THE LORD SAID to Moses and Aaron, 2“When anyone has a swelling or a rash or a bright spot on his skin that may become an infectious skin disease, he must be brought to Aaron the priest or to one of his sons who is a priest. 3The priest is to examine the sore on his skin, and if the hair in the sore has turned white and the sore appears to be more than skin deep, it is an infectious skin disease. When the priest examines him, he shall pronounce him ceremonially unclean. 4If the spot on his skin is white but does not appear to be more than skin deep and the hair in it has not turned white, the priest is to put the infected person in isolation for seven days. 5On the seventh day the priest is to examine him, and if he sees that the sore is unchanged and has not spread in the skin, he is to keep him in isolation another seven days. 6On the seventh day the priest is to examine him again, and if the sore has faded and has not spread in the skin, the priest shall pronounce him clean; it is only a rash. The man must wash his clothes, and he will be clean. 7But if the rash does spread in his skin after he has shown himself to the priest to be pronounced clean, he must appear before the priest again. 8The priest is to examine him, and if the rash has spread in the skin, he shall pronounce him unclean; it is an infectious disease.
9“When anyone has an infectious skin disease, he must be brought to the priest. 10The priest is to examine him, and if there is a white swelling in the skin that has turned the hair white and if there is raw flesh in the swelling, 11it is a chronic skin disease and the priest shall pronounce him unclean. He is not to put him in isolation, because he is already unclean.
12“If the disease breaks out all over his skin and, so far as the priest can see, it covers all the skin of the infected person from head to foot, 13the priest is to examine him, and if the disease has covered his whole body, he shall pronounce that person clean. Since it has all turned white, he is clean. 14But whenever raw flesh appears on him, he will be unclean. 15When the priest sees the raw flesh, he shall pronounce him unclean. The raw flesh is unclean; he has an infectious disease. 16Should the raw flesh change and turn white, he must go to the priest. 17The priest is to examine him, and if the sores have turned white, the priest shall pronounce the infected person clean; then he will be clean.
18“When someone has a boil on his skin and it heals, 19and in the place where the boil was, a white swelling or reddish-white spot appears, he must present himself to the priest. 20The priest is to examine it, and if it appears to be more than skin deep and the hair in it has turned white, the priest shall pronounce him unclean. It is an infectious skin disease that has broken out where the boil was. 21But if, when the priest examines it, there is no white hair in it and it is not more than skin deep and has faded, then the priest is to put him in isolation for seven days. 22If it is spreading in the skin, the priest shall pronounce him unclean; it is infectious. 23But if the spot is unchanged and has not spread, it is only a scar from the boil, and the priest shall pronounce him clean.
24“When someone has a burn on his skin and a reddish-white or white spot appears in the raw flesh of the burn, 25the priest is to examine the spot, and if the hair in it has turned white, and it appears to be more than skin deep, it is an infectious disease that has broken out in the burn. The priest shall pronounce him unclean; it is an infectious skin disease. 26But if the priest examines it and there is no white hair in the spot and if it is not more than skin deep and has faded, then the priest is to put him in isolation for seven days. 27On the seventh day the priest is to examine him, and if it is spreading in the skin, the priest shall pronounce him unclean; it is an infectious skin disease. 28If, however, the spot is unchanged and has not spread in the skin but has faded, it is a swelling from the burn, and the priest shall pronounce him clean; it is only a scar from the burn.
29“If a man or woman has a sore on the head or on the chin, 30the priest is to examine the sore, and if it appears to be more than skin deep and the hair in it is yellow and thin, the priest shall pronounce that person unclean; it is an itch, an infectious disease of the head or chin. 31But if, when the priest examines this kind of sore, it does not seem to be more than skin deep and there is no black hair in it, then the priest is to put the infected person in isolation for seven days. 32On the seventh day the priest is to examine the sore, and if the itch has not spread and there is no yellow hair in it and it does not appear to be more than skin deep, 33he must be shaved except for the diseased area, and the priest is to keep him in isolation another seven days. 34On the seventh day the priest is to examine the itch, and if it has not spread in the skin and appears to be no more than skin deep, the priest shall pronounce him clean. He must wash his clothes, and he will be clean. 35But if the itch does spread in the skin after he is pronounced clean, 36the priest is to examine him, and if the itch has spread in the skin, the priest does not need to look for yellow hair; the person is unclean. 37If, however, in his judgment it is unchanged and black hair has grown in it, the itch is healed. He is clean, and the priest shall pronounce him clean.
