St. Paul's Thorn in the Flesh

By Edward M. Merrins, M.D.


Notwithstanding the Puritan aversion to the relics of saints, one cannot help wishing that some day there will be found a genuine image of the apostle Paul, perhaps among the ruins of ancient cities or in some secluded monastery; for, besides giving welcome information as to what manner of man he was outwardly, it might also give a positive clue to .the nature of the strange infirmity which he called a thorn in the flesh. It is certain that paintings and statues of him existed in the early centuries of Christianity. Augustine states that Marcellina, a lady who lived in the second century, preserved an image of the apostle among her household gods. Chrysostom alludes to a portrait of him which hung in his chamber, but unfortunately does not describe it. Writing to the Empress Constantia, deprecating the growing use of images for devotional purposes, Eusebius tells of a woman who came to him with two painted figures which she said represented the Saviour and the apostle Paul. In those specimens of early Christian art, of a more or less imaginary character, which have come down to us, Paul is depicted as a man of small stature, with the elegant, contemplative head of a Greek philosopher. There is no sign in them of any blemish or deformity that might have been his thorn in the flesh.

The traditional descriptions of his personal appearance are interesting, though not of the earliest possible date. In the “Acts of Paul and Thekla,” a romance of the third century, the apostle is said to have been “short, bow-legged, bald, with meeting eyebrows, hook-nosed, full of grace.” In the writings of Lucian of the fourth century, he is alluded to as “the bald-headed, hook-nosed Galilean, who trod the air into the third heaven and learned the most beautiful things.” In the sixth century, Job of Antioch writes that Paul was round-shouldered, with a sprinkling of gray in his head and ample beard, an aquiline nose, grayish eyes, meeting eyebrows, and that he had a most genial expression of countenance, with a mixture of pale and red in his complexion. According to the historian Nicephorus, Paul was short and dwarfish in stature, and, as it were, crooked in person and slightly bent; his face was pale, and aspect winning; he was bald-headed, and his eyes were bright; his nose was prominent and aquiline; his beard was thick and tolerably long; both head and beard were sprinkled with white hairs.

While not wholly reliable, these traditionary pictures probably have some foundation in truth. Plainly they are not flattering, but only a man of morbidly sensitive mind would think the defects mentioned so distressing as to be almost intolerable, and none can be properly described as a buffeting messenger of Satan.

Judging by the apostle’s own statement, the thorn seems to have been a disease with this history: it was physical; it was painful; it frequently humiliated him; it was conjoined with his visions and revelations; yet it did not seriously impair his bodily strength, weaken his will, darken his mind, or in any way prove an insurmountable hindrance to successful missionary work. In examining these several points, it will become evident that no diagnosis hitherto made is quite satisfactory.

1. It was a physical infirmity. Assuming that God would not afflict so devoted a servant as Paul with physical suffering, Chrysostom and others have argued that the thorn must have been the opposition of enemies. Several passages of Scripture Which refer to hostile foreign nations as thorns in the body politic of Israel are quoted in support of this view (Num. 33:55; Joshua 23:13; Judges 2:3). But Paul was told at the time of his conversion that he had to suffer many things as the apostle of Jesus Christ, and his experience, long before the thorn troubled him, confirmed the prediction. Indeed, as foretold by our Lord, all his servants in those days had to expect the same suffering. “They shall lay their hands on you, and shall persecute you, delivering you up to the synagogues and prisons . . . . Some of you they shall cause to be put to death. And ye shall be hated of all men for my name’s sake.” How then could Paul regard the opposition he encountered as a singular affliction? Further, when his temperament is considered, and recalling the deplorable fact that he himself had once been a cruel persecutor of the church, surely he was the last man in the world to pray for exemption from the fiery trials which Christians everywhere were exhorted to meet with fortitude, even with thankfulness and gladness.

While agreeing in the main that the thorn was spiritual, some commentators think the temptations which arose from doubt, despondency, faint-heartedness in his calling, torments of conscience on account of his former life, and blasphemous suggestions of the devil, were his besetting infirmity. Perhaps it is true the stout heart of the apostle sometimes quailed, and he was made despondent by “the fear that kills; hope that is unwilling to be fed; cold, pain, and labor, and all fleshly ills”; and the memory of Christians for their witness dead. He was more than human if his cheerfulness and serenity were never disturbed by all he passed through. But his mental depression was not of long duration, and was never so profound as to have been in itself a thorn. The undaunted activity of his life and the general tone of his letters show his hopeful, resilient disposition; and, as he said himself, in spite of all his troubles he was very happy (2 Cor. 7:4).

That Paul’s infirmity was actually in the flesh is the first and natural impression made by his reference to it; but, as pain in man is seldom or never pure physical sensation as in the lower animals, we may admit the thorn penetrated to the spiritual nature in so far as his bodily distress was augmented by the troubled thoughts to which it gave rise.

2. It was painful. Whether the terms in the original should be translated “thorn in the flesh,” “stake in the flesh,” or “stake for the flesh,” is not a matter of great importance. Stake or thorn, used in this connection, suggests bodily pain, severe and to some extent incapacitating.

3. It was a mysterious infirmity. The apostle calls it an angel of Satan. This does not necessarily imply it was a form of demoniacal possession, or an infirmity totally unlike any other. To the Jew all the evils of life were angels of woe. Thus the Psalmist, in his recital of the plagues which came upon the Egyptians at the time of the Exodus, states that God “cast upon them the fierceness of his anger, wrath, and indignation and trouble, a band of angels of evil” (Psalm I28:49). Likewise in the deuterocanonical Jewish Scriptures we read: “There be spirits that are created for vengeance, which in their fury lay on sore strokes; in the time of destruction they pour out their force, and appease the wrath of him who made them. Fire, and hail, and famine, and death, all these were created for vengeance; teeth of wild beasts, and scorpions, serpents, and the sword, punishing the wicked to destruction. They shall rejoice in his command merit, and they shall be ready on earth when need is; and when their time is come, they shall nor transgress his word.”1

All we need infer from Paul’s malady being called an angel of Satan is that its nature was not understood, that it baffled the skill of St. Luke and his other medical advisers, and that it sorely tried the faith and patience of the apostle.

