Lange Commentary - Leviticus 13:1 - 14:57

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Lange Commentary - Leviticus 13:1 - 14:57


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THIRD SECTION

Laws Concerning Leprosy

Chaps. 13, 14

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PRELIMINARY NOTE

The disease of leprosy has happily become so rare in modern times in the better known parts of the world that much obscurity rests upon its pathology. The attempt will only be made here to point out those matters which may be considered as fixed by common consent, but which will be found sufficient for the illustration of the more important points in the following chapters.

In the first place, then, it appears indisputable that leprosy is a broad name covering several varieties of disease more or less related to one another. These are separable into two main classes, one covering the different, forms of Elephantiasis (tuberculated and anæsthetic); the other, the Lepra vulgaris. Psoriasis, Syphilis, etc. It is the former class alone with which Leviticus has to do as a disease. At the present time the tuberculated variety is said to be the more common in those countries in which leprosy still exists to any considerable extent, while the anæsthetic was probably more prevalent in the time of Moses. The latter is described by Celsus under the name of ëåýêç , and Keil maintains that the laws of Moses in regard to leprosy in man relate exclusively to this. Clark, however, has shown “that the two in a great number of cases work together, and as it did in the days of Moses, the disease appears occasionally in an ambiguous form.” Wilson has recorded a number of cases in detail, showing the interchange of the two forms in the same patient. The symptoms of the disease intended by Moses sufficiently appear in the text itself, and if these symptoms cover what would now appear in medical nomenclature as different diseases, then all those diseases, classified under the general name of leprosy were intended to be included in the Levitical legislation.

Nothing whatever is said in the law either of the origin, the contagiousness, or the cure of the disease. In modern experience it seems to have been sufficiently proved that it is hereditary, but only to the extent of three or four generations, when it gradually disappears; neither is it in all cases hereditary, the children of lepers being sometimes entirely unaffected by leprosy, and on the other hand the disease often appearing without any hereditary taint. In its first appearance it is now often marked only by some slight “spot” upon the skin, giving no pain or other inconvenience, but obstinately resisting all efforts at removal, and slowly but irresistibly spreading. Sometimes months, sometimes years, even to the extent of twenty or thirty years, intervene between the first appearance of the “spots” and their development. It is not improbable that in the course of many centuries a considerable modification in the rapidity of its progress may have taken place in a disease which is found gradually to die out by hereditary transmission. The question of its contagiousness is still much mooted among the medical faculty. The better opinion seems to be that it is not immediately contagious, but is propagated by prolonged and intimate intercourse in the case of susceptible persons. At least it is certain that in all known instances of the prevalence of the disease one of the most important of the means of control has been the segregation of the lepers, and where this precaution has been neglected, the disease has continued to prevail. After the leprosy has once acquired a certain degree of development, there is no known means of cure. Everything hitherto attempted has been found to rather aggravate than mitigate the disorder. It is asserted that it yields to medical treatment in its earliest stages when the “spots” first appear, and a number of distinct cases of cure are recorded; but the doubt will always remain whether the disease which yields is really leprosy, or whether something else has not been confounded with an undeveloped stage of the true disease. However this may be, it is certain that after it has once become developed to any considerable extent it is incurable by any remedies at present known, although spontaneous cures do sometimes occur. The reliance for its control is more upon diet, cleanliness, and general regimen, than upon specific antidotes.

Medical observations upon the disease in modern times have been made in the island of Guadaloupe, where it broke out about the middle of the last century, and was very carefully investigated by M. Peyssonel, a physician sent out by the French government for the purpose. An account of the result, of his examination, as well as of other investigations of English, French, and German physicians in other islands of the West Indies whither it had been imported from Africa, and in other parts of the world is given by Michaelis (Laws of Moses, Art. 208, 210). Also of especial importance is a “Report on the leprosy in Norway by Dr. Danielssen, chief physician of the leper hospital at Bergen, and Prof. Boeck” (Paris, 1848). The subject of late years has considerably interested physicians, and the London “College of physicians” have published a report upon it, based upon a series of questions addressed to nearly all parts of the world where the disease now prevails. Many other authorities are cited by Clark in his preliminary note to these chapters. A particularly valuable discussion of the disease may be found in Wilson, Diseases of the skin, ch. xiii. (5th Am. Ed., pp. 300–314 and 333–381). The disease appears to have been more or less common in Western Europe from the eighth century down, but received a great extension at the time of the crusades. At one time a partial enumeration by Dugdale mentions eighty-five leper houses in England alone, six of which were in London, and it continued to linger in Scotland until the middle of the last century. It still exists to a considerable extent in Iceland and Norway, and in all the countries bordering the Eastern shores of the Mediterranean, especially Syria and Egypt, where it has found a home in all ages, in some parts of Africa, Arabia, and India.

