A Lesson from Leviticus: Leprosy

A Lesson from Leviticus: LeprosyAuthor(s): Gilbert LewisSource: Man, New Series, Vol. 22, No. 4 (Dec., 1987), pp. 593-612Published by: Royal Anthropological Institute of Great Britain and IrelandStable URL: http://www.jstor.org/stable/2803354 .

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A LESSON FROM LEVITICUS: LEPROSY

GILBERT LEWIS

University of Cambridge

Sufferers from leprosy have had to bear not only their affliction but often also bitter social rejection. The Bible played a part in this. I encountered a distant effect of it in New Guinea. It prompted this inquiry into why leprosy was singled out in Leviticus. The story of leprosy provides a more general lesson about cultural relativity and our selective blindness. It shows how words, concepts of sin, and responses to illness, may be confused and change with time. The influence of a written source is strong. In this instance time tangled up attitudes taken to taboo, pollution and sin. Robertson Smith's critical approach to the Bible explains the effects of political circumstances on the development of ethical concerns. In leprosy we find a shift from taboo to sin to disease. There was, I argue, a contrast between priest and leper, a contrast of type and anti-type, the opposition between holy and unclean. The principle at stake was the value.set on life as against death. Connotations of sin came later. These have deflected people for a long time from the diagnostic criteria set out in Leviticus.

There are traps in the identification of illness. This article is about leprosy, a disease with a long history of misery behind it. The history of a concept is not necessarily the same as the history of the word. The name we give the disease had other referents in the past, and ideas once linked with the name differ from the facts we now link with the disease. The Bible and ideas of sin have influenced responses to it.

There is nothing in the entire range of human phenomena which illustrates so impressively the divine power of the Redeemer, and the nature and extent of his work of mercy on man's behalf, as this leprosy. There are many most striking analogies between it and that more deadly leprosy of sin which has involved our whole race in one common ruin. It is feared as contagious; it is certainly and inevitably hereditary; it is loathsome and polluting; its victim is shunned by all as unclean; it is most deceitful in its action . . . Who can fail to find in all this a most affecting type of man s moral leprosy? Like it, this too is hereditary, with an awfully infallible certainty. As surely as we have inherited it from our fathers do we transmit it to our children (Thomson I 882: 653-4).

The connotations of sin have changed, even since the Rev. Dr Thomson's day; far more since Biblical times. The moral significance attached to leprosy has blinded people to evidence. Unwarranted beliefs were long-lasting and influential.

I should explain what started my interest-an echo of these beliefs and their practical consequences in New Guinea. When I returned to a village in the West Sepik Province, I was dismayed to find that almost thirty people in the village had leprosy. Five years before there had been one man with leprosy. He was young, married, and he had lepromatous leprosy, an infectious form. The

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Government health policy in I968 was to segregate people with lepromatous leprosy for treatment because they might infect others. If they absconded against advice, a policeman might be sent by the government patrol officer to fetch them back. When I was first there, the man with leprosy ran away from the local hospital repeatedly, so he was sent to a hospital at the coast for treatment, too far away to escape. His brother and father looked after things for him. His wife tended his gardens. She had no child.

Five years later, when I came back, he was still away at the coast undergoing treatment although the policy of segregation had changed. Then a betrayal of trust was exposed: his wife and his elder brother were caught having sexual intercourse in a garden by the elder brother's wife. Shock, scandal, recrimina- tion flared up; and they were still angry when, with the timing of classic tragedy, the leper returned from the coast, climbing the hill with gifts, to announce that he was judged well again and had come home for good. In the last village before his own, he was told what had happened. He left his gifts there on the path and went, destroying his gardens, cutting his fruit-bearing trees and palms to lay waste and wreck them (nauwom nari'in)1 as he came. Then he entered the village to seek out his brother and his wife.

But the bloody denouement people expected was stopped, partly because the kiap (the government patrol officer) was already entangled in the matter. With much effort, a kind of solution was reached that involved fines on both sides, a short spell of gaol for the elder brother, and a stab from the husband to the wife in her thigh with a bit of wood. She seemed to accept it without rancour-in fact while I was dressing the infected wound she talked about it, I thought, almost happily; and they settled down again together, she and her returned husband.

Attitudes to illness: leprosy at this village-and in Leviticus Leprosy was notjust another kind of sickness for these people. The events I have recounted so briefly span more than five years; the man had slightly thickened earlobes, his eyebrows had lost some hairs at the edges, but otherwise he looked quite normal, and felt strong and well. But he was forced to leave his home; he was fetched by police on more than one occasion; and much trouble came to his family. Sik lepro, the Pidgin for leprosy, means something special to the Gnau villagers. It is set apart.

This is true in the sense which the haus lepro summed up. The haus lepro was a house for the treatment of lepers built down by the river some way off from the mission hospital and the main part of the mission; the local people had had experience of the special rules for leprosy which led to segregation. The policy changed by I975 when I returned. People were to be treated at home. Health education patrols came to find cases and to tell people about the disease. They tried to impress on them the need for treatment. They emphasised the risk of destructive changes, the horrible effects of the disease, and the dangers of contagious spread. But the villagers diagnosed as having the disease showed only superficial skin blemishes. There was little that seemed to justify so much concern.



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Occasionally, however, people were seriously ill with swellings which had come with no injury to account for them. People recalled sik lepro and suggested that as the diagnosis. With it went fear of spread to others. It was the singling out of sik lepro that first struck me. Later I was to hear of other cases; for example, the death of a man I had known on my first visit. His belly and legs had swollen. He felt weak. He tried to walk down to the Mission hospital but the path along the ridge leading to it passed through the nearest neighbouring village. When he came to this village, the people there would not let him pass through because they said his illness would infect them. They said he had sik lepro. He was turned back. He died shortly after at home, his belly grossly swollen. The body was buried with special haste for fear of the illness jumping to someone else.

In retrospect people in the village said he had died of sik lepro. The strange swelling was what counted for them to make a diagnosis of sik lepro. They had learned there were special horrors to leprosy. They were not convinced of them by the skin blemishes of early leprosy but they granted them to what they took for the bad sik lepro where there was swelling.

The Gnau people give leprosy (in its Pidgin form) a new meaning and range of reference. In some ways we share their attitudes to it. We may have passed on to them an attitude which has its source in the book of Leviticus. When afterwards, I looked up Leviticus on leprosy, I was struck by the amount of space given to leprosy, a good deal more, for example, than to the food rules. What was the reason for so much space devoted to this leprosy?

The verses on leprosy which have led to much misery are chapter 13: 45, 46. They follow the extensive directions, minutely detailed, on how to identify leprosy. They say this:

And the leper in whom the plague is, his clothes shall be rent, and the hair of his head shall go loose, and he shall cover his upper lip, and shall cry: 'Unclean, unclean'. All the days wherein the plague is in him he shall be unclean; he is unclean; he shall dwell alone; without the camp shall his dwelling be.