4. It was humbling. The particular cross necessary to keep a person in a humble frame of mind depends on his character, on the form of pride to which he is prone. In those inclined to be vain of their beauty or strength, nothing is so mortifying as bodily disease, deformity, or disabling weakness. The intellectually proud are humbled by confusion of mind. The saint is humbled by the temptations and failures of the spiritual life. As Paul was a saint, the thorn has been sought in the workings of his moral nature; to be precise, it has been asserted by several of the church fathers and by many writers in their wake, that the apostle’s infirmity was a rebellious sensuality. His use of the word “flesh” to indicate the corrupt, carnal nature of man; his graphic description of the deadly struggle which takes place, in the twice-born, between the old nature and the new; his frequent and urgent entreaties to mortify or crucify carnal desires; the rendering in the Vulgate of σκόλοψ τῇ σαρκί by stimulus carnis; and the morbid influence which the peculiar temptations of the celibate life exercise over the minds of those devoted to it, combined to secure for this speculation its almost general acceptance by the theologians of the Roman Catholic Church. It must be rejected: such an infirmity is not congruous with the character and work of the apostle. That an infection of nature doth remain, even in them which are regenerate, cannot be denied; but it is preposterous to suppose that Paul, who was all absorbed in the service of Christ, should have been pursued by a sinful passion to such an extent as to be humiliated by it in his ministry. He gloried in his thorn: how could he glory in shameful lusts? How could concupiscence be a check or counterpoise to spiritual pride?2

In the opinion of several of his biographers, it was the loathsomeness of his infirmity which humiliated him; they imagine he was a repulsive object, with his eyes “red, swollen, and rendering a whitish, filmy matter, the tears overflowing, the eyelids blinking from an intolerance of light, and the face contorted by spasms of pain.” This is difficult to believe. To the Corinthians the apostle writes: “In all we do, we avoid putting obstacles in people’s way, so that no fault may be found with our ministry. On the contrary, we are trying in everything to recommend ourselves as God’s ministers should do.” Now an affliction which strongly disposed people to despise him, Would have been a very serious obstacle indeed to the success of his work as a Christian missionary. The Greeks and Romans were worshipers of beauty and strength, and personal grace was regarded as the necessary adornment of their religious philosophers. Notwithstanding the ugliness of Socrates, and his own lameness, Epictetus is able to say: “For we ought not even by the aspect of the body to scare away the multitude from philosophy; but by his body, as in all other things, a philosopher should show himself cheerful, and free from troubles.” The Jews looked upon disease and deformity as the stigmata of moral evil; hence they excluded from the priesthood those with physical blemish. Few of any nationality in those days, when the natural instincts of humanity were crusted or frosted over, had much respect or sympathy for the permanently sick and deformed unless they belonged to their own families. Would Paul, the bearer of a message which was seldom Welcomed at first, for to the Greek it was foolishness and to the Jew a stumbling-block, come before such people with his embassy made more difficult still by a disfiguring disease which caused his hearers to turn from him with loathing? Now and again in the course of his life he may have been so afflicted, as when he was among the Galatians, but there is no ground for thinking his malady was chronically loathsome. When Alfred the Great, the English king who more than any other devoted himself unselfishly to the service of his people, prayed to God for the removal of the mysterious thorn which afflicted him, “he entreated of God’s mercy that in His boundless clemency He would exchange these torments for some lighter disease; but with this condition, that it should not show itself outwardly, lest he should become an object of contempt, and less able to benefit mankind; for he had a great dread of any such complaint as makes men useless and contemptible.” Every man of healthy spiritual life feels the same dread. Who could render great service to his fellow-men, if constantly compelled to face them disfigured by disease, and with the consciousness that the success of his work was dependent on the immediate impression he made? History shows that the man whom God selects as His ambassador is always suited to his mission. Judging by the impression he made on kings, governors, councils, centurions, and even on howling mobs, Paul was so suited; his countenance was not repulsive.

5. It was connected with his visions and revelations. This is inferred from the statement: “And by reason of the exceeding greatness of the revelations . . . . there was given to me a thorn in the flesh, a messenger of Satan to buffet me, that I should not be exalted overmuch.” The attacks of his infirmity were therefore intermittent, occurring about the same time as his ecstasies, or occurring then with exceptional severity. In discussing this point it is assumed that the ecstasies of the apostle, while they differed in religious value from those of other mystics, did not differ in kind.

It has been suggested that the exquisite spiritual pains which mystics endure in connection with their transcendent experiences, may have been the thorn. Those to whom such experiences have been granted, declare that as the full glare of the sun is painful to the bodily eye, so there is pain when truths of surpassing glory are revealed to finite human faculties; that the awakened and intense aspirations after God make the limitations of this earthly existence an intolerable oppression; that there is anguish in the surrender of every ordinary religious support or enjoyment, when the soul, suspended between heaven and earth, and conscious of its sinfulness, can derive solace from neither, and may even believe itself forsaken by the God it loves. But during this mortal life the pain of conscious imperfection is the inevitable and salutary accompaniment of heavenly visions; it is the depth essential to the superhuman height; hence it cannot have been the thorn which Paul called a messenger of Satan.

This connection between his bodily affliction and his spiritual visions and revelations renders ineffectual the plausible arguments in favor of the thorn’s being a disease such as epilepsy or malaria. According to the experience of the initiated, the principal marks of the genuine mystical state are as follows: —

It comes suddenly. The believer spends much time in meditation and prayer, and surrenders himself wholly to the Divine will. Suddenly, when least expected, the palace doors are opened and the King steps forth.

It is of transient duration, seldom lasting more than an hour or two.

