Answer
In the apostle Paul’s letter to the Galatians, he mentions having a bodily affliction: “You know that because of physical infirmity I preached the gospel to you at the first” (Galatians 4:13, NKJV). Other translations describe his malady as a “bodily illness” (NASB) and a “bodily ailment” (ESV). Moreover, Paul refers to his affliction as “my trial” in Galatians 4:14 (NKJV), which other translations render as “my illness” (NIV) and “my condition” (ESV). Neither Galatians nor any other book of the Bible clearly identifies Paul’s infirmity. However, many scholars find reasons to believe that it may have been poor eyesight.
Those who believe Paul’s infirmity was poor eyesight find supporting evidence elsewhere in Galatians, though the connections are rather tenuous. First, Paul mentions the Galatians giving him their eyes as an act of kindness: “What then was the blessing you enjoyed? For I bear you witness that, if possible, you would have plucked out your own eyes and given them to me” (Galatians 4:15). Though advocates of the poor-eyesight interpretation acknowledge that Paul’s description in this verse isn’t literal, they suggest he may be figuratively alluding to his bodily ailment. Those who disagree with this view argue that he is merely using a vivid word picture (e.g., Matthew 18:29) to highlight the Galatians’ affection for him.
A second piece of evidence that advocates for the poor-eyesight theory comes at the conclusion of the letter when Paul mentions writing in large letters, possibly indicative of vision problems: “See with what large letters I am writing to you with my own hand” (Galatians 6:11). Those who disagree with this interpretation suggest that Paul may be writing in large letters for emphasis, or possibly drawing attention to when he stopped using an amanuensis (i.e., a writing secretary) to whom he often dictated his letters (also see 1 Corinthians 16:21; Colossians 4:18).
Some advocates of the poor-eyesight interpretation cite the blindness Paul experienced at his conversion as support: “Saul rose from the ground, and although his eyes were opened, he saw nothing. So they led him by the hand and brought him into Damascus” (Acts 9:8). However, the context in Acts suggests that his blindness had a supernatural origin and purpose and was only temporary (Acts 9:18). Thus, it’s unlikely that Paul’s physical infirmity was an ongoing problem related to his conversion experience.
There are numerous minority views of Paul’s infirmity. A few early church fathers thought it was migraine headaches. Some modern scholars have suggested epilepsy, a neurological disorder that causes recurrent seizures. Such a condition would have significantly challenged caretakers in the first century. To some, that may explain Paul’s acknowledgment that the Galatians “did not scorn or despise” him because of his condition (Galatians 4:14).
Another minority view is that Paul’s ailment was malaria, a mosquito-borne illness that can cause fever and even death in some cases. This explanation is based on the details of Acts 13, which relates how Paul came to Galatia in the first missionary journey. Paul, traveling with Barnabas and Mark, came to the city of Perga, situated in a marshy area in Pamphylia, where malaria seems to have been endemic. It was from Perga that Mark abandoned the team (Acts 13:13), and an illness they encountered there may have prompted his departure. If Paul had indeed contracted malaria in the lowlands of Perga, his move to Pisidian Antioch in Galatia was sensible, since Antioch sat about 3,600 feet higher than Perga, and mosquitos would have been less active there. However, there is no evidence that the elevation of Galatia was a factor in Paul’s stay there. Presumably, any sickness could have caused him to have a layover in the region.
Yet another view is that Paul’s mention of his infirmity was a metaphorical reference to persecution in general. This interpretation is consistent with how some understand his description of having a thorn in the flesh (2 Corinthians 12:7) as referring to scars, the residual effect of persecution. However, the Greek word Paul uses, translated as “infirmity” in Galatians 4:13, clearly refers to a physical affliction in the only other verse where he uses it (1 Timothy 5:23). Furthermore, the Gospels and Acts use the word exclusively in reference to physical ailments (e.g., Matthew 8:17; John 5:5; Acts 28:9).
In summary, the majority view that Paul’s infirmity in Galatians 4:13 was poor eyesight has more supporting evidence than other explanations. Furthermore, Paul testified that God worked through his condition to preach the gospel to the Galatians. His infirmity couldn’t thwart God’s plan to use him to make disciples of all nations (Matthew 28:19–20), illustrating the truth that God works all things together for good (Romans 8:28).
