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MEDICINE IN THE TALMUD
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The publisher and the University of California Press Foundation gratefully acknowledge the generous support of the S. Mark Taper Foundation Imprint in Jewish Studies.
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MEDICINE IN THE TALMUD natural and supernatural therapies between magic and science
Jason Sion Mokhtarian
university of california press
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University of California Press Oakland, California © 2022 by Jason Sion Mokhtarian Library of Congress Cataloging-in-Publication Data Names: Mokhtarian, Jason Sion, author. Title: Medicine in the Talmud : natural and supernatural therapies between magic and science / Jason Sion Mokhtarian. Description: Oakland, California : University of California Press, [2021] | Includes bibliographical references and index. Identifiers: lccn 2021042917 (print) | lccn 2021042918 (ebook) | isbn 9780520389410 (hardback) | isbn 9780520384040 (ebook) Subjects: lcsh: Medicine in rabbinical literature. | Medicine— Religious aspects—Judaism—History. | Alternative medicine. Classification: lcc r135.5 .m65 2021 (print) | lcc r135.5 (ebook) | ddc 610—dc23/eng/20211006 LC record available at https://lccn.loc.gov/2021042917 LC ebook record available at https://lccn.loc.gov/2021042918 Manufactured in the United States of America 28 27 26 25 24 23 22 10 9 8 7 6 5 4 3 2 1
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For Stefanie
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CONTENTS
Abbreviations Acknowledgments Disclaimer Preface 1. 2. 3. 4. 5.
Medicine on the Margins Trends and Methods in the Study of Talmudic Medicine Precursors of Talmudic Medicine Empiricism and Efficacy Talmudic Medicine in Its Sasanian Context Conclusion Notes Glossary Bibliography Source Index General Index
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ABBREVIATIONS
rabbinic sources B. or b.
Babylonian Talmud
M. or m.
Mishnah
T. or t.
Tosefta
Y. or y.
Yerushalmi Talmud
Rabbinic tractates ‘Abod. Zar.
‘Abodah Zarah
B. Bat.
Baba Batra
B. Mes.i‘a
Baba Mes.i‘a
B. Qam.
Baba Qamma
Bek.
Bekorot
Ber.
Berakot
Bes.ah ‘Erub.
Bes.ah ‘Erubin
Git.. H . ul.
Git.t.in H . ullin
Ketub.
Ketubbot
Mak.
Makkot
Menah. .
Menah. ot
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.
x Abbreviations
Ned.
Nedarim
Nid.
Niddah
’Ohal.
’Ohalot
Parah
Parah
Pesah. . Qidd.
Pesah. im Qiddušin
Roš Haš.
Roš Haššanah
Sanh.
Sanhedrin
Sot.ah Šabb.
Sot.ah Šabbat
Šeb.
Šebi‘it
Šebu.
Šebu‘ot
Šeqal.
Šeqalim
Ta‘an.
Ta‘anit
Tem.
Temurah
Yebam.
Yebamot
Yoma
Yoma
dictionaries DJBA
Sokoloff, Dictionary of Jewish Babylonian Aramaic
DJPA
Sokoloff, Dictionary of Jewish Palestinian Aramaic
languages Gk.
Greek
JBA
Jewish Babylonian Aramaic
MIr.
Middle Iranian
MP
Middle Persian
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ACKNOWLEDGMENTS
I owe a debt of gratitude to many people for their support while writing this book. I wrote much of it at Indiana University, where numerous conversations with colleagues there in the Department of Religious Studies helped to shape its arguments. I thank them all for raising the bar as high as possible for producing rigorous scholarship and for enlightening me about what it means to study religion. In 2020, I was fortunate to have joined Cornell University’s Department of Near Eastern Studies as the Herbert and Stephanie Neuman Chair in Hebrew and Jewish Literature. I am grateful to my new colleagues in Ithaca for making me feel so welcome during a turbulent two years due to the pandemic. The two peer reviewers of this book provided many insightful comments on it in its earlier stages, and I want to thank them for taking the time to read the manuscript as closely as they did. I am indebted to Lennart Lehmhaus and Mark Geller for inviting me to participate in a panel on ancient Jewish medicine at the European Association of Biblical Studies annual conference in Leuven in 2016, where I first presented some of the ideas in this book. I would like to thank Charlotte Fonrobert for giving such a thoughtful response to a paper that I delivered at the 2016 Association for Jewish Studies conference. I appreciate the conversations that I have had with Monika Amsler and Shulamit Shinnar, both of whom helped me resolve difficulties that I faced in my research. Adam Becker was extremely generous with his time and made many corrections and bibliographical suggestions that significantly improved the final product. I want to particularly acknowledge Jordan Rosenblum, who helped me formulate one of the central arguments of this book. xi
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xii Acknowledgments
Finally, Abby Kulisz was kind enough to help me read some of the Syriac sources in the original language. I want to thank the staff at University of California Press for their hard work on this book project. Eric Schmidt is a wonderful editor and true professional, and I am grateful to have had his support over the years. I am equally indebted to the project editor Cindy Fulton for her hard work on taking this book through production. I appreciate LeKeisha Hughes for her patience and advice in shepherding this book through its various stages. The copy editor, Ben Alexander, did a marvelous job preparing the manuscript for publication, and I thank him for his diligent work. Above all, I must thank my family. I feel blessed to have such loving parents and a mother-in-law who have always supported me unconditionally. I also want to acknowledge the memory of Stuart Greenberg, whose life continues to be a blessing in our family. To Stefanie, I dedicate this book to you with love and gratitude. To Eliana and Rafael, you are and will always be my best medicine.
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DISCLAIMER
Do not try these remedies at home—the author and the press are not responsible.
xiii
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PREFACE
What, if anything, does the Talmud have to do with medicine? At first glance, the question seems odd, since the Babylonian Talmud is primarily a collection of rabbinic laws and stories that represent normative Jewish behavior. While this perception is of course partially accurate, it is also true that the Talmud contains a variety of other genres. Indeed, the Talmud is by far the richest source of medicine in ancient Judaism before the rise of Islam. As this book reveals, the rabbis of late antiquity were experts not only in law, but also in the medical sciences of their time. The rabbis were, in other words, interested in more than what most scholars assume. Thus, the question about what the Talmud has to do with medicine is a productive one that expands and enriches our understanding of what the Talmud is. For reasons that I explain in this book, the Talmud’s medical passages have been marginalized in the Jewish tradition since the early medieval era, including in academic Talmudic studies today. In fact, the standard volume on Talmudic medicine is still Julius Preuss’s Biblisch-talmudische Medizin, published over a century ago in 1911. Since then, the topic has received a lot of attention, but disproportionately more by medical doctors and scientists than by PhD’s in late antique Judaism. It is my hope, then, that this monograph will help to fill in this lacuna in the field of Talmudic studies and stimulate greater interest in the rabbinic medical tradition among scholars in the field. There are a number of other reasons why I wrote this book. First, it contributes another case study in an important recent trend in Talmudic studies that promotes reading the Babylonian Talmud within its wider xv
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cultural environment in the Sasanian Empire. The topic of medicine is particularly fruitful in this regard because, as this book argues, the rabbis often adopted and adapted medical knowledge from outside their community. In terms of contextual study, medicine may in fact be one of the richest subjects in which to interrogate the relationship between the Talmud and other late antique corpora. Relatedly, the second reason that I wrote this book was to try to integrate further the Aramaic incantation bowls into the field of Talmudic studies. As the only other corpus of writings produced by Jews of the Sasanian world, the incantation bowls are invaluable resources for broadening our perception of Jewish culture in the Sasanian world beyond the purview of the rabbis. One reason that Talmudists have not utilized the bowls to their full potential is due to their ostensible lack of overlap with the Talmud. In this book, I use the topic of medicine as a bridge between the two corpora, since many of the incantation bowls protect or heal clients from illness in a manner similar to some of the Talmudic therapies. Finally, another motivation for writing this book was to bring into conversation the fields of Talmudic studies and the history of medicine. By doing so, this book models an interdisciplinary approach that draws from a disparate field to learn something new about the rabbinic corpus. Likewise, I hope that this book will also be of value to historians of ancient medicine who are interested in learning how the rabbis of late antique Babylonia thought about and treated human sickness.
the babylonian talmud This book focuses on the Babylonian Talmud, aka the Bavli, which is a vast collection of traditions produced by rabbis who flourished along the Tigris and Euphrates Rivers under the rule of the Persian-Sasanian Empire (224–651 c.e.). The Bavli was transmitted orally for centuries by around eight generations of rabbis called Amoraim (sg. Amora) before it was edited. The redaction of the Bavli was undertaken by anonymous editors, often referred to as the Stammaim, probably sometime in the sixth or seventh century, though scholars continue to debate the details of this complex process. When I refer to the “Talmud” in this book, I mean the Babylonian Talmud—not to be confused with the other, earlier Talmud, known as the Yerushalmi (or Palestinian) Talmud. This latter work was composed by Amoraim who lived in the land
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of Israel (or Palestine) under Roman rule. Both Talmuds are structured as commentaries on the Mishnah, a synthesis of biblical law produced by rabbis called Tannaim (sg. Tanna). The Tannaim, who date from the first to early third century c.e., are also responsible for the Tosefta, a collection of rabbinic laws comparable to the Mishnah, as well as for many baraitot (sg. baraita), which are recorded in the Bavli.
the program of this book Chapter 1 of this book describes the genre of medical therapies in the Talmud and the role of rabbis and physicians in Babylonian Jewish medical culture. It provides a synopsis of the types of afflictions and remedies found in key sources—especially in the Git.t.in Book of Remedies and in two other compilations in Bavli ‘Abodah Zarah 27a–29a and Bavli Šabbat 108b–111b. These three sources share in common linguistic and literary features, which substantiate my argument that the medical therapies are an identifiable subgenre within the Talmudic corpus. In addition, this chapter analyzes the complex relationship between rabbinic medical knowledge and law (halakha), particularly as they relate to Sabbath regulations. It also discusses the reception and marginalization of the Talmudic therapies by medieval commentators and physicians. In chapter 2, I offer an overview of the history of the field of Talmudic medicine, which I critique for its anachronistic and apologetic tendencies. These problems are largely a result of the fact that the lion’s share of research on the topic of Talmudic medicine has been published by experts in all sorts of disciplines—medical doctors, ophthalmologists, dentists, psychologists, ethicists, classicists, among others—but not, surprisingly, by Talmudists. By contrast, this book situates the therapies within the field of rabbinics as a corrective to some of the fallacies that have prevailed in the field. After this overview, chapter 2 goes on to explain why the category “medicine”—which scholars often conflate with “magic”—is an appropriate one to use in reference to the Talmud, and to outline some of the methodological challenges inherent in the study of ancient medicine, especially the problem of identifying ancient diseases and plants using modern terms, with which historians of medicine often grapple. Chapter 3 focuses on the similarities and differences between the Talmudic therapies and medical traditions found in earlier Jewish literature,
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including in the Bible, Second Temple texts, the Mishnah, and the Yerushalmi Talmud. Although there are not many direct precursors to the Talmudic therapies, the Babylonian rabbis were creative in building on these traditions as a way to support their unique perspective and practices regarding health and illness. Compared to other Jewish cultures, the Babylonian Talmud downplays the role of God and sin in human illness and health, and instead promotes the idea that God authorized humans to heal themselves using the natural world that He created, such as plants and animals. Chapter 4 examines the empirical background to the Talmudic medical therapies and the rabbis’ testing of amulets. It focuses on descriptions of remedies that offer detailed instructions on how to perform them, as well as on those which warn of negative side effects. In this chapter, I explain why the rabbis believed that certain therapies worked, including those whose efficacy we today would view as questionable. Chapter 5 surveys the multiple nonrabbinic contexts—Akkadian, Greek, Syriac, and Mandaic, as well as the incantation bowls—that played a role in the formation of Talmudic therapies. It argues that Talmudic medicine was part of a broader, shared medical culture in the Sasanian world, and that the rabbis prioritized healing over the threat of idolatry by permitting anything that heals, even if it comes from the outside. In support of this, I also analyze texts that portray the rabbis learning therapies from Arabs and pagans, as well as from Jewish women such as Abaye’s mother. Finally, I end this chapter by arguing that the rabbis “rabbinized” the anonymous therapies that they learned from outsiders as a way to maintain control over their Jewish peers in this aspect of daily life.
notes on translations, transcriptions, and manuscripts Except when indicated otherwise, the translations of Talmudic texts in this book are based on the standard Vilna edition. Citations of manuscripts rely on the Sol and Evelyn Henkind Talmud Text Databank provided by the Saul Lieberman Institute of Talmud Research at the Jewish Theological Seminary. At times I consulted the Friedberg Genizah Project via the Friedberg Jewish Manuscript Society (https://fjms.genizah.org). In most cases I only record variants that may impact the analysis of a text. My translations of medical terms and phrases are indebted to Michael Sokoloff’s Dictionary
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of Jewish Babylonian Aramaic. For the Yerushalmi Talmud, I follow Talmud Yerushalmi According to Ms. Or. 4720 (Scal. 3) of the Leiden University Library with Restorations and Corrections, ed. Yaacov Sussmann (Jerusalem: Academy of the Hebrew Language, 2001). Biblical quotations are from The Jewish Study Bible, ed. Adele Berlin and Marc Zvi Brettler (New York: Oxford University Press, 2004). Abbreviations of Talmudic tractates, as well as transcriptions of Hebrew and Aramaic words, follow the conventions of The Society of Biblical Literature Handbook of Style for Ancient Near Eastern, Biblical, and Early Christian Studies, ed. Patrick H. Alexander, John F. Kutsko, James D. Ernest, Shirley Decker-Lucke, and David L. Petersen (Peabody, MA: Hendrickson Publishers, 1999).
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chapter 1
Medicine on the Margins
Medicine is not the first topic that one expects to encounter when studying Talmud. The Babylonian Talmud, or Bavli, is primarily a collection of rabbinic laws and stories structured as a commentary on the Mishnah. But as scholars have emphasized in recent years, it is also an anthology of overlapping genres: laws, stories, court cases, rituals, folklore, and magic—these are just some of the categories that Talmudists interrogate.1 Although redacted side by side, each of these categories exhibits distinctive literary features and content. In this book, I focus on a small but significant genre of Talmudic text that experts often neglect to study—namely, healing therapies for specific ailments, or what I will call Talmudic medicine. The rabbis of Sasanian Babylonia were clearly invested in the healing arts. Indeed, the Bavli is by far the largest repository of texts on healing and illness in ancient Jewish literature before the rise of Islam. Unfortunately, there are few synthetic studies on this topic by specialists in late antique Judaism. As a result, scholars who rehabilitate the medical tradition—which, like magic, has been forced to the margins of Jewish normativity since the Middle Ages—are in a position to illuminate new aspects of Babylonian rabbinic culture. How did the Jews of Sasanian Babylonia think about, classify, and treat illnesses? Did the rabbis engage in medical observation and practice, and if so, what does this imply about their expertise in medical science? And finally, in what ways is Talmudic medicine a Babylonian rabbinic invention, stimulated by exegesis and law, and in what ways is it an appropriation of Greek and Babylonian scientific knowledge? It is these types of questions that I address throughout this book. 1
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2 Medicine on the Margins
ailments and therapies The Talmud refers to over seventy different afflictions in Jewish Babylonian Aramaic.2 This number of Aramaic terms would increase were one to include ailments that are attested exclusively in non-Talmudic magical sources like the Jewish incantation bowls and the Sword of Moses.3 The majority of these are commonplace problems, such as toothaches and headaches, while others are more serious conditions like pleurisy and liver or lung malfunction.4 Despite the rabbis’ restrictions against human autopsy, the Talmud is familiar with diseases of the internal organs, including the kidneys, spleen, heart, and intestines.5 The rabbis gained some of this knowledge from inspecting slaughtered animals.6 The rabbis were also aware of the dangers that nature poses to one’s health—from the perils of scorpion stings and thorn piercings to the risks of consuming spoiled food—and had a nuanced understanding of the deleterious effects of climate and the environment on human health.7 Although the Bavli routinely mentions ailments in the context of law,8 it also contains a set of sources that discuss illnesses and their remedies on their own terms. The richest of these are medical clusters found in b. Git.. 68b–70b, b. ‘Abod. Zar. 27a–29a, and b. Šabb. 108b–111b. These pages are comprised of detailed therapies for dozens of afflictions: nosebleeds, strangury, earaches, and anal fissures, among others. To heal them, the Talmud recommends a range of options—from spells and amulets to natural drugs and baths. In general, the Bavli endorses human treatments over divine intervention. In other words, faced with the dilemma of whether to trust one’s health to God, as the Bible advocates, or to human physicians and plant-based drugs, Babylonian rabbis were in favor of the latter.9 There exists contradictory evidence regarding the extent to which the Babylonian Jews and rabbis created (or strove to create) a comprehensive and organized medical system. On the one hand, the Talmud does not embrace any uniform theory about etiologies or healing, nor does it construct an elaborate taxonomy of diseases on par with earlier cuneiform or later Arabic medicine. Redactionally, the therapies are scattered throughout various tractates in the Bavli, especially Berakot, Šabbat, Ketubbot, Git.t.in, and ‘Abodah Zarah, meaning that there is little coherence to the subject matter as a single topic of inquiry.10 Healing was not a central concept in rabbinic ideology, at least relative to the importance of the idea within early Christian beliefs.11 True, the Bavli records many detailed remedies; but qualitatively, as the his-
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torian of medicine Samuel S. Kottek indicates, most of them are “incidental and informative” or so “brief, fragmentary and/or unclear that they remain obscure.”12 The rabbis were, after all, first and foremost legal thinkers, not physicians. The Talmud’s lack of systemization could be the result of several factors, including the relative dearth of biblical and Tannaitic precedents on which the rabbis could expound via exegesis. From a societal perspective, there were no institutions of medical learning or practice in Jewish Babylonia around which centralization might occur. It is also possible that the rabbis did not want to compete in this arena of society with Christians, Greeks, and Babylonians. For all these reasons, it appears that the rabbinic movement was not focused on creating a comprehensive and organized medical system. On the other hand, as we will see, the Babylonian rabbis did much more than just dabble in therapy. To the contrary, they debated treatments, identified drugs, explained etiologies, and performed remedies on themselves and one another. Exegetically, the rabbis took advantage of any earlier authoritative tradition from the Bible and the Mishnah that they could find through which to unpack their own ideas about health and illness. At the same time, they innovated and invented concepts and terms not found in other Jewish languages or cultures, and when they did borrow ideas from external medical systems, they often rabbinized them. Finally, the best evidence of the Talmud’s efforts to create a medical system is its inclusion of the medical therapies that this book will analyze.
