Medicine in Bible and Talmud

17.07.2016 - 20.07.2016

Research unit und Panel auf der Jahrestagung der European Association of Biblical Studies (EABS) in Leuven, Belgien
Chairs: Markham J. Geller und Lennart Lehmhaus

Auf der Jahrestagung der European Association of Biblical Studies (EABS) in Leuven, Belgien, konnten Markham J. Geller und Lennart Lehmhaus (A03, SFB 980) erstmals mit ihrer thematischen Programmsektion zur jüdischen Medizin- und Wissensgeschichte in der Antike insgesamt drei Sitzungen mit zehn Vortragenden und einer Respondentin für alle Beiträge organisieren. Die Präsentationen mit einem Schwerpunkt auf spätantiken, rabbinischen Texten befassten sich mit jüdischer Medizin von der Bibel bis zu frühislamischen, auf Arabisch verfassten Werken.

  

Program/Schedule

2016 EABS & IOQS Annual Meeting, Leuven, Belgium, 19 July 2016

Research Unit: MEDICINE IN BIBLE AND TALMUD

This research unit/ panel is generously sponsored by the Collaborative Research Center SFB 980 “Episteme in Motion”, Freie Universität Berlin and the German Research Fund/ Deutsche Forschungsgemeinschaft (DFG)

Research unit chairs: Markham J. Geller, Lennart Lehmhaus

 

Session Program

Session I : Jewish Concepts of Health, Illness and the Human Body (90 mins.)
Chair: Markham J. Geller, Freie Universität Berlin/ UCL London

Belinda E.S. (UCL London): "Conceptualizations of the Human: The First Domino in Medicine?"

Jason Mokhtarian (Indiana University, Bloomington): "Charms against Diseases and Bodily Injury in the Aramaic Bowl Spells from Sasanian Mesopotamia"

Regis Nessim Sachs (Paris): "On Fevers The Third Discourse on Consumption by Isaac Israeli (850 - c 932)"
     

Session II: Talmudic Approaches to Therapy (90 mins.)
Chair: Lennart Lehmhaus, SFB 980 “Episteme in Motion”, Freie Universität Berlin (time allocated)

Monika Amsler (Universität Zürich): "The Whole of the Sugya is More than the Sum of its Parts: Git 67b-70b and its Diverse Medical Backgrounds"

Tanja Hidde (BabMed project, Freie Universität Berlin): “Bugs used as drugs“ – Insects in rabbinic medical treatment"

Sara Ronis (St. Mary’s University Texas, San Antonio/ Harvard University, Cambridge, Mass.): "'Place it Under the Stars Overnight': Exposing Rabbinic Attitudes toward Exposed Water"
     

Session III: Jewish images of the physician and healer (ca. 180 mins.)
Chair: Jason Mokhtarian, Indiana University, Bloomington (time allocated)

Isabel Cranz, University of Pennsylvania, Philadelphia): "Ben Sirach, Chronicles and the Legitimacy of the Physician"

Tirzah Meacham (University of Toronto): "The Expert Physician and Embryotomy in Rabbinic Literature"

Markham J. Geller (Freie Universität Berlin/ UCL London): "Abaye as medical expert ('mn)" 

Lennart Lehmhaus (SFB 980 “Episteme in Motion”, Freie Universität Berlin): "Rabbis and/as doctors? Expert knowledge, medical practitioners and the division of healing professions in Talmudic tradition"

Response to all papers: Julia Watts-Belser, Georgetown University, Washington D.C.

   

Abstracts for all papers

Session I: Jewish Concepts of Health, Illness and the Human Body
Chair: Markham J. Geller

IA) Belinda E.S., UCL London – Concepts of Disease in traditions of (Late) Antiquity

In my talk, I will examine the role and importance of how the human being is conceptualized in the realm and practice of medicine. The basic assumptions that form any theory that undergirds medical practice, both in antiquity and today, greatly determine how we subsequently define health, illness, as well as the goal and method(s) of healing. Just as in antiquity Mesopotamians, Israelites and Greeks held beliefs that resulted in different conceptualizations of the human (and their medicine), so today there is a myriad of therapeutic schools and systems that differ based on this assumption.

More specifically, I will share findings on the ancient Israelite understanding of the human being based on my analysis of the figurative use of all body part terminology in the Hebrew Bible. I will also compare this with Empedocles’ understanding that was very influential in the world of early Greek medicine. Finally, I will draw on my training and experience as a psychologist to address the narrower question of physical and mental illness in light of these differing conceptualizations, framing that question within the context of language as a means of expressing ideologies.