The first question to consider is the nature of Biblical leprosy; the instructions for its diagnosis in Leviticus are explicit. The surprise is that people in the past have paid them so little attention.

What is leprosy? And what was it? Most of us probably think of leprosy as a disease which may be mutilating and horribly disfiguring. We know it is contagious, that it is slowly progressive. But behind what many of us might say in plain recall of what we know, some other images spring to mind: the rotted lumpy face, glazed eyeballs, hands without fingers, the leper's touch, contagion. These are the images that lurk in the Silver Man in Rudyard Kipling's 'The Mark of the Beast', in 'The Blanched Soldier' in Sherlock Holmes's case, in the fate of Ben Hur's mother and sister. Imagine those horrors and then we should not be so surprised that leprosy was singled out. We might accept that for the Israelites casting out the leper was a way of protecting the rest of the community.



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But, if Leviticus gives such attention to leprosy, we might ask whether leprosy plagued the ancient Hebrews more than other peoples?2 And what, exactly, were their ideas about contagion and infection? Were they medically sound on other infectious kinds of sickness? Leprosy cannot have been the only one they suffered, or the worst, or the most obvious. Was it the most disfiguring? The most deadly?

I go too fast. Leprosy is not a simple example of a contagious or infectious disease. Years may intervene between exposure and the appearance of any signs of the disease. People may live for years among lepers without catching it. Not all forms of leprosy are infectious; by no means all people exposed to someone with infectious leprosy catch it. Were the dangers of infection so much more striking or apparent to the ancient Hebrews?

And then there is something else we should notice. One of the chapters of Leviticus is about how to restore the sufferer to the community after the signs of his affliction have disappeared. So this leprosy might disappear or heal by itself. But textbooks of medicine do not write of lepromatous leprosy disappearing spontaneously, or of the body becoming whole again.3 So what was this leprosy of the Bible?

The answer is plain. The Biblical leprosy was not what we call leprosy. The instructions to the priest in Leviticus Chapter I 3 make that clear. They state the diagnostic criteria and they are explicit. No reference is made to deformity, loss of feeling, destructive changes, or blindness, or paresis. In doubtful cases, the unclean lesions should show changes after seven days. Leprosy as we know it does not move so fast in seven days; its pernicious advance is very slow. Various skin conditions might fit some of the Biblical criteria: vitiligo, psoriasis, fungal infections. The Biblical rules could cover a number of different sores and skin conditions according to current medical classifications.

The discrepancy between the Biblical leprosy and the leprosy of a medical textbook is well-known to Biblical commentators. The Bible uses the Hebrew word zara'at to refer to the 'unclean' skin lesions. This word was translated in the Septuagint as lepra (deriving from the Greek lepros, 'rough and scaly', lepis, 'a scale'). Medical writers of the first few centuries of the common era (such as Paulus Aegineta, Aetius, Oribasus, Polybius) use lepra to refer to a circular, superficial scaly eruption of the skin, and write of it as a condition which is curable and not serious, or contagious. Some commentators have thought that the disease they called elephantiasis was the leprosy of modern medical writers (Adams I 846, ii: i-i 5). It was quite distinct and different from lepra (Macalister I902; Waldstein I905; Brody I974; Browne I975).

During the Dark Ages leading up to the Medieval period, the word for one kind or set of skin conditions, lepra, came to refer to different conditions and it eventually settled in the derivative word-forms of various European languages as a word which applied to leprosy as we now know it.4 What I saw happening on a tiny scale in a few villages of New Guinea had a touch of resemblance to what had happened centuries before in Europe. The foreign name was adopted and adapted, carrying still some of the associations belonging to it in its former reference. The lamentable history of social attitudes to leprosy is a lesson on the consequences of paying great attention to words, but small attention to facts. It



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is possible with some words to point to what they refer to: things that can be observed. The close description of observable facts given in Leviticus I 3 is what enables us to recognise that zara'at did not refer to the disease we now call leprosy. Zara'at translated into lepra gave issue to derivative forms with polymorphous and sometimes perverse referents.

The history of leprosy in the West shows the persistence of attitudes that stem from a written source, and their link to a label or name. The name endures; its denotation changes. The label remains fixed in the mind, its moral associations change but not out of recognition; what it refers to does almost shift out of recognition. It shifted regardless of the instructions about diagnosis set out in the Bible. Instead an inferred moral message or meaning took hold of people's imaginations. Its appeal to their emotions allowed them to pass blindly over what was written in the Bible discrepant with their practice. Something similar was happening in the small community I studied in New Guinea. If someone now is surprised to learn that the passages in Leviticus are not after all about the same leprosy as he had supposed, his own surprise will cast perhaps a little light on that long story of blindness.

The Jews were not led along quite the same paths. Their Bible stayed in Hebrew and they followed the letter of its instruction. Zara'at stayed zara'at. In Talmudic tradition, leprosy was not considered contagious in a medical sense. The Mishnah (Danby I933) does not consider the pagan or gentile or the resident alien with leprosy-signs to be unclean (Mishnah, Nega'im 3. I). If someone plucked out the signs of uncleanness, the white hairs, or cauterised quick flesh before he came to the priest, he was clean; but if he did so after he had been certified unclean, he was still unclean (Nega'im 7.4).

Was leprosy a sort of sickness to the Israelites?

This is a critical question. Would we be right to suppose that the Israelites thought of zara'at as a kind of sickness or an illness? It is difficult to avoid assuming so when we think about it in English: we can hardly detach the words 'leprosy' or 'malignant skin-disease' from the idea of sickness. The chapters in Leviticus are concerned with signs of 'cleanness' and 'uncleanness' in the body, that is with ritual purity and impurity, and with what to do about someone who is unclean and how to bring him back into the community when the uncleanness has left him. There is no discussion of measures to care for him or remedy the body signs which show him to be unclean. The word for 'plague' (nega') and the word for 'leprosy' (zara'at) both derive from roots with meanings of 'to smite' (naga', 'smite, blast, touch, reach'; zara' 'smite, strike, pierce, sting'). Chapters I3 and I4 of Leviticus nowhere use the main verb for 'becoming sick', or 'being sick' (halah) with reference to the 'plague of leprosy'.5

Something else strongly prompts the question of whether they thought it was a kind of illness. The chapters on leprosy describe leprosy in a house, in garments, and leprosy in anything made of skins, which are all 'unclean' as a person with leprosy is unclean. We use the idea of sickness with reference to people and living creatures. We do not speak of things such as houses or garments falling sick, except figuratively. But we do sometimes speak of



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infective or infected materials, or of contaminated objects. The idea of an infected person and a contaminated object have something in common. That brings closer the Biblical sense of 'uncleanness' in leprosy. What is at issue is ritual impurity, and not a medical problem as we should understand it. Biblical commentators pointed this out long ago.

