Sunday, January 19, 2014

Gaonim and the Ban on Talmudic Medicine

In his post on a cure using the skin of a hyena (Yoma 84a), R. Slifkin returns to his well-used quote of Rav Sherira Gaon:
We must inform you that our Sages were not physicians. They may mention medical matters which they noticed here and there in their time, but these are not meant to be a mitzvah. Therefore you should not rely on these cures and you should not practice them at all unless each item has been carefully investigated by medical experts who are certain that this procedure will do no harm and will cause no danger. This is what our ancestors have taught us, that none of these cures should be practiced, unless it is a known remedy and the one who uses it knows that it can cause no harm.
R. Slikin then writes:
A similar statement can be found in the famous treatise of Rabbeinu Avraham ben HaRambam, and it was also endorsed as a legitimate (albeit minority) view by Rav Shlomo Zalman Auerbach. These views were also cited by my own mentor, Rav Aryeh Carmell ztz"l. 
On the other hand, according to Rabbi Moshe Meiselman, this remedy was certainly effective, at least in Chazal's time and place. Rabbi Meiselman claims that Rav Sherira Gaon just meant that we do not know how to apply Chazal's remedies, that the treatise of Rabbeinu Avraham ben HaRambam is a forgery, that Rav Shlomo Zalman was writing off-the-cuff and should not be taken too seriously (pp. 101-2), and that Rav Carmell was a proponent of heresy!
Never mind that Rabbi Meiselman, Shlita, does not discuss Rabbi Carmell zt”l. Nor does he say that Rav Shlomo Zalman should not be taken seriously. He also does not say that the maamar on aggados of Rabbeinu Avraham ben HaRambam is a forgery (more on this below). A little bit of precision would be helpful.

Post-chareidi inventions

The post-chareidi phenomenon discussed on this blog involves the invention of radical new theologies that are then justified with the claim that they are compatible with classic Jewish thought.

As Rabbi Meiselman has pointed out, one method used by the new literature is the superficial citation of isolated passages from Chazal and the classic commentaries. “This projects a false image of what authentic Torah analysis is about and obfuscates the views that are actually presented in these sources. One must always remember that a single statement must be understood within the context of an author’s entire work.  No statement exists in isolation.”
Another methodology is to seek out convenient singular or minority opinions and weave them together, thereby creating a new Torah that is radically different from the one that has been passed down from generation to generation. 
More insidiously, in their anxiousness to show that the Torah can accommodate any theory emerging from the hallowed halls of academia, contemporary writers often find it necessary to dismiss statements of Chazal as nothing more than reflections of the primitive, outmoded conceptions of their time. If Chazal had no special insight into the material world, their views on realia obviously have no binding authority.

Medical quote from Rav Hai Gaon

As a case in point, consider R. Slifkin’s earlier quote attributed to Rav Sherira Gaon. The quote does say that Chazal’s medical knowledge was not derived from Torah shebe’al peh (“they are not matters of mitzvah”) but from contemporary practice that “they saw in their day”. This is the same stance taken by the Rashba, a staunch defender of Chazal’s authority in all other areas. Although the medical remedies in the Talmud are not to be followed, Rav Sherira (contra R. Slifkin’s constant refrain that Chazal were prone to error in realia) nowhere hints that Chazal were mistaken. Nor does he say that Chazal did not know mathematics, astronomy, or the other natural sciences.

We now turn to the responsum of Rav Hai Gaon – the son of Rav Sherira and his collaborator. Rav Hai Gaon was asked to explain a piece of Gemora containing medical advice (a passage in Brachos). He writes:
[The Braisa teaches:] Six things heal the sick. 
[You asked:] How do they heal and what is the explanation of each term? To begin with you must know that today's remedies are not like those of earlier times, for there are a number of things that the earlier generations knew about what lies in this food that we do not know today. Furthermore, one may not rely on those remedies today because we do not know how they were to be applied. In addition, there is no single remedy that heals all illnesses; rather, each one has the power to heal one type of malady. [1]
The explanation given by Rav Hai for the prohibition against using Chazal's remedies is precisely the one offered in subsequent generations (e.g. the Maharil) – that we do not know how to apply them properly.

