His Sefer Refuos is Earliest Known Extant
Hebrew Medical Work
According to tradition, the angel Rephael taught Noach all about healing the body and relayed to him different recipes for various medications. Noach recorded all that he learned in a book which he called “Sefer Refuos.” Noach taught this information to his son Shem and the information was handed down from generation to generation. In addition many international scholars in Macedonia, Egypt, India and elsewhere copied these medicinal recipes and facts about the body after translating them into their own languages and thus the spread of knowledge of healing was born.
Shlomo HaMelech was in possession of a Sefer Refuos which probably contained the information originally learned by Noach from the angel Rephoel. This Sefer disappeared about three hundred years later when Chizkiyahu became king. Chizkiyahu the King decided that he would hide it because he believed it was detrimental for the Children of Israel to have access to it.
Three reasons were given for Chizkiyahu the King to conceal the book. One, because of the medicinal instructions in the book, people were healed so easily that people stopped praying to Hashem to be healed. Chizkiyahu wanted people to once again realize that their health was dependent on Hashem and turn to Him in prayer. Another reason given was that there were recipes and antidotes for poisoning in the book and it was feared that people would use these recipes to poison people. The third reason given for the book being concealed was that there were idolatrous practices discussed in the book for the purpose of discerning what about them was forbidden and it was feared that people were beginning to practice these idolatrous acts.
In Islamic legend, Asaf ben Berachia was a minister, scribe, or companion of Shlomo Hamelech (Sulayman), who had knowledge of Sefer Refuos (Book of Medicine). It is this Assaf Ben Berachia who brings the Queen of Sheba’s throne “in the twinkling of an eye” to King Solomon according to the Koran.
Assaf ben Berachia* or Assaf Harofeh is also the name given for the author of medical manuscripts that were discovered dating 1500 years ago, which are of the oldest extant Hebrew medical book. Scholars do not really know who Assaf Berachiah was but believe that he was a Jewish teacher of medicine in Syria and lived near Teveriah during the sixth century.
Because the manuscripts refers to the three Greek pillars of medical science: Hippocrates traditionally known as the Father of Medicine, Pedanius Dioscorides, author of the five volume medical encyclopedia about Greek Herbal medicine and the Greek physician Galen of Pergamon who founded experimental physiology, the Assaf ben Brachia who authored this book did not live during the time of Shlomo HaMelech. However he did live before the establishment of Islam and the recording of the Koran. It is very possible that the Islamists decided to name King Solomon’s wise sage for this author.
Manuscripts of Sefer Refuos
Sefer Refuos , also known as Sefer Assaf appears in at least eighteen manuscripts found in libraries all over the world including in Vienna, Paris, Florence, Munich, Leiden, Basle, Berlin, London, Oxford, Leningrad, New York and Jerusalem. The most complete manuscript is the one found in Munich at the Bayerische Staatsbibliothek, known as MS Munich #231.
Many of the manuscripts, some of which are older than others are composed of fragments. The oldest extant manuscript seems to be one found in the JTS library in New York which was originally found in the Cairo Geniza and is called JTS 10160.
Its Medical Terminology and Vocabulary
The book contains ancient customs and Jewish medical ethics as well as is a source of ancient Jewish remedies. It includes Hebrew, Aramaic, Persian, Latin, and Greek medical terminology. Excerpts from Greek medical books, some of which have disappeared and are not known from any other sources, appear in Hebrew in Sefer Refuos.
Assaf coined his own Hebrew medical vocabulary, clarifying them by including Latin or Greek terms written in Hebrew transliteration. The manuscripts of Assaf include treatises on physiology, embryology, diseases of various organs, hygiene, medicinal plants, urology, aphorisms, diagnoses based on pulse and urine, ingredients for the creation of medicines from plants and animals and the oath of Assaf. Because of the latter, he has become known as the “Jewish Hippocrates.”
The Prevention of Diseases
Assaf Harofeh discusses how to prevent disease by adhering to exercise, baths, ointments, massage, sunshine, fresh air, clean water, various beverages, the proper choice of foods and the correct manner of breathing.
According to Assaf Harofeh many diseases come as divine retribution for sins and that davening, Teshuva and Tzedokoh, are important factors in healing. He strongly emphasizes that Hashem is the only true healer and that physicians’ first duties are to fear Hashem and practice virtue.
Important Discovery of How Blood Circulates
Assaf describes the heart as the seat of the soul.
The following is his description of how blood moves throughout the body:: “The pulsations of the blood vessels (the pulse) derive from the animating spirit; they originate from the heart, travel to the farthest extremities of the body, from which they return to the heart like water propelled by the wind….”
