A Physician’s Reflections on Old Testament Medicine

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Latter-day Saints demonstrate a perennial interest in health issues of all kinds, from the dietary role of meats to the therapeutic use of herb teas. At least some of this interest can be attributed to Mormon appreciation of the Old Testament, a feeling of kinship with the Jews, and a belief that the Law of Moses included a strict health code akin to the Word of Wisdom.[1]

Of course, no attempt to draw parallels between such fluid cultural elements as health and diet can claim to be exact, particularly over millennia. Nevertheless, certain general patterns can be observed in Hebrew concern for health which went far beyond the dietary portions of the Law of Moses and led ultimately to moral principles that helped lay the foundation for modern medicine. The gospel view of human beings as allies of God, in the quest for solutions to life’s problems has been particularly fruitful in the patient-physician relationship. 

This essay is not meant to be a comprehensive account of health issues among the Hebrews and their contemporaries, nor is it strictly chronological. Rather, it is a summary of certain major themes by a physician interested in the enduring consequences of earlier traditions. 

Stories of plague, pestilence, and other medical problems dot the biblical record, both as significant events in the lives of those affected and as examples of the Lord’s intervention. Plagues of lice, boils, and fatalities of Egyptian firstborn preceded the liberation of the Israelites (Exod. 8-13). Jacob’s wrestle with divinity left him with a permanent limp (Gen. 32:25). On one occasion, Israel’s enemies were struck blind and destroyed by plague (2 Kings 6, 2 Chron. 32). The experiences and metaphors of illness and healing have close ties with Israel’s spiritual health as well.[2] The Israelites saw illness as both the natural result of mortality and as punishment for sin. God was the supreme physician, sending both sickness and cure in response to sin and repentance. “I kill and I make alive; I wound, and I heal; neither is there any that can deliver out of my hand” (Deut. 32:39). At the time of the Exodus, he re assured them: “I will put none of these diseases upon thee, which I have brought upon the Egyptians: for I am the Lord that healeth thee” (Exod. 15:26). He also spelled out the conditions for health and illness: “If I send a pestilence among my people; if . . . [they] shall humble themselves, and pray, and seek my face, and turn from their wicked ways; then will I hear from heaven, and will forgive their sin, and will heal their land” (2 Chron. 7:13-14). 

While individual and collective righteousness were enjoined, mortal efforts at healing were required too. Under Mosaic law, if one inflicted harm, “he shall pay for the loss of his time, and shall cause him to be thoroughly healed” (Exod. 21:19). In Talmudic tradition, this passage authorized physicians to practice medicine, even if their prescriptions conflicted with the laws of the sabbath and of kosher diet.[3]

The Bible only rarely gives specifics of ancient illness. Thus, King Asa was “diseased in his feet” (1 Chron. 16:12), but it is not clear whether this was gout (the traditional interpretation), gangrene, or something else. Job’s “sore boils” may have been one of several ailments. The Pentateuch makes elaborate differentiations between ritually unclean and clean skin eruptions, and the leprosy of the Old Testament is generally believed not to be the same disease we know by that term today. 

Folk medicine included bandages, splints, oils, poultices, and a variety of herbal remedies such as Balm of Gilead, which may or may not be related to the soothing unguent of the same name used in the United States in the late eighteenth century.[4] The hyssop plant, commonly colonized by penicillium mold, was employed.[5] Classical times saw the spread of panaceas like the Great Theriac, a complex concoction containing snake flesh, symbol of healing power.[6]

Egyptian influence on Israelite medicine was significant not only because of the two peoples’ association during centuries of bondage, but because the Nile culture enriched the known world. As recently as Dickens’s time, quacks could attract crowds by claiming the title, “Doctor of Egypt.” Even now physicians adorn their prescription pads with Rx, meaning “take thou,” a symbol identified with the Roman Jupiter, but ultimately derived from the “Eye of Horus,” another early symbol of healing.[7]

Among the oldest Egyptian writings is the Edwin Smith Surgical Papyrus, a rational document that denies magic, describes diseases by means of case histories, and recommends manual therapy, rest, diet, and the judicious use of medicines.[8] Though our earliest copies date from shortly before Moses, this papyrus may be derived ultimately from Imhotep, a third dynasty physician and architect (c2700 B.C.) who later was deified as the Egyptian god of healing, equivalent to the Greek Aesculapius.[9] He also combined the roles of astronomer, philosopher, and sage with that of high priest, thus setting a pat tern for the practice of medicine, a combination of medicine and religion that flourished until the rise of Greece. 

