Leviticus 13:1-59 NIV
Regulations About Defiling Skin Diseases
1The Lord Said to Moses and Aaron, 2“When anyone has a swelling or a rash or a shiny spot on their skin that may be a defiling skin disease,a they must be brought to Aaron the priest or to one of his sonsb who is a priest. 3The priest is to examine the sore on the skin, and if the hair in the sore has turned white and the sore appears to be more than skin deep, it is a defiling skin disease. When the priest examines that person, he shall pronounce them ceremonially unclean. 4If the shiny spot on the 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 isolate the affected person for seven days. 5On the seventh day the priest is to examine them, and if he sees that the sore is unchanged and has not spread in the skin, he is to isolate them for another seven days. 6On the seventh day the priest is to examine them again, and if the sore has faded and has not spread in the skin, the priest shall pronounce them clean; it is only a rash. They must wash their clothes, and they will be clean. 7But if the rash does spread in their skin after they have shown themselves to the priest to be pronounced clean, they must appear before the priest again. 8The priest is to examine that person, and if the rash has spread in the skin, he shall pronounce them unclean; it is a defiling skin disease.
9“When anyone has a defiling skin disease, they must be brought to the priest. 10The priest is to examine them, 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 them unclean. He is not to isolate them, because they are already unclean.
12“If the disease breaks out all over their skin and, so far as the priest can see, it covers all the skin of the affected person from head to foot, 13the priest is to examine them, and if the disease has covered their whole body, he shall pronounce them clean. Since it has all turned white, they are clean. 14But whenever raw flesh appears on them, they will be unclean. 15When the priest sees the raw flesh, he shall pronounce them unclean. The raw flesh is unclean; they have a defiling disease. 16If the raw flesh changes and turns white, they must go to the priest. 17The priest is to examine them, and if the sores have turned white, the priest shall pronounce the affected person clean; then they will be clean.
18“When someone has a boil on their skin and it heals, 19and in the place where the boil was, a white swelling or reddish-white spot appears, they must present themselves 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 that person unclean. It is a defiling 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 isolate them for seven days. 22If it is spreading in the skin, the priest shall pronounce them unclean; it is a defiling disease. 23But if the spot is unchanged and has not spread, it is only a scar from the boil, and the priest shall pronounce them clean.
24“When someone has a burn on their 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 a defiling disease that has broken out in the burn. The priest shall pronounce them unclean; it is a defiling 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 isolate them for seven days. 27On the seventh day the priest is to examine that person, and if it is spreading in the skin, the priest shall pronounce them unclean; it is a defiling 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 them clean; it is only a scar from the burn.
29“If a man or woman has a sore on their head or 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 them unclean; it is a defiling skin disease on the head or chin. 31But if, when the priest examines the sore, it does not seem to be more than skin deep and there is no black hair in it, then the priest is to isolate the affected person for seven days. 32On the seventh day the priest is to examine the sore, and if it has not spread and there is no yellow hair in it and it does not appear to be more than skin deep, 33then the man or woman must shave themselves, except for the affected area, and the priest is to keep them isolated another seven days.34On the seventh day the priest is to examine the sore, and if it has not spread in the skin and appears to be no more than skin deep, the priest shall pronounce them clean. They must wash their clothes, and they will be clean. 35But if the sore does spread in the skin after they are pronounced clean, 36the priest is to examine them, and if he finds that the sore has spread in the skin, he does not need to look for yellow hair; they are unclean. 37If, however, the sore is unchanged so far as the priest can see, and if black hair has grown in it, the affected person is healed. They are clean, and the priest shall pronounce them 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; they are clean.
40“A man who has lost his hair and is bald 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 a defiling 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 a defiling skin disease, 44the man is diseased and is unclean. The priest shall pronounce him unclean because of the sore on his head.
45 “Anyone with such a defiling disease must wear torn clothes, let their hair be unkempt, cover the lower part of their face and cry out, ‘Unclean! Unclean!’ 46 As long as they have the disease they remain unclean. They must live alone; they must live outside the camp.
Regulations About Defiling Molds
47“As for any fabric that is spoiled with a defiling mold—any woolen or linen clothing, 48any woven or knitted material of linen or wool, any leather or anything made of leather— 49if the affected area in the fabric, the leather, the woven or knitted material, or any leather article, is greenish or reddish, it is a defiling mold and must be shown to the priest. 50The priest is to examine the affected area and isolate the article for seven days. 51On the seventh day he is to examine it, and if the mold has spread in the fabric, the woven or knitted material, or the leather, whatever its use, it is a persistent defiling mold; the article is unclean. 52He must burn the fabric, the woven or knitted material of wool or linen, or any leather article that has been spoiled; because the defiling mold is persistent, the article must be burned.
