Wednesday, December 5, 2012

Shiur Theatre: Maimonides and Galen, Act Three

Here is the third of the three acts; for Act One please click here, for Act Two please click here. I have also appended the source sheet at the end - and video of another Shiur Theatre presentation, "When Konstantinos Met Sarah", is now on-line at Koshertube here.

ACT III – Nutrition

NARRATOR: After a short pursuit, President Goldschmiedt catches up with Galen, but is unable to convince him to return to the interview. She returns to the office for a follow-up conversation with Maimonides, regarding his dietary prescriptions.

President and Maimonides return and sit down.

P: Well, that was certainly interesting. They did warn me that he was excitable.

M: Yes, an unfortunate side effect of the trait which also produced his brilliance; he never did get that under control. Does that mean the job is mine?

P: I do have a few questions for you. I am Jewish, and I have studied your medical and Jewish writings. Can you take a few minutes to explain your philosophy on diet?

M: Certainly. The primary goal of dietetic advice is to improve digestion;[1] one should stay far from constipating foods,[2] and eat foods that will pass through the system rather than rot inside the person.[3] One should never overeat, even with therapeutic foods.[4] This is based on experiments, which lead me to suggest that foods that taste good tend to be better digested, soft and moist food are most easily digested, and fattier foods are harder for the stomach to break down and lead to obesity.[5]

P: And what of nutrition?

M: All food has some nutritious element; the question is whether it will be digested well, and whether that particular nutritious character will be good or bad for someone who is ill. Foods with strong tastes are less nutritious, but sweet foods are good. Hard foods are nutritious, but digestion takes a while.[6]

P: You might want to look up a fellow named William Fletcher, before you come to work here.

M: Fletcher? Okay; I believe in receiving truth from whoever offers it.[7] I also believe that one must eat foods which will neutralize the moisture-dryness balance in the body, and which will keep the temperature moderate. In particular, one should avoid fresh fruits and vegetables.[8]

P: Avoid fruits and vegetables? And I suppose chicken soup is bad as well?

M: Oh, no! Chicken soup is excellent as food and medicine!

P: Well, that's a relief.

M: Yes, I got that from the Arabic texts of Ibn Zohr and Al Tamimi.

P: (astounded) Great – chicken soup is from the Arabs. What next? Is any of your medicine Jewish?

M: Certainly. The Sages of the Talmud were very concerned about washroom facilities, and so they wanted little to do with vegetables, particularly leafy ones, or bran.[9] They avoided foods with very strong tastes unless they were specifically medicinal, both because they considered the foods harmful and because water might be harmful and so they did not want us to be excessively thirsty.[10]

P: I see; very interesting. (closes folder) Well, it looks to me as though you will do nicely for our position, although you will need to do substantial reading in order to catch up on today's medicine.

M: That's no problem; I understand there is a Yeshiva University Torah miTzion Beit Midrash in your city; I'll feel right at home there.

(rise and walk off)

[1] Medical Aphorisms 20:1
[2] Hilchos Deios 4:13
[3] Medical Aphorisms 23:109
[4] ibid 20:12
[5] Ibid. 20:5-6, 62-63
[6] Ibid. 20:1, 11, 58-66
[7] Introduction to Shmonah Perakim
[8] Medical Aphorisms 20:46-47, 51; Hilchos Deios 4:11
[9] Pesachim 42b, Shabbos 81a, Eruvin 55b-56a
[10] Eruvin 29b, 56a

Act One: Getting Acquainted
1.         Rambam, Mishneh Torah, Hilchot Deiot 2:5
סייג לחכמה שתיקה, לפיכך לא ימהר להשיב ולא ירבה לדבר, וילמד לתלמידים בשובה ונחת בלא צעקה ובלא אריכות לשון, הוא שאמר שלמה דברי חכמים בנחת נשמעים
Silence bounds wisdom. Therefore, one should not rush to respond or speak much, and one should teach students calmly and gently, without yelling and without verbosity. As Sh'lomo said, "The gentle words of sages are heard."

2.         The Medical Aphorisms of Moses Maimonides 17:4
One should not neglect physical exercise for the body, as do people of learning who diligently study the entire day and night. Rather, it is proper that the body and all limbs be moderately active, and that each limb perform its movement, so that all organs, both external and internal, receive benefit therefrom.

3.         The Medical Aphorisms of Moses Maimonides 18:2
The most beneficial of all types of exercise is physical gymnastics to the point that the soul becomes influenced and rejoices, such as hunting and ball-playing, because emotions of happiness often suffice to heal just by their presence. Thus, rejoicing and happiness alone will make many people’s illnesses milder. For others, both the illness on the one hand, as well as the emotional upset that led to it, disappear.

4.         Rambam, Commentary to Mishnah Nedarim 4:4
חייב הרופא מן הדין לרפאות חולי ישראל והרי הוא בכלל אמרם בפירוש הכתוב והשבתו לו לרבות את גופו שאם ראהו אובד ויכול להצילו הרי זה מצילו בגופו או בממונו או בידיעתו
The doctor is obligated to heal Jewish patients; it is included in the explanation of the text, "'You shall return it to him' – including his body." One who sees another lost, and who could save him, does so with body, money or knowledge.

5.         Rambam, Mishneh Torah, Hilchot Yesodei haTorah 4:13
אין ראוי לטייל בפרדס אלא מי שנתמלא כריסו לחם ובשר, ולחם ובשר הוא לידע האסור והמותר וכיוצא בהם משאר המצות
One should not tour pardes unless his belly is filled with bread and meat, which means knowledge of prohibited and permitted things, and similar elements of other mitzvot.

