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The life of one of the great Jewish physicians, who has come to be known

in history as Maimonides, is of such significance in medical biography

that he deserves to have a separate sketch. Born in Spain, his life was

lived in the East, where his connection as royal physician with the

great Sultan Saladin of Crusades fame made his influence widely felt. He

is a type of the broadly educated man, conversant with the culture of
/> his time and of the past, knowing much besides medicine, who has so

often impressed himself deeply on medical practice. While the narrow

specialists in each generation, the men who are quite sure that they are

curing the special ills of men to which they devote themselves, have

always felt that whatever of progress there was in any given time was

due to them, they occupy but little space as a rule in the history of

medicine. The men who loom large were the broad-minded, humanely

sympathetic, deeply educated physicians, who treated men and their ills

rather than their ills without due consideration of the individual, and

who not only relieved the discomfort of their patients and greatly

lessened human suffering, and added to the sum of human happiness in

their time, but also left precious deeply significant lessons for

succeeding generations of their profession. Hippocrates, Galen,

Sydenham, Auenbrugger, Morgagni, these are representatives of this great

class, and Maimonides must be considered one of them.

Moses Ben Maimum, whose Arabic name was Abu Amran Musa Ben Maimum Obaid

Alla el-Cordovi, who was called by his Jewish compatriots Ramban or

Rambam, was born at Cordova in Spain, on the 30th of March in 1135 or

1139, the year is in doubt. It might not seem of much import now after

nearly eight centuries, but not a little ink is spilt over it yet by

devoted biographers.

We are rather prone to think in our time that the conditions in which

men were born and reared before what we are pleased to call modern

times, and, above all, in the Middle Ages, must have made a distinct

handicap for their intellectual development. Most of us are quite sure

that the conditions in medieval cities were eminently unsuited for the

stimulation of the intellect, for incentive to art impulse, for uplift

in the intellectual life, or for any such broad interest in what has

been so well called the humanities--the humanizing things that lift us

above animal necessities--as would make for genuinely liberal education.

We are likely to be set in the opinion that the environment of the

growing youth of an old-time city, especially so early as the middle of

the twelfth century, was poor and sordid. The cares of the citizens are

presumed to have been mainly for material concerns, and, indeed, mostly

for the wants of the body. They were only making a start on the way from

barbarism to something like our glorious culmination of civilization. As

the heirs to all the ages in the foremost files of time we are

necessarily far in advance of them, and we are only sorry that they did

not have the opportunity to live to see our day and enjoy the benefits

of the evolution of humanity that is taking place during the eight

centuries that have elapsed.

As a matter of fact, there was much more of abiding profound interest in

real civilization in many a medieval city, much more general

appreciation of art, much more breadth of intelligence and sympathy with

what we call the humanities, than in most of our large cities. The large

city, as we know it, is eminently a discourager of breadth of

intelligence. Specialism in the various phases of money-making obscures

culture. Maimonides, born in Cordova, was brought up amid surroundings

that teemed with incentives of every kind to the development of

intelligence, of artistic taste, and everything that makes for

cultivation of intellect rather than of interest in merely material


It is well said that it is hard to judge the Cordova of old by its

tawdry ruins of to-day. The educated visitor still stands in awe and

admiration of the great mosque which expressed the high cultivation of

the Moors of this time. It is a never-ending source of wonder to

Americans. The city itself has many reminders of that fine era of

Moorish culture and refinement of taste and of art expression, which

made it in the best sense of the word a city beautiful. The Arab

invaders had found a great prosperous country which had been the most

cultured province of the Roman Empire, and on this foundation they made

a marvellous development. The banks of the Guadalquivir, says Mr. S.