It is accompanied by a complete suspension of all external consciousness. In the words of the apostle, the soul does not know whether it is in the body or not.

The subject is passive during the ecstasy; he feels as if his own will were in abeyance, as if he were grasped and helped by a superior power. Paul was “caught up” into the third heaven.

The mystic can find no terms, no means, no comparison, whereby to render the sublimity of the wisdom, and the delicacy of the spiritual feeling, with which his soul is filled. So far, the experience is incommunicable; it is granted to the individual for his own comfort and edification. Hence the apostle had not the power, it was not lawful for him, to speak of all he saw and heard.

The state is one of spiritual illumination. It is a blessed mood, in which the mystic sees into the life of things. It is no nebulous ecstasy, but a state of transcendent wonder associated with absolute clearness of mind. To this intellectual enlightenment there is added a state of moral exaltation, an indescribable feeling of elevation, elation, and joyousness, and a quickening of the moral sense, which is fully as striking and more important than the enhanced intellectual power. In this respect the content of the revelation is communicable, as may be seen from the writings of Daniel, Ezekiel, and other-prophets. Paul told the Ephesian elders that he shrank not from declaring unto them the whole counsel of God; indeed, the truths he received as a prophet of God he was bound to proclaim. Whether the greater part of his distinctive message came to him in this way cannot be known; but it is certain that by means of his visions he received both spiritual illumination and practical guidance in matters pertaining to his missionary calling.

This illuminative or noetic quality of his ecstasies constitutes an insuperable objection to the idea that the thorn was epilepsy. In the functional forms of this malady, the epileptic is completely unconscious during the actual seizure. The peculiar psychical states which precede and follow it, and which occasionally exist in the intervals between the attacks, are wholly due to the disease; they never lift the unfortunate victim into the realm of pure truth; on the contrary, such states are characterized by hallucinations, illusions, and disturbance of the sense of personality. Moreover, epilepsy sooner or later darkens the mind; it blunts the higher moral and mental faculties, impairs the memory, and so weakens the will as to take away all stability of purpose. The whole character is changed for the worse; there are frequent outbursts of wrath and violence, and other grave exhibitions of misconduct. It is true that in some epileptics there is an unusual susceptibility to religious impressions, to whatever is mystical and awe-inspiring, and in primitive states of society persons of this kind were found among the prophets and seers; but there is in them no corresponding moral elevation, the spiritual value of their revelations is seldom either great or permanent, and before long their light is quenched.3 If ever there was a man with steadfast will and tenacity of purpose, making all his powers subservient to one particular end, and that end the good of others, not the gratification of morbid fancies, it Was Paul; far from becoming irascible as he grew older, he became more like Christ in his gentleness, patience, and compassion; intellectually, he had a larger and clearer comprehension of religious truth than any of his contemporaries, his revelations are of inestimable value for all generations, and to the end of his life his mind remained acute and profound.

The diagnosis of epilepsy has been favored by those who think the thorn was a loathsome affliction, because they imagine epilepsy is a loathsome disease. It hardly deserves the epithet. The effect produced on the spectator by the convulsions is rather that of weirdness; even the lower animals are sometimes strangely affected by the unearthly cry which ushers in an attack.

Similar objections apply to the ingenious conjecture that the infirmity of the apostle was malarial fever.4 In the light of recent discoveries of medical science, it seems incongruous to associate the paroxysms of this disease with spiritual visions and revelations. It has now been demonstrated that malaria is a transmissible disease due to the presence and multiplication in the blood of microscopic organisms which are transferred from one human being to another, generally, if not always, by the bites of mosquitoes. The regularly recurring paroxysms of chills, fever, and sweating depend on the sporulation of these germs in the blood, each variety having its own definite life cycle, thus producing the corresponding varieties of the disease known as tertian, quartan, and other forms. When the disease becomes chronic, the patient suffers from weakness, anemia, emaciation, jaundice, enlarged spleen, and tendency to hemorrhages. Both in its acute and chronic forms malaria has been, and still is, an extremely common disease in nearly all parts of the world. It was so prevalent in ancient times as to contribute vastly to the downfall of the Greek and Roman empires.

Conforming to the supposed exigencies of Paul’s case, malaria also is said to be a loathsome disease. “If Paul were first seen in a Galatian village, or house, lying in the mud on the shady side of a wall, for two hours shaking like an aspen leaf, the gratitude that he expresses to the Galatians, because they did not despise nor reject his infirmity, was natural and deserved.” A somber background is given to this picture by the gratuitous assumption that the apostle was lying in the mud when first seen by his future converts. Apart from this, what is there loathsome in the complaint, even though the patient shakes like an aspen leaf? In days when the keenest pleasure of people was found in the awful cruelties of the gladiatorial shows, it is difficult to believe that the Galatians were upset by the sight of a person with malarial fever.

In favor of the thorn’s being malaria is the periodicity of its attacks, and the accompanying headache and prostration. Against it, is the association of visions and revelations with the disturbed mental state produced by fever; the dependence of the fever upon the pernicious activities of mosquitoes and microscopic parasites; the unlikelihood of Paul’s praying for deliverance from an ailment so common; and the improbability, if he were the subject of malarial cachexia, of exhibiting, as he did, extraordinary mental and physical vigor to the end of his life.

The ground being now fairly clear, the following diagnosis is offered as being most in harmony with Scripture, with tradition, and as tending to reconcile many of the arguments of previous writers. Paul was early afflicted with a refractive error of vision (perhaps hypermetropia complicated by astigmatism); this became worse in after years, and the effort to see clearly imposed a constant and abnormal strain upon the muscles and nerves of the eyes; in consequence, there appeared periodically the symptoms of eye-strain,—intense headache, gastric disorder, insomnia, physical and mental depression,—a state of weariness and painfulness (2 Cor. 11:27).

