Monday, October 31, 2011

Rambam: The greatest doctor and architect of them all?

In its erev Rosh HaShanah edition, HaModia printed the following remarkable story:

The following story was told to me by the son of one of the prominent Roshei Yeshivah of the last generation.

One morning, shortly after Pesach, the Gadol called his son to say that he had noticed some blood and needed a ride to the doctor’s office. The doctor was, in fact, worried enough about the possibility of intestinal cancer to immediately schedule an appointment for his patient with a well-known gastroenterologist.

Walking back to the car with his father, the son expressed concern over the possibility of receiving a frightening diagnosis from the specialist. The Rosh Yeshivah responded with the following story: An architect once told the Netziv that there was a flaw in the Volozhin yeshivah building; if the defect was not corrected, the expert said, the building would surely collapse.

But the Netziv was not at all alarmed; since the building had been constructed in accordance with structural principles laid out by the Rambam, he told the expert, there was simply no possibility that it would fall in. (Not long ago, I spoke to someone who recently visited Volozhin, and he reports that the building is still standing.)

“It is not possible that I have intestinal cancer,” the Gadol told his son. “The Rambam gave his havtachah that anyone who follows his directives for healthful eating, as I have, will not get sick.”

The Bosh Yeshivah’s trust in the Rambam’s guarantee was well-warranted, as it turned out. When the examination revealed no evidence of bleeding, the specialist questioned the patient about any recent dietary changes. He soon determined that the temporary bleeding had likely been caused by intestinal irritation brought on by the maror the Rosh Yeshivah had eaten at the Sedarim.

I have no idea if either the story about the unnamed Rosh Yeshivah or the story about the Netziv are true. But there are many problems with both of them.

First of all, where does the Rambam write about structural requirements in building a house? I'm not saying that he doesn't - but I consulted a few people and nobody could think of where he writes about such a thing. This leads me to doubt the veracity of the story (but it is true that Volozhin is still standing).

Second, and most importantly, Rambam did not even believe that Chazal any supernatural insights into science. He even believed that prophets were fallible in such things. All the more so would he not have believed himself to possess any supernatural, infallible insights into either architecture or physiology. (See too Menachem Kellner, "Maimonides on the Science of the Mishneh Torah: Provisional or Permanent?")

It is true that Rambam in Hilchos Deyos 4:30 gives an assurance that anyone who follows his dietary and medical advice will never fall sick. But this was no kabbalist's promise (however much they are worth). It was simply a reflection of his belief that he was an excellent physician who had selected the best of Galenic medicine.

Rambam had some excellent advice about healthy eating, exercise, and clean air. But I would not recommend anyone to fully follow his advice; after all, he disapproved of eating fruits. And his medical advice in general was based upon obsolete ideas of "the four humors" and certainly exhibited the standard flaws of medieval medicine, such as recommending a small amount of bloodletting in the spring and fall.

A recent Jewish book about eating a healthy diet purports to be based upon Rambam's principles and claims that "the foundation of this system is perfectly up to date and reliable." I have not read the book, but the evidence given for this claim is rather shaky. The author writes that "Rabbis, doctors and nutritionists have read through this book and verified its principles" - but to what extent does his book accurately reflect Rambam's system? And the fact that "the commentaries on Rambam's works maintain that his advice about health and the prevention of disease remains relevant today" is hardly evidence that it actually is accurate.

I am also wondering to what extent the unnamed Rosh Yeshivah was really following Rambam's advice in such things. Was he engaging in bloodletting? And it is especially interesting that his intestinal bleeding resulted from eating maror. That sounds like he was eating a sizable quantity of horseradish. But according to Rambam, suitable foods for maror are wild lettuce and endives, not horseradish, and a kezayis is the size of an olive. He should have followed Rambam in that area!

Yet I have no doubt that a person who believes himself to be following Rambam's dietary and medical advice, and who believes that Rambam has some kind of divine authority in his assurance, will be extra healthy. My reason for this is not that I believe that Rambam's medical advice competes with that of modern medicine. Rather, it is that the placebo effect is extremely powerful. (Incidentally, Rambam himself was quite ahead of his time in his realization of the power of the placebo effect!)

I'll sign off with the old story about the man who attended a shiur from his Rav about how the Gemara instructs a house to be built. He decided to build his house exactly according to the Gemara's standards, and spent many months constructing it. But as he finished hammering in the final nail, the entire house suddenly collapsed. Furious, the man came to his Rav to complain. The Rav says: "You know, Tosafos asks that question!"

(Thanks to S. for some links)


  1. Both stories are baloney. Why are you dealing with them? Tons of stupid stuff gets published in these papers. Who cares?