the git. t. in book of remedies The Talmud contains several lengthy medical sources. These include a handbook called the Git.t.in Book of Remedies (b. Git.. 68b–70b)13 and two other compilations of therapies (b. ‘Abod. Zar. 27a–29a and b. Šabb. 108b–111b). In addition to these, there are shorter texts on bloodletting, pediatrics, brain surgery, and other relevant subjects. As I show below, these sources mention the same ailments, share a set of unique motifs and literary forms, and prescribe similar therapies. The Git.t.in Book of Remedies is the most complete medical work in ancient Judaism.14 In a series of important publications, the Assyriologist and historian of medicine Markham J. Geller argues convincingly that this work “was probably based upon an Akkadian vademecum”15 and “employs a significant number of Akkadian loanwords or calques of Akkadian medical expressions,”
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4 Medicine on the Margins
especially for plants.16 Talmudic medical plants stemmed from the botanical standards of the time and were only infrequently inspired by biblical precedents.17 The Git.t.in Book of Remedies is part of a broader medical culture in Sasanian Iran. Although seamlessly redacted into the Bavli’s tractate on divorce deeds, the handbook’s style and content stand out from typical Talmudic discourse. Totaling approximately one thousand words, it is comprised of over forty remedies to treat over two dozen afflictions arranged from head to toe.18 The ailments in the Book of Remedies are the following:19 blood of the head migraine cataracts night-blindness20 day-blindness nosebleed blood coming from the mouth molar (pain) larynx (pustules/pimples in?)21 pleurisy22 arrow (injury by)23 (drinking) uncovered water abscess/boil heart palpitation heaviness of heart intestinal inflammation (or: “sickness of the heart”)24 dysentery sting (or: “worms”)?25 fierce sting (or: “white worms”)?26 to stop (diarrhea) (diseased) spleen illness (perh. “hemorrhoids,” “anal worms,” or “gall-bladder disease”?)27 malady/hip-disease28 strangury outer strangury29
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inner strangury skin disease In terms of treatments, many of these afflictions are remedied through potions or mixtures of materia medica that the sick person eats, drinks, or applies to the affected area—such as smearing salves of acacia and aloe to treat hemorrhoids, bathing in boiled plants to cure strangury, or stanching a bloody nose by inserting tampons with medicine on them. The empirical background to these techniques is notable. In an article on observation in rabbinic literature, Richard Kalmin contends that a process of trial and error, along with a recording of failures, fueled the production of these types of therapies.30 Giuseppe Veltri agrees, noting that the “rabbis insisted on empirical and pragmatic criteria to judge customs, medical procedures, and remedies.”31 These aspects of Talmudic medicine make these therapies relatively unique within the ancient Jewish tradition. Yet whether the rabbis participated in or were aware of the testing procedures behind the therapies is hard to determine. The Talmud usually does not describe how or why a given therapy works or was invented; it simply presents them in their final form. Or, as David L. Freeman puts it: “No rationale, theory, example, or proof is offered in support, no authority or tradition is quoted, the remedy is just assumed to be effective.”32 There are different ways to interpret this. It may reflect the fact that the Talmud adopted the therapies, and perhaps even translated them, from an authoritative outside source or community of experts. If so, then the rabbis were neither responsible for nor witnesses to the testing or the creation of the remedies. Geller’s emphasis on the Akkadian context is supported by this interpretation. Alternatively, it may be the case that the rabbis did not feel that it was necessary to explain the therapies because they believed that their origins and efficacy were rooted in exegesis, word-play, popular folklore, or God’s creations. Either way, scholars today bear the burden of trying to unmask the processes that lie behind the creation of the Talmudic therapies. The Book of Remedies was likely an independent written or oral composition that the editors of the Talmud inserted into tractate Git.t.in immediately after some magico-medicinal traditions on qordiaqos, fevers, the Exilarch, and the Solomon-Ashmedai tale.33 It is also possible, as Dan Levene has suggested, that the Solomon-Ashmedai tale is the introductory myth for the handbook, in a style reminiscent of other magical works.34 Such insertions of independent sources—including, for example, a folkloric cycle about pious men and a
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6 Medicine on the Margins
dreambook—are not uncommon in the Bavli.35 These independent sources often exhibit influences from nonrabbinic contexts. One can speculate regarding the motives for incorporating the Git.t.in Book of Remedies in the Talmud and in the tractate on divorce deeds, as parallels to the incantation bowls show: that is, the bowls’ numerous references to divorce deeds—which separate clients from demons—are an interesting point of connection and possible explanation for why the remedies appear in this tractate.36 Beyond that, its inclusion does not appear to have been for the sake of legal inquiry, since most of the handbook’s medical information and terms do not get recycled and become fodder for specific legal discussions elsewhere in the corpus. Moreover, it is difficult to discern any sort of didactic message behind the therapies. All that said, to the extent that the rabbis preserved and commented on the handbook, they accepted its authority on several grounds. The rabbis probably considered the Git.t.in Book of Remedies to be a collection of therapies that “serve as paradigmatic examples of aesthetic value and achievement,” or as “an exemplary canon,” to borrow language from Moshe Halbertal.37 The Book of Remedies is, in other words, a distinctive genre composed in the form of an instruction manual, with its authority conceived “from its unique intrinsic merit, like that of a great book,” rather than from any potential normative or curricular aspects.38 Indeed, it is noteworthy that the Talmud does not make it obligatory for Jews or rabbis to practice or study the medical therapies. The Talmud does not frame the remedies, in and of themselves, in terms of whether they are permitted or forbidden, as they do with other rituals.39 As Rav Sherira Gaon, the head of the Pumbedita academy in the tenth century, understood, the Talmud’s medical therapies are not commandments.40 A second reason that the Book of Remedies was included in the Talmud was in the spirit of having the Oral Torah be a comprehensive repository of all known traditions. The integration of medical knowledge, often originating from an outside source, into canonical or, in the case of the Talmud, legal discourse is common in ancient corpora.41 The merging of science into canons of law and theology is reminiscent of how the Zoroastrian work the Dēnkard describes the third-century Sasanian King Shapur I collating Indian and Greek medicine, physics, and other sciences with the Avesta.42 Third, the rabbis likely included the Book of Remedies as a practical way to fulfill commonplace needs in Jewish society, including ones that halakha was unable to satisfy.43 As Daniel Boyarin has shown, in contrast to Hellenistic Jewry and Christians, the rabbis were focused on the importance of the human
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body.44 The rabbis recorded the remedies as a way to help their fellow Jews follow the requirement to protect one’s health or to save a life, core Jewish values.45 The art of healing physical afflictions thus became part of the rabbis’ mission to serve Jewish society. By transmitting the medical handbook, the rabbis were also able to assert control over this aspect of everyday life by regulating the practices such that they conformed to the rabbinic worldview. Part of the ambiguity surrounding the medical handbook’s purpose is a result of its anonymity. Its first six remedies do not refer to the rabbis at all. This feature of the work complicates scholars’ attempts to date it, since many anonymous traditions in the Bavli are the products of later redactors, the Stammaim.46 Geller is correct when he maintains that the medical handbook “probably reflects the art of folk medicine in the third century ce,” 47 though I would add that a fourth- or even fifth-century dating is also reasonable. It is conspicuous that the third-generation Amora Rabbah bar Rav Huna, who died circa 322 c.e., offers the remedy for a toothache in b. Git.. 69a, followed by a remedy for pustules in the larynx attributed to the second-generation Palestinian Rabbi Yoh. anan, who died circa the end of the third century.48 Before the beginning of Bavli Git.t.in 70a—where there is an obvious stylistic switch away from the introductory formula that begins by naming the ailment—there are Babylonian Amoraim from the early fifth century who respond to the anonymous therapies.49 For these and other reasons, the core of the Git.t.in Book of Remedies (before 70a) likely dates to the third or fourth century c.e. If this is correct, then the anonymous therapies may reflect a different transmission stream than other unattributed materials, which are often thought to be products of later editors. Kalmin has proposed a similar thesis: Medical and magical recipes and dream interpretations are different from the unattributed statements so ubiquitous throughout the Talmud, which are virtually always argumentational in character. The unattributed remedies, magical cures, and dream interpretations are also atypical in that with relative frequency, named Amoraim comment on them, suggesting that they tend to be earlier than typical unattributed statements, and that they were transmitted differently than attributed statements, perhaps with less exactitude, or in a less formally published form.50
The unusual transmission of the medical therapies can help to further unravel the complexities of the Bavli’s redactional history (see chapter 5). As this book will show, the Talmudic medical therapies are distinctive in content, style,
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aim, transmission, and redaction in large part because they are an “epistemic genre,” or “texts that develop in tandem with scientific practices.”51 In my opinion, the anonymity of the Git.t.in Book of Remedies is in part a result of its origins from within a nonrabbinic group of—presumably at least—Jews. As I already mentioned above, there is little evidence to suggest that the rabbis considered the therapies to be obligatory practices that satisfied a divine commandment incumbent on a Jew. Except for the appearance of some rabbis, the Git.t.in Book of Remedies does not often overtly advertise its affiliation with the Jewish religion—such as, for example, by referring to the Patriarchs, invoking God, or quoting or even alluding to the Bible. Although it is mostly anonymous, the medical handbook is, however, not entirely unattributed, as over twenty rabbis make an appearance. From beginning to end, the work becomes increasingly rabbinic, especially starting in b. Git.. 70a, once the handbook’s formulaic structure changes. Except for Rabbi Yoh. anan and several others, the sages in this work are Babylonian Amoraim from the first through the seventh generation. Many are associated with the rabbinic academy at Sura, near Babylon. The list of sages is a veritable who’s who of rabbis who surface in other medical texts—save for, unexpectedly, Rav, Shmuel, and Rava, who are not featured prominently in the handbook. In the Git.t.in Book of Remedies, the rabbis engage in all sorts of medical practices— they offer treatments, establish drugs, perform remedies, and debate etiologies. In the following text, for instance, Rabbah bar Rav Huna is the purported transmitter of a remedy for molar pain: For a [painful] molar. Rabbah bar Rav Huna said: Bring a clove of garlic, crush it with oil and salt, put it on the thumbnail on the side that hurts, and surround it with a rim of dough, but be careful of the flesh because it can cause leprosy.52
Except for the attribution to a rabbi, this remedy’s style conforms to the formula of the classic anonymous therapies that I examine in this book. Its last line—a warning against the side effects of an incorrect procedure—is a refrain in the medical therapies and demonstrates their empirical background. Babylonian rabbis sometimes identify medicinal plants as well. For example, in a treatment for delareya—which Marcus Jastrow’s Dictionary defines as “diarrhea”—the Palestinian sage Rabbi Yehoshua ben Levi recommends thistle, which the Babylonian rabbi Abaye identifies as prickly safflowers. Our rabbis taught in a baraita: One who has sex while standing is seized with spasms; [one who has sex] while sitting is seized with delareya [perh. “diarrhea”
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or “abdominal spasms(?)”];53 [one who has sex] with her on top and him on the bottom is seized with delareya. What is delareya? Rabbi Yehoshua ben Levi said: “The drug for delareya is thistle.” What is thistle? Abaye said: “Prickly safflower.”54
This text begins with a baraita that teaches that having sex while sitting down or with her on top can cause delareya (diarrhea?), a Greek word.55 In response to the question of what delareya is, the Talmud, instead of answering directly, identifies the drug that treats it, according to Rabbi Yehoshua ben Levi. This Palestinian Amora is an authority in medical matters who, according to b. Ketub. 77b, was not afraid to study Torah with men afflicted with ra’atan, a contagious skin disease. To cure delareya, Rabbi Yehoshua ben Levi recommends thistle as the drug of choice—which Abaye, a Babylonian sage, then identifies as prickly safflower. The rabbis did not always agree on the particulars. For example, some rabbis in the Book of Remedies offer alternative etiologies for an affliction called frailty: Mar Ukva said: “One who drinks white t.ilya-wine is seized by frailty.” Rav H . isda said: “There are sixty types of wine. The best is red aromatic [and] the worst is white t.ilya.” Rav Yehudah said: “One who sits near a fire on the mornings of Nissan, rubs oil [on oneself], and goes out and sits in the sun is seized by frailty.”56
Mar Ukva here states that drinking a certain type of white wine makes one frail, with Rav H . isda clarifying that this is the cheapest of sixty types of wine. Rav Yehudah, however, gives a second possible cause of frailty—namely, that it seizes overheated bodies. Again, it is important to note that this debate between rabbis is in the supplemental medical section immediately after the anonymous therapies in the Book of Remedies’ end, at the beginning of b. Git.. 70a.
therapies in ‘abodah zarah 27a–29a and šabbat 108b–111b In addition to the Git.t.in Book of Remedies, the Babylonian Talmud has two other collections of therapies. The first one, in ‘Abodah Zarah 27a–29a, begins as a debate over m. ‘Abod. Zar. 2:2’s statement regarding under what circumstances it is permitted for a Jew to be healed by non-Jews. The Gemara’s answers tend to center on if the non-Jewish physician is a reputable expert (in which case he will not purposefully harm the Jewish patient) and on whether
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or not the affliction is life-threatening. The medical therapies in b. ‘Abod. Zar. 27a–29a are more entwined with halakhic and aggadic discourses than the Git.t.in Book of Remedies. Beginning in 28a, the passage discusses particular diseases and remedies. Some of the ailments referenced include a crack in the skin, anal fissures, earaches, and eye diseases. This collection of remedies rabbinizes and expands on the anonymous remedy format found in the Git.t.in Book of Remedies and also contains a greater variety of literary formats. Rabbis appear prominently throughout it, offering medical-legal opinions, listing drugs, and warning of mortal dangers. On multiple occasions, Palestinian sages are depicted as suffering from ailments—Rabbi Yoh. anan from scurvy, Rabbi Yaakov from an anal fissure, and Rabbi Abbahu from an earache. True to its character within the tractate on idolatry, b. ‘Abod. Zar. 27a–29a also depicts the rabbis learning therapies from outsiders, such as when Rabbi Yoh. anan and Abaye are taught remedies from a mat.ronita and an Arab, respectively. In sum, although this collection of therapies is similar to the Git.t.in Book of Remedies in a number of ways and likewise influenced by Akkadian medicine,57 its contents are more rabbinized and integrated into legal and narrative discourses. A third cluster of medical traditions is found in Bavli Šabbat 108b–111b. As Geller has shown, some of these therapies were similarly influenced by Akkadian thought.58 Similar to b. ‘Abod. Zar. 27a–29a, these therapies are interwoven into halakhic and aggadic discourses, with a strong presence of rabbis. This collection is a commentary on Mishnah Šabbat 14, which probes whether one is permitted on the Sabbath to consume foods or drinks with medicinal properties. Mishnah Šabbat 14:2–4 itself alludes to some simple cures: purgative water or a cup of root-water helps jaundice, and vinegar alleviates a toothache. In its commentary on these traditions, b. Šabb. 108b–109a considers the use of wine and vinegar as cures for eye illnesses and the swelling of injured hands and feet. Later, the Talmud gives therapies for fluke worms and the threats of snakes, which are followed by related short stories. Finally, b. Šabb. 110a–b presents a lengthy series of options for fertility, zaba, and jaundice. The similarities between the three main medical sources point to an organic connection between them, as well as between other shorter therapies attested elsewhere in the Bavli. These therapeutic traditions exhibit distinctive literary, lexical, and thematic features. Most prominently, they repeat variations of the same formula—namely, a specific ailment followed by a list of materia medica and instructions (see below). The therapies also often rely on identical appli-
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cation methods—such as “tearing open” an animal (e.g., a donkey womb, pig, black hen, or hornless buck),59 or using “worn-out linen rags in the summer and cotton [rags] in the winter” (e.g., for zaba, hemorrhoids, and anal fissures).60 Some therapies share the same ingredients, including cumin and worm-colored alkali, as well as preparatory directions, like crushing drugs in a mortar.61 Finally, the same four Babylonian Amoraim figure prominently in the three main collections of therapies—namely, Mar Ukva, Shmuel, Abaye, and Rav Ashi.
lexicon of medical terms The Jewish Babylonian Aramaic vocabulary of drugs and afflictions contains terms that appear in nonmedical registers. The blurred line between food and medicine contributes to this overlap. Some common foods, like dates, could have both beneficial and harmful qualities, thereby necessitating debates over when and how to eat (or not eat) them.62 Moreover, the verbs that the Talmudic therapies use to describe the preparation or application of drugs are used in other contexts, including, again, in culinary ones. Many Talmudic drugs were prepared and administered like foods and beverages, which was of course common in antiquity.63 Some of the names of afflictions are also generic words for a body part (e.g., “spleen” in b. Git.. 69b). The medical lexicon therefore frequently co-opts and ritualizes commonplace items, actions, and language, rather than being solely in the domain of specialized knowledge. On the other hand, there are terms that are attested exclusively in medical contexts. For example, the term for ostrich egg appears only once in the Talmud, in a remedy against zaba.64 Other such medical terms are loanwords from Akkadian, Greek, or Iranian, or have cognates in Syriac and Mandaic. For instance, b. Git.. 69b’s remedy for hemorrhoids suggests acacia (from Greek) and silver dross (from Iranian). The latter substance also appears in the following text in b. Git.. 86a, which illustrates a mixture of lexical registers. In the middle of a discussion regarding the sale of slaves, Abaye (or an anonymous tradition)65 gives the ingredients for a salve that one can smear on a boil using a goose feather. Rav Yehudah established the document for the sale of slaves: “Our slave is assigned to slavery, and is exempted from and cleared of claims, and demands, and claims of the king and queen, and no one’s mark is on him, and he is cleared of any blemish or any boil that appears on him within four [years after sale, regardless of
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whether it is] new or old.” What are its remedies? Abaye said: “Slag of iron, silver dross, sulfur, wine-vinegar, olive oil, and white naphtha, and one smears it [on it] with a goose feather.” 66
Abaye’s remedy here is given in response to a medical-legal conundrum that the sale of a slave must address: is the sale valid if a slave develops boils in the first four years after the sale? Abaye’s salve for boils is, at least implicitly, a solution to the problem. Among the therapy’s ingredients are silver dross and slag of iron, which one smears on the boil using a goose feather. These two metals, which are unique to Talmudic medical discourse, are at the same time juxtaposed with everyday items such as olive oil and wine. This one example demonstrates how the medical lexicon was composed of both technical and commonplace terms and items.
literary form of the therapies Many of the Talmudic therapies follow a basic script that begins with the name of the ailment followed by a list of ingredients and instructions on how to prepare and apply them. For [name of ailment] . . . bring / let one bring / one should bring [list of materia medica] . . . prepare [them in this way] . . . apply [them in this way] . . . alternative option [if not, do this] . . .67
The first step of naming the ailment is a familiar technique in traditional medicine based on a need for classification: one cannot heal what one cannot identify. After the introductory formula, the therapy gives directions on which medicinal ingredients are needed and how to concoct and administer them. To prepare the drugs, one boils, cooks, burns, roasts, soaks, or grinds them, and to apply them, one drinks, eats, or rubs them—among other actions. Tools were sometimes used in this process. For example, offering us a glimpse into how people of this time consumed drugs, the Metropolitan Museum of Art in New York City has an archaeological relic of a Sasanian medicine dropper.68 As the Talmud describes many times, people often ingested medicine with wine or beer, a common practice in antiquity (see b. Git.. 69a–70a).69 Wine itself was medicinal, as b. B. Bat. 58b expresses: “I, Wine, am the source of all cures.” Drinking
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the wrong wine can also have negative effects; for example, drinking the foam can cause pleurisy (b. H . ul. 105b), and drinking t.ilya-wine can cause frailty. The anonymous therapies in the Talmud do not explicitly mention the involvement of physicians, apothecaries, or rabbis. Who, then, supervised or performed them? Is this omission merely a result of the obvious need for professional involvement—so obvious in fact that one need not even mention it?70 There is some data to support this. For instance, one could argue that some materia medica would have been too obscure for an average person to procure without professional assistance, and that many remedies demanded technical expertise to execute properly. Moreover, the Talmud itself says that Jews turned to bloodletters and Jewish and pagan doctors for treatments. On the other hand, the Talmud’s impersonal and anonymous presentation of the therapies may indicate that they were practiced as home remedies, either by oneself or with the help of family, friends, or laymen. Some therapies could have been performed by the sick alone, while others would have required multiple people to perform. It is also possible that the therapies originated in a professional setting (perhaps among non-Jews), only to have the rabbis reorient them to an everyday context.71 If this is correct, perhaps the rabbis promoted home remedies as a way to discourage their coreligionists from relying on physicians, both pagan and Jewish? While it is hard to prove definitively, the totality of the evidence that I have seen suggests this may have been the case. The rabbis thus sought to maintain control over this aspect of Jewish society, but without adopting the title of physician. Hence, becoming knowledgeable of and transmitting remedies that did not require professional involvement was a way for the rabbis to help their coreligionists stay healthy and, at the same time, reduce interactions with competitors. Another recurring feature of the therapies is the insertion of anonymous rhetorical interjections that stimulate further details about remedies, drugs, etiologies, or symptoms. Such questions include: What is the remedy/healing? What is this ailment or drug? With what is it eaten? What causes the affliction? What are the symptoms?
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The answers to these questions are ordinarily anonymous or given by Abaye, as we saw in the remedy for boils in b. Git.. 86a. Before moving on, let us look at the first remedy in the Git.t.in Book of Remedies, for blood of the head, as an example of the literary form that I outlined above. It reads: For blood of the head, [bring] cypress, tamarisk, myrtle, olive, willow, bluestem, and cynodon, boil them together, and pour three hundred cups on this side of the head and three hundred cups on that side of the head. If not, bring a white rose [with leaves?] standing in a row, boil it in water, and pour sixty cups on this side of the head and sixty cups on that side of the head.72
This anonymous remedy follows the script: “For . . . bring . . . prepare . . . apply . . . if not.” It provides instructions on how to heal someone who has a mysterious condition called “blood of the head.” Whether this is a symptom or an affliction is unclear,73 but to cure it one boils shrubs and grasses and then pours three hundred cups of the mixture on each side of the head. Alternatively, one can boil a type of white rose and pour sixty cups on each side of the head. In contrast to some of the more specific posological details found in other remedies, these quantities of three hundred or sixty cups were not meant literally but rather to imply large amounts. Although unique in some ways, the Talmudic therapies’ script shares in common literary features with non-Talmudic books of magic from late antiquity and the Middle Ages, especially the Sword of Moses (H . arbe de-Moshe), the Book of Mysteries (Sefer ha-Razim), and texts from the Cairo Genizah.74 For example, the identification of a disease, problem, goal, or wish using the preposition “for . . .” (plus verb or noun), followed by instructions, is attested in these sources and appears to have been a widespread phenomenon in late antique magic and medicine more broadly.75 From a literary point of view, some of the remedies conform to designations of “magic” as a brand of texts that exhibit the same literary features.76 The Sword of Moses is a rich text with which to compare the Talmudic remedies. It contains a number of the same afflictions (e.g., cataract, migraine, and diseased spleen), though, in terms of the therapies themselves, there appear to be fewer precise parallels. It is equally important to highlight the literary and conceptual differences between the Talmudic therapies and these other sources: for example, the latters’ emphasis (e.g., in the Sword of Moses) on spells that are rendered over the ingredients, and the baqqaša-formula (“if you wish . . .”), which are not typically found in
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the former.77 While further research is needed to clarify the precise relationship between all these sources—including the incantation bowls—one can preliminarily deduce that some of their traditions either share common origins or borrow from one another.