Egyptian physicians also established such specialties as internists and sur geons, while others specialized in certain diseases or single organs. One result of Egypt’s national interest in medicine was a world-wide acclaim for health and long life, but this was relative success. Autopsies of mummified remains reveal such diseases as rheumatoid arthritis, spinal tuberculosis, bladder and kidney stones, and arteriosclerosis. 

Theories of disease etiology centered on a poisonous substance believed to emanate from decaying fecal material and other waste products.[10] The enema was an Egyptian invention; purges were common remedies; fastidious cleanliness was routine, including daily baths and washings, sanitation services, and the use of soaps. Nevertheless, witchcraft and exotic folk medicines also flourished and the early brilliance of Imhotep and the Edwin Smith Papyrus was not repeated. 

Twelve to fifteen hundred years after Imhotep, when Moses lived in Pharaoh’s family, Egyptian medical practice had become a complex blend of reason and superstition. The temple schools of the time taught the basics of hygiene, sanitation, and nutrition and perhaps constituted his foundation. The exclusion from the Law of Moses of medical sorcery and most forms of bizarre treatment is very striking when compared with such Egyptian practices as treating severe pediatric illness by ingestion of skinned dead mice or fevers with incantations, amulets, and potions which were sometimes more toxic than the disease.[11] Instead, Mosaic health practices focus on prevention, a gigantic conceptual leap, whether conscious or not. For instance, the Mosaic stress on cleanliness included frequent washing, especially before meals, the cleansing of cooking vessels or their destruction (Lev. 11:33), sanitation and proper waste disposal even during the nomadic period (Deut. 23:12-14), and, during the urban period, houses to be kept free from mold and mildew or be dismantled.[12] Of course, the context of these laws was one of ritual purity. For example, the reason given for camp sanitation was “for the Lord thy God walketh in the midst of thy camp” (Deut. 23:14). 

The Hebrews had many dietary laws, especially regarding meat. Offerings were to be eaten the day of sacrifice or the next but no later; carrion was for bidden; consumption of blood was not allowed (Lev. 7:15-17; 17:10-15; Exod. 22:31). Although the Mosaic prohibitions against pork and eating meat cooked in milk are sometimes interpreted as health matters, there is no indication in antiquity of any conscious association between these practices and ill ness. Since pork figured prominently in Egyptian and Babylonian sacrificial meals, and the Canaanites seethed their sacrifices in milk and drank blood, it seems more likely that these laws were to separate Israelites from idolatrous neighbors.[13]

A modern rabbi lists spiritual health, holiness, and purity as secondary rea sons for keeping a kosher diet, the primary one being to keep Israel “separated . . . from the nations.” He then notes among the benefits not only physical health, but also sensitivity to cruelty, subduing of desires, and acknowledgment of God’s goodness.[14] Many of these same reasons are clearly applicable to keeping the Word of Wisdom as well. 

Another spiritual law with medical benefits was the turning from the mundane to the spiritual — something modern doctors applaud as a means of relieving tension and preventing stress-related disease. Keeping the sabbath holy required scripture study, prayer, attendance at devotional meetings, and carrying out others of the 613 commandments of the Torah, a third of which had to do with health in one way or another.[15]

Portions of the Law of Moses and later scriptures prohibited magic, astrology, and witchcraft, all of them linked in various ways to quack medicine. (Deut. 18:10-11. See also Lev. 19:26, 31; 20:6, 27; Isa. 47:13-14; Exod. 22:18; Mic. 5:12.) In Babylon, Canaan, and Egypt, the black arts flourished. If demons caused disease, then magic was an appropriate treatment, up to and including human sacrifice. 

An important part of Babylonian medicine was divination or foretelling the future. One form involved having the patient breathe into a sacrificial animal’s nostrils, then studying the form and condition of its liver for signs of the patient’s disease and fate.[16] The Babylonian invention of astrology, heavily health-related, was uniformly and vigorously condemned by Old Testament and Talmud authors.[17]

Indeed, in the demon-filled world of ancient Near East beliefs, Israel’s theology was peculiar in asserting that illness involved simply the patient, God, and the natural world of mortality, even though belief in demons as a disease etiology was a widespread folk belief in Israel from earliest times, with increasing acceptance after the sojourn in Babylon.[18]

Jewish physicians seem to have upheld the theological view. The author of the apocryphal Ecclesiasticus, Ben Sirach, praises the use of medicines and the skill of doctors: “The Lord hath created medicines out of the earth; and he hath given men skill, that he might be honoured in his marvellous works, . . . of the most High cometh healing” (Eccles. 38:2-7). It is true that Tobit and Josephus, in Jewish apocryphal writings, mention exorcism, Jesus cast out evil spirits, and John 5 records belief in a pool of healing water. Still, as a prominent Jewish physician notes, compared with other cultures, “Jews have evinced little interest in irrational treatments such as the exorcism of demons and healing shrines, waters, and relics.”[19]

Unlike the physician-priest of Egypt and Mesopotamia, physicians in the Talmud were considered messengers from God and instruments in the accom plishment of the divine will. Levites were responsible for declaring what was clean and unclean; they did not engage in medicine in a therapeutic or even a diagnostic capacity, for their declarations pertained to ritual purity. Thus, according to the Mishnah, “anyone can decide whether a skin eruption is unclean or clean: the priest shall only pronounce the word ‘unclean’ in the case of uncleanliness.”[20] Lay healers were even called upon to treat sick Levites. 

