Maimonides - Medical Advice for Modern Men
One of History's Greatest Medical Teachers and Health Educators
Dec 23, 2008
Known variously as Moshe ben Maimon in Hebrew, Musa ibn Maymun in Arabic, Moses the son of Maimon in English or simply as Rambam (an acronym for Rabbi Moshe ben Maimon), Maimonides was a Jewish physician and philospher whose ideas had a profound influence on both the Jewish and the non-Jewish world.
Early years
Born in the early part of the 12th century in the Spanish city of Cordoba when the city was under the rule of the Muslim Almoravid dynasty, he was still in his teens when the region was conquered by the more austere Almohad dynasty from North Africa. His family fled that city; moving through Andalucia he went on to Fez in Morocco (where it was thought he acquired his medical education) and finally settled down in Egypt.
Best know by his Greek name Maimonides, he was the preeminent Jewish philospher of medieval times. Educated as a philosopher and teacher as well as a physician, he practised medicine in Cairo, where he gained a reputation for his outstanding clinical skills. In the course of time he was appointed physician to the Royal Court of Egypt’s ruler, Saladin.
Rabbi and Physician
Well known in Jewish circles for his works of Jewish scholarship and Rabbinic Law, it is less well known that he was fluent in both Arabic and Hebrew - and a practising physician whose advice holds good even for the 21st century. Despite a very busy clinical practice, Maimonides continued to educate himself about a variety of topics, both medical and non-medical, and wrote ten works covering several subjects (including a treatise on asthma). Probably the best known of these was a collection of essays entitled Regimen sanitatis (The preservation of youth) which was published in 1200.
Regimen sanitatis is actually a medical report written for Maimonides' distinguished patient Al Malik Al Afdal, the eldest son of Saladin. The prince sought Maimonides’ opinion about his illness – and in his text the physician not only dealt with the patient’s immediate problems, but also conscientiously covered the broader areas of prevention and health promotion. Reading this collection of essays reminds one that there is little new under the sun!
Since the young man’s symptoms were related to the intestinal tract, Maimonides advised his patient about his diet. His 800 year old aphorisms ring true even today “Avoid excessive eating” he said “consume a third less than would result in satiety and distension of the stomach”. Other advice was to avoid fatty meats and to use rough-grained rather than polished wheat. He emphasised the importance of fresh air, sunshine and good quality food.
He attached importance to selection of foods and eating habits, recommending a reasonable weight and advising the obese to “lose the fat of his flesh through appropriate dieting.” He believed that bodily exercise,especially that which involved movement, played a pivotal role in maintaining health.
Recognising the interaction between mind and body, he stated that “emotional experiences cause marked changes in the body which are clear and visible to all.” When adverse emotional states persist, a person is more prone to falling ill. Talking about treatment, he advocated a cheerful ambience, with attendants especially recruited who can “make the heart swell”. Music, humour and listening to cheerful stories were recommended to distract a patient from his suffering . Maimonides stated “cheerful stories exert a positive effect on mind and body, not only through distraction but also through laughter.”
Although Maimonides drew on the older teachings of Hippocrates and Galen, he elaborated a philosophy that placed explicit emphasis on not only the biological but also the psychological and social factors in health and ill health.
One key feature of his teachings was respecting patient autonomy. “Medicine” he clearly stated “recommends what is beneficial and warns against what is harmful. It does not compel this…but leaves the matter to the sick in the form of consultation. It is they who have the choice.”
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