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J R Soc Med. 2005 September; 98(9): 436.
PMCID: PMC1199652

Bubonic plague in the Book of Samuel

In 2000 the pages of the JRSM saw an intriguing exchange concerning an illness described in the Hebrew Bible. The story in 1 Samuel is that the Philistines, having captured the Ark of the Lord from the Israelites, experienced an outbreak of ‘tumours’ (Hebrew ophal), and the affliction followed them as they moved the Ark from city to city. Concluding that the Ark was responsible for this disaster, the leaders decided to return it to the Israelites along with a guilt offering of five golden tumours and five golden rodents (akbar). But soon after the arrival of these ‘statues’ (probably small wooden models covered with gold) in Beth-shemesh seventy Israelites died in that city. Evaluating this epidemic, JP Griffin1 concluded that the outbreak was plague, with its associated buboes. But WMS Russell2 responded that Griffin was ‘certainly erroneous’ because of a mistranslation (the tumours being haemorrhoids due to dysentery) and because the rat carrier of plague was not in the region at the time of the described events. Since then, advances in archaeology have shifted the weight of evidence towards Griffin; moreover, the ‘emerods’ of the King James Bible appear in all modern translations as tumours.

Bubonic plague, caused by Yersinia pestis, is transmitted by the bite of the flea Xenopsylla cheopsis. This flea lives off the blood of many species besides man but its most notorious relationship is with the black rat (Rattus rattus). Recent archaeological evidence has caused a rethinking of plague in the ancient Near East. Fossilized remains of the plague flea have been found in large numbers in Amarna, Egypt;3 and, since Amarna was occupied for only a few years, we can date this contact between human beings and plague fleas accurately to about 1350 BC—which is before the events described in the Book of Samuel. Moreover, archaeological studies in the Nile Valley indicate that R. rattus was introduced at this time, probably via ships from India. Evidence of bubonic plague has not been seen in Egyptian mummies but all the vectors were in place.4 These vectors could have spread a few miles north to Philistia.

From the story, it seems that the most characteristic features of the epidemic were rats and tumours. Dead rats, killed by the same bacillus that kills human beings, are seen in the streets of plague towns; and enlarged lymph nodes in the groin and axillae are the most obvious features of the illness. Why did the Philistines send statues of rodents and tumours to their neighbours? One interpretation is that the Philistines were offering a friendly warning: ‘We have experienced an epidemic and these are the things you should look out for’. Another is that the statues represented the essence of the judgment that had descended upon the Philistines, who hoped that the affliction would be passed on.

The above analysis assumes that the story of the epidemic, as told in 1 Samuel, is based on an actual occurrence. A widespread view is that biblical stories of this sort are the product of a religious reform movement that flourished hundreds of years after Samuel, in the late Iron Age; but it is acknowledged, nonetheless, that they may have historical kernels.5 The kernel here is large enough to indicate that, even if the account is fictitious, it is based on a personal knowledge of plague.


1. Griffin JP. Bubonic plague in biblical times. J R Soc Med 2000;93: 449 [PMC free article] [PubMed]
2. Russell WMS. Plague, rats and the Bible. J R Soc Med 2000;93: 553 [PMC free article] [PubMed]
3. Panagiotakopulu E. Fleas from Pharaonic Egypt. Antiquity 2001;75: 499-55
4. Panagiotakopulu E. Pharaonic Egypt and the origin of plague. J Biogeogr 2004;31: 269-76
5. Finkelstein I, Silberman NA. The Bible Unearthed: Archaeology's New Vision of Ancient Israel and the Origin of its Sacred Text. New York: Free Press, 2001:23

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press