38“When a man or woman has white spots on the skin, 39the priest is to examine them, and if the spots are dull white, it is a harmless rash that has broken out on the skin; that person is clean.
40“When a man has lost his hair and is bald, he is clean. 41If he has lost his hair from the front of his scalp and has a bald forehead, he is clean. 42But if he has a reddish-white sore on his bald head or forehead, it is an infectious disease breaking out on his head or forehead. 43The priest is to examine him, and if the swollen sore on his head or forehead is reddish-white like an infectious skin disease, 44the man is diseased and is unclean. The priest shall pronounce him unclean because of the sore on his head.
45“The person with such an infectious disease must wear torn clothes, let his hair be unkempt, cover the lower part of his face and cry out, ‘Unclean! Unclean!’ 46As long as he has the infection he remains unclean. He must live alone; he must live outside the camp.
47“If any clothing is contaminated with mildew—any woolen or linen clothing, 48any woven or knitted material of linen or wool, any leather or anything made of leather—49and if the contamination in the clothing, or leather, or woven or knitted material, or any leather article, is greenish or reddish, it is a spreading mildew and must be shown to the priest. 50The priest is to examine the mildew and isolate the affected article for seven days. 51On the seventh day he is to examine it, and if the mildew has spread in the clothing, or the woven or knitted material, or the leather, whatever its use, it is a destructive mildew; the article is unclean. 52He must burn up the clothing, or the woven or knitted material of wool or linen, or any leather article that has the contamination in it, because the mildew is destructive; the article must be burned up.
53“But if, when the priest examines it, the mildew has not spread in the clothing, or the woven or knitted material, or the leather article, 54he shall order that the contaminated article be washed. Then he is to isolate it for another seven days.
55After the affected article has been washed, the priest is to examine it, and if the mildew has not changed its appearance, even though it has not spread, it is unclean. Burn it with fire, whether the mildew has affected one side or the other. 56If, when the priest examines it, the mildew has faded after the article has been washed, he is to tear the contaminated part out of the clothing, or the leather, or the woven or knitted material. 57But if it reappears in the clothing, or in the woven or knitted material, or in the leather article, it is spreading, and whatever has the mildew must be burned with fire. 58The clothing, or the woven or knitted material, or any leather article that has been washed and is rid of the mildew, must be washed again, and it will be clean.”
59These are the regulations concerning contamination by mildew in woolen or linen clothing, woven or knitted material, or any leather article, for pronouncing them clean or unclean.
Original Meaning
WHEREAS LEVITICUS 12 regulates ritual impurity resulting from a mother’s healthy postpartum condition, chapters 13–14 have to do with abnormal conditions involving deterioration of the skin or surface of a human being, article of clothing, or house. That these chapters comprise a unit is confirmed by the conclusion at the end of chap. 14 (vv. 54–57), which summarizes the legislation in both chapters. The instructions here are addressed to Moses and Aaron (13:1) alone, not including the Israelites, apparently because the people were supposed to rely on the Aaronic priests as experts for diagnoses of skin disease or certification of healing. By contrast, diagnosis of genital discharges was left to the Israelites themselves (15:2) because they are private rather than externally visible.1
Since the symptoms of skin disease in chap. 13 are rather complicated and potentially ambiguous, it is no wonder their interpretation was left for priestly experts. This chapter contains a number of obscure Hebrew medical terms, the most important of which is the overall designation for ritually impure skin conditions: ṣaraʿat. While scholars have not managed to pin down a definitive etymology, the fact that scaling of the skin is the common denominator suggests that the malady is a repulsive scaly skin disease.2
The common translation “leprosy” has arisen from the LXX translation of ṣaraʿ at as lepra the word that also appears in the New Testament (Matt. 8:3; Mark 1:42; Luke 5:12–13). Just as Hippocrates appears to have used Greek lepra with reference to several skin diseases,3 Hebrew ṣaraʿat applies to a complex of conditions, including some that resemble psoriasis and vitiligo.
