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Leprosy

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A recent communication from a reader prompted me to write this article, just for your interest. It is of interest because of the number of times leprosy is mentioned in the Bible, and the way it was regarded.

There are several different types of leprosy, so which one was spoken of in scripture? As a nurse in the 1970s I remember nursing a man who had leprosy of the stomach. He had no outward signs on his body. (For more information see, for example, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660939/). Yet, in the Bible, those with leprosy were isolated. This study will look at the leprosy referred to, and the reasons why people who had it could not live in normal society.

Leviticus 13:2-on

“When a man shall have in the skin of his flesh a rising, a scab, or bright spot, and it be in the skin of his flesh like the plague of leprosy; then he shall be brought unto Aaron the priest, or unto one of his sons the priests:”

This counsel is given by God Himself to Moses and Aaron. Here leprosy is called a ‘plague’, and it is obvious that even then men knew what leprosy looked like. To be sure that an ailment was indeed leprosy and not some ordinary skin complaint (such as, say, psoriasis), the person affected had to visit the chief priest or one of the lower priests, who would then confirm whether the skin problem is leprosy or not:

“And the priest shall look on the plague in the skin of the flesh: and when the hair in the plague is turned white, and the plague in sight be deeper than the skin of his flesh, it is a plague of leprosy: and the priest shall look on him, and pronounce him unclean.”

It seems that the priests had a more detailed knowledge of leprosy. The initial suspicions caused friends or relatives to take a suspected leper to the priests. The priests then examined the skin further. Hair over a white spot would turn white, and the area affected would be seen to travel back into the body, far deeper than skin itself. If the initial suspicion and the later examination show the condition to be “like the plague or leprosy”, then it was declared to be “a plague of leprosy”. The unfortunate person was then said to be “unclean”.

Leprosy, in this context, tsara`ath, was a name given to three separate things – people, clothing and buildings. In modern language mildew or mould found on clothing or in a building, would be ‘leprosy’, because it looked just like the skin problem in many ways. The third application was to human beings. In the text above we see that the condition was white. There was also a black kind, which today we refer to as ‘elephantiasis’ (re the ‘elephant man’).

If a person was said to be ‘unclean’ because of leprosy, tame’, he or she was considered to be defiled or polluted, a term used for several problems – sexual, religious and ceremonial. It had the same level of ‘untouchability’ as, say, the eating of ‘unclean’ animals. Because of the intense ramifications of being called unclean, there were certain safeguards taken by the priest. This is very wise, for several conditions can have similar symptoms and signs.

“If the bright spot be white in the skin of his flesh, and in sight be not deeper than the skin, and the hair thereof be not turned white; then the priest shall shut up him that hath the plague seven days:”

The priest might note that the white spot that usually comes with leprosy is not very deep and the hair on that spot is not turned white. It could be that the leprosy is still immature. So, the priest makes sure that the person is locked up in his own house for seven days. On the seventh day he would return to look at the person again. If the spot or spots had not enlarged or spread, just to be sure, the priest locked him up for a further seven days (verse 5). It was a necessary waiting game, though leprosy developed quite fast at that stage.

On the fourteenth day, the priest returned. If the spot or spots were turned dark and had not spread, then the priest pronounced the person to be clean, much to the immense relief of both! On the other hand, if the spots had erupted into open wounds and developed scabs, and had spread, the priest had the unfortunate task of telling the person he or she did have leprosy. Even so, there are variations on this pronouncement. For example, if the leprosy was ‘old’. This, too, made a person ‘unclean’.

Now here seems to be a mystery. If the skin of a person was totally white – no bare flesh between, then he or she was ‘clean’! But, if spots became raw, with no epidermis, he or she was ‘unclean’. The reason why all-white skin was ‘clean’ might be because it was deemed a different condition, perhaps something like psoriasis.

If the raw spots then turned back to white, the priest would say he was ‘clean’. So, the condition was sequential. It developed certain signs at different phases. In fact the various signs and symptoms were often complex, so the priest had to have a thorough training in how to diagnose conditions.

One example is if the person had what appeared to be a healed boil. If under the ‘healed’ boil there was a white lump or spot that became red (probably around the edges), he had to see a priest. If he saw that the spot was depressed lower than surrounding skin and the hair had turned white, then leprosy was diagnosed and the person was unclean, because “a plague of leprosy (had) broken out of the boil”. (It seems that animals could also have this condition; the Armadillo, Mangabey monkeys, rabbits and mice).

If the old boil had a spot that was level with the rest of the skin, and had no white hairs, and was darkish, the locking-up process began. If the condition spread in that one week (even though the spot was dark and not white), then leprosy was diagnosed. If there was no spread, then it was an “inflammation of the burning”, or, a burn (sun burn?).

If the problem was found in a man’s beard or on the head, it was netheq, or “dry scall”, a skin eruption or scab. If the signs appeared to be certain, then leprosy was pronounced. Otherwise, the seven-day locking-up was used to see if anything got better or got worse. After that, if the condition did not recede, the person was shaved of hair (but not on the scall) and left another seven days. If there was no spread and the spots were not depressed, then the person had to bathe and put on fresh clothing, and could be pronounced clean.

In short, there were many signs and each had to be distinguished from leprosy, and there were many phases and possible diagnoses, as Leviticus proves! In fact, the very depth of diagnosis shows us that leprosy was not just an untrained idea, but a carefully managed one.

The man who had leprosy of his upper lip would have to tear up his clothing and, when he went outdoors, he had to warn others, by saying “unclean, unclean”. His upper lip had to covered, and his head was shaven. So, he had to make his condition obvious. The man who had leprosy had to leave his home and live outside the camp, on his own. It also seems that the same plague could affect clothing and buildings, which is why both had to be burned to nothing to destroy the infection and to stop possible spread. (We go through extensive cleansing today, when houses are infested with woodworm, etc.). In the case of clothing etc., if they could be washed and not be re-infested, then everything was alright.

