After humiliating the Philistine idol Dagon, God's punishment shifts directly to the bodies of the people of Ashdod. The physical blow that strikes them is severe, painful, and deeply humiliating, designed to deliver a clear message about their total powerlessness against Him. Because the people failed to understand the warning when God shattered their idol, He now deals with them with intense severity, striking their very bodies [מלבי"ם, אברבנאל, ביאור שטיינזלץ]. This devastation brings absolute ruin, leaving the city in a state of terror and desolation [רש"י, מצודת ציון].
The primary approach among commentators is that this plague is a harsh, agonizing disease accompanied by heavy bleeding, specifically afflicting the rectum [רלב"ג, אברבנאל, ביאור שטיינזלץ]. This specific affliction carries a profound symbolic weight. The Philistines mistakenly believed that they had captured the Ark of the Covenant through their sheer physical might and masculine prowess. In response, they are struck with a bleeding condition that mimics the way of women, a deliberate act to humble their male pride and bring upon them lasting disgrace [חומת אנך].
The dual nature of how this illness is recorded in the tradition highlights different aspects of the suffering. One perspective suggests that a polite euphemism is used to refer to the painful swelling of blood vessels, alongside the explicit name of the disease [רד"ק, אברבנאל]. Another view points out that the terminology stems from words associated with darkness, reflecting how the disease strikes a hidden, concealed part of the human body [מצודת ציון].
Alongside the medical explanation, another approach describes the plague in a much more tangible and miraculous way, linking the affliction to swarming creatures or mice. Some explain that the physical wounds and sores on their bodies actually took the shape of these creatures [מצודת דוד, מצודת ציון]. A more graphic interpretation describes a horrifying reality where actual mice invaded their bodies, ravaged their insides, and then emerged [רש"י]. Ultimately, these agonizing torments, brought about by God's direct intervention, become entirely unbearable. The immense suffering leaves the people of Ashdod with no choice but to admit their defeat and banish the Ark from their city [רלב"ג, אברבנאל].