  2. Let's see. Rambam in Hilchot Deiot says to eat grapes, cukes, watermelons, etc, before a meal, not at the main meal, and they should be fully digested before eating the main meal. Always eat fowl before meat, eggs before fowl, meat of small cattle before meat of large cattle. Eat cold foods in summer and hot in the winter. NEVER eat mushrooms. Never eat regular with a meal onions, peas, beans, garlic, meat of large cattle. Ducks and dates are bad to eat. Bathe once a week. There are ten times that one should pay special attention about going to the bathroom (before & after: intercourse, bathing, exercise, going to bed, rising.) If you are thirsty after a bath, ever drink cold water but mix it with wine first. Excessive sexual activity will result in foul smelling breath and body odor, teeth will fall out, eyebrows fall out.

    I'm cherry picking of course - Rambam has some good practical advice (eg regarding sleep & exercise) - but it is silly to suggest that his advice was anything more than the best medical knowledge of the time.

  3. Wait a sec...that's the Volozhin Yeshiva? It looks a lot smaller than it does in many photos. But I guess lots of historical monuments are. Ben Hecht's line is "Great in the imagination, sunken in the eye."

  4. Oh, by the way, it was Shammai who was the architect. :-)

  5. perhaps the netziv took his architectural info from Hilchos beis habchira.

  6. Paragraph 6=>
    Rosh Yeshiva

  7. I heard that the guy built the house three times only to see it collapse and only then did he find out that Rashi had the same problem!

    At any rate, this is yet another example of how people idolize those who would have been horrified to have been thought of in this way.

  8. I am not at all qualified to speak about what the Rambam actually wrote. However, I followed the diet outlined in the book that you linked to and I lost 100 pounds in about a year. I don't think the book follows the Rambam exactly. For instance, the book encourages eating fruit at certain times (especially melon which was apparently okay by the Rambam.

  9. Of course, you're right. But try convincing someone who actually believes the Rambam was the greatest doctor and architect. You'll get a response along the lines of: "Hashem gave the Rambam and Chazal the proper knowledge through Ruach HaKodesh. But the Rambam was so full of anivus, that he thought maybe he didn't have Ruach HaKodesh, and that he could be wrong. And [pick one]: [his forays into philosophy misled him about Chaza]l/ [he never authored those heretical passages you cited]. Oh, you rationalists, who worship at the altar of William of Occam--Your possibilities are so limited, your faith so frail, nebach!" Of course, your fictional interlocutor would not have heard of Occam's razor :)

    Michael Merdinger

  10. Funny that following the Rambam protected him from harm, but following the Torah by eating marror did not.

  11. Volozhin? Isn't that the yeshiva that had secular studies?

  12. Second, and most importantly, Rambam did not even believe that Chazal any supernatural insights into science.

    Saying they could err in science is NOT the same as saying they did not have any supernatural insights.
    You have no basis for such an extreme statement.
    And the Rambam definitely states that the Torah--wen properly understood--contains all true wisdom about the world.
    This is how the Rambam describes the Torah in MN. II 40:
    וכאשר תמצא תורה שכל טכסיסיה להביט במצעה על תקינות המצבים הגופניים וגם בתקינות הדעות, ונותנת הדגשתה למתן השקפות נכונות בה' יתעלה תחילה, ובמלאכים, ורצונה להחכים את האדם ולהבינו ולהעירו עד שידע את כל המציאות כפי הצורה האמיתית 23, תדע שאותו הטכסיס מאתו יתעלה ושאותה התורה אלוהית.

  13. Following the Rambam, I never eat truffles.

    Also, I can't afford them.

  14. I can understand a way of thinking that would say,"if God would inspire a misleading "natural history" of the world, why would He not also promulgate misleading insights from his ruach hakodesh"? In this way, one could have both....Chazal correctly using ruach hakodesh and simultaneously erring.

    Gary Goldwater

  15. I seem to recall from Hilchot Deot that Matzah is bad for you. So that might be enough to qualify...

  16. Easy on the bloodletting. Lower iron levels may be one reason that women live longer than men; donating blood a few times per year might just help men close that gap, and live longer. (For the record, my mother says that it is the daily housework that keeps women fitter, and living longer.)

  17. Early on in my time as a medical student I saw a Chasid admitted to hospital in diabetic coma. It transpired that he had been trying to treat his diabetes by following the advice on the Rambam.

    One person who I told this story to told me it was obvious that the Chasid had made a mistake in his interpretattion of the Rambam

  18. Very recent medical research says that the natural sugars in fruit and fruit juice can cause diabetes just like refined sugar itself, so maybe the Rambam actually was correct and the fruits he recommended contained a different sugar that isn't linked to diabetes. He did say to consume a little fruit and a lot of vegetables, so wasn't saying to cut out fruit entirely.

  19. Here is an example of an article linking fruit consumption to diabetes;

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