowned with a temple that was dedicated around 500 BC to Jupiter, Minerva, and Juno. These were the principal gods of Rome, although others were added to the pantheon as the Romans conquered other peoples and adopted their gods. Other gods also received greater honor, such as the goddess Pax, the personification of peace (based on the Greek goddess Eirene); Vespasian built and dedicated a temple in her honor in Rome in AD 75. The Roman emperor was the Pontifex Maximus and supreme high priest of Rome and the empire. In the mid- to late first century AD, the fastest-growing religion was the imperial cult, the worship of (usually) deceased Roman emperors. This cult became popular in the eastern Mediterranean cities, where worship of rulers was commonplace, but was regarded with indifference in Rome.

Religions and philosophies from all over the known world eventually made their way to Rome. Egyptian rites and religions gained followings, Mithraism acquired currency within the ranks of the military and among public servants, Judaism entered Rome probably with the Hasmonean delegation sent there around 139 BC, and Christianity came to Rome probably during the late 30s and early 40s of the first century AD through Jewish pilgrims visiting the east and through Judean immigration to Rome. Many Roman intellectuals lamented the fact that so many foreign superstitions had found their way to Rome, and that Roman peoples found them more attractive than their own state religion. Roman religion was largely controlled by the state through a set calendar and the appointment of priests and vestal virgins. It was practiced in public and in the home. As such, religious life was very much intertwined with social and political life. Roman religion engendered the need for its citizens to act with pietas, the honoring of one’s obligations to the gods, and with religio, which designated appropriate scruples and rites in the presence of the gods.

Summary

The birth of the church and the growth of Christianity took place within the wider social, religious, and cultural context of the Greco-Roman world. The politics and power of the Roman Empire provide the backdrop for the birth of Jesus (Luke 2:1), and since Rome was considered to be the center of the world, it was necessary that Paul himself testify to Jesus Christ there (Acts 19:21). The history, literature, and cultural background of Rome form an important background to the NT and should be studied along with the history and literature of Judaism during the time of Jesus and the apostles. Although the Romans were the primary threat to the survival of Christians in the ancient world, after the conversion of Constantine in the fourth century AD, they became the primary means by which Christianity spread to the rest of Europe and western Asia. See also Roman Law.

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).