The circumstantial and inferential evidence in favor of this view is strong. Original defects of vision are often intensified by scholastic and other pursuits which require close and constant application of the eyes to the work in hand. Paul was a diligent scholar when he sat at the feet of Gamaliel, and the incessant poring for years over the crabbed characters of Hebrew manuscripts, often by the dim artificial light of the period, was injurious to eyesight congenitally weak. With his extraordinary mental gifts it is somewhat remarkable that on reaching maturity he abandoned close study in favor of constant travel. Doubtless, his zeal as a missionary, whether Jewish or Christian, was the principal reason for this course; a minor reason may have been that he found study produced ocular pain and weariness, and relief could only be found in an outdoor life, which is the common experience of those who suffer from eye-strain. Paul cannot have loved travel for its own sake; judging by his letters, speeches, and the matter and the manner of his teaching, little or no impression was ever made upon his mind by the wonders of nature, or by any of the things which ordinarily make travel enjoyable. It is reasonable to hold that his powers of visual observation were not of normal range.

There are other hints to the same effect. Pleading before the Jewish council, the high priest orders him to be smitten on the mouth. Paul exclaims indignantly: “God shall smite thee, thou whited wall.” Granted that our Lord in one of his discourses likened hypocrites to whited sepulchers; the circumstances here are different, and the comparison not apt if it depends on the association of ideas. Uttered on the spur of the moment, the form of the rejoinder must have been suggested by the white robes of the high priest; yet it is clear, from the apology of the apostle, that he did not recognize his rank. “Now considering the position of the high priest as Nasi of the Sanhedrin, seated at the end of the hall, with the Al Beth Din on one side of him, and the Chachem on the other, it is almost inconceivable that Paul should not have been aware of his rank if he had not suffered from defective sight. All that his blurred vision took in was a white figure, nor did he see this figure with sufficient clearness to be able to distinguish that the overbearing tryant was no less a person than the high priest himself.”5

On another occasion, when preaching in an upper room, the apostle does not see a young man, seated in the window, falling asleep, yet the room was small and well lighted, and the gaze of a preacher in front of his audience naturally shifts from face to face to see the impression that is being made. When shipwrecked at Malta, he gathers a few sticks to add to the fire, but does not see the viper among them. Apparently, when addressing any one very earnestly, there was something peculiar in the intensity of his gaze which attracted the notice of the spectators. He “fastened his eyes” upon the cripple Whom he healed, and upon the magian sorcerer whom he discomfited. The argument that Paul could not gaze thus steadfastly if he was a sufferer from purulent ophthalmia is correct;6 but it is just what a person with defective vision often does: moreover, he corrugates or wrinkles his brows in the effort to see clearly the face of the person to whom he is speaking. This accords with the tradition that Paul was “close-browed” or had “meeting eyebrows”; for the habit, in time, produces a permanent frown. It is also to be noticed that he does not write his letters himself, but dictates them to an amanuensis, simply adding his signature in the large handwriting of one who cannot see clearly, and therefore writes but seldom. On his journeys he seems to have been led sometimes by his companions, as if not quite able to find his own way.

Another important point is his manner of illustrating spiritual truth by finding analogies in bodily vision Which would occur to none but those who were blind, or partially blind.7 Thus in the passage: “The god [or light] of this world hath blinded the minds of those which believe not, lest the light of the glorious gospel of Christ, who is the image of God, should shine unto them,” he intimates that to the natural man the objects of physical sight may be a hindrance to spiritual vision; that the light and forms of nature which are the revealers of the present world, may be the curtains of the heavenly world. Consequently, the deprivation of physical sight may prove to be a spiritual blessing, because the soul is then rendered more capable of seeing heavenly things. This idea, it is held, would not come naturally to a Jew. To him the forms of nature were of sacramental significance; he believed that the invisible things of God, since the creation of the world, might be clearly seen through the things that are made. And blindness never appeared to him as a possible blessing; it was the brand of sin (John 9:1–3). Hence, it is argued, it must have been the apostle’s own peculiar experience which enabled him to say that loss or diminution of sight might and did lead to clearness of spiritual vision. Certainly, this is now the common and happy experience of many of the sightless in Christian lands. A blind physician, writing for the comfort and help of those whose sight is failing irremediably, states that “the blind are often encouraged by a very living religious faith. This is not surprising, for, accustomed to accept the reality of things they do not see, they believe easily in the immediate presence of an unseen God, and incline to a mysticism which can lift them away from the things of earth and humanity.” In the words of the apostle they can say, “Our light affliction, which is but for a moment, worketh for us a far more exceeding and eternal weight of glory, when we look not at the things which are seen, but at the things which are not seen: for the things which are seen are temporal; but the things which are not seen are eternal.”

The collective weight of these facts and inferences justifies the conclusion that Paul had defective sight; he saw the things of this world darkly, as in an ancient mirror, wherein the reflection of objects was dim and perhaps distorted (1 Cor. 13:12).

The remarkable incidents of his conversion support this view. He was traveling from Jerusalem to Damascus when it occurred. “After leaving the sea of Galilee and crossing the river Jordan, his way lay over the desert of Damascus, barren lands which stretch in dreary succession along the base of the Antilibanus Mountains. All around were stony hills and thirsty plains, through which the withered stems of the scanty vegetation hardly penetrate.” Over this desert and under a burning sky, he kept impetuously on his course. Suddenly, as he describes it, there shone from heaven a great light above the brightness of the midday sun. Blinded by the radiance, he fell to the ground.