“if not . . .” As we just saw, many remedies include alternative options introduced by “if not.”78 This could, again, be a borrowing from Akkadian medicine, according to Geller.79 In what follows, I would like to propose five plausible interpretations of this phrase, which are not mutually exclusive. I agree with Kalmin when he writes about this phrase that “each case needs to be evaluated on its own terms.”80 (1) The phrase reflects the Talmud’s goal of encompassing all known medical traditions. As Veltri explains, this desire for comprehensiveness reflects “not only the traditional exegetical premise of rabbinic hermeneutics to discuss everything at length, but also the method of the ancient empirical sciences.”81 In terms of transmission, it is likely that some “if not” therapies were later supplements added under an initial rubric for a specific disease, perhaps in an organized medical manual. (2) The inclusion of therapeutic options is a latent acknowledgment that a given therapy might not be effective.82 In other words, to quote Veltri again, the Talmud views a “(magical) recipe, a remedy, or a plant” as “a possible cure,”83 and because of this, a sick person should try different remedies until one works. (3) The reason for including secondary options is in case a person does not have the techinical capability or is unable to acquire the necessary ingredients or tools for a given therapy. Bavli Šabbat 110b’s remedy for jaundice suggests that the latter were actual considerations: . . . bring the head of a salted scaled fish,84 boil it in beer, and drink it. If not, bring brine of locusts. If there is no brine of locusts, bring clear brine. And take him to a bathhouse and rub it on him. If there is no bathhouse, place him between an oven and a wall.85
This therapy makes it clear that the alternative options are given in the event that brine of locusts and a bathhouse are unavailable.86 In some of the “if not” therapies, the secondary options are easier to accomplish than the earlier ones.87 Hence, in the text above, if one cannot find locust brine, then one can
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use clear brine; or if one cannot access a bathhouse, then one can stand near an oven to achieve a similar effect on the body. If we believe that the order in which the Talmud presents alternative therapies was purposeful, then these additions were perhaps meant to increase access. Another example of this trend toward simplification is seen in the two cures that b. Git.. 67b recommends to treat an ongoing heatstroke: For an ongoing heatstroke, bring a black hen, cut it open crosswise, shave the middle of [the sick person’s] head, place [the hen] on it and leave it until it sticks [cf. MS Vatican 130: “putrefies”].88 Then [the sick person should] go down and stand in the water up to the neck until becoming very ill, and submerge, come up, and sit down. If not, [the sick person should] eat leeks, go down and stand in the water up to the neck until becoming very ill, and submerge, come up, and sit down.89
The main difference between these two therapies is what the patient does before becoming submerged in water up to the neck. In the first one, the patient has a dead hen placed on his or her head—surely an unpleasant experience, especially if it is left there until it rots (see MS Vatican 130)—whereas in the second, one simply needs to eat leeks, which are common in Talmudic therapies.90 The second therapy is, in other words, a more comfortable and realistic option. (4) Some therapies use “if not” to provide different methods of treatment for the same ailment. For instance, in b. Šabb. 110b one excerpt for jaundice reads: Rabbi Yoh. anan said: “Someone who wants to heat up [the body of a person afflicted with jaundice] should wrap him in his sheet.” Rav Ah. a bar Yosef was ill with [jaundice]. Rav Kahana did this for him, and he was healed. If not, bring three measures equal to one-tenth griv of Persian dates, three measures equal to one-tenth griv of bitumen from honeycomb(?), three measures equal to one-tenth griv of worm-colored alkali plant, boil them in beer, and drink. If not, bring a donkey foal, shave the middle of [its] head, let blood from [the donkey’s] forehead, and put it on [the sick person’s] head. But be careful of the eyes lest [the blood] blind them. If not, bring the head of a buck placed in . . . [?], boil it in beer, and drink. If not, bring a hunchbacked pig, tear it open, and put it on [the sick person’s] heart. If not, bring [or: “eat”] leeks . . . [?] of garden beds.91
This text begins with Rav Kahana curing Rav Ah. a bar Yosef of jaundice by wrapping him up in a sheet, as Rabbi Yoh. anan advises. The above text’s list
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of therapies, connected by a series of “if not” phrases, shows the diverse techniques that the Talmud endorses toward one illness. The five options here are: 1. drinking a potion (of dates, bitumen, and alkali); 2. pouring donkey blood on the sick person’s head; 3. drinking a potion with a buck’s head; 4. placing a pig on the sick person’s heart; and 5. eating leeks. Options one and three are liquid concoctions that the sick person drinks, while the fifth is eating leeks. The second and fourth options involve animals: either pouring donkey blood on the head of the afflicted or a transference ritual using a pig. To the best of my knowledge, the Talmud’s choice of these animals is not derived from any symbolic import that they have in ancient Judaism. The placing of the pig on the patient’s heart appears to be related to an Akkadian remedy against the asakkû-demon, which is a carrier of a host of diseases, including jaundice.92 One text about this, provided in an essay by JoAnn Scurlock, reads: [Take] a piglet; [put it] at the head of the afflicted person. Remove its heart (and) [put it] on the man’s epigastrium. [Sprinkle] its blood on the sides of the bed. Disarticulate the piglet and spread (the pieces) out over the sick man, then purify and cleanse that person with pure sweet water from the holy water basin and pass the censer and reed torch by him and scatter seven and seven cakes baked in ashes at the outer gate and give the piglet as his substitute and give (its) flesh instead of his flesh, (its) blood instead of his blood so that they may take (it instead of him). Give the heart which you put on his epigastrium instead of his heart so that they may take (it instead of him).93
The Talmud’s fourth remedy appears to be a stripped-down, depaganized version of this Akkadian transference ritual. These sorts of contextual resonances may have played a role in the Talmud’s sequencing of alternative therapies, raising the possibility that the transmitters (or editors) of these therapies intentionally put the magical therapy of outside origins fourth, and then followed it up with an easier option (eating leeks) as a way to discourage the non-Jewish practice that uses a pig. Another text to consider is the remedy for an infected (grape-like) pustule, which Rav Safra calls a precursor of death. The text’s use of the phrase “in the meantime” implies that one should perform a sympathetic therapy while carrying out the empirical solution.
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Rav Safra said: “This infected [lit.: ‘grape-like’] pustule is a precursor of the Angel of Death.” What is the remedy? Rue in honey or parsley in t.ilya-wine. In the meantime, let him bring a grape of the same type [as the pustule], and roll it over it: a white [grape] for a white [pustule], [and] a black [one] for a black [one].94
This therapy recommends that people infected with a serious pustule perform a sympathetic magical practice (white for white, black for black) while they await the procurement, preparation of, or efficacy of the natural ingredients that will heal it. Thus, the magical practice appears to be a stopgap measure to be done until the preferred empirical method is executed, or a concurrent action that is needed to somehow help activate the natural remedy. (5) A fifth but less likely explanation for the alternative therapies connected by “if not” is that the Talmud believes that sick people should use each option in a different circumstance as it relates to the same affliction. For instance, in the case of an earache, b. ‘Abod. Zar. 28b provides six possible treatments before giving a mnemonic—“moist for dry, dry for moist”—as guidance that one should do the dry treatments for wet earaches, and vice versa. Outside of this example, however, I have not found other texts that support this explanation.
how jewish are the therapies? To what extent are the Talmudic therapies Jewish? Of course, on a basic level any text in the Bavli—regardless of its external origins or marginalization by later generations—is Jewish simply because it is a part of the sacred canon.95 Nevertheless, as I describe in this book, the therapies (as well as the ancient Jewish sciences more broadly) were influenced by external, especially Mesopotamian, systems of knowledge and were part of scientific developments in the Sasanian and Mediterranean worlds.96 For scholars today, comparing the Bavli’s remedies with outside medical texts can help to unpack rabbinic appropriations and innovations. Still, definitions of “Jewishness” are vulnerable to essentialist and apologetic arguments. Talmudic medicine is, in the end, neither entirely foreign nor essentially Jewish.97 Over a century ago, Julius Preuss, breaking from tradition, made the radical claim for his time that “there is, therefore, no ‘medicine of the Talmud,’ which might perhaps be compared to the medicine of Galen or of Susrutas. There is also no Jewish medicine in the sense that we speak of an Egyptian or a Greek medical science.”98 In some
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ways, Preuss’s evaluation is right. Talmudic therapies are not derived from the expected features of ancient Judaism, and many were customs that Jews shared in common with non-Jews (see chapter 5). Even when not ostensibly appropriated from external systems of knowledge, the content of the Talmudic therapies for named ailments is still not particularly Jewish in character. While the Git.t.in Book of Remedies does mention the Sabbath, Jewish names, the calendar, the Mishnah, and Elijah, these types of references are limited and often made in passing. Conspicuously missing from the therapies are invocations of Yahweh or the Patriarchs, a reliance on earlier Jewish texts as the basis of materia medica or procedures, and borrowings from ritual or mythic symbols from their ancestors.99 The therapies are not rooted in any obligation to Torah or to God. Moreover, unlike Jubilees or Asaph’s Book of Remedies, the Talmud does not ascribe the therapies to angels, Noah, or other intermediaries.100 (On the role of the rabbis in the therapies, see below.) In short, the Talmud does not present the therapies as patent expressions of Jewish religious identity.101 Although this may be surprising given the fact that the therapies appear in a sacred canon, this separation of medicine from theology was in fact common in antiquity.102
talmudic medicine in the middle ages Another approach toward answering the question of the Jewishness of the therapies is to explore their complicated reception in the post-Talmudic era. How did medieval Jewish authorities—such as Rashi, Moses Maimonides, and the authors of medical manuscripts from the Cairo Genizah—interpret the Bavli’s remedies for ailments?103 Did they believe in the efficacy of such therapies because they were codified in the Oral Torah? Or did they view such remedies as archaic and ineffective? And if the latter, how did they explain their inclusion in the Oral Torah? Many, but by no means all, medieval and modern commentators and scientists reject the value of late antique rabbinic remedies, instead promoting the standards of their own time. This tension between tradition and science is felt up until today. Among Jews living in the medieval Islamic world, the marginalization of the Talmudic therapies was largely a result of the translation and dissemination of Greek medicine.104 The rise of Greco-Arabic medicine precipitated a rupture in paradigms that made Jews view the Talmudic therapies—as well as the incantation bowls—as incommensurable
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relative to the scientific knowledge of the time.105 A skeptical attitude toward Talmudic medicine is on record by the tenth century, when the Geonim express doubt about its efficacy. This claim that the Bavli’s medicine was ineffective forced authors to explain away its negative implication that the rabbis were in error and their traditions unreliable. Commentators justify their position in various ways, such as by arguing that they were unable to correctly identify the plants in the Bavli, thereby making it impossible to practice the therapies.106 Others argue that the biological makeup of human beings and the natural world had evolved through the centuries such that the older therapies had become passé. Rav Sherira Gaon sums up these attitudes toward rabbinic remedies this way: Our sages were not physicians. They only recommend that which their experience had proved helpful; and their advice in these fields is by no means law. We must therefore not rely on medicines mentioned in the Talmud. Only he may use them who has them examined and confirmed by experienced physicians and who has the assurance that at least they can do no harm.107
For Rav Sherira Gaon, Talmudic medicine’s efficacy was neither trustworthy nor legally binding. This skeptical attitude was pervasive among other medieval and early modern Jewish groups as well, including Kabbalists, the Tosafists—who were well-versed in the Talmudic therapies—and the Karaites who rejected the authority of Oral Torah altogether.108 However, not all authorities denied the value of Talmudic medicine. For example, Rabbi Shlomo ben Adret (aka Rashba), who died in the early fourteenth century in Spain, supported the Talmudic remedies’ effectiveness and legitimacy as part of a conservative response to Maimonides and Greek science.109 Later medieval and early modern thinkers likewise confronted the conflict between rabbinic ideas and contemporary medicine. For instance, in eighteenth-century Italy, the famous Talmudist and physician Isaac Lampronti tried to thread the needle, arguing that there are times when he follows the opinions of natural philosophy even when they disagree with the rabbis, and there are times when he follows the rabbis, who he believes had access to certain religious truths and secrets, via Scripture, to which physicians did not.110 Lampronti’s wavering sometimes favors the divine tradition over naturalistic thought, as seen in his acceptance of the rabbinic statement that the kidneys advise an individual to do good or evil (b. Ber. 61a).111 Finally, in a recently published book, Marek Tuszewicki demonstrates the persistence of
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some rabbinic ideas and customs in the folk medicine practiced among some Ashkenazi Jews at the beginning of the twentieth century.112 Medieval Jews became leaders in medicine under both Islam and Christendom.113 Perhaps the best-known example is the twelfth-century philosopher and jurist Moses Maimonides (Rambam). Working within the Arabic-Galenic tradition, Rambam was a successful physician and author of numerous medical works.114 He viewed the practice of medicine as an obligation to the community derived from an interpretation of the biblical law regarding one’s duty to return lost objects to a neighbor (Deut. 22:2).115 When it came to another Talmudic science—astronomy—Maimonides maneuvers his rejection of the rabbis’ authority by arguing that the ancient sages were subject to the limitations of the scientific currents of late antiquity. Maimonides says this in the Guide of the Perplexed, where he explains that the rabbis made incorrect astronomical conclusions because their comprehension of mathematics was imperfect: “Do not ask of me to show that everything they have said concerning astronomical matters conforms to the way things really are. For at that time mathematics were imperfect.”116 Maimonides resorts to the principle of historical relativism as a way to give the rabbis a pass on their lack of scientific acumen in astrology without compromising their integrity or authority. But did Maimonides have a similar skepticism toward Talmudic medicine? To date, scholars have disagreed on this issue, even though it is clear that Rambam tends to characterize the Talmudic remedies as superstitious beliefs of the past.117 Maimonides’s limited engagement with Talmudic medicine corroborates his fidelity to Galen.118 As Isadore Twersky notes, Maimonides endorsed empiricist approaches toward medical practices, which he believed “should be as scientific as possible,” with the testing of drugs’ efficacy based on “reason or experience.”119 Maimonides actually disparages people who rebuff empirical medicine and instead rely solely on the will of God to heal them.120 For Maimonides, one problem with the Talmudic therapies is their irrational and magical elements. In his writings, he tends to ignore the Talmud’s superstitions and demons while retaining some of its ideas and instructions regarding diet and bloodletting.121 This distinction is in part determined by their efficacy: if it works, then it is permitted. In this vein Rambam accepts the principle of expert amulets in b. Šabb. 61a–b.122 Yet in On Idolatry, Maimonides is dismissive of the healing power of magical incantations, concluding that they bring neither injury nor benefit.123 Despite this, Maimonides
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understood that spells can provide a modicum of emotional relief in dire situations.124 Building on rabbinic traditions, he thus permits reciting spells over a scorpion or a snake bite, even on the Sabbath, as a way to settle the mind. In the Guide of the Perplexed, Maimonides writes leniently about amulets and remedies. In this excerpt from Book 3, he quotes b. Šabb. 67a, which says that any action done with the intention of healing is permitted and not considered among the “Ways of the Amorites”: They say explicitly: All that pertains to medicine does not pertain to the Amorite usages. They mean by this that all that is required by speculation concerning nature is permitted, whereas other practices are forbidden . . . You must not consider as a difficulty certain things that they have permitted, as for instance the nail of one who is crucified and a fox’s tooth. For in those times these things were considered to derive from experience and accordingly pertained to medicine and entered into the same class as the hanging of a peony upon an epileptic and the giving of a dog’s excrements in cases of the swelling of the throat and fumigation with vinegar and marcasite in cases of hard swellings of the tendons. For it is allowed to use all remedies similar to these that experience has shown to be valid even if reasoning does not require them. For they pertain to medicine and their efficacy may be ranged together with the purgative action of aperient medicines.125
Maimonides concedes that there may be remedies that are proven to work through experience or observation.126 The rabbis’ experiences substantiated their belief that their healing practices worked, even though, to Maimonides, such beliefs are mistaken and do not follow reason. As this brief survey shows, Maimonides’s attitude toward Talmudic medicine was mixed: though he supported some Talmudic ideas about diet and bloodletting, he also relied on his own up-to-date medical knowledge that deemed most of the remedies to be ineffective. In general, I agree with Tzvi Langermann when he writes that Maimonides was “more tolerant of folk remedies than he was of astrology,” but that he “tried to discount the folk remedies described in the Talmud in a respectful sort of way.”127 This attitude exemplifies medieval Judaism’s tendency to marginalize the Talmudic remedies.
rabbis and therapies This later marginalization notwithstanding, is it fair to assume that the Jews and rabbis of Sasanian Babylonia practiced and believed in the Talmudic therapies? Although the Talmud does not describe the rabbis as trained phy-
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sicians who charge a payment for their services,128 it does depict them engaging in all sorts of medical activities: they transmit, analyze, debate, and perform remedies; identify, prepare, and consume drugs; and speculate about etiologies and demonic invasions of the body. The rabbis involved in these activities come from a range of time periods and locales. There are a few dozen rabbis—from the earliest Tannaim to the latest generations of Babylonian Amoraim—who are important figures in the medical tradition. Many of these are authoritative rabbis in Babylonia, such Rav and Shmuel from the first generation, or Abaye and Rava from the fourth. Notably, each of these four sages served a different community: Sura, Nehardea, Pumbedita, and Mah. oza, respectively. The therapies appear to have circulated widely and were not a specialty of any one city or academy. Some rabbis, however, had specific areas of expertise. Rav, for instance, offered advice about bloodletting, diet, and heart problems and was aware of the magical aspects of health and illness such as the evil eye. Rav also taught others what he knew. In b. Pesah. . 113a, he cautions his own son against consuming drugs and having his teeth removed, suggesting that such advice was passed on from father to son.129 Moreover, the rabbis of subsequent generations also valued Rav’s proficiency in medicine: a lot of his traditions are recorded in his name by later sages, including by his pupil Rav Huna, who is another significant voice in the Talmudic medical tradition.130 In b. Šabb. 82a, Rav Huna chastises his son Rabbah for ignoring the advice of Rav H . isda regarding how to avoid straining one’s rectum when defecating, which Rabbah dismisses as merely “profane subjects.” Rav Huna was also known for making medicine available to the community, as seen in b. Ta‘an. 20b: “When [Rav Huna] had something that healed, he would fill a water jug with it and hang it from the doorpost of his home, saying: ‘Anyone who needs may take some.’ ” This tradition epitomizes how the rabbis were motivated to learn medicine to help others in their community. The most famous rabbi in the medical tradition is Shmuel. Estée Dvorjetski and other scholars aver that he was learned in both Greek and Babylonian therapy because he migrated from Palestine to Babylonia and may have studied in the medical schools in Nisibis.131 A contemporary of Galen, Shmuel relates therapeutic traditions in the Yerushalmi Talmud, such as in y. Yebam. 8:1 (9a), where he says that a child with a fever must wait thirty days before circumcision (cf. b. Yebam. 71a–b and b. Šabb. 137a). Like Rav, Shmuel was interested in bloodletting and magic, though his knowledge of medicine was
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more extensive than that of his contemporary. According to Fred Rosner, Shmuel was acquainted with “ophthalmology, gynecology, pediatrics, anatomy, toxicology, urology, gastroenterology,” among other areas.132 In b. B. Mes.i‘a 113b, the rabbi boasts: “I know the remedy for all things except for these three things,” including “eating unripe bitter dates on an empty stomach.” Shmuel not only transmitted therapies, but also practiced what he preached: for example, b. Ned. 50b reports that “Shmuel used to defecate with [the aid] of a stalk, until his wife unraveled [the braids of her] hair because of him [as a sign of grief at his pain].”133 Shmuel also used his expertise to help others and was perhaps most renowned for his eye salves. In one tale in the Bavli, Shmuel wants to treat Rabbi Yehudah the Patriarch’s eye sickness, but when Rabbi refuses, Shmuel cleverly puts the medicine under the sage’s pillow so that it gets absorbed into his eyes while he sleeps: Shmuel the Astronomer was Rabbi’s physician. Rabbi was sick in his eye. Shmuel said to him: “I will paint medicine on your [eye].” Rabbi said: “I cannot.” [He said to him:] “I will indeed smear it on you.” He said to him: “I cannot.” [Shmuel] put a tube of medicine under his pillow, and he was healed.134
In this text, Shmuel acts as Rabbi’s physician—and does so successfully. Although it is rare that a rabbi carries the title of physician, the description of rabbis healing other rabbis appears elsewhere. In b. Šabb. 110b, Rav Kahana cures Rav Ah. a bar Yosef ’s jaundice by following Rabbi Yoh. anan’s instructions for heating up the body: Rabbi Yoh. anan said: “Someone who wants to heat up [the body of a person afflicted with jaundice] should wrap him in his sheet.” Rav Ah. a bar Yosef was sick with [jaundice]. Rav Kahana did this for him, and he was healed.135
In both these texts, the Babylonian rabbis cure a fellow sage using a remedy that they knew on their own or were taught by Rabbi Yoh. anan, a Palestinian sage. This pattern of transmission is not uncommon, particularly in the case of Rabbi Yoh. anan, whose traditions surface throughout Babylonian Talmudic medicine. As the texts above illustrate, the Talmud often reports of rabbis being ill with various ailments.136 Rabbi Yehudah the Patriarch gets a lot of attention in this regard.137 This motif of a sick rabbi surfaces in the literary contexts of therapies, laws, and stories. It is sometimes linked to the commandment of visiting the sick.138 Some rabbinic tales, usually about miraculous healing,
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actually represent a narrative subgenre unto themselves.139 As Mira Balberg has argued, portrayals of rabbis suffering from intestinal disease can function as symbols of salvation and righteousness.140 Other texts express theological and anthropological ideas regarding the relationship between suffering, sin, atonement, righteousness, and divine love and punishment. For example, in b. Ber. 5a Rava counsels that when people suffer, they should examine their actions and commitment to Torah-study; if, after doing so, they discover that these were not the cause, they can conclude that it is a case of “sufferings of love,” whereby God makes the righteous suffer as a sign of His divine love.141 These texts—among many others that one could cite—help to contextualize the therapies and portrayals of suffering rabbis.
