Elinor LIEBER (Oxford, England)

B2 9
Thi s ver y l ong He br e w wor k has never yet been publ i s hed i n full, a nd I a m
now pr e pa r i ng t he fi rst cr i t i cal edi t i on of t he t ext , f r om all t he ma nus c r i pt s ,
t oget her wi t h a t r ans l at i on a nd not es *. I n vi ew of t he ma ny di ffi cul t i es i nvol ved
i n t hi s t ask, s ome of whi ch I shal l be di scussi ng her e, any concl usi ons I shal l
pr e s e nt ar e onl y t ent at i ve, a nd I woul d wel come any c omme nt s , s ugges t i ons
or ques t i ons whi ch mi ght hel p me t o deal wi t h t he ma n y pr obl e ms whi ch st i l l
r e ma i n t o be sol ved.
Th e Book of Medi ci nes is a mi s l eadi ng na me , si nce it i mpl i es t hat t he
wor k i s si mpl y a col l ect i on of pr es cr i pt i ons . I t is i n fact an encycl opaedi a,
cover i ng al mos t ever y as pect of anci ent medi ci ne, ot he r t ha n s ur ger y and
obs t et r i cs . As s uch it t akes i t s pl ace i n t he gr eat t r adi t i on of medi cal encycl opaedi c
wor ks , i n Gr eek, Lat i n, Sans cr i t , Syr i ac, Chi nese, Ti bet an and Ar abi c, whi ch
we r e compi l ed f r om t he ver y begi nni ng of t hi s er a u p t o t he end of t he
Mi ddl e Ages, and we r e al ways ba s e d on mu c h ear l i er mat er i al .
Accor di ng t o i t s I nt r oduc t i on t he Bo o k of Medi ci nes wa s copi ed by
anci ent sages f r om t he Book of Shem, son of No a h , whi ch wa s t aken down
by Noa h af t er t he Fl ood f r om t he wor ds of t he Angel Raphael , God' s heal i ng
angel . The sages of I ndi a, Macedoni a , Egypt and Me s opot a mi a a r e par t i cul ar l y
speci fi ed, but onl y f our of t h e m ar e act ual l y n a me d : Hi ppocr at es , Asaf t he
J e w , Di oscor i des a nd Gal en. Apar t f r om Asaf, of wh o m we know not hi ng,
t hes e a r e t he gr eat es t n a me s i n Gr eek medi ci ne. If t hey have been i nt ent i onal l y
pl aced i n chr onol ogi cal or der , it woul d denot e t ha t Asaf l i ved be t we e n t he t i me
of Hi p p o c r a t e s a nd t hat of Di os c or i de s ; t ha t is, at s ome per i od bet ween
t he 5t h cent ur y B.C. and t he 1st cent ur y A.D. However , no physi ci an, J ewi s h
o r ot her wi s e, is known by t hi s na me , al t hough sever al mi n o r Bi bl i cal f i gur es
a r e cal l ed Asaf ; and i n Mus l i m l egend Asaf wa s i ndeed a sage, as t he vi zi er
of Ki ng Sol omon.
I n t he ma i n t he wor k cl ai ms t o r e pr e s e nt t he medi cal t eachi ngs of Asaf, as
t a ke n pr e s uma bl y f r om t he l egendar y Book of Medi ci nes . However , s ome of
t he sect i ons a r e pr e s e nt e d i n t he n a me of a si mi l ar l y u n k n o wn Yohanan, or
J ohn. I n bot h cases t hes e t eachi ngs a r e r e por t e d as if t hey ha d been t r ans mi t t -
ed by wor d of mout h, a nd h a d t he n been t a ke n down i n wr i t i ng by t he hear er ,
pos s i bl y a pupi l .
The act ual concept s expr es s ed i n t he wor k ar e over whel mi ngl y Gr eek, a nd
l ar gel y Hi ppoc r a t i c i n or i gi n. However , as hi nt ed i n t he I nt r oduct i on, t her e a r e
(*) I am mos t grateful to the Wel l come Trust , London, for t hei r support of t hi s work.
