Chapter 8

3. Food should be taken always in the sitting position. There should be no riding nor walking, nor movements of the body until digestion is finished. The man who takes a walk or any strenuous occupation immediately after eating subjects himself to serious dangers of disease.

4. Day and night should be divided into twenty-four hours. Men should sleep for eight hours, and so arrange their sleep that the end of it comes with the dawn, so that from the beginning of sleep until sunrise there should be an eight-hour interval. We should all leave our beds about the time that the sun rises.

5. During sleep a man should lie neither on his face nor on his back but on his side, the beginning of the night on his left and at the end on his right. He should not go to sleep for three or four hours after eating and should not sleep during the day.

6. Fruits that are laxative, as grapes, figs, melons, gourds, should be taken only before meal time and not mixed with other food. It would be better to let these get into the abdominal organs and then take other food.

7. Eat what is easily digestible before what is difficult of digestion. The flesh of birds before beef and the flesh of calves before that of cows and steers. (Birds were then thought more digestible than other flesh; we have reversed the ruling. The note shows how light and digestible their flesh was considered and the reason therefor.)

8. In summer eat cooling food, acids, and no spices. In winter, on the contrary, eat warming foods, rich in spices, mustard, and other heating substances. In cold and warm climates one should eat according to the climatic conditions.

9. There are certain harmful foods that should be avoided. Large salt fish, old cheese, old pickled meat, young new wine, evil-smelling and bitter foods are often poisonous. There are also some which are less harmful, but are not to be recommended as ordinary nutritive materials. Large fish, cheese, milk more than twenty-four hours after milking, the flesh of old oxen, beans, peas, unleavened bread, sauerkraut, onions, radishes and the like. These are to be taken only in small quantities and only in the winter time and they should be avoided in the summer. Beans and lentils are to be recommended neither in winter nor summer.

10. As a rule one should avoid the eating of tree fruits, or not eat much of them, especially when they are dry and even less when they are green. If they are unripe they may cause serious damage. Johannesbrod is very harmful at all times, as are also all the sour fruits, and only small amounts of them should be eaten in summer or in warm countries.

11. The fruits that are to be recommended dry as well as fresh, are figs, grapes, and almonds. These may be eaten as one has the appetite for them, but one should not accustom himself to eat them much, though they are healthier than all other fruits.

12. Honey and wine are not good for children, though they are beneficial for older people, especially in winter. In summer one-third less of them should be eaten than in winter.

13. Special care should be taken to have regular movements of the bowels that carry off the impurities of the body. It is an axiom in medicine, that so long as evacuations are absent, or difficult, or require strong efforts, the individual is liable to serious disease. Every medical means should be taken to overcome constipation in order to escape its dangers. For this purpose young people should be given salty food, materials that have been soaked in olive oil, salt itself, or certain vegetable soups with olive oil and salt. Older people should take honey mixed with warm water early in the morning and four hours later should take their breakfast. This proceeding should be followed up from one to four days until the constipation is overcome.

14. Another axiom of medicine is that so long as a man is able to be active and vigorous, does not eat until he is over-full, and does not suffer from constipation, he is not liable to disease. Even such men, however, are much safer if they do not take food that may disagree with them.

15. Whoever gives himself up to inactivity, or puts off evacuations of the bowels, or suffers from constipation, will be sure to suffer from many diseases and will see his strength disappear even should he eat the best food in the world and make use of all the remedies that physicians have. Immoderate eating is a poison for men and the cause of many diseases which attack them. Most diseases come from either eating too much or partaking of unsuitable food. That was what Solomon meant with his proverb: "He who puts a guard over his mouth and his tongue protects himself from many evils," that is to say, whoever protects his mouth from the overindulgence in food and his tongue from unsuitable speech protects himself from many evils.

16. Every week at least a man should take a warm bath. One should not bathe when hungry, nor after eating until the food is digested, and bathe the whole body in warm but not too hot water and the head in hot water. Afterwards the body should be washed in lukewarm and cool water until finally cold water is used. One should pour neither cold nor even lukewarm water on the head, nor bathe in cold water in the winter time, nor when the body is tired and in perspiration. At such times the bath should be put off for a while.

