The term ẓaraʿat is traditionally rendered "leprosy" because of its translation by Greek lepra (LXX, New Testament, and Josephus). The Greek covers a wide range of diseases that produced scales. Greek lepra may have included true leprosy, i.e., Hansen's disease, but is definitely not limited to it. In fact, biblical descriptions of ẓaraʿat do not include the necrosis associated with Hansen's disease. Thus far no skeletons of the biblical period show any signs of Hansen's disease. The term ẓaraʿat is a generic name, embracing a variety of skin ailments, including many non-contagious types. Thus, the illness of Miriam was transient (Num. 12:10–15) and that of Naaman did not prevent him from mixing freely in society (II Kings 5). Probably only those actually banished from their fellowmen were lifelong sufferers, e.g., the four "lepers" forced to live outside Samaria (II Kings 7:3–10) and King Uzziah, who was permanently quarantined in separate quarters (II Chron. 26:19–21). Medical texts of the ancient Near East attribute disease either to black magic or the sufferer's sin (R.C. Thompson, Assyrian Medical Texts (1923); A.L. Oppenheim, Ancient Mesopotamia (1977, 288–305). In the Bible, whenever a reason is given for an attack of ẓaraʿat, it is in connection with a challenge to a duly constituted authority (Zakovitch).   Miriam challenged the prophetic supremacy of Moses; Gehazi disobeyed the will of his master Elisha (II Kings 5:20–27); and Uzziah challenged the exclusive prerogative of the priests to offer incense. In the case of sin and black magic, rituals are prescribed that bear a striking resemblance to those in the Bible (see below), with one critical difference. In contrast to the Mesopotamian situation, in which priests may be healers, the Bible always attributes the healing of individuals to the intervention of prophets (e.g., Gen. 20:7; II Kings 5). The priest himself only rules on the purity or impurity of the sufferer (Kaufmann). -The Laws of Leviticus 13–14 Leviticus 13–14 is composed of the following sections: the diagnosis of the afflictions of the skin (13:2–28, 38–39, summarized below), of the hair (13:29–37), and of the scalp (13:40–44); the ostracism of the incurable (13:45–46; cf. Lam. 4:15); the diagnosis of the deterioration of garments, due probably to mildew or fungus (13:47–59); the ritual for the rehabilitation of the healed "leper" (14:1–32); the diagnosis of the "leprosy" of houses, probably caused by the spread of dry rot, mineral precipitates, or the growth of lichens and fungi (14:33–53); and the summary (14:54–57). The structure is logical, with houses being put at the end (cf. 14:34), a reflection of the reality of the period in which the texts were written. Though not all the technical terms are understood (see the commentaries), the symptoms given are capable of precise medical definition. The affliction can occur spontaneously (13:2–17), follow a furuncle (13:18–23) or a burn on the skin (13:24–28), or develop on the head or beard (13:29–45). The first symptoms are those of a swelling, or subcutaneous nodule, a cuticular crust (sappaḥat), and whitish-red spot (baheret). "The crux of the matter lay in the degree of cutaneous penetration which the disease had achieved. If it affected the epidermis or outermost layer of skin and did not produce pathological changes in the hairs, the affliction was not regarded as especially serious. As such it might consist of eczema, leukoderma, psoriasis, or some allied cutaneous disease. But if the affliction had infiltrated the dermis (corium) and had caused hairs to split or break off and lose their color, then "leprosy" was to be suspected" (R.K. Harrison). This diagnostic principle also applied to disease affecting the scalp (13:29–37) where the affliction was spoken of as netek (neteq) (JPS "scall"). -The Role of the Priest The Israelite priest, while usually not involved in individual healing according to the Bible, is involved in epidemics where he intercedes through sacrifices, Num. 17:11ff.; II Sam. 24:25 – David officiating as priest. Deut. 24:8–9, which deals with contagious skin diseases enumerated here is a possible exception; and contrast the laws pertaining to gonorrhea, Lev. 15. The priest was called in to inspect the affliction. If "leprosy" was only suspected but not certain, the priest imposed a seven-day quarantine. At the end of this period the afflicted was examined again, and if no further degeneration was apparent he was isolated for another week, after which he could be pronounced healed. The priest, however, did nothing to promote the cure. His rituals were performed only after the disease had passed. It was the responsibility of the afflicted himself to pray (I Kings 8:37–38; II Kings 20:2–3) and fast (II Sam. 12:16) in order to win God's healing. Deuteronomy 24:8–9 charges the people to follow the authority of the priests in all matters dealing with "leprosy," citing as precedent the case of Miriam (see Num. 12:11–16), who challenged the