248
THE HEBREW BOOK OF MEDECINES
ATTRIBUTED TO SAF THE PHYSICIAN :
an early mediaeval encyclopaedia of Greek mdecine,
based on an Indian model.
t r aces of I ndi an, anci ent Egypt i an and Per s i an i nf l uence of var i ous ki nds . The
I nt r oduc t i on says not hi ng of Ar ab medi ci ne whi ch, i ndeed, pays onl y a mi n o r
r ol e i n t he wor k, a nd is mai nl y expr es s ed i n cer t ai n t echni cal t e r ms , whi ch ma y
even have been a dde d l at er . Thi s pe r ha ps account s for t ha t even mo r e unexpect ed
f i ndi ng : t he r el at i ve l ack of Gal eni c concept s .
As i n cer t ai n ot her anci en encycl opaedi as , s uch as t he Gr eek wor k of Paul
of Aegi na, or t he Ar abi c Canon of Avi cenna, i t ems obvi ousl y t a ke n f r om ot her s
a r e pr e s e nt e d wi t hout a ny r ef er ence t o t he t r ue aut hor . I n our Book, mor eover ,
s ome of t hes e bor r owe d i t e ms a r e a t t r i but e d t o Asaf or t o Yohanan. I n ei t her
case, t he t as k of i dent i fyi ng t he s our ce, whenever possi bl e, a dds gr eat l y t o t he
di ffi cul t y of edi t i ng t hi s wor k.
So f ar 18 ma nus c r i pt s cont ai ni ng gr eat er or l esser pa r t s of t he Book have
been f ound i n var i ous Eur ope a n l i br ar i es . The l ongest ext ends t o s ome 250
fol i os. Yet no ma nus c r i pt pr ovi des any scr i bal i nf or mat i on r egar di ng t he
a ut hor s hi p, pr ovenance or dat i ng of t he wor k, or even of t he ma nus c r i pt itself.
On pal aeogr aphi c evi dence, however , t he dat es of t he ma nus c r i pt s r ange f r om
t he 12th t o t he 15th or 16th cent ur i es , a nd al l ar e appar ent l y of Eur ope a n or i gi n,
mai nl y f r om I t al y. They all var y i n t he ext ent a nd or de r of t hei r s ubj ect - mat t er
a nd none pos s es s es any t abl e of cont ent s . Mor eover , unl i ke mos t ot her anci ent
encycl opaedi as, t hey l ack any f or mal bi bl i ogr aphi cal di vi si on i nt o b o o k s ,
c ha pt e r s and so on. I t is t hus al mos t i mpos s i bl e t o de t e r mi ne t he act ual ext ent
of t he wor k, even in i t s pr e s e nt f or m, l et al one i t s or i gi nal nucl eus . I t al mos t
cer t ai nl y gr ew by accr et i on over t he year s or even t he cent ur i es a nd
a ppe a r e d i n a n u mb e r of di f f er ent ver s i ons .
As far as can be j udge d f r om t he ext ant mat er i al , i n i t s mos t compl et e f or m
t he wor k begi ns wi t h t he I nt r oduct i on, whi ch offers a l egendar y hi s t or y of
medi ci ne. Thi s is f ol l owed by l ong sect i ons on t he a na t omy of t he body a nd on
t he anci ent equi val ent of physi ol ogy, whi c h i ncl udes embr yol ogy, as wel l as
wh a t was cal l ed by Gal en t he us e of t he pa r t s . The body is al so cons i der ed as
a mi c r oc os m of t he u n i v e r s e : i t s f our bas i c el ement s bei ng equat ed t o t he
c ompone nt s of t he h u mo u r a l t heor y, i n bot h heal t h and di sease. However , t hes e
t ypi cal medi aeval concept s unde r go s ome unus ua l modi f i cat i ons i n our wor k.
For exampl e, t he ai r one of t he f our s t a nda r d Gr eek el ement s is he r e
r epl aced by t he wi n d or spi r i t ; bot h of whi c h a r e expr es s ed in He br e w
by t he s a me wo r d : ruah. Mor eover , t he spi r i t is by f ar t he mos t i mp o r t a n t
el ement of t he four, and it s eems t o c or r e s pond r oughl y wi t h t he Gr eek pneuma
as unde r s t ood by t he a dhe r e nt s of t he Gr eek Pne uma t i c School , r a t he r t h a n
wi t h t he t wo or mor e t ypes of p n e u ma des cr i bed by Gal en a nd t he Ar ab
phys i ci ans .