Lane-Poole in The Moors in Spain (London, 1887), were bright with

marble houses, mosques, and gardens, in which the rarest flowers and

trees of other countries were carefully cultivated, and the Arabs

introduced their system of irrigation which the Spaniards both before

and since have never equalled. The greatest beauty of the city, of

course, had come, and some of it had gone, before Maimonides' time. So

much remains in spite of time and war, and many unfortunate influences,

that we can have some idea how beautiful it must have been in his youth

seven centuries ago, and how even more beautiful in the foretime. Of the

great mosque writers of travel can scarcely say enough. Mr. Lane-Poole

says: Travellers stand amazed among the forest of columns which open

out apparently endless vistas on all sides. The porphyry, jasper, and

marbles are still in their places; the splendid glass mosaics, which

artists from Byzantium came to make, still sparkle like jewels in the

walls; the daring architecture of the sanctuary, with its fantastic

crossed arches, is still as imposing as ever; the courtyard is still

leafy with the orange trees that prolong the vistas of columns. As one

stands before the loveliness of the great mosque, the thought goes back

to the days of the glories of Cordova, the palmy days of the Great

Khalif, which will never return.

Of all the countries in which the Jews all down the centuries have lived

there is probably none of which they have been more loud in praise than

Spain. Their poets sang of it as if it were their own country; for

centuries the people were happier here than probably they have been

anywhere else for so long a period. Elsewhere in this book I have called

attention to all that Spain meant in Europe during all the centuries

from the beginning of the Roman Empire down to the end of the Middle

Ages. Maimonides was fortunate in his birthplace, then, and while

circumstances compelled the family to move away, this change did not

come until a good effect had been produced on the mind of the growing

youth. Even when persecution came, Maimonides clung to Spain with a

tenacity born of deep affection and emphasized by admiration for all

that she was and had been. Cordova was the jewel of the Spain of this

time, and though much less than she had been in the long preceding time,

when she was the birthplace of Lucan and the two Senecas, or even than

what she had been in Abd-er-Rahman's days, or when she was the

birthplace of Averroes, still she remained wonderfully beautiful and

attractive, winning and holding the affections of men.

Maimonides' father, Maimum Ben Joseph, was a member of the Rabbinical

College of Cordova, and famous for his knowledge of the Talmud. There

are some writings of his on mathematics and astronomy extant. He

directed the education of his son, who, like many another distinguished

scholar in later life, seems to have exhibited very little talent in his

early years. There is no rule in the matter. Precocity often

disappoints. Genius is often dull in childhood, but there are exceptions

that prove both rules. The basis of education in Spain at that time

among the Jews was the Bible, the Talmud, mathematics, and astronomy, a

good rounded education in literature, the basis of law, and some exact

physical science. After his preliminary education at home Maimonides

studied the natural sciences and medicine with Moorish teachers.

Nature-study, in spite of frequent expressions that declare it new in

modern times, is as old as man. He also received a grounding in

philosophy as a preparation for his scientific studies. At the age of

twenty-three he began the composition of a commentary on the Talmud,

which he continued to work at on his journeys in Spain and in Egypt.

This is considered to be one of the most important of this class of

works extant, though, almost needless to say, similar writings are very


In the light of wanderings in philosophy during the centuries since, it

is rather interesting to quote from that work the end of man as this

Jewish philosopher of the middle of the twelfth century saw it. Recent

teleological tendencies in biology add to the interest of his views.

According to Maimonides, Man is the end of the whole creation, and we

have only to look to him for the reason for its existence. Every object

shows the end for which it was created. The palm-trees are there to

provide dates; the spider to spin her webs. All the properties of an

animal or a plant are directed so as to enable it to reach its purpose

in life. What is the purpose of man? It cannot lie alone in eating and

drinking or yielding to passion, nor in the building of cities and the

ruling of others, since these objects lie outside of him, and do not

touch his essential being. Such material striving he has in common with

the animal. A man is lifted from a lower to a higher condition by his

reason. Only through his reason is he placed above the animals. He is

the only reasonable animal. His reason enables him to understand all

things, especially the Unity of God, and all knowledge and science serve

only to direct man to the knowledge of God. Passions are to be subdued,

since the man who yields to passion subjects his spirit to his body, and

does not reveal in himself the divine power which in him lies in his

reason, but is swallowed up in the ocean of matter.

Not long after Maimonides passed his twentieth year the family,

consisting of the father and his two sons, Moses and David, and a

daughter, moved from Cordova to Fez, compelled by Jewish persecutions.

