There are in the New Testament a number of problems which, because of the inadequacy of the evidence available, are surrounded with uncertainty. One such is the question of Paul’s “thorn in the flesh” mentioned in 2 Corinthians 12:7. Over the centuries many solutions have been proposed, at times with excessive confidence; but in the nature of the case it is impossible to escape from the realm of conjecture. The apostle’s silence concerning such symptoms as would enable a diagnosis to be made may be taken as being in accord with the mind of God, for subsequent history would seem to indicate that it has been of more benefit to the Church to remain in ignorance on this matter than would have been the case had the nature of the infirmity been fully known. Had a particular affliction—epilepsy, for example—been designated, the great majority of Christians would have been inclined to dismiss the apostle’s problem as one remote from the reality of their own experience.

As things are, however, there has been a discernible tendency, as Lightfoot has pointed out, for interpreters in different periods of church history to see “in the apostle’s temptation a more or less perfect reflection of the trials which beset their own lives” (Commentary on Galatians, pp. 186 ff). This tendency, unconscious though it has been, is perfectly understandable. It has been an instinctive tendency, and there is no doubt that it has been a right tendency; for it is of the essence of Holy Scripture that it is profitable and applicable in a truly dynamic and existential manner to every circumstance and to every age of the Church. Is there a single servant of Christ who cannot point to some “thorn in the flesh” from which he has prayed to be released, but which has been given him by God to keep him humble, and therefore fruitful, in his service? Every believer must learn that human weakness and divine grace go hand in hand together. Hence Paul’s “thorn in the flesh” is, by its very lack of definition, a type of every Christian’s “thorn in the flesh,” not with regard to externals, but by its spiritual significance.

The earliest patristic reference to this question is found in Tertullian (about 200 A.D.) who mentions that it was said that Paul was afflicted with earache or headache. The tradition that the “thorn in the flesh” was headache is noticed also by Chrysostom, Jerome, and others of the early fathers. Chrysostom, however, finds the suggestion that Paul’s body was given over to Satan for the infliction of physical pain quite unacceptable, and, taking the term “Satan” in its general Hebrew sense of “adversary,” understands the “messenger of Satan” by which Paul was buffeted to signify all the adversaries who opposed Paul in the work of the gospel. This view that the reference is to the endurance of external persecutions has the support of a number of the ancient authors, including Augustine and Theodoret.

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The mistranslation of the Latin Vulgate version (fourth century), “goad of the flesh”—stimulus carnis—may have given rise, as Luther supposes, to the opinion that Paul was afflicted with impure temptations of the flesh, an opinion which prevailed in the medieval period and which came to be generally approved in the Roman Catholic church. This view is dismissed as ridiculous by Calvin, in whose judgment the reference is to “every kind of temptation with which Paul was exercised.” Luther also rejects the view that temptation to carnal lust is intended, or for that matter, some physical ailment, and explains the “thorn in the flesh” of the various temptations and trials to which the apostle was subject.

Of more recent hypotheses there are several that deserve mention. One is that Paul suffered from a severe form of ophthalmia. Attention is drawn to Galatians 4:15 where Paul, who has just been speaking of “an infirmity of the flesh” (verse 13), says that the Galatians would, if possible, have plucked out their eyes and given them to him; and it is suggested that hints of defective eyesight may also be discerned elsewhere in the New Testament (e.g., Gal. 6:11; Acts 23:5, and Acts 9:9, 18).

Another theory which has found wide favor is that Paul suffered from epilepsy, the recurrent attacks of which thoroughly incapacitated and humiliated him. Other great men, such as Caesar, Mahomet, Cromwell and Napoleon, have been cited as epileptics, but it is extremely questionable whether they were in fact such, and in any case modern medical knowledge leads to the conclusion that the symptoms of epilepsy are unlikely to have been those of Paul’s “thorn in the flesh.”

Perhaps no recent conjecture has been of greater interest than that of Sir William Ramsay who strongly advocated the form of recurrent malarial fever which is known in the Eastern Mediterranean. This fever is accompanied by prostrating paroxysms, severe headache, unsightly eruptions and feelings of self-contempt. The theory is enthusiastically embraced by the contemporary French Roman Catholic scholar E. B. Allo (Seconde Epitre aux Corinthiens, pp. 313 ff).

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Most recently the French Protestant scholar Ph.H. Menoud has advanced the novel hypothesis that the apostle’s “thorn in the flesh” was not a physical complaint at all, but was the “great sorrow and unceasing pain” in his heart because of the unbelief of the Jewish nation (Rom. 9:1–3). The context demands, he feels, a trial peculiar to the Apostle Paul as a counterweight to the exceptional revelations granted him (in Studia Paulina, pp. 163 ff).

Many other solutions have been offered, such as hysteria, hypochondria, gallstones, gout, rheumatism, sciatica, gastritis, leprosy, lice in the head, deafness, dental infection, neurasthenia, an impediment of the speech and remorse for the tortures he had himself inflicted on Christians prior to his conversion. No doubt there will be fresh proposals in years to come, for this is a matter which will never be regarded as closed while there are minds to speculate on it.

Was this “stake for the flesh” (which is a more accurate rendering of the Greek than “thorn in the flesh”) the same as the infirmity of the flesh which halted him in Galatia and led to his preaching the gospel there for the first time? (Gal. 4:13). Was it one and the same with the affliction which overtook him in Asia, causing him to despair even of life? (2 Cor. 1:8). And does he refer to the same thing when he tells the Thessalonians that, having wished to visit them once and again, it was Satan that hindered him on each occasion? (1 Thess. 2:18). These are interesting and legitimate questions, but it is impossible to answer them with certainty. What is absolutely certain is that God’s word to his apostle, “My grace is sufficient for thee; for my power is made perfect in weakness” (2 Cor. 12:9), holds good for every servant of his in every age and in every circumstance.

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