Stigma and sin Leviticus does not judge the leper morally; but it defines him as one of the category of persons and things which are ritually impure. As Brody points out (1974: II I-I2), although there is no explicit moral condemnation of the man found to be leprous, the terms for moral valuation are all there in the text. Leviticus does not deny that leprosy is punishment for sin; it simply ignores the idea. Other parts of the Old Testament imply connexions between leprosy and sin, and Rabbinical comment made these connexions more explicit.

Early Christian writers, such as Justin Martyr, Origen, Chrysostom and Tertullian, interpreted the Levitical rules about leprosy in terms of sin and divine retribution. Leprosy was the external revelation of internal evil, an emblem of sin which branded the person defiled by sin outwardly on his skin. For simony, avarice and lust, the man or woman was smitten with leprosy. By the Middle Ages, leprosy had become a disease of the soul as well as of the body (Brody 1974). The bishop, priest or ecclesiastical jury who decided whether someone had leprosy, had power to cut him off from ordinary life. The rules differed with time and place, but separation was the common and persistent theme. The leper was dead to the world (by Rothar's edict: il est mort quant au siecle). In leprosy, the body's corruption declared spiritual corruption. The body's corruption was outward so it could be seen. By the sixteenth century, there was confusion of syphilis and leprosy, both lust-tainted, for Fracastoro to sort out (Brody I974).

Slowly over the centuries that follow the Middle Ages, the numbers of lepers in Europe decline and slowly too the moral stigma so closely bound to leprosy attenuates and changes. It attenuates but the stigma has not wholly died out (Gussow & Tracy I970). Its vestiges remain in the attitudes we take to the disease, the unreasoning horror of leprosy that has seemed to justify the segregation and the special treatment of lepers for centuries (Richards I977;

Waxler I98I). Something of that stigma lingers with us still. But the question I have in mind concerns a much earlier period: Biblical times. Why was leprosy singled out originally?

Robertson Smith on change in the religion of the Semites I propose to examine the rules for cleansing the leper to see if they throw some light on the reasons for leprosy being given such prominence in Leviticus. My working assumption is that the mode of treatment may indicate some of their beliefs about the nature or the cause of the condition. The cleansing involves a complicated series of rites with sacrifices. Some of the elements and actions in them occur in other contexts and might suggest a meaning by associations of



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ideas and similarities. Old Testament sacrifice is a complex ritual system; the order and forms set out for cleansing the leper are peculiar. I have used Robertson Smith's Religion of the Semites (I889) as a guide to Old Testament sacrifice. He has been criticised for speculating about the history of sacrifice, but that makes him an excellent guide-he shows an acute interest in historical context, social and ritual change, the changing imagery of relationships between God and man; he analyses the effects of taboo, of vested interests in sacrifice, the role of priests in the purification of sin, the shifts in theology and ideology (although he did not call it that). Ideas of pollution and sin both touch leprosy and time has tangled them up.

If a student of anthropology knows nothing else of Robertson Smith on sacrifice, he will know that Robertson Smith put forward the idea that Semitic sacrifice originated as a totemic rite in which the clan killed their totem and together ate it in a communal feast-a communion meal. That anthropological version of what Robertson Smith's views were often carries with it the teaching that his views were speculative in a bad sense,6 that Nilus's fifth-century description of Saracen camel-slaughter is no basis for a theory. So many do not bother to read what Robertson Smith himself had to say.

Robertson Smith took the rite of sacrifice to be the typical form of all complete acts of worship in Semitic religion (I889: 214) He stressed the persistence of the rite despite elaborations of procedure. Its meaning had not been single, constant and established throughout its history. Robertson Smith wrote when the views of Wellhausen had opened a radically new critical approach to the dating and interpretation of the texts of the Bible. When, by whom, where had the redaction of different parts of the text taken place? Did they reflect past oral traditions faithfully recorded, or preoccupations current at the particular times when they were set down in writing? How was the patchwork of different textual strata put together, by synthesis or compilation? Robertson Smith considered sacrifice in the spirit of that new critical approach. He interprets the religion of the Semites in the contexts of the people's changing political history and circumstances. The functions of taboos and sacrifice alter over time; and ideas of wrong-doing and sin change too.

From sacrifice to sin People are likely to draw on their own experiences for analogies and images to help them form ideas of their relationship to God. But religion cannot wholly remain a matter of ideas and feelings; people need to express them visibly and audibly in acts of worship. The worship is directed into specific and outward forms. The god is brought into particular relationship with people, objects, times and places. The reiteration of the first holy places, where God revealed himself, moves on to the identification of a holy land, then a temple and an altar, a localisation progressing from many sanctuaries to the one central most holy place. The ancient Semites were first a nomad tribal people, like others round them. They were born to their religion and their God was the God of their tribe, who fought with them on their side against other tribes with their false gods,



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who were real but failed them beforeJahweh. The rules of the community were binding on all its members; they distinguished them from surrounding tribes and served in a period of intertribal wars to weld the people together into a unity. The rules, as may be the case with taboo, created a distinctive sense of identity (Fortes I966), a religious identity as a people set apart by their taboos from others like them round about. The religious rules were public not private matters. The individual who broke them endangered the community. Equality in fellowship and the solidarity of kinship, the ties and authority of father to son provided imagery for the relationship. The many holy places, a tent of the Lord, a travelling ark of the Covenant, belong to a tribal people whose god moves with them-their shield and their strength. They conquer, they establish a kingdom, they settle a land.

The imagery of tribute and homage, of the gift to smooth a superior's face appears. The reigning image is of king and servant, of victory, a religion ofjoy, the celebration of power and prosperity. With a king, settled agriculture and settled cities and a capital, the distance between God and his worshippers grows. Monotheism accords with the idea of absolute or final justice coming from one source, the king over all, the supreme and single judge whose decrees are laws. Ordinary slaughter has to be distinguished from sacrifice. All sacrifice must be brought to the central place of worship. Between king and people, between God and worshipper, there is distance and a place for the mediator. The priesthood grows stronger in the role of mediator between the people and God. The kingdom is a holy land; the offerings of a settled people include their cereal offerings.

Then the large and powerful kingdom is divided and begins to fall; Israel first, to the Assyrians. The power of Babylon rises, Judah is besieged and Jerusalem taken, the Temple destroyed. The people experience adversity, downfall and exile; the prophets cry against them for their backsliding, their whoring, their foreign women, their altars to other gods, their luxury.

The sense ofjoy and prosperity celebrated goes from worship to be replaced increasingly by a sense of guilt, offence against God, and the need to pacify his just anger by expiation and propitiation. After the destruction of the kingdoms and experience of exile, the themes of sin and punishment, of the need to atone, come to dominate the whole sacrificial system altering its character so that its focus is on sacrifice because of sin. An ethical framework develops in which the individual person's offences and his sin are ever before him. With the kingship fallen, the priests gain the leadership of the people in exile and after exile. The systematic shaping of the sacrificial cult was the work of priests in the time of their authority and in accord with their views of guilt and sin. Most of Leviticus was codified and written down in these post-exilic times. It bears the priestly stamp. The priest compiled different traditions, arranged them and gave them a coherent shape.