authority of Moses (alternatively, the late writer of Numbers 12 (see Sperling) was inspired by the juxtaposition of priestly authority in matters of "leprosy" with the mention of the unnamed punishment laid on Miriam by God in Deuteronomy 24:9). It is noteworthy that in Miriam's case healing did not come through Aaron the priest, who was a party to the offense, but through the prophet Moses and his prayer. In the Bible, healing comes from God directly (Ex. 15:26) or through the prophet (e.g., Moses, Ex. 15:25; Elisha, II Kings 2:21; Isaiah, II Kings 20:7–8). -The Ritual The prescribed ritual for the healed "leper" is of interest. Three separate ceremonies are required: for the first day (Lev. 14:2–8; also invoked for houses, 14:48–53), the seventh (14:9), and the eighth (14:10–32). The first-day ritual is performed by the priest outside the camp or city from which the "leper" has been banished. Cedar wood, crimson cloth, and a live bird are dipped into an earthen vessel containing a mixture of fresh water and the blood of a second bird. The "leper" (or "leprous" house) is sprinkled with this mixture seven times, after which the live bird is set free. The "leper" is admitted into the camp or city after he washes his clothes, shaves all his hair, and bathes, but he is not allowed to enter his residence. That is permitted him on the seventh day after shaving, laundering, and bathing again. On the eighth day he brings to the sanctuary oil and sheep for various offerings – whole, meal, purification, and reparation. The whole and purification animals may be commuted to birds if the "leper" is poor. However, the reparation lamb and log of oil may not be changed, because the blood of the lamb and the oil are needed to daub the "leper's" right ear lobe, right thumb, and right big toe. This complex ceremonial is elucidated by comparison with similar prescriptions in the ancient world. There is much evidence of the banishment of evil by carriers (J. Frazer, The Golden Bough, 6 (1935), 249ff.), especially animals (e.g., Hittite: F. Sommer and H. Ehelolf, Das hethitische Ritual des Papanikri von Komana (1924), III 45, Rev. iv, 5ff.; Mesopotamia and Israel: see azazel ). Aspersions of materials such as cedar, scarlet wool, and hyssop are also known (e.g., J. Laesse, Studies in the Assyrian Ritual… (1955); R.C. Thompson, The Devils and Evil Spirits of Babylon, vol. 2, 1904). Moreover, a letter of Nergal-sharrani to King Esarhaddon refers to an apotropaic prayer and a ritual for kamūnu fungus, which appeared in the inner court of the temple of Nab – and for the kattarru fungus on the walls of storehouses (R.F. Harper, Assyrian and Babylonian   Letters, 4 (1896), no. 367 = SAA XIII:71). Clearly, then, the purpose of the "leper's" ritual of the first day was to exorcise the demonic disease and banish it to a place of no return, e.g., the desert (see azazel ) or the open country in the case of the leper (ha-sadeh; Lev. 14:7, 53). In keeping with P's exclusion of the priest from participation in the healing of individuals, the ritual is prescribed only after "the priest sees that the 'leper' is healed" (14:3). If ritual purification is the purpose of the ritual of the first day, why its week-long extension? Here, in keeping with the priestly system of scaled impurities, a severe defilement endures for eight days after healing and calls for a three-stage purification, which reduces and finally eliminates this vestigial impurity (see Purity and Impurity, Ritual ). The rite of the first day enables the leper to mingle with, but not touch, the members of his community, nor can he enter a confined space lest he defile what it holds (see 14:8b; rabbinic מאהיל, cf. Kelim 1:4; Neg. 13:3, 7, 8, 11; Jos., Ant., 3:261ff.; Jos., Apion, 1:279ff.; cf. Num. 19:14). These restrictions are removed only at the end of the seventh day, after he has again shaved, laundered, and bathed. Having been restored to his community and household, he is still impure vis-à-vis the realm of the sacred: he has to be rehabilitated in the eyes of his God (ten times the text insists that the ritual is "before the Lord," Lev. 14:11–31). In the eighth-day ritual – the third and final stage – he therefore brings to the sanctuary a complex of sacrifices. The purification offering purges the sacred area of the defilement brought on by his "leprosy" (see atonement ); the whole and meal offerings expiate the sin that might have caused his affliction (e.g., Miriam, see above); the reparation offering is his expiation in case he has trespassed on sancta (maʿal, a sin punishable by leprosy, e.g., Uzziah, II Chron. 