The mental status exam in talmudic medicine.

An early reference to the clinical evaluation of “delirium” appears in the seventh chapter of the Talmudic tractate dealing with divorce documents and proceedings.1 The Rabbis in Mishnaic (ie, Tannaim) and Talmudic (ie, Amoraim) times, extending from the beginning of the Common Era to ~800 CE, needed absolute assurance regarding a husband’s willful intention to divorce his wife for a variety of religious, legal and social reasons. These reasons include, but are not limited to: the fact that once properly divorced a member of the Priestly sect cannot remarry his divorced wife, and religiously-valid divorces are necessary to assure that biological offspring of a remarried, but improperly-divorced, wife are not religiously and socially ostracized; these “illegitimate” offspring are referred to as Mamzerim. In addition, in the event a couple was childless, there were circumstances where a devoted husband would proactively give his wife a “conditional” divorce that would go into effect “retroactively” if he were to be confirmed dead as a result of a dangerous journey, war, or terminal illness; this was done in order to free her of the biblical obligation of Levirate marriage. A valid divorce document was essential to the woman’s ability to petition religious courts successfully in order to collect the monetary support outlined in her original marriage document. The religious importance of assuring valid divorce and its documentation was also reflected in the necessity of messengers carrying these documents on behalf of a husband residing outside of Israel to his wife residing within Israel to take oaths that the writing and signing of the divorce document were