Tzaraath (Hebrew: ṣāraʿaṯ), variously transcribed into English and frequently translated as leprosy (though it is not Hansen's disease, the disease known as "leprosy" in modern times), is a term used in the Bible to describe various ritually impure disfigurative conditions of the human skin,[1] clothing,[2] and houses.[3] Skin tzaraath generally involves patches that are white and contain unusually colored hair.[4] Clothing and house tzaraath consists of a reddish or greenish discoloration.[5]
The laws of tzaraath are given in depth in chapters 13–14 of Leviticus, and several Biblical stories describe individuals who have contracted tzaraath.
Variant transcriptions of the name into English include saraath, zaraath,[6] tzaraat,[7] tsaraat, tzaraas, and tsaraas.
The Hebraic root tsara or tsaraath (Hebrew: צָרַע "to be struck with leprosy, to be leprous"), and the Greek lepros (Greek, Ancient (to 1453);: λεπρός), refer to conditions other than Hansen's disease.[8] The editors of the Septuagint translated the term tzaraath with Greek lepra (Greek, Ancient (to 1453);: λέπρα), which in classical sources referred to psoriasis and similar skin conditions; at the time Hansen's disease was known in Greek by a different term (elephantiasis graecorum).[4] The connection with the bacterial infection now known as Hansen's disease increased as the latter disease spread more widely, and was firmly established by Islamic works on medicine in the 9th century.[8] The classical Greek term lepra stems from the noun lepis Greek, Ancient (to 1453);: λεπίς (a scale (of a fish)), which in turn stems from the verb lepó Greek, Ancient (to 1453);: λέπω (to peel), hence 'leprosy' (literally, morbid scaliness).[9] Variants of the word leprosy conflating tzaraath with Hansen's disease were used from the earliest English translations of the Bible, including Wycliffe's, Tyndale's, and Coverdale's.
The linguistic root of tzaraath (צרע) may mean "smiting";[10] the Arabic cognate tzaraa (صرع) has a similar meaning.[11] Alternatively, tzaraath may be derived from the Hebrew word tzirah (wasp), based on the idea that tzaraat affects the skin in a manner resembling a wasp's sting.[12] Other theories suggest a connection to the roots שרע ("to spread") or זרע ("seed", i.e. a growth).[13]
The manifestation of tzaraath is termed a negah "affliction", nega'im (plural:).[14]
There are three varieties of nega'im that relate to human flesh:
White patches of the skin are confirmed as tzaraath by the occurrence of one of three signs:[16]
Tzaraath skin patches can come in three varieties (13:2 HE): se'et ("a rising" or "discoloration"[19]), sapahat ("a scab"), and baheret ("a bright spot"). The meaning of these terms is obscure, but they may suggest that tzaraat consists of an abnormal skin texture as well as color. However, rabbinic interpretation almost universally concluded that these three terms refer to different shades of color (white like wool or like snow, etc.) rather than different textures.[13] The rabbis even argued the phrase "its appearance is deeper than the skin of his flesh" (13:3 HE) refers to color ("deeper" presumed by the rabbis to mean "of lighter color").[13] As se'et and baheret (both terms which may refer to color and not texture) are later discussed individually (HE, HE), while sapahat (apparently referring to texture) is not, sapahat may be considered a possible feature of se'et or baheret rather than an individual condition; in which case, the rabbinic interpretation may also be the original meaning of the verses.[19]
Paradoxically, if the tzaraat covers a person's entire body, it is considered pure, and no isolation or purification ritual is needed.[20] However, according to a minority interpretation, it is not the entire body, but the entire lesion (including any "islands" of previously healthy skin within the lesion) which must be covered by tzaraat in order to have this pure status.[21]
Boils and burns, as occur naturally as a result of an abscess, blunt force trauma or thermal insult to the skin, are not tzaraath and do not carry impurity. During the healing phases of these wounds, however, if certain signs that mimic those of the aforementioned patches appear, tzaraath may occur.
Confirmation is by the occurrence of one of two signs:[22]
The initial symptom of this type of tzaraath is patches of hair loss. According to Maimonides, scalp and beard tzaraath is characterized by hair loss without any change to the skin of the bald spot.[25] The Tosefta, however, maintains that the skin of the bald spot becomes altered.
