Hebrew Medical Ethics
and the Oath of Asaph
Sussmann Muntner, MD
Documentation is not exact, but it may be as-
sumed that Asaph the physician (Asaph Har-
ofe) lived in the Middle East in the sixth century.1-6
Several chapters of Asaph's Book of Medicine were
based upon classical Hebrew texts written several
hundred years before his time. These sources were
edited and combined by Asaph and included in one
comprehensive book to which he added several
chapters, translations, and commentaries in He-
brew.7,8 There is no indication of Arabic influence
in this text.9 The book, however, does contain ref-
erence to pagan physicians who employed modified
forms of witchcraft forbidden in the biblical litera-
ture.10 It has been determined without doubt that
the book was written in the Near East, ie, Palestine
or Babylonia." Thus it becomes evident that the
text was compiled at a period prior to the conquest
of these countries by Islam, which occurred ap-
proximately 650 AD.12 Asaph was a disciple of the
Hippocratic school and may have studied at the
ancient Alexandrian school. Several of his treatises
and opinions are similar to those of Rufus; an ex¬
ample occurs in his introduction, which includes his
opinion of the quality of water and the eastern cli¬
mate as well as the tradition of teaching—"I shall
teach thee"—and the Medicine Pauperum (Eupor-
ista).13'15 Further proof of the antiquity of the book
is evident in the ancient language used and the
fact that the book had already reached France in
the eighth century, as well as the fact that it was
propagated in the Eastern Jewish diaspora at the
time of the Gaonim.
Asaph presents moral concepts which challenge
physicians throughout the ages.15 One finds ethical
precepts throughout the book but they appear in
the most concentrated form in his Medicina Pau¬
perum, his General Foreword, in the Foreword for
the Selected Aphorisms of Hippocrates, and espe¬
cially in his Covenant With His Disciples.1*'1' One
of the concepts presented is that learning of medi¬
cine is only for the elect, those possessing lofty
qualities, who have gone through difficult tests and
have shown that they are fit to be accepted into
the academy which is composed of men who are
themselves of superior intellect and the highest
character.
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When the physician feels that he has mastered all avail¬
able knowledge, he may attempt to practice, for then only
will he be fit to exercise his calling and possess the neces¬
sary skill. Otherwise he will work blindly, and he will only
cause harm and destruction.
Not everyone who applies for entrance to the Acad¬
emy may be accepted.
He learns symptoms and acquires much information which
he does not grasp, for only the wise men endowed with the
scientific spirit and the intellect can fully comprehend all
that he needs to know and understand.
Asaph sees in medicine the perfect mixture of
science, art, and ethics.6 Only science can be learned
from books or lectures. Spiritual matters that un¬
derlie knowledge cannot be learned directly but, as
with all other arts, can be transmitted only by
means of suggestions and the use of symbols. The
wise man is silent or reveals his wisdom secretly,
and only to those he is certain can understand
him. When he speaks, he does so in metaphors and
images. He must have faith in his pupils; hence he
chooses men of wisdom and intuition, for only they
will understand him. He does not rely upon the writ¬
ten word to teach them his mysteries. Therefore we
cannot judge a man merely by the books he has
left behind. His dearest secrets remain always un¬
written, and even unspoken. The foolish and ignor¬
ant have no access to them. Even with the wise,
the knowledge is imparted only to small carefully
chosen groups, such as those to whom Rabbi Yo-
hanan ben Zakai taught the mystic speculation
about the divine chariot. Hence the ancient physi¬
cians chose their pupils by a test as difficult as
the crossing of the Red Sea.
The intelligent will understand that wisdom was only al¬
lotted to the understanding, the fools have no part of it,
it was given to the wise, to them its source was revealed.
Asaph demands that pupils understand not mere¬
ly the matter discussed but above all the spirit
and ethical import contained in the words expressed.
He understood that the spoken word alone cannot
teach. Instruction is possible only when two souls
meet each other, as when a patient who wants to
be helped meets a doctor who wants to help him.
A pupil, too, can often learn from his teacher with¬
out a word being spoken. Thus when Asaph himself
wishes to speak of abdominal pain, he reveals all
 he knows about the abdomen and intestines, which
includes what is revealed and what is not revealed
to the human eye.
Oath of Asaph
The Oath of Asaph has much similarity to the
Oath of Hippocrates, for it includes such concepts
as abstaining from the use of poisons and from ad¬
ministration of abortive remedies to pregnant wom¬
en, the use of surgery only if the physician is
qualified to do so, the avoidance of sexual contact
in the homes of patients, and the confidence of
medical information. All the other admonitions are
taken from traditional Hebrew ethics.
Asaph proposes the establishment of an order
consisting of an association of physicians of high
mental and moral caliber, thus, an academy of the
elect. The covenant adopted by Asaph and Rabbi
Yohanan ben Zavda for presentation to candidates
desiring to enter this academy represents both au¬
thentic scientific spirit and concepts of the tradi¬
tional Hebrew ethics. The text is based in part on
traditional writings composed centuries earlier.