26:16–21; cf. Lev. 5:14–19; and see sacrifices ). The blood of the animal of reparation and the oil are successively daubed on the extremities of his body so that he may have access to the sanctuary and its sancta (as far as allowed to a layman). That sanctification is the purpose of this ritual is demonstrated by the consecration service of the priest (Ex. 29; Lev. 8), where the daubing of the same parts of the body is prescribed and where a mixture of oil and sacrificial blood is used (in sprinkling, not in daubing: note verb qadesh "sanctify." Ex. 29:21; Lev. 8:30). Israel's sanctification motif is illuminated by comparison with similarly structured rituals in the ancient Near East, where there is abundant attestation of daubing (see anointing ). The incantations recited during the ritual smearing of persons, the statues of gods, and buildings testify that its object is purificatory and apotropaic: to wipe off and ward off the incursions of menacing demonic forces. Hence it is always the vulnerable parts of bodies (extremities) and of structures (corners, entrances) that are smeared with substances with alleged special properties (e.g., Pritchard, Texts, 338). The Bible's "leprosy" laws are directed toward the larger community and do not constitute a priest's manual. As such, whatever additional incantations and exorcisms that may have been performed are lost to us. The purificatory and apotropaic are steps in the healed "leper's" rehabilitation, which enabled him to return to his community and qualified him to have access to the Sanctuary and God. Ezekiel's ritual of consecration for the altar is strikingly analogous: blood is to be daubed on its horns and the corners of its two gutters, located at its middle and bottom (Ezek. 43:20). These points correspond to a person's ear lobe, thumb, and big toe. There can be no question that the purpose of this altar ritual (as in the consecration of the priests) is sanctificatory; the same must be said of the eighth-day ritual for the "leper." (Jozeph Michman (Melkman) / S. David Sperling (2nd ed.) -In the Second Temple and Talmud The laws of leprosy are given in great detail in the Talmud, and a whole tractate of the Mishnah and Tosefta, Nega'im , is devoted to them. It is reported that in the courtyard of the Temple itself, on the northwest, there was the Chamber of the Lepers where the lepers remained after they had been cured, and where they bathed on the eighth day of their purification, awaiting their admittance for the anointing of their toes (Neg. 14:8; Mid. 2:5). In the New Testament there are numerous references to lepers. In the two instances in which Jesus is said to have cured lepers (one an individual – Luke 5:12–14; cf. Matt. 8:3; and the other a group of ten – Luke 17:12), he told them, "Go show yourself to the priest," after their cure, and one passage (Luke 5:14) adds, "and make an offering for thy cleansing, as Moses commanded…" This is evidence that the biblical laws were in operation, both as regards the functions of the priest and the obligatory offering. The Apostles are told in general to cleanse the lepers (Matt. 10:8; Luke 7:22). On the other hand there are hardly any references in the tannaitic period to actual cases of leprosy. Tosefta Negaim (6:1) includes the "house affected by leprosy" (Lev. 14:34–53) among those laws which "never were and never will be," their purpose being merely "to expound and receive reward therefore" (cf. rebellious son ). Eleazar b. Simeon, however, adds that there was a site in the vicinity of Gaza which used to be called "the enclosed ruin" (which was presumably a house affected by leprosy which had been destroyed in accordance with the law (Lev. 14:45), and Simeon b. Judah of Kefar Akko (according to the amendment of Elijah Gaon of Vilna) said that there was a site in Galilee which used to be pointed out as having within its bounds leprous stones. It is also stated that according to the halakhah, the law of quarantine for lepers fell into abeyance when the Jubilee year (see sabbatical year and jubilee ) was not in operation (cf. Tosef., Ber. 5b top), i.e., presumably during the Second Temple period. Josephus, who was both a priest and lived during the time of the Temple, in his description of the Mosaic laws, states that it was forbidden to the leper to "come into the city at all (or) to live with any others, as if they were in effect dead persons." He makes a sharp contrast between this law and the fact that "there are lepers in many nations who are yet in honor, and not only free from reproach and avoidance, but who have been great captains of armies, and been entrusted with high office in the commonwealth and have had the privilege   of entering into holy places and temples" (Ant., 3:261–9). It is possible, however, that this passage is merely a reference to Naaman, the commander of the army of Syria (II Kings 5, especially vs. 5 and 18). By the time of the compilation of the Mishnah and Tosefta, at the beginning of the third century, the laws of leprosy were regarded as the most abstruse and complicated of laws. Eleazar b. Simeon on one occasion said to R. Akiva, "What have you to do with aggadah? Turn to the subject of leprosy" (Ḥag. 14a). Although, according to the Talmud, leprosy did not exist in Babylon "because they eat turnips and drink beer and bathe in the Euphrates" (Ket. 77b), it seems to have existed