Wednesday, April 2, 2014

Preventing The Spread Of Infection

Leviticus 13:29-59

“If a man or woman have a plague upon the head or the beard; Then the priest shall see the plague: and, behold, if it be in sight deeper than the skin; and there be in it a yellow thin hair; then the priest shall pronounce him unclean: it is a dry scall, even a leprosy upon the head or beard.” (Leviticus 13:29-30) 

A scall is any scaly or scabby skin disease.  Many people are familiar with mange, which is fairly common among dogs and cats, but can afflict almost any mammal, and can be spread by just touching the bedding the animal was on. Animals with mange may lose all their hair and become quite debilitated if not treated. If the rash appeared to go deeper than just the surface of the skin, and the hair was dying and discolored, it indicated the person had a scall.

“And if the priest look on the plague of the scall, and, behold, it be not in sight deeper than the skin, and that there is no black hair in it; then the priest shall shut up him that hath the plague of the scall seven days: And in the seventh day the priest shall look on the plague: and, behold, if the scall spread not, and there be in it no yellow hair, and the scall be not in sight deeper than the skin; He shall be shaven, but the scall shall he not shave; and the priest shall shut up him that hath the scall seven days more: And in the seventh day the priest shall look on the scall: and, behold, if the scall be not spread in the skin, nor be in sight deeper than the skin; then the priest shall pronounce him clean: and he shall wash his clothes, and be clean.” (Leviticus 13:31-34)

If the scaly area did not appear to go deep in the skin or there was no black hair to indicate a loss of color, the person was to be quarantined for a week.  If at the end of a week, there was no dying hair or deepening of the scaliness, and it had not spread, they were to shave around the area and wait another seven days.  If it had still not spread or gotten deeper, there was no infection and the person just needed to wash his clothes before going out into the public. 

“But if the scall spread much in the skin after his cleansing; Then the priest shall look on him: and, behold, if the scall be spread in the skin, the priest shall not seek for yellow hair; he is unclean.  But if the scall be in his sight at a stay, and that there is black hair grown up therein; the scall is healed, he is clean: and the priest shall pronounce him clean.”(Leviticus 13:35-37)

If the rash began to spread or get worse, it was obviously still there, and there was no need to wait for the hair to begin to die.  If it didn’t spread or get worse, and the hair began to grow again, the disease was dead and the there was no danger.

“If a man also or a woman have in the skin of their flesh bright spots, even white bright spots; Then the priest shall look: and, behold, if the bright spots in the skin of their flesh be darkish white; it is a freckled spot that groweth in the skin; he is clean.” (Leviticus 13:38-39)

Spots that had a slightly different color but were not otherwise different from the surrounding skin, such as age spots, were not infectious and called for no special treatment.

“And the man whose hair is fallen off his head, he is bald; yet is he clean.  And he that hath his hair fallen off from the part of his head toward his face, he is forehead bald: yet is he clean.” (Leviticus 13:40-41)

Baldness did not indicate a problem, whether it involved the loss of all the hair or just a receding hairline.  It was not contagious.

“And if there be in the bald head, or bald forehead, a white reddish sore; it is a leprosy sprung up in his bald head, or his bald forehead.  Then the priest shall look upon it: and, behold, if the rising of the sore be white reddish in his bald head, or in his bald forehead, as the leprosy appeareth in the skin of the flesh; He is a leprous man, he is unclean: the priest shall pronounce him utterly unclean; his plague is in his head.” (Leviticus 13:42-44) 

Sores on the head were to be examined just like sores anywhere else.  If infection was detected, since it was on his head where it would be readily spread and hard to control, the person was considered infectious.

“And the leper in whom the plague is, his clothes shall be rent, and his head bare, and he shall put a covering upon his upper lip, and shall cry, Unclean, unclean.  All the days wherein the plague shall be in him he shall be defiled; he is unclean: he shall dwell alone; without the camp shall his habitation be.” (Leviticus 13:45-46)

A person who had a contagious infection was to keep his head uncovered, and wear torn clothes to get people’s attention.  He was also wear a cloth like a hospital mask and warn those he came in contact with of the danger.  He demonstrated his concern for other people by ensuring they were not knowingly placed in danger, even though it might be embarrassing to him.

“The garment also that the plague of leprosy is in, whether it be a woollen garment, or a linen garment; Whether it be in the warp, or woof; of linen, or of woollen; whether in a skin, or in any thing made of skin; And if the plague be greenish or reddish in the garment, or in the skin, either in the warp, or in the woof, or in any thing of skin; it is a plague of leprosy, and shall be showed unto the priest: And the priest shall look upon the plague, and shut up it that hath the plague seven days: 

And he shall look on the plague on the seventh day: if the plague be spread in the garment, either in the warp, or in the woof, or in a skin, or in any work that is made of skin; the plague is a fretting leprosy; it is unclean.  He shall therefore burn that garment, whether warp or woof, in woollen or in linen, or any thing of skin, wherein the plague is: for it is a fretting leprosy; it shall be burnt in the fire.” (Leviticus 13:47-52)

Clothing and bedding, especially of natural fibers can sometimes harbor the pathogens which cause infection.   Modern hospitals use disposable bandages and pads to absorb discharge from sores and infections.  In those days cloth and leather were expensive and were not usually considered disposable.  Any piece of cloth or leather exhibiting a reddish or greenish stain from discharge from a wound was to be shown to the priest.

The priest was to set the item aside and reexamine it after seven days.  If the stain spread. It indicated the pathogen was still alive and the item was to be burned to ensure it would not be reused.

 “And if the priest shall look, and, behold, the plague be not spread in the garment, either in the warp, or in the woof, or in any thing of skin; Then the priest shall command that they wash the thing wherein the plague is, and he shall shut it up seven days more: And the priest shall look on the plague, after that it is washed: and, behold, if the plague have not changed his colour, and the plague be not spread; it is unclean; thou shalt burn it in the fire; it is fret inward, whether it be bare within or without.” (Leviticus 13:53-55)

If the stain had not spread after seven days,  the cloth or leather was to be washed, and not used for seven more days.  If the stain had not changed color or washed out, even though it had not spread, they were to burn the cloth as the infection was still alive and the article was not safe to use as it would not be possible to tell how far it might have spread.

“And if the priest look, and, behold, the plague be somewhat dark after the washing of it; then he shall rend it out of the garment, or out of the skin, or out of the warp, or out of the woof: And if it appear still in the garment, either in the warp, or in the woof, or in any thing of skin; it is a spreading plague: thou shalt burn that wherein the plague is with fire.” (Leviticus 13:56-57) 

If the washing caused the stain to change color but did not wash out completely, that part of the cloth or leather was to be cut out and disposed of but the rest of the material was considered safe.   If the stain showed up elsewhere, they were to burn the entire item.

“And the garment, either warp, or woof, or whatsoever thing of skin it be, which thou shalt wash, if the plague be departed from them, then it shall be washed the second time, and shall be clean.” (Leviticus 13:58) 

Even if the item seemed to be safe, it was to be washed again before being used as a precaution.

“This is the law of the plague of leprosy in a garment of woollen or linen, either in the warp, or woof, or any thing of skins, to pronounce it clean, or to pronounce it unclean.” (Leviticus 13:59)

It was not until the late 1800’s or early 1900’s that doctors realized that infected bedding and bandages spread infection to other patients.  As a result, more than half of the people treated for wounds in hospitals died of infections prior to World War I.   Joseph Lister’s discoveries changed that, recommending the very things God had commanded Israel more than three thousand years before.  Think of the lives that would have been saved if doctors had taken God’s command seriously rather than as mere superstition.

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