There are two confirming signs:[26]
While baldness is not a form of tzaraath, patches that occur on a bald scalp may be tzaraath if they meet the criteria mentioned by the Torah. Such an eruption on a bald scalp must appear in a distinct fashion, but is regulated by rules similar to that of tzaraath on the skin; however, it can only occur on men. For a scalp eruption to be tzaraath, the lesion must be a white patch tinged with red (נגע לבן אדמדם).[27] This can occur in one of two places: within what are referred to as a man's posterior baldness (קרחת) and anterior baldness (גבחת).
To determine whether a skin condition is indeed tzaraath, the afflicted individual must visit a kohen (a priest, possessing direct male lineage to Aaron). The kohen, trained in examining lesions and diagnosing tzaraath, examines the lesion according to the previously mentioned criteria, and determine whether it meets the specifications of tzaraath. If during the initial examination the lesion meets the criteria for tzaraath, the kohen pronounces the individual ritually impure (tamei, טמא).[28]
If the criteria are not met by the lesion during the initial examination, the individual is confined to his home for seven days, pending a follow-up examination.[29] If the criteria for tzaraath are again not met and the lesion has not spread, there is a difference in protocol depending on the type of lesion.
After the second confinement period of seven days, those with skin patches or bald patches are re-evaluated once more. If the criteria for tzaraath have still not been met, the individual is declared pure. He or she, must, however, wash both his or her body and garments; due to the confinement, he or she is considered impure in some sense.
If the lesion was declared ritually pure and later it spread, it must be shown once again to a kohen, who will then pronounce it tzaraath.[34]
If, however, the criteria for tzaraath have been met, either during the initial inspection or at either of the two follow-ups (when applicable) or even after a previous pronouncement of purity, the individual is declared impure. The individual is declared impure even if the lesion did not worsen or spread but remained the same—the skin eruption must become dimmer in appearance for it to be declared pure at the second follow-up examination.[35]
The biblical emphasis appears to be on the ritual impurity that results from a diagnosis of tzaraath, not on any possible medical danger. The commands repeatedly discuss the sufferer's "pure" or "impure" status, only rarely mentioning "healing", and no Biblical story of tzaraath appears to involve the danger of death to the afflicted person.
The individual who is declared impure with tzaraath is referred to as either a tzarua (צרוע) or a metzora (מצורע).[36] Such individuals must live alone outside the confines of their community, and call out [ritually] impure, [ritually] impure.[37] They must tear their garments, keep their hair unkept or uncut (פרוע), and cover their upper lip;[37] these practices are expressions of mourning.[38] In a different interpretation, the mouth must be covered, to prevent contagion.
A few medical historians, such as Arturo Castiglioni, regard this as the first model of sanitary legislation.[39] Nevertheless, some (though not all[40]) Talmudic laws treat tzaraath as noncontagious: non-Jewish victims of tzaraath were not considered ritually impure;[41] in special circumstances (during a holy day, or for a bridegroom after his wedding) the kohens inspection could be delayed until after the celebrations;[42] in cases where white hair is a sign of tzaraat, if the white hairs were plucked before the inspection then the person was not declared impure.[43] Similarly, in the Biblical description of house-tzaraath, individuals are encouraged to remove their belongings from the house before the house and its contents are pronounced impure.[44]
See also: Metzora (parashah).
