The Lord will smite thee with the botch of Egypt. Whether you understand this passage of the extraordinary plagues which God inflicted on the Egyptians at the time of His people's deliverance, or of the ordinary diseases which had before prevailed among them, though the latter is more probable, still Moses signifies, that whilst the Egyptians were smitten with these plagues, God's people escaped them, in order that this distinction might more clearly represent His favor. For it could not happen naturally that in the same place the diseases, from which the Israelites were free, should afflict the Egyptians alone. God therefore threatens, that if they should despise His Law, He would deal with them as they had seen Him deal with heathen nations. And assuredly, since God then chose to multiply His people miraculously, it can be by no means doubted but that He wonderfully privileged them by the bestowment of health and rigor. It is doubtful whether by diseases of the fundament He signifies hemorrhoids or prolapsus, or some other secret disease, such as that which attacked the Philistines when they captured the ark of the covenant. (1 Samuel 5:6.) He subjoins other diseases, in which there appear special marks of God's wrath; for although they sometimes affect the children of God also, still I have shewn elsewhere that the same punishments are so dealt out to them respectively, that they widely differ from each other. When Job was smitten with terrible ulcers, so as to become corrupt, he seemed for a time to present the marks of a reprobate person; but what in that holy man was an exercise of patience, is in the transgressors of the Law the just reward of their crimes by the curse of God.

The "botch" (rather "boil;" see Exodus 9:9), the "emerods" or tumors 1-Samuel 5:6, 1-Samuel 5:9, the "scab" and "itch" represent the various forms of the loathsome skin diseases which are common in Syria and Egypt.

The Lord will smite thee with the botch - שחין shechin, a violent inflammatory swelling. In Job ii., one of the Hexapla versions renders it ελεφας, the elephantiasis, a disease the most horrid that can possibly afflict human nature. In this disorder, the whole body is covered with a most loathsome scurf; the joints are all preternaturally enlarged, and the skin swells up and grows into folds like that of an elephant, whence the disease has its name. The skin, through its rigidity, breaks across at all the joints, and a most abominable ichor flows from all the chinks, etc. See an account of it in Aretaeus, whose language is sufficient to chill the blood of a maniac, could he attend to the description given by this great master, of this most loathsome and abominable of all the natural productions of death and sin. This was called the botch of Egypt, as being peculiar to that country, and particularly in the vicinity of the Nile. Hence those words of Lucretius: -
Esther Elephas morbus, qui circum flumina Nili
Nascitur, Aegypto in media; nec praeterea usquam.
Lib. vi., ver. 1112.
Emerods - עפלים ophalim, from עפל aphal, to be elevated, raised up; swellings, protuberances; probably the bleeding piles.
Scab - brg garab does not occur as a verb in the Hebrew Bible, but gharb, in Arabic, signifies a distemper in the corner of the eye, (Castel)., and may amount to the Egyptian ophthalmia, which is so epidemic and distressing in that country: some suppose the scurvy to be intended.
Itch - חרס cheres, a burning itch, probably something of the erysipelatous kind, or what is commonly called St. Anthony's fire.
Whereof thou canst not be healed - For as they were inflicted by God's justice, they could not of course be cured by human art.

The Lord will smite thee with the botch of Egypt,.... Which some understand of the leprosy, Of that sort of it called "elephantiasis", frequent among the Egyptians; See Gill on Leviticus 13:2. Thevenot (i) relates, that when the time of the increase of the Nile expires, the Egyptians are attended with sharp prickings in their skin like needles. So Vansleb says (k),"the waters of the Nile cause an itch in the skin, which troubles such as drink of them when the river increases. This itch is very small, and appears first about the arms, next upon the stomach, and spreads all about the body, which causes a grievous pain; and not only the river water, but that out of the cisterns drank of, brings it, and it lasts about six weeks.''Though some take this botch to be the botch and blain which the Egyptians were plagued with for refusing to let Israel go, Exodus 9:9,
and with the emerods; or haemorrhoids, the piles, a disease of the fundament, attended sometimes with ulcers there; see 1-Samuel 5:9,
and with the scab and with the itch: the one moist, the other dry, and both very distressing:
whereof thou canst not be healed; by any art of men; which shows these to be uncommon ones, and from the immediate hand of God.
(i) Apud Scheuchzer. Physic. Sacr. vol. 3. p. 426, 427. (k) Relation of a Voyage to Egypt, p. 35, 36.

the botch of Egypt--a troublesome eruption, marked by red pimples, to which, at the rising of the Nile, the Egyptians are subject.
emerods--fistulÃ&brvbr; or piles.
scab--scurvy.
itch--the disease commonly known by that name; but it is far more malignant in the East than is ever witnessed in our part of the world.

The botch of Egypt - Such boils and blains as the Egyptians were plagued with, spreading from head to foot: The emerodes - Or piles.