In bold outline then, these were Robertson Smith's views on the changes which affected sacrifice among the Semites. They provided the background and larger view for trying to explain what was done about the leper. The main themes I shall now discuss concern why the leper was regarded as unclean and how his uncleanness contrasted with the extreme cleanness required of the priest



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and the nazirite. Uncleanness had to be excluded from contact with holy things. The leper's taint must cut him off from any contact with holy things. The rule had a religious not a medical basis. The underlying religious theme which recurs in many details I looked up is the contrast between death and life; death is polluting, life is the great good. Priest and nazirite contrast with leper; priest and nazirite have to do with holy things; the leper is tainted as if by death. To forbid the mixture of holy things with uncleanness has the character of taboo. The purpose is to preserve life from being contaminated and mixed with death. The means lie in obedience to God and observance of the code of holiness.

The ritual cleansing and the uncleanness of the leper The ritual procedure for the cleansing of the leper is a rite of passage, a readmission, to the community of those who may worship together. The cleansing is not treatment in any medical sense. The sacrificial system of Leviticus is a priestly elaboration made coherent by the priestly conception of sin and expiation. The cleansing of the leper has been fitted into that system. My argument is that the leper was singled out as a human emblem of uncleanness, tainted by death, which contrasted with the image of the cleanness required for contact with holy things, epitomised in the priest and the nazirite. But later the ethical preoccupation of the priests with sin, their own interests bound up in their mediating role and their control exercised through sacrifice, led to them recasting the cleansing of the leper in the prevailing mould, as something to be done for the expiation of sin. Notions of sin have gradually changed from concern with actions, or with a state of being, to concern with the individual actor and his intentions. The earlier regard for the action, rather than the actor's motives or intentions, puts it closer to the attitude people take to taboos and their breach.

The leper is said to be 'unclean' (tame'). Unclean things defile and they must be avoided. They cannot be brought near things associated with the worship of God; they are unsafe for common life and transmit uncleanness by contact, even by overshadowing. By contrast clean people, clean things, are free to approach God in worship. The quality of uncleanness is intrinsic to the things or states so defined; with them it is primary, but it may also be transmitted in less degree to things brought into contact with them. The rules of avoidance, the ways to purify, show how uncleanness may vary in degree of taint.

Why must the leper be kept outside the camp? Nothing unclean must approach God in worship (Numbers S: I-3). Uncleanness must be kept far from the worship of God; and kept from the camp of the children of Israel; and indeed kept from the land of the people of God. 'Defile not ye yourselves in any of these things; for in all these the nations are defiled, which I cast out before you. And the land was defiled, therefore did I visit the iniquity thereof upon it, and the land vomited out her inhabitants' (Leviticus I 8: 24, 25).

What is the relation of unclean to holy? Reciprocal exclusion, for they must not mix. Holy things, things which are separated from common use and dedicated to God, must be kept from all contact with uncleanness. Things



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become holy by association with God, or by being dedicated to God. All holiness is therefore derivative save only the holiness of God. But unclean things are intrinsically unclean: the quality is primary not derivative. The leper is an unclean person; that is his strong identification. He must be put outside the camp so that he can have no contact with holy things, nor defile clean people by contact.

It is in keeping with the character of taboo that leprosy should be defined unclean but the reason why be not given. Although no reason is clearly advanced, some passages suggest why leprosy was singled out. One reason stands out in the story (Numbers I2: 9-I 5) of God's anger with Miriam when she, with Aaron, spoke against Moses, their brother, because of the Cushite woman whom he had married.7 God made Miriam leprous, 'as white as snow'. and Aaron said, 'Let her not, I pray, be as one dead, of whom the flesh is half consumed when he cometh out of his mother's womb'. Although a few other cases of leprosy occur in the Old Testament,8 this one says most clearly what is foul about leprosy.

Miriam's leprosy is likened to the flesh of the dead. The dead bring uncleanness. According to the Mishnah's list of the different degrees of uncleanness, the uncleanness of the leper is exceeded only by the uncleanness of bone from a corpse, and by the uncleanness of a corpse itself (Mishnah, tractate Kelim I.4). The priest was forbidden to defile himself for the dead (i. e. to bury or come near the dead or to observe the mourning rites) except for the death of some close kinsman (Leviticus 1I: I-4). In the case of the high priest, he could not mourn even for the death of his own mother or father (Leviticus 2I: I0-I2). The most holy place was strictly to be kept from any defilement by contact with the dead. The general rules about the dead, pollution by them, and purification are given in Numbers i9; the rules for the priests were special rules of avoidance. The priests might not leave their hair dishevelled or tear their clothes in mourning for the dead (Leviticus Io: 6, 21: Io, cf. Numbers S: i8, Ezekiel 24: 17, 22). 'But the leper in whom the plague is, his clothes shall be rent, and the hair of his head shall go loose, and he shall cover his upper lip' (Leviticus I3: 45). In effect, he should be as one in mourning, unclean by contact with the dead. But the uncleanness is in himself, in his own flesh, and he must be cast out of the camp. The rules point to that association of leprosy to a living death which medieval Christian thinking preserved: il est mort quant au siecle.

Death, and flesh 'half-consumed', white as though dead flesh, carry the worst taint. The taint must not come near anything that is holy. Life and prosperity are good; this is the great theme which Moses, nearing the end of his life, declares for God on the day of the Blood Covenant. And death is evil.

See I have set before thee this day life and good, and death and evil, in that I command thee this day to love the Lord thy God, to walk in His ways, and to keep His commandments and His statutes and His ordinances; then shalt thou live and multiply, and the Lord thy God shall bless thee in the land whither thou goest in to possess it (Deuteronomy 30: I 5, I6).

The design of the cleansing rites The cleansing rites for the leper have three phases; the first phase, outside the camp; the second phase of seven days, waiting within the camp although the



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leper must not enter his tent (house); the third phase, his cleansing through sacrifice at the door of the tent of meeting when the priest makes atonement for him. The three-phase procedure has the pattern of a staged transition; the first phase outside the camp is concerned with separating the leper from the foulness that was in him so that he may enter the camp; the second phase is a marginal one within the camp where he is allowed back to civil life but is still not clean enough to enter his own house or to come in contact with family life, or to have marital intercourse; the third phase makes expiation for him through sacrifice. The third phase shows the priestly concern for sin and atonement-it is the leper's final purification which restores him clean to the community of worshippers. The priests' view of the purpose of sacrifice is that it expiates for sin. Rites based on ancient practice are fitted or reconciled to this dominant view. The scheme is made coherent.