 

IB) Jason Mokhtarian, Indiana University, Bloomington – Charms against Diseases and Bodily Injury in the Aramaic Bowl Spells from Sasanian Mesopotamia

This paper is a detailed literary analysis of several Aramaic incantations from late Sasanian Mesopotamia that deal with the topic of bodily injury and disease. By drawing from the discipline of medical anthropology, I explore the relationship between the (counter)charms’ intentions of protection against evil spirits and illness, on the one hand, and the types of social relations between family members or neighbors that these bowls often describe as the impetus for commissioning the spell. If one assumes that the sorcerers and clients of the bowls did not work in cultural isolation from surrounding cultures, then one can inquire what the relationship is between the spells, patterns in Sasanian society (e.g., family structures), and the various other Sasanian religions such as Talmudic Judaism and Zoroastrianism. The specific incantations that I will discuss at the conference include: VA.2423 and its counterpart VA.2416 (Levene, Jewish Aramaic Curse Texts from Late-Antique Mesopotamia, 2013, pp. 35-51), JBA 1 and JBA 2 (eds. Shaul Shaked, James Nathan Ford, and Siam Bhayro, Aramaic Bowl Spells: Jewish Babylonian Aramaic Bowls, Volume One, 2013, pp. 56-61), and a few others. Some of these texts interest me because they demonstrate how some late antique Sasanians believed that social tensions with neighbors and family members could cause disease and bad luck. The VA.2423-VA.2416 combination is particularly illuminating in this regard: this lengthy qybl’ spell, composed by a scribe who is responsible for at least two other bowls, is a client’s (Abba son of Barkhita) countercharm. Its function is to send back whence they came those curses made upon him by antagonists named ‘Immi daughter of Rebecca’ and ‘Mar’ and ‘Lili,’ her two children. After the introduction outlining the bowl’s purpose, the first incantation contains a laundry list of the negative forces (paralleled in numerous other bowls) unleashed upon Abba son of Barkhita: curses, oaths, afflictions, bans, demons, sorceries, oaths, and then—turning to the body—illnesses like “fever,” “tertian fever,” and “inflammation of the bone.” The incantation is only liminally Jewish as it references Psalm 91, is written in Jewish Babylonian Aramaic for Semitic-named client against Semitic-named enemies, and contains a clear rabbinic parallel in its reference to R. Joshua bar Perahiah who appears as an authoritative figure who makes official the charm’s efficacy. It is also worth mentioning that the incantations in JBA 1 and JBA 2, about Hanina ben Dosa, also fights the spirits infecting the body, head, temple, ear, skull, and eyes. In my presentation, I would like to perform a detailed literary analysis of these sources while simultaneously contextualizing them vis-à-vis other cultures and literatures of the time period, especially in the Talmud and in the Middle Persian corpus, which engage the topic of magic in a similar manner.

       

IC) Regis Nessim Sachs, Paris – On Fevers The Third Discourse on Consumption by Isaac Israeli (850 - c 932)

The Third Discourse on Consumption (Latham & Isaacs1) has been translated from Arabic into French by myself and compared with three Hebrew editions (BNF 1126, 1127 and 1170) that had been translated from Arabic. The Arabic version published by Latham & Isaacs is mainly based on the Köprülü kütüphanesi manuscript 962 to be found in Istanbul. This presentation focuses on the beginning of the third discourse, which is dedicated to the definition and diagnostic description of the hectic fever. It aims at:

a- Highlighting Isaac Israeli’s work being influenced by Greek medicine and potentially by the Bible and the Talmud

b- Determining whether the hectic fever described by Isaac Israeli is today referred to as pulmonary tuberculosis

Modern translators have retrospectively concluded that it refers to today’s tuberculosis. In the Xth century, phthisis2 used to refer to any form of consumptive disease. Consumption was also defined by the word « phthisis » in the Bible3. From the XIXth century onwards, this term has been used to describe tuberculosis, in the light of the symptomatic descriptions by Laennec and of the identification of the TB (tubercle bacillus) by Koch.

In ancient times, fevers were described observing the phenomena (e.g. the heat of the body) that were exclusively related to them, without considering any other co-existing disease occurrence4. The Bible and the Talmud include here and there some definitions of fevers. Later on, fevers were generally described as situations where the animal heat and artery pulses were not normal, normality being specific to each individual. These fevers were also associated with any altered function of the human body5. The invention of the thermometer goes back to the XVIIth century6.

The theories of humours by the Greek authors (mainly Galen and Hippocrates) were widespread in ancient times and subscribed to in the Middle Ages. They establish four « cardinal humours »7 in the human body: the blood, the phlegm, the bile the black bile. The disease was a humour disorder (temperament) which was specific to each individual.