Here it is said that they had to submit to wearing the mask of Islam in

order to lead a peaceful existence. This has been doubted, however, and

his whole life is in flagrant contradiction with any such even apparent

apostasy from the faith of his fathers. Father and son took advantage of

the opportunity of intercourse with Moorish physicians and philosophers

to increase their store of knowledge, but could not be content in the

political and religious conditions in which they were compelled to live.

About 1155, then, they went to Jerusalem, but found conditions even more

intolerable there, and turned back to Egypt, where they settled down in

Old Cairo. In 1166 the father died, and after this we learn that the

sons made a livelihood, and even laid the foundation of a fortune, by

carrying on a jewelry trade. Moses still devoted most of his time to

study, while his brother did most of the business, but the brother was

lost in the Indian Ocean, and with him went not only a large sum of his

own money, but also much that had been entrusted to him by others.

Maimonides undertook to pay off these debts and at the same time had to

meet the necessities not only of himself and sister, but also of the

family of his dead brother. It was then that he took up the practice of

medicine and succeeded in making a great name and reputation for

himself. He continued to write, however, and completed his commentary on

the Talmud.

About the age of fifty Maimonides, as seems to be true of a good many

men who live to old age, became rather discouraged and despondent about

himself. He refers to himself in his letters and writings rather

frequently as an old and ailing man. He had nearly twenty years of

active life ahead of him, but he had the persuasion that comes to many

that he was probably destined to an early death. His son was born

shortly after this time, and that seems to have had not a little to do

with brightening his life. While in Egypt Maimonides married the sister

of one of the royal secretaries, who, in turn, wedded Maimonides'

sister. Maimonides took on himself the education of his son, who also

became a physician, though his father was not to have the satisfaction

of watching his success in the practice of his chosen profession. This

son, Abraham, became the physician of Malie Alkamen, the brother of

Saladin, and, besides, was a physician to the hospital at Cairo. His

son, David, the grandson of Maimonides, practised medicine also at Cairo

till 1300. He in turn left two sons, Abraham and Solomon, who achieved

reputation in the chosen profession of their great-grandfather.

Maimonides, after the birth of his son, became one of the busiest of

practising physicians. Indeed, it is hard to understand how he had the

time to do any writing in his busy life. Still less can we understand

his time for teaching. He was the physician to Saladin, whose relations

with Richard Coeur de Lion have made him known to English-speaking

people. Every morning, as the Court physician, Maimonides went to the

palace, situated half a mile away from his dwelling, and if any of the

many officials and dependents that then, as now, were at Oriental

courts, were ill, he stayed there for some time. As a rule he could only

get back to his own home in the afternoon, and then he was, as he says

himself, almost dying with hunger. Knowing the scantiness of the

Oriental breakfast, we are not surprised. There he found his

waiting-room full of patients, Jews and Mohammedans, prominent and

unimportant, friends and enemies, he says himself, a varied crowd, who

are looking for my medical advice. There is scarcely time for me to get

down from my carriage and wash myself and eat a little, and then until

night I am constantly occupied, so that, from sheer exhaustion, I must

lie down. Only on the Sabbath day have I the time to occupy myself with

my own people and my studies, and so the day is away from me. What a

picture it is of the busy medical teacher at all times in the world's

history, yet it must not be forgotten that it is from these busy men

that we have derived our most precious lessons in caring for patients

rather than disease, in the art of medicine rather than medical

science--and their practical lessons have been valuable long after the

fine-spun theories of the scientist that took so long to elaborate have

been placed definitely in the lumber room.