sabbath laws of medicine The rabbis’ expertise in medicine is frequently prompted out of a concern for Sabbath violations. For example, under what circumstances can one prepare or consume medicine on the Sabbath? And what is the rule if a foodstuff can be eaten as both medicine and food? At times the Talmud describes the sages debating these questions in rabbinic academies. In b. Šabb. 140a, Rav Ah. a bar Yosef is suffering from an ailment called heaviness of heart and goes to Mar Ukva for advice. The Gemara explains that one can use asa foetida, referred to in the Mishnah, to treat this problem. The Mishnah says that on the Sabbath one may not soak asa foetida in warm water as a medicine to drink, but may dip it in vinegar as a spice, since it is permitted for healthy individuals to eat foods with known healing properties.142 The Mishnah does not, however, report what specific ailment asa foetida cures—a detail that the Gemara fills in, as it does on other occasions as well.143 In b. Šabb. 140a, Mar Ukva gives Rav Ah. a bar Yosef a potion with asa foetida, which he consumes before inquiring in the academy of Rav Adda (or Mar bar Rav Adda) about the laws of consuming and soaking asa foetida on the Sabbath. Here is the relevant excerpt: For what [ailment is asa foetida] prepared? For heaviness of heart. Rav Ah. a bar Yosef was sick with heaviness of heart. He came in front of Mar Ukva. [Mar Ukva] said to him: “Go drink three shekels of asa foetida for three days.” He went and drank it on Thursday and Friday. The next morning he went and asked in the study hall [about whether to take the third dose on the Sabbath]. They said to him—it was taught in the academy of Rav Adda, and some say it was taught in the academy
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of Mar bar Rav Adda: “A person can drink one or two qabs [of it] and not worry [about violating the Sabbath].” [Rav Ah. a bar Yosef] said to them: “I was not asking about drinking, but rather what about soaking?” Rav H . iyya bar Avin said to them: “This situation happened to me, and I went and asked Rav Adda bar Ahavah but he was uncertain, [so] I went and asked Rav Huna and he said—this is what Rav said: “One may soak it in cold water and leave it in the sun.” . . . [In this case] because he drank it on Thursday and Friday, if he did not drink on the Sabbath his life would be in danger [because he did not finish the required dosage].144
In this text, Rav Ah. a bar Yosef uses asa foetida after consulting with Mar Ukva, who tells him to drink three-shekel weights of it for three days. When the third dose turns out to be scheduled for the Sabbath, Rav Ah. a bar Yosef turns to his colleagues in the study academy to find out whether he is permitted to drink the asa foetida on the day of rest, which they reassure him that he is. After this, however, Rav Ah. a bar Yosef clarifies that his question was actually not about drinking but about soaking the asa foetida on the Sabbath: was this a violation? Rav H . iyya bar Avin answers this by stating that, when he faced a similar situation, Rav told him that it was permitted to soak the asa foetida in cold water (as opposed to warm water, as the Mishnah forbids) and heat it up in the sun, since not taking the third dose would result in a “mortal danger,” therefore permitting one to violate the rules of the Sabbath. The rabbis express a lenient attitude toward treating someone who is seriously ill on the Sabbath. In cases of mortal danger, medical treatment was obligatory even if it violated the Sabbath laws. The rabbis were stricter in enforcing the Sabbath laws in situations of less serious illness in part because permitting medicine on the Sabbath would disregard the prohibition against grinding.145 In order to distinguish between cases of grave versus minor illness, the rabbis created medico-legal categories to be able to identify which ones were a danger to life. To this end, rabbinic law differentiates between external and internal afflictions. The latter are defined as life-threatening or disabling afflictions located from the lips inward, or the internal organs.146 The Talmuds and medieval commentators go to great lengths to catalog the ailments that are in this category.147 Of particular note in this regard is the influential digest of medical ethics, titled On Danger, by Nah. manides.148 In b. ‘Abod. Zar. 28b, the rabbis debate the procedure for “lifting up an ear,” presumably to fix a dislocated jaw, on the Sabbath. Is it better to use the hand or medicine in this circumstance, they ask?
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Rav Shmuel bar Yehudah taught: By hand but not by medicine. There are some who say by medicine but not by hand. What is the reason? The hand causes inflammation.149
Rav Shmuel bar Yehudah argues that it is preferable to treat a dislocated jaw by hand since the use of medicine would be a violation of the Sabbath. But others disagree, because fixing it by hand causes inflammation. This text then continues on this theme in the context of eye salves for an inflamed eye. Although most eye afflictions were not considered internal or life-threatening, an inflamed eye was an exception. Hence, Rav Zutra bar T. oviyah says in the name of Rav: “It is permitted to smear a salve on an inflamed eye [lit.: ‘rebels’] on the Sabbath,” if the drugs were pounded in a mortar the day before. After this, there is a disagreement between Rav Yehudah and Rav Shmuel bar Yehudah: “Rav Yehudah allowed the use of an eye salve on the Sabbath, [but] Rav Shmuel bar Yehudah said to them: ‘Whoever follows Rav Yehudah profanes Sabbaths.’ ” This text preserves different opinions regarding what medical actions are allowed on the Sabbath, with Rav Yehudah’s lenient view spurned by Rav Shmuel bar Yehudah. The passage goes on to report that Rav Shmuel bar Yehudah suffered an eye sickness and affirms the authority of Rav Yehudah in this matter. In the end, Rav Shmuel bar Yehudah was sick in his eye. He sent [a question] to [Rav Yehudah]: Allowed or forbidden? [Rav Yehudah] sent [the answer] to him: For everyone it is permitted, but for you it is forbidden. Was it on account of my view?! It was that of Mar Shmuel, since it once happened that there was a certain woman150 in the house of Mar Shmuel whose eye was inflamed on the Sabbath. She complained but no one paid attention to her, [and as a result] the eye burst and she died.151 Mar Shmuel went152 and taught: It is permitted to use a salve on an inflamed eye on the Sabbath. What is the reason? Because the sinews of the eye are suspended from the heart.153 What is an example? Rav Yehudah said: “Such as an internal hemorrhage, secretion, eye pain, tearing, or inflammation. [It is permitted] at the onset of the dimness of the eyes, to the exclusion of the end of the dimness of the eyes, or the brightening of the eye, which is not [permitted].”154
In the opening lines, Rav Yehudah replies to Rav Shmuel bar Yehudah—who is suffering from an eye problem—that everyone except him is permitted to use eye salve on the Sabbath. Rav Yehudah justifies this argument by attributing it to Mar Shmuel who, after witnessing a woman’s eye burst, ruled that one is permitted to do so. In support of this position, the text then
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anonymously describes that the sinews of the eyes are connected to the heart, implying that the eye sickness is a serious affliction. After this, Rav Yehudah lists six examples of such eye problems.155 Save for “dimness of the eyes,” which is from Akkadian, these terms are derivations of Aramaic roots, and some appear in other medical texts. In the end, this text puts on display the intersection between medical and legal discourse—that is, Rav Yehudah’s technical knowledge of these eye ailments assists the rabbis in making a legal determination regarding the permissibility of medicinal practices on the Sabbath.
rabbis and physicians There exists no evidence of medical institutions in Jewish Babylonia.156 It seems that individuals were free to pursue their desired method of treatment, whether it be herbal drugs, prayer, rituals, incantations, bloodletting, or all of these approaches. With no institutions in charge, physicians, bloodletters, laymen, rabbis, and sorcerers created local networks of alternative options for the sick. People also likely dealt with illness by practicing home remedies, in either their home or that of a healer. In b. B. Qam. 46b, Rav Ashi says that “one who has a pain goes to the healer’s house.” Another text, in the Yerushalmi Talmud, recounts how Bar Gironti the physician gets carried around in a litter in order to make house calls on the Sabbath (y. Bes.ah 1:5 [60c]). Detailed information about professional physicians in Jewish Babylonia is relatively scarce, including when compared to the Palestinian context.157 One rich source, translated below, deals with the question of whether the offending party in a fight between two people is responsible for paying damages to the victim when the victim’s wounds ulcerate at a later date after seeing a physician. In the middle of this source, the Bavli adds a remedy, as it often does. This text’s interest in physicians is in the context of a case that involves a payment to a doctor for treating a wound. It reads: As it was taught in a baraita: If [the injured party] defied the words of the doctor and ate honey or any type of sweet—since honey and any type of sweet is harmful to a wound—and the wound became scabby, one can say that [the offending party] must heal him. The Torah says “except” (Exod. 21:19). What is “scabby”? Abaye said: “A rough seam/a scabby sore(?).”158 What is its remedy? Alkali, bitumen, and pitch. And if [the offending party] says to [the injured party], “I will heal you,” he should say to him, “I consider you to be like the lion [and] the lamb.” And if he
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says to him, “I will bring a physician who heals for free,” he should say to him, “A physician who heals for free is worth nothing.”159
Based on an interpretation of Exodus 21:19, the text’s opening tradition clarifies that the offending party is responsible for paying for the wound of a victim, even when the victim does not follow a doctor’s orders regarding avoiding sweets that can slow recovery and cause scabs. The word for “scabby,” garguteni, has caused confusion—not only in the Bavli itself (“what is scabby?”), but also for later commentators and modern scholars. Elsewhere in the Talmud, the word means “basket” or “wicker object,” making it possible that it is related to Greek gyrgathos (“wicker basket”).160 Abaye’s description that the scab feels like a “rough seam” seems to match this identification. In the last section of the text, after the anonymous remedy for scabs (“alkali, bitumen, and pitch”), the Talmud lists a series of potentially fraudulent scenarios that could arise in the process of finding a physician to treat the victim. The Talmud is essentially offering advice on how to avoid becoming victim to a scam. In one scenario, the offending party volunteers to personally act as the victim’s healer; in another, the victim offers to take the money and self-heal. Rabbinic literature refers to at least six physicians by name.161 Some portrayals of these figures are hostile, while others are more favorable.162 Rabbinic texts at times point out the negatives of relying on doctors. For example, m. Qidd. 4:14 states that “the best among physicians is destined for Gehenna,” perhaps due to their arrogance, greed, malpractice, or idolatrous methods.163 In b. Pesah. . 113a, Rav continues this distrustful attitude and says that one should not live in a city where a physician is its leader. At other times, healers are praised. In b. Ta‘an. 21b–22a, Abba the Bloodletter is said to have received greetings from the heavenly academy even more than Abaye because he separated men from women during the medical procedure and refused to charge students for his services.164 The rabbis liked Abba the Bloodletter because he followed their rules of gender separation and supported Torah study. The most well-known doctor in the Talmud is named Benjamin (or Minyomi) the Physician. The Talmud depicts a mutual enmity between Benjamin and the sages. In a text about the epiqoros, Rava disparages the physician’s household because it finds the rabbis’ rules of t.repa to be restrictive. Rava said: “Like those of the household of Benjamin the Physician, who say, ‘How have the rabbis benefited us? They have not allowed a raven nor forbidden a dove.’ ” When a defective animal of the household of Benjamin was brought in front of Rava,
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if he saw a reason to permit it, he would say to them, “Look, I allow you a raven,” and if he saw a reason to forbid it, he would say to them, “Look, I forbid you a dove.”165
Here, the physicians are following rabbinic law to the extent that they bring a defective animal in front of Rava for a ruling. The rabbis and physicians disagreed on certain issues, as seen in b. Sanh. 75a, where, after the rabbis consult doctors about what to do with a man who is lovesick for a woman, the doctors reply that the woman must submit to the man, a position that the rabbis reject. Despite this, rabbis and physicians were nevertheless at times dependent on one other. The rabbis, for their part, learned about medicine from physicians: in b. ‘Abod. Zar. 28b, Rava accepts the recommendation of Benjamin the Physician regarding the use of kidney fluid for an earache— “Rava said: ‘Benjamin the Physician told me [that] all fluids hurt the ear except for the fluid of a kidney.’ ” According to the Talmud, the rabbis sometimes divulged specialized knowledge of medical treatments to the public, causing physicians to protest. For instance, in b. Šabb. 133b–134a Rava teaches people in Mah. oza, a suburb of Ctesiphon, the recipe for salves, which he learned from Abaye’s mother. Rava’s dissemination of the salve’s two ingredients results in Benjamin the Physician’s family ripping their clothes in protest, since it stripped them of authority and financial security: Abaye said: “Mother said to me, ‘A salve for all sores is seven parts fat and one [part] bitumen.’ ” Rava said: “Bitumen and pitch.” Rava taught this in Mah. oza, and the sons of Benjamin the Physician rent their clothes. [Rava] said to them: “I have left one [remedy] for you, for Shmuel said, ‘A skin disease/scabs seizes one who washes his face but does not dry it.’ ” What is the remedy? Let one wash in a brew of mangel-wurzel.166
In the second half of this text, Rava toys with the family of physicians by suggesting that Shmuel knows the causes and remedy for a skin disease/scabs. In conclusion, in Jewish Babylonia there existed a tension between, on the one hand, the physicians as nonrabbinic experts in diseases and remedies and, on the other hand, the rabbis whose interest in law and in serving the community led them to cultivate expertise in those same subjects. This tension in expertise is present in other areas of late antique Jewish life as well, as Tzvi Novick has shown in the case of farmers and butchers.167 As I discuss more in chapter 5, one of the motivations for the rabbis in their preservation of outside medical knowledge was to bolster their legal authority and status as communal leaders.
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chapter 2
Trends and Methods in the Study of Talmudic Medicine
In this chapter, I review past and current trends in the field of Talmudic medicine in order to position this study on the historiographical spectrum.1 Publications on Talmudic medicine have often been apologetic and anachronistic, retrojecting modern science into the ancient canon as a way to put on display Judaism’s positive attitude toward health. According to this view, ancient Jewish medical rituals are rational and scientific and thus fittingly practiced today.2 As this chapter shows, these tendencies are partly a result of the fact that the majority of research on Talmudic medicine has been conducted by physicians, scientists, laypersons, and rabbis, rather than by historians of late antique Judaism and Talmudists.
apologetics and anachronism Research into Talmudic medicine began in eighteenth-century Europe as an extension of the study of biblical medicine, which by that time was thriving. In part due to this connection to the Bible,3 the field was plagued by assumptions about the sacred nature of the texts or the false harmony between ancient laws and modern medicine. For some, Biblical-Talmudic medicine was the word of God, eternally present and effective, and in agreement with or antecedent to contemporary science.4 These types of assumptions have adulterated the study of Talmudic medicine from its inception until today. Relatedly, philosemitic explanations of Jewish scientific genius—validated by the disproportionate number of Jewish Nobel Prize winners—supports the notion 31
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32 Trends and Methods
that the canonical writings of Judaism must contain some sort of wisdom or form of rational thinking that accounts for such success in science, as if the study of their contents intellectually prepares a Jew for scientific rationality.5 While there is of course merit in biographical studies that explain how scientists’ religious background may have affected their theories (for example, in the case of Albert Einstein), it is an overgeneralization to presume that all scientists who were raised in a rabbinical household or educated in a yeshiva are successful because of these experiences.6 These trends appear already in the first synthetic work ever published on the subject, Benjamin Wolff Gintzburger’s 1743 University of Göttingen dissertation, written in Latin, titled Medicina ex Talmudicis Illustratam.7 The dissertation—the first by a Jew at this university’s medical school—attempts to show the congruity between Talmudic and Galenic medicine, even dating some Talmudic materials earlier than Galen as a way to showcase Jewish innovation.8 Time and again, Galen serves as a benchmark for this type of argument in the field. Researchers often maintain that the Bavli is the earliest attestation of a given disease, remedy, or theory, or that the rabbis had scientific insights that even the great Greek physicians did not.9 As Jews living in eighteenth- and nineteenth-century Europe, scholars of Talmudic medicine were influenced by their surroundings. Gintzburger and later authors, including those associated with the Haskalah and Wissenschaft des Judentums movements, make apologetic claims regarding the virtues of Talmudic medicine or hygiene as a response to social pressures, especially the reality of anti-Semitism.10 As John M. Efron argues in a book on medicine among modern German Jews, the latent message of Gintzburger’s writings was intended “to show that Judaism’s medical culture (and, by extension, the rest of its cultural edifice) was in no way inferior to that of the other ancients or, for that matter, the moderns.”11 Similarly, the Polish activist, sculptor, and scientist Alfred Nossig (1864–1943) promoted the Talmud “as a source of national and racial purity and health and as a positive force for the progress of civilization.”12 Talmudic medicine has always been easy to politicize for dogmatic or political purposes. A century or so after Gintzburger, research on the Talmudic sciences surged. For instance, books on zoology, botany, and mathematics were published, mostly in German, circa 1840–80.13 Books on medicine by IsraelMichel Rabbinowicz and Eliakim Carmoly were organized by tractate or chronologically by person.14 A book by a Russian layman from this time
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period, Reuben Josef Wunderbar’s Biblisch-talmudische Medicin (1865)—an achievement for its time—argues that Jewish laws nurture one’s health and protect one from illnesses such as leprosy and syphilis.15 In the twentieth century, a group of influential scholars took the study of Jewish and Talmudic medicine to new heights. For example, Sussman Muntner, a physician, and Isidore Simon, a psychiatrist, published important studies on Bavli medicine and Asaph the Physician.16 Along with their peers, they served as editors of key journals that transformed and popularized the field.17 Throughout the twentieth century scholars and museums in America, Europe, and Israel were publishing monographs and articles in English and Hebrew on Talmudic medicine.18 For instance, in 1935 Jacob Snowman, a doctor and mohel from a British family of jewelers, wrote A Short History of Talmudic Medicine, a watershed book in English.19 Around the same time in America, Solomon Kagan—a physician, rabbi, and medical historian—published research articles and popular essays, including two that were printed in the newspaper the Jewish Advocate, which ran a series of articles on the subject (1927–29).20 The topic of Talmudic medicine was in vogue among American Jews, appearing in mainstream papers, as illustrated in short pieces printed in the Detroit Jewish Chronicle (1933), California Medicine (1951), and elsewhere.21 By the 1970s, the long list of publications and the public attention they garnered led the field to become more fully integrated in the history of Jewish medicine, as well as in the history of medicine more broadly, culminating in essays such as Arturo Castiglioni’s “The Contribution of the Jews to Medicine” in Louis Finkelstein’s The Jews: Their Role in Civilization, as well as chapters on Talmudic medicine by Benjamin Lee Gordon in Medicine throughout Antiquity, Plinio Prioreschi in A History of Medicine, and Laura M. Zucconi in Ancient Medicine: From Mesopotamia to Rome.22 Despite this attention, many experts often neglect to include the Bavli in general histories of medicine.23 Of special note from the early twentieth century is the masterwork Biblischtalmudische Medizin (1911) by the physician Julius Preuss.24 Translated into English in 1978 and into Hebrew in 2012, this book is still the most famous and cited book on the topic.25 Although impressive in its proficiency of technical terms and avoidance of apologetics, the book is outdated, especially in light of the advancements that have been made in rabbinics and the history of medicine since its publication over a century ago. From a specialist’s perspective, Preuss does not differentiate between Palestinian and Babylonian rabbinic traditions or sufficiently engage the Roman and Sasanian contexts,
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among other shortcomings.26 By today’s standards, the book—while a milestone for its time—leaves much to be desired. As this abbreviated review of past scholarship illustrates, a majority of the research on the topic of Talmudic medicine has been conducted by medical doctors, psychiatrists, psychologists, ophthalmologists, dentists, scientists, historians of medicine, and rabbis.27 Indeed, the most prolific author in the field today, Fred Rosner, is a medical doctor. In Israel, Samuel S. Kottek, the esteemed historian of Jewish medicine, also earned a medical degree, while Avraham Steinberg, winner of the Israel Prize and author of Encyclopedia of Jewish Medical Ethics, is a pediatric neurologist and rabbi. The research conducted by these and other scholars with comparable orientations has obvious merit, especially for Talmudists who likely possess a different set of skills. There are undoubtedly valuable nonhistorical orientations toward Talmudic medicine, such as medical and biomedical ethics, contemporary healing movements, pastoral care, and the medical humanities.28 That said, the fact that the preponderance of research on Talmudic medicine has been produced by doctors and scientists has predisposed the field to problematic assumptions and trends that scholars of late antique Judaism—whose work is based on historical, philological, and literary methods—are trained to minimize.29 In addition to doctors and scientists, there are numerous scholars working in philosophy, classics, and Assyriology who have used their expertise to research Talmudic medicine in fruitful ways.30 No doubt, each of these perspectives—including those of doctors and scientists—offers unique insight into what might otherwise be a neglected aspect of the complex subject. Yet most of these scholars are not trained PhD’s in Talmudic studies.31 What is obviously missing from past research on Talmudic medicine is scholarship produced by historians of late antique Judaism and Talmudists. Why is it that the experts who are perhaps best equipped to study Talmudic medicine as part of rabbinic culture and late antique Jewish society have not done so? I believe that there are at least three reasons for this disregard. First off, experts who analyze healing often do so in the context of Jewish magic. While there is of course value in this approach, it has the unintended side effect of sidelining the many remedies with no identifiable magical component (see below). A second reason for the lack of research is a result of the remedies’ marginalization from the Geonic period until today (see chapter 1). Finally, a third reason might be due to the false impression that in order to research the therapies one needs to possess expertise in the medical sciences (i.e., training
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as an MD), when, in reality, the archaic nature of the remedies does not necessitate technical knowledge of medicine as much as it does expertise in Talmud, Aramaic, and late antique history and culture.32 Ultimately, while Talmudists have failed to research the therapies on account of their marginalized, ineffective, and technical nature, it is actually the opposite perspective that has motivated MD’s and scientists to study them—namely, the view that Talmudic medicine is scientifically valid or the earliest attestation of contemporary knowledge, and hence worthy of pride.
