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BY The Thorn in the Flesh “Wheresoever I open St. Paul’s Epistles, I meet not words but thunder, and universal thunder, thunder that passes through all the world.” J. Doone “It is frankly disappointing to see how Paul hardly ever allows the real Jesus of the Nazareth to get a word in.” C.G. Jung “In the autumn of the year of the city 815 (which would be 62 A.D., in our way of counting time) Aesculapius Cultellus, a Roman physician, wrote to his nephew who was with the army in Syria as follows: My dear Nephew, A few days ago I was called in to prescribe for a sick man named Paul. He appeared to be a Roman citizen of Jewish parentage, well educated and of agreeable manners. I had been told that he was here in connection with a law-suit, an appeal from one of our provincial courts, Caesarea or some such place in the eastern Mediterranean. He had been described to me as a “wild and violent” fellow who had been making speeches against the People and against the law. I found him very intelligent and of great honesty. A friend of mine who used to be with the army in Asia Minor tells me that he heard something about him in Ephesus where he was preaching sermons about a strange new God. I asked my patient if this were true and whether he had told the people to rebel against the will of our beloved Emperor. Paul answered me that the Kingdom of which he had spoken was not of the world and he added many strange utterances which I did not understand, but which were probably due to his fever. His personality made a great impression upon me and I was sorry to hear that he was killed on the Ostian Road a few days ago. Therefore I am writing this letter to you. When next you visit Jerusalem, I want you to find out something about my friend Paul and the strange Jewish prophet, who seems to have been his teacher. Our slaves are getting much excited about this so-called Messiah, and a few of them, openly talked of the new kingdom (whatever that means) have been crucified. I would like to know the truth about all these rumours and I am
Your devoted Uncle, The Reply: “That is what Joseph told me, with tears running down his old cheeks. I gave him a gold piece when I left him, but he refused it and asked me to hand it to one poorer than himself. I also asked him a few questions about your friend Paul. He had known him slightly. He seems to have been a tent maker who gave up his profession that he might preach the words of a loving and forgiving God, who was so very different from that Jehovah of whom the Jewish priests are telling us all the time. Afterwards, Paul appears to have traveled much in Asia Minor and Greece, telling the slaves that they were all children of one loving Father and that happiness awaits all, both rich and poor, who have tried to live honest lives and done good to those who were suffering and miserable. I hope that I have answered your questions to your satisfaction. The whole story seems very harmless to me as far as the safety of the state is concerned. But then, we Romans never have been able to understand the people of this province. I am sorry that they have killed your friend Paul. I wish that I were at home again, and I am, as ever,
Your dutiful nephew, From The Story of MANKIND, Hendrik Willem van Loon (1) “I am a Man which am a Jew of Tarsus, a city in Cilicia, a citizen of no mean city.’ Thus Paul, who was by trade a tentmaker (Acts 18:3), describes himself in Acts 21:39. Tarsus, a little town of 20,000 in-habitants lying at the foot of the Tarsus Mountains in the south of Turkey, has preserved none of its former glory. Paul had every reason to laud his native city to the skies. An inscription calls Tarsus “The great and wondrous metropolis on Cilicia,” and the Greek geographer Strabo mentions that Tarsus had a university to match those of Athens and Alexandria. The famous teacher of the Emperor Augustus, Athenodorus the philosopher, was one of its sons.” From The Bible as History by Werner Keller. (2) The inhabitants of Tarsus had long ago carved the Cilician gates out of sheer rock to ensure passage of trade. The city of Tarsus was a city, in today’s parlance which would definitely have had “parallel runways”. Paul was born to a family in Tarsus which had done well socially and economically. Paul’s family had Roman citizenship, but he was “circumcised on the eighth day, of the people of Israel, of the tribe of Benjamin, a Hebrew born of Hebrews, as to the law a Pharisee.” (Phillipians 3:5). This establishes Paul’s racial descent and point out that he was not a descendant of some northern tribe. Judah and Benjamin were the two southern tribes composing the kingdom of the Davidic monarchy. Tarsus as a city was capital of the Roman province of Cilicia whose governor had been Cicero just 30 years prior to Paul’s birth. Its location with the Mediterranean in front, the Tarsus Mountains behind and the main road connecting Asia to Syria right through it made it a crossroads. The Old Testament often mentions “the ships of Tarshish.” During Paul’s life it became a “free city” of the Roman Empire with a population of little over one million. (3) The historical Paul then was born in a