His reputation as a writer on medical topics is not as great as that

which has been accorded him for his writings on philosophy and in

Talmudic literature, but he well deserves a place among the great

practical masters of medicine, as well as high rank among the physicians

of his time. There is little that is original in his writing, but his

thoroughgoing common sense, his wide knowledge, and his discriminating,

eclectic faculty make his writings of special value. As might have been

expected, the Aphorisms of Hippocrates attracted his attention, and,

besides, he wrote a series of aphorisms of his own. The most interesting

of his writings, however, is a series of letters on dietetics written

for the son of his patron Saladin. The young prince seems to have

suffered from one of the neurotic conditions that so often develop in

those who have their lives all planned for them, and little incentive to

do things for themselves. The main portion of his complaints centred, as

in the case of many another individual of leisure, in disturbances of

digestion. Besides, he suffered from constipation and feelings of

depression. Doubtless, like many a young person of the modern time, he

was quite sure that these symptoms portended some insidious organic

ailment that would surely bring an early death. When fathers, having

done all that there is to do, just expect their sons to enjoy the

fruits of the paternal accomplishments, conditions of this kind very

often develop, unless the young man proceeds to occupy himself with even

more dangerous distractions than he finds in unending thought about his

own feelings.

The rules of life and health that Maimonides laid down in these letters

have become part of our popular medical tradition. Probably more of the

ordinarily current maxims as to health have been derived from them than

would possibly be suspected by anyone not familiar with them. In various

forms his rules have been published a number of times. A good idea of

them can be obtained from the following compendium of them, which I

abbreviate from a biographical sketch of Maimonides by Dr. Oppler, which

appeared in the Deutsches Archiv fuer Geschichte der Medizin und

Medicinische Geographie (Bd. 2, Leipzig, 1879).

1. Man is bound to lead a life pleasing to God if he wants to

have a healthy body, and he must hold himself far from

everything that can hurt his health and accustom himself to

whatever renews his strength. He should eat and drink only

when hungry and thirsty and should be particularly careful of

the regular evacuation of his bowels and of his bladder. He

must not delay either of these operations, but as far as

possible satisfy the inclination at once.

2. A man must not overload his stomach but be content always

with something less than is necessary to make him feel quite

satisfied. He should not drink much during the meal and only

of water and wine mixed, taking somewhat more after digestion

has begun and after digestion is completed, in moderation

according to his needs. Before a man sits down to table he

should note whether he has any tendency to evacuation and

should make the body warm by movement and activity. After this

exercise he should rest a little before taking food. It is

very beneficial after work to take a bath and then the meal.

3. Food should be taken always in the sitting position. There

should be no riding nor walking, nor movements of the body

until digestion is finished. The man who takes a walk or any

strenuous occupation immediately after eating subjects himself

to serious dangers of disease.

4. Day and night should be divided into twenty-four hours. Men

should sleep for eight hours, and so arrange their sleep that

the end of it comes with the dawn, so that from the beginning

of sleep until sunrise there should be an eight-hour interval.

We should all leave our beds about the time that the sun


5. During sleep a man should lie neither on his face nor on

his back but on his side, the beginning of the night on his

left and at the end on his right. He should not go to sleep

for three or four hours after eating and should not sleep

during the day.

6. Fruits that are laxative, as grapes, figs, melons, gourds,

should be taken only before meal time and not mixed with other

food. It would be better to let these get into the abdominal

organs and then take other food.

7. Eat what is easily digestible before what is difficult of

digestion. The flesh of birds before beef and the flesh of

calves before that of cows and steers. (Birds were then

thought more digestible than other flesh; we have reversed the

ruling. The note shows how light and digestible their flesh

was considered and the reason therefor.)

8. In summer eat cooling food, acids, and no spices. In

winter, on the contrary, eat warming foods, rich in spices,

mustard, and other heating substances. In cold and warm

climates one should eat according to the climatic conditions.

9. There are certain harmful foods that should be avoided.

Large salt fish, old cheese, old pickled meat, young new wine,

evil-smelling and bitter foods are often poisonous. There are

also some which are less harmful, but are not to be

recommended as ordinary nutritive materials. Large fish,

cheese, milk more than twenty-four hours after milking, the

flesh of old oxen, beans, peas, unleavened bread, sauerkraut,

onions, radishes and the like. These are to be taken only in

small quantities and only in the winter time and they should

be avoided in the summer. Beans and lentils are to be

recommended neither in winter nor summer.