6.         Rambam, Mishneh Torah, Hilchot Deiot 5:7
תלמיד חכם לא יהא צועק וצווח בשעת דבורו כבהמות וחיות, ולא יגביה קולו ביותר אלא דבורו בנחת עם כל הבריות...
A scholar may not shout or scream when speaking, like a beast, and he may not raise his voice, but he must speak gently with all others…

7.         Rambam, Introduction to the Guide of the Perplexed (Friedlander translation)
אני האיש אשר כשיציקהו הענין ויצר לו הדרך ולא ימצא תחבולה ללמד האמת שבא עליו מופת אלא בשיאות לאחד מעולה ולא יאות לעשרת אלפים סכלים, אני בוחר לאמרו לעצמו, ולא ארגיש בגנות העם הרב ההוא, וארצה להציל המעולה האחד ההוא ממה שנשקע בו ואורה מבוכתו עד שישלם וירפא:
When I have a difficult subject before me-when I find the road narrow, and can see no other way of teaching a well established truth except by pleasing one intelligent man and displeasing ten thousand fools-I prefer to address myself to the one man, and to take no notice whatever of the condemnation of the multitude; I prefer to extricate that intelligent man from his embarrassment and show him the cause of his perplexity, so that he may attain perfection and be at peace.

Act Two: Approach to Practicing Medicine
8.         Rambam, On Asthma, page 41
One should never say, "This disease is similar to that other one."… Nor should one say, "I have seen how my elders have treated this condition in such or such way."

9.         Rambam, Mishneh Torah, Hilchot Deiot 4:4
היום והלילה כ"ד שעות, די לו לאדם לישן שלישן שהוא שמונה שעות
Day and night are twenty-four hours; it is sufficient to sleep for one-third of those, eight hours.
10.      Letter of Rambam
I would not return to Fostat until the afternoon. Then I was almost dying with hunger, but I would find the antechambers filled with people, both Jews and non-Jews, nobles and common people, judges and policemen, friends and foes – a mixed multitude, awaiting the time of my return. I would dismount from my animal, wash my hands, go forth to my patients and entreat them to bear with me while I partook of some slight refreshment, the only meal I would take in the 24 hours. Then I would go forth to attend to my patients, and write prescriptions and directions for their various ailments. Patients would go in and out until nightfall, and sometimes even, I solemnly assure you, until two hours or more in the night. I would converse with and prescribe for them while lying down from sheer fatigue; and when night fell I was so exhausted that I could scarcely speak.

11.      Rambam, Commentary to Mishnah Chagigah 2:1
ושמע ממני אני מה שנתברר לי לפי דעתי ממה שעיינתי בו מדברי חכמים, והוא, שהם מכנים במעשה בראשית למדעי הטבע והמחקר בראשית הבריאה.
Listen to me: It has been made clear to me, in my opinion, from my analysis of the words of sages, that they name "the deeds of Bereishit" the science of nature and investigation into the original creation.

12.      Rambam, Mishneh Torah, Hilchot Yesodei haTorah 4:12
בזמן שאדם מתבונן בדברים האלו... מוסיף אהבה למקום ותצמא נפשו ויכמה בשרו לאהוב המקום ברוך הוא
In examining these things… he will increase love of Gd and his soul will hunger and his flesh will long to love Gd…

13.      Rambam, Sh'monah Perakim, Chapter 7
כי כל נביא לא יתנבא אלא אחר שייקנו לו המעלות השכליות כולן
For no prophet will prophesy until all of the intellectual levels are his.

14.      Rambam, Sh'monah Perakim, Chapter 5
ועל זה ההיקש יהיה למלאכת הרפואה מבוא גדול מאד במעלות, ובידיעת ד', ובהשיג ההצלחה האמיתית, ויהיו לימודה ודרישתה עבודה מן העבודות הגדולות, ולא תהיה אז כאריגה וכנגרות
Based on this logic, medical practice is of great entrée in attributes, in knowledge of Gd, and in achieving true success. Learning it and seeking it are among the greatest forms of worship, unlike weaving or carpentry.

15.      Rambam, Mishneh Torah, Hilchot Deiot 4:1
אי אפשר שיבין או ידע דבר מידיעת הבורא והוא חולה,
One cannot know or understand anything of Gd when he is ill…

16.      Rambam, On Asthma, pg. 95
Do not assume that I am the one into whose hands you should deliver your soul and body for treatment. May the Lord be my witness that I know for certain about myself that I too am among those who are deficient in this art, [who] stand in awe of it, and who find it difficult to achieve its goal.

17.      The Medical Aphorisms of Moses Maimonides 25:59
There is one disease which is so common that I think that no one can escape it, except a rare individual, even during long periods of time. This disease can be of greater or lesser severity, like other physical and spiritual illnesses. The illness to which I refer consists of the fact that every individual person considers himself more perfect than he really is, and desires and lusts that all that enters his mind should possess perfection, without effort and fatigue.

Act Three: Nutrition
18.      Rambam, Sh'monah Perakim, Introduction
ושמע האמת ממי שאמרה
And listen to truth from the one who says it.

19.      Rambam, Mishneh Torah, Hilchot Deiot 4:11
לעולם ימנע אדם עצמו מפירות האילנות, ולא ירבה מהן ואפילו יבשין ואין צריך לומר רטובים...
One must always avoid tree fruit and not increase of them, even when they are dry, much less when they are moist.

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