The characteristics of the disease are the exceedingly slight symptoms at its first appearance; its insidious, and usually very slow progress, the horribly repulsive features of its later stages when the face becomes shockingly disfigured, and often the separate joints of the body become mortified and drop off one by one; and its usually sudden and unexpected termination at the last, when the leprosy reaches some vital organ, and gives rise to secondary disease, often dysentery, by which life is ended. Meanwhile, during the earlier stages, generally very prolonged, there is no suffering, and the ordinary enjoyments of life are uninterrupted.

Leprosy, with these characteristics, especially its hidden origin, and its insidious and resistless progress, has always seemed a mysterious disease, and among the heathen as well as among the Jews, has been looked upon as an infliction especially coming from God. In fact in Hebrew history it was so often employed in Divine judgments, as in the case of Miriam, of Gehazi, and of Uzziah, and was also so often healed by miraculous interposition, as in the case of Miriam also, and of Naaman, as to give some reason for this belief; while the peculiar treatment it received in the law tended still further to place leprosy in a position of alienation from the theocratic state, and actually included the leper in that “uncleanness” which was utterly excluded from approach to the sanctuary. The disease thus became a vivid symbolism of sin, and of the opposition in which this stands to the holiness of God; while at the same time its revolting aspect in its later stages made it such an image, and indeed a beginning, of death itself that it is often most appropriately described by Jewish as well as other writers as “a living death.” Much of the association with death and the body in the corruption of death, thus attached to leprosy and the corruption at work in leprosy. It is not necessary here to speak of the prevailing Hebrew notion that all suffering was the consequence of individual sin, and was proportioned in severity to the degree of that sin; for however deeply seated such ideas may have been in the minds of many of the Israelites, and however much they may have increased the popular dread and abhorrence of leprosy, they find no shadow of encouragement whatever in the law.

In regard to what is called “leprosy” in houses, in textile fabrics, and in leather, it is not necessary to suppose that the name is intended to convey the idea of an organic disease in these inanimate things. The law will still be sufficiently clear if we look upon the name as merely applied in these cases to express a kind of disintegration or corruption, such as could be most readily and popularly described, from certain similarities in appearance, by the figurative use of the word. In the same way the terms out of joint, sick, and others have come among ourselves to be popularly used of inanimate things, and such words as blistered, bald, and rotten, have a technical figurative sense almost more common than their original literal one. These modes of disintegration have been often investigated with great learning and labor; but it is not surprising that at this distance of time, and after such profound changes in the arts and the habits of men, the result of all such investigations should remain somewhat unsatisfactory. Just enough has been ascertained to show that inanimate things, of the classes here described, are subject to processes of decay which might be aptly described by the word leprosy; but precisely what the processes were to which the Levitical law had reference it is probably impossible now to ascertain definitely. The most satisfactory treatment of the subject from this point of view is to be found in Michaelis (ubi supra, Art. 211). He instances in regard to houses, the formation of saltpetre or other nitrous salts upon the walls to such an extent in some parts of Germany as to become an article of commercial importance, and to be periodically scraped off for the market. By others the existence of iron pyrites in the dolomitic limestone used for building in Palestine has been suggested as leading in its decomposition to precisely the appearances described in the law—hollow streaks of the green ferrous sulphate and the red of ferric sulphate—upon the walls of the houses affected; but proof is wanting of the existence in that stone of pyrites in sufficient abundance to produce the effects contemplated in the law. Both these explanations, however, are suggestive of methods of disintegration which might have occurred, but for the determination of which we have not sufficient data. It is the same with the explanation of Michaelis in regard to woolen fabrics,—that the wool itself is affected by diseases of the sheep upon which it has grown. The fact itself does not seem sufficiently well authenticated; nor if it were, would it be applicable to garments of linen. Nevertheless, this is suggestive of defects in the materials,—which were in all cases of organic production—arising either from diseased growth, or from unskilfulness in the art of their preparation, which would after a time manifest themselves in the product, much in the same way as old books now sometimes become spotted over with a “leprosy” arising from an insufficient removal of the chemicals employed in the preparation of the paper pulp.

But whatever the nature and origin of this sort of “leprosy,” it is plainly regarded in the Levitical law as is no sense contagious, or in any way calculated to produce directly injurious effects upon man. It is provided for in the law, it would appear, partly on the general ground of the inculcation of cleanliness, and partly from association with the human disease to which it bore an external resemblance, and to which the utmost repugnance was to be encouraged. Even the likeness and suggestion of leprosy was to be held unclean in the homes of Israel.