The wor k al so cont ai ns l ong sect i ons on r egi men, i n t he wi des t sense of
t he t e r m, t hat is, on t he ma n a g e me n t of t he body i n heal t h a nd i n di f f er ent
di s e a s e s ; as wel l as nume r ous pr es cr i pt i ons and a l ong i t em on Medicine for
the Poor. The t wo ma i n ma nus c r i pt s al so i ncl ude a n ext r emel y i nt er es t i ng
medi cal oat h, s uppos ed t o have been s wor n t o Asaf a nd Yoha na n by t hei r
pupi l s : t oget her wi t h a c o mme n t a r y on t ha t oat h, pe r ha ps f r om a l at er ha nd.
Whi l e it s hows ma ny affi ni t i es wi t h t he Hi ppocr at i c Oat h, t he He b r e w oa t h
is nei t her a pa r a phr a s e nor a di r ect a da pt a t i on of t he Gr eek t ext . However ,
pa r a phr a s e d ver si ons of t he Hi ppoc r a t i c Aphorism a nd of t he Materia medica
of Di oscor i des can easi l y be i dent i f i ed. I t s eems l i kel y t ha t det ai l ed s t udy of
t he He br e w oat h, as of t hes e t wo pa r a phr a s e s , ma y shed ne w l i ght on t he i r
Gr eek equi val ent s , al t hough t hi s t a s k is ma d e di ffi cul t by t he c or r upt s t at e
of t he ext ant t ext s a nd by t he f r equent r evi si ons whi c h t hey have unde r gone .
A st i l l mo r e i nt r i gui ng as pect of t he wor k is t he pr es ence of a n u mb e r
of i t ems whi c h a r e basi cal l y Gr eek, but i ncl ude concept s whi c h I have not
249
f ound el sewher e, i n Gr eek or non- Gr eek t ext s . Two of t hes e ar e of pa r t i c ul a r
i n t e r e s t : one bei ng a gener al des cr i pt i on of t he bl ood-vessel s, whi ch s eems t o
e mbody t he concept of t he ci r cul at i on of t he b l o o d ; whi l e t he ot her pr e s e nt s
a novel expl anat i on of t he me c ha ni s m of t he pul se. They wi l l be di s cus s ed
el s ewher e i n speci al pa pe r s , but i n t he l i mi t ed t i me at my di sposal I hope t o
whet your appet i t es by bri efl y cons i der i ng t he fi rst of t hes e i t ems at l east .
The hi ghl y unus ua l na t ur e of t hi s account of t he bl ood-vessel s wa s fi rst
r ecogni sed i n 1933, her e i n Par i s , by Dr. I s i dor e Si mon. Unf or t unat el y hi s f i ndi ng
ha s si nce be e n al mos t t ot al l y i gnor ed. Dr. Si mon ma i nt a i ne d t ha t As a f
pr eceded Har vey, and al l ot her s , i n act ual l y pos t ul at i ng t he ci r cul at i on of t he
bl ood, al t hough. Dr Si mon t he n modi f i es t hi s concl usi on by cl ai mi ng t ha t Asaf
coul d not possi bl y have unde r s t ood t he si gni fi cance of hi s own s t a t e me nt s (1).
Accor di ng t o my own r eadi ng of t hi s sect i on, however , t he ci r cul at i on of
t he bl ood is not speci fi cal l y expr essed, t hough it can cer t ai nl y be i nf er r ed f r om
t he t ext . Yet it s eems t o me t ha t t o j ust i f y our a ut hor ' s pr i or i t y, it is neces s ar y
t o s ubj ect t hi s t ext t o f ar mo r e det ai l ed anal ysi s t ha n Dr. Si mon wa s abl e t o
do i n hi s account of t he Book of Medi ci nes as a whol e.