17. As soon as one leaves the bath one should cover oneself, and especially cover the head, so that no draught may strike it. Even in summer, care must be taken to observe this rule. After this one should rest for a while until the heat of the body passes off and then should go to table. If one could sleep a little just before a meal it is often very beneficial. Neither during the bath nor immediately after it should cold water be drunk, and if there is an inappeasable thirst a little wine and water or water and honey should be taken. In winter it is beneficial to rub the body with oil after the bath.

18. Venesection should not be practised frequently, for it is only meant for serious illness. It should not be permitted in winter or summer, nor during the months of April or September (the "r" months). After passing his fiftieth year an individual should abstain from venesection. Venesection should not be practised on the day when one takes a bath or goes on a journey or returns from it. On the day when it is practised less than usual should be eaten and drunk, and the patient should give himself to rest, undertake no work nor bothersome occupation, and take no walk.

19. Whoever observes these rules of life faithfully I guarantee him a long life without disease. He shall reach a good old age, and when he comes to die will not need a physician. His body will remain always strong and healthy, unless of course he has been born with a weak nature, or has had an unfortunate bringing up, or should be attacked by epidemic disease or by famine.

20. Only the healthy should keep these rules. Whoever is ill or a sufferer from any injuries, or has lost his health through bad habits, for him there are special rules for each disease, only to be found in the medical books. Let it be remembered that every change in a life habit is the beginning of an ailment.

21. If no physician can be secured, then ailing people may use these rules as well as the healthy.

These rules are, of course, full of the common sense of medicine that endures at all times. For the tropical climate of the Eastern countries they probably represent as good advice as could be given even at the present time. With them before us it is not surprising to find that on other subjects Maimonides was just as sensible. Perhaps in nothing is this more striking than in his complete rejection of astrology. Considering how long astrology, in the sense of the doctrine of the stars influencing human health and destinies, had dominated men's minds, and how universal was the acceptance of it, Maimonides' strong expressions show how much genius lifts itself above the popular persuasions of its time, even among the educated, and how much it anticipates subsequent knowledge.

It is well to remind ourselves that as late as the middle of the eighteenth century Mesmer's thesis on "The Influence of the Stars on Human Constitutions" was accepted by the faculty of the University of Vienna as a satisfactory evidence not only of his knowledge of medicine, but of his power to reason about it. At the end of the twelfth century Maimonides was trying to argue it out of existence on the best possible grounds. "Know, my masters," he writes, "that no man should believe anything that is not attested by one of these three sanctions:--rational proof as in mathematical science, the perception of the senses, or traditions from the prophets and learned men." His biographer in the monograph "Maimonides," published by the Jewish Publication Society of America[5], expresses his further views on the subject in compendious form, and then gives his final conclusion as follows:

"'Works on astrology are the product of fools, who mistook vanity for wisdom. Men are inclined to believe whatever is written in a book, especially if the book be ancient; and in olden times disaster befell Israel because men devoted themselves to such idolatry instead of practising the arts of martial defence and government.' He says, that he had himself studied every extant astrological treatise, and had convinced himself that none deserved to be called scientific. Maimonides then proceeds to distinguish between astrology and astronomy, in the latter of which lies true and necessary wisdom. He ridicules the supposition that the fate of man could be dependent on the constellations, and urges that such a theory robs life of purpose, and makes man a slave of destiny. 'It is true,' he concludes, 'that you may find strange utterances in the Rabbinical literature which imply a belief in the potency of the stars at a man's nativity, but no one is justified in surrendering his own rational opinions because this or that sage erred, or because an allegorical remark is expressed literally. A man must never cast his own judgment behind him; the eyes are set in front, not in the back.'"

While Maimonides could be so positive in his opinions with regard to a subject on which he felt competent to say something, he was extremely modest with regard to many of the great problems of medicine. He often uses the expression in his writings, "I do not see how to explain this matter." He quotes with approval from a Rabbi of old who had counselled his students, "teach thy tongue to say, I do not know." In this, of course, he has given the best possible evidence of his largeness of mind and his capacity for making advance in knowledge. It is when men are ready to say, "I do not know," that progress becomes possible. It is very easy to rest in a conscious or unconscious pretence of knowledge that obscures the real question at issue. A great thinker, who lived in the century in which Maimonides died, Roger Bacon, set down as one of the four principal obstacles to advance in knowledge indeed, as _the_ one of the four that hampered intellectual progress the most, the fact that men feared to say, "I do not know."