      
Biography

Isaac Israeli was born in Egypt in the middle of the IXth century8. He was a neoplatonic Jewish philosopher who used to exchange letters with Saadia Gaon9. He worked in Cairo as an oculist, before emigrating to Qairouan to serve as a court physician for the Aghlabids and then for the Fatimids. He died in Qairouan in 932. In addition to his philosophical work, he wrote medical books that were highly praised in the West, among which the Book on Fevers that includes 5 chapters. The third discourse is studied in this paper.

1- The structure is divided as follows: a) definitions of the human decline (consumptions) whether natural or adventitious (with or without fever); b) the definition of the decline attended with fever, that is to say the hectic fever. There are two main parts:

1.1. the disease itself, with no prior pathology, that mainly occurs on predisposed grounds suggesting tuberculosis;

1.2. The hectic fever succeeding either fevers or chronic diseases, which does not exclude the reactivation of a silent tuberculosis but also suggests other hypothetic diagnoses.

2- Each of these two parts is developed according to the knowledge of the time, particularly inspired by Galen. Medical notions are revealed throughout the Bible and the Talmud that do not offer a synthetic summary on fevers.

3- Generic symptoms generally characterize the hectic fever: Heat pervades the whole body; Its force is yet gentle; And emaciation of the body resulting from its dryness and desiccation.

The specific symptoms of the hectic fever depend on the moisture being assimilated or not: moisture normally goes through four assimilation steps. Symptoms occur when any of these steps is altered and are specific to each of them. The alteration of the last two steps is most severe.

All symptoms are described and detailed in the light of the author’s experience, who refers to nature, plants and trees, to make it all easily understandable.

Further details will be provided during the EABS annual meeting.

In conclusion. This discourse and the Book on Fevers made Isaac Israeli famous throughout the Middle Ages. Isaac Israeli has obviously been influenced by Greek medicine that had been translated into Arabic. The Bible and the Talmud can also be considered as an influence of minor importance. Hectic fever does include pulmonary phthisis, but cannot be merely understood as tuberculosis.

Notes

1 Cambridge 1991

2 Grmek M. D. Les maladies à l’aube de la civilisation occidentale. Payot, PARIS 1983

3Shahefet, תפחש (consomption ou phtisie) Levit. 26 : 16 ; kaddahat, קדחת ; daleket,דלקת ;shidafone, שדפון

Deut. 28 : 22. Ibid. Kadahat is daily fever and Daleket must be astrong fever , according to Ibn Ezra is tertian or quartan fever in J. Preuss Biblical and Talmudic medicine p. 160.

4 A.C.Fages Histoires critiques et apologétiques de la fièvre. Medical thesis. Montpellier 1820. P. 10

5 Frank J. ENCYCLOPÉDIE DES SCIENCES MÉDICALES; Pathologie médicale. p. 94, 1835. Consulté en ligne sur Google livres en octobre 2015.

6 Boorstin D. Les découvreurs. Collection BOUQUINS. Robert Laffont. P. 359. 1983.

7 The four cardinal humours were conceived of as moist entities derived from food and digestion.

8 Sachs R.N : Médecins juifs du Xème au XVIIème siècle. L’Harmattan 2014.

9 Altman A. and Stern SM. UCP.2009.

 

Session II: Talmudic Approaches to Therapy
Chair: Lennart Lehmhaus

IIA) Monika Amsler, Zürich – The Whole of the Sugya is More than the Sum of its Parts: Git 67b-70b and its Diverse Medical Backgrounds

The sugya bGit 67b-70b ("If one is seized by qurdiaqos...") embraces fascinating stories such as of king Solomon and the demon-king Ashmedai as well as about the misbehaved servants of the Exilarch. On the other hand, the sugya contains three different types of medical recipes such as the "imperative recipe" (usually introduced with ...ליתי), the "unintroduced recipe" (e.g. for disease X: Y and Z...) and the "numerical recipe" (e.g. eight things are good for... six things cure... three things kill...). The paper will show how the different components relate to each other and how they reflect different types of medicine, with the latest redaction clearly favouring one.