I n f act it ha s l ong been cl ai med t ha t cer t ai n Hi ppocr at i c wr i t i ngs s how
an awar enes s of t he ci r cul ar mot i on of t he bl ood, al t hough t hi s vi ew has al so
been hot l y di s put ed (2). Ther e is no doubt , mor eover , t ha t our He br e w account
of t he bl ood-vessel s s hows ma ny affi ni t i es wi t h t he des cr i pt i on f ound i n c ha pt e r s
12-18 of t he Hi ppoc r a t i c t r eat i s e known as Bones. Yet, i nt er est i ngl y enough, i t
does not r e pr oduc e t he ver y pas s age i n Bones ( chap. 11) whi ch s peaks of a
si ngl e ma i n vei n appar ent l y t aki ng a ci r cul ar r out e a r ound t he body. I n any
case, even if s ome Hi ppocr at i c wr i t i ngs s eem t o hi nt at t he ci r cul ar move me nt
of t he bl ood, t hey cer t ai nl y pr ovi de no i nt i mat i on of a ci r cul at or y system
begi nni ng a nd endi ng i n t he hear t . Yet t he cent r al i t y of t he he a r t s eems t o
have been known t o t he anci ent Egypt i ans and it wa s f i r ml y es t abl i s hed b y
Pl at o and Ar i st ot l e (3). However , t he t wo l at t er l i kened t he bl ood-vessel s t o a
cent r i f ugal s ys t em of i r r i gat i on- canal s, whi ch car r i ed t he bl ood f r om t he he a r t
t o t he per i pher y, whe r e it wa s t ot al l y abs or bed. Thi s concept of t he f unct i on
of t he vessel s wa s adopt ed by Gal en and by mos t of hi s s ucces s or s up t o t he
t i me of Har vey, al t hough t hey r ej ect ed t he i dea of t he cent r al i t y of t he he a r t ,
cl ai mi ng t ha t it pl ayed onl y a mi nor r ol e : t he l i ver bei ng t he ma i n s our ce of
di s t r i but i on of t he bl ood (4).
To est abl i sh t he concept of t he ci r cul at i on of t he bl ood, i n however t heor et i c-
al a f ashi on, t hr ee el ement s ar e r equi r ed ; all t hr ee of whi ch a r e cl ear l y pr e s e nt
i n our He br e w wor k, des pi t e t he c or r upt i on of t he ma nus c r i pt s . I n t he f i r st
pl ace our t ext speci fi cal l y s t at e t hat t he he a r t is t he di s t r i but i on poi nt of t he
bl ood whi ch goe s a r o u n d t he body. Secondl y, t he ma s s of t he bl ood i s
obvi ousl y not t hr ough t o be abs or bed at t he per i pher y, si nce i t i s sai d t o r e t u r n
f r om t he per i pher y t o t he hear t . Thi r dl y, it is cl ear l y i mpl i ed t ha t t he bl ood
r eaches t he per i pher y by one r out e a nd r e t ur ns f r om it by a n o t h e r : t hus
f ur t her i mpl yi ng mot i on i n a ci rcl e, r a t he r t ha n an ebb- and flow move me nt
of t he bl ood t o and f r om t he hear t .
As f ar as I can tell our t ext is t he fi rst t o sat i sfy all t hr ee of t hes e
cr i t er i a. Yet it pr ovi des onl y t he cr udes t anat omi cal des cr i pt i on of t he ci r cul ar
cour se, it does not di s t i ngui s h bet ween t he ar t er i es a nd vei ns, ci r cul ar cour se, i t
ent i r el y l acks any physi ol ogi cal account of t he mot i on of t he he a r t a nd i t gi ves
no hi nt of a pul mona r y ci r cul at i on. However , as r egar ds t he t heor et i cal concept of
t he ci r cul at i on of t he bl ood and in this alone i t appear s t o pr ecede not onl y
t ha t by Har vey, i n hi s r eas oned des cr i pt i on of t he ci r cul at i on of t he bl ood a r ound
t he body as a whol e, but al so i t s exposi t i on i n t he ear l i est known account of t he
250
pul mona r y c i r c ul a t i on: as gi ven by I bn an-Nafi s, t he 13th cent ur y Ar ab
phys i ci an (5).
