(Click on the picture to see it in full)
The midrash states (citing R Tanchuma) that
When the Israelites left Egypt, the vast majority of them had blemishes. Why? Because they worked with the clay and bricks and ascended to the top of the building, and the builder when he ascended on top of the walls, either a stone would fall and cut off his hand, or the board or the clay would enter his eyes and he would become blind, so they had blemishes.I believe there are other derivations (from Shir Hashirim) but I will not address them now, for lack of time.
When they came to the wilderness of Sinai, Hashem said: is this to the honor of the Torah that I should give it to a generation of people with blemishes? And if I wait until other are established {the next generation} I am delaying the giving of the Torah. He said to the angels that they should descend to the Israelites and heal them.
And know that this is so, for Rabbi Yehuda cited Rabbi Simone: How do we know that they did not have amongst them those who were lame? For it is stated (Shemot 19:17)
nitzav only means upon his legs.
And how do we know there was none missing an arm? For it is stated (Shemot 24:7):
{and the "we will do" part implies such ability to do}
And how do we know there were no blind people? For it is stated (Shemot 20:14):
ro`im literally means "saw"}
And how do we know that there were no mute people? For it is stated (Shemot 19:8):
And if you do not learn from here, you can learn from another place, for it is stated (Shemot 15:26):
Thus we have that they were healed.
{and I would note that it does not say "on the Egyptians" but "in Egypt." That is, all the blemishes and diseases that I put upon you in Egypt I will no longer put on you in the future, but will remove it from you. Why? For I am the LORD that healeth thee.}
Update:
To make to final derivation clearer, the midrash is comparing perfect (past tense) שַׂמְתִּי with imperfect (future tense) אָשִׂים. Just as in the future, Hashem will not place upon them, apparently in the past Hashem did. Hashem will stop this imposition of physical deformity. Thus, He is Hashem who heals them.
In terms of the genesis of this midrash, looking only at the prooftexts offered here, I believe the following order was followed:
First, the prooftext of Shemot 15:26:
כָּל-הַמַּחֲלָה אֲשֶׁר-שַׂמְתִּי בְמִצְרַיִם, לֹא-אָשִׂים עָלֶיךָ, כִּי אֲנִי ה, רֹפְאֶךָ
"...I will put none of the diseases upon thee, which I have put upon the Egyptians [lit. in Egypt]; for I am the LORD that healeth thee"
was the first basis of the Midrash. What is the idea of Hashem being a healer, if He is saying that he will not place the maladies upon them in the first place?
Further, why specify "in Egypt" rather than "on the Egyptians." (Recall, this is a hyper-literal reading of the verse.)
It must be that in the past, Hashem did impose certain maladies on them in Egypt.
Once you have this, there are two things to be filled in. (Now in general in midrash, no detail is invented without a basis and prooftext.)
The first is the specific maladies and proofs that no Israelite possessed them. That was the first part of the midrash, which showed, for example, that all the nation answered, and so all of them must have been capable of answering.
The second is an accounting for how the Israelites obtained these maladies. The words אֲשֶׁר-שַׂמְתִּי בְמִצְרַיִם implies they obtained them in Egypt, so it makes sense it was a result of the servitude. And once we know which maladies they were healed from, creation of the backstory flows naturally.
It is possible that other psukim enter into this picture, but I do not have the time to consider them.
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