Maimonides’ Medical Writings

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An Arab poet sang in praise of Maimonides’ art of healing:

Galen’s heart heals only the body,

but Abu-Amram’s (Maimonides’) the body and soul.

Mosad HaRav Kook recently reprinted Dr. Suessmann Muntner’s scholarly edition of Maimonides medical works, which it first published in 1957-1969. The edition comprises seven of Maimonides’ medical works in Hebrew translations. Guide to Good Health was written by Maimonides at the request of Sultan Al-Afdal, a son of Saladin, who sought his medical aid and advice. The treatise– perhaps the best of its kind composed in the Middle Ages – was, like all other medical works of Maimonides, originally written in Arabic. It was translated into Hebrew and Latin and taught in universities.

The first edition of the Latin translation appeared in Florence in 1477, about thirty years after the invention of printing. In his English introduction to this work, Dr. Muntner states: “The treatise shows us Maimonides not only as a scholar and physician but also as a healer of the mind, comforting and encouraging all those who turned to him for help. It is a mark of his greatness that while treating his sovereign with all the honor and respect due to him and expressing his fervent prayers and hope for his speedy recovery, he does not hesitate to condemn in an indirect manner, his incontinence, gluttony and lust. Physical and mental well-being are inter-dependent, teaches Maimonides. A healthy person is cheerful and content, whereas a sick one is always depressed and dissatisfied. Complete recovery can therefore be furthered by deepening the sick man’s moral conviction, through the perusal of the moral exhortations of the prophets and philosophers, and by leading him to regulate his life in accordance with them…”

The Medical Aphorisms of Moses. According to Dr. Muntner, Maimonides lectured on occasions to the medical staff of the Naziri Hospital in Cairo, which had been founded by Sultan Saladin. This work as well as his Summary of Galenus and Commentary on the Aphorism of Abukrat (Hippocrates), he wrote for his own use  as textbooks for his lectures. In this work, Maimonides assembled and at times commented upon medical rules, which he selected from the writings of Galen and later physicians.

The book consists of twenty-five treatises, the last of which contains a critic of Galen, whose views were law in the Middle Ages. It is in this treatise that Maimonides demands research through experiment, condemning the uncritical acceptance of views, even though held by the most famous scholars and shared by the majority of savants. Dr. Muntner remarks that Maimonides wrote this fifty years before Roger Bacon,who is generally regarded as the first to have heralded the advent of crticial science. Maimonides’ book was twice translated into Hebrew in the 13th century.

Mosad HaRav Kook also published Dr. Muntner’s editions of Maimonides Commentary on the Aphorisms of Abukrat, On Hemorrhoids, On the Increase of Physical Vigour, On Ashthma,  Lexicography of Drugs  and Medical Responses. The latter treatise too was written for Sultan Al-Afdal who asked Maimonides for his medical help and opinion. Maimonides’ remaining medical works include a treatise On Poisons and their Antidotes, Dr. Muntner published a medieval Hebrew translation of this treatise with his own commentary back in 1942. He probably prepared a new edition for Mossad Harav Kook, but could not see it through print, because of his death in 1973.

Dr. Muntner was born in Kolomea, Eastern Galicia in 1897 and studied medicine in Germany. He was an active Zionist and a founder of he World Maccabi Union. One one occasion, having learned that anti-Semites were planning to attack Einstein, he and other Jewish students “abducted” the great physicist from his Berlin home and brought him to a safe place.

Muntner practiced as a physician in Berlin until 1933, when he settled in Jerusalem. He devoted all his free time to the study and resarch of the literary heritage of medieval Jewish physicians, particularly of the medical writings of Maimonides. He traveled widely in search of manuscripts and called upon Jewish personalities to help publish the great sage’s medical works. he was convinced that the famous religious philosopher, commentator and legislator was also a towering figure in the art of healing, many of whose views are still valid today, and that only by studying his writings would be able to fully appreciate his greatness.

People ask whether Maimonides’ books on medicine still have value for us today. Muntner writes in the English preface to the Guide to Good Health.

“Of course his prescriptions have become obsolete and have no value in the  light of the more efficient treatments of our time; but his ideas about preventive medicine, public hygiene, approach to the suffering patient, and the preservations of the health of the soul have not become obsolete, especially as they come from the pen of a religious legislator, such as Maimonides.

“To this very day we do not properly appreciate the value of preventive as compared with curative medicine. Rational methods of nutrition and hygiene have lowered the death rate of the newborn from about fifty to five percent…

“What Maimonides teaches us is public and private hygiene, the preservation of the health of body and soul. He emphasizes preventative medicine and mental hygiene as factors of fundamental importance in the preservation of individual and public health…

“What Maimonides demands in the handling of a patient is not a partial, but a total treatment; not a treatment of the body or part of the body, but of body and soul as a whole; not the treatment of the illness, but the treatment of the patient.