53“But if, when the priest examines it, the mold has not spread in the fabric, the woven or knitted material, or the leather article, 54he shall order that the spoiled article be washed. Then he is to isolate it for another seven days. 55After the article has been washed, the priest is to examine it again, and if the mold has not changed its appearance, even though it has not spread, it is unclean. Burn it, no matter which side of the fabric has been spoiled. 56If, when the priest examines it, the mold has faded after the article has been washed, he is to tear the spoiled part out of the fabric, the leather, or the woven or knitted material. 57But if it reappears in the fabric, in the woven or knitted material, or in the leather article, it is a spreading mold; whatever has the mold must be burned. 58Any fabric, woven or knitted material, or any leather article that has been washed and is rid of the mold, must be washed again. Then it will be clean.”
59These are the regulations concerning defiling molds in woolen or linen clothing, woven or knitted material, or any leather article, for pronouncing them clean or unclean.
Leprosy in the Bible
The fact of the following rules for distinguishing the plague of leprosy being incorporated with the Hebrew code of Laws, proves the existence of the odious disease among that people. But a short time, little more than a year when symptoms of leprosy seem extensively to have appeared among them; and as they could not be very liable to such a disorder amid their active journeying and in the dry open air of Arabia, the seeds of the disorder must have been laid in Egypt, where it has always been endemic.
There is every reason to believe that this was the case: that the leprosy was not a family complaint, hereditary among the Hebrews, but that they got it from their contacts with the Egyptians and from the unfavorable circumstances of their condition in the house of bondage. The great excitement and irritability of the skin in the hot and sandy regions of the East produce a far greater predisposition to leprosy of all kinds than in cooler temperatures; and cracks or blotches, inflammations or even contusions of the skin, very often lead to these in Arabia and Palestine, to some extent, but particularly in Egypt.
Besides, the subjugated and distressed state of the Hebrews in Egypt, and the nature of their employment, must have rendered them very liable to this as well as to various other blemishes of the skin; in the production of which there are no causes more active or powerful than a depressed state of body and mind, hard labor under a burning sun, the body constantly covered with the excoriating dust of brick fields, and an impoverished diet—to all of which the Israelites were exposed while under the Egyptian bondage.
It appears that, in consequence of these hardships, there was, even after they had left Egypt, a general predisposition among the Hebrews to the contagious forms of leprosy—so that it often occurred as a consequence of various other affections of the skin. And hence all blemishes or blains—especially such as had a tendency to terminate in leprosy—were watched with a jealous eye from the first [Good, Study of Medicine]. A swelling, a pimple, or bright spot on the skin, created a strong ground of suspicion of a man's being attacked by the dreaded disease.
Like the Egyptian priests, the Levites united the character of physician with that of the sacred office; and on the appearance of any suspicious eruptions on the skin, the person having these was brought before the priest—not, however, to receive medical treatment, though it is not improbable that some purifying remedies might be prescribed, but to be examined with a view to those sanitary precautions which it belonged to legislation to adopt.
The leprosy, as covering the person with a white, scaly scurf, has always been accounted an offensive blemish rather than a serious malady in the East, unless when it assumed it’s less common and malignant forms.
When a Hebrew priest, after a careful inspection, discovered under the blemish the distinctive signs of contagious leprosy, the person was immediately pronounced unclean, and is supposed to have been sent out of the camp to a place provided for that purpose.
If the symptoms appeared to be doubtful, he ordered the person to be kept in domestic confinement for seven days, when he was subjected to a second examination; and if during the previous week the eruption had subsided or appeared to be harmless, he was instantly discharged. But if the eruption continued unabated and still doubtful, he was put under surveillance another week; at the end of which the character of the disorder continued to manifest itself, and he was either doomed to perpetual exclusion from society or allowed to go at large. A person who had thus been detained on suspicion, when at length set at liberty, was obliged to "wash his clothes," as having been tainted by ceremonial pollution; and the purification through which he was required to go was, in the spirit of the Mosaic dispensation, symbolical of that inward purity it was instituted to promote.
Those doubtful cases, when they assumed a malignant character, appeared in one of two forms, apparently according to the particular constitution of the skin or of the habit generally. The one was "somewhat dark" [Leviticus 13:6]—that is, the obscure or dusky leprosy, in which the natural color of the hair (which in Egypt and Palestine is black) is not changed, as is repeatedly said in the sacred code, nor is there any depression in the dusky spot, while the patches, instead of keeping stationary to their first size, are perpetually enlarging their boundary. The patient laboring under this form was pronounced unclean by the Hebrew priest or physician, and hereby sentenced to a separation from his family and friends—a decisive proof of its being contagious.
