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September 2016

Boils—A Modern Take on the Plague of Egypt

Author Affiliations
  • 1University of Miami Miller School of Medicine, Department of Dermatology and Cutaneous Surgery, Miami, Florida
  • 2New York Medical College School of Medicine, Valhalla
JAMA Dermatol. 2016;152(9):991. doi:10.1001/jamadermatol.2016.0245

Before modern science could explain ancient phenomena, people turned to religion and faith for answers. The Bible has long provided guidance for many religions, but it is often underappreciated as a historical text with insights into medical afflictions.

The Book of Exodus documents 10 biblical plagues that passed over Egypt as a form of punishment. The sixth plague fell upon the people as “festering boils [which] will break out on men and animals throughout the land.” The condition, known as Zaraath, described throughout the Bible, is commonly referred to as “leprosy.” The Book of Leviticus in the Hebrew Bible contains guidelines for diagnosing leprosy, such as, “when a man shall have in the skin of his flesh a rising, a scab, or bright spot…the priest shall look on the plague in the skin of the flesh: and when the hair in the plague has turned white, and the plague in sight be deeper than the skin of the flesh, it is a plague of leprosy.”1 Despite a widely accepted interpretation of this pathologic description as leprosy, much controversy still surrounds the differential diagnosis of the described disease. Dermatologist E. L. McEwen claimed that the description found in Leviticus encompassed various inflammatory skin diseases, while scholar Julius Preuss narrowed down the differential diagnosis to syphilis or leprosy.1

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