Was this light really celestial, coming from a source outside himself, or was it a subjective sensation pure and simple? Several writers claim it was wholly subjective; further, they assert there was nothing miraculous in any of the physical occurrences which happened at the time. So far as the blindness itself is concerned, the contention does not conflict materially with the narrative. It is not incredible that on the memorable day of the conversion, the sun shone with extraordinary heat and brilliancy, and the travelers felt its heavy power. The light did not hurt the normal eyes of the attendants. With Paul it was different: his weak and sensitive eyes had already been injuriously affected by the heat and glare of the journey; during the morning hours, lost in the profound meditation which preceded the revelation of Jesus to him, he was oblivious of his surroundings, and heedless of warning bodily sensations. In consequence, his eyes were unable to bear the unearthly radiance at noon, and, at the moment when blindness fell upon him, he experienced the sensation, not uncommon when the eyes receive sudden injury, of an instantaneous flash or scintillation of bright light. How could he afterward describe such a physical experience in ordinary language, except by saying there suddenly shone from heaven a great light? On the other hand, if it be insisted that the light was supernatural, the limitations of our knowledge do not permit of an utter denial. “Why should we think the celestial sphere may not be all about us, and sometimes, in some sudden and illuminating moment, pierce through the mystic cloud which generally hides it from our vision.”8 However this may be, unless we reject the facts of the narrative altogether, it cannot be denied that on the way to Damascus the apostle was blinded suddenly by intense light.

The exposure of the eyes to light greater than they can bear produces the disorder known as amaurosis, usually functional. Of this there are several degrees. In the severest, as after a vivid stroke of lightning, there may occur complete and instantaneous blindness, apparently from temporary paralysis of the retinŠ. The effect produced on the eyes of Paul by the intense light to which he was exposed, was very similar. The symptoms are characteristic. “The gait and general aspect of the patient are peculiar,—he is hesitating and hopeless looking. He no more tries to see objects. He holds up his head; the eyes are open and turned upwards. He feels his way with his feet, and his hands are extended before him. He does not look toward you, or at anything in particular.” So it was with Paul. When he rose from the ground, “he opened his eyes and saw nothing,” and they led him by the hand and brought him into Damascus.

What was the state of Paul’s mind during his stay in the dark world, not knowing when, if ever, he would see the light again? Prior to his conversion, when embarrassed by his poor sight, had the possibility of being smitten with total blindness ever crossed his mind? Did he now think this had happened, and that he must resign himself to it as well as to his other losses consequent upon his conversion to Christianity? Was this the beginning of his crucifixion to the world, and the world’s crucifixion to him? All we know is that in anguish of soul the apostle spent the time in prayer and fasting. At the end of three days his prayer was answered; his sight returned, “and straightway there fell from his eyes, as it were scales.”

In cases of functional amaurosis, it is not unusual for the sight to be restored, after a variable time, to what it was before, even though all perception of light was at first quite lost.

The allusion to scales falling from the eyes is usually considered to be metaphorical. Yet the phenomenon actually occurs in functional diseases of the retina. In the malady of night-blindness, caused by temporary exhaustion of the retinal sensibility from prolonged exposure to diffuse bright light, “two little dry films, consisting of fatty or sebaceous matter and epithelial scales, often form on the conjunctiva at the inner and outer border of the cornea. Their meaning is not understood, but they are sometimes absent in this disease and present in other conditions.”9 “In many of these patients there are distinctly noticed peculiar, silvery-gray, scaly patches of thickened epithelium, at the outer border of the ocular conjunctiva near the cornea. They disappear at the same time with the blindness.”10 The apostle recovered his sight, but this blindness left his eyes somewhat weaker than they had been. With care, however, he was able to work for years without greater inconvenience than commonly falls to the lot of people with imperfect sight.

We come now to the visitation of the thorn. Paul states that it first began to trouble him at a time when he was receiving important revelations, about fourteen years before he wrote his second letter to the Corinthians. The highest visions and revelations are given to qualify for service. The vision he beheld on his way to Damascus changed him from the persecuting Pharisee into the apostle of Jesus Christ. His message, at first, had the same limitations as that of the other apostles: to the Gentiles it was not so gracious as to the Jews. Later revelations, by giving him larger and clearer conceptions of the truth as it is in Jesus, qualified him for a broader field of service. Consequently, it is held that the revelation of tremendous importance by which he discerned the catholicity of Christianity and its absolute freedom from the bonds of Jewish ceremonialism, must have come to him in Antioch, just before he and Barnabas were set apart for work among the Gentiles; and the conjecture is very plausible that the revelations of this period were followed by the appearance of his peculiar infirmity.

Starting on their missionary journey with John Mark as an attendant, Paul and Barnabas sailed from Seleucia to Cyprus. Here they encountered Elymas the magian. Afraid of losing his honorable and lucrative position on the island, he opposed Paul and tried to cover him with ridicule. Did he taunt him with his poor vision, insinuating, after the manner of Orientals, that it was evidence of moral obliquity or blindness? Perhaps so, if we are at liberty to emphasize the personal pronouns in the stern judgment pronounced by Paul: “And now, behold, the hand of the Lord is upon thee, and thou shalt be blind, not seeing the sun for a season.”

Leaving Cyprus the missionaries sailed for Pamphylia. About this time occurred the severe illness of Paul which led to the abandonment of this particular tour, the desertion of the party by Mark, to the apostle’s great indignation, and the journey to the highlands of Galatia. Paul refers to this illness as follows: “Ye know that because of an infirmity of the flesh I preached the gospel to you the first time, and that which was a temptation to you in my flesh ye despised not, nor rejected; but ye received me as an angel of God, even as Christ Jesus. . . . I bear you witness that, if possible, ye would have plucked out your eyes and given them to me.” It was more than a local affection; it was a general disease, which, besides making him loathsome, inflamed his eyes so badly as to threaten him with blindness. The Galatians found it a trial to listen to him while he Was in that condition, but they overcame their repugnance; believed the gospel he brought them; and, in gratitude, were willing to sacrifice their own eyes, if so be his might be saved.

