Insights from Rambam on the Art of Healing
(from Rambam's Hanhagat HaBri'ut)
1. If a person cared for himself the way he cares for his horse he would avoid many serious illnesses. You won't find anyone who gives his horse too much fodder. He measures out only as much as the horse can tolerate. But he himself eats to excess. He makes sure his animal gets proper exercise to keep it healthy. But when it comes to himself he neglects exercise even though this is a fundamental principle in health maintenance and the prevention of most illnesses (1:3).
2. Even with the utmost care and caution it is impossible to avoid constant minor fluctuations in our physical functioning. Sometimes the stools become a little soft, sometimes a little dry. One day a person may find a change in his digestion or feel a mild headache or a slight pain in some other part of his body, and so on. Don't be in a hurry to take medications for these kinds of minor problems. Nature will take care of them without any need for medicines. Follow your normal health regime. If you try to treat these minor ailments, either you will do the wrong thing and cause harm or, if you do the right thing, while you may succeed in restoring the normal balance, you have also taught your body to become lazy and it will no longer function properly without outside assistance (4:3).
3. If the illness is stronger than the patient there is no hope of saving him and the physician is of no benefit at all. If the patient is stronger than the illness he has no need for a physician because nature will cure him. It is only when the strength of the patient and the illness are equal that medicine is needed to strengthen the patient... Most doctors are greatly mistaken in this and think they are strengthening the patient's natural vitality when in fact they are weakening it. On this subject Aristotle in his Perception and the Perceptible said that the cause of most patient deaths is the treatment they receive from physicians who are ignorant of nature (2:4).
4. If the patient can be treated through diet alone he should not be treated with medicines. If it is impossible to control the illness without medications, the first choice should be medicines that are nourishing and foods that have medicinal properties. When using medicines one should begin with mild ones. If these are sufficient, well and good. Only if they are insufficient should one use stronger medicines. Wherever a single, simple drug can be used one should not use a compound. If the illness cannot be controlled without a compound, one should use the least number of ingredients. Medicines consisting of many ingredients should only be used when absolutely necessary (2:21-22).
5. One should never forget to strengthen the patient's physical vitality with nourishing food and to strengthen his spiritual powers with fragrant odors, with music, by telling him happy stories that expand the heart, and by distracting his mind with things that make him and his friends laugh. The people chosen to take care of him should be those who know how to cheer him up (2:20).
6. The physician should make every effort to see that everyone, sick and healthy alike, should always be cheerful, and he should seek to relieve them of the spiritual and psychological forces that cause anxiety. This is the first principle in curing any patient, especially if his illness is bound up with his mind and emotions, as in the case of those who are gloomy and depressed. In all such cases the physician should do nothing before improving their state of mind.... The physician should not think that he can alter these emotions through his medical knowledge and expertise. This can be achieved only through moral guidance and the religious teachings we have received from the prophets (3:13-14).
7. Sometimes doctors make a serious mistake but the patient survives. Other times they make what they think to be a minor mistake, and the patient also thinks it to be of little consequence, but it becomes the cause of the patient's death. Every thinking person should bear this in mind. Any intelligent person can study medical literature and understand when or when not to use various treatments. What is so difficult, even for a skilled physician, is to apply this knowledge in individual cases. For those who know nothing about the fundamentals of healing and treat it casually and talk a lot, nothing seems difficult. They don't think there is any illness that requires careful deliberation. The common run of people think medicine can be learned quite easily, whereas it is really extremely difficult to master even for a conscientious physician (4:7-8).
By Rabbi Avraham Yehoshua Greenbaum
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