The first phase: outside the camp. Is the removal of uncleanness a transfer of uncleanness or an exorcism? This first phase cannot be regarded as involving sacrifice in priestly terms because it does not take place by the altar or the sanctuary. Some scholars have regarded it as a rite concerned with driving out an evil force (Porter I976: I06-7). Its form, and some of the words used, suggest that it was an ancient rite which the priestly redactors found awkward to fit into their sacrificial scheme. It is uniquely linked to leprosy. Sin is not referred to here.

The rites use two small clean birds (nowhere else in the Old Testament are two small birds needed for a rite9); the first small bird is killed. The second, the living bird, was let go into 'the open field'. The release of the bird suggests the parallel to the scapegoat on the Day of Atonement, the goat on which the high priest had laid all the sins of the children of Israel. It was sent 'unto a land which is cut off', the wilderness (Leviticus I6: 22), to bear away the sins to a waste- place. 10 The parallel to the live bird released into the open field is striking. There is a transfer of the badness to the bird and it is sent off away to the 'open field'. Blood from the killed bird was sprinkled seven times on the leper with cedar wood, scarlet wool and hyssop (see Nega'im I4. for Talmudic traditions about the procedure); hyssop, scarlet and cedar wood are used to prepare the water to purify from death pollution in the rites involving the red heifer (see Numbers I9).

Shaving the hair. This is evidently cleansing, but it has more to it. The leper had to shave off all his hair first outside the camp on the day of the rites with two small birds. This was preparatory to his re-entry to the camp. On the seventh day after that, he had again to shave off all hair, even his eyebrows. The shaving is set as a ritual duty. Besides the leper, the Bible says two other kinds of people must cut off hair as a ritual duty: the nazirite and the Levite priest. Is there a discernible connecting reason?

First, the nazirite, the man who has vowed to consecrate himself to God, the subject of Numbers chapter 6: his hair, like that of Samson, was the sign of his vow. 11 The nazirite was set apart and holy. His dedication required that he keep utterly away from contact with the dead. Indeed we find that the nazirite was as



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holy as the high priest in respect of contact with the dead; neither was allowed to mourn, even for his dead mother or his dead father. The cutting of the nazirite's hair (head-hair) marked his return to normal life. The consecrated hair was offered to God as a sacrifice on the altar. Second, the Levite priests who were the other kind of person for whom shaving the hair was a ritual duty. The Levites were separated from among the children of Israel, cleansed by sprinkling with water and by shaving all over, and so purified before their dedication for service to God (Numbers 8). The three for comparison thus are: the nazirite, consecrated by his vow and his hair dedicated, who must cut it off and offer it up before return to normal life; the Levite, to be offered and dedicated to the service of God, who must shave his hair to remove any taint it might bring from normal life; the leper, having been so tainted and outcast, who must shave his hair before he comes back into contact with normal life, and then again, before he comes before the altar in worship.

But there is a more striking comparison and contrast to make between leper and priest. It is contained in the final cleansing of the leper, and in the hallowing and installation of Aaron and his sons.

The thirdphase: the offeringsforsin andguilt. Four kinds ofsacrifice are to be made, and in this order: the guilt-offering ('asham); the sin-offering (hatta't); the burnt-offering ('ola); and the meal-offering (minhah). Each of these is accounted among things most holy (kodesh ha kodashim). The sin-offering is systematically accompanied, in the priestly scheme, by a burnt-offering, and the burnt- offering by a meal-offering. The sequence of these three offerings conforms to the fixed pattern of the priestly system for expiation of sin. But in the case of the leper they were preceded by a curious guilt-offering. The leper's guilt-offering is distinctive to the cleansing of the leper. It contains the striking point of similarity to something done for the installation of Aaron and his sons. Blood of the guilt-offering is to be put on the leper's right ear, his right thumb and his right great toe (Leviticus I 4: I 3, I 4).

The striking parallel is that Moses put blood from the ram sacrificed as the installation offering of Aaron and his sons in exactly those same places when he consecrated them for the office of priest (Leviticus 8: 23, 24). The right side of the body is the good, propitious side (Eisenstein I905); the ear, thumb and toe may serve to stand for the whole person by marking top, middle and bottom of his body. Such use of blood only occurs in the consecration of Aaron and his sons, and for the leper. Indeed, sprinkling or putting blood at all on someone as a ritual act occurs only here and in Exodus chapter 24 to mark the Blood Covenant.

The tainted leper first had to wait in the camp seven days before he came to take part in the rites which involved holy things: Aaron and his sons newly consecrated had to wait seven days at the end of their rites before they could resume contact with ordinary people. They had been so close to holy things. For Aaron and his sons the move was from the dangerously holy back to the community and normal life; for the leper the move was from being unclean and outcast back to the community and normal life, and then to worship.

The uses of blood and the distinctive offerings raise three questions: first, a



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question of the religious significance of blood; second, what is the significance of the leper's guilt offering? third, what ideas of guilt and sin are these? Will answers to them help to throw any more light on the Biblical concept of leprosy?

The priestly tendency was to assimilate the theory and practice of all sacrifice to the sin- and guilt-offerings which were their main interests. The blood of any sacrifice brought to the altar was given expiatory significance.12 The blood is appointed to make expiation: 'For the life of the flesh is in the blood; and I have given it to you upon the altar to make atonement for your souls; for it is the blood that maketh atonement by reason of the life' (Leviticus I7: i i). But the placing of the blood may not always have had that expiatory significance. In the case of the burnt-offering, the blood was to be dashed round about against the altar. Perhaps in origin this wasjust a way to return the blood and give it back to God. The ancient significance of blood is given in Leviticus I7: I-9 where the Israelite is commanded to offer the blood of any animal he slaughters to God. 13

God is the source oflife and the blood belongs to him. It must be given back. The association of blood with life, and touching it on the leper to re-cover him symbolically with life (sc., to cover over, to hide, to cleanse with life, see note I2) after his recovery from the death-tainted uncleanness of leprosy, is a possible significance for this use of blood. The oddness of what is done with the blood isolates this sacrifice as peculiarly linked to leprosy. If we suggest this offering has been given a meaning within the priestly scheme which it did not have before, then what might have been its first significance? Will a comparison of the two help?

The guilt-offering of the leper The guilt offering of the leper is like the installation of Aaron and his sons not only in the application of blood, but also in that it requires oil. The oil is sprinkled, then put on the same places as the blood from the guilt-offering was put, and on the head of the leper. In the case of Aaron and his sons, Moses anoints them and sprinkles some of the oil on their vestments and the altar to sanctify them, but does not put it on ear, thumb and toe. 14 In the Psalms (Psalm 23: 5; 92: II; I04: I5) and elsewhere (Genesis 28: i8; Judges 9: 9), anointing the head with oil is used to honour and welcome the guest; oil symbolises vigour, prosperity and gladness. Could they have put oil on the leper who was recovered from his taint and cleansed, perhaps in sign of welcome back into the community?