crossroads city of the world of a lineage present in the area for generations. Little is known of his personal appearance except as in the Apocryphal New Testament quoted by Malcolm Muggeridge: “Paul, a man of small stature, with his eyebrows meeting and a rather large nose, somewhat baldheaded, bandylegged, strongly built, of gracious presence, for sometimes he looked like a man and sometimes he had the face of an angel.” (4) Tonight’s topic has its origin in 2 Corinthians 12:7: “And lest I should be exalted above measure through the abundance of the revelations, there was given to me a thorn in the flesh, the messenger of Satan to buffet me, lest I should be exalted above measure.” In the exposition of the Greek used to describe the noun in the object of the above sentence 3 probabilities exist: (1) Crucifixion on the cross but such usage arose 200 years after Paul’s death. (2) Stake as used for impalement. The word Padisades derives from rows of stakes used to slow and impale enemy attackers. (3) Thorn is well attested to in the Septuagint and other classical sources of Greek anthology even Aesop’s Fables, a word meant to imply a wound that is not fatal. (5) Throughout history most scholars, historians, and popular novelists have seized on this reference and elaborated it into astounding proportions so that almost without exception it has been assumed to represent physical debility. So firmly is this held that Goodspeed in an American translation of the New Testament says “a bitter physical affliction.” Phillip’s translates it in 1950 as “a physical handicap.” (6) Popular theory on Paul’s affliction has three main types of interpretation. First, the Roman Catholic expositors, especially those with monkish leanings, have thought Paul referred to carnal desire and solicitations of the flesh. The Latin Vulgate translation is “stimulus carnis.” Second, commentators of the Eastern Church and Erasmus have suggested a personal enemy who sought to slander him. The third explanation is some physical or nervous element. They have included weak eyesight, malaria, or neurologic and/or psychiatric medical problems. (7) To dissect these theories a bit, there is no Scripture to suggest Paul was particularly subject to bodily temptation. There is the famous “It is better to marry than to burn” (I Corinthians 7:9) and the critique of his attitude toward women generally. The matter of personal enemies in the church is dismissed by his referral to the malady being “a messenger of Satan.” The eyesight theory stems from two sources. In his letter to the Galatians he says “For I bear you record that if had been possible, ye would have plucked out your own eyes, and have given them to me.” (Galatians 4:15). He states that he writes with large letters (RSV) (Galatians 6:11). Then there is the famous blinding on the Damascus road followed by three days without sight. (Acts 9:3—9; Acts 22:6—13; Acts 26:13-16) In the neurologic sphere epilepsy has been a favorite diagnosis. Thombroso (1891) and Bryant (1953) believed Paul’s Conversion was epileptic rather than mystical. William James (1902) believed it might be a “physiological nerve storm or discharging lesion like that of epilepsy.” When I began this paper temporal lobe epilepsy was my favorite. I had first proposed this in my wife’s Sunday school class in 1958 without approbation. In 1970 this article in the British Journal of Psychiatry appeared. Case 3 fits our study here tonight. “Personal history: The patient was born in 1920 to middle class Jewish parents. The father, a jeweler, died of cancer of the kidney at the age of 45; the mother was alive and good health at the age of 68. The patient was the fourth child in a family of five. He had an undistinguished school career, then a long series of jobs, in none of which did he give or receive satisfaction. He was an active homosexual between the ages of 15 and 28. Personality and religious background: Shy; quiet; tidy and meticulous; a poor mixer who preferred the company of his own sex. He was brought up strictly in the Jewish orthodox faith and remained devout until the age of 17. Although he afterwards ceased to attend regular worship, he felt guilty about these lapses. History of epilepsy: The patient had seizures with an average frequency of two or three a week from the age of four. The aura consisted of a flutter in his stomach which rose up to his neck; he would then lose consciousness and make stereotyped rhythmical movements, scratching his left leg with his left hand or pulling up his sock. The attacks lasted between 7 and 10 seconds and were followed by drowsiness and headache, but he was able to continue his work almost immediately when the attack was over. Conversion experience: The patient’s first religious experience occurred in St. Ebba’s hospital during photic stimulation. He had a vision in which he was in the cockpit of an aeroplane flying over a mountainous region of France. The aircraft gained altitude and brought him to a different land, a land of peace. He had no cares and no burdens. He felt that the power of God was upon him and was changing him for the better. Afterwards, ‘people seemed changed somehow’. When asked if this was a conversion experience, he said, ‘I prefer the words change of heart; I became intensely interested in following the teachings of Jesus Christ.’ As soon as he came out of the hospital he went to a Billy Graham meeting where ‘he gave his heart to the Lord and his name to the Counsellor’. He became a firm member of the Pentecostal Church. One night a year later he had a very vivid dream of the Crucifixion. About two months after this he had a daytime visual hallucination in which he saw angels with their harps, praying and worshipping. He was able to continue working in a desultory way throughout this purely visual experience. During this period the patient had a woman friend who was religious in a more conventional way and did her best to moderate his ideas. Through her influence he became a Methodist and somewhat less fanatical. He had one time told her that he was able to pick up other people’s thoughts. Investigations: Electroencephalograms showed a persistent spike focus at the right sphenoidal electrode and an air encephalogram demonstrated deformity of the right temporal horn in the supracortical cleft, suggesting the presence of a tumor in the antero-medial part of the temporal lobe. Follow up: When seen after 2 1/2 years the fits were less frequent and less severe. He would go blank for a few seconds only, and never fell. The frequency was one or two a week. There was little diminution in his preoccupation with religion. He soon brought any conversation round to a religious topic and frequently said that we must all believe in the Lord Jesus Christ. He had walked in the streets carrying a banner with the legend “Be prepared to meet thy God’, and he showed no ability to modify his conversation according to his company. He continued to believe that a religious meaning would underlay ordinary events.” (8) In the Journal of Bible and Religion, Drs. Hisey and Beck, a biochemist and pathologist offer a paragnosis, or diagnosis after death by contemporaneous accounts, on Paul, espousing an occipital lobe-temporal lobe injury by hemorrhage would explain the Damascus road experience with resulting aphasia and epileti-form attacks. (9) Others have postulated migraine and still others, asthenia. But as Hermann Bindner says in his “Alleged Illness of Paul” the passage in Galatians 4:13-14: “you know it was because of a bodily ailment that I preached the gospel to you at first; and though my condition was a trial to you, you did not scorn or despise me but received me as an Angel of God, as Christ Jesus.” Bindner goes on to say that from this “arises the problem of Paul’s illness and the task of the diagnostician. But as interesting as it may be to join into the relevant guesswork, it can hardly be considered sensible that an illness, which was outwardly recognizable, perhaps even repulsive, did not hinder the apostle in his preaching.” Bindner’s article points to asthenia as a possibility and says thus Paul’s appearance among the Galatians at the time of his first missionary journey was feeble and scarcely representative of the power of God. (10) Suffice it to say that no one knows what Paul’s “thorn” was because he never lifted the veil. Sir Thomas Browne calls this “the virtue of Taciturnity”. Neil Gregor Smith in the Journal Interpretation in 1959 quotes Osler’s advice to his medical students to learn to consume their own smoke. He warned them that the atmosphere of life was darkened unnecessarily by people’s murmurings over the ills which are the inevitable lot of man. He quoted George Sands: “people knew how to live and die in those days, and kept their infirmities out of sight... It was a point of good breeding to hide one’s sufferings.” (11) Now to the Innominate Theory of the “Thorn in the Flesh”. The great 19th century Scottish Pauline historian, Sir William Ramsay, suggested burning malaria fever which was so prevalent in that part of the world in Paul’s time. This suggestion, by the way, was made several years before the anopheles mosquito was established as the vector. Ramsay suggests Paul went up into Galatia to get to higher altitude and away from Malaria. (12) On the Sunday right after reading this as I sat in a Methodist Church the thought occurred: What can make you short and of unusual facies, but allow you freely to travel unharmed in malarial infested areas? Let us look at some pertinent items. Malaria was common in Greece during the Fifth century B.C. In the first century B.C. a very severe type of malaria appeared in the agricultural districts around Rome and it is known through Ramsay’s work to be present around the plains of Pamphylia. (13) Furthermore, the same great Roman Roads that allowed Paul to travel freely opened the gates to the spread of pestilence such as malaria. The December 8, 1988 issue of the New England Journal of Medicine shows that the medical world has not conquered malaria. (14) For eons of time other forces have worked on this problem. In Science, November, 1949 Pauling’s Nobel Prize winning article appeared and introduced man to molecular biology but other greater forces had known it for centuries. (15) In 1954 in the British Medical Journal, Allison first reported protection from malaria by the presence of sickle