recent trends There has been a recent surge in interest in the topic of health and illness among historians of late antiquity.33 As Heidi Marx-Wolf and Kristi UpsonSaia have explained in an introductory essay on the “state of the question” in the field, this new wave of scholarship has rebutted the earlier prevailing view that late antiquity after Galen was a time of stagnation in medical thought and practice.34 Not surprisingly, the lion’s share of this new research focuses on the Greco-Roman and Christian Mediterranean world. This is in part due to historians’ longstanding romanticization of the Greek sciences as pillars of Western thought, as well as the widespread availability of relevant sources.35 The study of medicine and science in the field of classics is clearly more developed than in Sasanian studies, the context in which Babylonian Talmudic therapies are best studied. Albeit slower to develop, the topic of Sasanian medicine is a growing field of study, though there has not yet been an attempt at writing a synthesis of medicine in late antique Iran. This desideratum is not a result of a shortage of relevant medical sources; if anything, it is a result of the overwhelming record of relevant, understudied sources from the Sasanian milieu. A history of medicine in the Sasanian period will require collaboration among experts in different disciplines and languages. A necessary first step, then, is for scholars to research each corpus on its own terms. The study of Talmudic medicine is at the forefront of this effort. Of particular significance is the innovative work of Markham J. Geller on the Babylonian-Akkadian background to Talmudic medicine.36 More than anyone else, Geller has advanced the field tremendously through the use of interdisciplinary methods, his deep knowledge of Semitics, his long-term commitment to the critical study of the topic, and productive collaborations and mentorship. In addition to Geller, other scholars—including Lennart
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Lehmhaus, Monika Amsler, Shulamit Shinnar, and others—have researched rabbinic medicine (including in Palestinian sources) from various angles, culminating in dissertations, articles, edited volumes, sourcebooks, and monographs.37 These publications are rapidly altering the landscape of the field. Even with this progress, there is much left for scholars to accomplish. From the perspective of Jewish studies more broadly, one priority should be to triangulate magico-medical traditions—in the Bavli, the incantation bowls, Hekhalot literature, Asaph’s Book of Remedies, and Genizah texts—to try to answer the question of to what extent there was a core medical tradition in Jewish antiquity. Adding to the complexity of this question is the vast quantity of non-Jewish medical materials—for example, in Greek, Akkadian, Syriac, Mandaic, Pahlavi, New Persian, and Arabic—that scholars can use to situate the place of Jewish medicine within the wider Mediterranean and Iranian contexts.
methodological issues This book brings Talmudic studies into conversation with some theories and methods in anthropology and the history of science and medicine. For instance, Talmudic medicine represents another case study in the enduring debate over the benefits and drawbacks of applying modern Western categories—such as magic, medicine, and science—to ancient or foreign cultures. There is of course a wide spectrum of opinions regarding the meaning and utility of these categories in both emic and etic dimensions.38 This book engages some of these problems of interpretation as they relate to Talmudic medicine by asking the following questions: Why is “medicine” (or “medical healing”) a suitable category to use in reference to the Talmudic therapies?39 How should scholars today define what counts as medicine in the Talmud? In other words, what are the criteria for including a given tradition or text in this category? Did late antique Jews and rabbis construct a category of medicine? If they did, in what ways is it commensurable and incommensurable with our modern notions and strategies? If they did not, should we then refrain from imposing this category onto the Talmud?
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In a historical study of the Talmudic therapies, what are the costs and benefits of drawing from modern biomedical research? What can one learn by doing so? As I argue in this book, the rabbis constructed a distinct and coherent literary and epistemic genre of medical healing. Put another way, the Talmud contains a genre of therapies aimed at healing specific bodily afflictions. Many of these therapies subscribe to the principles of observation, trial and error, or personal experience that are not commonly attested in legal discourse.40 In my opinion, these features of the empirical, drug-based therapies conform to some (though admittedly not all) of the basic contours of what we today identify as medicine, at least to the extent that they attempt to heal or prevent bodily illness through observation and the wielding of natural drugs. This is not to ignore the inherent differences: Talmudic medicine’s archaic methods and terms, different conceptions of efficacy, belief in the supernatural, and irrational reliance on spells and amulets, among other aspects, do not preclude applying the category “medicine” to the therapies—so long as we acknowledge that efficacy and rationality are variegated, subjective, and culturally constructed and that our research is a process of translation and interpretation.41 Even when the Talmudic therapies’ beliefs or methods seem to us to be irrational, their goal—to heal an illness—is rational.42 There are at least ten pieces of data that demonstrate that the Talmud constructed an independent category of medical healing: 1. The Talmud uses terms such as “to heal,” as well as technical terms found only in the therapies. 2. The Talmud refers to hundreds of materia medica made up of plants, minerals, and animal parts to be consumed or applied to the affected area (among other uses)—some are unique to the medical recipes, while others were consumed as foods or drinks or used for other everyday purposes.43 3. The Talmud has a taxonomy of over seventy afflictions, many of which are introduced in a classificatory formula (“For [name of disease], do this therapy . . .”). 4. The Talmud contains dozens of therapies for named ailments, using a variety of methods, with instructions about the preparation and quantities of drugs to be used.
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5. Although they share certain features in common with other ritual texts, and are intertwined with halakha and aggada, the literary features of the Talmudic therapies contain idiosyncratic styles, terms, motifs, and content, marking them off as a unique genre and discrete handbook that the editors of the Bavli deemed important enough to incorporate into the corpus. 6. In Sasanian Persia there were Jewish and non-Jewish physicians, bloodletters, bowl sorcerer-scribes, and other specialists who treated the sick. 7. The remedies are based on modes of rationality that are at times different from halakha and analogous to what we would identify as the scientific methods of empiricism, trial and error, and observation of nature—and the rabbis tested, via trial and error, the efficacy of amulets. 8. Authoritative rabbis such as Rav, Shmuel, and Abaye were invested in transmitting, debating, and practicing therapies. 9. Although the Talmud mixes magical and empirical therapies, some Jews may have been aware of differences between practitioners, methods, and perhaps even outcomes between, on the one hand, magic spells or rituals and, on the other, empirical techniques like drugs and forms of surgery. 10. The Talmud expresses, via exegesis of biblical and Tannaitic traditions, a positive attitude toward human healing and the use of plant-based medicines, even erring on the side of permitting any act that heals despite the potential for idolatry. The fact that the Talmud contains an identifiable genre of healing therapies eases the burden that scholars face when having to create and apply criteria, based on predetermined templates, for interpreting what counts as medicine in the Talmud.44 In other words, the Talmud can do some of this work for us. Rather than invoking the logic of common knowledge—whereby “if it looks like medicine to me, then it will look like medicine to you” 45—it is the rabbinic corpus itself that guides and delimits our study. At the same time, research on the Talmudic therapies requires scholars to go beyond the rabbinic perspective by drawing from contemporary theory, the history of medicine, and comparisons with other world cultures.46 As the philosopher of science Nick Jardine once put it, “etics without emics is empty, emics without etics blind.” Here is the full quote: Learning from anthropology, an older and wiser discipline, we have seen how etics without emics is empty, emics without etics blind . . . Etic history of science with-
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out emics is empty, if not anemic, because it fails to engage with the life-worlds of past practitioners of the sciences. It is also condescending, because in failing to examine past agents’ perceptions and conceptions it presumes their irrelevance for proper understanding of the development of the sciences. Emics without etics is blind because it wilfully blinds itself to much of our knowledge of the natural and social worlds, knowledge that could profitably be used in investigating past lifeworlds. It is also condescending, emetically so, in presuming that even thus blinded it can go native in past cultures. A history of science properly respectful of the differences of the past must seek out combinations of emics with etics appropriate to its various subjects and aims.47
Neither an emic nor etic perspective by itself is sufficient. One has to strike a healthy balance between rabbinic and modern perspectives, in part as a way to circumvent the limitations that we have in understanding how ancient people thought. When writing history of science, one should therefore be aware of the inevitable anachronisms between ancient and contemporary perspectives.48 Another reason that medicine is a productive analytic category when applied to the Talmud is because it is a relatively stable concept across varying historical contexts. Does there not exist a cross-cultural phenomenon of magico-medical healing in many world cultures and societies? Does humanity not have some sort of psychic unity when it comes to sickness and death? And are there not “universal biological manifestations” of diseases that exist “independent of cultural setting” that can be constants in the comparison of medical cultures?49 If the answer to these questions is yes, which I believe it is, then in my opinion the treatment of specific physical afflictions is a less flawed and more transparent and unified phenomenon for scholars to categorize and identify across human history than the criteria that we tend to use to identify magic, science, and religion—all of which are likewise sometimes aimed at explaining or relieving physical suffering. To be sure, our cultural meanings of sickness and pain, the genetic makeup of diseases, and the ways that we experience, think about, and treat illnesses all differ and change across time and space—but everyone gets sick and dies, and most individuals and societies try to prevent illness. Staying healthy, in tandem with general selfpreservation, is an innate biological goal of human beings.50 Still, in spite of these shared human experiences, historians should not assume that there are simple forms of continuity between ancient and modern categories or rationalities with respect to health and illness. In an article titled
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“Uses and Abuses of Anachronism in the History of the Sciences,” Jardine describes the caution that one should take in assessing a historical instantiation of science that reflects “our common humanity”: Historians should never, I suggest, simply assume that by virtue of our common humanity we share psychological or social characteristics with past societies. Rather in each case they should investigate the relevant continuities and discontinuities between the past societies in question and our own. . . . A second moral is that historians of the sciences should never simply take for granted the historical continuities needed to underwrite the application of present categories to past institutions and societies. These continuities need to be established case by case.51
As this quote suggests, the psychic unity and shared human experiences of health and illness cannot account for the different way that each society, including the rabbis of late antiquity, thinks about and practices healing. Even within Sasanian Jewry there were different perspectives about illness. In fact, researching the Talmudic therapies helps to expand our scholarly purview beyond the hegemony of the rabbis. To the extent that many of the therapies originated from outside the rabbinic community and have been marginalized in the Jewish tradition since the Middle Ages, this book’s recovery of medicine goes against the grain of traditional paradigms. As Elizabeth Shanks Alexander has elucidated, scholars of late antique Judaism tend to focus on canonical rabbinic sources, rather than on marginal ones such as the incantation bowls.52 This book focuses on the margins of the rabbinic tradition by prioritizing three sets of data: 1. The Talmud’s healing therapies for specific ailments—that is, therapeutic texts, some of which, though rabbinized, likely originated outside the rabbinic movement (see chapter 5). As I discussed in chapter 1, these therapies have been marginalized since the Middle Ages. 2. The Aramaic incantation bowls from late Sasanian Mesopotamia—that is, Jewish relics that illustrate how Jews and their neighbors thought about the supernatural causes of diseases and the use of spells and amulets to combat them. One benefit of writing a book on Talmudic medicine is that it is a topic where one can exploit these underutilized data, since a lot of the bowls were intended to protect clients from diseases or to curse rivals with illness. Although the exact relationship between rabbinic culture and the bowls is not yet well understood,53 it is clear that they share a
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worldview and lexicon with respect to the role of demons and the supernatural in health and disease. 3. The magico-medical texts from non-Jewish communities, including Akkadian, Greek, Syriac, Mandaic, and Middle Persian sources—that is, outside sources that contextualize the cultural milieu of Talmudic medical thought and practice. Comparisons between the corpora help to demonstrate that the rabbis did not operate in a vacuum when it came to healing practices and beliefs.
why medicine and not magic? Scholars of late antique Judaism typically study healing or medicine as subcategories of magic.54 Healing was, of course, one of the main objectives of ancient Jewish magic.55 This is seen in amulets and bowls, as well as in the juxtaposition of healing alongside other goals in magic handbooks like the Sword of Moses. Ancient Jews turned to sympathetic rituals and potent objects to control supernatural spirits and natural illnesses that attacked the body and caused illness. Thus, many of the Talmud’s therapies are magical to the extent that they avail themselves of amulets, spells, and sympathetic logic, among other features that scholars often categorize as magic. Magic and medicine were clearly intertwined phenomena in late antiquity. At the same time, it is important to recognize that in the Talmud not all magic is medicine, and not all medicine is magic. In other words, scholars who subsume Talmudic medicine under the category of magic tend to ignore the therapies that have few, if any, identifiable magical elements. (Conversely, medical doctors and scientists who study Talmudic medicine tend to ignore magical remedies in favor of empirical ones.) This in itself demonstrates the limitations and flaws of the use of magic as a definitive category. Many therapies, such as potions and salves, do not meet the most obvious criteria of magic, such as a reliance on incantations. In his book Jewish Magic before the Rise of Kabbalah, Yuval Harari agrees with this assessment when he points out that “many of the prescriptions” in b. Git.. 68b–69b “are not in this category” of “magic healing,” which involves incantations, but instead “can be considered folk medicine that is not magical.”56 Moreover, some of the healing therapies that do contain magical elements are different from other types of magic rituals in rabbinic literature. Gideon Bohak, author of the book Ancient Jewish Magic, alludes to this latter point when he compares the magical therapies
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in the Git.t.in Book of Remedies to other types of ancient Jewish magic rituals: “Thus, while this vademecum provides valuable information on the use in Babylonian rabbinic medicine of rituals which we would classify as ‘magic,’ and which probably reflect local Mesopotamian practices, it displays no real overlap with the kind of magical rituals we have been studying throughout the present study.”57 Therefore, even when we do characterize the therapies as magic, they stand out. But does the Talmud itself distinguish between magical healing and empirical therapies? The answer to this question is not straightforward. On the one hand, the Talmud does not usually make intellectual or literary distinctions between, say, remedies that use amulets versus ones that use salves. As I discuss in chapter 4, oftentimes a single therapy relies on both magic and science in tandem. For the most part, then, such distinctions are scholarly constructs. That said, there is evidence that suggests that the Talmud and some Jews were aware of the differences between different therapeutic strategies and their concomitant practitioners.58 Joseph Naveh and Shaul Shaked make a similar claim in the introduction to a volume on the incantation bowls. Referring here to the Talmudic remedies, they contend: This must have been perhaps the most common form of medical treatment in the period under question, and it was based, one may take it, on the use of herbs and practical physical treatment which perpetuated traditional lore, but which was rarely codified in books. All of these forms of medical practice were kept more or less strictly separate from the magical method of treatment. It seems however reasonable to assume that patients or their kinspeople had recourse to different methods of treatment at the same time, especially when the danger seemed grave. In practice, we rarely find magical handbooks that give medical instruction. The medical books proper may sometimes contain instructions that seem to us naive or “magical”; such recipes however were considered, as far as we can tell, to be physically efficacious, and were not aimed at achieving magical ends, which may be characterized as being concerned with controlling the spirits and subduing the malevolent powers that cause disease. Despite a certain measure of overlapping, in practice we experience little difficulty in distinguishing between magical and medical writings.59
From this perspective, a magical therapy in the Bavli’s medical handbook— albeit “magical”—is nevertheless medical to the extent that its intent is to heal a physical affliction. The authors rightly note that people sought out alternative methods for a single illness.
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Despite advancements in the study of ancient magic in recent years, the category “magic” still garners controversy, with some preferring to jettison it once and for all.60 As Randall Styers explains, magic “has offered scholars and social theorists a foil for modern notions of religion and science and, more broadly, a foil for modernity itself.” 61 Its ubiquitous usage across disciplines, corpora, and time periods has turned it into a generic umbrella term under which there are dozens of subcategories.62 In response to this, the historian of religion Jonathan Z. Smith has urged scholars to use what he calls “middlerange typologies,” including healing, instead of magic. For these (and for other) reasons, I see little merit in continuing the use of the substantive term “magic” in second-order, theoretical, academic discourse. We have better and more precise scholarly taxa for each of the phenomena commonly denotated by “magic” which, among other benefits, create more useful categories for comparison. For any culture I am familiar with, we can trade places between the corpus of materials conventionally labeled “magical” and corpora designated by other generic terms (e.g., healing, divining, execrative) with no cognitive loss. Indeed, there would be a gain in that this sort of endeavor promises to yield a set of middle-range typologies—always the most useful kind—more adequate than the highly general, usually dichotomous, taxa commonly employed.63
Following the spirit of this critique, this book uses medicine—or, more precisely, empirical therapies for specific bodily illnesses—as a way to add nuance to the continued reliance on the category “magic” in the evaluation of rabbinic healing. Put another way, once we replace the category “magic” with the category “healing” (or “medicine”), the topic becomes open to therapies that are not magical. Magic thus becomes a subcategory of healing, as opposed to the other way around. In my view, this tactic is useful if for no other reason than that it rejiggers Talmudic data in a novel way by focusing on the empirical therapies that not only get excluded from studies on magic proper, but that also represent an understudied subject in rabbinics in its own right.64 Before moving on, one further point is worth mentioning, which is that the rabbis themselves distinguish between healing and illicit magic. For the rabbis, any act that heals is permitted and not considered prohibited outsider magic, or the “Ways of the Amorites.” As I examine more in chapter 5, the “Ways of the Amorites” are foreign superstitious practices—such as dragging a corpse through a cemetery in an attempt to revive the dead, or urinating in front of a stove to make one’s meal cook faster—that the rabbis typically
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prohibit. Healing, however, is the exception. In y. Šabb. 6:10 (8c), the tradition reads: Rabbi Shmuel [taught in the name of] Rabbi Abbahu in the name of Rabbi Yoh. anan: “Anything that heals is not subject to the prohibition of the Ways of the Amorites.” 65
The rabbis shield healing practices from the Amorite label, setting up a dichotomy between real healing and illicit magic. The parallel tradition in b. H . ul. 77b is ascribed to Abaye and Rava. Abaye and Rava both say: “Whatever is done for healing is not subject to the prohibition of the Ways of the Amorites. Whatever is not done for healing is subject to the prohibition of the Ways of the Amorites.” 66
In marked contrast to the Torah’s prohibitions against outside magic, with these statements important rabbis from both Palestine and Babylonia espouse a tolerant point of view toward any acts that heal, even if they are potentially idolatrous magic. The rabbis carve out a special ideological space for healing practices.