One of the most interesting features of Maimonides' career for the modern time is the influence that his writings exerted over the rising intellectual life of Europe within a half century after his death. Most people would be rather inclined to think that this Jewish author of the East would have very little influence over the thinkers and teachers of Europe within a generation after his death. He died in 1204, just at the beginning of one of the great productive centuries of humanity, perhaps one of the greatest of them all. In literature, in art, in architecture, in philosophy, and in education, this century made wonderful strides. Two of its greatest teachers, Albertus Magnus and his pupil, Thomas Aquinas, quote from Moses AEgyptaeus, the European name for Maimonides at that time, and evidently knew his writings very well. Maimonides was for them an important connecting link with the world of old Greek thought. Others of the writers and teachers of this time, as William of Auvergne, and the two great Franciscans, Alexander of Hales and Duns Scotus, were also influenced by Maimonides. In a word, the educational world of that time was much more closely united than we might think, and it did not take long for a great writer's thoughts to make themselves felt several thousand miles away. Maimonides was, then, in his own time one of the world teachers, and, in a certain sense, he must always remain that, as representing a special development of what is best in human nature.

V

GREAT ARABIAN PHYSICIANS

In order to understand the place of the Arabs in medicine and in science, a few words as to the rise of this people to political power, and then to the cultivation of literature and of science, are necessary. We hear of the Arabs as hireling soldiers fighting for others during the centuries just after Christ, and especially in connection with the story of the famous Queen Zenobia at Palmyra. After the destruction of this city we hear nothing more of them until the time of Mohammed. During these six and a half centuries there is little question of education of any kind among them except that at the end of the sixth century, the Persian King Chosroes I, who was much interested in medicine, encouraged the medical school in Djondisabour, in Arabistan, founded at the end of the fifth century by the Nestorian Christians, who continued as the teachers there until it became one of the most important schools of the East. It was here that the first Arab physicians were trained, and here that the Christian physicians who practised medicine among the Arabs were educated.

Among the Arabs themselves, before the time of Mohammed, there had been very little interest in medicine. Gurlt notes that even the physician of the Prophet himself was, according to tradition, a Christian. Mohammed's immediate successors were not interested in education, and their people mainly turned to Christian and Jewish physicians for whatever medical treatment they needed. When the Caliphs came to be rulers of the Mohammedan Empire, they took special pains to encourage the study of philosophy and medicine; though dissection was forbidden by the Koran, most of the other medical sciences, and especially botany and all the therapeutic arts, were seriously cultivated.

Until the coming of Mohammed, the Arabs had been wandering tribes, getting some fame as hireling soldiers, but now, under the influence of a feeling of community in religion, and led by the military genius of some of Mohammed's successors, whose soldiers were inspired by the religious feelings of the sect, they made great conquests. The Mohammedan Empire extended from India to Spain within a century after Mohammed's death. Carthage was taken and destroyed, Constantinople was threatened. In 661, scarcely forty years after the _hegira_ or flight of Mohammed, from which good Mohammedans date their era, the capital was transferred from Medina to Damascus, to be transferred from here to Bagdad just about a century later, where it remained until the Mongols made an end of the Abbasside rulers about the middle of the thirteenth century. At the beginning the followers of Mohammed were opposed to knowledge and education of all kinds. Mohammed himself had but little. According to tradition, he could not read or write. The story told with regard to the Caliph Omar and the great library of Alexandria, seems to have a foundation in reality, though such legends usually are not to be taken literally. Certainly it represents the traditional view as to the attitude of the earlier Moslem rulers to education. Omar was asked what should be done with the more than two million volumes. He said that the books in it either agreed with the Koran, or they did not. If they agreed with it they were quite useless. If they did not, they were pernicious. In either case, they should be done away with, because there was an element of danger in them. Accordingly, the precious volumes that had been accumulating for nearly ten centuries, served, it is said, to heat the baths of Alexandria for some six months--probably the most precious fuel ever used. Fortunately for posterity, the edict was not quite as universal in its application as the story would indicate, and exceptions were made for books of science.

