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Friday January 26, 2007

A medical portrait of Maimonides

by stephen mark dobbs
correspondent

Maimonides is one of our greatest sages, a man and mind of enduring insight and wisdom over the passage of 800 years. He was a Renaissance man before the Renaissance: physician, thinker, Torah scholar and community leader.  Many Jews know of him as the philosopher author of “The Guide for the Perplexed” and his philanthropic concept of “the ladder of charity.”

But fewer readers are aware of Maimonides’ productive career as a physician, one in which his most significant contribution was to reconcile faith and God with the rationalist tradition and scientific knowledge. The connection of healthy body with the divine was devised by the Greeks; medicine was essentially a religious activity.

“Maimonides,” by Sherwin B. Nuland, a professor of surgery at Yale, studies Maimonides from this medical perspective.

Maimonides was the most prominent physician to write about medicine from a Jewish perspective and sense of compassion. The Talmud considers the physician as a messenger and a partner of God. In the Mishneh Torah Maimonides writes: “A man should aim to maintain physical health and vigor, in order that his soul may be upright, in a condition to know God.”

As a 12th-century Jew living in a Muslim world, Maimonides read the ancient texts in Arabic, which provided a bridge between the Hellenistic era and that of the Renaissance and then the Enlightenment. Maimonides was among the early vanguard seeking to remove the veils of superstition of the Dark Ages that cast shadows over all learning, including medicine. He and other Jewish physicians were sought after by royal courts throughout the Muslim world and Christian Europe.

From the earliest days of medicine, physicians had read Hippocrates (“Do no harm”) and Galen of Pergamon (“the four humours.”) Medical education was dominated by their works in numerous translations. Maimonides’ contribution to the literature was not so much in adding new knowledge about the human body or treatment of disease, as it was in understanding and communicating a philosophical attitude and value system for the practice of medicine. Maimonides was in fact not a researcher and he did not discover anything. But he devised a comprehensive world view that embraced the psychological, spiritual and ethical aspects of medicine.

In one sense Maimonides did create new knowledge, the knowledge of “the whole person,” which in the 21st century often refers to alternative, complementary or integrative medicine that seeks a unity of body, mind and spirit. Also supporting the Jewish perspective were biblical injunctions (first outlined in Leviticus) regarding hygiene, sanitation and public health. These reinforced the link between physical and moral purity. Finally, in the struggle between God and the free will of man, care of the body was left to man.

Maimonides wrote 10 medical books, the largest and most important being “The Medical Aphorisms of Moses,” which became the best known of his works in Christian Europe. Some 25 discourses provide commentary on 1500 medical aphorisms. Maimonides dares to cite Galenic errors and contradictions, setting precedents regarding the nature of evidence. His brave assault on ancient authority was heresy, but the great physician insisted on the importance of verification.

Nuland concedes that while Maimonides may not have made any new clinical breakthroughs, to challenge venerable authority was a singular development and critical to generating new medical knowledge.

Nuland is the best-selling author of “How We Die.” How fitting that he should construct a medical portrait of the great Jewish physician who taught so much about life.

“Maimonides,” by Sherwin B. Nuland (Schocken Books, 223 pages, $19.95.)

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