Some scholars have contended that Hebrew ṣaraʿat and Greek lepra do not refer to modern “leprosy,” now known as Hansen’s disease, for which Greek could use another term: elephantiasis.4 In fact, dermatologist Marvin Engel has concluded that “the symptoms described in Leviticus 13 do not correspond to any known skin disease.”5 By contrast, R. K. Harrison has put forth a detailed medical argument that although the etymology of ṣaraʿat is uncertain, and although diseases can change over time and ṣaraʿat in Leviticus 13–14 applies to a variety of conditions that can even affect fabrics and houses, some key symptoms of the chronic form of human ṣaraʿat in Leviticus 13 correspond to those of Hansen’s disease. Therefore, it appears that biblical ṣaraʿat could have at least included an ancient form of the loathsome disease we now label “leprosy.”6
The fact that ṣaraʿat applies to a broad range of human and non-human phenomena points to the key for understanding Leviticus 13–14: The concerns of these chapters for diagnosis and quarantine are not with one or more medical conditions per se, but with recognizing outward appearances that place persons or things in the ritually impure category, which must be kept separate from the sacred sphere. Because we are dealing here with the world of religious ritual rather than medicine, scientific identification of “scale disease” is not crucial for understanding the biblical message.
These considerations point to the key for understanding Leviticus 13–14. The concerns here for diagnosis and quarantine are not with one or more medical conditions per se, but with recognizing outward appearances that place persons or things in the ritually impure category, which must be kept separate from the sacred sphere. Because we are dealing here with the world of religious ritual rather than medicine, scientific identification of “scale disease” is not crucial for understanding the biblical message.
Aside from misidentification of ṣaraʿ at as leprosy, the common interpretation of Leviticus 13–14 and Numbers 5:1–4, where persons afflicted by the disease are banished from the Israelite camp, is fraught with additional misconceptions: (1) that the purpose of quarantine or banishment is to keep the disease from spreading, and (2) the purification rituals of chapter 14 serve the goal of healing the disease. A quick reading of the biblical text dispels such notions. In Numbers 5:3 the Lord states the reason for banishment, which also applies to persons with abnormal genital discharges or who have been contaminated by corpses: “so they will not defile their camp, where I dwell among them.” The concern is not contagion that would make other people unwell, but rather protection of the Lord’s holy domain from association with impurities that represent heightened states of mortality.
Buttressing the idea that the topic is ritual influence rather than medical contagion is the fact that an individual whom a priest certifies as healed from scale disease is not immediately free to reenter the camp but must undergo extensive ritual purification to transfer him or her back to the “pure” category (ch. 14). Obviously the rituals have nothing to do with medical healing; they can begin only when the person is already healed.
Here is a reader’s digested outline of the diagnoses and other instructions in Leviticus 13, following the introduction to divine speech in verse 1:7
Impure scale disease on persons (vv. 2–44)
general diagnosis (vv. 2–17)
hair turns white, affected area appears deeper than skin (vv. 2–8)
white discoloration, white hair, raw flesh (vv. 9–17)
special cases (vv. 18–44)
in place of boil: white discoloration or reddish-white shiny spot, deeper than skin, white hair (vv. 18–23)
in place of burn: reddish-white or white shiny spot, white hair, deeper than skin (vv. 24–28)
on head or beard: deeper than skin, yellow or thin hair (vv. 29–37)
not impure scale disease: numerous dull-white shiny spots (vv. 38–39)
on bald head or forehead: reddish-white affected area (vv. 40–44)
Prescribed behavior of skin diseased persons (vv. 45–46)
clothes rent, hair disheveled, cover moustache, cry “impure,” dwell apart (vv. 45–46)
Impure “scale disease” = mold in fabrics (vv. 47–59)
bright green or bright red affected area (vv. 47–59)
In Leviticus 13:2–44 the diagnostic procedure is logical. A person suspected of having scale disease is brought to a priest, who inspects the affected area. If he observes a clear manifestation of the disease according to the criteria listed above, he pronounces the person ritually impure. If there is a question, however, the priest quarantines the person for a week, after which he examines the affected area again. If it betrays signs of scale disease, it is pronounced as such, but if the case is still ambiguous, there is another week of quarantine. If no changes for the worse identify the condition as scale disease, the priest declares the individual “pure,” that is, free from that serious impurity. However, apparently as a result of a two-week quarantine for suspected scale disease, the person has incurred minor impurity that requires laundering his or her clothes (vv. 6, 34).