This BRIGHT WHITE leprosy is the most malignant of all the varieties the disease exhibits, and it was marked by the following distinctive signs: A glossy white and spreading scale, upon an elevated base, the elevation depressed in the middle, but without a change of color; the black hair on the patches participating in the whiteness, and the scaly patches themselves perpetually enlarging their boundary. Several of these characteristics, taken separately, belong to other blemishes of the skin as well; so that none of them was to be taken alone, and it was only when the whole of them concurred that the Jewish priest, in his capacity of physician, was to pronounce the disease a malignant leprosy.
If it spread over the entire frame without producing any ulceration, it lost its contagious power by degrees; or, in other words, it ran through its course and exhausted itself. In that case, there being no longer any fear of further evil, either to the individual himself or to the community, the patient was declared clean by the priest, while the dry scales were yet upon him, and restored to society. If, on the contrary, the patches ulcerated and quick or fungous flesh sprang up in them, the purulent matter of which, if brought into contact with the skin of other persons, would be taken into the constitution by means of absorbent vessels, the priest was at once to pronounce it an inveterate leprosy. A temporary confinement was them declared to be totally unnecessary, and he was regarded as unclean for life [Dr. Good]. Other skin affections, which had a tendency to terminate in leprosy, though they were not decided symptoms when alone, were: "a boil" (Leviticus 13:18-23); "a hot burning,"—that is, a fiery inflammation or carbuncle (Leviticus 13:24-28); and "a dry scall" (Leviticus 13:29-37), when the leprosy was distinguished by being deeper than the skin and the hair became thin and yellow.
This modification of the leprosy is distinguished by a dull white color, and it is entirely a cutaneous disorder, never injuring the constitution. It is described as not penetrating below the skin of the flesh and as not rendering necessary an exclusion from society. It is evident, then, that this common form of leprosy is not contagious; otherwise Moses would have prescribed as strict a quarantine in this as in the other cases. And hereby we see the great superiority of the Mosaic Law (which so accurately distinguished the characteristics of the leprosy and preserved to society the services of those who were laboring under the uncontagious forms of the disease) over the customs and regulations of Eastern countries in the present day, where all lepers are indiscriminately proscribed and are avoided as unfit for free contact with their fellow men.
The person who was declared affected with the leprosy forthwith exhibited all the tokens of suffering from a heavy calamity. Rending garments and uncovering the head were common signs of mourning. As to "the putting a covering upon the upper lip," that means either wearing a moustache, or simply keeping a hand over it. All these external marks of grief were intended to proclaim, in addition to his own exclamation "Unclean!" that the person was a leper, whose company everyone must shun.
Hansen’s Disease in the Medicine
Leprosy, also known as Hansen's disease (HD), is a chronic infection caused by the bacterium Mycobacterium leprae and Mycobacterium lepromatosis. Leprosy takes its name from the Latin word Lepra, while the term "Hansen's Disease" is named after the physician Gerhard Armauer Hansen.
It is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external sign. Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of secondary infections; these occur as a result of the body's defenses being compromised by the primary disease.
Secondary infections, in turn, can result in tissue loss causing fingers and toes to become shortened and deformed, as cartilage is absorbed into the body. Treatment for multibacillary leprosy consists of rifampicin, dapsone, and clofazimine taken over 12 months. Single dose multidrug therapy (MDT) for single lesion leprosy consists of rifampicin, of loxacin, and minocycline. The move toward single-dose treatment strategies has reduced the rates of disease in some regions. World Leprosy Day was created to draw awareness to those affected by leprosy.
In 1995, the World Health Organization (WHO) estimated that between 2 and 3 million people were permanently disabled because of leprosy at that time. In the past 20 years, 15 million people worldwide have been cured of leprosy.
Leprosy has affected humanity for over 4,000 years, and was recognized in the civilizations of ancient China, Egypt and India. Although the forced quarantine or segregation of patients is unnecessary in places where adequate treatments are available, many leper colonies still remain around the world in countries such as India (where there are still more than 1,000 leper colonies), China, and Japan.
Leprosy was once believed to be highly contagious and was treated with mercury—all of which applied to syphilis, which was first described in 1530. It is possible that many early cases thought to be leprosy could actually have been syphilis. The age-old social stigma associated with the advanced form of leprosy lingers in many areas, and remains a major obstacle to self-reporting and early treatment. Effective treatment first appeared in the late 1940s. Resistance has developed to initial treatment. It was not until the introduction of MDT in the early 1980’s that the disease could be diagnosed and treated successfully within the community.