hemoglobin. (16) In 1977 Pasvol and Weatherall from Oxford reported in Nature on the effects of fetal hemoglobin on the susceptibility of red cells to faciparium malaria. (17) Then in 1986 in Nature, Glint et al. in a study from Melanesia supported the hypothesis that thalassemia frequency exhibits an altitude and latitude dependency with malaria endemicity. This explains the persistence of high frequencies of thalassemia in many parts of the world. (18) The accompanying map graphically demonstrates the distribution of malaria and the more common hemoglobinopathies. A larger map illustrates the geographic distribution of major hemoglobin abnormalities in 1960. (19) How long has thalassemia been around? Edward Zaino in 1964 in the Annals of the New York Academy of Science wrote of Paleontologic Thalassemia and points out the ability to detect thalassemia by skull appearance and x-ray. What is unclear is which way the gene migrated. The earliest archeologic evidence of generalized osteoporosis is reported from Messina, Sicily. But there are similar findings in Peruvian Indians, and Mayas or Yucatan in the younger ages. Zaino favors origin of the mutant site of thalassemia in the former Mediterranean Valley south of Greece and Italy with migration to the Near East and India, thence across China, the Bering Strait and North and South America. In 1950, Romer and Dorken claim it arose in Asia and was transmitted by Alexander the Great’s Army. An Armenian origin with West and East spread is suggested. (20) Remembering that in 1970, the Glomar Challenger deep sea drilling vessel discovered a layer of salts more than 2 kilometers thick means that the Mediterranean was once evaporated. This was due to closure at Gibraltar and probably across Sicily. If that happens again it will drop a meter a year and dry up in only 1500 years. It is likely that an evaporating Mediterranean led to a lot of puddles to breed mosquitoes. Thus was born the need for thalassemia. (21) But enough. In 1925, Cooley described these children and the definition of thalassemia began. (22) With thalassemia from both parents early death results with thalassemia in one parent the minor form occurs with no discernible symptoms. However, an intermediate form exists with variable symptoms with predominately fetal hemoglobin. This group of people may have changed facies, usually a bit mongloid or rodent faced. They are moderately anemic. They are short and they have delayed sexual maturation. (23) If one were born in a small city in a Jewish home after the Dispersion of the tribes of Israel one’s gene pool would be limited. If one were born in one of the larger cities of the world, on a major crossing route one would have a greater chance to acquire different genes especially if located on the great thalassemia band of the world on a malarial plain bordering the formerly evaporated Mediterranean. If one had thalassemia intermedia one could travel freely to Macedonia, Corinth, Salonika, Malta, Rome and not worry about Chloroquine prophylaxis. Even today the Greek villages have the malaria and thalassemia in abundance. Did Paul have thalassemia? Since it is not possible from the scriptural evidence or secular history to identify Paul’s “thorn” one can present evidence for thalassemia. First, the exegesis favors a physical malady. Second, the passages in Galatians suggest a visible change in Paul’s appearance which could have been produced by a relatively more severe intermediate form of thalassemia. This same form of thalassemia with its anemia could explain the “feebleness” of Paul when he first arrived at the higher altitudes in Galatia. Also, he could be expected to feel much better on returning to lower lying coastal areas where he could spend most of his missionary career. Most of all natural selection would have resulted in an individual particularly suited to travel a malaria infested area of the world (even to Rome). Thus it is possible to think that a watershed event in one of the world’s great religions and its distribution occurred because of a hostile environment and nature’s solution. This leaves these events subject to your own interpretation. Will Durant has said: “Civilization exists by geological consent, subject to change without notice.” So let us consult Durants again: “Does history support a belief in God? If by God we mean not the creative vitality of nature but a supreme being intelligent and benevolent the answer must be a reluctant negative. Like other departments of biology, history remains at bottom a natural selection of the fittest individuals and groups in a struggle wherein goodness receives no favors, misfortunes abound, and the final test of the ability to survive... nature and history do not agree with our conceptions of good and bad; they define good as that which survives, and bad as that which goes under; the universe has no prejudice in favor of Christ as against Genghis Khan.”(24) Perhaps Paul has the last word for in II Corinthians 12 the next 2 verses after our theme tonight say, “For this thing I besought the Lord thrice that it might depart from me; and He said unto me; My grace is sufficient for thee: For my strength is made perfect in weakness.”
