Sefer Refuot (Book of Remedies), by the author known as Asaph, is a work of mystery. It is the oldest known medical work written in Hebrew, but the date and place where it was written are unknown. In spite of these fascinating questions (or perhaps because of them), it has never been translated in its entirety into any contemporary language and is little studied. This discussion of Asaph’s book relies heavily on an article written in 1992 by Dr. Stephen Newmyer, professor of Classics at Duquesne University. Dr. Newmyer’s article is the most recent publication on the topic that I could find in a JSTOR search. Dr. Newmyer, in turn, draws from all other authorities on the subject, including: Seussman Muntner (1951); Elinor Lieber (1984); Harry Friedenwald (1944); Fred Rosner (1977); and others; as well as his own examination of one of the original manuscripts, that held by the Bavarian National Library in Munich. Citation: “Asaph’s ‘Book of Remedies’: Greek Science and Jewish Apologetics,” Sudhoffs Archiv, Band 76, Heft 1 (1992).
Image courtesy the National Library of Israel.
Asaph chose to write in biblical Hebrew, eschewing the Aramaic scientific vocabulary which the sages of the Talmud developed for their many discussions of medical matters. Instead, he coined his own Hebrew medical vocabulary, often made up of compound words, and clarified them by including Latin or Greek terms written in Hebrew transliteration. He was familiar with Dioscorides, the 1st century Greek physician whose encyclopedia of botanical medicines was the standard reference on the subject for 1500 years. He understood health and disease as a function of the balance—or imbalance–between the four “humors,” a Greek idea described by Hippocrates (5th century BCE) and enlarged upon by Galen (3rd century CE). He does not, however, indicate any knowledge of Arabic medicine, a fact used to date his writing to before the rise of Islam in the 7th century.
Frustratingly, Asaph’s use of biblical Hebrew obscures his origins. However, it may reveal the author’s unique approach. Newmyer suggests that Asaf deliberately chose Hebrew because that language was suited to Asaf’s intention to instruct his medical students—and a wide audience of Jewish readers for whom biblical Hebrew would have been a lingua franca in the widespread diaspora of late antiquity—in the Jewish morality underpinning medical practice. This intent can be seen in the Physician’s Oath placed as a conclusion to the book. Most historians remark on the similarities of the oath to that of Hippocrates, finding evidence of the Greek model upon Asaph’s book is based. For Newmyer, the ways in which the oath deviates from the Greek model are more revealing. Asaph’s “characteristic manner of reworking the Greek medical sources … has the effect of transforming Greek science into a uniquely Jewish amalgam.” For example, Asaph restates the role of God in sickness and healing, as described in the Torah: “For I am the Lord that heals you,” (Exodus 15:26) and “I put to death and I keep alive; I wound and I heal” (Deuteronomy 32:39).
The Hippocratic Oath begins by invoking the Greek deities of medicine, who are asked to witness the intent of the physician. It then lists the ethical practices expected of the physician, and states, as well, what he should not do. Asaph lists many of the same dos and don’ts, but differs markedly from the Greek model by weaving references to the guiding the hand of God throughout the oath. Asaph also enjoins the Jewish physician to treat any patient, regardless of their means to pay a fee: “Do not harden your heart [and turn it away] from pitying the poor and healing the needy” (Asaph 7)–something not mentioned at all by Hippocrates.
Newmyer points out that the Hippocratic Oath is a kind of contract between the student and his teacher: “I will reverence my master who taught me the art… I will allow him things necessary for his support, and will consider his sons as brothers.” In contrast, Asaph’s oath is a kind of covenant of the medical community, sealed by Asaph’s students as they recite “We will do all that you exhorted and ordered us [to do], For it is a commandment of the Torah, And we must do it with all our heart, with all our soul and with all our might, To do and to obey Not to swerve or turn aside to the right hand or the left” (39-43).
Translation of Asaph’s Oath by Shlomo Pines:
[1] This is the pact which Asaph ben Berakhyahu and Yohanan ben Zabda made with their pupils, and they adjured them with the following words:
[2] Do not attempt to kill any soul by means of a potion of herbs, [3] Do not make a woman [who is] pregnant [as a result of] of whoring take a drink with a view to causing abortion, [4] Do not covet beauty of form in women with a view to fornicating with them, [5] Do not divulge the secret of a man who has trusted you, [6] Do not take any reward [which may be offered in order to induce you] to destroy and to ruin, [7] Do not harden your heart [and turn it away] from pitying the poor and healing the needy, [8] Do not say of [what is] good; it is bad, nor of [what is] bad: it is good, [9] Do not adopt the ways of the sorcerers using [as they do] charms, augury and sorcery in order to separate a man from the wife of his bosom or a woman from the companion of her youth, [10] You shall not covet any wealth or reward [which may be offered in order to induce you] to help in a lustful desire, [11] You shall not seek help in any idolatrous [worship] so as to heal through [a recourse to idols], and you shall not heal with anything [pertaining] to their worship, [12] But on the contrary detest and abhor and hate all those who worship them, put their trust in them, and give assurance [referring] to them, [13] For they are all naught, useless, for they are nothing, demons, spirits of the dead; they cannot help their own corpses, how then could they help those who live?