The kinds of sacrifice in the priestly system can normally be distinguished by what is done with the remains of the offering. The installation offering for Aaron and his sons, the ram sacrifice, has the character of a peace-offering (zebah-shelamim, also translated as shared-offering) because of what is done with the flesh: the fat, kidney and liver are burnt as an offering to God, the priest (in this case Moses) receives the breast, the worshippers (in this case Aaron and his sons) receive the rest-all share in the flesh of the ram sacrificed. This is a shared or communion feast of the kind Robertson Smith took to be close in form to the original sacrificial rite. The peace-offerings are usually expressions of thanksgiving.



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The leper's guilt-offering is not said to be thanksgiving (although that might seem appropriate to the circumstances of his recovery). It is specifically called a guilt-offering and allied in the text to the sin-offering (Leviticus I4: I 3). But the text does not say what is to be done with the remains of the guilt-offering. Perhaps the priestly codifiers reconciled the peculiar sacrifice of the leper's he-lamb to the themes which preoccupied them. They called it a guilt-offering, and fitted the sin-offering and burnt-offering to it to make the whole pattern clear. Yet the leper's he-lamb offering resembles, by what is done with the blood, the installation-offering of Aaron and his sons, which in turn is like a peace-offering. It might be in keeping with the idea of thanksgiving for recovery and of welcoming the leper back into the community to wonder whether his 'guilt-offering' once had features of the peace-offering too. The sense in which the leper has committed sin or incurred guilt, except by his intrinsic uncleanness, is not made any plainer by the list of things for which other guilt-offerings are required.

Guilt and sin We must remember that Old Testament ideas of guilt and sin differ much from modern ones. These ideas deal with inadvertent offences which involve break- ing a command of God (Leviticus 4 and 5). It is hard to see much difference between the character of the sin and the guilt offences. 'Sin' and 'sin-offering' are one and the same word in the Hebrew text; 'guilt' and 'guilt-offering' are another single word ('asham).15 The instructions about the guilt-offering stress the value of the ram required as forfeit or fine in silver shekels (Leviticus 5: I 5). The first mention of the guilt-offering in Leviticus 5 does not say whether the animal was to be burnt on the altar, .or what part was. It is just an animal made over to the priests. Some scholars have supposed that this was the original form of the guilt-offering-something like a fine or reparation due to the priests. But the 'asham was brought into the sacrificial system; this is clear from Leviticus 7: I-7. Further offences which incur guilt are listed in Leviticus 5: 20-25. They are social offences consciously committed by an individual and require restitution to the aggrieved party as well as the fine of the ram for a guilt-offering. 16

All offerings (korban) are things 'brought near to' God-this is the literal sense of korban. Sin (hatta't) is incurred by doing anything which is forbidden by a command of God. The root from which hatta't comes (hatta') means 'to fall or miss one's aim, to make a false step, to fail in one's duty'. In Leviticus chapter 4, the sins for which sin-offering makes atonement are inadvertent sins, not wilful sin; rebelliously or presumptuously to break commandments would merit death (see Numbers I5: 30, 3i: Deuteronomy I7: 12). The 'sins' which require the sin-offering are inadvertent transgressions and include the conditions of ritual impurity. Sin in this sense includes defilement and uncleanness. It is the action or the state which matters, not intention. The laws and rules are like taboos. Sin and uncleanness are conflated. Sin, the false-step, takes someone or a people astray from God, and the sin-offering is to restore a right relationship to God. Someone in a state of sin cannot approach God; the priest must make expiation for him so that he may be restored. The expiation of sin is made the central



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object of sacrifice and permeates the system, but its ethical sense is not spelled out. After the old, explicit statements about the rules, the false steps, a growing concern emerged in the prophets and the priests for awareness of sin by a people downfallen and estranged from God because they had whored after false gods, foreign women, and luxury. The idea of sin takes on a more familiar shape.

Conclusions The problem of the skin conditions described in Leviticus is, first, why they received so much attention. They were taken to be unclean. The taint which might have called for such special recognition was the taint of death. If the skin conditions were seen as a mixture of dead and living in the flesh of a person, that might explain why the person with 'leprosy' was singled out, indeed came close to being the type example of an unclean person, the image for the outcast. The danger was to others, and to holy things. That is how the leper was defined. The form of the rules is that of taboo. Other things are identified in Leviticus as unclean (e.g. a woman 'in the days of her impurity', the hare, the stork, the hoopoe and the bat) because of their state, what they are, not because of sin in our modern sense, or disease, or because of what they have done. The rules regarding them are specific. They are given in the apodictic form: 'Thou shalt . . . Thou shalt not . . .' without explanations. They are set out as commands, as taboos would be set. Knowledge of God is knowledge of his Law, rather than knowledge of him in himself. They mark out the people for whom they are commands; the rules set them apart. The principle of the code which identifies the people is reiterated in Leviticus: 'Ye shall be holy for I the Lord your God am Holy'.

The idea that life and death must not be mixed may be discerned in the command not to mix the blood (which is the life) with the flesh which can be eaten (Leviticus I7: I4). Mary Douglas (I966) and Edmund Leach (I964) both put forward a theory of taboo which made ambiguity, the mixture of kinds or the confusion of proper boundaries, the heart of the matter. The leper would be taboo in that sense as someone of mixed dead and living flesh. 17 Such a view would help explain the special ruling for the man who is wholly leprous, which is otherwise astounding: 'behold, if the leprosy have covered all his flesh, he shall pronounce him clean that hath the plague; it is all turned white: he is clean' (Leviticus I3: I3).

The great theme of the code of holiness in Leviticus is: 'Ye shall be holy for I the Lord your God am holy'. The commands of God are rules for holiness, to set the people apart and make them a holy people. Those people who were most strictly separate, in the sense of dedicated to God, were the priests and the nazirite. They could have no contact with the dead. The leper is almost like an opposite of them: he carried in his person a defiling taint which excluded him absolutely from any contact with holy things, even contact with clean people, even contact with the community. Holy and unclean are the two strong positive ideas (Peake I902). Each excludes the other; they are wholly opposed in relationship to God. Each admits of degrees in their quality. If the high priest and perhaps the nazirite might represent the types of person who are most holy;



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the leper might represent something like their anti-type, the type of person who is most unclean. In its most simple and powerful (perhaps also its first) expression, the polarity of principle was one between life and death. A spiritual afterlife is no issue in the Covenant. The theme in Deuteronomy 30: I9 is life here: 'I call heaven and earth to witness against you this day, that I have set before thee life and death, the blessing and the curse; therefore choose life that thou mayest live, thou and thy seed'.