Once the metzoras lesion vanishes, he is evaluated by a kohen, who leaves the community to examine him. When the priest had certified that tzaraath had been cured,[45] the biblical text requires that the formerly infected person (metzora) undergo a number of ritual events, some occurring immediately,[46] and some occurring a week later.[47]
Initially, the person took two kosher birds, cedar-wood, scarlet, and ezov.[48] "Living" water was placed in an earthenware vessel, over which one of the birds was slaughtered and into which the blood was allowed to run.[49] The kohen then dipped the remaining bird and other items into the bloodied water, and sprinkled it on the metzora seven times.[50] The live bird was freed into the open field.[50] The metzora washed their garments from impurity and shaved off all their hair.[51]
The metzora then waited for seven days to begin the final steps of his purification ceremony; in this period he must avoid his own home, but may mix with other people.[51] On the seventh day, he again washed his garments from impurity and again shaves off all of his hair, and was then deemed pure.[52] On the eighth day, he brought three animal sacrifices to the sanctuary: a sin-offering of a female lamb, and a guilt-offering and a burnt-offering, both male lambs.[53] (One who could not afford this sacrifice would instead offer birds rather than lambs for the sin-offering and burnt-offering.[54]) Blood from the slaughtered guilt-offering was placed on his right ear, right thumb and right big toe;[55] then some of the oil for the sacrifice was poured into the priest's left palm, and applied with the priest's right forefinger onto the metzora right ear lobe, right thumb, and right big toe.[56] The rest of the oil from the priest's palm was poured on the metzora 's head.[57] Finally, the sin-offering and burnt-offering were sacrificed.[58]
Some scholars speculate that the initial ritual may have originally been connected to sympathetic magic, with the living bird representing the departure of ritual impurity. Hyssop might simply be a good implement to use for sprinkling, with cedar-wood perhaps having alleged medicinal properties. Alternatively, tzaraath is seen as akin to death (12:12 HE), and the use of "living" water dyed with blood (representing life: 12:23 HE) and scarlet dye, along with cedar and ezov which also appear in the ceremony of purification from corpse-impurity (19 HE), represent the symbolic return of the metzora to life.[59]
The Hebrew Bible also speaks of tzaraath in several stories:
Tzaraath can also afflict garments.[64] Garment tzaraath is relevant to only three materials:
In a wool or linen garment, the tzaraath may appear uniformly throughout the fabric, or else be limited to the garment's woof or to its warp (או בשתי או בערב).[65]
Tzaraath appears in clothing as an greenish (ירקרק – yerakrak) or reddish (אדמדם – adamdam) eruption.[66] This has been interpreted as either a intense color ("the greenest of greens") or a mild one ("less than fully green").
Such clothing must be brought to the kohen for inspection. A garment cannot be declared impure upon initial examination; rather, it is confined for seven days, and if on the seventh day, the eruption has spread, the garment is declared impure with tzaraath.[67] Subsequent to a declaration of tzaraath, the garment, whether wool, linen or leather, is completely burnt in fire; if the tzaraath was confined to the woof or warp, only that need be burnt.[68]
Upon re-evaluation after the seven-day confinement, the kohen may instruct that the garment with the eruption be washed and confined once more for seven days.[69] If upon a second re-evaluation after the second seven days of confinement, the kohen sees that the eruption did not dim and did not spread, the garment is declared impure and must be completely burnt.[70]
If the second re-evaluation reveals a dimming of the eruption, the kohen tears the area with the eruption from the garment and burns the torn out portion completely.[71] The torn out area is patched to allow for a reinspection of the area for return of the lesion.[72] If, the eruption returns to the patch, there is no confinement period instituted and the entire garment is completely burnt; if a lesion reappears on the garment but not on the patch, the garment must be burned but the patch can be saved.[73] To recapitulate, if the lesion remained as it was after the first week of confinement, it is washed and reconfined. If it remained as it was after the second week of confinement, it is burned.[72]
If, however, upon the second re-evaluation, the lesion disappears, the garment must be immersed in a mikveh (ritual bath) and is then pure.[74]
Fabrics and clothing affected by tzaraath were required by the text to be burnt entirely,[75] unless it was the form of tzaraath that faded after washing but came back after being torn out, in which case it could be considered ritually pure as soon as the tzaraath had gone, and it had subsequently been washed.[76]
The third and last type of tzaraath mentioned by the Torah affects buildings.[77] If an individual notices an affliction on his house, he is to inform a kohen. The kohen will then command that they empty the house of all of its contents prior to his inspection; this is to prevent further financial loss, because should the house be confined, everything within it became impure as well.[78]
When the kohen comes to perform the inspection, he looks for lesions on the wall that appear either intense green (ירקרקת) or intense red (אדמדמת) and that appear sunken below the plane of the wall's surface (שפל מן הקיר, literally "lower than the wall"). If this is what he sees, the kohen exits the house and confines it for seven days.[79]
On the seventh day, upon re-evaluating the eruption, if the kohen sees that the eruption has spread beyond what it had been, the afflicted stones are removed, the area around the afflicted stones is scraped and both the removed stones and clay plaster are cast into a place of impurity.[80]
The void is filled with new stones and clay plaster and the house is confined for another seven days. If upon a second re-evaluation, the negah has returned after new stones have been plastered in, the negah is deemed tzaraath and the entire house must be dismantled.[78] If the negah does not return, the house is pronounced pure, and the same purification process mentioned in relation to tzaraath of human flesh is employed here.
