There is a marked similarity between the trumpets and the vials or bowls. The same elements of creation are affected in both cases in the same order: the earth, the sea, the rivers and springs, the sun, the light, the river Euphrates, and thunderings, lightnings, and earthquake.
These sores affected only those who had ‘the mark of the beast, and upon them which worshipped his image’. The early plagues of Egypt fell on both the Egyptians and the Israelites, but from the fourth plague onwards (Exodus 8:21-22) God spared his people and afflicted only the Egyptians. The plagues of Egypt were a supernatural intervention by the Lord, and yet illustrate his government of the world. Some diseases, such as AIDS, are obviously linked to sinful practice. Although this disease is not completely selective, who can fail to see that it is, in the main, suffered by those who break God’s commandments and indulge in promiscuity and worse? Do those who deny this believe that God ever judges men? Are they unwilling to admit that those who practise sexual impurity have broken his commandments? God has his ways of convincing the unwilling. But we cannot say in every case why God allows disease to touch a life, for his counsels are hidden from us. Not all illness is a mark of judgment. God has other reasons for sending it besides judgment. In different passages of Scripture sickness brings correction, aids humility and patience, and teaches the saints to long for heaven. The same disease may come upon one as a final judgment, and upon another as a chastisement or even a deliverance from this world, transferring them into the presence of God. The mark of the beast is invisible on earth, but it is blatantly obvious from heaven.
The first judgement is to do with afflictions in the body. How literally should we take this? Is the fulfilment of this vial limited to diseases which actually bring painful boils and sores upon people? Surely not. Subsequent vials inflict not just bodily afflictions. Literal illness has certainly been a means of judgement through the history of the world, but in this book of symbols so often it is the spiritual counterpart that is intended. This surely goes beyond physical illness. In addition it depicts an ever-deepening unrest and pain that sweeps through a society living without God. The soul also can be afflicted with painful boils, as the conscience torments a man. David says: ‘When I kept silence, my bones waxed old through my roaring all the day long. 4 For day and night thy hand was heavy upon me: my moisture is turned into the drought of summer’ (Psalm 32:3-4). He is describing his spiritual suffering.
Do such diseases affect all who receive the mark of the beast? Do we see a distinction made in the history of the world between those who belong to the beast and those who do not? Is it obvious that such diseases only affect the wicked? If not, how can the passage say that the sore came only upon those who worshipped the beast? Certainly believers are affected by diseases just as unbelievers are, and sickness appears to make no distinction between the two. Indeed, it is part of the testimony of believers that they respond differently to the same trials that those in the world face. They view them in a spiritual way, seeing the Lord’s hand in them and understanding the fact that he trains his people through trials. They exercise patience and wait for their good things in the world to come.