Yet , as we shal l see, t hi s pi onner vi ew of t he ci r cul at i on is unl i kel y t o b e
t he or i gi nal cont r i but i on of our He br e w compi l er . The fact t ha t i t s t r es s es t he
cent r al i t y of t he he a r t ma y possi bl y be due t o anci ent Egypt i an i nfl uence, pe r ha ps
t r a ns mi t t e d t hr ough hel l eni st i c Al exandr i a, or el se ma y be a t t r i but e d t o Ar i st ot l e.
On t he ot her hand, si nce t he hear t - val ves ar e not me nt i one d it ma y wel l
pr ecede t he t i me of Er a s i s t r a t os . I t coul d t her ef or e be a Gr eek and possi bl y
a Gr eek- Jewi sh pr oduc t of Al exandr i an medi ci ne, f r om t he 3r d cent ur y B.C.
or ear l i er . Though possi bl y i nf l uenced by anci ent Egypt i an concept s , a nd cer t ai nl y
ba s e d on t he Hi ppocr at i c wor k Bones, or on a c o mmo n sour ce, t hi s uni que
account has so f ar onl y c ome t o l i ght i n a He br e w ver si on.
Un i t s f undament al r el i ance on Gr eek medi ci ne and i n i t s i nt er es t in a na t omy
and phys i ol ogy, our He br e w encycl opaedi a bear s s ome r es embl ance t o t he
Syr i ac a nd ear l y Ar abi c wor ks of t hi s ki nd. Yet not onl y does it l ack t he i r
pr e domi na nt l y Gal eni c out l ook, it even s hows si gns of ear l y Lat i n modi f i cat i ons
of Gr eek concept s , whi ch cannot be di scussed her e. Mor eover , it al so di ffers
f r om t he Gr aeco- Ar abi c t r adi t i on i n t he f or m of i t s pr es ent at i on, a nd even i n
mu c h of i t s s ubj ect - mat t er . I t i ncl udes i mpor t a nt sect i ons, s uch as t he i nt r oduc-
t or y h i s t o r y of medi ci ne and t he medi cal oat h, whi ch ar e not f ound i n
any anci ent medi cal encycl opaedi a ot her t ha n t he t wo ol dest I ndi a n wor ks of
t hi s ki nd. Ther e ar e di f f er ent r ecens i ons of t he s a me bas i c I ndi an ma t e r i a l f r om
t he ear l y cent ur i es B.C., or even bef or e. I n t hei r pr e s e nt f or ms , a t t r i but e d t o
Cha r a ka and Sus r ut a r espect i vel y, t hey dat e f r om t he fi rst cent ur y A.D.,
al t hough a good deal of l at er mat er i al , up t o t he 7t h cent ur y at l east , ha s si nce
been a dde d (6).
Li ke t hes e I ndi an wor ks our He br e w encycl opaedi a ha r ks back t o t he super-
na t ur a l or i gi ns of medi ci ne : in t he one case e ma na t i ng f r om God t hr ough Noah,
and i n t he ot her case f r om t he I ndi an gods . Mor eover , all t hr ee wor ks ar e
ent i r el y cas t in t he moul d of t he t eachi ngs of an anci en sage : a f or m qui t e,
unl i ke t ha t of any Gr aeco- Ar abi c encycl opaedi a. One is t hus f or ced t o t he
concl usi on t ha t whi l e t he cont ent s of our wor k ar e essent i al l y Gr eek, as f ar
as i t s s t r uc t ur e is concer ned t he compi l er l ooked t o t he I ndi an encycl opaedi as .