The name of this disease we know not. The one which first suggests itself is small-pox, and, strange to say, it fits in very well with all the circumstances. It is a very common disease in the East, and Paul, obliged to associate with all sorts and conditions of men, often for a long time, as in his voyages and imprisonments, frequently incurred the risk of acquiring it, for of course the isolation of the infected, and other sanitary measures to prevent contagion, were then unknown; when severe, the eyes are badly inflamed, and the general condition of the patient is such that he “presents a picture of hideous disfigurement and helpless bodily discomfort, without a parallel in acute infectious diseases”; convalescence is protracted, which makes a stay at some health resort desirable, and, even in this period, the swollen features, the inflamed eyes, the soreness and desquamation of the skin, and the offensive odor, continue to render the patient repulsive; it is a disease of which many people are mortally afraid, so that friends, and relatives even, desert the sick,11 and therefore those who take their place out of sheer good-will, especially if strangers, thoroughly deserve such praise and gratitude as Paul expressed to the Galatians. However, this suggestion is put forward tentatively; it sufficiently answers the purpose to know that during his sickness, whatever it was, his eyes were badly inflamed.

In time this inflammation disappeared, so that it was no longer distressing to see the face of the apostle; but, in the sequel, it evoked the symptoms which constituted the thorn. Before this illness his sight had been poor, but the accommodative power of his eyes had been able to secure for him fairly good vision. The increase in the ocular defects and weakness, wrought by the inflammation, now rendered this power insufficient; the muscles and nerves of the eyes were unable to meet the additional strain. Hence there followed ocular pain and weariness, and the weariness eventually extended to the whole nervous system, inducing constant headaches, gastric disturbance, insomnia, depression of mind and body, and other symptoms. This was the physical basis of his infirmity, and it answers to all the descriptive points specified in the early sections of this paper.

It was a mysterious visitation. An ocular malady involving eye-strain is a very complex disorder. Until the last few years it baffled the skill of medical science, for the connection between imperfect vision and the symptoms enumerated was not recognized. The intractable sufferings of several famous men—Carlyle, Huxley, Darwin, Heine, De Quincey, Parkman, Wagner, and others—appear to have been wholly, or in part, of this nature, and the distinguished physicians consulted by them were unable to give more than temporary relief.12 The disorder, therefore, was utterly beyond the comprehension of the physicians of olden time, unless they were blessed with miraculous gifts of discernment and healing.

It was painful. The headaches due to eye-strain are most distressing, often resembling true migraine. In describing his own case a physician writes: “I suffered for thirty years from terrific headaches, frequent attacks of uncontrollable vomiting, and extreme nervous debility.”13 His eyes to ordinary observation seemed quite normal; the concealed refractive error was found only after long and careful search. “It is a horrid evil for me that I can read hardly anything,” Darwin complains, “for it makes my head almost immediately begin to sing violently.” And Carlyle tells of his “villainous headaches,” “feverish headaches,” “shifting from headache to headache.”

There is a very early and sustained tradition, first distinctly mentioned by Tertullian and afterwards by Jerome, that headaches were the apostle’s thorn. “I would unhesitatingly adopt this view,” wrote Philip Schaff, “if it were not for the objection that headache, even in its severest form, does not present the feature of such repulsiveness as to make the sufferer an object of contempt.”14 If, as we maintain, Paul’s infirmity was not chronically loathsome, this objection has no weight. St. Chrysostom objects on other grounds. He argues that Paul’s thorn “cannot have been a headache, as some suppose; it cannot have been any physical malady. God would not have delivered over the body of his chosen servant to be tortured in this way. The apostle is surely speaking of opposition encountered, or suffering endured from enemies.” This argument can be refuted easily. Many of God’s chosen servants, Job is an illustrious example, have been tortured by disease, and among the sufferers from severe headache we may mention Pascal, Calvin, Milton, Henry Martyn, Robertson of Brighton, and Chrysostom himself.

Other symptoms of eye-strain which add to the pain or discomfort of the patient are insomnia, gastric distress, and depression of mind and body. We know that Paul suffered from insomnia, for he mentions his sleepless nights, when recounting his trials. There is no evidence of gastric trouble, but the symptom is very common in these cases. The life of Darwin, a victim of eye-strain, was one long struggle against sickness; he dreaded to go away from home, fearing his stomach would fail, and excitement or fatigue always caused a bad form of vomiting. As to depression of mind and body, this accompanies such attacks inevitably, for it is hard to be cheerful with an atrocious headache and general nervous prostration.

It was connected with his visions. The symptoms of eyestrain are not of uniform duration and intensity. Usually, of course, they are evoked whenever the weak eyes of the patient are subjected to unusual strain; but if his visual powers are continually exercised to the full, though short of actual overstrain (and in this connection it is fair to assume that Paul was always a student, taking his parchments with him on his travels), the symptoms are liable to appear whenever the tone of the nervous system is lowered, as by fatigue or excitement. Hence a great deal depends on the general health. If this is good, and the patient is free from anxiety or other depressing influence, he keeps fairly comfortable; contrary conditions are apt to cause an exacerbation of his malady. The apostle, always ready to spend and be spent for others, was subject to great drains upon his nervous energy. Besides the exhausting labors and perils of his calling, there was the heavy burden of the care of all the churches. His visions and ecstasies, preceded as they were by prolonged study, meditation, and prayer, must also have been very exhausting. The prophet Daniel, after one of his visions, “fainted and was sick certain days”; after another he writes: “There remained no strength in me; for my comeliness was turned in me into corruption, and I retained no strength”; on another occasion he exclaims, “O my lord, by reason of the vision my sorrows are turned upon me, and I retain no strength.” In the spiritual as in the physical world, the law seems to prevail for finite creatures, that for every action there is an opposite and equal reaction; as high as we have mounted in delight, in our dejection do we sink as low.15

The connection between the periodical outbreaks of his malady and his visions is plain. The spiritual exaltation of the vision was followed by a period of mental and physical depression, which induced an exacerbation of his malady. This occurred so regularly as to establish for the apostle the relation of antecedent and consequent between his ecstasies and his thorn.