Prophets were not physicians either, although some performed dramatic cures (including healing the sick and raising the dead). Elisha healed the Shunammit boy by placing “his mouth upon his mouth” in a manner similar to today’s artificial resuscitation and Elijah the Tishbite may have used this same method, though Jesus quite clearly did not in any of his raisings of individuals from the dead.[21] Isaiah healed King Hezekiah of boils with the aid of a poultice made of figs, a treatment resembling one prescribed for horses in the Ras Shamra texts.[22] 

This separation between the priest-prophet and the physician roles, while helpful in establishing the physician’s separate responsibility, also means that it was an ambiguous role. A modern physician tabulated thirty-two adjectives commonly used to describe a good doctor, balanced by an equally long list of biting criticisms.[23] Similar lists could have been made by the Israelites at various times, ranging from pragmatic to fatalistic. The Mishnah excludes doctors from the resurrection and destines “the best physicians” for “hell.”[24] Even the author of 2 Chronicles says that King Asa “sought not to the Lord, but tp the physicians,” implying condemnation (2 Chron. 16:12). On the other hand, Talmudic authors considered physicians so important that they forbade living in a town without one.[25] Ecclesiasticus 38:1, 12-13 is emphatic: “Honour a physician with the honour due unto him for the uses which ye may have of him: for the Lord hath created him . . . give place to the physician. There is a time when in their hands there is good success.” Certainly, Mormon attitudes toward medicine show a similar evolution from the active mis trust of Brigham Young to the almost routine use of complex heart procedures among modern General Authorities. Of course, dramatic changes in the nature of medicine also occurred.[26]

Several types of medical practitioners were active in ancient Israel, that corresponding to what we refer to as doctor being called rophe. A rophe who for his training and experience was selected as a certified municipal physician was named rophe umman (“learned doctor”), rendered expert testimony in court and treated the poor at community expense. Distinction was made be tween physicians who were theoreticians, arriving at their medical principles by deduction, and those who were natural scientists, employing empiricism and experimentation. However, this was not the specialization of Egypt—there was not even a separate military physician, nor was there any division between medicine and surgery, otherwise universal in antiquity.[27] It is interesting that rophe derived from a root meaning to alleviate or assuage. Elsewhere the physician’s title was related to words meaning magic or knowledge.[28] It suggests that the Israelite doctor made medicine more than a craft or a solitary pursuit of obscure learning. The eloquent sixth century A.D. Oath of Asaph, no doubt had roots in Old Testament times: 

And now, trust in the Lord your God, the God of truth, the living God, for He puts to death and brings to life. He smites and He heals. He bestows understanding to man and teaches him to serve. He wounds in righteousness and justice and heals in mercy and loving kindness . . . He causes healing plants to grow and puts skill to heal in the hearts of sages . . . for He was their creator and . . . apart from Him there is no Saviour.[29]

A faith that encouraged empiricism and practicality made medicine an appealing profession, especially when many countries refused to let them own land. Jewish doctors grew so famous that, in the sixteenth century when Francis I of France fell ill, he specifically requested a Hebrew doctor. The man appeared but admitted he had become a Christian. “Take him away,” shouted the ailing king. “Bring me a Jewish physician.” Half of medieval rabbis made their living as physicians, and even now a disproportionate number of Jews go to medical school.[30]

The Old Testament contribution to medicine is thus much more than lists of diseases and dietary rules, stories of prophetic cures and obsolete therapies. It embodies an affirmation of life and the importance of healthy bodies as mortals relate to God. The Old Testament teaches a reason for compassionate service and reverence for life by recognizing the divine in human beings. 

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[1] W. D. Davies, “Israel, the Mormons, and the Land,” Truman G. Madsen, ed., Reflections on Mormonism: Judaeo-Christian Parallels (Salt Lake City: Brigham Young University Religious Studies Center, 1978), pp. 79-97.

