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ss nucleus - winter 1998,  Differential Diagnosis 26

Differential Diagnosis 26

Luke 13:10-17. Jesus healed a crippled woman on the Sabbath, much to the annoyance of the synagogue ruler. But what disease process lead to the woman's disability?

Let's first examine the facts of the case. We are not told the age of the woman but we are informed that she had been suffering from a deformity of the spine for 18 years. She was bent over (Greek synkyptein - 'bent together') and unable to straighten herself up (Greek anakyptein) at all. What could cause serious deformity and stiffening of the vertebral column?

Osteoporotic collapse is one possibility, as is osteoarthritis. However, we are told that the disease process started 18 years before, when the woman would have been at an age too young to suffer from these senile degenerative conditions.

Tuberculosis, also called Pott's disease of the spine, was known in the ancient world as revealed by the examination of a mummified Egyptian priest of the XXIst Dynasty.[1] However, it usually affects two adjacent vertebrae and the disc between causing a localised angulation of the vertebral column rather than rigidity of its whole length.

Having excluded these conditions the most likely remaining diagnosis is that of ankylosing spondylitis. With a relatively young age of onset it is a chronic inflammatory condition that results in a fixed deformity of the spine, giving a posture classically described as looking like a question mark (ie ?).

But what are we to make of the comments that she had been 'crippled by a spirit' and that it was Satan who had 'kept her bound'?

Unlike some other gospel examples of healing,[2] there is no suggestion that this woman was actually possessed by a demon. Nonetheless, it does seem that in her case it was an evil spirit that had caused the physical disease.

This healing certainly divided those who saw it. While the woman praised God, having been set free from her stiffened spine, it was the stiff-necked synagogue ruler who was really trapped in his rigid, unloving interpretation of OT law!


Differential Diagnosis 27

Asa, King of Judah, suffered from 'diseased feet', which may have contributed to his death (1 Ki 15:23-24). What pathological process could have been involved?

Find out in the next issue.

References
  1. Palmer B (Ed). Medicine and the Bible. Carlisle: Paternoster Press, 1986:26
  2. Lk 4:33-37; 8:26-39; 9:37-45
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