Improving Bible translations: the example of sickness and healing

John J. Pilch

Abstract

Every scholar and teacher has a list of infelicitous translations which misrepresent or distort the meaning intended by biblical authors. The time has come to prepare new translations that are more respectful to the ancient author, what the author intended to say, and actually said. Such a translation should also respectfully report what the original audience understood. Ideally, this translation should also make sense to the modern reader in another culture. In the matter of sickness and healing, medical anthropology has provided an excellent set of terms and definitions that fulfill all these hopes.

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Though it sounds offensive, the Italian proverb, "traduttore, traditore" (every translator is a traitor), actually reflects a widely recognized fact. Translating from one language to another is a challenging task. Rarely is there a one-to-one equivalence from one language to another. The translator is inevitably going to make an unfortunate choice of words. For example, to translate the Hebrew word, yehudim, and the Greek word, ioudaioi, into the English word Jew is anachronistic. The English word Jew and the realities associated with that word known to all contemporary English-speaking peoples reflects the beliefs and practices of modern Judaism which is rooted in the Babylonian and Palestinian Talmuds of the sixth century CE. The more appropriate rendition of the Hebrew and Greek words would be the literal translation Judean, a term used by outsiders (e.g., the Romans) to describe all those who professed allegiance to the God of Israel whose Temple was located in Jerusalem, in Judea (Pilch 1999: 98-104).

Similar anachronism characterizes English language translations of Hebrew and Greek words in the Bible relating to health, sickness, healing, etc. In this article, we review the challenges of translating these terms and propose alternatives suggested by medical anthropology, a cross-cultural discipline.

Problems in Translation

It is an axiom in linguistics that all meanings encoded in language derive from the social system of those using the language (Malina 2000). By itself, a single word can represent different concepts. "Pound" can be a unit of weight or can describe a blow with a fist or some other object. In some English speaking countries it is also a unit of currency. Dictionaries list the range of meanings of words within a specific social system and frequently update that range in the case of living languages. Yet philologists like James Barr (1961) have demonstrated that dictionaries of biblical theology and similar enterprises based on a study of words in isolation are woefully inadequate, misleading, and in many instances just plain wrong. For instance, "Abba" simply never meant "Daddy" in the ancient world and its literature (Barr 1988),

Thus the Hebrew and Greek words that literally should be translated as "evil eye" are usually translated "envy," "greed," "stingy," and the like in the Bible (Pilch 2000b: 23; further on this topic see Elliott and his bibliography). The social systems of circum-Mediterranean cultures have a culturally-specific understanding of "evil eye" and interpret words usually used, like "envy", very differently from Western social systems. The phrase and concept, "evil eye" is indeed related to the physical, human eye, especially one that does not look or appear to function normally. But it is not the physical abnormality that they fear. The eye is considered to be linked with the heart from which both good and base sentiments emerge. That's where the real threat will come from. Even the recent Greek--English Lexicon based on semantic domains evidences no awareness of the meaning of evil eye in circum-Mediterranean cultures (Louw and Nida I:88.165; 57.108; but especially missing the mark in 23.149)

At the level beyond words, sentences express complete thoughts, but they generally do not express complete meanings. One can understand the sentence: "he hit it," but the sentence is impossible to interpret without additional information. Who is "he"? What is "it"? Sometimes it takes many sentences, for instance, an entire Gospel, to express a complete meaning. It isn't until the centurion comments: "Truly this man was a son of god" (Mark 15:39), that the full meaning of the opening statement in Mark's Gospel becomes clear: "Here begins the proclamation of Jesus Messiah, the Son of God" (Mark 1:1).

Medical Anthropology

A sub-discipline or specialty of anthropology, medical anthropology developed after World War II (1945) when Western countries sought to share the benefits of Western medicine with other cultures. The failures and disappointments experienced by Western health-care practitioners pointed out just how deeply ethnocentric and biomedically reductionist is the medical science they were trying to spread. Matters have improved considerably in the last fifty years though much more progress remains to be made (see Pilch 2000a: 19-38).