 

IIB) Tanja Hidde, FU Berlin (BabMed) – “Bugs used as drugs“ – Insects in rabbinic medical treatment

In medical passages of rabbinic literature, animal properties are often used as ingredients for various remedies. While some of these properties may only have been “Decknamen” for medical plants, insects were widely used for medical treatment in the ancient world. Like in other cultures, insects have an ambiguous status. On the one hand, the behavior of insects is often praised in rabbinic pedagogical discourses (as Harrison King showed recently in “Reading Animal Morality), on the other hand “vermin” evokes disgust and entomophagy has its taboo aspects as reflected in the Jewish dietary laws. The bite or sting of insects was feared by the ancients, since antidotes have not been at hand. This is expressed for example in Bavli Git 70a: “One who swallows a hornet will certainly not live”. Likewise, the swallowing of leeches was a well-known risk to health in antiquity. Both rabbinic and Greco-Roman sources describe how the swallowing of leeches can take place. This and other examples of remedies against insects or with insect-ingredients will provide a profitable field for investigating modes of transregional exchanges and adaptation of cultural patterns.

 

IIC) Sara Ronis, Harvard/ St. Mary’s University Texas, San Antonio – “Place it Under the Stars Overnight”: Exposing Rabbinic Attitudes toward Exposed Water

The rabbis of Sasanian Babylonia lived in a cosmopolitan world at the nexus of a wide range of medical practices and knowledge. Scholars continue to examine the rabbis’ retention and transmission of inherited and contemporaneous medicine. This paper examines one particular area of medical knowledge – how and when to expose water under the stars – in order to understand rabbinic strategies of transmission, integration, and harmonization.

The rabbis of the Babylonian Talmud inherited an extensive corpus of rabbinic law which insisted that the consumption of water that had been exposed overnight was extremely dangerous and even fatal. In the Mishnah and the Tosefta, the consumption of exposed water is strictly forbidden. In the Babylonian Talmud, dramatic rituals are enacted to protect the unwary – and the extremely thirsty – from the unimaginable harm related to the drinking of exposed water. Contrary to the many halakhic warnings, however, the Babylonian Talmud (Avodah Zarah 29a) records a tradition where the effectiveness of a medication is contingent precisely on its overnight exposure under the stars.

In this paper, I argue that this Talmudic tradition is a vestige of much older Mesopotamian medical practices. Indeed, both Akkadian and Babylonian medical recipes include the dicta to “let (the preparation) spend the night under the stars.” Erica Reiner has suggested that the ancient Mesopotamian exposure of medical preparations to the starry night is meant to “ascertain that the celestial powers make the medication efficacious” (“Astral Magic in Babylonia,” 48). While rabbinic literature does not contain evidence that the rabbis understood this rationale, the rabbis clearly know of the practice, and of its alleged efficacy.

Though it contradicts all of their inherited rabbinic traditions around water exposure, the Babylonian rabbis nonetheless integrate this practice into their medical discourse. However, I demonstrate that they continue to mark it as foreign by putting the teaching in the mouth of an Arab other. This move is part of a broader rabbinic construction of the Arab other, but it is also evidence of a larger rabbinic approach to older medical traditions. Thus, this project sheds light on the survival of much older ancient Near Eastern medical knowledge in Sasanian Babylonia, the systematization of rabbinic medical practices, and the rabbis’ diverse strategies to integrate contradictory knowledge into an ostensibly holistic system.

 

Session III: Jewish images of the physician and healer
Chair: Jason Mokhtarian (Indiana University)

Isabel Cranz, Philadelphia (University of Pennsylvania) – Ben Sirach, Chronicles and the Legitimacy of the Physician

This paper will discuss the biblical view on the various specialists involved in the art of healing with particular focus on the physician (רופא). Physicians are referenced sporadically throughout the Bible (cf. Genesis 50:2; Jeremiah 8:22; Job 13:4). A more detailed picture of physicians and their standing in Judean society emerges in the Book of Chronicles and the apocryphal wisdom Book of Ben Sirach. Although 2 Chronicles 16:12 criticizes the ruler Asa for turning to the physicians, Ben Sirach 38:1-15 has a more positive attitude towards physicians portraying them as divinely legitimized recipients of God’s grace. While these passages contain more details about healers than the rest of the Bible, they do not clarify whether physicians had always existed as legitimate representative of the healing profession, or whether they were an innovation introduced to Judea during the Hellenistic period.

Scholars working from the perspective of the Chronicler, tend to take recourse to Ben Sirach and argue that physicians had always been accepted such that the true crime of Asa consisted of relying on physicians alone without consulting God through other authorities (cf. Pancratius C. Beentjes; Wilhelm Rudolph). Scholars writing from the perspective of Ben Sirach, by contrast, argue that the Chronicler rejects physicians out of principle and that the author of the wisdom poem works hard to defuse theological concerns related to the profession of healing (cf. Johannes Marböck; Gerhard von Rad). This contradiction can be resolved when considering that the language used by Ben Sirach implicates not only the deity, but also echoes the deeds of Moses the prophet and sacrificial offerings brought at the temple. Thus, the poem implies that the consultation with healers is legitimate so long as it is done in combination with other specialists like priests and prophets. From this point of view, the role of the Judean healer and his interaction with other professions corresponds to standing of the asû in Assyro-Babylonian Sources who yielded the best results when consulted alongside other religious authorities such as exorcists.