Chazal knew more than we do, not less

Even more significant, the Gaon begins his response by telling us that the problem is not that Chazal were ignorant of things that we now know, but precisely the reverse - that they knew things about the powers of the various plant and animal products that we do not know!

The Parma text attributed to Rav Sherira Gaon

Rabbi Meiselman points out (Ch. 16) that, to date, four fragments (mostly from the Cairo Geniza) have been found that have been associated with this responsum, one in Oxford, two in Cambridge and the remaining one in the Palatine Library of Parma, Italy.

The first three do not contain R. Slifkin’s quote. The first three contain various portions of Rav Sherira’s Arabic explanations of the difficult Talmudic terms. One of the Cambridge manuscripts also contains the text of the inquiry, while the Oxford manuscript contains Rav Sherira’s concluding remarks. These three manuscripts all overlap to some extent and are therefore undoubtedly part of Rav Sherira’s responsum. Not one of them contains the discussion of the prohibition against using Talmudic medicine. In fact, the Cambridge manuscript containing the inquiry skips directly from there to the explanations of terms.

The Parma manuscript, conversely, contains no part of the linguistic section. It begins with the inquiry, as in the Cambridge text, and then proceeds with the discussion of why we may no longer rely on Chazal’s remedies.

Since these manuscripts were first discovered, successive generations of researchers have all assumed they belong to a single responsum and that the discussion in the Parma manuscript was originally the preamble to Rav Sherira’s response. Although there are a number of serious difficulties with this view, since it is the one that most scholars have adopted over the years Rabbi Meiselman proceeds on the assumption that it is correct. 

(However, R. Tuvia Katzman of Machon HaTalmud notes, in a soon to be published article, that the identification of the Parma ms. as part of Rav Sherira’s responsum is based upon a single piece of evidence – the congruence of the inquiry in this ms. with that in T-S G2.49 (Cambridge). Against this he cites three pieces of strong counter-evidence including the fact that it appears to be diametrically opposed to the reason given in his son, Rav Hai’s responsum – that Chazal knew more than we do and that we are ignorant of how to apply the remedies. See footnote 140 on p220 for the details.

On the assumption that the Parma manuscript is Rav Sherira, it is unlikely that Rav Sherira and his son would have held diametrically opposed opinions on such a fundamental issue. Therefore if the attribution of the Parma text to Rav Sherira is to be accepted, it is reasonable to interpret it in light of Rav Hai’s statement. As we mentioned earlier, nowhere does Rav Sherira say that Chazal were mistaken.)

[It was standardly taught in medical schools that stomach ulcers was from too much stress or the wrong kind of food. In the 1980s, Dr. Robin Warren hypothesized that some stomach ulcers are caused by a bacterium and could be treated with anti-biotics. For this, Dr. Warren was savagely ridiculed, and called a crackpot by the scientific and medical community and his papers were rejected in the relevant conferences. In 2005, he and his collaborator were awarded the Nobel Prize in medicine and millions of sufferers have been helped. This is a helpful story to keep in mind before ridiculing the medical advice mentioned in the Talmud and at the same time a step towards becoming an informed consumer of science.]

Rabeinu Avraham ben HaRambam

 Rav Meiselman’s book contains a detailed analysis of the sources of the maamar odos derashos Chazal of Rabeinu Avraham ben HaRambam. The appendix to the book contains a painstaking analysis by Rabbi Gavriel Rubin (a friend from Ohr Sameach days).

Rabbi Meiselman does not say (contra R. Slifkin) that “the treatise of Rabbeinu Avraham ben HaRambam is a forgery”. What he does say is that there is a single manuscript of the original Arabic that has been discovered in the Cairo Genizah. The original Arabic fragment does not discuss the controversial quotes used by R. Slifkin which has the discussion of Chazal’s knowledge of science (p.90). 