It was humiliating. The moral weakness of the apostle, as he states himself, was a tendency to spiritual pride This is the common failing of men with such exceptional gifts. “There are peculiar temptations which assail the thinker. He is in danger of being intoxicated by the influence which he gains over others; he feels himself elevated by the greatness of the thoughts with which his mind habitually deals, and which from time to time it originates. If, besides intellectual gifts, the thinker possesses acute sensibility, strong moral intuitions, heroic powers of indignation and pity, his temptation is to suppose that he is made of finer clay than other men, and that he has a natural title to preeminence and sovereignty over them. Such is the temptation of moral reformers.”16 If allowed to develop, the apostle’s failing would have manifested itself by impatience with the dull and un-spiritual; an intolerance of opposition; an unwholesome domination of the consciences of others.17 The humiliation of the thorn counteracted these tendencies, and the malady we name was adequate for the purpose, although it was neither loathsome nor disfiguring.

It was humiliating, because the irritability and depression accompanying an attack of his complaint so soon after a vision or revelation, made him painfully aware of his un-worthiness, and of his inability to sustain himself, unaided, in the heavenly places. If he was familiar with the Greek classics, as some suppose, perhaps he sometimes remembered, when his ecstasies were over, Plato’s magnificent myth about the gods who at certain high festivals mount in solemn procession to the topmost vault of heaven, and, taking their place on its dome, gaze over the infinite depths of perfect truth, the spectacle of which supports the fullness of their being; but the souls of those immortals accompanying them who are unable to sustain the vision, sink down to earth, baffled, wearied, and maimed, and are embodied as men, their condition in this lower life being dependent on the fidelity with which they strive upward toward the glory they have once seen. If thoughts of this kind passed through Paul’s mind, they made him very gentle with the foolish and slow of heart, who were not able to grasp quickly the full import of the truths he taught them, or who did not always respond in their conduct to the truths they knew; and the self-control necessary to restrain the exhibition of his irritation and depression, disposed him to regard charitably all those whose moral failings were due, more or less, to their abnormal physical condition,—all told, no small section of the human race.

The malady humbled him because, owing to his highly strung nervous organization, it prostrated him on critical occasions when it seemed most important that his apostolic authority and powers should be vigorously asserted. It laid him low when he visited Corinth to repress the disorder which had arisen in the church, so that contemptuous remarks were made about the weakness of his bodily presence. He feared similar prostration on his next visit if they continued to cause him anxiety, for he wrote: “I fear when I come I shall not find you such as I would . . . . lest again when I come, God shall humble me before you” (2 Cor. 12:21). This physical weakness prevented him from dominating unduly the conscience or judgment of others, simply by the force of his own personality.

It was also humiliating because it was a trial, to a man of his active, strenuous nature, to be partially disabled when there was so much work to be done in the world. Thus it counteracted his tendency to pride, by reminding him that God doth not need man’s work or His own gifts, and that

“thousands at His bidding speed,
And post o’er land and ocean without rest.”

Perhaps these periods of inactivity schooled him to bear with patience the weary imprisonments of later years.

In short, the humiliation of his painful, distressing, but not disfiguring affliction lay in its abiding disclosure to him of his spiritual weakness, notwithstanding the granting to him of the highest visions and revelations; it made him realize the utter inability in himself either to attain to personal holiness, or to perform adequately the work of his ministry. In a thorn of this kind he could well glory; it made him depend wholly upon the divine grace and strength; it promoted the growth in him of such virtues as meekness and lowliness of heart; and it trained him to deal gently with the weak and erring, conscious that he was himself encompassed with infirmity.

He drew further strength and glory from his affliction. Apart from anything else, these recurring attacks of illness were sufficiently severe and frequent to constitute a thorn for any ordinary man. But as Paul, at one time or another of his life, had to endure almost every form of suffering, it is hard to think he would have prayed so earnestly for deliverance from this particular infirmity, chronic though it was, had it not seemed to threaten an issue from which he shrank, in his human weakness. This further trial, we venture to say, was the fear of blindness. Once grant that his eyes were badly

BSac 64:256 (Oct 1907) p. 689

affected, and there is nothing improbable in the assertion. With his weak and oftentimes painful vision, was it possible for him to forget that he had once been blind for three days, and his sight was then only restored as by a miracle? In those days, who was there to assure him that, bad as his eyes were, at the worst he would not again enter the dark world, never to return? If this fear sharpened the thorn, then it penetrated deeply. None but those who have passed through the experience or apprehension of approaching blindness can estimate its bitterness. The prospect of physical helplessness is alone a grievous cross to an independent nature. “If we ardently desire sight,” writes a blind author, “it is not to enjoy the delight of faces and to distinguish colors, but much more to be freed from the thousand restraints which blindness throws around us everywhere, in the street, in the house, at the table. It is to escape from the dependence which, even if friendly, weighs upon us.”

A deeper trial was the thought of the insurmountable hindrance blindness would be to his evangelistic work. He was God’s chosen messenger to the Gentiles. The field, white unto the harvest, lay stretched before him in all its immensity. He was straitened in himself till his work was accomplished. “Woe is me if I preach not the gospel,” he declared. Yet how could he perform his great task if he were totally blind and helpless?

“When I consider how my light is spent
Ere half my days, in this dark world and wide,
And that one talent which is death to hide
Lodged with me useless, though my soul more bent
To serve therewith my Maker and present
My true account, lest he returning chide,—
Doth God exact day labor, light denied?”

For Paul, the devoted servant of God, could there have been a more painful, humbling thorn? In his distress, he besought the Lord repeatedly for deliverance. It was not granted, as Matheson points out, because the further task lay before him of helping to solve the dark problem of human suffering. The thorn was not removed; but after a time he ceased to desire its removal, for he was given insight into its meaning and value. There burst upon him the conviction that the divine power of Christianity was itself simply the strength to sustain weakness; that the earthly glory of the Master had mainly consisted in his ability to support with unmurmuring love the weight of a bitter thorn, at the last a crown of thorns. In his affliction the apostle therefore discerned that he was but following the footsteps of Christ along the dolorous way, and must exhibit the patience, gentleness, and resignation with which the Son of man bore his trials. So the thorn became to him the unmistakable sign of his apostleship. It united him to Christ in suffering, and enabled him to sympathize deeply not only with the trials of his fellow-men, but also with the groaning and travailing together in pain of the whole creation. He accepted his affliction, therefore, with cheerful resignation, confident that, whatever happened, nothing could separate him from the love of God, and that the strength of Christ would be manifested in his weakness for the salvation of men.

