Part 2: Biblical Leprosy

In Temple times, leprosy was a severe source of impurity that necessitated the removal of the victim from three spheres of holiness: The Temple, the Levitical Camp, and the commonwealth.

Diagnostics: Symptoms of Leprosy

The laws concerning leprosy are found in Leviticus chapters 13-14, part of the so-called “priestly code” (P),[1] and come as part of a compendium of laws dealing with impurities that emanate from human beings (Lev. 12-15). The first subject addressed in this section is that of a woman who gives birth (Lev. 12:1-8). According to the Torah, when a child is born, the mother contracts טומאה, spiritual impurity,‎ and takes on the status of נדה as in the days of her menstrual separation.[2] From this example and other scenarios that involve natural occurrences of life, it is apparent that the concept of impurity is not synonymous with sin, even though certain transgressions are known to impute impurity.[3]

In general, all issues that emanate from the reproductive unit, whether male or female, are considered טמא‎, ritually impure,[4] and prevent the person in question from interacting with anything that must remain in a state of ritual purity (Lev. 15:31-33). In addition to these, death is a primary source of impurity – as טומאה is contracted when encountering a human corpse or when touching a dead animal (Num. 19:11-12; Lev. 11:24-40). In severe cases of impurity, an extended purification process is required that may culminate with offerings that represent atonement for the past and/or dedication for the future. In the mildest cases, all that is required of an individual to regain purity is ablution consummated by sunset.[5]

In Temple times, leprosy was a severe source of impurity that necessitated the removal of the victim from three spheres of holiness: The Sanctuary which housed the sacred items used in the divine service; the Levitical camp that surrounded the Sanctuary, and the camp of the general populace.[6] The טומאה of leprosy was communicable by contact (person to person/object)[7] and by shadowing.[8] The purification process of a leper is described in Leviticus 14:1-32, and will be discussed intermittently throughout this paper.

In the Hebrew Bible, the term for leprosy is צָרַעַת (ṣāraʻaṯ) – Greek Septuagint: λέπρᾱ; and a person inflicted with leprosy is called a מְצֹרָע‎ (metzora),[9] or אִישׁ־צָרוּעַ.[10] For hundreds of years, the common translation of “leprosy” led to the popular association with Hansen’s Disease,[11] a chronic infectious illness that can lead to facial deformity, loss of feeling, and rotting of the members.[12] However, the symptoms outlined in Leviticus 13 are far different from true leprosy, and the consensus among modern scholars is that ṣāraʻaṯ was used to describe a variety of skin diseases in the absence of advanced medical science.[13] This position may be supported by the fact that the Torah uses the same term to diagnose mildew or mold in garments (Lev. 13:47-52) and homes (Lev. 14:34-53) in addition to bodily diseases. Whatever the case, the subject of ṣāraʻaṯ was relevant enough toward the end of the second Temple era that an entire tractate of the Mishnah (Negaim) is devoted to its laws.[14]

The symptoms of human ṣāraʻaṯ are covered in Lev. 13:1-46 and are presented in five scenarios where basic procedures of inspection, quarantine, and diagnosis are outlined.[15] The Torah states: “When a person has on the skin of his body a swelling, a rash, or a discoloration, and it develops into a scaly affection on the skin of his body, it shall be reported to Aaron the priest or to one of his sons, the priests (Lev. 13:2).”

Verse 2 identifies and catalogues three preliminary symptoms that can develop into serious leprosy: שְׂאֵת (śə’êṯ) – an elevation of the skin; סַפַּחַת (sapaḥaṯ) – a scab or lesion on the skin; and בַהֶרֶת (bahereṯ) – a white patch of skin. Verses 4-8 go on to address the symptoms and development of bahereṯ, while vv. 9-17 assess the usual symptoms of śə’êṯ. In respect to both forms the Torah describes two basic shades of color that may appear on the skin, making for a total of four possible shades.[16]