(1) Willem van Loon, H. The Story of Mankind. New York: Simon and Schuster; 1974: 110. (2) Keller, W. The Bible as History. New York: William Morrow and Co.; 1964: 381. (3) World Book Encyclopedia. Chicago: Field Enterprises; 1965: 37 (4) Muggeridge, M. and Vidler, A. Paul, Envoy Extraordinary. New York: Harper and Row; 1972: 14. (5) Park, D. Paul's Thorn or Stake? Novum Testamentum 1980; XXII: 179-183. (6) Mullins, T. Pauls Thorn in the Flesh. Journal of Biblical Literature 1957, LXXII: 299-303. (7) Hope, N. Paul's Thorn and Ours. Christianity Today; Dec. 5, 1969. (8) Dewhurst, K. and Beard, A. W. Sudden Religious Conversion in Temporal Lobe Epilepsy. British Journal of Psychiatry. 1970; 117: 497-507. (9) Hisey, A. and Beck, J. Paul's "Thorn in the Flesh": a Paragnosis. The Journal of Bible and Religion. (10) Bindner, H. The Alleged Illness of Paul. Theologische Zeitschrift 1976; Jan.-Feb. 2-13. (11) Smith, N. The Thorn That Stayed. Interpretation 1959; XII: 409-416. (12) Ramsay, W. St. Paul, the Traveller and the Roman Citizen. New York, 1904; 94-97. (13) Cartwright, F. Disease and History. New York, New American Library, 1972: 139. (14) Krogstad, D., Herwaldt, B. Chemoprophylaxis and Treatment of Malaria. New England Journal of Medicine 1988; 319; 1539—40. (15) Pauling, L., Itano.H., Singer, S. et al. Sickle Cell anemia, a Molecular Disease. Science 1949; 110: 543. (16) Allison, A. Protection afforded by Sickle—Cell trait aginst Subtertian Malarial Infection. B.M.J. 1954; 1: 290. (17) Pasvol, G., Weatherall, D.J., Wilson, R. Effects of Foetal Haemoglobin on Susceptibility of Red Cells to Plasmodium Falciparum. Nature 1977; 270: 171. (18) Flint, J., Hill, A., Bowden, D. et al. High Frequencies of A-Thalassemia are the Result of Natural Selection by Malaria. Nature 1986; 321: 744-749. (19) Lehman, H. Ager, J. in Stanbury, The Metabloic Basis of Inherited Disease. New York: McGraw—Hill; 1960: 1086. (20) Zaino, E. Paleontologic Thalassemia. Annals of New York Academy of Sciences 1964; 119: 402—410. (21) Gore R. Sea of Man's Fate. National Geographic 1982; 162: 694-737. (22) Cooley, T., Lee, P. A Series of Cases of Anemia with Splenomegaly and Peculiar Bone Changes. Tr. Am. Pediat. Soc., 1925. (23) Pearson, H. Thalassemia Intermedia. Annals of New York Academy of Sciences 1964; 119: 390. (24) Durant, W. and Durant, A. The Lessons of History. New York: Simon and Schuster; 1968: 46.
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