Reading the Bible, like delivering health care across cultures, is a challenge in cross-cultural communication, understanding, and interpretation. Some basic definitions developed by medical anthropology, taught in many health science curricula, and accepted by increasing numbers of Western medical and allied health practitioners are quite valuable for all readers of the Bible, including specialists and translators. These definitions help modern readers of the Bible to gain a better understanding of and appreciation for healing and related problems presented in that document produced by and in ancient Eastern Mediterranean cultures. Moreover, these definitions helps modern readers recognize how inappropriate, anachronistic, and ethnocentric are the questions too often put to the biblical text on the topic of healing (e.g., "miracles" is a word deriving from Enlightenment insights for which there is no corresponding Hebrew or Greek word, hence it should never occur in Bible translations).

Basic definitions: Disease and Illness

In a cross-cultural perspective, the "normal" human situation is known as well-being. Even before beginning formal education, members of a culture learn what well-being means in their culture. Health is but one element of human well-being. Not all cultures would agree with Western folk wisdom which claims: "When you have your health, you have everything." In Mediterranean cultures, honor is everything, and losing honor--even in perfect health!--is sometimes equivalent to death.

Moreover, health, like sickness, is defined and interpreted by each culture. The majority of a native tribe in a South American country have a facial skin condition which to Western, "scientific" eyes would indicate a health problem. Yet in this tribe, the majority believe their condition is "normal" and healthy, while members with a smooth, unblemished skin condition are considered the anomaly. The challenge in reading the Bible is to learn, understand, and respect its understanding of health and sickness problems without imposing upon them a modern, Western medical interpretation.

When a person loses any aspect of well-being, that is considered a misfortune. Sickness is just one human misfortune. It is at this point that medical anthropology provides some very basic definitions that have important consequences for translating and interpreting the Bible. For medical anthropologists, the English word "sickness" identifies a reality, the loss of some aspect of health however a culture has defined it. The words "disease" and "illness" are not realities. Rather, they are explanatory concepts presenting two different perspectives on the reality, "sickness."

Disease is an explanatory concept (not a reality) that describes abnormalities in the structure and/or function of human organs and organ systems. This would include pathological states even if they are not culturally recognized. Disease is the special focus of biomedicine and the biomedical model. To "battle" disease, biomedicine must first correlate constellations of signs and symptoms for the purpose of explaining, predicting, and controlling the condition. The technical jargon for these strategies is diagnosis, prognosis, and therapy.

Illness is an explanatory concept that describes the human (in contrast to the biomedical) perception, experience, and interpretation of certain socially disvalued states including but not limited to disease. Illness describes both a personal and a social interpretation of the reality, sickness. The individual may be afflicted, but that individual's social network (family, village, etc.) is also involved and afflicted. From this perspective, illness is in large part a cultural construct. Culture dictates what to perceive, value, and express, and then how to live with the illness.

The Revised Standard Version of the Bible (RSV) uses the English word "sickness" twenty-one times, "disease" ninety-five times, and "illness" nine times. In each instance, the English word renders more than one Hebrew or Greek word; and conversely, the same Hebrew or Greek word is rendered by different English words. It is impossible to discern the reason why translators chose to be so inconsistent in rendering the original Hebrew or Greek. To illustrate, consider Deuteronomy 7:15 in two English translations:

"And the LORD will take away from you all sickness (hali); and none of the evil diseases (madweh) of Egypt, which you knew, will he inflict upon you, but he will lay them upon all who hate you. (RSV)

"The LORD will turn away from you every illness; all the dread diseases of Egypt that you experienced, he will not inflict on you, but he will lay them on all who hate you. (NRSV)

For the Hebrew hali in Deut 7:15, the Brown-Driver-Briggs lexicon suggests sickness, disease--presumably as synonyms. For the Hebrew madweh (deriving from dawah--to be ill, unwell), the lexicon suggests illness and sickness and considers both Hebrew words in Deuteronomy 7:15 to be synonyms. This judgment might be appropriate on the basis of literary analysis, but can it be defended on philological grounds? If lexicographers believe that the two Hebrew words are synonyms, do they consider the variety of English equivalents: sickness, disease, illness to be synonyms also? If so, they may have been guided by English language dictionaries (including e.g., MERRIAM WEBSTER'S MEDICAL DESK DICTIONARY) which consider the English words as synonyms. In both instances, Hebrew and English dictionaries, the lexicographers have paid no attention to the insights and distinctions of medical anthropologists.