Sometime before the 15th century, the original Arabic (possibly a part of HaMaspik leOvdei Hashem) was translated into Hebrew. We do not have the original Hebrew translation and we do not have much information about the copyists.  One of the manuscripts  may  have been written by Eilberg (or Eilenberg) in the mid 16th century. This manuscript is unusable because the author makes radical changes and inserts his own comments at will. Another manuscript (from Oxford) was included in the Vilna edition of the 1877 Eyn Yaakov. Certain places in the Oxford and Paris copies bear no relation to the Arabic manuscript.

Rabbi Vidal HaTzrtfati (1540-1690) reports having seen the Arabic version of the ma’amar and gives an extensive synopsis of it. The synopsis is consistent with the Arabic text discovered in the Cairo Geniza, which, of course, does not have the controversial section. In fact, the second, fourth and fifth parts of the ma’amar form a complete unit. The third controversial section (which is also not in the Arabic) is not essential to the flow of the ma’amar (p93).

Deviating from the Rambam

We therefore cannot rule out the possibility that controversial quote in the third section of the ma’amar is a later interpolation. R. Reuven Margoliot has observed that the author of the ma’amar’s text is different from that of the Rambam.
According to the Rambam the passage in Pesachim concludes: Venitzchu chachmei umos ha'olam - "And the wise men of the nations of the world were victorious."  This variant is shared by a number of Rishonim, including Rabbeinu Tam (c. 1100-1171) as quoted by the Rosh. 

The author of the Ma'amar, by contrast, makes much of the fact that Rebbi Yehudah HaNasi did not rule definitively in accordance with the Chachmei Umos HaOlam. He takes it as a sign of Rebbi Yehudah's integrity that he did not give their view any stronger endorsement than the evidence warranted.  The version of the text he quotes is the same as what is found in the familiar Vilna edition, according to which Rebbi Yehudah HaNasi merely says that their view seems more likely. 

It would be very surprising if Rabbeinu Avraham knew of both variants the Gemora yet chose to ignore the one cited by his father and base an argument specifically upon the alternative. Hence if one wishes to maintain that Rabbeinu Avraham is the author of this section one must conjecture that he did not even know of his father's text, which would be very strange indeed. (p109)
Even if this issue can be resolved, there are other problems with the Hebrew copy of the ma’maar.

Rabeinu Avraham ben HaRambam was a staunch supported and defender of his father. We thus almost never find him disagreeing with his father’s halachik rulings, and certainly not in fundamental principles. However, this does happen in the controversial quote. For example, the ma’amar cites a passage from Chulin (124a) in support of the superiority of rational argument even over prophetic tradition. 
In this passage an Amora makes an assertion, to which his colleague replies, “I swear that even if Yehoshua bin Nun said it, I would not listen to him.” The context is a halachic debate involving the laws of purity. As the author interprets it, the implication is that when logic is involved, there can be no appeal to authority - even in matters of halachah! 
In other words, if I am not convinced logically, I must not accept any one else’s word, even if he belongs to an earlier period - even if he is Moshe Rabbeinu’s protégé and successor Yehoshua bin Nun.

The Rambam was not oblivious to this passage. In his Peirush HaMishnayos he explains it to mean that prophecy plays no role in establishing the halachah. Hence it is a statement about the halachic process in specific, not about the establishment of truths in general. 

In fact, in an epistle to the people of Marseilles (Montpelier) on the topic of astrology the Rambam identifies three legitimate grounds for believing a proposition: 1) logical demonstration; 2) the evidence of the senses; and 3) receipt from an accepted authority such as a Navi or tzaddik.
From this encapsulation it is clear that the Rambam, in contrast to the author of the Ma'amar, does consider receipt from an authoritative personality as valid grounds for belief.  This disagreement, compounded by their divergent interpretations of the Gemora, certainly calls into question the ascription of this discussion to Rabbeinu Avraham. (p112-113)
The radical position advocated in this part of the Ma'amar is not even hinted at in any of Rabbeinu Avraham's other writings. Moreover, it is at odds with the Rambam's positions in numerous respects. Either of these would be sufficient grounds for doubting its authenticity. It was the espousing of a similar position by Azariah de Rossi that prompted Rav Yosef Karo (1488-1575) - the Beis Yosef - to take the extreme measure of ordering his books burnt.
The integrity of the text and the faithfulness of the translation has to be examined critically  before it can be accepted. Rabbi Meiselman’s book is ground breaking in this regard, and hopefully more critical analysis will be undertaken. We refer the reader to the book for the full details, as we only mentioned some of the points given that this is a blog post.


