Paranormal Healing
16
Fever and Dysentery in Acts 28:8 and Ancient Medicine
This essay explores ancient views concerning the character of fever and dysentery, as well as both natural and supernatural treatments sometimes prescribed for them. Such information affords us a clearer sensitivity to how Luke’s earliest audiences may have conceived the severity of this ailment, hence appreciated the healing reported here.
And it happened that Publius’s father was bedridden due to intermittent fevers and dysentery. Thus Paul entered, prayed, and laid hands on him, and thereby cured him. (Acts
28
:
8
)
One could examine Acts 28:8 from a variety of important and complementary angles, such as literary, historical, or medical approaches. My particular interest in this essay, however, is to demonstrate how the ailment would sound in an ancient medical setting. Recognizing how it would sound in such a setting will help us to hear the ailment of Publius’s father more sympathetically, and to appreciate the dramatic character of the healing more fully, that is, in a manner closer to how Luke’s ideal audience would likely have heard the passage. Although I will open with a brief mention of modern suggestions about the nature of the ailments, my purpose here is not to diagnose these ailments in modern medical terms, but to examine how an audience familiar with ancient medical conceptions would have heard Luke’s brief mention of them.
To pursue this objective, I draw on ancient medical texts. Admittedly, most of Luke’s audience would not have technical expertise in the Hippocratic corpus;¹²⁴⁶ but fevers and dysentery were pervasive ailments, and ancient medical sources offer us the fullest available window into the sorts of ideas about them that circulated in antiquity. Although the documentary papyri reflect a more popular level, their descriptions of cases are more limited. (From my PhD student Thomas Grafton’s dissertation, I add to the discussion on fever brief remarks from these sources to the original article on which this essay is largely based.)¹²⁴⁷
However accurate or inaccurate their empirical diagnoses, ancient medical reports also provide the most thorough extant observations available from antiquity. This approach may be of special interest to those who, like myself, believe Luke the physician a particularly likely candidate for the first-person companion of Paul in this part of Acts.¹²⁴⁸
Fever and Dysentery
After briefly noting some possibilities in more modern medical terms of what may have afflicted Publius’s father, I will turn to ancient observations and speculations regarding fevers and dysentery.
The Ailments in Modern Terms
In modern terms, some suggest plausibly that the fever depicted here was a kind of fever traditionally associated with Malta and known as “Malta fever.” In 1887 scientists discovered its cause, a microorganism called Micrococcus melitensis, found in the milk of goats on the island. The recurrent and intestinal character of the ailment fits this description.¹²⁴⁹ Untreated, it usually lasts about four months, but it could last two or three years.¹²⁵⁰
Nevertheless, Barrett’s caution is prudent: this proposal is plausible and may be accurate, but it is not completely certain because “there are other causes of fever.”¹²⁵¹ Ancients associated a range of maladies with “fever,” and the heart of Luke’s ideal audience, which was almost certainly not located on Malta, would have conceived of Luke’s description in much more general terms than an illness particular to the island.
Even if we could be certain that today’s Malta fever existed in the first century and that Publius’s father had this ailment, typical ancient observers would have likely classified it simply as “fever,” as Luke does. The more general kind of recurrent fever with which Luke’s audience would be most familiar would likely correspond, in today’s terms, to malaria.
Fever, most commonly malaria (but sometimes typhoid), was widespread in Mediterranean antiquity.¹²⁵² In fact, of diseases appearing in ancient medical literature, malaria and tuberculosis appear to be the most common.¹²⁵³ Malaria includes a variety of febrile diseases spread by the anopheles mosquito;¹²⁵⁴ but though malaria was known to be more common in swampy areas,¹²⁵⁵ people did not yet understand the connection.
