Could Goliath Have Suffered from Gigantism or Acromegaly?

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In Malcolm Gladwell’s book, David and Goliath: Underdogs, Misfits, and the Art of Battling Giantsthe renowned author compares the biblical text to modern medicine to try and understand and even explain Goliath’s unnatural height.

Clearly, a lot of what Gladwell and other doctors have hypothesized is speculation, but there is enough evidence from the biblical text to suggest that Goliath could have suffered from an actual medical condition known as gigantism or even its counterpart acromegaly, which can manifest in adults even after they’ve reached maturity.

In both rare instances, an individual can grow to an incredible height due to an excessive production of growth hormone (GH) which causes abnormal skeletal and tissue growth. Most forms of gigantism are identified and treated at an early age. In the ancient world, however, this would not have been the case.

Excessive production of GH is often the result of swelling in the pituitary gland, and in some cases, a benign tumor can press on the pituitary, secreting excessive amounts of GH.

The most obvious symptoms of gigantism and acromegaly include a larger than normal body structure as well as the enlargement of the organs, muscles, hands, feet, and forehead.

Excessive sweating, thicker skin, and a protrusion of the jawbone are also common.

And Dr. Ian Chapman writes in the Merck Manual that some patients with acromegaly experience a “cartilaginous proliferation of the larynx (which) leads to a deep, husky voice.” This may explain why Goliath was able to physically and verbally intimidate the armies of Israel, as his voice carried across the valley (1 Samuel 17:8).

Long-standing acromegaly can also produce “barrel chest”, which Dr. Eric J. Olson of the Mayo Clinic describes as, “a rounded, bulging chest that resembles the shape of a barrel.” This could also explain why Goliath had such a large suit of armor, which the biblical text says weighed “five thousand shekels of bronze” (1 Samuel 17:5). In today’s terms, that could be anywhere from 90 to 140 pounds. Matthew Henry points out in his commentary, however, that the term “shekel” could also have been used to indicate the cost of Goliath’s armor that would have been customized to suit his unusually large frame.

Needless to say, Goliath’s defensive armor and weaponry were larger, heavier, and more expensive than most and would have required a man of substantial size and strength to wield.

Unfortunately, when left untreated, most patients with acromegaly or gigantism have reduced life expectancies and will often deal with extreme arthritis, heart conditions, dizziness, headaches, fatigue, decreased mental function, and even blurred vision if the tumor on the pituitary glands presses on the optic nerves.

Some, including Malcolm Gladwell, believe that this could explain several of Goliath’s shortcomings hinted at in the biblical text and why he laughed when David came at him with “sticks” (1 Samuel 17:43) when the text says that David walked into the valley with a single shepherd’s staff (1 Samuel 17:40)

If Goliath did have acromegaly and experienced mental, mobility, vision issues (unknown to the Israelites), he would only be effective in close range, hand to hand combat. So, did his size help or hinder?

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