Two considerations challenge such a decision. One, without the benefit of a microscope and other sophisticated modern medical technology, the ancients (like contemporary peasant societies) simply did not know human health problems in the same way contemporary Western people do. In technical terms, the ancients did not even possess a basic, scientific view of such problems which would include a knowledge of germs, viruses, and the like, since such a view had not yet emerged. Two, the culture shock experiences that eventually produced the discipline of medical anthropology also contributed to the development of a helpful set of concepts and definitions that could bridge cultural gaps and make adequate sense of native concepts to sophisticated members of modern Western culture. It would seem that sickness (or sicknesses) as defined in medical anthropology would be more appropriate in the passage just cited (Deut 7:15). There is a reality here (sickness), but we have no specific evidence to determine whether it is a disease (biomedical problem) or an illness (a cultural interpretation of a misfortune).

The problem is more acute with the case of leprosy in the Bible. Biblical scholars agree with medical historians, paleopathologists, and medical anthropologists that so-called "leprosy" in the Bible is definitely not Hansen's disease (Pilch 2000a: 39-54). The Hebrew and Greek words in the First and Second Testament are not the proper terms for "true" leprosy. The symptoms of this so-called leprosy described at length in Lev 13-14 are not at all characteristic of "true" leprosy. The problem under consideration in Leviticus also affects garments (Lev 13:47) and the walls of houses (Lev 14:37-38) which could not possibly apply to "true" leprosy. Yes, throughout Lev 13-14, the RSV, NRSV and many English translations refer to the "disease" of leprosy. The NRSV observes in an explanatory note on leprosy: "a term for several skin diseases; precise meaning uncertain." The Brown-Driver-Briggs lexicon suggests as a meaning for this Hebrew word (nega') stroke, plague, mark, plague-spot. Among these perhaps "mark" would be preferable.

Disease, as defined by medical anthropology, is not an appropriate rendition of this Hebrew word anywhere in the Bible. Archaeologists and paleopathologists have yet to find ancient bones in Israel that give indications of "true" leprosy. In other words, there is no evidence that whatever the Bible is concerned with in these passage is a disease. Even the explanatory footnote in the NRSV is incorrect. They were skin conditions; we don't know whether they were diseases or not. Rashes or pimples are not diseases. Again, "mark" would be preferable since something visible on the skin (on garments; on houses) rendered these people and things unclean. The concern was about impurity, pollution, uncleanness. Uncleanness was polluting; it made other people unclean. The problem was not physical contagion which the word disease brings to mind. When Jesus or anyone touched a so-called "leper" in the Biblical stories, no "mark" transferred from the afflicted person to Jesus. Pollution, however, did transfer. Jesus was viewed as now being unclean as these petitioners were unclean The consequence of such pollution was obligatory separation from the holy community (Lev 13:45-46). Jesus' deliberate touching of such polluted persons was his symbolic way of reintegrating them into community. Given the socio-cultural meanings attributed to this condition ("leprosy") and its consequences in the Bible, a more appropriate English translation would be "the illness of so-called leprosy" using illness as defined by medical anthropology.

Basic Definitions: Curing and Healing.

According to medical anthropologists, curing is the outcome anticipated relative to a disease, namely, a successful attempt to gain effective control over disordered biological and/or psychological processes. Medical science also admits that cures are quite rare (see Pilch 2000a: 141-43). In the early part of the last century, most diseases peaked and were subsiding before medicine discovered the cure. The human body built up an immunity or learned how to defend itself against the pathogens. Public health made progress, too: sanitation improved, water supplies were purified to a more reliable degree, people changed their eating habits for the better, etc. It is also important to note that cures take place on a one-to-one basis, between the therapist and the client.

Healing is directed toward illness and is an attempt to provide personal and social meaning for the life problems created by sickness, whether it is a disease or an illness. Treatment therefore can be directed toward either aspect of a human problem (the disease or the illness). Either one alone can be treated successfully, or both can be treated together successfully. Thus it is always important to ascertain precisely what the client thinks was healed, or in what the healing consists. A common complaint against modern biomedicine is that the therapist focuses exclusively on curing the disease, while the client yearns for healing, for rediscovering or finding new meaning in life. Often the tasks are divided: medical specialists attend to curing, while pastoral care teams attend to healing.