 

Tirzah Meacham, Toronto – The Expert Physician and Embryotomy in Rabbinic Literature

A number of places in rabbinic literature refer to embryotomy, the dismemberment up of a fetus while in utero, in order to facilitate birthing to save the mother’s life. The primary texts which discuss the requirement to perform embryotomy are mOhalot 7:4 and tYevamot 9:5. Other sources, such as mNiddah 3:5, tNiddah 4:14, mBekhorot 8:1, mKaretot 1:3, Minor Tractate Semahot 1:8 and the Babylonian Talmud on some of these sources, mention the existence of such a surgical procedure and assume its practice. This paper addresses the question of who were the practitioners of embryotomy in classical rabbinic literature. Just as in Greek medicine, in Jewish sources midwives were the primary caregivers for birthing women. In Greek medicine, midwives were expected to call in a male physician for problematic births. In Jewish culture, however, men were strongly discouraged from looking at a woman’s genitalia in any sexual context. It is assumed that they generally did not attend births for that reason. The text in tGittin 3:8-9, tBaba Qama 9:11 and tMakkot 2:5 discuss the liability of an expert physician practising under the aegis of the rabbinic court. One case involves injuring someone while attempting a cure and the other is injuring a woman during an embryotomy. Could it be that these texts would consider a woman an expert physician? In bAvodah Zarah 28a a non-Jewish woman who treated Rabbi Yohanan was considered an expert physician. In questions addressed to rabbis concerning abortion, one of the claims is that since a woman is not obligated in procreation, her destruction of seed was less problematic than for a man to do so since he is obligated in procreation. Given the considerations that midwives normally attended births and were likely quite skilled in aiding birthing women and given that issues of modesty may have prevented males from gaining any expertise in the area of childbirth (other than expertise in animal births), as well as the idea that women are not obligated in procreation we must ask: Could a Jewish woman have been considered an expert physician and hence appointed by the court to perform embryotomy?

 

Markham J. Geller, UCL London/ FU Berlin (SFB 980) – Abaye as medical expert ('mn)

The 3rd century Amora, Abaye, is often cited in the Bavli for his repertoire of medical and magical recipes, although relatively little special attention has been paid to him in this capacity. This paper will give some examples of Abaye's awareness of local Babylonian prescriptions and medical knowledge.

 

Lennart Lehmhaus, FU Berlin (SFB 980) – Rabbis and/as doctors? Expert knowledge, medical practitioners and the division of healing professions in Talmudic tradition

The study of Jewish knowledge culture(s) from a comparative perspective is still in its incipient stage. This paper seeks to contribute to this emerging field as well as to enter into a dialogue with neighboring disciplines by concentrating on the multifaceted dimensions of the Jewish-Talmudic discourse on secular or technical knowledge, with a special focus on medicine and the body.

The question of transmission and transmitter of medical knowledge seems to have been answered often too hastily. Thus, in many studies rabbinic sages whose names are connected to teachings about medicine were straightforwardly labeled as “doctors”, “physicians” and “medical experts”. However, except for a substantial familiarity with certain medical issues these texts do not provide any information about those rabbis working as doctors in practice. Furthermore, also the direct equation of the rabbis with the Greco-Roman medical writers and philosophers is a flawed one. In light of a pluralism of collaborating and competing medical practitioners (root cutters, drug sellers, midwives, hygienists, health specialists etc.) in Greco-Roman culture, why should the rabbis just have interacted with these “elite physicians”.

This paper does not seek to decide whether some rabbinic scholars were trained as doctors, indeed, since this assumption is hard to substantiate. Rather, I would like to discuss the question how knowledge of the body and medical expertise is seen and represented in the Talmudic sources. Did the rabbis have a clear definition of certain healing professions? Can we discover special fields of expertise related to different medical fields? How did the Talmudic authors see the interaction between rabbis and non-rabbinic Jews as well as non-Jews in the field of medicine? And finally, how did the rabbis deploy these exchanges and interactions with others in order to boost their medical knowledge.

This discussion will help to gain a deeper understanding of rabbinic ways of authorization or rejection of particular technical knowledge. Moreover, also the strategy of self-fashioning in two, sometimes contradicting roles, as religious and medical experts, within their Late Antique cultural background will be explored.