“All of the psyycho-somatic discoveries of our days are nothing but rediscoveries with more sounding names. The fact that bodily ailments or pathological phenomena are deeply influenced by spiritual and mental processes, which sometimes are their only causes, was well known to all great doctors from Hippocrates to Charcot. But none of these doctors stressed or investigated the relations between psyche and soma as Maimonides did. And this 800 years ago….”

(To be continued)

The Jewish Press, July 10, 1987 p. 8

When working at Mossad Harav Kook in Jerusalem I had the privilege of assisting the late Dr. S. Muntner in the final preparations for the printing of his Hebrew edition of Maimonides’ Guide to Good Health. In the last years of his life, Dr. Muntner was able to publish various medical treatises of Maimonides, not only in Hebrew, but also in English, French and German. During one of his visits to New York, I accompanied him to the home of Dr. Murray Peshkin, a famous allergist, who was to write an introduction to Muntner’s English edition of Maimonides’ treatise On Asthma.

Dr. Peshkin, who died seven years ago, at the age of eighty-eight, was a president of both the American College of Allergists and the American Association for the Study of Allergy and was founder and president of the Asthma Care Association of America. According to the obit. in the New York Times- which was kindly brought to my attention by my good friend Prof. J.I. Dienstag- Peshkin was the author of more than one hundred papers on allergy and asthma. He was responsible for a breakthrough in the treatment of childhood and juvenile asthma, known as “parentectomy.”

The term defined a treatment for children with “untractable asthma” wrote the N.Y. Times that involved the temporary separation of the child from the parental home and the establishment of another “warm emotional climate” with new mother and father figures. In his conversation with Dr. Muntner, Dr. Peshkin spoke with reverence of Maimonides and his treatise on Asthma. Muntner’s English edition of this treatise was published by J.B. Lippincott in 1963. The volume features a preface by Dr. Bela Schick, the famous pediatrician and discoverer of the Schick test for diptheria as well as aan introduction byy Dr. Peshkin. Dr. Schick and Dr. Peshkin were intimate friends. As director of Mount Sinai Hospital’s pediatric department,  Dr. Schick had sponsored Dr. Peshkin’s research in childhood asthma at the hospital’s clinic.

We can quote here only several sentences from Schichk’s enthusiastic preface which he wrote a few years before his death- at the venerable age of 90- in 1967:

“When I heard of the existence of the medical writings of Maimonides, I became curious and looked forward to the time when I, as a physician, would be able to read the ideas that Maimonides held concerning asthma and other medical problems. The reading of the manuscript was an exciting and rewarding experience. I was impressed by he depth of Maimonides’ knowledge of the disease, by the clarity of the discussions of its cause and of the influence of the environment, as well as the general health of the individual, upon the  disease.”

After mentioning some of Maimonides’ observations, and recommendations for the treatment of the disease, Dr. Schick concludes:
“It is a great pleasure and a privilege and most enlightening to read this distinguished physician’s discussions contained in his manuscript on asthma. It is fascinating for a physician of the 20th century to realize what a vast knowledge this medical genius had acquired 800 years ago. Maimonides most certainly must elicit our greatest admiration and respect for his comprehensive medical observations and phenomenal philosophical works.”

Dr. Peshkin’s introduction is written with the same enthusiasm as Dr. Schick’s preface:

“In spite of spectacular modern advances made in the theoretical and practical aspects of allergies, the studies of the asthmatic state, written in the 12th century by Maimonides still merit our attention.”

Dr. Peshkin compares the treatment of asthma patients today to that suggested by Maimonides stressing what he calls Maimonides’ prophetic statement that the success of relieving the patient  from asthma depends largely on an intimate knowledge of the total patient.”

After reading this book, we cannot escape from the feeling that we have relearned many things besides affording us a better and clearer perspective of the meaning of medicine to the great physicians of 800 or more years ago.”

The book also contains an article, “Maimonides the Physician” by Dr.Morris Fishbein, who was for many years the editor of the Journal of the American Medical Association.

In 1966 Dr. Muntner published an English edition of Maimonides’ treatise on Poisons and their Antidotes. This was followed by the publication together with Dr. Fred Rosner, of English editions of Maimonides’ On Hemorrhoids, Medical Responses (English title: Maimonides Answers to Queries) and the Medical Aphorisms of Moses (Maimonides). Since the death of Mr. Muntner, Dr. Rosner has continued on his own to prepare scholarly editions of Maimonides medical writings in English translation. his publications in this field include a new English translation of the treatise On Poisons and their Antidotes, based on Muntner’s Hebrew edition of the work.