10. As a rule one should avoid the eating of tree fruits, or

not eat much of them, especially when they are dry and even

less when they are green. If they are unripe they may cause

serious damage. Johannesbrod is very harmful at all times, as

are also all the sour fruits, and only small amounts of them

should be eaten in summer or in warm countries.

11. The fruits that are to be recommended dry as well as

fresh, are figs, grapes, and almonds. These may be eaten as

one has the appetite for them, but one should not accustom

himself to eat them much, though they are healthier than all

other fruits.

12. Honey and wine are not good for children, though they are

beneficial for older people, especially in winter. In summer

one-third less of them should be eaten than in winter.

13. Special care should be taken to have regular movements of

the bowels that carry off the impurities of the body. It is an

axiom in medicine, that so long as evacuations are absent, or

difficult, or require strong efforts, the individual is liable

to serious disease. Every medical means should be taken to

overcome constipation in order to escape its dangers. For

this purpose young people should be given salty food,

materials that have been soaked in olive oil, salt itself, or

certain vegetable soups with olive oil and salt. Older people

should take honey mixed with warm water early in the morning

and four hours later should take their breakfast. This

proceeding should be followed up from one to four days until

the constipation is overcome.

14. Another axiom of medicine is that so long as a man is able

to be active and vigorous, does not eat until he is over-full,

and does not suffer from constipation, he is not liable to

disease. Even such men, however, are much safer if they do not

take food that may disagree with them.

15. Whoever gives himself up to inactivity, or puts off

evacuations of the bowels, or suffers from constipation, will

be sure to suffer from many diseases and will see his strength

disappear even should he eat the best food in the world and

make use of all the remedies that physicians have. Immoderate

eating is a poison for men and the cause of many diseases

which attack them. Most diseases come from either eating too

much or partaking of unsuitable food. That was what Solomon

meant with his proverb: He who puts a guard over his mouth

and his tongue protects himself from many evils, that is to

say, whoever protects his mouth from the overindulgence in

food and his tongue from unsuitable speech protects himself

from many evils.

16. Every week at least a man should take a warm bath. One

should not bathe when hungry, nor after eating until the food

is digested, and bathe the whole body in warm but not too hot

water and the head in hot water. Afterwards the body should be

washed in lukewarm and cool water until finally cold water is

used. One should pour neither cold nor even lukewarm water on

the head, nor bathe in cold water in the winter time, nor when

the body is tired and in perspiration. At such times the bath

should be put off for a while.

17. As soon as one leaves the bath one should cover oneself,

and especially cover the head, so that no draught may strike

it. Even in summer, care must be taken to observe this rule.

After this one should rest for a while until the heat of the

body passes off and then should go to table. If one could

sleep a little just before a meal it is often very beneficial.

Neither during the bath nor immediately after it should cold

water be drunk, and if there is an inappeasable thirst a

little wine and water or water and honey should be taken. In

winter it is beneficial to rub the body with oil after the


18. Venesection should not be practised frequently, for it is

only meant for serious illness. It should not be permitted in

winter or summer, nor during the months of April or September

(the r months). After passing his fiftieth year an

individual should abstain from venesection. Venesection should

not be practised on the day when one takes a bath or goes on a

journey or returns from it. On the day when it is practised

less than usual should be eaten and drunk, and the patient

should give himself to rest, undertake no work nor bothersome

occupation, and take no walk.

19. Whoever observes these rules of life faithfully I

guarantee him a long life without disease. He shall reach a

good old age, and when he comes to die will not need a

physician. His body will remain always strong and healthy,

unless of course he has been born with a weak nature, or has

had an unfortunate bringing up, or should be attacked by

epidemic disease or by famine.

20. Only the healthy should keep these rules. Whoever is ill

or a sufferer from any injuries, or has lost his health

through bad habits, for him there are special rules for each

disease, only to be found in the medical books. Let it be

remembered that every change in a life habit is the beginning

of an ailment.

21. If no physician can be secured, then ailing people may use

these rules as well as the healthy.

These rules are, of course, full of the common sense of medicine that

endures at all times. For the tropical climate of the Eastern countries

they probably represent as good advice as could be given even at the

present time. With them before us it is not surprising to find that on

other subjects Maimonides was just as sensible. Perhaps in nothing is

this more striking than in his complete rejection of astrology.