In the course of their conquests, however, the Mohammedan Arabs captured the Greek cities of Asia Minor. They were brought closely in contact with Greek culture, Greek literature, and Greek thought. As has always been the case, captive Greece took its captors captive. What happened to the Romans earlier came to pass also among the Arabs. Inspired by Greek philosophy, science, and literature, they became ardent devotees of science and the arts. While not inventing or discovering anything new, like the Romans they carried on the old. Damascus, Basra, Bagdad, Bokhara, Samarcand all became centres of culture and of education. Large sums were paid for Greek manuscripts, and for translations from them. Under the famous Harun al-Raschid, at the end of the eighth century, whose name is better known to us than that of any others, because of the stories of his wandering by night among his people in order to see if justice were done, three hundred scholars were sent at the cost of the Caliph to the various parts of the world in order to bring back treasures of science, and especially of geography and medicine. It is an interesting historical reflection that the Japanese and Chinese are doing the same thing now.

The Arabs were very much taken by the philosophy of Aristotle, and it became the foundation of all their education. Greek thought, as always, inspired its students to higher things. Soon everywhere in the dominions of the Caliphs, philosophy, science, art, literature, and education nourished. Medicine was taken up with the other sciences and cultivated assiduously. Freind, in his "Historia Medicinae," says that the writings of the old Greeks which treated of medicine were saved from destruction with the other books at Alexandria, for the desire of health did not have less strength among the Arabs than among other nations. Since these books taught them how to preserve health, and were not otherwise contrary to the laws of the Prophet, that served to bring about their preservation. Freind also calls attention to the fact that grammars and books which treated of the science of language were likewise saved from destruction. Besides the library, the Arabs, after their conquest of Alexandria in the eighth century, came under the influence of the university still in existence there.

In the West, in Spain, the Arabs enjoyed the same advantages as regards contact with culture and education as their conquest of the Eastern cities and Alexandria brought them in the East. While it is not generally realized, Spain was, as we have pointed out, the province of the Roman Empire in the West that advanced most in culture before the breaking up of the Empire. The Silver Age of Latin literature owes all of its geniuses to Spain. Lucan, the Senecas, Martial, Quintilian, are all Spaniards. Spain itself was a most flourishing province, and under the Spanish Caesars, from the end of the first to about the end of the second century, increased rapidly in population. Spain was the leader in these prosperous times, and the tradition of culture maintained itself. When Spain became Christian the first great Christian poet, Prudentius, born about the middle of the fourth century, came from there. He has been called the Horace and Virgil of the Christians.

The coming down of the barbarians from the North disturbed Spain's prosperity and the peace and culture of her inhabitants, but it should not be forgotten that the first medieval popularization of science, a sort of encyclopedia of knowledge, the first of its kind after that of Pliny in the classical period, came from St. Isidore of Seville, a Spanish bishop.

There has been considerable tendency to insist that Spanish culture and intellectuality owe nearly all to the presence of the Moors in Spain. This can only be urged, however, by those who know nothing at all of the Spanish Caesars, the place of Spain in the history of the Roman Empire, and the continuance of the culture that then reached a climax of expression during succeeding centuries. On the contrary, the Moors who came to Spain owe most of their tendency to devote themselves to culture and education to the state of affairs existent in Spain when they came. There is no doubt that they raised standards of education and of culture above the level to which they had sunk under the weight of the invading barbarians from the North, and Spain owes much to the wise ruling and devotion to the intellectual life of her Moorish invaders. All the factors, however, must be taken together in order to appreciate properly the conditions which developed under the Arabs in both the East and the West. The Arabs invented little that was new in science or philosophy; they merely carried on older traditions. It is for that that the modern time owes them a great debt of gratitude.

RHAZES

The most distinguished of the Arabian physicians was the man whose rather lengthy Arabian name, beginning with Abu Bekr Mohammed, finished with el-Razi, and who has hence been usually referred to in the history of medicine as Rhazes. He was born about 850 at Raj, in the Province of Chorasan in Persia. He seems to have had a liberal early education in philosophy and in philology and literature. He did not take up medicine until later in life, and, according to tradition, supported himself as a singer until he was thirty years of age. Then he devoted himself to medical studies with the ardor and the success so often noted in those whose opportunity to study medicine has been delayed. His studies were made at Bagdad, where Ibn Zein el-Taberi was his teacher. He returned to his native town and was for some time the head of the hospital there. Later he was called by the Sultan to Bagdad to take charge of the renovated and enlarged hospital of the capital. His medical career, then, is not unlike that of many another successful physician, especially of the modern time. At Bagdad he had abundant opportunities for study, and the ambition to make medicine as well as to make money and gain fame.