Fevers
Of greater concern for our purposes is the way that Luke’s audience would have conceived of fever and dysentery. In the Septuagint and extant first-century Christian sources, only Luke (and only in this passage) employs the plural form of puretos, i.e., “fevers.”¹²⁵⁶ The plural appears this way for a single person frequently and appears notably in medical writers.¹²⁵⁷ Presumably Luke means that the father’s fevers were intermittent, coming and going, as fevers often did (and as malaria commonly does in its earlier stages).¹²⁵⁸
Luke’s contemporaries were widely familiar with intermittent fevers. One form of intermittent fever is nocturnal malaria, which appears to leave its mark in ancient sources. Thus one medical source writes of a person suffering from fever on and off for 52 days, delirious and unable to sleep at night but sleeping the rest of the time.¹²⁵⁹ Others reported experiencing their worst attacks of fever at midday.¹²⁶⁰ In a winter fever¹²⁶¹ (the season depicted in Acts 28), the fever would usually abate if the patient lost consciousness, but it might afterward return dangerously.¹²⁶²
Fevers could be seasonal, and ancient writers often distinguished four types.¹²⁶³ “Quartan” fevers, though milder than some others, were the longest,¹²⁶⁴ but said not to last more than a year.¹²⁶⁵ Although said to usually strike men between the ages of 25 and 45 (Publius’s father is presumably older), it would come most often in autumn and persist only if accompanied by another sickness.¹²⁶⁶ In quartan fever’s early stages one lacked an appetite but later regained it; the sufferer produced white mucous and sometimes a noisy stomach and bloody stool. After this sort of fever ended one remained weak and light-headed.¹²⁶⁷ Quartan fever could produce a coma.¹²⁶⁸
Another category of fever mentioned by ancient physicians was “semitertian”;¹²⁶⁹ still another sort involved “summer fevers.” In the latter, on the seventh through the ninth days rough bite-like (yet not itchy) bumps appeared on the skin; sometimes the person became comatose, or at least remained sleepy throughout the summer. This form of fever was rarely fatal, but no treatment was effective.¹²⁷⁰ “Tertian” fevers were accompanied by nightmares, hemorrhages, and sometimes delirium.¹²⁷¹ The night preceding an attack was usually more difficult than the night afterward.¹²⁷²
Whereas fevers proved fatal to some, others survived; thus some fevers proved milder than others.¹²⁷³ In the most dangerous cases, a person would die on the fourth day or earlier.¹²⁷⁴ The assault of some fevers was said to decrease at the fourth day, but the second bout would run till the seventh day; the third till the eleventh; and so on, up to twenty days.¹²⁷⁵ They could also last longer, through sixty days.¹²⁷⁶ Depending on the sample size for empirical observations, one might conclude that they often varied in length with the individual so afflicted.
Ancient medical writers described “fever” in various ways. Some who wrote in the Hippocratic tradition depicted fevers as coming in various colors, each of which felt different to those touching the afflicted.¹²⁷⁷ The various speculations about causes and cures suggest just how uncontrollable these maladies were. It was thought that excess wine or exhaustion could produce winter fever, but that this could become other diseases.¹²⁷⁸
As one might guess from the etymology of fever (puretos), many connected it at least figuratively with an internal fire (pur). Thus fever may be “kindled” and glands “inflamed”;¹²⁷⁹ a sick person burns with a heavenly fire.¹²⁸⁰ Some opined that excess phlegm produced the fever by swelling tissues;¹²⁸¹ one could supposedly treat this problem by warming the body for three or four days (so that sweat would relieve the fever), not cooling the person until the fourth day.¹²⁸² Among the more unusual reports, some opined that quartan fever was incompatible with epilepsy, and cured it!¹²⁸³ Views concerning fevers varied, but clearly some proved quite dangerous.