Considering how long astrology, in the sense of the doctrine of the

stars influencing human health and destinies, had dominated men's minds,

and how universal was the acceptance of it, Maimonides' strong

expressions show how much genius lifts itself above the popular

persuasions of its time, even among the educated, and how much it

anticipates subsequent knowledge.

It is well to remind ourselves that as late as the middle of the

eighteenth century Mesmer's thesis on The Influence of the Stars on

Human Constitutions was accepted by the faculty of the University of

Vienna as a satisfactory evidence not only of his knowledge of medicine,

but of his power to reason about it. At the end of the twelfth century

Maimonides was trying to argue it out of existence on the best possible

grounds. Know, my masters, he writes, that no man should believe

anything that is not attested by one of these three sanctions:--rational

proof as in mathematical science, the perception of the senses, or

traditions from the prophets and learned men. His biographer in the

monograph Maimonides, published by the Jewish Publication Society of

America[5], expresses his further views on the subject in compendious

form, and then gives his final conclusion as follows:

'Works on astrology are the product of fools, who mistook

vanity for wisdom. Men are inclined to believe whatever is

written in a book, especially if the book be ancient; and in

olden times disaster befell Israel because men devoted

themselves to such idolatry instead of practising the arts of

martial defence and government.' He says, that he had himself

studied every extant astrological treatise, and had convinced

himself that none deserved to be called scientific. Maimonides

then proceeds to distinguish between astrology and astronomy,

in the latter of which lies true and necessary wisdom. He

ridicules the supposition that the fate of man could be

dependent on the constellations, and urges that such a theory

robs life of purpose, and makes man a slave of destiny. 'It is

true,' he concludes, 'that you may find strange utterances in

the Rabbinical literature which imply a belief in the potency

of the stars at a man's nativity, but no one is justified in

surrendering his own rational opinions because this or that

sage erred, or because an allegorical remark is expressed

literally. A man must never cast his own judgment behind him;

the eyes are set in front, not in the back.'

While Maimonides could be so positive in his opinions with regard to a

subject on which he felt competent to say something, he was extremely

modest with regard to many of the great problems of medicine. He often

uses the expression in his writings, I do not see how to explain this

matter. He quotes with approval from a Rabbi of old who had counselled

his students, teach thy tongue to say, I do not know. In this, of

course, he has given the best possible evidence of his largeness of mind

and his capacity for making advance in knowledge. It is when men are

ready to say, I do not know, that progress becomes possible. It is

very easy to rest in a conscious or unconscious pretence of knowledge

that obscures the real question at issue. A great thinker, who lived in

the century in which Maimonides died, Roger Bacon, set down as one of

the four principal obstacles to advance in knowledge indeed, as the

one of the four that hampered intellectual progress the most, the fact

that men feared to say, I do not know.

One of the most interesting features of Maimonides' career for the

modern time is the influence that his writings exerted over the rising

intellectual life of Europe within a half century after his death. Most

people would be rather inclined to think that this Jewish author of the

East would have very little influence over the thinkers and teachers of

Europe within a generation after his death. He died in 1204, just at the

beginning of one of the great productive centuries of humanity, perhaps

one of the greatest of them all. In literature, in art, in architecture,

in philosophy, and in education, this century made wonderful strides.

Two of its greatest teachers, Albertus Magnus and his pupil, Thomas

Aquinas, quote from Moses AEgyptaeus, the European name for Maimonides at

that time, and evidently knew his writings very well. Maimonides was for

them an important connecting link with the world of old Greek thought.

Others of the writers and teachers of this time, as William of Auvergne,

and the two great Franciscans, Alexander of Hales and Duns Scotus, were

also influenced by Maimonides. In a word, the educational world of that

time was much more closely united than we might think, and it did not

take long for a great writer's thoughts to make themselves felt several

thousand miles away. Maimonides was, then, in his own time one of the

world teachers, and, in a certain sense, he must always remain that, as

representing a special development of what is best in human nature.