The Law of the Leper

(A term given by God to Moses). Leprosy was by no means necessarily permanent. The disease could reverse itself and leave the person ‘clean’, even if parts of the body literally fell off beforehand. The priest was sent for to see what had happened, and if it looked like the person’s leprosy had stopped or was healed, the priest commanded the person to make certain sacrifices and to perform a set of rituals.

The person who was thus cleansed had to shave off his hair, wash all over, and change his clothes, before he was allowed back into the camp. However, he was not allowed back into his own tent for seven days. After that time, he was again to shave all hair off his body, even his eyebrows, wash all his clothes and take a bath. Only then was he deemed to be fully clean. After that the priest expected the person to make sacrifices to God. After several rites, the priest gave a sin offering to God: “and the priest shall make an atonement for him before the LORD”. (14:8).

Leprosy in Canaan

God commanded Aaron to make vigilant observations when the people finally entered Canaan. These included the priest going in to a house where leprosy is suspected in the wooden walls (which tells us that most people no longer lived in tents but in towns/cities). He would look at the walls (after everything had been emptied out of the dwelling) to see the extent of damage.

If the plague was diagnosed, then the house/tent was locked up for seven days. If on the seventh day the priest found the problem had spread, he told the family to take the stones (of the hearth, etc) to be removed and thrown into a place kept aside for things unclean. The family had to scrape clean the walls and floor, and remove the scrapings to the unclean place. New stones were then taken into the structure and the walls were replastered. If, after all that effort, the leprosy came back, it was called a “fretting leprosy”. There were even more detailed requirements, and these were “the law of leprosy”. Other conditions were given by God for the keeping of health.

What we see is God Himself showing the people how to maintain an hygienic house and healthy body. The detailed rules were for the safekeeping of the people of Israel – we could expect nothing less from the God Who had chosen Israel for His own.

New Testament

Jesus’ disciples were commanded to go out and preach the Gospel, and to heal the sick, etc., including the lepers, who, of course, were not allowed into the city with active infection. This separating of lepers was for the good of the whole community. Even today, certain diseases lead to isolation of individuals, to prevent further spread of the condition. This was proposed in the 1980s with AIDS, but the idea was quashed by activists and some within government, even though it was a good solution. Because they did not act, the disease is now out of control worldwide.

What is Leprosy?

Apparently, a quarter of a million more cases are diagnosed worldwide every year. (re Leprosy Mission). It is caused by a bacillus, Mycobacterium Leprae, and/or Mycobacterium lepromatosis. Usually the Leprae grows slowly with an incubation period of about five years, though symptoms may not appear for twenty years... which makes it a chronic condition.

You might expect that leprosy is highly contagious, but it is not. Casual contact will not pass on the disease, though it might pass to others in the same way as a cold. It is contracted via droplets from the nose and mouth, during close and frequent contact with an infected person (probably years).

Left untreated, leprosy will damage the skin, nerves, limbs and eyes. In almost all cases treatment is by multidrug therapy. (Excerpts from The Leprosy Fact Sheet, February 2010, World Health Organisation (WHO), Media Centre, copyright 2012) (http://www.who.int/mediacentre/factsheets/fs101/en/index.html ).

Hope began with the invention of Dapsone in the 1940s, which arrested development of the disease. Because treatment took many years patients often gave up. Sadly, the disease became immune to the drug, but another group of medications took its place in the 1960s: Rifampicin and Clofazimine. Soon after that Dapsone was added to the two new drugs, and all three now form the basis for treatment. The combination actually kills the infection, curing the patient. Leprosy (known also as Hansen’s Disease) today is curable. Other antibiotics may also be used. In the past 20 years alone, 16 million have been cured of the disease. However, there is no room for complacency – 200 cases a year are diagnosed in the USA alone. There are over 1000 leper colonies in India, and many hundreds in China.

Who Gets It?

Certain countries have a preponderance of leprosy cases, which are often found in poor areas where people live in close proximity to each other. Even so, it is believed that 95% of people are naturally immune to the disease. There appears to be a link between leprosy and Parkinson’s Disease at the genetic level. Westerners who live in an infected area for some years may also get the disease when they return home to the West; all cases in the West appear to be in this category.

People with poor sanitation and water supplies, and poor diet are greatly at risk. Types of leprosy are:

Paucibacillary (tuberculoid). This is the least severe kind. Patients show one or two patches of pale-coloured skin, which might feel numb. This type is the least contagious.

Multibacillary (lepromatous). More severe than tuberculoid, it has widespread bumps and rashes, numbness and muscle weakness. Nose, kidneys and male sexual organs may also be affected.

Borderline. This is when both types merge.

A doctor will cut away some of a lesion (biopsy) and send it for analysis. However, some cases do not show as leprosy in laboratory tests. Even in the UK people should not think they will not get Leprosy. (http://www.dailymail.co.uk/health/article-2535940/Were-proof-leprosy-White-middle-class-couple-BOTH-struck-stigmatised-disease.html). Before being diagnosed, this couple were thought to have syphilis – another chronic disease that can take about 20 years to show itself.

What should interest us is that of the Levitical rules of society, sometimes called Mosaic Laws, many were at the behest of God Himself. The diagnosis of leprosy at that time was more comprehensive and thorough than it is today in Western countries! And its treatment was thorough and quite humane, with regular check-ups to see if the affected person was healed. This suggests that at least some cases were cured by natural means.

© February 2015

Published on www.christiandoctrine.com

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