problems of identifying ancient diseases and drugs Can scholars accurately identify and translate Talmudic diseases and drugs using modern terminology? Awkwardly, producing critical editions and translations of ancient medical texts—which is one of the main activities in the field and rightly seen as a necessary first step before historical evaluation—is one of the more problematic activities in which historians of medicine engage.67 When it comes to the unavoidable hazard of identifying and translating ancient diseases, the historian of medicine Adrian Wilson maintains that too often “the modern concept” of a disease “is extended backwards in time,” such that “the disease as presently conceived is seen as a permanent entity, and it is assumed that it can be diagnosed retrospectively on the basis of earlier texts which in fact conceived that disease in radically different terms from those underlying the modern concept.” 68 Perhaps the most well-known problem of disease identification in Jewish history is the case of biblical leprosy, which most scholars agree is not equivalent to modern leprosy.69 As we will see throughout this book, scholars often offer different interpretations of Talmudic afflictions.70
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The best methods of identifying ancient diseases integrate textual evidence with other forms of data, if available—such as archaeological, paleopathological, paleoimmunological, entomological, and epidemiological data.71 In theory, this type of interdisciplinary approach could help to more accurately identify some of the diseases in the Talmud, but unfortunately such relevant nonliterary data is scarce.72 Given this situation, it is not surprising that the majority of scholars identify Talmudic diseases based on an interpretation of textual details, a method that can sometimes lead to misinterpretations because rabbinic texts are often short on specifics and not historically reliable.73 Assyriologist Nils P. Heeβel and other historians of medicine describe a number of limitations when scholars attempt to identify ancient diseases, called “the problem of retrospective diagnosis”: The difficult situation is well-known: diseases change over time, some vanish, some come into being, descriptions of symptoms are not systematic enough for a differential diagnosis, diseases are categorized differently over time and space, names of diseases can change over time or the same name denominates different diseases, diseases that originate in a specific area are transmitted to more distant regions and finally and most importantly modern diseases are defined on micro-bacteriological or pathological-anatomical grounds whereas in ancient times diseases were defined solely on a symptomological basis.74
For all these reasons, it is difficult for text-based scholars like Talmudists to make precise identifications of ancient diseases. Moreover, there are evolutionary considerations that make it fallacious to equate ancient and modern diseases: pathogens can mutate and evolve over time; some diseases become extinct, while new ones emerge; parasites follow human migrations; and symptoms change, as do the people who treat them.75 In ancient times illnesses were governed by population trends, environmental influences, irrigation technology, the status of wild and domestic animals, and the farming habits of a society—all of which are valid considerations.76 Without more information on such aspects of Sasanian society, these are all complicating factors to any attempt at the precise identification of diseases. The identification of ancient plants and other materia medica may be on firmer ground thanks to medieval word lists, botanical science, and sustained local traditions of pharmacology. Still, reconstruction is full of obstacles, such as mistranslations (which come to light due to philological advancements) or the attestation of multiple names for the same plant.77 There is some
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terminological continuity between, for instance, the Bavli and medical documents from the Cairo Genizah. For example, eruca sativa (also known as garden rocket) is attested in Judeo-Arabic/Arabic recipes, medical books, and drug lists in the Genizah for a variety of uses, as well as in Aramaic in b. Šabb. 109a, where the blind Rav Sheshet says: “Even for me, rocket is beneficial for [my eyes].”78 Indeed, some of the natural substances mentioned in ancient and medieval medicine—including garden rocket—are still used in today’s pharmacology.79 These problems of identification were not lost on medieval and early modern Talmudic commentators who argued that because they were unable to correctly identify the Talmud’s archaic terms for plants, they could not practice the therapies even if they wanted to—that is, it was their own shortcomings that prevented proper identification. Some commentators also believed that the Bavli’s therapies were obsolete and should not be performed in their era because of “changes in nature.”80 These arguments were a respectful way for later authorities to reject the Talmudic therapies, since such explanations do not insinuate that they were ineffective. On the contrary, these views imply that the rabbis possessed accurate knowledge and helped their communities. Both of these arguments are summarized nicely in a collection of responsa written in seventeenth-century Germany by Yair Chaim Bacharach: It is impossible to use the remedies mentioned by our Sages, because of ignorance of the meaning of the words which are the names of the herbs our Sages mentioned . . . because of ignorance of the amounts and [proper] usage; and because the nature of the generations has changed, as Tosafot and the halakhic authorities ruled in several places.81
In seventeenth-century Poland, the famous Talmudic commentator Rabbi Shmuel Eliezer Edels (Maharsha) focused on defending the rabbis from any scrutiny that would result from claims that the Talmudic therapies are ineffective: One can see from this that the Talmud is not deficient in any of the wisdoms because for every illness you will find in it a complete and reliable remedy, to those who understand their language. Let no one mock the Sages of the Talmud by saying that they were deficient in knowledge of medicine.82
Maharsha stresses that the rabbis of late antiquity had a comprehensive arsenal of effective remedies. He is sure to add that this is apparent to “those who understand their language,” intimating that it is his contemporaries’ inability to accurately identify the Talmud’s medical vocabulary that makes them say
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that the sages are foolish. Over the centuries, this pessimism regarding the proper identification of the Talmud’s medical terms exacerbated the marginalization of the therapies. Let us now review one example of the difficulties that scholars face when trying to identify diseases in the Talmud. The rabbis were aware of the hereditary nature of certain diseases, including what appears to be the blood disorder hemophilia.83 In fact, some researchers point to rabbinic literature as the earliest record of Hemophilia A.84 In b. Yebam. 64b, Rabbi Yoh. anan reports that one time in Sepphoris Rabban Simeon ben Gamaliel warned the fourth sister in a family not to circumcise her newborn because of her family’s history of death during the procedure in three previous instances. It is notable that women are front and center in discussions regarding the rules of circumcision in cases when a baby’s life is threatened.85 The text from b. Yebam. 64b reads: Come and hear, for Rabbi H . iyya bar Abba said in the name of Rabbi Yoh. anan: There was an occurrence with four sisters in Sepphoris where the first had [her son] circumcised and he died; and the second [did the same] and he died; and the third [did the same] and he died. The fourth [sister] came in front of Rabban Simeon ben Gamaliel. He said to her: Do not circumcise [your son]. But maybe if the third [sister] had come [to ask his advice], he would have also told her this? If so, what was the [purpose of] Rabbi H . iyya bar Abba’s attestation? But maybe he was telling us that the sisters establish a presumption. Rava said: Now that you have said that the sisters establish a presumption, [then] a man should not marry a woman from a family of epileptics or from a family of lepers. But this [is a case] with a presumption established three times.
Later, the passage adds: In the case of circumcision it accords well: there are families whose blood is weak [or: “loose,” “soft”],86 and there are families whose blood is constricted.87
The description that b. Yebam. 64b provides about the blood disorder— namely, that it is transmitted from a carrier mother to a son, and that it is a danger during circumcision—matches the transmission pattern of hemophilia as known today.88 The Talmud explains that families with “weak blood” are prone to bleeding, a detail that Samuel S. Kottek describes as having “an unusual air of clinical and epidemiological accuracy.”89 However, even if this text is describing a condition similar to hemophilia, the level of detail that it provides about the hereditary blood disorder—which it does not identify by name—is trivial when compared to the vast amount of current scientific
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research on Hemophilia A and B, a medical insight that dates to the nineteenth century. This knowledge gap exists in virtually all comparisons of Talmudic diseases and their ostensible modern counterparts. Moreover, other Talmudic sources that allude to hereditary blood disorders do not support an identification of hemophilia. Despite these limitations, there are tools that scholars can use to improve identifying Talmudic ailments and materia medica. For instance, comparative linguistics helps to decode ambiguous Jewish Babylonian Aramaic terms via comparison with Syriac and Mandaic cognates, or, in the case of loanwords from Iranian or Greek, with foreign equivalents. At the forefront of this effort, the philological researches of James Nathan Ford and Siam Bhayro, among others, have made significant progress on establishing a more scientific approach toward the identification of medical terms in the bowls and Aramaic texts.90 For example, since Syriac and Mandaic sources have cognate terms for eye diseases, comparative linguistics helps scholars define obscure ophthalmological terms.91 Still, it is important to recognize that the meanings of cognate terms are not always stable across Aramaic dialects (or between Akkadian and Aramaic), and that the methods of comparative linguistics do not avoid all the problems of identification described above. A significant number of Talmudic illnesses are fevers or problems with the eyes or skin.92 In these cases, the Talmud’s differential taxonomy can be extensive—though still not as extensive as Mesopotamian medicine.93 Among other words, rabbinic texts and Jewish magical sources refer to fevers as išata (lit. “fire”) and šimša (lit. “sun,” and perhaps implying a type of sunstroke or heatstroke). These serve as base terms for compound nouns denoting different types or lengths of fevers.94 The rabbis thus use everyday words to create a taxonomy for fevers. As Irina Wandrey points out, “The rabbinic terminology for fever has no obvious Biblical roots,” and the biblical terms—namely, daleqet, qadah. at, and h. arh. ur (see Lev. 26:16 and Deut. 28:22)—“are found only seldom in rabbinic language usage.”95 The Targum Pseudo-Jonathan to Deuteronomy 28:22, however, rewords this with “fever/ inflammation of the bones” and (perhaps) “intestinal inflammation”— terms attested in the Git.t.in Book of Remedies.96 Unfortunately, since the date of this Targum is debated, it is hard to trace any links between these texts. That said, it is, I believe, unlikely that the Targum significantly predates the Bavli, if it does at all.97
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The Talmud recommends both magical and empirical treatments for different types of pyrexia. For example, in b. Git.. 67b Abaye’s mother advises someone afflicted with a heatstroke to drink water, undergo bloodletting (or eat fennels), and consume red meat and wine: For a one-day heatstroke, a pitcher of water. For a two-day heatstroke, bloodletting [or: “fennels”].98 For a three-day heatstroke, red meat on coals and pure wine.99
By contrast, in b. Šabb. 66b Abaye’s mother prescribes amulets and recitations as treatments for a one-day fever (išata). With respect to dermatological disorders, the Talmud has a complex classification system. There are different terms for what scholars translate as abscess (bu‘ata), abscess/boil (mursa), skin lesion (h. arpupita), crack in the skin (simt.a), boil (ših. na), sore (kiba), among others. In b. Ned. 81a, some of these ailments are linked together: “a skin lesion of the body brings about boils and sores.” Notably, these translations do not utilize current classifications of skin lesions used in, for instance, the Merck Manual—such as macules, papules, plaques, nodules, vesicles, or purpura.100 Attempts at such specificity are risky as it is hard to pinpoint the Talmudic terms’ exact denotations due to their rare attestations and lack of descriptive details—and of course because the rabbis did not use the same taxonomy as we do today. In attempts at identification, linguistic and textual data only go so far, often leaving one with more questions than answers. For instance, the word “abscess/boil” (mursa) is related to the root “to rub, crush,” while the word “sore” (kiba) is related to the root “to roast, burn.” Given this, perhaps mursa is a skin rash caused by friction, whereas kiba is a burn or a burning feeling on the skin? Unfortunately, these reconstructions are nearly impossible to corroborate, since neither the descriptions nor the remedies of them conform to these linguistic details in any meaningful way. Like fevers, the Talmud does not take a single approach toward skin problems. This helps support the idea that Jews sought out alternative methods for skin problems. It has empirical remedies—such as one in b. Sanh. 84b where, in the middle of a debate regarding the laws against striking one’s parents, the Talmud probes the permissibility of a son lancing his father’s abscess (see MS Jerusalem–Yad Harav Herzog 1). Another remedy, for an abscess/boil, is to drink wine with worm-colored alkali (b. Git.. 69b). Bavli ‘Abodah Zarah 28a also recommends finger-snapping “a crack in the skin,”101 an ailment that a rabbi warns is a “precursor of fever”:
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Rava102 said: “This crack in the skin is a precursor of fever.” What is the remedy? Hit it with sixty finger-snaps and cut it open crosswise. But these words apply only when its top is not white; if its top is white, it does not matter.103
The Talmud proposes that a person should snap one’s fingers sixty times on the crack in the skin, and then cut open the skin crosswise to drain it out. It adds a qualification to this remedy based on a diagnostic detail: one should do finger-snaps only for cracks whose tops are not white. But not all the therapies for this skin problem are practical: one remedy is a magical incantation (b. Šabb. 67a). Finally, the Talmud sometimes uses the same terms for animal and human ailments. For example, b. H . ul. 51a’s reference to a sheep with some form of paralysis (perhaps hip-disease or sciatica) is the same term that b. Git.. 69b uses in reference to humans, and b. H . ul. 47a and b. Sanh. 84b likewise both refer to an abscess for animals and humans.104 Moreover, in some cases the same remedy is applied for humans and animals, and both could be subjected to bloodletting.105 Given these types of overlap, it is not surprising that, in style and lexicon, the Talmudic remedies at times mimic either rituals of animal inspection or texts that describe animal illnesses and remedies.106
conclusion This chapter has shown how since the middle of the eighteenth century the majority of scholarship on Talmudic medicine has been apologetic and anachronistic when judged by current academic standards. These trends are a product of the fact that most of these studies were published by medical doctors, scientists, or rabbis, rather than by experts in Talmudic studies and in Aramaic and Sasanian culture. Thankfully, there is a burgeoning sector of Talmudists who are applying up-to-date textual and historical approaches toward the medical passages. Finally, this chapter has discussed how scholars working in this field can avoid some of the problems of past research, such as retrospective diagnoses and the challenges of identifying ancient diseases and materia medica, by drawing from the insights and methods in the history of science and medicine.
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chapter 3
Precursors of Talmudic Medicine
In the history of Jewish medicine, the Talmudic therapies are situated between, on the one hand, the Biblical era, which embraced theological, natural, and supernatural worldviews about health and illness, and, on the other hand, the medieval period, when Greek and Arabic medical science flourished. Although the magical and empirical elements of Talmudic medical thought resemble both what came before and after it, the Hebrew Bible was not the direct building block of the Bavli therapies, nor were the Bavli therapies the basis of subsequent Jewish medicine in the Middle Ages up until today. The Hebrew Bible contains few healing therapies.1 The ancient Israelite priests in charge of the Jerusalem Temple were not physicians or transmitters of remedies, but rather, as Larry P. Hogan explains, “health inspectors who pronounced the presence of leprosy or some other illness that would render a person unclean.”2 Practical knowledge about diseases was mostly diagnostic for the purpose of determining ritual purity. Although related, purity and impurity are fundamentally different concepts than those of health and disease.3 For example, Leviticus 13–14 describes skin diseases and mold as causes of impurity. The priests, working as expert diagnosticians, examined but did not treat a person’s rash, discoloration, or other afflictions, and, after the disease was healed, they would then oversee the rituals of purification. In the early rabbinic period in the land of Israel, the Tannaim built on the biblical system within a new cultural matrix. For example, Mira Balberg has shown that Mishnah Nega‘im, on Leviticus’s skin afflictions, reflects a mixture of biblical interpretation and Galenic thought within a Greco-Roman setting.4 51
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The Tannaim used their exegetical acumen to become enforcers of bodies to advance their reputations as medical experts. By comparison, the majority of the Babylonian Talmudic therapies were shaped less by the Bible than they were by the sciences of their time.5 The Babylonian Talmud conceptualized the causes of illness and the role of human physicians in healing them in a more expansive way than the Bible and Mishnah did. According to the Bible, it was a vindictive God who punished sinners with sickness, and only He who could heal (see Exod. 15:26), while the sick could precipitate relief through fasting, sacrifice, repentance, or prayer— actions aimed at pleasing God.6 This idea persisted into rabbinic Palestine and Babylonia. Bavli Nedarim 41a reflects this: Rabbi Alexandri said in the name of Rabbi H . iyya bar Abba: “A sick man may not recover from his illness until all his sins are forgiven, as it is written, ‘He forgives all your sins, heals all your diseases’ (Ps. 103:3).” Rav Hamnuna said: “He returns to the days of his youth, as it is written, ‘Let his flesh be healthier than in his youth; let him return to his younger days’ (Job 33:25).”7
In this text, Palestinian sages cite Psalm 103:3 in support of the idea that repentance is required for God to heal a person’s sickness. For the rabbis, this Psalm may mean that illness plays a role in purging sin from the body.8 Rav Hamnuna, a Babylonian Amora, follows this up by quoting a verse from the book of Job about redemption that suggests that one’s body gets rejuvenated after recovery. For the rabbis, another path to bodily salvation was Torah-study. For instance, b. ‘Erub. 54a compares natural drugs with the Torah-qua-drug, arguing that unlike natural drugs that help one part of the body while simultaneously hurting another, God’s healing does not have this side effect, since the Torah “is a drug of life for his entire body,” a statement supported by Proverbs 4:22 (“healing for his whole body”). As these examples show, rabbinic literature continues the biblical line of thinking—often by citing the Bible itself—that God and piety are the arbiters of sickness and recovery. The Bavli broadens its perspective on health and illness beyond such assumptions. The genre of therapies on which this book is focused tends to refrain from moralizing and theologizing language. For Babylonian Jews, sin was not the sole cause of illness, nor was God the sole healer. The Talmud contains a range of ideas about the etiologies of illness conceived in natural, supernatural, divine, and human terms.9 But relative to other ancient Jewish
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cultures, the Bavli focuses more on natural and demonic causes. Within the Bavli itself there are at times tensions between these explanations. For example, in b. H . ul. 105b Abaye’s belief that one should keep away from drainpipes in order to avoid sewage gets contradicted by his teacher, who says that the reason to do so is in order to avoid demons.10 Babylonian Jews viewed health and illness as part of an everyday world populated with curses and evil spirits—which, though sometimes personalized, can attack anyone anywhere at any time for a variety of reasons. Some texts suggest that the rabbis, because they are “important people,” are more susceptible to demonic attack (see b. Pesah. . 110a). Even still, demons and diseases did not attack sinners only. For Babylonian Jews, healing was by and large a human activity aimed at protecting against the dangers in the natural and supernatural worlds. Talmudic medicine is, therefore, more concerned with nature and demons than it is with God and sin. This drift away from God caught the attention of medieval Jewish thinkers who felt the need to account for it. Nah. manides, for instance, argued that this shift was due to the fact that the ancient Israelites had lived during the prophetic period, whereas the rabbis lived after God’s presence had waned.11 Historians today can attribute this rupture to a variety of factors, including Sasanian influences.12 When it came to healing, the rabbis believed that God’s mantle was passed on to human beings. In b. Šabb. 77b, the Talmud insists that God created even the lowliest of bugs with the intention that human beings use them as materia medica. Rav Yehudah said in the name of Rav: “All that the Holy One, blessed be He, created in His world, He did not create a single thing without purpose. He created the snail for a scab; He created the fly for a hornet [sting]; the mosquito for the snake [bite]; a snake for boils/eruptions; and a spider for a scorpion [sting].” How is this done? One brings one black and one white [snake?], boils them, and rubs [the boils/eruptions?] with it.13
Rav Yehudah, reporting in the name of his teacher Rav, says in Hebrew that God created insects so that humans could use them to treat boils or animal bites. These sympathetic cures use insects to treat insect bites (notwithstanding snakes for boils). The anonymous end of the text does not fully describe the application, but presumably it involved rubbing the ingredients on the affected area. The Yerushalmi Talmud contains a parallel version of this tradition, which Lennart Lehmhaus has analyzed and translated as follows:
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Eliahu asked R. Nehorai: “For what reason did the Holy One, blessed be He, create the worms and reptiles in His world?” He replied: “They were created in order to be useful for us. If human beings sin against God [and God wants to destroy them] he looks at them [i.e., the worms and reptiles] and says: ‘When I keep alive those who are not useful, then I have to keep alive those [= human beings] who are useful.’ ” Furthermore he said to him: “By the way, some of them could be useful [for human beings]: a fly [helps] for the sting of a hornet/wasp, a bug for the [bite of a] bloodsucker, a snake for sores, a snail against a skin disease/rash(?), a lizard [or: “spider”] for the [bite of a] scorpion.”14
As Lehmhaus clarifies, this passage may be based on a misunderstanding of esoteric medical nomenclature: the references to insects may in reality be “secret names (Decknamen) that refer to specific healing substances—a strategy well known from other ancient medical traditions.”15 The Yerushalmi version of the text also exhibits some telling similarities and differences with the Bavli parallel that corroborate some of the points just made. For example, the Yerushalmi Talmud mentions the simple remedies in the context of God’s desire to destroy humans as a result of their sin—a theological idea that the Bavli ignores. What the Bavli does include, which the Yerushalmi Talmud does not, is a brief description of the medical procedure: bring a black or white one, boil, and rub. These two differences exemplify contrasting points of emphasis that each Talmud takes toward healing practices: the Yerushalmi Talmud is more concerned with human sin, whereas the Bavli is interested in elucidating the therapeutic technique and making clear that God intended all His creations (not just bugs and reptiles) to be used as drugs. The idea that God created the natural world for human beings to use as medicine is already found in the Wisdom of Ben Sira from the second century b.c.e. In the quote below from chapter 38, Ben Sira praises physicians by stating that God endows them with wisdom and provides them access to the plants of the earth as medicine. Honor physicians for their services, for the Lord created them; for their gift of healing comes from the Most High, and they are rewarded by the king. The skill of physicians makes them distinguished, and in the presence of the great they are admired. The Lord created medicines out of the earth, and the sensible will not despise them. Was not water made sweet with a tree in order that its power might be known? And he gave skill to human beings that he might be glorified in his marvelous works. By them the physician heals and takes away pain; the pharmacist makes a mixture from them.16
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This text says that God created physicians and pharmacists and blessed them with virtuous skills and resources, including natural drugs. Ben Sira’s positive attitude toward doctors—including presumably Jewish ones—is in part a result of the status of medical professionals in the Hellenistic world.17 Although the rabbis did not have access to most Second Temple extracanonical works, it is worth noting that rabbinic literature was acquainted with the Wisdom of Ben Sira.18 As Catherine Hezser explains, the Yerushalmi Talmud paraphrases some of it in a wider discussion that “deals with various kinds of diseases and natural afflictions for which the shofar is blown, presumably to enable people to say a prayer to prevent them.”19 There was therefore at least some continuity between Second Temple and rabbinic medical ideas. Other Second Temple sources also describe sickness in natural and supernatural terms in a manner analogous to the Bavli. Works like Jubilees and Enoch, among others, invoke materia medica and effective words against demons and sickness.20 Angels and demons are mediators of health and sickness, or act as a person’s helpers or enemies in the battle against disease. For example, in the Testament of Solomon the king uses spells to defeat diseasecausing evil spirits, while in the Book of Tobit the protagonist’s eye injury is cured with fish gall.21 Regarding the purported use of drugs at Qumran, there remains some debate.22 Josephus reports that the Qumran community made inquiries into the healing qualities of roots and rocks.23 In terms of disease, among the Dead Sea Scrolls are a number of fragments on skin diseases and other ailments.24 For the purposes of this book—given that the rabbis were apparently not privy to the pharmacological sources in the Dead Sea Scrolls or to the therapeutics mentioned in Josephus25—these sources are merely contextually useful, since they had little to no impact on Babylonian Talmudic medicine. The lost Book of Remedies—which the rabbis believed came from King Solomon and was hidden away by King Hezekiah—may have had information that would shed light on any continuities between prerabbinic and Talmudic pharmacology, but this work is not extant.26 Finally, Jubilees 10:10–14, dating to the second century b.c.e., narrates the origins of medical thought by explaining how the angels divulged herbal therapies to Noah as a way to combat evil spirits: “And we explained to Noah all the medicines of their diseases, together with their seductions, how he might heal them with herbs of the earth. And Noah wrote down all things in a book as we instructed him concerning every kind of medicine. Thus the evil spirits were precluded
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from (hurting) the sons of Noah.”27 This work attributes the emergence of medicine with ancestral figures.
exodus 21 and the authority to heal The rabbis of late antiquity were resourceful in finding biblical verses that they could interpret as prooftexts to support their medical practices and beliefs. One of these beliefs was the requirement to seek a physician’s help when one is ill. The rabbis justify the importance of human healers through a close reading of Exodus 21:18–19: When men quarrel and one strikes the other with stone or fist, and he does not die but has to take to his bed—if he then gets up and walks outdoors upon his staff, the assailant shall go unpunished, except that he must pay for his idleness and his cure.