Tzaraath infections in houses were to be treated similarly harshly according to the biblical regulations, and didn't have any exceptions; stones showing the symptoms had to be removed, and the house had to be scraped, with the removed stones and scraped-off clay being cast into a rubbish heap outside the city,[81] and if the infection returned once replacement stones were laid and daubed with clay, then the whole house had to be dismantled, with the rubble again going to the tip outside the city.[82] Additionally, people who had been in a house while it was infected with tzaraath was considered ritually impure until the evening came, and anyone who had eaten or slept there had to also wash their clothes.[83]
A house that was "healed" from tzaraat received a purification ritual virtually identical to that of a healed person, involving cedar-wood, scarlet, ezov, and two birds.[84] However, the second half of the person's purification ritual, involving Temple sacrifices, was not performed.
Rabbinic tradition includes an extensive elaboration of the tzaraath laws recorded in the Bible. The rabbinic laws of tzaraath appear in Mishnah tractate Nega'im.
Rather than interpreting the biblical descriptions of tzaraath in the manner of modern doctors, classical rabbinical literature took an extremely literal view. This is shown in the following laws:
Rabbinic literature describes additional laws regarding priest's inspection of tzaraath:
If someone cuts off some skin or a part of his body to remove a tzaraat lesion, he becomes impure, even if he had no confirming signs. He may become pure only after another lesion forms.[95] The exception is when a lesion appears on the tip of the foreskin and is cut off during circumcision, which is permitted, because a positive commandment overrides a negative commandment.[95]
Additional laws relate to the sacrifice offered at the metzoras recovery:
There are a number of limitations to tzaraath as it applies to clothing:
At least two afflicted stones are necessary for removal of any stones and at least two new stones must be used to fill the void.[102] If the afflicted wall is shared by two houses owned by two neighbors, both neighbors must help to remove the afflicted stones, scrape and place the new stones, but only the owner of the house whose interior was afflicted performs the replastering. It is from this ruling that the proverb Oy l'rasha, oy l'scheino (אוי לרשע אוי לשכנו, "Woe to the wicked! Woe to his neighbor!") originates.[102]
There are numerous limitations put on the tzaraath that afflicts houses:
The Talmud, and most historic Jewish literature (for example Rabbi Samson Raphael Hirsch), regards tzaraath as a punishment for sin, and argue that cure from tzaraath only comes about through repentance and forgiveness. The verse itself arguably suggests this, as it directs those who find themselves afflicted to seek out a Kohen (priest) and not a doctor, even though generally the Torah encourages seeking medical treatment from doctors.[107]
The Talmud lists seven possible causes for tzaraath: lashon hara ("evil tongue", i.e. malicious gossip), murder, a vain oath, illicit sexual intercourse, pride, theft, or miserly behavior. Elsewhere, the connection with gossip is supported by the wordplay metzora (leper) - motzi [shem] ra (slanderer).[108] One modern source asserts that as a "physical manifestation of a spiritual malaise," tzaraath is a "divine retribution for the offender's failure to feel the needs and share the hurt of others."[109]
In particular, Midrash Rabbah sees the different types of tzaraath as increasing levels of punishment, which could be curtailed at any stage if repentance was made:
Each Biblical victim of tzaraath is stated to have received the condition due to some violation of biblical laws, including Joab for the murder of Abner (whose blood was shed deceitfully in time of peace), Gehazi (for 1. rebelling against Elisha's decision to not take payment for a miracle God had worked 2. working deceitfully to take the payment 3. lying to Elisha, saying he hadn't done the thing); and Uzziah for burning incense in the Temple (a ritual whose performance was limited to priests).