In vv. 47–59 a parallel procedure of priestly examination at one-week intervals is applied to fabrics affected by mold or mildew, with the following differences:
1. The priest does not pronounce a fabric impure without quarantining it for at least a week.
2. The affected material is washed before a second week of quarantine, if this is necessary.
3. If the abnormal condition fades after the fabric has been washed and quarantined for a second week, the priest tears/cuts out the affected area.
4. An impure fabric is destroyed by fire.
BLIGHT OF THE living dead. A person afflicted with the appearance of “scale disease” was ritually impure to a high degree, as shown by the facts that he or she was banished from the camp, and the ritual process following healing was a long and complex one (ch. 14). The severity of the impurity can be explained by the close connection between scale disease and death, the concept on which the Israelite impurity system appears to be based (see ch. 12).
Several pieces of evidence link scale disease to death, indicating that it could be characterized as the “blight of the living dead.” (1) Miriam was temporarily smitten with scale disease because she and Aaron jealously spoke against Moses and his divinely appointed authority (Num. 12). Aaron vividly described the horror of her condition when he confessed to Moses and begged for mercy on Miriam: “Let her not be as one dead, who emerges from his mother’s womb with half his flesh eaten away” (Num. 12:12 NJPS). Thus, persons whose flesh was rotting away with scale disease looked like living dead persons!8
(2) Aside from being socially marginalized by living apart from others for the duration of the scale disease (Lev. 13:46; cf. Num. 5:1–4), the sufferer had to adopt a self-stigmatizing appearance and behavior by wearing torn clothes, letting his hair be disheveled, covering the lower part of his face,9 and calling out, “Impure! Impure!” (Lev. 13:45; NIV “Unclean! Unclean!”). Calling out like this warned people to avoid contamination by contact with him. However, the condition of his clothes and hair were like that of one mourning for the dead (Targum Pseudo-Jonathan; cf. Lev. 10:6; 21:10). For whom was he mourning? Himself! Perhaps his funerary appearance intensified his need to call out while covering part of his face in order to clarify the nature of his mourning so that others would not approach to comfort him.
(3) The first-day purification ritual for a person healed of scale disease (14:4–7) resembled that of one who had been contaminated by a corpse (Num. 19): Both had to be sprinkled with a liquid mixture that included blood and fresh (lit., “living”) water that either included or had contacted cedar, scarlet thread, and hyssop.
Scale disease as divine punishment. Although the lifestyle of a person afflicted with scale disease was pitiful, there is no indication in Leviticus 13–14 that the condition served as punishment for sinful action. However, in 14:34 the Lord began the law of scale disease/fungus in houses: “when you enter the land of Canaan, which I give you as a possession, and I inflict a fungous infection upon a house in the land you possess. . . .”10 This does not say that the Lord used fungus to punish the occupants for their sin, but it does acknowledge that he could cause scale disease.
In biblical narratives there are some striking instances in which God smote sinners with scale disease as severe punishment. We have already mentioned Miriam. When Gehazi, the servant of Elisha, deceitfully gained a reward from Naaman for what God had done to heal Naaman of his scale disease, the Syrian’s loathsome malady came back on Gehazi (2 Kings 5:20–27). The Lord smote King Uzziah with scale disease when he angrily refused to accept the warning of priests not to encroach on their divinely authorized, exclusive prerogative of burning incense. Even though he was king, he had to live out the rest of his days in separate quarters (2 Chron. 26:16–21; cf. 2 Kings 15:5). It is no coincidence that the prophet Isaiah experienced his temple vision of the Lord and his royal glory “in the year that King Uzziah died” (Isa. 6:1). The earthly and heavenly monarchs presented the greatest possible contrast: the mortal, impure, sinful, unholy impotentate versus the immortal, pure, sinless, holy Potentate of time and eternity.