Healing is social and communal. It takes place between the therapist and the community (sick person, family, network, etc.--everyone benefits). Anthropologists note that healing is equally as basic and fundamental as the gift relationship or the exchange relationship in any culture. Healing is one of the primary forms of symbolic action. Healing always takes place, infallibly, one hundred percent of the time. Eventually every sick human being comes to terms with the sickness and discovers or creates new meaning in life, whatever it may be. Sometimes we may not agree with the meaning. Family, friends, alumni were shocked when Dr. Henry van Dusen, president of Union Theological Seminary, NYC, and his wife, both suffering from terminal illnesses committed suicide and left an explanatory note. For these two theologians, the decision and action was, in their judgment, healing, that is, it provided final meaning to their lives.

In the RSV, the word "cure" appears sixteen times, but the word "heal" and related words (health) more than sixty times. Still, as with disease and illness, the English translation often renders the same Hebrew or Greek words inconsistently. For example, the RSV translates the Greek word iaomai by "heal" most of the time. In Luke 9:11, however, the RSV reports: "And ... he cured (iato) those who had need of healing (therapeias)." In part, dictionaries are at fault. Arndt-Gingrich-Bauer-Danker's GREEK-ENGLISH LEXICON OF THE NEW TESTAMENT AND OTHER EARLY CHRISTIAN LITERATURE lists "heal" and "cure," presumably as synonyms, as the meaning of iaomai. More disappointing is the fact that even contemporary medical dictionaries do not incorporate the insights and definitions of medical anthropology (see MERRIAM WEBSTER'S MEDICAL DESK DICTIONARY). They too treat all these English words as synonyms: disease and illness, heal and cure (Pilch 2000a: 151-59, Glossary). In regard to the Bible, however, equal blame must be placed on translators, exegetes, and others who focus too narrowly on words and dictionary definitions without paying sufficient attention to the social system which gives these words meaning (Malina 2000).

We have no scientific evidence at all concerning the exact physical (or other) problems that specific petitioners in the Bible presented for attention, and no before and after x-rays, lab work, and other such tests. Therefore, it seems best not to use the word cure at all. A "cure" in the technical sense may have taken place, but we have no evidence for it. That word represents a biomedical perspective, one in fact that only came to fruition within the last one hundred years or less. It would seem best to render all the terms by the English word "heal." For whatever the actual, physical results of interventions by Elijah, Elisha, Jesus, Paul or others in the Bible, it seems quite clear they did give meaning to their client's lives. That is the definition of healing. While physical changes may have taken place (e.g. translations say that cripples walk, the blind see, the hemorrhage stops), it is possible that actual physical improvements also occurred. We simply have no way of knowing that these events (paralysis, blindness, hemorrhages) involved organic changes unless, as in the case of leprosy, we could find the actual bones or other materials which could provide scientific evidence for such a change. As noted above, we have found no such bones in Israel raising fair suspicion about the existence of "true leprosy" at that time.

Healers

The RSV uses the word "physician" 18 times mostly translating the Hebrew rope and the Greek hiatros; the word "healer" just 3 times (once for the Hebrew rope!). It doesn't use the word "doctor" at all, which is quite correct. (The Anchor Bible translation of The Wisdom of Ben Sira uses the anachronistic term doctor consistently in Sirarch 38). According to the OXFORD ENGLISH DICTIONARY (OED), the primary meaning of "doctor" is a teacher or instructor and was used in 1387 to describe St. Augustine, the first doctor of England. In 1377, the word was used as it still is today to describe one who in any faculty or branch of learning has attained the highest degree conferred by a university, that is, the Ph.D. A sixth and specialized meaning of the word also testified in 1377, but still current in popular current use, is applied to any medical practitioner, or a wizard or medicine man in primitive tribes.

The word "physician" in current English usage refers to someone licensed to practice medicine, a doctor of medicine. The OED traces the earliest use of physician with this meaning to 1809, as the title of all medical practitioners in the United States. An earlier occurrence (1225) was much more inclusive describing any one who practiced the healing arts, including medicine and surgery. The primary meaning of physician listed in the OED refers to a student of the natural sciences or of physics. The contemporary baggage that the word physician carries makes it a dubious choice for translating the Hebrew rope or the Greek hiatros. In the Bible, God is, of course, the one and only healer (Exod 15:26). It is interesting to note that the RSV translates the Hebrew rope as healer in this passage, rather than by the RSV's customary rendition: physician. The patriarch Joseph commanded his servants who were "healers" (RSV: physicians) to embalm Jacob, his father (Gen 50:2). King Asa neglected Yahweh in favor of "healers" (RSV: physicians). In all the other instances (Job 13:4; Jer 8:22; Tob 2:10; Sir 38:1, 3, 12, 13, 15)RSV similarly renders the Hebrew word for "healers" by the word physician. It does the same with the Greek word (hiatros: Matt 9:12; Mark 2:17; 5:26; Luke 4:23; 5:31; Col 4:14).

