This article originally appeared in the Jewish Free Press, Calgary

Prescriptions or Prayers *

Among the monarchs who reigned over our people in biblical times, Hezekiah king of Judah stood out as one of the most virtuous. To the scriptural accounts of his righteous exploits the rabbis of the Talmud added their own traditions about royal edicts that met with their approval (as well as a few that they found objectionable).

One of the items that figures in the Talmud's list of Hezekiah's praiseworthy decrees was that "he suppressed a book [or, according to the Jerusalem Talmud: a tablet] of remedies, and this earned him their [the rabbis'] approval."

They deduced this detail from the wording of the prayer in which Hezekiah implored the Almighty to grant him a reprieve from an illness even after the prophet Isaiah had assured him that he would never recover. The king had asked the Almighty to give consideration to the fact that "I have done what is good in your sight." Not content with this vague allusion to good deeds, Rabbi Levi identified it with a specific achievement, that of suppressing the book of remedies.

Most of the early commentators interpreted this obscure statement in accordance with standard values of Jewish piety. Thus, Rashi explained that Hezekiah wanted people who were afflicted with illnesses to rely on contrite prayer rather than on medical treatments. Rabbi Ḥananel of Kairowan spelled out the king's motives more explicitly: "It was because people were placing their trust in that book instead of seeking divine compassion for the patient." This approach finds confirmation in the Talmud's juxtaposition of this episode to another of Hezekiah's edicts, one that was recounted in the Bible: He shattered the brazen serpent that had been fashioned by Aaron to contain the plague of vipers and which had evidently been preserved until his time as an object of magical adoration.

This interpretation dovetails nicely with a tradition that credited the authorship of the Book of Remedies to the wise king Solomon, and claimed that its pages contained foolproof cures to all the ailments that might plague the human organism. We may well appreciate Hezekiah's concern that, if health could be restored immediately and effortlessly by following the instructions in a medical tome, then people might well lose sight of their ultimate dependence on divine mercies.

Some authors went so far as to assert that the illnesses that befall Jews should never be ascribed to natural causes. Rabbi Moses Naḥmanides believed that God himself assumes the responsibility for removing sickness from our bodies, and that Israel has no need for conventional medical therapies. For this reason, in biblical times those who were afflicted by illnesses--which invariably beset them as on account of their sins--turned to prophets, not to physicians, for relief.

Not all Jewish thinkers were at ease with this tradition or with the values that underlie it. In his commentary to the Mishnah, Rabbi Dr. Moses Maimonides, himself a renowned physician and author of numerous medical monographs, inserted a lengthy excursus in which he analyzed the rabbinic tradition about Hezekiah.

At the root of Maimonides' discussion was his unshakable conviction that there can be no religious justification for depriving a patient of an effective medical treatment.

Why, then, did the sages of the Talmud praise Hezekiah for suppressing the Book of Remedies? Maimonides' initial suggestion is that the volume in question was not a work of true medical science, but merely a digest of popular medical quackery based on superstitious nonsense, and as such it was not approved by the Torah. Its remedies were probably akin to talismans that allegedly have the power of channelling astral energies to perform tasks like the curing of diseases.

As a scientist, Maimonides was evidently troubled by the thought that our ancestors could ever have tolerated such superstitious nonsense in the first place, in violation of the Torah's strict admonitions against idolatrous practices. Perhaps (as suggested by Rabbi Solomon Ibn Adret) he was also wondering why such a book was merely "suppressed" and not destroyed altogether. The best explanation he could come up with was that the book's author had intended it purely for educational or anthropological reading, but not to be applied to actual medical treatment. However, later generations were not so sophisticated in their medical understanding and began to take the book seriously, impelling King Hezekiah to order its removal.

As an alternative hypothesis, Maimonides speculated that perhaps the book, though based on legitimate science, had contained a chapter that described antidotes for various poisons; and this chapter had in turn contained details about the poisons they were supposed to counteract. When aspiring assassins caught on to the fact that they could use the book as a manual for the mixing of lethal poisons, Hezekiah decided to take it out of circulation.