I think the Biblical attitude to leprosy grew first from these religious themes. Maimonides refused to follow the symbolists in finding reasons for the details in rules for various sacrifices: 'Why a lamb and not a ram was chosen is, he says, an idle inquiry, befitting fools, but not the serious mind'. Each commandment has necessarily a reason as far as its general character is concerned; but as regards its details it has no ulterior object. These details are devised as tests of man's obedience (quoted by Hirsch I905). One strength in setting ritual rules, but not setting out the reason for them or what they mean, is that they may persist while interpretations change. The power to evoke feelings, and meanings, stays open for reinterpretation as times and ideas and interests change. The rules about leprosy provide an example of this. The uncleanness of leprosy is a matter in Leviticus of preserving boundaries, setting holy things apart from risk of contact with uncleanness. The question why some people might be smitten with leprosy is not answered in Leviticus. But words with roots which mean to smite or strike or pierce are likely to focus efforts after meaning.

They might focus either on the moral or the medical implications. The verses concerning the man who is wholly leprous occasioned comment from Francis Bacon: 'Some of the most learned Rabbins have travailed profitably and profoundly to observe, some of them a natural, some of them a moral, sense or reduction of many of the ceremonies and ordinances. As in the law of leprosy . . .one of them noteth a principle of nature, that putrefaction is more contagious before maturity than after: and another noteth a position of moral philosophy, that men abandoned to vice do not so much corrupt manners, as those that are half good and half evil' (Bacon I974: 3 9). The natural, or medical, sense overtook the moral meaning long after the Biblical period. Biblical attitudes to leprosy had little or nothing to do with attitudes of the sort we now take to illness.

In matters of sickness in the Old Testament, it is God who disposes; and man does not seem even to propose much. For the statutes and ordinances of God teach right conduct. If people conform in righteousness, God 'will put none of the diseases upon thee, which I have put upon the Egyptians for I am the Lord that healeth thee' (Exodus I5: 26). To miss one's step,, to err, or, worse, rebelliously to break these commands, is to risk a smiting by illness. The rules define what is safe, what is clean. Most sickness, the smiting and plagues, come retributively in the Old Testament; they are affliction or punishment or destruction. And pestilence recurs in the Bible story: it is almost a theme of the Exodus. In the deciphered texts from ancient Egypt, Babylon, and Assyria, gods and years of pestilence are named. Many of these texts are older than the Bible, and they suggest an experience of plagues, which may have marked those times when cities emerged in ancient Mesopotamia, and the population grew



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and intermingled in numbers that could support new epidemic and infectious diseases among them (McNeill I979: 64-6, 74-82).

In comparison with writings from ancient Egypt and Mesopotamia, the Old Testament has little to say about sickness and medicine. The Bible alludes to demons, witches, diviners, apothecaries and bandages; but rarely, except as a touch of imagery or a passing reference. Instead of any detailed or specific instruction on the treatment of illness, what it has to say directly about sickness and health is cast in a stark mould of command to do right according to the teaching of the Law; and if not God's mercy to the righteous, then there is affliction, according to thejustice of God who will punish the iniquitous and will smite his enemies. It puts thought about the meaning of sickness in a different frame from ours now.

I referred to the changing conceptions of sin and moral relationships in the Bible. The attitudes to illness are not set rigid in the one harsh mould I have just mentioned. The Book ofJob is a meditation on the relation of sin and suffering, and good and evil. Whether the suffering of a righteous man can be reconciled with divine justice was perceived as a problem not only by the author ofJob but also by Babylonian poets and by their king (Sigerist I967: 427-8). The Israelites probably shared much of their knowledge of illness, their attitudes to it and how to treat it, with the Semitic peoples who lived round them; but the Bible is not a source to reveal such resemblances. The Apocryphal book of Ecclesiasticus, the Wisdom ofJesus ben Sirach, written in about i8o B.C., comments on bodily and mental health in chapters 30-34 and gives advice. The book strikes a different note from the Levitical instructions. It reflects its times and the influence of Greek thought.

Sigerist (I967: 446-7), like Sudhoff and some other historians of medicine, was prepared to see the Israelites as pioneers of public health because of the influence of their ideas about purity and pollution. The notion of contagion grew, they thought, from ideas of the danger of defilement by touch and closeness. The precepts of Leviticus taught fear of contamination. These were first religious ideas, not medical ones, but they had hygienic consequences. The chapters on leprosy stand out as source of that influence. I hope I have shown that this was not their first intention, nor were those attitudes original.

A more general lesson in the story of leprosy is about cultural relativity and our selective blindness. Its example shows how words, concepts of sin, and responses to illness, may be confused and change with time. Our impulse is to see or set a medical frame around the Biblical instructions; you might say we medicalise their leprosy. We find it difficult to think about the subject without thinking of sickness. Medical associations are so well entrenched around the word that the word traps our thinking. Its meanings were different in the past, they change with culture, and this relativity in concepts of leprosy is liable to catch us out. Our bias lets us listen uncritically to explanations of their rules which attribute hygienic motives to them. We rationalise their behaviour for them in line with our own assumptions. We are ready to accept that they must have seen the problem like that. But it comes as a shock to learn that Bible leprosy was not our leprosy, and to realise, further, for how long in modern times those passages in Leviticus were taken to be about the same thing, even



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though the instructions for diagnosis make it plain they were not. Many people must have read them with that selective blindness.

The instructions on what to look for to make the diagnosis, the diagnostic criteria given in the form of precise facts to observe, make the discrepancies clear across a gulf of time. Criteria of that sort, referring to facts for observation, have provided the basis for disease categories and diagnosis, at least ideally, in Western medicine. We need such criteria to know when we are comparing like with like, especially if we wish to distinguish social and cultural influences from biological ones. The history of leprosy contains shifts of reference disguised by the same name, just as I saw it happening almost before my eyes in the West Sepik; by noticing what facts are covered by the label, we can see the changes.

Strong versions of cultural relativity come close to implying that all that matters is what people think. There are issues here of both relativism and subjectivism. Mary Baker Eddy's position on sickness and healing was rather similar, or even more idealist and subjectivist; on the basis of the belief that the spirit is everything and matter nothing, she developed the Christian Science of healing. An anti-positivist and strong sceptical view of scientific medicine might say that truth and falsity depend on certain assumptions about the nature of reality which are not constant and universal among all peoples, but varied and parochial. Medicine of the kind we are familiar with is a cultural product peculiar to us, resting like any other on our characteristic assumptions about the kind of world we live in. Its facts are taken to be facts only if the assumptions are accepted. But do the facts of some diseases go away if the thought changes? Can we investigate what people say about their illnesses without bothering whether what they say is true or false? To say that the reality of illness is subjective (and determined by particular cultural views) sounds like the extreme idealist position if the possibility of finding objective criteria of disease is denied. Some recent writing in medical anthropology has that ring when it says all illness realities are fundamentally semantic, taking the meaning-centred approach advocated by Good and Good (I98I), but without noticing their proviso that 'it is not (their) argument that disease is not biological or that meanings of illness and symptoms are independent of physiological conditions' (Good and Good I98I: I76).