Since his day, a host of incurable sufferers, including prospective and actual denizens of the dark world, with his example before them of cheerful resignation to a burden irremovable even by prayer, have found deliverance from their fears and distress. In a letter to a friend named Leonard Philara, who hoped a celebrated oculist might be able to improve the sight of the poet, Milton writes: “The darkness which I experience is, owing to the singular goodness of the Deity, passed amid the pursuits of literature and the cheery salutations of friendship. Why may not one acquiesce in the privation of his sight when God has so amply furnished his mind and conscience with eyes? While He so tenderly provides for me, while He so graciously leads me by the hand and conducts me on the way, I will, since it is His pleasure, rather rejoice than repine at being blind. And, my dear Philara, whatever may be the event, I wish you adieu with no less courage and composure than if I had the eyes of a lynx.” St. Francis of Assisi speaks in the same brave and composed strain. When a physician remonstrated with him for his incessant weeping over his sinfulness, because it was injuring his sight, the saint replied: “It is not fitting, Brother Medico, that, for the love of that light which we have here below in common with the flies, we should shut out the least ray of the eternal light which visits us from above; for the soul has not received the light for the sake of the body, but the body for the sake of the soul. I would, therefore, choose rather to lose sight of the body than to repress those tears by which the interior eyes are purified, so that they may see God.” Many more instances of this courageous faith of the blind or partially blind might be given, did space permit.

The apostle fortunately retained his sight to the end of his life, and perhaps in his old age the symptoms of his infirmity were less harassing. Contemplating the work of a life so sorely tried and hindered, one is tempted to ask, What might not the apostle have accomplished if he had always enjoyed perfect health and strength? As it was, despite his weakness and pain, he fought a good fight, he finished his course. “What missionary is there, what preacher, what man intrusted with the cure of souls, who can be compared with him, whether in the greatness of the task which he accomplished, or in the holy energy with which he carried it out? He worked with the most living of all messages and kindled a fire; he cared for his people like a father, and strove for the souls of others with all the forces of his own; at the same time he discharged the duties of the teacher, the schoolmaster, the organizer. When he sealed his work by his death, the Roman empire from Antioch as far as Rome, nay, as far as Spain, was planted with Christian communities.”18

In conclusion, it may be admitted that we shall never know beyond all possible dispute the exact nature of Paul’s thorn in the flesh. But the malady we have described seems better than any other to collect into a pathological unify the scattered and fragmentary allusions to the peculiarities and infirmities of the apostle found in Scripture and tradition; it is congruous with his character and career; it corresponds closely and reasonably with every point in Paul’s own statement: “And by reason of the exceeding greatness of the revelations, there was given to me a thorn in the flesh, a messenger of Satan to buffet me, that I should not be exalted overmuch. Concerning this thing I besought the Lord thrice, that it might depart from me. And he hath said unto me, My grace is sufficient for thee, for my power is made perfect in weakness. Most gladly therefore will I rather glory in my weaknesses, that the strength of Christ may rest upon me.”


1) Eccles. 39:28–31. For an article on this whole subject, see “The Powers of Darkness,” Bibliotheca Sacra, April and July, 1906.

2) Schaff, Presbyterian Review, 2:378.

3) For the symptoms and course of epilepsy, see art. “The Malady of Saul,” Bibliotheca Sacra, October, 1904.

4) Ramsay, St. Paul, The Traveller and Roman Citizen, p. 96; McGiffert, The Apostolic Age, p. 319.

5) Farrar, Life and Work of St. Paul, Excursus 10.

6) Ramsay, op. cit., p. 38.

7) Matheson, Spiritual Development of St. Paul. On the subject of blindness, its physical limitations and spiritual compensations, more than usual weight should be given to the opinions of this very suggestive writer, who became blind himself when he was twenty years old.

8) Lyman Abbott, Life and Letters of Paul, p. 38.

9) Nettleship, Diseases of the Eye, p. 246.

10) Soelberg Wells, Diseases of the Eye, p. 444.

11) See Carlyle’s grim description, in his history of the French Revolution, of the conduct of princes, courtiers, and prominent ecclesiastics, when the French king Louis XV lay dying of small-pox.

12) Gould’s Biographic Clinics.

13) Ranney, N. Y. Medical Record, April 18, 1903.

14) Presbyterian Review, 2:378.

15) In a recent commentary the learned authors are inclined to attribute the diversities of Paul’s literary style to his variable moods. In their opinion, the writings of the apostle furnish abundant evidence of his highly strung nervous organization. “It is likely enough,” they continue, “that the physical infirmity from which he suffered, the thorn in the flesh which had such a prostrating influence upon him, was of nervous origin. But constitutions of this order are liable to great fluctuations of physical condition. There will be lucid moments, and more than lucid moments, when the brain will work not only with ease and freedom, but with an intensity and power not vouchsafed to other men. And times such as these will alternate with periods of depression, when body and mind are alike sluggish and languid” (Sanday and Headlam, International Critical Commentary, Romans, p. 59).

16) Seeley, Ecce Homo, p. 192.

17) In his life of the apostle, Renan observes: “Paul had too energetic a personality to form an original school. He always crushed his disciples; they only played around him the part of secretaries, of servants, of courtiers. Their respect for their master was such that they never dared to teach freely. When Paul was with his flock, he existed alone; all others were crushed or seen only through him.”

18) Harnack, What is Christianity, p. 203.