And this is the convenant that Asaph, the son of Bere-
chyahau, and Jochanan, the son of Zabda, entered unto
with their disciples and enjoined them saying:
"Take heed that you kill not any man with a root decoc¬
tion; do not prepare any potion that may cause a woman
who has conceived in adultery to miscarry; and do not lust
after beautiful women to commit adultery with them; and
do not divulge a man's secret that he has confided unto
you; and do not be bribed to do injury and harm and do not
harden your heart against the poor and the needy; rather
have compassion upon them and heal them. Do not speak
of good as evil nor of evil as good. Do not follow in the
ways of sorcerers to enchant by magic and witchcraft to
part a man from his beloved or a woman from the husband
of her youth. Do not convet any bribe or reward to assist
in sexual misdemeanors. Do not make use of any manner
of idol-worship to heal thereby nor trust in its healing
powers but despise, detest and hate all its worshippers
and those that trust in it and cause others to believe in it
for it is all worthless and of no avail. They rely on
demons and hosts which do not exist and inasmuch as they
cannot help their lifeless bodies, how can they save the
living? And now, trust in the Lord your God, the God
of truth, the living God, for He puts to death and brings
to life. He smites and He heals. He bestows understanding
to man and teaches him to serve. He wounds in righteous¬
ness and justice and heals in mercy and loving kindness.
No guile is concealed from Him, and nothing is hidden
from His sight. He causes healing plants to grow and puts
skill to heal in the hearts of sages by His manifold mercies
to declare His wonders to the multitudes and to under¬
stand all living things for He was their creator and that
apart from Him there is no Savior. The peoples trust in
their idols that they may save them from their afflictions,
but they cannot save them from their sorrows, for their
trust and hope are in the lifeless.
"Therefore, it is fitting that you keep yourselves apart
from them and hold yourselves aloof from the abomination
of their idols and cleave unto the Lord of all flesh. Every
living creature is in His hands to kill and to bring to life
and none can be delivered from His hand.
"Be mindful of Him at all times and seek Him in truth
and righteousness all the days of your life and in all that
you do and He will help you in all your undertakings and
you shall be happy in the eyes of all men. The peoples
will neglect their gods and idols and will yearn to serve
the Lord as you do, for they will perceive that they have
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put their trust in mockery and that they have labored in
vain—when they turn to their god he will not help and
will not save. And as for you, be strong and let not your
hands slacken for you shall be rewarded for your labors.
"The Lord is with you when you are with Him and if you
keep His convenant and walk in His statutes and cleave
unto them you shall be as saints in the eyes of all flesh,
for they will say, 'Happy is the people that is in such a
state; happy is the people whose God is the Lord.' "
And their disciples answered and declared: "All that
you have admonished us and commanded us we shall do,
for it is ordained in the Torah and we will carry it out
with all our heart and soul and might: we will do and lis¬
ten and not deviate nor turn to left or right."
Thereupon, their masters blessed them in the name of
the Almighty God, the Lord of heaven and earth saying:
"Behold the Lord your God, His prophets» His Torah are
witnesses unto you; be you God-fearing, do not stray from
His commandments; walk in His statutes; do not seek after
unjust benefit and do not aid the evil-doer to shed inno¬
cent blood. Do not mix poison for any man or woman to
kill his fellow-man, nor disclose their constitution; do not
give them to any man nor give any devious advice. Do not
cause the shedding of blood by essaying any dangerous
experiment in the exercise of medical skill; do not cause
a sickness in any man; do not hasten to maim and do not
cut the flesh of man by any iron instrument or by brand¬
ing but first observe twice and thrice and then give your
counsel. Guard against haughtiness and conceit. Do not
bear a grudge against a sick man, and beware of revenge¬
ful acts. Do not set upon those that hate the Lord but keep
His ordinances and commandments, walk in all His ways
that you may find favor in His eyes, and that you may be
pure, faithful and upright."
Thus did Asaph and Jochanan admonish and adjure
their disciples.
The Oath of Asaph was translated from the Hebrew by Fred
Rosner, MD, Brooklyn, NY.18
References
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2. Simon, I.: Asaf Ha-Jehoudi, Paris: Lipschutz, 1933.
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4. Muntner, S.: Asaph the Physician, Bibliography, Qirjath
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5. Muntner, S.: The Antiquity of Asaph the Physician, Bull
Hist Med 25:101-131 (March-April) 1951.
6. Muntner, S.: Introduction to the Book of Asaph the Physi-
cian, Jerusalem: Geniza, 1957 (Hebrew)
7. Loew, J.: Aramaische Pflanzennamen, Leipzig: Verlag Wil-
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Madrid, 1947.
12. Muntner, S.: "The Book of Medicine of Asaph," in A Levin-
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13. Muntner, S.: The Antiquity of Asaph's Book on Medicine,
Harefuah 33:10-12, 1947 (Hebrew).
14. Muntner, S.: The Contents of Asaph's Book on Medicine,
Harefuah 39:2-3, 1950 (Hebrew).
15. Muntner, S.: Medical Ethics by Asaph the Physician,
Harophe Ha-ivri 1, New York, 1947 (Hebrew).
16. Muntner, S.: The Earliest Translations of Greek Medicine
in Antiquity, read before the International Congress on the His-
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17. Muntner, S.: The Language of Asaph, Leschonenu 17:218
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18. Rosner, F., and Muntner, S.: The Oath of Asaph, Ann In-
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