Isadore Simon in his French book, Asaph ha-Iehoudi, médecin et astrologue du Moyen Age published in 1933 concludes that Assaf Harofeh with his important discovery of how blood circulates actually forestalled William Harvey (1578-1657) by nine hundred years. Harvey is wrongly credited as being the first one to correctly describe blood’s circulation in the body!
Assaf uses the following Hebrew terms: gidim (“sinews”), mesillos meforados (“separate paths”), te’alos (“channels”); he calls limbs macḥlekos ha-guf (“body parts”) and cḥadrei ha-mo’acḥ are “chambers of the brain”.
Specific locations in the body he assigns to the seichel (“intellect”), binah (“understanding”), da’as (“knowledge”), and the yetẓer (“will”). “The spirit (ru’acḥ) resides in the head; understanding, in the heart; and fear, in the hidden recesses of the body.”
There are many sentences in the book which begin with the words “And I shall teach you” indicating that the book had at one time served as oral medical teachings. In the introduction, Assaf HaRofeh relates the story of Noach writing down his knowledge of medicine:
Assaf states that “melancholy is spiritual, not corporeal.” He gives the number of bones (evarim) from the Talmud ( Makkos 23b) as 248, and adds 365 as the number of sinews corresponding to the days of the lunar year. The bones are fed by their marrow.
Based on the Gemorrah Assaf discusses the existence of an imperishable bone – the luz (“the nut of the spinal column”). He espouses the Torah’s view that the embryo is completely shaped in its mother’s womb 40 days after conception. Although the section “On the Influence of Diet” is based on Hippocrates, Assaf discusses at greater length various foods, drawing on the sayings of Jewish sages as well as on popular wisdom. He mentions only the meat of animals permitted according to Halachah..
Jewish Sources Quoting Assaf Harofeh
Assaf Harofeh is mentioned in many Jewish sources. Rabbi Yehuda Ibn Kuraish, the ninth century North African Jewish grammarian mentions Sefer Assaf when discussing a book of remedies bearing Aramaic names. Rav Hai Gaon of Pumbedita (939-1038 C.E.) makes a reference to Sefer Assaf in his commentary on the Mishnah, Tohoros. Rashi (1040-1105) in his commentary on Sefer Shoftim 15:15 cites Sefer Refuos. The Radak, Rav Dovid Kimchi (1160-1235) in his commentary on Hoshea 14:7 discusses how he learned from Assaf Harofeh that certain wines are medicinal. The Ramban (1194-1270), in his Shaar Hagemul talks about “what is written in the early Greek medical books and that of Assaf the Jew.”
Oath of Assaf
Foremost among Hippocrates’ writings which served Assaf as a model was the famous oath, which he adapted into a Jewish version . It is called the Oath of Assaf and is a one thousand Hebrew word code of ethical conduct for Jewish physicians to be taken upon completing their studies.
Here are some excerpts from the Oath of Assaf:**
Do not attempt to kill any soul by means of a potion of herbs,
Do not divulge the secret of a man who has trusted you,
Do not take any reward [which may be offered in order to induce you] to destroy and to ruin,
Do not harden your heart [and turn it away] from pitying the poor and healing the needy,
Do not say of [what is] good; it is bad, nor of [what is] bad: it is good,
Now [then] put your trust in the L-rd, your G-d, [who is] a true G-d, a living G-d,
For [it is] He who kills and makes alive, who wounds and heals,
Who teaches men knowledge and also to profit,
Who wounds with justice and righteousness, and who heals with pity and compassion,
No designs of [His] sagacity are beyond His [power]
And nothing is hidden from His eyes.
Who causes curative plants to grow,
Who puts sagacity into the hearts of the wise in order that they should heal through the abundance of His loving-kindness, and that they should recount wonders in the congregation of many; so that every living [being] knows that He made him and that there is no saviour [other] than He.
For the nations trust in their idols, who [are supposed] to save them from their distress and will not deliver them from their misfortunes
For their trust and hope is in the dead.
For this [reason] it is fitting to keep yourselves separate from them; to remove yourselves and keep far away from all the abominations of their idols,
Remember Him always and seek Him in truth, in righteousness in an upright way, in order that you should prosper in all your works
And He will give you help to make you prosper in [what you are doing], and you shall be [said to be] happy in the mouth of all flesh.
And the nations will abandon their idols and images and will desire to worship G-d like you,
For they will know that their trust is in vain and their endeavor fruitless,
For they implore a god, who will not do good [to them], who will not save [them].
As for you, be strong, do not let your hands be weak, for your work shall be rewarded,
The L-rd is with you, while you are with Him,
If you keep His pact, follow His commandments, cleaving to them,
You will be regarded as His saints in the eyes of all flesh, and they will say:
Happy the people whose [lot] is such, happy the people whose G-d
is the L-rd.