This law deals with an instance when two men get into a fight and the assailant is held liable for recompensing the victim’s lost wages and medical expenses. The early commentators and rabbis focus on the law’s implication: namely, that the ruling that the assailant needs to pay for the victim’s medical expenses implies the existence of doctors who can provide such services.28 In rabbinic literature, the Tanna Rabbi Ishmael cites Exodus 21:19 to prove that God authorized human beings to heal. This is recorded in the Bavli in the context of a prayer that one should say before visiting a bloodletter. When one goes to let blood, one should say: “May it be Your will, O Lord my God, that this deed will be a remedy for me, and You shall heal me for You are God the trustworthy Healer, and Your remedy is true, because it is not the position of people to heal, but they have become accustomed to this.” Abaye said: “A person should not say thus, for the academy of Rabbi Ishmael taught in a baraita: ‘and his cure’ (Exod. 21:19)—from here [we learn] that authority was given to the physician to heal.”29
This passage begins with a prayer for bloodletting that praises God as the true healer and criticizes human attempts to heal. In response, Abaye rejects the need to say this prayer and instead cites the school of Rabbi Ishmael’s interpretation of Exodus 21:19, which proves that God gave authority to physicians. In other words, Abaye is here expressing a partiality for human medicine over a reliance on the belief that God is the only true healer—a preference among Babylonian sages that is corroborated by the Bavli’s inclusion of the dozens
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of therapies. Later authorities, such as Nah. manides and Joseph Karo, supported the notion that medicine is a human obligation sanctioned by God.30 But such a claim did not come without some controversy. For example, the Tosafot and medieval authorities debate whether Exodus 21:19 implies that humans are permitted to heal only man-made injuries. For instance, Abraham ibn Ezra distinguishes between visible wounds treatable by man and internal diseases that only God can heal; he writes that Exodus 21:19 “teaches that permission was granted to doctors to heal bruises and wounds that are visible. However any disease that is internal is in the hands of God to be healed.”31 Other authorities, however, argue against this, often seizing on the emphatic repetition of the root RP’ in the verse as proof that a human physician, with exertion, is indeed permitted to heal any ailment.32
other sources of medical knowledge In another case of biblical exegesis that stimulates medical thought, the rabbis identify a reference to sickness in Deuteronomy 7:15 to be a variety of possible illnesses. The biblical verse says that God will not punish the Israelites with the diseases that He brought upon the Egyptians. The Lord will ward off from you all sickness; He will not bring upon you any of the dreadful diseases of Egypt, about which you know, but will inflict them upon all your enemies.
In b. B. Mes. i‘a 107b, five rabbis—Rav and Shmuel followed by three Palestinians—offer different interpretations of the verse’s reference to “all sickness”: the evil eye, wind (or spirit), cold drafts, excrement, and gall. The passage alludes to how some of these ailments are responsible for ninety-nine out of a hundred deaths. It reads: “The Lord will ward off from you all sickness” (Deut. 7:15). Rav said: “This is the evil eye.” Rav is consistent with his reasoning, for Rav went to a graveyard [and] did what he did [i.e., performed magic]. He said: “Ninetynine [died] as a result of the [evil] eye and one [died] of natural causes.” Shmuel said: “This is the wind/spirit.” Shmuel is consistent with his reasoning, for Shmuel said: “Everyone [dies] from the wind.” But according to Shmuel [there is a difficulty, for] there are those who are killed by the government. For [those people] also, were it not for the wind [or: “demon”] [ziqa], one could make dragon’s blood33 and live.
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Rabbi H . anina said: “This is the cold,” for Rabbi H . anina said: “Everything is in the hands of heaven except for cold drafts, as it is written, ‘Thorns and snares are in the path of the crooked; he who values his life will keep far from them’ (Prov. 22:5).” Rabbi Yosi b. H . anina said: “This is excrement . . .” Rabbi Eleazar said: “This is gall . . .”34
This text is a rare instance when the Talmud reveals the logic behind the rabbis’ viewpoints regarding the causes of disease and death. Rav and Shmuel’s interpretations of Deuteronomy 7:15 are based on each sage’s own “reasoning” and life experiences. Rav’s position that it is the evil eye stems from the sage’s own practice of performing magical acts at graveyards. Although the Talmud is cryptic about what exactly Rav does at the graveyard, probably as a way to frown upon such actions, manuscript Escorial, a fifteenth-century witness, explains: “He took myrtle twigs and planted them in the graveyard and he discovered that ninetynine shriveled and one dried up: those that shriveled died from the evil eye, whereas the one that dried up died of natural causes.”35 This variant describes Rav planting myrtle into the graves to test if they shriveled or dried up, a metaphor for whether the person died by the evil eye or by natural causes. The Yerushalmi Talmud contains a lengthy parallel text in y. Šabb. 14:3 (14c). Rav and Shmuel also make an appearance here, but this time in joint statements with Rabbi H . iyya the Great and Rabbi H . anina. This text begins with the motif of “ninety-nine die,” and then turns to an exegesis of Deuteronomy 7:15. Compared to the Bavli text, it honors God and attributes one death to the hand of heaven instead of to natural causes. Rav and Rabbi H . iyya the Great both said: “Ninety-nine die from the [evil] eye, and one by the hand of heaven.” Rabbi H . anina and Shmuel both said: “Ninety-nine die from the cold, and one by the hand of heaven.” Rav said what he knew, and Rabbi H . anina said what he knew: because Rav dwelled there [in Babylonia] where the evil eye is widespread, he said that ninetynine die from an evil eye, and one by the hand of heaven; because Rabbi H . anina lived in Sepphoris, where it is cold, he said that ninety-nine die from the cold, and one by the hand of heaven. . . . Rabbi H . uniya Yaakov from Efratayim in the name of Rabbi: “ ‘The Lord will ward off from you all sickness’ (Deut. 7:15)—this is burning [fever](?).” Rabbi H . una [said], or a baraita in the name of Rabbi Eliezer ben Yaakov taught: “ ‘The Lord will ward off from you all sickness’ (Deut. 7:15)—this is anxiety [or: ‘greed’]” . . .
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Rabbi Abun said: “ ‘The Lord will ward off from you all sickness’ (Deut. 7:15)— this is the evil inclination whose beginning is sweet but whose end is bitter.” Rabbi Tanh. uma in the name of Rabbi Eleazar [in the name of] Rabbi Menah. ama in the name of Rav: “ ‘The Lord will ward off from you all sickness’ (Deut. 7:15)—this is gall, as Rabbi Eleazar said: ‘Ninety-nine die from the gall, and one by the hand of heaven.’ ”36
According to the Yerushalmi Talmud, the reason that Rav believed that ninety-nine people died by the evil eye was because he lived in Babylonia, where the evil eye was ubiquitous, and the reason that Rabbi H . anina thought that ninety-nine died by the cold was because he lived in Sepphoris, where it was cold. In both Talmuds, then, a sage’s medical worldview is legitimized by life experiences and habitat. Both texts also illustrate that interpretations of Deuteronomy 7:15 triggered a range of ideas regarding health and illness. Other texts likewise discuss whence the rabbis learned about diseases and symptoms. For example, b. Sanh. 48b gives three explanations for how Rav Nah. man knew what gout (podagra) felt like. Rav Yehudah said in the name of Rav: “All the curses that David cursed upon Joab were actualized among his descendants” . . . “[May the house of Joab never be without someone suffering from a discharge or an eruption, or] a male who handles the spindle” (2 Sam. 3:29)—[this happened] to Asa, for it is written: “However, in his old age he suffered from a foot ailment” (1 Kgs. 15:23). Rav Yehudah said in the name of Rav: “He was seized by gout.” Mar Zutra the son of Rav Nah. man said to Rav Nah. man: “What is this like?” He said to him: “Like a needle in raw flesh.” How did [Rav Nah. man] know this? If you wish, say that he suffered from it; or if you wish, say that he received the tradition from his teacher; or if you wish, say: “The counsel of the Lord is for those who fear Him” (Ps. 25:14).37
Populated with Babylonians, this passage defines King Asa’s foot ailment as gout, a Greek word,38 which Rav Nah. man claims feels “like a needle in raw flesh.” After this, the Bavli spells out the three ways that Rav Nah. man knew what gout felt like: he suffered from it himself; he heard it from his master; or he learned it from scripture’s message that those who fear God are blessed to know His secret. Thus, personal experiences, rabbinic traditions, and biblical verses are the possible sources of Rav Nah. man’s knowledge of gout’s symptoms. The rabbis gain insight into diseases and medicines in other ways as well. For example, as Giuseppe Veltri notes, they also “learned their medical
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recipes/prescriptions and pharmaceutical knowledge almost exclusively from books and informants.”39 Such written books are difficult to trace in the Sasanian era, though the similarities between the Bavli remedies and the Sword of Moses and Genizah handbooks suggest that works like these latter ones probably did exist. The Git.t.in Book of Remedies may be, or may be based on, a written template of this sort. Finally, other sources of medical information were fables. For instance, one remedy in the Git.t.in Book of Remedies lists five therapies for an ailment of the spleen in the form of potions, rituals, and recitations. In the fifth remedy, the Talmud explains how an unsolved mystery about a goat resulted in an ingredient being used in a healing ritual. This final therapy reads: If not, bring a fish and roast it on a blacksmith’s [coals], eat it with the blacksmith’s water, and drink from the blacksmith’s water—[there was]40 a certain goat that was drinking the blacksmith’s water, and [when] it was slaughtered, no spleen was found in it.41
This text alludes to a folk story to account for why it recommends consuming roasted fish and the water of a blacksmith: once upon a time there was an incident where a goat that drank from the blacksmith’s water ended up having a missing spleen. This tale—which may be related to a popular tradition recorded by Celsus, who for an enlarged spleen suggests “water, in which a blacksmith has from time to time dipped his red-hot irons”—is the logic behind the therapy.42
tannaitic and hebrew medicine Tannaitic traditions allude to simple empirical remedies in the context of legal discussions. For example, the Mishnah, Tosefta, and baraitot refer to the use of oil, hot water, compresses, and honey to help treat wounds.43 Some of these ancient remedies were probably effective, as, for instance, modern studies of the use of honey to heal wounds have shown.44 Many of these traditions act as prompts for the Bavli’s medical laws and practices in various ways. For example, b. Yoma 83a expounds on the Mishnah’s statement that an “expert” can force-feed a patient on Yom Kippur, a day of fasting. Both Talmuds consider the legal implications of this by exploring the rights of the sick and replace the expert with a physician. What is one supposed to do when a sick person who is seized by “stupor” goes against the doctor’s orders and refuses to eat? Here is the excerpt:
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[M. Yoma 8:5] “A sick person may be given food at the word of experts. [And if no experts are there, he may be given food at his own wish, until he says ‘Enough!’].” Rabbi Yannai said: “[If] the sick person says, ‘I need [to eat],’ but the doctor says, ‘He does not need [to eat],’ we listen to the sick person.” What is the reason? “The heart alone knows its bitterness, [and no outsider can share in its joy]” (Prov. 14:10). It is obvious. Lest you say that a doctor is more certain [than the sick person], he tells us otherwise. [If] the doctor says that he needs [to eat], but the sick person says that he does not need [to eat], we listen to the doctor. What is the reason? Stupor seized him.45
In the opinion of Rabbi Yannai, in a case where a sick person wants to eat despite the doctor’s recommendation against doing so, the sick person’s wishes are honored. The rationale for this opinion is that a doctor cannot empathize with the patient’s suffering, as Proverbs 14:10 teaches. Sick people know what is best for their recovery, even if the doctor “is more certain.” A doctor’s expertise does not lead to having complete authority when it comes to a patient’s pain.46 In this case, the rabbis protect patient autonomy. However, in the reverse scenario—where the doctor says to eat, but the sick person refuses— one follows the doctor’s opinion, since this could be an instance where stupor prevents the sick individual from making a rational decision. In this text, one sees how the Mishnah becomes fodder for medical ideas in the Bavli. The parallel text in y. Yoma 8:4 (45a–b) illustrates how the Bavli anonymously adds the reference to stupor, in support of why one should follow the opinion of the physician, and the prooftext from Proverbs 14:10, in support of why one should follow the opinion of the sick. The Yerushalmi Talmud reads: If a sick person says, “I can [fast on Yom Kippur],” and the physician says, “He cannot,” they listen to the physician. [If] the physician says, “He can,” and the sick person says, “I cannot,” they listen to the sick person. There is need [for an opinion] when the sick person says, “I can,” and the physician says, “I don’t know.” Rabbi Abbahu in the name of Rabbi Yoh. anan: This is dealt with as a case of life and death, and in any case of life and death [the needs of the sick person] override the Sabbath [and holiday].47
The two Talmuds agree on the rules of whose opinion is to be followed in which cases. The Yerushalmi Talmud, however, includes a scenario where the sick person says he can fast, but the physician is uncertain, in which case rabbinic intervention is required. In this case, Rabbi Abbahu and Rabbi Yoh. anan
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declare that it should be treated as a matter of life and death, meaning that the sick person is permitted to violate the requirement to fast. At times, the Babylonian rabbis update Tannaitic traditions based on their own language and location. For instance, b. B. Mes.i‘a 78b interprets the mishnaic term lightning as an eye disease: “What is meant by ‘lightning’? Here [in Babylonia] they translated it as ‘eye disease’ [nehorta].” 48 The Talmud also contains a plethora of Hebrew traditions about doctors, health, and illness, especially as it pertains to food and diet.49 Some are linked to similar ideas in Greek medical sources, which makes sense given their likely origins in Palestine as well as the existence of Jews in the Roman world who composed medical writings in Greek.50 For example, a baraita in b. B. Qam. 82a offers five health benefits of eating garlic: Our rabbis taught [in a baraita]: Five things were said about garlic—it satiates, it warms [the body], it makes the face shine, it increases semen, and it kills vermin in the intestines.51
This last benefit has a counterpart in the writings of Dioscorides, the firstcentury-c.e. author of De Materia Medica.52 Some baraitot are structured formulaically as lists of good versus bad food, as seen in b. ‘Abod. Zar. 29a: Our rabbis taught in a baraita: Six things heal a sick person from their sickness, and their healing is a healing; and these are cabbage, beets, water of dry sisin, the maw, the womb, and the lobe of the liver. And there are those who say also small fish, and moreover small fish make fruitful and strengthen a man’s entire body. Ten things bring back sickness to the sick, and his sickness is harsh; and these are the one who eats ox-meat, fat, roast meat, birds’ meat, roast egg, pepperwort, shaving, bathing, cheese, or liver. Some say also nuts, others add also melons. In the School of Rabbi Ishmael it was taught: Why are they called melons? Because they are injurious to the whole human body as swords.53
This text exemplifies another common literary assemblage of interconnected therapies, found throughout the Talmud, which are in Hebrew and likely stem from a Greco-Roman context. In this case, it catalogs foods and hygienic practices that either heal or exacerbate someone’s sickness. The baraita does not elucidate why certain foods are harmful or beneficial—save for at the end, when it explains that the reason that melons are considered dangerous to the sick is because in Hebrew the word for “melons” sounds like the word for “injurious.” For the Tannaim, word-play is a determining factor for its recommendation regarding which foods to avoid. The Babylonian rab-
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bis also used word-play in similar ways. For example, in b. ‘Erub. 28b–29a Rav H . isda says that “a raw/uncooked [lit.: ‘living’] mangel-wurzel kills a healthy [lit.: ‘living’] man.”54 The Gemara assumes that Tannaitic traditions about health and illness are authoritative. In b. Ber. 44b, the Talmud clarifies how an individual might be able to utilize a certain food that a baraita says has both beneficial and harmful qualities without injuring oneself: [The rabbis taught in a baraita:] Spleen is good for the teeth but bad for the intestines. What is the solution? One should bite it and then throw it away. Leeks are bad for the teeth but good for the intestines. What is the solution? One should boil and swallow them.55
The language here is reminiscent of a remedy in b. Git.. 70a where one rabbi chews and spits out prickly safflower, while another chews and discards it. This, again, demonstrates the cohesion of medical discourse and practice in the Talmud. Bavli Šabbat 109b discusses parasitic worms, saying that eating old barley flour can lead to infection. This sugya begins as a commentary on m. Šabb. 14:3, which restricts the medicinal use of Greek hyssop on the Sabbath. The Mishnah does not, however, indicate what ailment hyssop treats—a detail that the Babylonian rabbis fill in. In antiquity, hyssop had multiple subspecies, making it difficult for the rabbis (and for modern scholars) to decipher which type of hyssop the Bible and Mishnah are referencing.56 In the Bible, hyssop is attested in a purification ritual in Numbers 19 that uses it, along with the ashes of a burnt red cow, for someone who was impure from touching a corpse. Likewise, Leviticus 14:1–12 mentions hyssop as an ingredient that a priest dips into the blood of a sacrificial bird to sprinkle on someone who has been healed of skin disease. Psalm 51 adds, “Purge me with hyssop till I am pure; wash me till I am whiter than snow.” From a chemical perspective, phytochemists have argued that “Biblical hyssop is the carvacrol chemotype of the plant Majorana syriaca.”57 Carvacrol has antiparasitic and antimicrobial properties that help gastrointestinal and other illnesses.58 Although the Bible mentions hyssop in the context of ritual impurity, the historian of medicine Zohar Amar maintains that hyssop’s symbolism as a purifying agent is linked to the plant’s antimicrobial properties.59 Here is b. Šabb. 109b, which records the rabbinic debate about the precise classification of hyssop, before then elucidating that, when eaten with black
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dates, it is a treatment for parasitic worms that are caused by eating old barley flour. Rav Yosef said: “[The hyssop in the Torah called] ezob is abarta bar hamag [i.e., a type of thyme]. [The hyssop in the Mishnah called] ezobyon [Greek hyssop] is abarta bar hing [i.e., another type of thyme].” Ulla says: “[The hyssop in the Torah] is white marjoram [marwa].” Ulla happened to come upon the house of Rav Shmuel bar Yehudah. They brought before him white marjoram. He said: “This is the ezob that is written in the Torah.” Rav Pappi says: “It is marjoram [šumšuq].” Rav Yirmiyah from Difti said: “It is reasonable that [the identification] accords with Rav Pappi, for we learned in the Mishnah: ‘The commandment of hyssop [mandates] three stems, on which there are three calyxes’ (m. Parah 11:9). And marjoram [šumšuq] is the one found thus.” For what [ailment] is [it] eaten? For parasitic worms. What is it eaten with? With seven black dates. What does it come from? From [eating] forty-day-old barley flour in a vessel.60
With respect to identifying medicinal herbs, the rabbis faced similar problems that scholars today do. In the text above, the rabbis update earlier Hebrew terms according to their Aramaic lexicon in Sasanian Babylonia. This text’s Babylonian provenance is made clear by the presence of Persian words. For starters, Ulla’s identification of hyssop as “white marjoram” is a calque of the Middle Persian phrase “white herb” (marw ī spēd), attested in the Pahlavi text titled Khusrow son of Kawād and the Page, albeit in the context of the scents of flowers, not medicine.61 In addition to this, the Talmud refers to a second Persian plant ascribed to Rav Yosef, a third-generation Pumbeditan who plays a role in at least six key medical sources on a variety of topics from bloodletting to eye problems to snapping the heart strings. He identifies biblical and mishnaic hyssop as thyme (abarta), a Persian word that appears in Abaye’s recipe for bent heart cartilage in b. ‘Abod. Zar. 29a. It is possible that the rabbis are playing a game of reverse-engineering by connecting thyme, a materia medica in use in their time, to the biblical term as a way to create an aura of authority and efficacy around the plant’s usage. In other words, the motivation for the identification may be aimed at supporting the assumption that the common plant in their own time that they used for parasitic worms works because it is identifiable with a plant in the Bible and Mishnah. The passage in b. Šabb. 109b then continues its identification of Mishnaic terms, this time for “pennyroyal”:
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[M. Šabb. 14:3]: But one may eat pennyroyal [yo‘ezer]. What is pennyroyal [yo‘ezer]? [It is] pennyroyal [put.naq]. For what [ailment] is it eaten? For fluke worm. What is it eaten with? With seven white dates. What does it come from? From [eating] a piece of meat and water62 on an empty stomach . . .63
This anonymous text identifies pennyroyal in the Mishnah with Middle Persian “pennyroyal” (MP *pūtnak).64 For both hyssop and pennyroyal, b. Šabb. 109b records a question-and-answer about what ailment the herbs cure (parasitic and fluke worms), what to eat them with (black and white dates), and where they come from (eating old barley or meat on an empty stomach). The literary form of these two texts is therefore a combination of identificationqua-exegesis of the Mishnah’s plants followed by a remedy and etiology. The fact that the Bavli references worms in this context is not surprising given that it contains detailed knowledge of parasites.65 Some foods were known to be prone to contamination. For example, consuming foods infected with parasitic worms or insects could be potentially lethal, as seen in this text: Rav Yehudah said: The meqaq-worm of books, the tekak-worm of silk garments, the ila-worm of grapes, the peh-worm of figs, and the hah-worm of pomegranates are all dangerous [if eaten]. A certain student was sitting before Rabbi Yoh. anan and eating figs, [when] he said to him: “Rabbi, there are thorns in the figs!” [Rabbi Yoh. anan] said to him: “A peh-worm has killed him.” 66
Rabbi Yoh. anan knows immediately what has happened to the student without even having to inspect the fig. This text shows the rabbis’ awareness of threats from the natural world, including a sophisticated taxonomy of parasitic worms, presumably based on observation and experience.