(Conclusion next week)

The Jewish Press, Friday July 17, 1987 p. 9

Maimonides’ treatise On Poison and their Antidotes was written at the request of Vizier Al-Fadhil who wanted the public to be informed how to administer immediate aid to persons bitten by poisonous animals.

Maimonides states in the preface that he would fully describe the preparations and the dosages of the antidotes “making superfluous the relevant services of a physician.” He also relates that the vizier imported into Egypt, at his, Maimonides’ suggestion, ingredients of antidotes, which were not available in the country.

The treatise was very popular in medical circles in the Middle Ages and was taught at universities.

Dr. Muntner, in the introduction to his English edition, stresses that it is of value even today:

“Maimonides modestly says that his treatise does not contain anything new… Nevertheless, the treatise is full of original experiments and views, even new and important discoveries, some of which have only recently been rediscovered.

“Maimonides teachings concerning victims of bites and the treatment they require: his description of the great theriac, his knowledge of mad dogs, of truffles and other poisonous mushrooms, his accurate account of the treatment of those whose digestive system has already been burnt by the poison, and how to deal with bites and stings, whether by cautery, cutting, sucking, nursing the wound, vomitives antidotes, a suitable diet, keeping the patient awake, sedatives applied to the affected spot or taken internally – all hold good to this very day. Equally remarkable are the accuracy of the proportions of the ingredients contained in the recipes, the composition of the doses, and their use according to the age of the patient.”

Mossad Harav Kook’s new edition of Maimonides medical writings in Hebrew translation carries a short appreciation of the late Dr. Muntner’s personality.

“Something about Dr. Muntner,” written by Eliyahu Reichmann of the Tangiers-Toronto Reichmann brothers, graces the first volume.

Reichmann relates that when he first visited Israel- towards the end of 1948 – his late father gave him along one thousand dollars as Shliach Mitzvah money.

In Jerusalem he paid a visit to the late Rabbi Akiva Schreiber, the Rav of Pressburg. The latter told him that in Me’ah Sh’arim resided many old people who were in need of medical treatment but couldn’t afford it. When Reichmann left the rabbi’s apartment, he met in the corridor Dr. Muntner, who was living in the same building. The Pressburger Rebbetzin introduced the two men to each other. Dr. Muntner invited Reichmann into his apartment. As he was talking with his host about the situation of many old people in Me’ah She’arim of which he had just learned from the Rav of Pressburg, an idea occurred to Reichmann how to use the money his father had given him along.

‘how much do you charge for a visit?” he asked Dr. Muntner.

“Two dollars,” the physician replied.

“Doctor, give me a wholesale price,” Riechmann said. “I will leave with you one thousand dollars You will treat all the persons who come to you from Me’ah She’arim, not charging anything to those who cannot pay. On my next visit to Israel, you will tell me how much I owe you.”

Dr. Muntner agreed to the proposition and accepted the money.

Reichmann visited Israel again in the summer of 1949. He went to the physician to settle the account.

Dr. Munter opened his drawer, took from it the envelope with money, which he had received from Reichmann, and returned it to the latter.

“What, you didn’t treat the people of Me’ah Sh’earim,” a surprised Reichmann exclaimed.

“I did,”Dr. Munter replied. “But you don’t owe me anything! I am returning to you the money you have deposited with me, and I want you to know that I am in debt to you. Through you I have encountered more than one hundred angels in Jerusalem.”

Reichmann was amazed. “Dr. Munter, you are a rational human being, how can you talk of having met angels?”

“I am a physician and I know what are the minimal needs of man,” Dr. Muntner said.”Thanks to you I have now more than one hundred patients who do not eat, drink or sleep. For this reason, I regard them as angels. It is through you that I have made their acquaintance!”

***

Reichmann and Muntner became good friends. Later when Reichmann learned that Muntner was engaged in the study of the history of medicine and was particularly interested in the medical writings of Maimonides, he invited him to Tangier and traveled with him through Spain, searching for old manuscripts in libraries and museums.

Reichmann concludes his short essay as follows:

“Many friends of mine have been asking me to obtain for them the medical writings of Maimonides published by Dr. Muntner. They have vanished from the bookshops and are difficult to come by. When I met Dr. Yitzchak Raphael- head of Mossad HaRav Kook and spoke with him about Dr. Muntner, he told me that his books are much sought after, but are not available. I gladly offered to help in the publication of a new edition.”

The Jewish Press, Friday, July 24, 1987 p.22