There is good evidence that beliefs about the significance of an illness may have great power to alter outcome and experience in illness. Indeed the history of leprosy is a sad illustration of that point; it makes one think of the personal misery which social attitudes to the disease have caused to be added to the direct affliction of bodily damage. There was some of that in the case of the man from the village in New Guinea whom I described at the beginning. The power of moral attitudes to blind or overcome attention to the facts of disease is an old story. The history of leprosy has obvious and continuing relevance to our immediate present.

NOTES

' This is an expression of anguish, outcry and self-desolation which Gnau people may carry out in extreme grief or loss, especially for the sudden death of someone young and loved, or occasionally as outcry against deep injustice.



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2 No evidence suggestive of leprosy has been found anywhere in skeletons from before the sixth century A.D. (Moller-Christensen i967: 295-306); after that there is evidence from Egypt, France and Britain (Browne 1975).

3 The clinical forms of leprosy vary in course and progress. Some may show acute reactions which subside; skin lesions in tuberculoid leprosy may disappear or change; the 'burnt-out case' was probably scarred or deformed.

4 The rise and fall of the numbers diagnosed with leprosy in Europe is a curious story. It is not clear in what ways differences of diagnostic criteria, the spread and prevalence of tuberculosis, hygienic measures, resistance and relative immunity, may have changed the prevalence of leprosy in Europe from the high numbers of the Middle Ages (McNeill 1979: i64-8). Gilbert White (1929) in his 37th letter (8 January 1778) speculates on why there were so few lepers in his time (clean linen, changed diet). He also cites the case of a 'leper' in his parish: it is a good example of how flexibly the term was used.

5 There is only one phrase 'behold if the plague of leprosy be healed in the leper' (Leviticus i4: 3) in which the usual verb for to 'be healed' is used (nirppa' from the root rapa', 'heal, mend').

6 See Hubert and Mauss (I899: 29-3 5); Leach (I976: 88-93). 7 Rabbinic traditions connected with this passage led them to see leprosy as punishment for

slander, pride and arrogance (Ginsberg i96i: 423-7). 8 The other cases are in Exodus 4: 6, 7; 2 Kings 5; and 2 Chronicles 26. 9 J. G. Wood (I892: 390-I) discusses what species it could be. Some Talmudic writers thought

the swift which is small and has sharp claws to scratch the skin. But any small birds, such as two sparrows, would be suitable.

10 The goat was referred to as the goat of Azazel. Azazel is an evil demon in the book of Enoch. Azazel may be a place name, the Precipice. In later times, the goat was pushed over a cliff to its death a few miles fromJerusalem (Mishnah tractate Yoma 6: 6-8).

" The nazirite does not fit unambiguously either into Leach's (i958) or into Hallpike's (i969) characterisations of the symbolic associations of hair: the nazirite abstains from wine but not from sex (though love leads Samson to his downfall); the nazirite does not live an ascetic or wild life outside the community, but he remains with the community.

12 The verb kipper which is translated as 'expiate' or 'make atonement' comes from a root (kapar) with a range of meanings which includes 'to cover, to cover over or to hide, to expiate or to atone, to be covered or obliterated, to be forgiven'.

13 The blood of domestic animals must be offered at the shrine on the altar. The blood of hunted animals must be poured out on the ground and covered with dust (Leviticus IT: I3; also Deuteronomy I2: I5, i6, 22-25).

14 It is called anointing and suggests an association of priest to king (Porter I976: 6o, 71). 15 'Asham 'fault' 'guilt' is related to a verb 'asham meaning to 'lie wild, waste, or desolate, to be

laid waste, to be condemned, to be guilty'. The etymological implication of 'asham might seem to imply that guilt is a state that the person finds himself in, whereas sin (hatta't) is an active false step or error. The related 'ashman means 'solitudes, wilderness, region of shades, in the desolate places as the dead, darkness'.

16 The Mishnah (Zebahim 5.5) lists six kinds of guilt-offering. 17 The point about confusion of boundaries might apply to the rules about sexual impurity which

touch reproductive functions. Some seem to identify products of the reproductive functions which are not in their proper place: the issues or fluxes of the man or woman. But childbirth and menstruation bring impurity too. To my mind what counts in these rules more than matter out of place or ambiguity is their association either with the reproduction of life or with death.

REFERENCES

Adams, F. I846. The seven books of Paul Aegineta, vol. 2. London: The Sydenham Society. Bacon, F. I974 (I605). The advancement of learning and New Atlantis. Oxford: Clarendon. Brody, S. N. I974. The disease of the soul. Ithaca: Cornell Univ. Press. Browne, S. G. I975. Some aspects of the history of leprosy: the leprosie of yesterday. Proc. R. Soc.

Med. 68, 485-93. Danby, H. I93 3. The Mishnah. Oxford: Clarendon Press.



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Douglas, M. I966. Purity and danger. London: Routledge & Kegan Paul. Eisenstein, J. D. 1905. Right and left. In TheJewish Encyclopedia. New York: Funk & Wagnalls. Fortes, M. I966. Totem and taboo. Proc. R. anthrop. Inst. I966, 5-22.

Ginsberg, L. I96I. The legends of theJews. New York: Simon & Schuster. Good, B. & M. Good, I98I. The meaning of symptoms. In The relevance of social sciencefor medicine

(eds) L. Eisenberg & A. Kleinman. Dordrecht: Reidel. Gussow, Z. & G. S. Tracy I970. Stigma and the leprosy phenomenon in the nineteenth and

twentieth centuries. Bull. Hist. Med. 54, 425-49.

Hallpike, C. I969. Social hair. Man (N.S.) 4, 256-64.

Hirsch, E. G. I905. Sacrifice in theology. In TheJewish Encyclopedia. New York: Funk & Wagnalls. Hubert, H. & M. Mauss I 899. Essai sur la nature et la fonction du sacrifice. L'Ann&e sociologique 2,

29-I3 8. Leach, E. R. I958. Magical hair. J. R. anthrop. Inst. 88, I47-64.

I964. Anthropological aspects of language: animal categories and verbal abuse. In New directions in the study of language (ed.) E. H. Lenneberg. Cambridge: M.I.T. Press.

I976. Culture and communication. Cambridge: Univ. Press. Macalister, A. I902. Leprosy. In The Dictionary of the Bible (ed.) J. Hastings. Edinburgh: T. & T.

Black. McNeill, W. H. I979. Plagues andpeoples. Harmondsworth: Penguin. Moller-Christensen, V. I967. Evidence of leprosy in earlier peoples. In Diseases in antiquity (eds)

D. R. Brothwell & A. T. Sandison. Springfield: Thomas. Peake, A. S. I902. Unclean, uncleanness. In The Dictionary of the Bible (ed.)J. Hastings. Edinburgh:

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A Lesson from Leviticus: Leprosy