According to the Torah, only a kohen[17] has the authority to diagnose a ṣāraʻaṯ and pronounce the condition unclean (Lev. 13:3). Without the priest’s formal declaration, there is no impurity, even if the symptoms of ṣāraʻaṯ appear to be obvious.[18] Likewise, even if a leper is cleansed, he does not gain readmittance to the community or the Sanctuary until he has shown himself to the priest and fulfilled the prescribed ritual.[19] As we shall see, the relationship between the kohen and the metzora is unparalleled to anything else attested in Scripture or ANE ritual. Throughout the entire process of the metzora’s experience, his fate relies solely on the discretion of the kohen whose job is to inspect, monitor, and diagnose; not to heal.[20]

In every scenario, the common denominator in determining whether a shaded sore has developed into a full-blown ṣāraʻaṯ is when there appears to be a depression in the skin with the hairs turned white therein (vv. 3, 10, 20, 25). Intermediate stages of development where hairs are not white, or in the process of becoming white, and the surface area of the shaded sore may spread or the coloration may fade (vv. 4-5; 12-17; 21-23; 26-28; 31-37) are causes for determining whether a malady requires first and second round quarantine, or whether an ailment has developed into ṣāraʻaṯ or is simply a מִסְפַּ֣חַת (rash) or בֹּ֥הַק (tetter).[21] The latter two conditions are considered clean and a natural occurrences. Thus, there is a discernable distinction between ṣāraʻaṯ and what may be considered common or natural skin diseases. This becomes overwhelmingly apparent in the next two scenarios.

The third and fourth scenarios pertain to flesh wounds that develop into ṣāraʻaṯ after they have healed. Verses 18-23 describe the symptoms of שְׁחִ֑ין (inflammation) while vv. 24-28 cover eruptions that are born out of burns. For the purpose of this discussion, it should be presumed that שְׁחִ֑ין covers all types of injury and illnesses to the skin.[22] While it may be tempting to categorize these ailments as natural inflammation or infection, v. 18 presents a catch that is often overlooked:

“When an inflammation [שְׁחִ֑ין] appears on the skin of one’s body and it heals, and a white swelling [שְׂאֵ֣ת לְבָנָ֔ה] or a white discoloration [בַהֶ֖רֶת לְבָנָ֣ה] streaked with red develops where the inflammation was, he shall present himself to the priest.”

Once again, the issue at hand concerns the monitoring of a leprous śə’êṯ or bahereṯ that appears in the place where a previous wound had healed. Rashi explains: “The boil became healed, and, in its place, it produced another plague.” [23] Accordingly, even if the inflammation or burn was still festering and exhibiting symptoms similar to ṣāraʻaṯ, it could not be eligible for examination by the kohen until the wound had healed and the preliminary stages of śə’êṯ and bahereṯ had set in.[24] These peculiar details and others like it contribute to the distinction of ṣāraʻaṯ from true leprosy as well as other natural skin ailments; and indicates the possibility of a miraculous source, a topic that will be discussed at length in the next section, The First Case of a Metzora. ­

The final two scenarios pertain to ṣāraʻaṯ of the head or face (vv. 29-39) and baldness at the front and back of the head (vv. 40-44). Regarding the latter, the same identifying properties as ṣāraʻaṯ of the body are used to assess spots where balding takes place (v. 43). However, ṣāraʻaṯ of the scalp or beard is treated differently: Whereas as the combination of apparent skin depression and white hair constitutes basic leprosy of the body – in areas where thick dark hair is prominent, a malady that appears to go deeper than the skin must turn hair yellow for the spot in question to qualify as ṣāraʻaṯ. If yellow hair appears but there is no apparent depression in the skin, then a process of monitoring and quarantine is initiated (vv. 31-39).

In every case where there is a legitimate concern that a מִכְוָה, סַפַּחַת, בַהֶרֶת, שְׂאֵת, or שְׁחִ֑ין may become a case of ṣāraʻaṯ, the individual in question must be brought [הוּבָא, Hofal 3ms] to the priest. This passive verb is used three times in the pericope: Once for the individual’s primary symptom and initial inspection (13:2), once for the secondary symptom and inspection (13:9), and lastly for the leper to report his cleansing (14:2). It is worth noting that an apparent conflict of interest arises regarding the latter. When the metzora appears before the priest to begin his cleansing process he is already healed. Ibn Ezra notes the dilemma and suggests a reason for the passive conjugation of the verbal root בּוֹא:

“He shall be brought is to be interpreted like its counterparts (Lev. 13:2), “He shall be brought, i.e., by his consent or against his will.” For it is possible that after the plague of leprosy is removed the afflicted person will not want to bring what he is obligated to.⁵

As we shall see later in this study, this noted dilemma will become a relevant issue as we interpret Yeshua’ interactions with lepers.[25]

Footnotes:

[1] William S. Morrow, An Introduction to Biblical Law (Grand Rapids, M.I.: Eerdmans Publishing Co. 2017), 111.

