Maimonides (1135-1204) and his philosophy of medicine.

Moses Maimonides was born in Cordova, the capital of Moorish Spain, on 30 March 1135. His father, Maimon, was a judge of the Jewish religious courts. Until the family fled to Fez in 1159, because of religious persecution, Maimonides was a pupil of the philosopher– physician Averroes (1126–98). From Morocco the family moved on to Palestine and then to Egypt. Shortly after arriving in Cairo, his father died and his brother David, a dealer in precious stones, was drowned in the Indian Ocean, leaving a widow and young daughter. Maimonides wrote: “... how should I console myself? He grew up on my knees and he was my brother, he was my pupil; and he traded in the market and earned, and I could sit safely at home.” Now he had to practise medicine to support both families. His learning and wisdom were already widely acknowledged and in 1170 he was appointed physician to the Court of Saladin. He also became Rayyis (Head) of the Jewish community. He was 36 years old. Life was not easy. Maimonides described a typical day’s work as follows: “My duties to the Sultan are very heavy. I am obliged to visit him every day, early in the morning; and when he or any of his children, or any of the inmates of his harem, are indisposed I dare not leave Cairo, but must spend the greater part of the day in the palace.... I repair to Cairo very early in the day, and even if nothing unusual happens, I do not return to Fostat until the afternoon. Then I am fatigued and hungry. I find the antechambers filled with people ... I converse with and prescribe for them while lying down from sheer fatigue, and when night falls I am so exhausted that I can scarcely speak.” Maimonides would have much preferred to continue the contemplative life of a sage, a rabbi, and a philosopher (fig 1). He was deeply versed in the classical writings of Hippocrates, Aristotle, and Galen and in the rabbinic teachings of the Bible and the Talmud. He recognised that science had not achieved certain knowledge of nature and wrote: “The dangers are obvious to the wise while the fools do not find anything diYcult ... Behold: inasmuch as a man be perfect in this wisdom, new doubts arise in him which lead to added contemplation.” He attributed the causes of errors to : “(1) Love of contradiction and opposition which hinders people from conceiving a thing as it is in reality; (2) profundity of the thing to be conceived, its subtlety, its power, and the diYculty to conceive it; (3) foolishness of the conceiver and his disability to apprehend what is quite within the powers of conception; (4) and the fourth cause is routinism, since people adhere by nature to their habits, incline to them and detest any other opinion, even if it be nearer to the truth.” Maimonides advocated a very broad education for doctors and emphasised the need to maintain physical health and vigour, for, as he wrote: “... it is impossible for one to understand sciences and meditate upon them when he is hungry or sick.” He enumerated rules for maintaining health, telling those who obeyed them that: “I give him a guaranty that ... he will not need a physician, and his body will be perfect and faultless all his days. This on the condition that his body was not imperfect from birth, that he has not adopted bad conduct from childhood, and that there did not come a disaster of plague or dryness upon the world.” He was fully aware of the importance of psychosomatic disorders and warned against hurrying to treat such cases with medicine. He Figure 1 Moses Maimonides (AD 1135–1204). Arch Dis Child Fetal Neonatal Ed 1998;79:F227–F228 F227