[14] Now [then] put your trust in the Lord, your God, [who is] a true God, a living God, [15] For [it is] He who kills and makes alive, who wounds and heals, [16] Who teaches men knowledge and also to profit, [17] Who wounds with justice and righteousness, and who heals with pity and compassion, [18] No designs of [His] sagacity are beyond His [power] [19] And nothing is hidden from His eyes.
[20] Who causes curative plants to grow, [21] Who puts sagacity into the hearts of the wise in order that they should heal through the abundance of His loving-kindness, and that they should recount wonders in the congregation of many; so that every living [being] knows that He made him and that there is no savior [other] than He. [22] For the nations trust in their idols, who [are supposed] to save them from their distress and will not deliver them from their misfortunes [23] For their trust and hope is in the dead. [24] For this [reason] it is fitting to keep yourselves separate from them; to remove yourselves and keep far away from all the abominations of their idols, [25] And to cleave to the name of the Lord God of spirits for all flesh, [26] And the soul of every living being is in His hand to kill and to make live, [27] And there is none that can deliver out of His hand.
[28] Remember Him always and seek Him in truth, in righteousness in an upright way, in order that you should prosper in all your works [29] And He will give you help to make you prosper in [what you are doing], and you shall be [said to be] happy in the mouth of all flesh. [30] And the nations will abandon their idols and images and will desire to worship God like you, [31] For they will know that their trust is in vain and their endeavor fruitless, [32] For they implore a god, who will not do good [to them], who will not save [them].
[33] As for you, be strong, do not let your hands be weak, for your work shall be rewarded, [34] The Lord is with you, while you are with Him, [35] If you keep His pact, follow His commandments, cleaving to them, [36] You will be regarded as His saints in the eyes of all flesh, and they will say: [37] Happy the people whose [lot] is such, happy the people whose God is the Lord.
[38] Their pupils answered saying: [39] We will do all that you exhorted and ordered us [to do], [40] For it is a commandment of the Torah, [41] And we must do it with all our heart, with all our soul and with all our might, To do and to obey [43] Not to swerve or turn aside to the right hand or the left [44]. And they [Asaph and Yohanan] blessed them in the name of God most high, maker of heaven and earth.
[45]And they continued to charge them, and said: [46] The Lord God, His saints and His Torah [bear] witness, that you should fear Him, that you should not turn aside from His commandments, and that you should follow His laws with an upright heart, [47] You shall not incline after lucre [so as] to help a godless [man in shedding] innocent blood. You shall not mix a deadly drug for any man or woman so that he [or she] should kill their fellow-man, [49] You shall not speak of the herbs [out of which such drugs are made]. You shall not hand them over to any man, [50] And you shall not talk about any matter [connected] with this, [51] you shall not use blood in any work of medicine, [52] You shall not attempt to provoke an ailment in a human soul through [the use of] iron instruments or searing with fire before making an examination two or three times; then [only] should you give your advice.* [53] You shall not be ruled – your eyes and your heart being lifted up – by a haughty spirit. [54] Do not keep [in your hearts] the vindictiveness of hatred with regard to a sick man, [55] You shall not change your words in anything, [56] The Lord our God hates [?] [this?] being done, [57] But keep His orders and commandments, and follow all His ways, in order to please Him, [and] to be pure, true and upright.
[58] Thus did Asaph and Yohanan exhort and adjure their pupils.
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*Bodleian MS variant of [52]: You shall not provoke an ailment in a human soul. Do not cause a defect in a man through haste in breaking open the flesh of man with an iron instrument or with searing by fire before making an examination two or three times; then you should give your advice.
(Translation: Shlomo Pines, 224-226)
Source: Shlomo Pines, “The Oath of Asaph the Physician and Yohanan Ben Zabda. Its Relation to the Hippocratic Oath and the Doctrina Duarum Viarum of the Didache.” Proceedings of the Israel Academy of Sciences and Humanities 9, 1975: 223-264.
Translation of the Hippocratic Oath:
I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgment.
I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master’s children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else.
With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage.
Nor shall any man’s entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. Moreover, I will give no sort of medicine to any pregnant woman, with a view to destroy the child.
Further, I will comport myself and use my knowledge in a godly manner.
I will not cut for the stone, but will commit that affair entirely to the surgeons.
Whatsoever house I may enter, my visit shall be for the convenience and advantage of the patient; and I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free.
Whatever, in the course of my practice, I may see or hear (even when not invited), whatever I may happen to obtain knowledge of, if it be not proper to repeat it, I will keep sacred and secret within my own breast.
If I faithfully observe this oath, may I thrive and prosper in my fortune and profession, and live in the estimation of posterity; or on breach thereof, may the reverse be my fate!
[1] “Asaph’s ‘Book of Remedies’: Greek Science and Jewish Apologetics,” Sudhoffs Archiv, Band 76, Heft 1 (1992). Dr. Newmyer’s article is the most recent publication on the topic that I could find in a JSTOR search. Dr. Newmyer, in turn, draws from all other authorities on the subject, including: Seussman Muntner (1951); Elinor Lieber (1984); Harry Friedenwald (1944); Fred Rosner (1977); and others; as well as his own examination of one of the original manuscripts, that held by the Bavarian National Library in Munich.