Their pupils answered saying:
We will do all that you exhorted and ordered us [to do],
For it is a commandment of the Torah,
And we must do it with all our heart, with all our soul and with all our might, To do and to obey
Not to swerve or turn aside to the right hand or the left
,
Comparison of Hippocratic Oath to Assaf Harofeh Oath
In 1992 Dr. Stephen Newmyer, professor of Classics at Duquesne University in Pittsburg, Pennsylvania, published an article comparing the Hippocrates Oath to that of Assaf Harofe, “Asaph’s Book of Remedies; Greek Science and Jewish Apologetics,” Sudhoff Archiv Bd.
Newmyer asserts that Assaf restates the role of G-d in sickness and healing, as described in the Torah: “For I am the L-rd that heals you,” while the Hippocratic Oath begins by invoking the Greek deities of medicine, who are asked to witness the intent of the physician. The Hippocratic Oath then lists the ethical practices expected of the physician, and states, as well, what he should not do. Assaf Harofeh lists many of the same dos and don’ts, but significantly differs from the Greek model by constantly referring to the guiding hand of G-d throughout the oath. Assaf also enjoins the Jewish physician to treat any patient, regardless of their means to pay a fee: “Do not harden your heart [and turn it away] from pitying the poor and healing the needy” – something not mentioned at all by Hippocrates.
Professor Suessman Muntner’s work on Sefer Refuos
According to Professor Alexander Suessman Muntner, Assaf Harofeh was the first medical writer to recognize the possibility of a hereditary factor in certain diseases.
Professor Alexander Suessman Muntner (1897-1973) was a Jewish Polish medical doctor from Kolomyya who immigrated to Eretz Yisroel in 1933. He devoted his life to studying the history of Jewish medicine. He published the Hebrew translation of Maimonides’ medical treatises from manuscripts as well as from previous versions. In 1949 Muntner published an annotated book of the writings of Shabbetai Donnolo, (923 C.E.-982) the Italian-Greek Jewish physician who quotes Assaf Harofe. In 1957 he published a one hundred fifty page Hebrew book entitled Mavo leSefer Assaf Harofe (Introduction to the book of Assaf Harofe). Two years later he joined the faculty of Hebrew University where he served as Professor of the History of Medicine. Muntner served as the Medical Editor of the first edition of the Encyclopedia Judaica.
Dr. Fred Rosner Discusses Assaf HaRofeh
Dr. Fred Rosner, born in Berlin, Germany has served as Professor of Medicine at the Mt Sinai School of Medicine and was author of numerous books on Jewish Medical Ethics. He collaborated with Professor Muntner on the English translation of Moses Maimonides’ Medical Writings and discusses Assaf Harofeh in his book, “Encyclopedia of Medicine in the Bible and Talmud.”
He tell us that although parts of the book Sefer Refuos have been translated and published, there is still no publication which includes the entire manuscript of Assaf Harofeh.
Rosner quotes the acclaimed medical historian, bibliographer and librarian Colonel Fielding Hudson Garrison: “In Garrison’s ‘History of Medicine’ a single sentence concerning Asaph is recorded: ‘Perhaps the oldest Hebrew medical text written in Asia is a Book of Remedies by Assaf Judaeus, a Mesopotamian physician of the seventh century.’”
Dr Rosner also informs us that Assaf Harofeh is mentioned in the French three volume medical history text of Alexandra Laignel Lavastine and he bring us an English translation of what the French medical historian writes:
“A clinician, Asaph the Jew is the author of the first book on medicine written in Hebrew. Originally from Palestine, Asaph taught medicine in one of the medical schools in Syria with his collaborators Yehuda and Yohanan HaYarhoni.
“He wrote a treatise on drugs inspired by Dioscorides in which he gives us a detailed description of more than one hundred plants. Guided by the works of Galen, he studied fevers, the pulse and [therapeutic] regimens. His aphorisms, his practice of uroscopy and his prognostics were inspired by Hippocrates. Finding insufficient the terminology that he extracted from sources of the medical [parts of the] Talmud, he added neologisms taken from Greek and Latin…”
Assaf Harofeh Medical Center which has recently been renamed Yitzchak Shamir Hospital after the seventh Prime Minister of Israel is located less than ten miles from Tel Aviv and was initially named after the author of Sefer Refuos.
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*Its author has also been known as Assaf Hayehudi (the Jew) Assaf Katan (the small) Assaf HaChacham (the wise) and Assaf Hayarchoni (the astrologer).
** Source: Shlomo Pines, “The Oath of Asaph the Physician and Yohanan Ben Zabda. Its Relation to the Hippocratic Oath and the Doctrina Duarum Viarum of the Didache.” Proceedings of the Israel Academy of Sciences and Humanitis 9, 1975: 223-264.
Ami, Jan. 30, 2019
כד שבט 5779