[2] Julius Preuss, Biblical and Talmudic Medicine, Fred Rosner, trans, and ed. (1911; reprint ed., New York: Sanhedrin Press, 1978), pp. 141-42. This principle is reaffirmed for modern Israel by Bruce R. McGonkie, Mormon Doctrine, 2nd ed. (Salt Lake City: Book craft, 1966), p. 346. 

[3] Ibid., Preuss, p. 25. 

[4] Leon Goldman, “The Balm of Gilead,” Archives of Dermatology 112 (June 1976): 881. 

[5] S. Levin, “Job’s Syndrome,” Journal of Pediatrics 76 (Feb. 1970): 326.

[6] Christopher Lawrence, “The Healing Serpent — The Snake in Medical Iconography,” Ulster Medical Journal 47 (1978): 136.

[7] Otto L. Bettman, A Pictorial History of Medicine (Springfield, 111.: Charles G. Thomas, 1956), pp. 1-7. 

[8] John A. Wilson, The Culture of Ancient Egypt (Chicago: The University Press, 1951), pp. 56-58. 

[9] Peter Tompkins, Secrets of the Great Pyramid (New York: Harper and Row, 1971) ; Bruce Lawrence Ralston, “I Swear by Imhotep the Physician,” New York State Journal of Medicine 77 (Nov. 1977): 2148-52. 

[10] Robert O. Steuer and J. B. de C. M. Saunders, Ancient Egyptian and Cnidian Medi cine (Berkeley: University of California Press, 1959), p. 54. 

[11] Bettmann, Pictorial History, pp. 1-7.

[12] Lev. 14:35-48. See also R. Schoental, “A Corner of History: Moses and Mycotoxins,” Preventive Medicine 9 (1980) : 159-61. 

[13] Louis Evan Grivett and Rose Marie Pangborn, “Origin of Selected Old Testament Dietary Prohibitions,” Journal of the American Dietetic Association 65 (Dec. 1974) : 634-38. See also M. Katz, “The Jewish Dietary Laws,” South African Medical Journal 50 (Nov. 1976): 2004-5. 

[14] Ibid., Katz, pp. 2004-5. 

[15] Gerald N. Weiss, “The Jews’ Contribution to Medicine,” Medical Times 96 (Aug. 1968) : 798.

[16] Note the structural similarity between this and the recent common pregnancy test in which a woman’s urine was injected into a rabbit and the effect on its ovaries examined. For a general discussion of religious symbolism in science, see Roy Branson, “The Secularization of American Medicine,” (monograph) Hasting’s Center Studies, 1973, pp. 17-28. 

[17] Jer. 10:2, “Be not dismayed at the signs of heaven.” See also Preuss, Biblical and Talmudic Medicine, pp. 140-41. 

[18] Ibid. 

[19] S. Levin, “Jewish Ethics in Relation to Medicine,” South African Medical Journal 47 (June 1973) : 929. For a discussion of the Jewish philosophy of learning see Jacob Neusner, The Glory of God Is Intelligence (Salt Lake City: Brigham Young University Religious Studies Center, 1978), pp. 8-12. 

[20] Preuss, Biblical and Talmudic Medicine, pp . 27, 18-19. 

[21] 2 Kings 4:32-35, 1 Kings 17:17-32; Matt. 9:24-25; Luke 7:13-15; John 11:40-44. See also Z. Rosen and J. T. Davidson, “Respiratory Resuscitation in Ancient Hebrew Sources,” Anesthesia and Analgesia 51 (July-Aug. 1972) : 503.

[22] J. B. Hardie, “Medicine and the Biblical World,” Canadian Medical Association Jour nal 94 (Jan. 1966) : 35. 

[23] Fielding H . Garrison, “Th e Evil Spoken of Physicians an d the Answer Thereto, ” Contributions to the History of Medicine (New York: Hafner Publishing Co., 1966), pp . 545-57. 

[24] Preuss, Biblical and Talmudic Medicine, p. 23. 

[25] S. Levin, “Jewish Ethics, ” p . 928. 

[26] For a good discussion of this development, see N. Lee Smith’s review of Medicine and the Mormons: An Introduction to the History of Latter-day Saint Health Care by Robert T. Divett, in DIALOGUE : A JOURNA L OF MORMO N THOUGH T 17 (Spring 1984) : 157-59; and N. Lee Smith, “Wh y Are Mormons So Susceptible to Medical and Nutritional Quack ery? ” The Journal of Collegium Aesculapium 1 (Dec. 1983) : 29-43 . 

[27] Preuss, Biblical and Talmudic Medicine, ch. 1. 

[28] Ibid., p. 30.

[29] Sussman Muntner, “Hebrew Medical Ethics and the Oat h of Asaph,” Journal of the American Medical Association 205 (Sept. 1968): 928. 

[30] S. Levin, “Jewish Ethics,” p. 927.