The highest concentration of biblical laws is found in Ex. 25 – Num. 36. Scholars like to divide these sections into two categories, “holiness code” (H) and “priestly code” (P), in their composition analysis. (P) is supposed to predate (H). The laws from P dominate Ex. 25-31 and Lev. 1-16.

[2] Leviticus 15:19-24.

[3] E.g., Leviticus 18:19.

[4] Unusual male discharge (Lev. 15:1-15), emission of semen (15:16-18), menstruation (15:19-24), unusual female discharge (15:24-30).

[5] E.g., Leviticus 18:19.

[6] Rashi to Num. 5:2. Cf. Talmud Bavli, Pesachim 67a; Sifra Parshat Tazria.

[7] Leviticus 13:45-46.

[8] Leviticus 14:46-47. Cf. Mishnah, Negaim 13.7.

[9] Pual, passive participle of the root צָרַע, lit. “to have leprosy.” See Lev. 14:2.

[10] Qal, passive participle of the same root. אִישׁ־צָרוּעַ – lit. “a leprous man.”

[11] True leprosy is caused by a rod-shaped acidfast bacillus, Mycobacterium leprae, and was discovered by Gerhard Armaeur Hansen in Bergen, Norway, in 1873 (Leprosy in the Bible: encyclopedia.com, November 29, 2021).

[12] “Leprosy.” In Encyclopedia Judaica. Vol. 11, 33. Jerusalem, Israel: Keter Publishing House Ltd., 1972.

[13] Ibid.

[14] Negaim is one of thirteen tractates that has no Gemara in either Talmuds (Bavli and Yerushalmi). Nevertheless, the Talmud devotes considerable discussion and analysis to the laws of ṣāraʻaṯ and matters pertaining to its subject.

[15] Basic Leprosy and rashes (vv. 1-8); Symptoms common to swelling (vv. 9-17); Inflammations (vv. 18-23); Burns (vv. 24-28); Leprosy of the head or face (vv. 29-37); and baldness at the front and back of the head (vv. 40-44).

[16] Talmud, Shevuot 6b.

[17] A priest in the line of Aaron: “it shall be reported to Aaron the priest or to one of his sons, the priests (Lev. 13:2).”

[18] Mishnah, Negaim 3.1.

[19] Ibn Ezra to Leviticus 14:3.

[20] See R. Campbell Thomas, M.A., F.S.A., “Assyrian Medical Texts.” Diseases of the Head, Translation XIII (February 1, 1924), 4.

In the ancient Near East, skin diseases were a cause for major concern and were often attributed to divine retribution or black magic. The cult priests oversaw the cleansing process but were also capable of concocting medicinal remedies for healing (Campbell 1924, 4). At any rate, the cleansing process was supposed to be therapeutic in nature whereas the responsibility of the Israelite Kohen was to diagnose and monitor. The Torah provides no medical remedy for צָרַעַת. The healing was miraculous in nature.

[21] See Leviticus 13:6, 39.

[22] See Isaiah 38:21 as a natural illness. See Ex. 9:9-11 as one of the 10 plagues of Egypt. Although God may inflict boils (Deut. 28:27, 35) it does not render ritual impurity according to the laws of צָרַעַת.

[23] Rashi to Leviticus 13:18.

[24] See Talmud, Chulin 8a.

[25] There is another delimma worth noting; but its subject is beyond the scope of this paper. The Torah states: “When it has been reported to the priest, the priest shall go outside the camp (14:3).” However, there is another passage that states: “He shall not go outside the sanctuary and profane the sanctuary of his God, for upon him is the distinction of the anointing oil of his God (Lev. 21:12).” As Ibn Ezra notes, this is resolved at the beginning of chapter 13 (v. 2) when the Torah states: “He should be brought to