Notice that Uzziah’s sin was sacrilege (verb mʿl), a trespass against God (2 Chron. 26:16, 18). Similarly, Gehazi’s offense can be construed as sacrilege in the sense that through greed and lying, he robbed God of credit for healing Naaman, implying that Elisha had performed the cure himself. The punishment exquisitely matched the crime: Having dishonestly taken Naaman’s belongings, he inherited his scale disease along with them.11
Scale disease as a severe form of divine punishment is well attested in ancient Near Eastern texts, particularly in Mesopotamian curses.12 So it is not startling that confirmation of the Lord’s treaty with the Israelite nation was reinforced by a curse that threatened violators with divinely induced Egyptian boils and incurable scabs and itches (Deut. 28:27). Nor should our eyebrows rise too high when we read that when Joab murdered Abner, David cursed Joab by wishing on his house a continuous supply of individuals afflicted with genital discharge and scale disease (2 Sam. 3:29).
AN ECOLOGY OF DECAY. Like the other biblical laws regulating ritual impurities, the instructions in Leviticus 13–14 are obsolete in terms of our obligation to observe them. However, from “scale disease” we learn about the human condition in relation to God. This impure affliction is a powerful metaphor for the human state induced by sin. Since the Fall (Gen. 3), our state of mortality progressively and inexorably moves us in the direction of decay and death (Rom. 5:12; 6:23).
Although our “healthy” mortality is not as ugly and its trajectory is not as precipitous as the heightened state of mortality represented by leprosy, it is all a matter of degree. Even if a priest should declare us “clean,” this is only relative. Still mortal, we remain unable to bask in the full glory of God’s presence. Still longing for immortality like the legendary Gilgamesh or a fountain of youth like Ponce de León, the Spanish explorer, we must await the divinely appointed day when “this perishable body must put on imperishability, and this mortal body must put on immortality” (1 Cor. 15:53 NRSV).
At first it appears strange to us that Leviticus 13–14 lumps blights on persons, garments, and houses, which cause their surfaces to deteriorate, in the same category of impure “scale disease.” Treating these phenomena as a unified problem is a remarkably wholistic approach to dynamic evil. But of course, I am almost as afraid that the computer on which I am typing will be infected with a “virus” (electronic, not even biological) as I am that my body will catch a disease from a malicious microbe.
The broad range of scale disease heightens its potency as a metaphor for our sin-induced state: Not only are human beings affected, so is our environment. In Romans 8, Paul expresses the hope “that the creation itself will be liberated from its bondage to decay and brought into the glorious freedom of the children of God. We know that the whole creation has been groaning as in the pains of childbirth right up to the present time” (Rom. 8:21–22).
We are the ultimate ecological disaster, the opposite of Midas, whose mythical touch turned everything to gold. But with us lies the choice to accept the solution from God, who alone can put us and everything around us back together again. Meanwhile, it is right and in our best interest to nurture our environment to the best of our imperfect ability. It is the only home we have!
Sickness and stigma. Identification of biblical “scale disease” with modern leprosy (Hansen’s disease) has compounded the suffering of lepers, who are rejected and ostracized partly on this basis. However, there is not the slightest hint in Leviticus 13–14 that this dermatological condition was invariably a punishment from God for moral failure. Because the cases of Miriam, Gehazi, and King Uzziah were dramatic, they are easily embedded in the foreground of our memory, but these were exceptional situations.
There is no warrant for assuming that a leper must necessarily have offended God. 2 Kings 5 does not mention that Naaman the Syrian needed forgiveness from Israel’s God along with his healing. Similarly, the Gospels do not record that Jesus forgave scale-diseased persons when he healed them (Matt. 8:2–4; Mark 1:40–44; Luke 5:12–14; 17:12–19). So we can leave behind the toxic moral stigma that some have attached to this disease.