In light of all these doubts on the controversial third section of the ma’amar, it does not seem likely that it was written  by Rabeinu Avraham ben HaRambam (the major part of the ma’aamar, though, might be imprecise copies of an original Arabic). It is  unsound for R. Slifkin to base his revolutionary new approach to Torah upon this controversial sub-section of the ma’aamr.

Likewise, the medical quote attributed to Rav Sherira Gaon can be understood in the light of his son Rav Hai Gaon’s statement that “for there are a number of things that the earlier generations knew about what lies in this food that we do not know today. Furthermore, one may not rely on those remedies today because we do not know how they were to be applied.”
No one suggests that Chazal were simply mistaken. In fact, it appears from the Maharshal and the Maharil that to make such a suggestion would be called mocking the words of the Chachamim, an offense with the most serious of consequences. In short, there is nothing in the teshuvos of the Geonim to justify the propounding of a radical new philosophy concerning Chazal’s knowledge of the world. (p233)
According to Rav Hai Gaon, how did Chazal know of remedies that we do not know? Perhaps, Chazal had a deeper understanding of the physical world based on their knowledge of Torah. There is an important passage in Rabeinu Avraham ben HaRambam’s Hamaspik leOvdei Hashem:
People can be divided into three groups. ... The second group consists of those possessed of insight, understanding, depth of thought and contemplativeness, who have delved into the various wisdoms and arrived at an understanding of the impetuses and causal factors of each and every phenomenon. 

Some of them even attained an understanding of the Cause of Causes - that is, HaShem, may He be exalted and praised - establishing their belief system upon the relationships between the various causal factors one to another. These are the nonreligious scholars and savants, such as the Greek philosophers and their followers. Even those individuals, however, were incapable of understanding the truth in its entirety, but came to the conclusion that HaShem, may He be exalted, never alters any natural process, nor does He introduce any cause from outside of the causal nexus.. 

By contrast, observers of religion, who understand the principle of the Torah, contemplate the secondary (i. e. natural) causes and reflect upon them in the same manner as the second group, comprised of the enlightened and scholars of nature, and do not fall short of them in attainment. On the contrary! They understand everything that the scholars of nature do and receive their respect and honor. But HaShem has informed them through His Torah of that which is beyond the understanding of the scholars and philosophers,  giving them indications and proofs of that which the philosophers denied regarding His knowledge of particular things, His observance of the circumstances of human beings and His special providence.
The wording of the phrase in italics is ambiguous. One might argue that Chazal received from the Torah only their awareness of hashgachah pratis - Divine providence - while their knowledge of “secondary causes” was obtained from other sources.

“A more natural interpretation of the phrase in italics seems to be that Chazal derived from the Torah everything known to the non-Jewish scholars, plus additional wisdom not possessed by them. It follows from this that wherever there is disagreement between the two forms of wisdom, Chazal’s must be presumed superior because of its Divine source”. (p90)


1. ברכות מד ע"ב: תניא, ששה דברים מרפאין את החולה מחליו ורפואתן רפואה. ואלו הן, כרוב ותרדין ומי סיסין, דבש וקיבה והרת ויותרת הכבד.
 זכרון לראשונים וגם לאחרונים חלק א סי' שצד (ראה גם אוצר הגאונים לברכות מד ע"ב): ששה דברים מרפאין את החולה. כיצד מרפאין ופירוש כל חדא וחדא. תחלה דע כי לא כענין רפואות שהיו הראשונים עושין רפואות שלעכשיו. ויש כמה דברים שהיו הראשונים יודעים שיש במאכל זה שאין יודעין אותו עכשיו. ואין לסמוך עכשיו על אותן רפואות לפי שאין אנו יודעין היאך רפואה בהן. ועוד, אין לך דבר מיוחד מרפא לכל חלי אלא כל אחד יש בו רפואה לדבר אחד.