The documentary papyri offer little description of fever (puretos), but they make clear the potential seriousness of this condition.¹²⁸⁴ Thus in P.Gur (215 BCE), one bedridden with fever could not defend his property. In P.Oxy 3.95 (96 CE), a public physician reports the vomiting and fever of a wounding victim; perhaps these conditions reflect infection from the wound. In P.Oxy 12.1582 (second century CE), fever is a serious condition requiring care. A later Christian text invokes Christ and the Spirit to exorcise fever and shivering, speaking of fever lasting between three and four days.¹²⁸⁵
Dysentery
As in Acts 28:8, Hippocratic writings sometimes mention fever and dysentery together.¹²⁸⁶ In one recorded case, a patient had dysentery, fever, and bloody stool, with pain in the belly growing from the thirtieth to the fortieth day; but the patient eventually recovered.¹²⁸⁷ Often this combination of symptoms occurred during the hot summer, when dysentery was most common.¹²⁸⁸ Summer fevers (see the brief discussion above) could be linked with diarrhea;¹²⁸⁹ in summer, drinking water often sickened those living near marshes with dysentery, diarrhea, and quartan fever.¹²⁹⁰ Dysentery and fever were most common in summer after a particularly rainy spring.¹²⁹¹ But the father of wealthy Publius would probably not live near a marsh, and the weather reported in Acts 28 is now cool (cf. Acts 27:9, 20; 28:2). It is possible that the symptoms have continued since the summer, or that one ailment has weakened his body to the extent that it has succumbed prematurely to another.
Dysentery was painful,¹²⁹² and sometimes led to death.¹²⁹³ One writer describes dysentery as accompanied by pain and colic, ulcerated intestines, the passing of phlegm and bloody stools; “The disease is long, painful, and usually mortal.”¹²⁹⁴ As in the instance above, some did recover from dysentery;¹²⁹⁵ others, however fared less happily. Thus one recorded patient swelled up, experienced diarrhea, and died.¹²⁹⁶ Hippocrates reportedly claimed that one would die from dysentery if the bile was black, but usually not if it was yellow.¹²⁹⁷ Despite the relative silence of ancient physicians about childhood sickness, a modern specialist concludes that “enteric diseases such as infantile viral diarrhoea and amoebic dysentery probably accounted for most of the high infant mortality observed in cemeteries.”¹²⁹⁸ Presumably dysentery also proved difficult for older persons, as Publius’s father probably is (in view of Publius’s rank, Acts 28:7).
Nevertheless, Hippocratic writers supposed that dysentery sometimes had beneficial effects. Thus, for example, painless dysentery with fever could help relieve intestinal blockage;¹²⁹⁹ fevers¹³⁰⁰ might be finally “cured” by diarrhea and dysentery that ended the sickness;¹³⁰¹ and fever might be rare when the bowels were loose.¹³⁰² Likewise, another text concludes that dysentery could cure some diseases by passing them off in the stools.¹³⁰³ But ancient physicians also recognized that dysentery normally weakened the patient rather than helped them.¹³⁰⁴
Proposed Treatments in Antiquity
Although some proposed treatments make sense (such as preventing excessive dehydration), many others will not strike modern readers as helpful. We survey first some ancient proposed treatments for fever; then, more briefly, some proposed treatments for dysentery; and finally, some comments regarding attempts to secure recovery through appeals to superhuman agents.
Treatments For Fever
Although the medical treatment some have supposed in 28:9 is unlikely there and no one proposes such treatment in the present verse, it is helpful to consider the sorts of treatments that Publius, a wealthy man (28:7), might have secured previously for his father.
