Health Care and the Rise of Christianity - by Hector Avalos
(Peabody, MA: Hendrickson, 1999). Pp. x + 166. Paper $12.95.

Extended version of a shorter review published in CBQ 63 (2001) 136-37.
Reviewed by Felix Just, S.J., Ph.D., Los Angeles, CA  90045

This short book about "the health-care system" of Early Christianity continues Avalos’ interest in combining medical anthropology and biblical studies, while his large previous work, Illness and Health Care in the Ancient Near East (Atlanta: Scholars Press, 1995) focuses on the pre-Christian era.

Avalos’ main thesis is that "The ideas of health care reflected in early Christianity constitute a system that was an important factor in attracting converts. As such, these ideas about health care constitute an important factor in the rise of Christianity itself" (p. 3; similarly p. 15). His introduction also briefly reviews related scholarship, none of which is sufficiently systematic or comparative, in his opinion.

Chapter 1 describes the elements considered essential for a study of "Health Care as a System": the socioreligious framework of health care systems, the etiology of illness, the socioreligious status of patients, available therapeutic strategies, the structure and complexity of healing rituals, economics (mainly the cost of therapy), geographical accessibility of therapeutic means, and temporal aspects (when healing is available, how long it takes, etc.). These elements provide the organizational structure of the rest of the book.

Chapters 2-3 briefly introduce "The Israelite Health Care Systems" (stressing the variety of health care ideas and practices in ancient Israel, but mostly describing the "levitical system") and "Major Greco-Roman Traditions" (mentioning Asclepius, Isis, Mithraism, and some "Secular Greco-Roman Traditions").

Chapters 4-8 analyze health care in Early Christianity, first discussing the socioreligious frameworks, then some therapeutic, economic, geographical, and temporal aspects. Most of the evidence provided is from the NT, with citations of non-canonical Christian writings and comparisons with Jewish and Greco-Roman materials mostly in the notes. The book concludes with a three-page "Comparative Synthesis" (including a helpful "Synopsis" chart, p. 119), endnotes, bibliography, and indices.

Avalos correctly stresses that questions about illness and healing should not be considered in isolation, but as part of larger social systems. Thus, he makes some fine observations about the hallmarks of "the early Christian health-care system," namely its emphasis on faith and healing "in the name of Jesus" (rather than complex therapies), its geographical accessibility (with wandering healers, patients need not travel to temples), its temporal availability (no restrictions against healing on the Sabbath), and its low cost (elimination of fees charged by professional physicians). Less convincing are his assertions that Christianity differed significantly from Judaism in some of these areas. For example, to highlight Christian monotheism (with "only God or Jesus as the healing deities"; p. 62), he argues that some forms of Judaism were not really monotheistic (attributing illness and healing to demons, angels, and other "divine figures"; pp. 61-3), as if these represented the dominant Judaism of the first century.

His main thesis, no matter how intriguing or plausible, must unfortunately be regarded as unproven. Since this book is so short (less than 100 pages of text, due to liberal use of blank pages between short chapters), numerous claims are left unsubstantiated. Although it sounds plausible that low cost and easy accessibility of healers might lead to large numbers of conversions, Avalos presents no direct evidence for this, except for NT stories of Jesus himself healing people. One could just as plausibly speculate, however, that fear of having to pluck out one’s eyes or chop off one’s hands (cf. Matt 5:29; 18:29; etc.) scared potential converts away! While claiming to be interested primarily in the early Church rather than the historical Jesus, Avalos does not explain how a story of Jesus healing someone in the Gospels can prove that Christians continued the same activities in the following centuries. Yet the evidence presented from non-canonical sources does not clearly support his central thesis that early Christianity’s "health care was a part of the core of its mission and strategy for gaining converts" (p. 119).

Avalos gives English definitions of illness, disease, patient, and contagion (p. 126, nt. 4), but unfortunately does not mention the Greek (or Hebrew) for these or related terms (health, healing, etc.), despite quoting many other words and texts in the original languages. Inattention to detail results in numerous other unsubstantiated assertions and errors. For example, Avalos erroneously claims that the blind and the lame are considered "impure" in the Hebrew Bible (pp. 35, 67). Although the Qumran texts consider these people "unclean/impure," the Bible consistently calls them "defective/blemished," but never "unclean." Similarly, his claim that "healings by Jesus are quite simple, requiring a short prayer to the one God" (p. 22) is wrong; Jesus never explicitly prays to God before healing anyone (John 11:41-42 is no exception, since the Johannine Jesus prays merely "for the sake of the crowd"). His summary of Greco-Roman disease etiologies (p. 66) also incorrectly associates the four humors with the four physical properties (cf. Galen, On the Natural Faculties 1.11).

While Avalos highlights the simplicity of Jesus’ therapeutic practices (rarely using spittle, mostly verbal commands), he neglects the importance of touch in biblical healings (p. 84). He mentions the pharmaceutical use of oil in Mark 6:13 (also Tertullian) and wine in 1 Tim 5:23 (pp. 82-83), but it is astounding that the therapeutic prescriptions of James 5:14-15 (calling the elders to pray over the sick and anoint them with oil), or the reference to buying "salves to anoint your eyes" (Rev 3:18, even if figurative), are never mentioned in this book! Similarly, although Avalos often speaks vaguely of wandering Christian healers, he does not specify who these are nor discuss their placement among the Pauline ministries (1 Cor 12:29-30).

Overall, this book is a good introduction to the types of questions medical anthropology can raise about illness and healing in early Christianity, but a much fuller study must still be written to provide a comprehensive assessment or to prove the main thesis.

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