No mention has thus far been made of a theory of this disease adopted by many physicians, and which, if established, might really assimilate the leprosy in houses and garments and skins to that in the human body, and explain the origin of all alike by the same cause. According to this theory, the disease is occasioned by vegetable spores, which find a suitable nidus for their development either in the human skin or in the other substances mentioned. If this theory should be accepted, the origin and effects of the disintegrating agencies would be the same in all cases. The late eminent physician, Dr. J. K. Mitchell, in his work upon the origin of malarious and epidemic fevers (Five Essays, p. 94), after quoting the law in relation to leprosy, says: “There is here described a disease whose cause must have been of organic growth, capable of living in the human being, and of creating there a foul and painful disease of contagious character, while it could also live and reproduce itself in garments of wool, linen, or skin; nay more, it could attach itself to the walls of a house, and there also effect its own reproduction. Animalcules, always capable of choice, would scarcely be found so transferable; and we are therefore justified in supposing that green or red fungi so often seen in epidemic periods, were the protean disease of man, and his garment, and his house.” He further quotes from Hecker statements corroboratory of his views in regard to the plagues of 786 and 959. This theory, however, has not here been urged, partly because it yet needs further proof, partly because no theory at all is necessary to account for the Levitical legislation in view of the facts presented in the law.

For the literature of the subject, besides the reference above given, see the art. by Hayman, Leper, Leprosy, in Smith’s Bibl. Dict., and the Preliminary note on these chapters in Clark’s Com. on Lev., together with the appended notes to the same.

At the opening of his “Exegetical” Lange has the following, which may be appropriately placed here: “First of all, it must be made prominent that the leprosy, under the point of view taken, and the sentence of uncleanness, is placed as a companion to the uncleanness of birth, as the representative of all ways of death, of all sicknesses. It is unclean first in itself, as a death element in the stream of life—in the blood—even as the source of life appears disturbed in the relations of birth; but still more it is unclean as a sickness spreading by transmission and contagion.

“Hence it appears also as a polluting element of physical corruption, not only in men, but also through the analogy of an evil diffusing itself, in human garments and dwellings. The analogous evils of these were, on this account, called leprosy.

“In this extension over man and his whole sphere it is, in its characteristics, a speaking picture of sin and of evil the punishment of sin; it is, so to speak, the plastic manifestation, the medical phantom or representation of all the misery of sin.

“Accordingly the leprosy, and the contact with it, is the specific uncleanness which excluded the bearer of it from the theocratic community, so that he, as the typically excommunicated person, must dwell without the camp.

“Nothing is here said of the application of human means of healing in reference to this evil. The leper was left with his sickness to the mercy of God and to the wonderfully deep antithesis of recovery and death; the more so, since leprosy in a peculiar sense is a chronic crisis, a progressive disease, continually secreting matter, whether for life or for death. Mention is made of external counteraction only in regard to leprosy in garments and houses. Hence, from its nature, it is altogether placed under the supervision of the priest. The priest knew the characteristics of the leprosy, and the course of its crises; he had accordingly to decide upon the exclusion and upon the restoration of the sick, and to express the latter by the performance of the sacrifice of purification brought for this purpose by the convalescent.

“Thus in conformity to the spirit of Oriental antiquity, the priest here appears as the physician also for bodily sicknesses, as a watchman over the public health. But for the cosmic evils he was still less a match than for those of the body; against such the prophet must reveal miraculous helps, e.g., against the bitterness of the water, and against the bite of the fiery serpents.

“The great contrast between the Old and the New Testaments is made prominent in the fact, that in the Old Testament the touch of the leper made unclean,—apparently even leprous;—while Christ by His touch of the lepers cleansed them from their leprosy. But it continued to be left to the priest, as the representative of the old covenant, to pronounce the fact. See Comm. S. Matt., p. 150.”

“The name Leprosy, öָøַòַú is derived from öָøַò to strike down, to strike to the ground; the leprosy is the stroke of God. Gesenius distinguishes the leprosy in men, the leprosy in houses (probably the injury done by saltpetre), and the leprosy in garments (mould, mildew). On this chronic form of sickness, fully equal to the acute form of the plague, comp the article Leprosy (Aussatz) in the dictionaries, especially in Herzog’s Real-encyclopädie, and in Winer. Four principal forms are distinguished, of which three are particularly described by Winer: 1) The white leprosy, Barras, ëåõêÞ . “This prevailed among the Hebrews (2Ki_5:27, etc.) and has hence been called by physicians lepra Mosaica. See the description in Winer, I. p. 114. 2) The Elephantiasis, lepra nodosa, or tuberculosa, tubercular leprosy, Egyptian boil, thus endemic in Egypt. “The sickness of Job was commonly considered in antiquity to have been this kind of leprosy.” 3) The black leprosy or the dark Barras. Later medical researches (to which the articles in Bertheau’s Conversations-lexicon, and Schenkel’s Bibel-lexicon refer) show the differences between the various kinds as less defined; the contagious character is called in question by Furrer (in Schenkel). In this matter indeed, it is a question whether the rigid isolation of the leprous has not hindered, in a great degree, the examples of contagion.” For a catalogue of the literature, see Knobel, p. 469 and beyond.