in Ereẓ Israel in mishnaic and amoraic times. R. Johanan and Resh Lakish stated that it is forbidden to walk four cubits, or 100 cubits (dependent upon whether there was a wind blowing at the time) to the east of a leper; R. Meir refrained from eating eggs which came from a district where lepers lived; R. Ammi and R. Assi never entered such a district; when Resh Lakish saw one he would cast stones at him, exclaiming, "get back to your location and do not contaminate other people"; and R. Eleazar b. Simeon would hide from them (Lev. R. 16:3). As Katzenelson points out, since the segregation enjoined in the Bible no longer applied in talmudic times, this segregation and its consequences were the result of popular feeling, and not a legal requirement. There is a geonic responsum which states explicitly, "among the people of the east, that is, in Babylonia, at the present time, if, God forbid, a scholar should be affected by leprosy, he is not excluded from the synagogue or the schools, since today the injunction, 'thy camp shall be holy' (Deut. 23:15; i.e., the laws of ritual cleanness) no longer applies" (Sha'arei Teshuvah, no. 176). Reference should be made to the allegation first mentioned by the Egyptian historian manetho , and repeated by chaereman , lysimachus , and other Egyptian writers hostile to the Jews, and quoted by apion , to the effect that not only was Moses a leper, but the children of Israel were expelled from Egypt because they suffered from leprosy. Indeed, according to Lysimachus the seventh day was called Sabbaton because of the leprous disease of the groin which they suffered which is called Sabbo in Egyptian (Jos., Apion, 1:227ff., 2:20–21). -In the Aggadah Aside from the practical issue of the observance of the regulations of ritual cleanness in general, and of the laws of leprosy in particular after the destruction of the Temple, it should be noted that the rabbis derived from the laws of leprosy a moral lesson. Homiletically interpreting the word meẓora as connected with moẓi shem ra, "the person guilty of slander or libel," they regarded leprosy primarily as a divine punishment for this evil, an interpretation which receives historical support by the punishment of Miriam for her slander of Moses (Num. 12:1–15), and the rabbis add that Aaron suffered the same punishment for the same reason (Shab. 97a). Among other sins which bring leprosy as retribution are "the shedding of blood, taking oaths in vain, incest, arrogance, robbery, and envy" (Ar. 16a), as well as benefiting from sacred objects (Lev. R. 17:3). From the combination of the cedar, which represents haughtiness, and the hyssop, the symbol of lowliness, in the purification rites for the leper (Lev. 14:4) the rabbis derived the lesson that man should ever humble himself (see Rashi to Lev. 14:4). The leper was one of the four unfortunates considered to suffer a living death (Ned. 64b; Sanh. 47a; cf. Num. 12:12). That leprosy was assumed to result from a lack of hygiene is indicated not only by the reason given for its absence in Babylon (see above), but also from such statements as that it comes from flies (Ḥag. 14a), whereas the notion that children born from intercourse with a menstruant woman will be afflicted by it (Lev. R. 15:5) is more likely to be related to issues of sin and impurity than to hygiene. The aggadah makes a considerable addition to the number of characters mentioned in the Bible as having been struck with leprosy. They include Cain (Gen. R. 22:12), the daughter of Pharaoh (Ex. R. 1:23), Aaron (see above), Doeg (Sanh. 106b), David (Sanh. 107a), Goliath (Lev. R. 17:3), and Vashti (Meg. 12b). According to the Midrash, the reference to the pharaoh who died (Ex. 2:23) actually refers to the fact that he was afflicted with leprosy. His advisers told him that the only cure was to bathe morning and evening in the blood of 150 Hebrew children, but the decree was averted by God, who in his compassion cured Pharaoh (Ex. R. 1:34). (Louis Isaac Rabinowitz) -BIBLIOGRAPHY: Kaufmann, Y., Toledot, 1 (1937), 539–58; Kaufmann, Y., Religion, 103–10; R.K. Harrison, in: IDB, 3 (1962), 111–3, 331–4. IN THE SECOND TEMPLE AND TALMUD: I.M. Rabbinowicz, La Médicine du Talmud (1880), 107ff.; G.N. Minkh, Prokaza i pes (1890); J. Preuss, Biblisch-talmudische Medizin (19233), 369–90; J.L. Katzenelson, Ha-Talmud ve-Ḥokhmat ha-Refu'ah (1928), 304–53; H.L. Strack and P. Billerbeck, Kommentar zum Neuen Testament aus Talmud und Midrash, 14 (1928), 745–63; Ginzberg, Legends, index; A.R. Short, The Bible and Modern Medicine (1953), 74–83. ADD. BIBLIOGRAPHY: Y. Zakovitch, Every High Official (1986); B. Levine, JPS Torah Commentary Leviticus (1989), 75–92; J. Milgrom, Leviticus 116 (AB; 1991); D. Wright and R. Jones, in: ABD, 4:277–82; R. Biggs, in: CANE III, 1916; H. Avalos, Illness and Health Care in the Ancient Near East (1996), 233–420; S.D. Sperling, in: HUCA, 70–71 (1999–2000), 39–55.

Encyclopedia Judaica. 1971.

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