Given the modern conceptual content carried by the English word "physician," it is not a good choice for rendering either the Hebrew or the Greek, specialized lexica notwithstanding.

Liddell and Scott seem to recognize this by suggesting as the meaning for hiatros, "one who heals, a mediciner, physician, or surgeon (for there seems to have been no professional distinction)." "Healer" therefore would seem to be the best choice in translating the Bible.

Conclusion

Someone could object that adopting these terms from medical anthropology (sickness, illness, heal, healer) and avoiding the terms cure and physician in Bible translations is to impose on ancient texts from ancient cultures concepts they did not possess. That is not the case. All serious students of the Bible and of ancient languages like Hebrew and Greek recognize that it is difficult to grasp the distinctions between the various Hebrew and Greek words in the Bible or ancient literature that pertain to sickness and health. Until that study is carried out, it seems advisable to accept medical anthropology's set of relevant terms refined for cross-cultural communication and interpretation which acknowledges the social location of the modern reader while respecting the social location of the ancient authors. If one is reading the Bible in a formal correspondence translation (literal; word-for-word), the reader or interpreter could be given a handy chart of Hebrew and Greek words relative to sickness and health which would facilitate understanding of the ancient texts. On the other hand, a dynamic equivalence translation (literary; meaning-for-meaning) can readily provide an explanation of this vocabulary for readers in the introduction, then insert the proper equivalents into the translation, and indentify the specific Hebrew or Greek word in a footnote to the verse.. This latter option would contribute to a vastly improved understanding and interpretation of healing in the Bible by all readers, lay and specialist alike.

Works Cited

Barr, James. 1988. Abba Isn't `Daddy.' JTS n.s. 39: 28-47. 1961. THE SEMANTICS OF BIBLICAL LANGUAGE. Oxford, UK: Oxford University Press.

Elliott, John H. 1992, Matthew 20:1-15: A Parable of Invidious Comparison and Evil Eye Accusation." BTB 22: 52-65.

Louw, Johannes P. and Eugene A. Nida, eds. 1988. GREEK-ENGLISH LEXICON OF THE NEW TESTAMENT BASED ON SEMANTIC DOMAINS. New York, NY: United Bible Societies. 2 vols.

Malina, Bruce J. 2000. THE NEW JERUSALEM IN THE REVELATION OF JOHN: THE CITY AS THE SYMBOL OF LIFE WITH GOD. Collegeville, MN: The Liturgical Press.

MERRIAM WEBSTER'S MEDICAL DESK DICTIONARY. 1993. Springfield, MA: Merriam-Webster, Inc., Publishers.

Pilch, John J. 2000a. HEALING IN THE NEW TESTAMENT: INSIGHTS FROM MEDICAL AND MEDITERRANEAN ANTHROPOLOGY. Minneapolis, MN: Fortress Press.

2000b. CHOOSING A BIBLE TRANSLATION. Collegeville, MN: The Liturgical Press.

1999. THE CULTURAL DICTIONARY OF THE BIBLE. Collegeville, MN: The Liturgical Press.

John J. Pilch, Ph.D (Marquette University) teaches scripture at Georgetown University, Washington, DC 20057-1135 (e-mail: pilchj@georgetown.edu). He is the author of THE CULTURAL WORLD OF JESUS SUNDAY BY SUNDAY. CYCLES A-B-C, 3 vols. (Collegeville, MN: The Liturgical Press, 1995-1997) and co-author with Bruce J. Malina of SOCIAL SCIENCE COMMENTARY ON REVELATION, (Minneapolis, MN: Fortress Press, 2000). Readers desiring additional information should consult his web-site: http://www.georgetown.edu/faculty/pilchj, and click on "Mediterranean Culture."

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