Other classical rabbinical writers saw tzaraath of houses as having a practical benefit. According to one, as well as being a punishment for miserliness, it also demonstrated that the house owner was lying, if they had said they did not own certain objects neighbours had asked to borrow, since the biblical regulations require the house owner to take all their possessions outside prior to confinement.[78] On the other hand, Rashi states that tzaraath of houses was a reward for the homeowner, arguing that the Israelite homes had previously been those of Canaanites, who had hidden their valuables in the walls; the tzaraath required the house owner to remove the bricks, and so find the treasures hidden there.[110]
The items used in the purification ritual - birds, cedar wood, and worm - were specifically included to deliver a message to the metzora. The sin most associated with tzaraath is lashon hara;[111] to speak derogatorily about others to one's friends is likened to birds, who chatter endlessly.[111] Similarly, the one who speaks ill of others is haughty, holding himself or herself high above others, like the tall cedar. To be healed, the metzora must erase arrogance, making themselves lowly like a worm. This is a play on words—the word tola'as (תולעת) means both "red" and "worm" – as well as hyssop.
The laws of tzaraath are not practiced by contemporary Jews. Several approaches have been suggested to explain why this is the case:[112]
Scholars suspect that the descriptions of tzaraath of the skin actually refer to a number of different skin diseases,[113] [114] which, owing to the undeveloped state of medical science at that period, were not distinguished. A wide range of diseases, infections, and skin conditions known to modern medicine have been suggested as differential diagnosis of tzaraath, including psoriasis, seborrhoeic dermatitis, favid, dermatophyte infections, nummular dermatitis, atopic dermatitis, pityriasis rosea, crusted scabies, syphilis, impetigo, sycosis barbae, alopecia areata, boil, scabies, lichen simplex chronicus, scarlet fever, lupus erythematosus, lichen sclerosus et atrophicus, folliculitis decalvans, morphea, sarcoidosis, and lichen planopilaris.[8]
Of the particular situations that Leviticus describes as being tzaraath,
Russian pathologist Gregory Minh discovered that leprosy is contagious; assuming that biblical tzaraat is non-contagious, he therefore concluded that tzaraath is in fact vitiligo. Similarly, Reuven Kalisher suggested that vitiligo is the most likely candidate for biblical tzaraath, as it is non-contagious, cause the hair located within the discolored area to turn white (also known as poliosis or leukotrichia), and can grow in size within a week to two-week period. Yehuda L. Katzenelson added that while vitiligo lacks the characteristic of biblical tzaraat, the Mishna (Negaim, chapter 1) also does not mention this characteristic. However Katzenelson concluded his analysis by listing many unanswered difficulties with Minh's opinion.[118]
One recent author suggests that tzaraath in fact corresponds to no naturally occurring disease: "By establishing rigid criteria, almost everyone who was examined was destined to fail to meet the criteria for diagnosis. Therefore this passage was designed to integrate persons with disfiguring skin diseases back into society, not to excommunicate them as was the practice in neighbouring societies."[4]
In addition to simple rashes,[119] inflammations,[120] and swellings,[121] the biblical text mentions a number of other conditions that could be confused with tzaraath. Among other situations the text considers harmless are the appearance of dull white spots,[122] white patches of skin without sores,[123] and baldness without sores;[124] The symptoms that the text considers to be indicative of disease include those of the spread of superficial swellings or spots (where there had previously been a boil),[126] and those of reddish-white sores in areas of baldness;[127] the former condition is identified by the Bible as plague, and scholars regard its symptoms as pointing to a diagnosis of smallpox,[115] while the latter is unidentified in the biblical text, but considered by scholars to indicate favus.[115]
In addition to infecting the skin, tzaraath is described by Leviticus as being able to infect historically common clothing fabrics, specifically wool, linen, and leather.[128] The biblical description of tzaraath in such fabrics is strikingly analogous to that of tzaraath in the skin, with, for example, spreading of the infection being tested for by isolating the fabric in question for first 7 days.[129] The principal symptoms are described as being green or red spots,[130] which spread within a week,[129] or that do not change appearance at all after a fortnight, having been washed after the first week,[131] or that return a week after having been torn out, if they also had faded with washing prior to being torn out.[132] These descriptions are regarded by scholars as most probably indicative of certain moulds,[10] [115] [113] [133] and especially matching infections by Penicillium (the fungus that produces penicillin).[10]
The biblical text also describes tzaraath as infecting the walls of houses;[134] the symptoms it describes are depressions in the wall, which are green or red,[135] and spread over a period of seven days.[136] The description is regarded by scholars as again being strikingly similar to the wording of the description of tzaraath infections in the skin, but still somewhat obscure;[10] it would seem to fit some form of fungal growth,[115] especially dry rot, which produces yellowish-green and reddish patches on walls.[10]