At this point in his commentary, Dr. Maimonides turned his attention to the problem that was really eating at him. After presenting the tradition about how Hezekiah supposedly suppressed the Book of Remedies in order to encourage people to turn to God in prayer, he launched into a vigorous tirade about how foolish and ill-conceived that interpretation was, and how it was downright silly to ascribe such misguided ravings to a leader of Hezekiah's moral stature!

For Maimonides it was utterly inconceivable that any intelligent and decent human being would deprive patients of effective medical treatment in order to provoke them to spiritual contrition. If we were to accept such thinking, we would similarly deny bread and water to the hungry in order to impel them to pray for divine compassion.

In the Guide of the Perplexed Maimonides observed that the talmudic sages had gone so far as to permit the administering of treatments that smacked of magic and could not be explained scientifically, provided that they had been shown to be medically effective in the past. At any rate, he noted, a person who is healed by a medical procedure is no less likely to offer thanks to God for that benefit than are hungry people who are moved to bless God in gratitude for their bread.

In spite of Maimonides' advocacy of unimpeded access to medical information, other rabbis remained sympathetic to the moralistic considerations that had been voiced by Rashi and his coterie. Several writers found fault with Maimonides' analogy between food and medical treatment. Rabbi Jacob Ibn Ḥabib argued that a natural condition like hunger is in an altogether different category from an illness that is an exceptional occurrence. Rabbi Jacob Emden wrote that the sure-fire cures in the Book of Remedies posed an especially serious challenge to pious faith, and should not be compared to the more limited effectiveness of scientific medical procedures.

Maimonides' position was subjected to a particularly scathing attack by Rabbi Abraham Karelitz, the Ḥazon Ish, who adduced a number of talmudic passages in order to demonstrate that Jewish tradition does not put any faith in the power of physicians to cure illnesses without divine assistance. Rabbis Emden, Karelitz and others were convinced that all illnesses should be interpreted as divine chastisements that are being inflicted in order to inspire people to repentance and prayer.

I personally would not pass judgment on the benefits or deficiencies of the Book of Remedies without having read it. While Hezekiah's edict makes that an unlikely proposition, there is still a possibility that copies might show up for sale on eBay or on late-night infomercials. At this very moment, operators might be standing by to process your purchase.

This article and many others are now included in the book

On the Trails of Tradition
On the Trails of Tradition

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  • First Publication:
    • The Jewish Free Press, Calgary, June 10, 2011, p. 11.
  • For further reading:
    • Freudenthal, Gad. 2005. Maimonides' Philosophy of Science. In The Cambridge Companion to Maimonides, 134-166. Cambridge Companions. Cambridge: Cambridge University Press.
    • Ginzberg, Louis. 2003. Legends of the Jews. Ed. Paul Radin. Trans. Henrietta Szold. 2nd ed. Philadelphia: Jewish Publication Society.
    • Jakobovits, Immanuel. 1959. Jewish Medical Ethics: A Comparative and Historical Study of the Jewish Religious Attitude to Medicine and Its Practice. New York: Philosophical Library.
    • Lewin, B. 1928. Otzar ha-Gaonim. Vol. 1. Haifa.
    • Preuss, Julius. 1993. Biblical and Talmudic Medicine. Trans. Fred Rosner. Northvale, NJ: J. Aronson.
    • Rosner, Fred. 1995. Medicine in the Bible and the Talmud: Selections from Classical Jewish Sources. Augm. ed. The Library of Jewish Law and Ethics v. 5. Hoboken, NJ: KTAV.
    • Schwartz, Dov. 2004. Studies on Astral Magic in Medieval Jewish Thought. Trans. David Louvish and Batya Stein. The Brill Reference Library of Judaism v. 20. Leiden: Brill-Styx.
    • Strousma, Sarah. 2001. 'Ravings': Maimonides' Concept of Pseudo-Science (critical essay). Aleph: Historical Studies in Science & Judaism 1: 141.
    • Zimmels, H.J. 1997. Magicians, Theologians and Doctors: Studies in Folk Medicine and Folklore as Reflected in the Rabbinical Responsa. Northvale, NJ: Jason Aronson.