Si nce our wor k di ffers i n so ma ny ways f r om ot her encycl opaedi as ba s e d
on Gr eek concept s , it is not s ur pr i s i ng t ha t t her e have been ma ny conf l i ct i ng
i deas r egar di ng i t s aut hor s hi p, pr ove na nc e a nd dat i ng. Well over a cent ur y ago
t he gr eat Mor i t z St ei ns chnei der (7) and ot her s ma i nt a i ne d t ha t it wa s a pseud-
epi gr aphi cal wor k, compi l ed a r ound t he 10th cent ur y A.D., a nd possi bl y bas ed
on. Syr i a t r ans l at i ons of anci ent Gr eek mat er i al . Al t hough it cl ai med t o r epr es ent
t he t eachi ngs of a Jewi sh sage cal l ed Asaf, s uch a per s on was mer el y a pr ot ot ype
a nd ha d i n fact never exi st ed. However , ever si nce 1916, whe n Venet i aner pr oduc-
ed t he f i r st compr ehens i ve s t udy of t he wor k as a whol e, t he pr evai l i ng vi ew
ha s been t ha t it basi cal l y r e pr e s e nt s t he t eachi ngs of a J ewi s h physi ci an n a me d
Asaf, who l i ved i n Pal est i ne or Me s opot a mi a at s ome t i me bet ween t he 3r d and
5t h cent ur i es A.D., al t hough t he wor k wa s l at er r evi sed and new mat er i al
wa s a dde d (8).
My own opi ni on coi nci des wi t h t he ol der vi ew, t hat t he wo r k is a pseudepi -
gr aphi cal compi l at i on f r om t he ear l y Mi ddl e Ages, whi ch t hen cont i nued t o gr ow
by accr et i on. However , I a m as yet unabl e t o offer a compr ehens i ve t heor y of
when, whe r e a nd how it evol ved, a nd due t o l ack of t i me I can onl y t h r o w out
a few suggest i ons on t hes e poi nt s . Some of t he Gr eek mat er i al ma y have or i gi nat ed
i n Al exandr i a or i n t he Syr i an or Per s i an cent r es of Gr eek l ear ni ng, whe r e t he
anci ent Egypt i an, Syr i an, Per s i an a nd fi nal l y Ar abi c i nf l uences wer e acqui r ed,
bef or e t he t ext s, i ndi vi dual l y or as a col l ect i on, f ound t hei r way t o Eur ope.
251
Fr o m i t s l anguage, whi c h a ppe a r s t o be a l at e f or m of Bi bl i cal - Mi shnai c He br e w,
and f r om ot her cons i der at i ons , s ome or mos t of t he i t ems ma y wel l have be e n
t r a ns l a t e d i nt o He br e w i n Sout he r n Eur ope , possi bl y i n Byzant i ne Sout he r n
I t al y, at s ome t i me be t we e n t he 8t h and 10th cent ur i es . He r e t oo t he wo r k
acqui r ed i t s Gr aeco- Lat i n i nf l uences a nd i t s encycl opaedi c f or m. The s t r ong
I ndi a n bi as i n i t s pr e s e nt a t i on al so pr oba bl y c a me t o Eur ope vi a We s t e r n Asi a,
si nce t he t wo ma i n I ndi a n encycl opaedi as has been t r a ns l a t e d i nt o Per s i an and
Ar abi c bef or e t he 10th cent ur y.
The ear l y medi aeval per i od s aw a r evi val of i nt er es t i n anci ent J ewi s h
cul t ur e, whi c h ma y t o s ome ext ent account , for t he ps eudepi gr aphi cal pr e s e nt a t i on
of t hi s wor k. I t s anci ent Gr eek p a g a n bas i s coul d t he n b e successf ul l y
camouf l aged by t he a dopt i on of t he I ndi a n mo d e l ; al bei t i n a J uda i s e d f or m
whe r e by medi ci ne wa s gi ven t o t he wor l d by t he J ewi s h dei t y a nd t he wo r k
as a whol e wa s a t t r i but e d t o a n anci ent J ewi s h s a g e , whos e pupi l s we r e
ma d e t o s wear a J udai s ed oat h.
REFERENCES
1. I. Si mon, Asaph Ha Iehoudi. Mdecin et Astrologue du Moyen-Age, Pari s, Li pshut z, 1933, p. 50.
2. See C. R. S. Harri s, The heart and the vascular system in ancient Greek medicine, Oxford,
Cl arendon Press, 1973, chapt er 2.
3. Pl at o, Timaios 11 c-d ; Ari stotl e, Parts of animals 668a, 10.
4. P. de Lacey ed. , Galen on the doctrines of Hippocrates and Plato, Berl i n, Akademi e Verl ag,
1978, Book VI passim.
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