Treatments of malaria focused on symptoms, especially the fever itself and the spleen.¹³⁰⁵ Many physicians treated winter fever with water and perhaps juices but significantly reduced food.¹³⁰⁶ Sponging a fevered person to cool them was also a useful treatment; in urgent cases, this therapy could take precedence even over observing the Sabbath.¹³⁰⁷
Other proposed treatments varied widely. The physician Celsus lists many different Greek medical opinions concerning how to treat fever, hence suggests “trying them all (De Medicina 3.14).”¹³⁰⁸ Ancients proposed various treatments of fever’s attendant chills, such as agaric mixed with hot water, or (in the case of tertian fevers) siderite (a mineral) with oil.¹³⁰⁹ Other alleged cures include:
•Deer flesh¹³¹⁰
•A wolf’s salted right eye used as an amulet (recommended by Magi)¹³¹¹
•cat feces with a horned owl’s claw used as an amulet (also recommended by the Magi for quartans)¹³¹²
•one substance that cures tertians and quartans and also cures the bite of rabid dogs¹³¹³
•one writer suggests that sexual intercourse cures quartan fever, so long as menstruation is beginning¹³¹⁴
Naturally some prescriptions appeal to substances so scarce as to be barely falsifiable; even the more readily acquired proposed cures were probably never empirically verified, but at best were attempted once and deemed cures if the person recovered.
Treatments For Dysentery
From a modern perspective, treatments for dysentery are not much more encouraging than those for fever, though some of these treatments may have been observed to control diarrhea and consequent dehydration, or to provide some nourishment the body could absorb despite diarrhea. Various folk cures for dysentery existed:¹³¹⁵
•navew seed with some warm water¹³¹⁶
•holly leaves, which are also helpful for cholera and menstruation; when mixed with wine, they prevent diarrhea¹³¹⁷
•a tree-fruit¹³¹⁸
•veal broth¹³¹⁹
•mallow (also useful against epilepsy);¹³²⁰ cultivated sorrel;¹³²¹ beeswax mixed with gruel;¹³²² juice from pounded vine leaves;¹³²³ and a decoction of white myrtle in wine¹³²⁴
One supposed cure proposed for dysentery that Paul and Luke certainly would have rejected was unbridled sexual activity.¹³²⁵ Traditional magical cures also existed.¹³²⁶
Paranormal Healing
Elsewhere Pliny notes that medicines afford little help against quartans; thus he notes some remedies proposed by magicians, starting with recommended amulets.¹³²⁷ Some who recovered also undoubtedly claimed superhuman causes for their cures; Lucian complains that, given all the idiots in circulation, it would not be surprising if some claimed healing through a revelation of the deceased charlatan Peregrinus.¹³²⁸
Although ancient writers describe some miracle workers who healed by means of prayer,¹³²⁹ they also report other specifically religious remedies. Old Romans worshiped Febris, goddess of Fever (to reduce her malevolence); three temples to Fever continued to exist in Paul’s day in Rome.¹³³⁰ (By contrast, Pliny regarded the temple to Febris as base superstition.)¹³³¹ Apparently the sick used charms that touched their bodies, which they afterward deposited in her sanctuaries.¹³³² People used incantations against fever and fever demons;¹³³³ because erotic magic was thought to cause “burning,”¹³³⁴ fever might also originate from such sources.¹³³⁵ Third-century CE Jewish astrological magic apparently attributed to the demon Lix Tetrax¹³³⁶ affliction with day-and-a-half fevers, which could be cured by invoking particular names¹³³⁷ or thwarted by the name of the archangel Azael.¹³³⁸ Hero cults also offered healings in answers to prayer, including for “quartan fever.”¹³³⁹
Here, by contrast, without sacrifices or charms, the true God provides healings through his agent, just as he has provided healings elsewhere in Acts.¹³⁴⁰ Although not the focus of this essay, that is of course the focus of Luke’s observations.
Conclusion
I have sought to offer a sense of how ancient physicians and (presumably) some other ancient observers perceived “fever” (here probably an intermittent fever) and “dysentery.” Ancient medicine lacked adequate means to prevent or cure these ailments, and even many treatments of the symptoms were inadequate. These ailments were often dangerous and sometimes fatal. People sometimes sought recovery from such ailments by attempting to appease or derive cures from deities. Such information may provide us greater empathy for Publius’s father and greater appreciation for the miraculous cure that Luke reports. It may also provide us increased appreciation for Luke’s portrayal of healing signs that demonstrate both the power and the benevolence of Paul’s God.