Epilepsy in its grand mal or major form was a well‐known illness of the ancient world. Its frightening and bizarre nature seemed to defy anything other than a supernatural explanation, and it was frequently put down to the influence of evil spirits. The Greeks, however, referred to it as the “divine” or “sacred disease,” considering its effects to derive from the activities of the gods; the Hippocratic school of medicine, on the other hand, considered that epilepsy was as much due to natural causes as any other illness. In view of the widespread occurrence of the disease, it is surprising that there are only two clear references to epilepsy in the Bible. There is a full account of the condition in the story of the epileptic boy (Mark 9.14–29 par.) and a passing reference at Matthew 4.24. In both cases the disease is represented as being due to the influence of unclean spirits. Such a view mirrored contemporary thought, and in Palestinian Judaism in particular there was a tendency to ascribe all illness to the influence of demons, although the rabbis were also aware of the familial nature of epilepsy and placed a ban on marrying a woman from an epileptic family (Yebam. 64.2).
The description of the epileptic boy at Mark 9, supplemented by the parallels in the other synoptic Gospels, provides such a full summary of the events of a grand mal epileptic seizure that any other diagnosis is unlikely. The account notes the immediate tonic phase of the fit with collapse and rigidity, followed by the clonic phase with its jerking convulsions, and finally a flaccid phase of deep coma before the eventual recovery of consciousness. Mark also notes the loss of weight and exhaustion characteristic of the severe form of the disease, with repeated and uncontrolled seizures. The danger to life and limb from falling into the fire or into water, which so distressed the boy's father, are well documented in such cases. In the phase of deep coma even the most painful stimuli may elicit no response from the patient and severe burns may result. Other injuries are not uncommon during an unrestrained fit.
Both Mark and Luke emphasize the demonic elements of the story, but Matthew plays down this interest and uses the verb selēniazetai, meaning “to be moonstruck” (a word occurring only here and at Matt. 4.24 in the New Testament). The verb is derived from the concept that epilepsy was under the influence of the moon, a view that persisted at least to the seventeenth century in Europe. All three versions of the story, however, preserve the tradition that Jesus ordered an unclean spirit to leave the boy in order to effect the cure.
The Markan account provides the additional information that the boy was also deaf and dumb. It is likely that this represents a conflation of two separate incidents, but if the tradition is accurate it suggests that the boy may well have suffered from some severe congenital handicap, of which epilepsy was but one sign. Although epileptiform convulsions may sometimes be a feature of hysterical (dissociative) states, together with deafness and mutism, such a diagnosis is untenable in this case in view of the classical picture presented and the presence of the self‐destructive incidents that are not found in hysterical illnesses.
The only other certain reference to epilepsy is the note at Matthew 4.24, where again the verb “to be moonstruck” is used. The text links together those who were possessed, epileptics, and those suffering from paralysis. The two latter categories should probably be construed as being descriptive of the former, so that the phrase would mean “those who were demon‐possessed, such as epileptics and paralyzed persons.” Although there are other references to convulsive illnesses in the synoptic Gospels (e.g., Mark 1.26), these are not presented as epilepsy and are more likely to be due to functional causes rather than organic disease.
Paul's “thorn in the flesh” (2 Cor. 12.7) has also been identified with epilepsy by some scholars. It is unlikely that this would have been idiopathic epilepsy in view of the late onset, but its clear temporal relationship to an “out of the body” experience (2 Cor. 12.2–4), possibly induced by the severe trauma of one of his many beatings or stonings (2 Cor. 11.23–25), would suggest that posttraumatic epilepsy cannot be ruled out.
There is no clear evidence of epilepsy in the Hebrew Bible, although the reference to “moon stroke” in Psalm 121.6 may possibly relate to epilepsy, particularly as it is placed in parallel to “sun stroke,” another serious, at times, fatal condition. It has been suggested that Saul and Ezekiel may both have suffered from epilepsy, but their abnormal behavior patterns are best explained in other ways.
J. Keir Howard