D. P. Wright issues a worthy challenge regarding modern attitudes to other diseases that some have stigmatized, such as cancer and AIDS:
Apart from the effect of a particular translation or the identification of the disease, the case of biblical ṣāraʿat provides a springboard for ethical thought about other diseases which are more in the public mind today, such as cancer or AIDS. There are many parallels between the Bible’s view about those suffering from ṣāraʿat and unscientific popular views about those suffering from the serious diseases of modern concern. These popular views grow out of society’s fears and attempts to explain evil, and out of its social context. These explanations, while turning chaos to order for some, are sometimes injurious, psychologically if not physically, to the sick. . . . Knowledge about the ancients’ symbolic understanding of biblical ṣāraʿat and the effects it had upon sufferers in antiquity can serve as an avenue for critiquing our own thinking (or mis-thinking) about modern disease.13
Wright does not pursue the way in which our understanding of biblical scale disease can enhance reflection on modern disease, but we can begin to do this here. The biblical stigma of scale disease was that of physical ritual impurity, not morality, necessitated by the requirement to protect the holy domain of the Lord’s earthly residence. The conceptual category of impurity was a symbolic system that belonged to the larger symbolic system of ancient Israelite ritual worship. This impurity represented mortality, the state resulting from the Fall that is shared by all human beings on Planet Earth. It did not represent the sinful action of a particular human being. If biblical scale disease, which carried severe ritual impurity within the Old Testament religious system, did not represent sinful action, even less should we attach moral stigma to modern diseases that the Bible has not labeled as ritually impure.
If an ancient Israelite could be quarantined by a priest and banished from the Lord’s camp for a condition that was not necessarily caused by his or her moral fault, how can we assume that a modern sufferer, who is neither quarantined nor banished in those ways, has “asked for it” by sinning? As recorded by Luke the physician, Jesus said: “Do not judge, and you will not be judged” (Luke 6:37).
When Jesus’ disciples saw a man who had been born blind, they assumed that he or his parents must have sinned (John 9:1–2). But Jesus absolved the man and his parents of moral responsibility: “‘Neither this man nor his parents sinned,’ said Jesus, ‘but this happened so that the work of God might be displayed in his life’” (John 9:3). Indeed, Christ could have said the same about Job, and especially about himself as he suffered crucifixion. The cross is the ultimate argument against the assumption that a person’s affliction must have been caused by sin committed by that person.
It is true that a disease, such as syphilis or AIDS, can directly result from specific sinful behavior, such as sexual promiscuity. When this happens, the result functions as a penalty. Compare Romans 1:27: “In the same way the men also abandoned natural relations with women and were inflamed with lust for one another. Men committed indecent acts with other men, and received in themselves the due penalty for their perversion.” However, while we should accept Paul’s warning for our own lives, there are several points to keep in mind.
(1) We cannot automatically extrapolate a sinful cause from a diseased result, assuming that a person with a particular disease must have committed a certain kind of moral fault. For example, babies can be born with syphilis or AIDS that they contract from their mothers, and AIDS can be transmitted by blood transfusions. We can take our cue for restraining “effect to cause” assumptions regarding sexually transmitted diseases from the Bible. While abnormal genital discharges can be caused by venereal disease, in Leviticus 15 there is no moral condemnation of a person with such a problem.
(2) Only God knows a person’s heart, so only God is judge. Even if we know that a person is unwell because of sin, our role is not to condemn or stigmatize but to comfort and relieve suffering as Jesus did, allowing him to make us sources of healing and purity (see comments on Lev. 11).
(3) God can both forgive and heal. The fact that Jesus forgave and healed a paralyzed man at the same time (Mark 2) shows that he was in need of both. Perhaps his suffering was due to his sin, but if so, Jesus didn’t bother to ask or tell. The paralytic didn’t need to be reminded that he was a suffering sinner, and whatever he had done was between him and God. As an example to us, Jesus gave him what he needed: healing grace, not moralizing.14