medicine in the yerushalmi talmud A familiar method in Talmudic studies is to compare parallel texts between the two Talmuds.67 Each corpus was the creation of separate but overlapping imperial, historical, and cultural contexts: the Bavli in its Babylonian-Sasanian context, and the Mishnah, Midrash, and Yerushalmi in their Greco-Roman
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context. In general, the writing of each rabbinic community exhibits a greater affinity with its local medical system. At the same time, rabbinic medical knowledge flowed across the political borders of the two empires, more commonly from west to east. As we have seen, Palestinian traditions about health and illness are embedded in the Bavli. For scholars of Babylonian Talmudic medicine, determining the provenance of a given tradition is an essential first step of analysis because of the differences in medical cultures that existed in Greco-Roman Palestine and Sasanian Babylonia. Markham J. Geller summarizes these differences as follows: Greek medicine, which would have been prevalent in Hellenistic Palestine, differed substantially from Babylonian medicine in several characteristic features. Greek physicians developed a new approach to healing, which was a direct result of the theory of humours. Disease, according to developing ideas in Greek medicine, could be controlled through manipulating the body’s internal imbalances, such as through diet, purges, and responding to environmental factors (seasonal changes), regimen, and finally bloodletting as the ultimate result of this logic. Babylonian medicine, on the other hand, retained its age-old approach to disease as the result of the attack of demons or external factors, for which remedies consisted primarily of drugs administered orally, through the anus, or through massage or fumigation.68
These differences manifest in how each rabbinic community thought about disease and medicine. Hebrew Palestinian traditions are sometimes influenced by Greek ideas, such as the theory of the humors, whereas the Bavli’s emphasis on demons and drugs stems from its Babylonian context. Although each Talmud contains medical ideas and terms that are unattested in the other, they also share in common some drugs, ailments, and medical laws. In the latter case, the Bavli often reworks received traditions from the Yerushalmi to fit its worldview. With respect to medical thought, two of the main differences between the Talmuds are the Bavli’s emphasis on magic and its inclusion of therapies. By comparison, the Yerushalmi Talmud eschews magical healing and does not have an independent medical handbook comparable to the Git.t.in Book of Remedies.69 The Yerushalmi does have a number of simple remedies with materia medica, but their quantity, length, and complexity are no comparison to the dozens of elaborate ones in the Bavli. It is not obvious to me why the Palestinian rabbis were less interested in recording therapies than their Babylonian counterparts, but it may be because the Jews of Roman Palestine
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had greater access to non-Jewish medical practitioners, whereas in Babylonia, after the decline of Akkadian medicine, there was a vacuum of medical options that the rabbis felt the need to fill in (see chapter 5). That said, the Yerushalmi Talmud does have a number of simple therapies for everyday maladies like earaches and skin problems. Its interest in these subjects is usually stimulated by legal concerns, especially Sabbath regulations. Many are framed based on the medical-legal category of life-threatening diseases or distinctions between food and medicine. In y. Šabb. 14:4 (14d), a rich medical text in the Yerushalmi, Palestinian sages, responding to one of Shmuel’s legal opinions, inventory diseases that are a danger to life. Shmuel said: “It is prohibited to put this saliva on the eye on the Sabbath.” Based on this, you may derive that a scab [is prohibited]. The Rabbis of Caesarea said: “This frog-disease is a danger to life.” Rabbi H . izkiyah of Acco said in the name of the Rabbis of Caesarea: “This disease(?) is a danger to life.” Rabbi Shmuel bar Rav Yitzh. ak said: “This carbuncle is a danger to life.”70
This text contains diseases and therapies not found elsewhere in rabbinic literature. Elsewhere, the Yerushalmi mentions unique materia medica, such as the plant h. aprita, which alleviates constipation.71 Some such traditions are, however, associated with Babylonian sages. Another remedy in the Yerushalmi Talmud is for colic, a Greek loanword.72 For this, it prescribes cress, a widely used ingredient in rabbinic and Near Eastern medicine. Rabbi Yehoshua ben Levi had colic. Rabbi H . anina and Rabbi Yonatan instructed him to grind cress on the Sabbath, put it in old wine, and drink it, so that his life would not be in danger.73
Two Palestinian rabbis tell Rabbi Yehoshua ben Levi, who is suffering from colic, that he is permitted to grind cress and drink it with old wine on the Sabbath. In addition to simple therapies, the Yerushalmi Talmud contains didactic short stories about physicians. Here is an excerpt from one such story about a man who steals a physician’s medicine chest (narteq, from Greek): Once a man stole a physician’s medicine chest. As he exited his son was wounded. He returned to [the physician] . . . The physician said: Return my medicine chest, as there are all types of drugs inside of it, and I shall heal your son.74
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This story does not tell us much about the Yerushalmi Talmud’s knowledge of medical therapies beyond the fact that the rabbis knew some Greek loanwords and may have interacted with physicians.
s.apdIna in the two talmuds In a series of linked texts in the two Talmuds, several rabbis suffer from a tooth or gum ailment, perhaps scurvy or stomatitis, called s.apdina (or variants thereof).75 In these texts, the rabbis receive effective therapies from a daughter of a Roman officer, a Roman noblewoman, and an Arab. In what follows, I compare two of these sources: y. Šabb. 14:4 (14d) and b. ‘Abod. Zar. 28a. Here is the first text, which, as Lehmhaus astutely points out, represents “probably the only compound recipe in the entire Yerushalmi”:76 Rabbi Abbahu [said] in the name of Rabbi Yoh. anan: Therefore, scurvy is a danger to life. Rabbi Yoh. anan had [this illness] and was receiving treatment from the daughter of Domitianus in Tiberias. On Friday he went to her, and he said to her: “Do I need to be treated tomorrow?” She said to him: “No. But if you should need something, take seeds of date palms (and some say Nicolaus dates) split in half and roasted and pounded together with barley husks and the dry excrement of a child and grind and smear the mixture. Do not reveal this to anyone.” The next day he went and expounded it in public. Some say she choked herself. Some say she converted to Judaism.
Rabbi Yoh. anan, sick with s.apdina, is being treated by a Roman woman named Domitianus. This woman is a medical expert, and perhaps even considered an “expert doctor,” since permission to be treated by someone holding this title is one of the three things that one should learn from this story (see below). As Tal Ilan makes clear, one can debate whether she is a Jew or gentile.77 In any case, she teaches the rabbi a detailed recipe for a salve: one grinds up roasted dates mixed with barley and child excrement and then smears it on the affected area. The woman asks Rabbi Yoh. anan not to divulge it to anyone, but he betrays her by disclosing it to the public, causing her to either kill herself in protest or to convert to Judaism out of respect. The Yerushalmi continues with three lessons to be learned from this story: You may learn from this three things: You learn from it that scurvy is a danger to life; that any [illness] that is from the lips inward may be healed on the Sabbath; and, in the name of Rabbi Yaakov bar Ah. a in the name of Rabbi Yoh. anan, that if he is an expert doctor it is permitted [to receive treatment].78
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In y. Šabb. 14:3–4, the rabbis debate whether the teeth and gums should be counted in the category of an internal life-threatening affliction which one can treat on the Sabbath. According to Rabbi Zeira in the name of Rabbi Ba Bar Zabda, teeth are not considered to be within the body cavity (“whatever is [located] in the throat/cavity [h. alal] inward may be healed on the Sabbath”), which is why m. Šabb. 14:4 rules that one may not sip vinegar as medicine for a toothache on the Sabbath. There are also hints that some internal afflictions may not be life-threatening (see, e.g., y. Šabb. 14:3 [14c]: “Interpret the rule [about treating an affliction from the lips inward] only to those that are lifethreatening”). However, these appear to be minority opinions. From what I can tell, both Talmuds seem to be relatively consistent in their claims that s.apdina is an internal affliction and that ailments from the lips inward are life-threatening ones that require treatment on the Sabbath. For example, in b. ‘Abod. Zar. 28a, Rav Nah. man bar Yitzh. ak reports that s.apdina “starts in the mouth and ends in the intestines,” meaning that it is internal (see below). The Bavli version of the story about Rabbi Yoh. anan’s scurvy begins with him receiving treatment from a noblewoman (mat.ronita) and ends with Abaye learning an effective remedy from an Arab after he tries the rabbis’ cures, which do not work. In typical fashion, it includes anonymous questions that probe the symptoms and etiology—information not found in the Yerushalmi. Come and hear: Rabbi Yoh. anan was sick with scurvy. He went to a certain noblewoman. She made him [medicine] on Thursday and Friday. He said to her: “What about on the Sabbath?” She said to him: “You will not need it.” [He said:] “But if I do need it, then what?” She said to him: “Swear to me that you will not reveal it.” He swore to her: “To the God of Israel I will not reveal it.” She revealed it to him. The next day he went and taught it in a public lecture. But he swore and said to her, “To the God of Israel I will not reveal it”?! [Rather, he said,] “To His people, I will reveal it.” But is there a desecration of God’s name? He revealed it to her from the very start. Therefore, it is like an internal affliction. Rav Nah. man bar Yitzh. ak said: “Scurvy [s.apdina] is different because it starts in the mouth and ends in the intestines.” What is its symptom? [If one] places something between the teeth and blood flows from the gums.79 What does it come from? From [eating food made of] very cold wheat or very hot barley, or hash of harsana-fish leftovers. What did [the noblewoman] make for him? Rav Ah. a the son of Rava said: “Yeast water, olive oil, and salt.” Rav Ashi said: “Yeast, olive oil, and salt.” Rav
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Yemar said: “Fat of the goose in the goose-wing [or: ‘applied with a goose feather’?].”80 Abaye said: “I did all these [recipes], but I was not cured until a certain Arab said to me, ‘Bring olive pits that have not ripened [more than] a third [of the way] and roast them on a new spade and stick [the ashes on the affected area].’ I did this, and I was cured.”81
Although these two versions of the story begin with the same basic plot line, there are important differences between them. For instance, whereas in the Yerushalmi the female protagonist tells Rabbi Yoh. anan the recipe before she requests that he not share it with anyone, the Bavli instead appends its therapies at the end of the text alongside the symptoms and etiology of s.apdina. As usual, the Bavli’s emphasis is on the therapy rather than on the legal lessons, which is how the Yerushalmi concludes. It is, however, anomalous that the Yerushalmi’s remedy is more detailed and complex than the Bavli’s.
conclusion The rabbis of late antiquity who were interested in therapeutics did not have access to a wealth of earlier medical traditions from which they could learn. Despite this, they zoomed in on any such tradition that they could to invent, justify, or explain their own medical system. The rabbis do not use the Bible as an authoritative source of medical information per se, but rather as a means of substantiating their own claims to expertise and authority. For example, as we saw, the rabbis interpret Exodus 21:18–19 in defense of their view that God permits humans to heal, and elsewhere they use Deuteronomy 7:15 as exegetical fodder to debate the common reasons that individuals perish—whether from the evil eye, wind, cold, gall, and other causes. In still other texts, the rabbis cite biblical verses, especially from the Writings, as prooftexts for their medical positions. For instance, the Talmud turns to a verse from Ecclesiastes 7:12—“wisdom preserves life of him who possesses it”—to praise rabbis who have made sound medical decisions. One sees this in b. Yoma 84a in the case of rabies: What is his remedy? Let him remove his clothes and run. Rav Huna the son of Rav Yehoshua was rubbed by one of them outside. He removed his clothing and ran. He said: “I accomplished in myself, ‘Wisdom preserves life of him who possesses it’ (Eccl. 7:12).”
The Talmud cites Ecclesiastes to validate Rav Huna’s performance of an anonymous therapy.
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The Mishnah, by contrast, contains some medical information on which the Gemara expounds. Two of the three main medical sources in the Bavli— namely ‘Abodah Zarah 27a–29a and Šabbat 108b–111b—begin as commentaries on these mishnaic traditions. As I showed in this chapter, the Babylonian rabbis fill in the gaps of the Mishnah’s allusions to foods or plants that have medicinal properties by specifying what ailments they heal and by identifying them in Jewish Babylonian Aramaic. The Talmud also contains baraitot that offer medical advice, especially about daily habits and diet, which the Babylonian rabbis discuss, build on, and debate at length. Finally, as we saw in the texts about s.apdina, the motif of “ninety-nine die,” and other sources, the two Talmuds contain parallel traditions and terms that show that there was an exchange of medical knowledge between the two rabbinic centers. The fact that Babylonian sages appear in Yerushalmi medicine, and vice versa, illustrates this overlap. Nevertheless, Babylonian rabbinic medicine was clearly far more advanced and complex than Palestinian rabbinic medicine, particularly when it came to the transmission and practice of healing therapies. In the end, most of the Babylonian Talmudic therapies are not directly influenced or inspired by traditions from the Bible, Mishnah, or Palestinian rabbis.
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chapter 4
Empiricism and Efficacy
The question of whether the Talmudic therapies are “magic” or “science” has orbited the field of Talmudic medicine since its inception. To the modern eye, one can classify some remedies as magic, others as science, and still others as a mixture of both. Julius Preuss observed this over a century ago when he called these two strands of thought “intimately intermingled.”1 Acknowledging the nuances of the division, he described magical healing and scientific medicine as “two rotating spheres which, in general, are concentric, but which have numerous points of contact.”2 This is still a useful model, but with the caveat that one understands that classifications of therapies as magic or science are based on modern academic categories. With respect to defining ancient Jewish science, Philip S. Alexander offers a useful description. Among other criteria, he identifies science with “a strong interest in understanding how the physical world works,” based on “an explicit or implicit assumption that nature is regular and is governed by immutable laws which are accessible to the human mind,” and which entails the “direct observation of the physical world.”3 As this chapter shows, many (though not all) of the Talmudic therapies meet these basic criteria, to the extent that the rabbis were invested in the study of nature and the body for the purposes of healing. To this end, the rabbis constructed sophisticated taxonomies of nature, for example between herbs and trees, as well as diseases and anatomy, based on observation and, presumably, experiments.4 In short, magical elements notwithstanding, medicine in the Talmud was an ancient empirical science, as Giuseppe Veltri and others have previously argued.5 72
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In recent scholarship, experts of Second Temple Judaism have upended a longstanding skepticism toward the idea that ancient Jews engaged in science.6 These publications foreground the physiognomic, astrological, astronomical, calendric, and pharmacological passages in the Dead Sea Scrolls, Enochic literature, and other sources. Skipping over late antiquity, as has often been done,7 scholars have likewise concentrated on works produced from approximately the eighth to tenth century c.e., a period of literary production on scientific topics, such as the mathematical treatise Mishnat ha-Middot (Treatise of Measures), Baraita de-Shmuel, Yetzirat ha-Walad, and Sefer Yetzirah (Book of Creation).8 Asaph’s Book of Remedies may also belong to this time period.9 This encyclopedic medical book, which is deserving of more scholarly attention as well as a full translation, is unique in the history of Jewish medicine in how it amalgamates biblical and religious thinking with Greek (especially Hippocratic) medical thought.10 In this way, it is different from the Bavli therapies, which do not frequently refer to the Bible or God.11 The date and provenance of Asaph’s work are debated—opinions range from the second to twelfth centuries, from Italy to Palestine to Babylonia.12 Some scholars trace it to the same time and place as the Babylonian Talmud, even though the relationship between them is poorly understood.13 Aviv Melzer has gone so far as to argue that Asaph spoke Persian and lived in third-century Persia, but probably in a community that was geographically or culturally closed off from the rabbinic movement, as evidenced by the fact that his work does not exhibit knowledge of the Bavli.14 From what I have seen, Asaph’s work is likely a compilation of medical knowledge coming from various centuries and locations and drawing from different sources, which, at least partially pseudepigraphically, was ascribed to a famous physician named Asaph.15 Perhaps influenced by Jubilees, the Hebrew medical work attributes its ideas to Noah.16 The text goes on to describe the flourishing of medicine among the sages of India, Macedonia, Egypt, and Aram, until Asclepius and magicians “traveled through the land, passing beyond India to the land east of Eden,” where “they found the medicinal trees and the trees of the tree of life.” God, however, smites them, causing medical knowledge to “lay dormant for 630 years, until the reign of King Artaxerxes.”17 From here, the excerpt ends by referencing those responsible for reinvigorating the medical tradition, including Hippocrates, Asaph, Dioscorides, and Galen. Thus, one of the aims of this introduction is to put Asaph the Jew on par with these other famous physicians, and to claim that the Jewish people played a key role in the history of medicine among humankind.
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As more scholars now recognize, the Babylonian Talmud—produced between the Second Temple and medieval eras—also contains scientific learning, including astrology, mathematics, biology, and, of course, medicine.18 To the extent that these Talmudic traditions are rooted in empiricism and observation of the natural world, and borrowed from outside medical systems, they laid an intellectual foundation for the later integration of the Greco-Arabic sciences into Judaism in the Islamic era.19 When compared to other ancient Jewish cultures, Babylonian Jewish medical culture was simultaneously more empirical in its application of trial and error, observation of nature, use of drugs, and surgical tools, and more magical in its invocation of spells and demonic thought. The rabbis juggle these innovations with their ancestral commitment to, for instance, biblical ideas regarding divine punishment and forgiveness in sickness and health. In addition, the rabbis create medical laws to help regulate the practice of therapies. Talmudic medicine was thus holistic, covering the three basic pillars of healing throughout human history: nature, magic, and religion.20
natural therapies with detailed instructions Talmudic therapies utilize an array of natural substances, including but not limited to plants and herbs, minerals, and animal parts.21 Many are consumed as food or drink, while others are applied to the affected area as ointments. For example, to heal an affliction—usually identified as pleurisy (inflamed chest tissues) or catarrh (inflamed mucous membrane)—the Git.t.in Book of Remedies says that one should prepare and drink the following potions: For pleurisy/catarrh: bring sal ammoniac about the size of a pistachio nut, honeyed galbanum about the size of a nut, a spoonful of white honey, a nat.la-measure of Mah. ozan clear(?) brine, boil them together, and when the sal ammoniac boils [then] the entire [potion] is cooked. If not, bring one quarter of a log of white goat milk and let it drip on three stalks of cabbage [or: “a plowed field”?]22 and stir it with a stem of marjoram, and when the stem of marjoram is cooked [then] the entire [potion] is cooked.23
This therapy gives detailed directions for the preparation of two concoctions, including how to determine when they are fully cooked. In the first remedy, one boils together specific amounts of four natural ingredients, namely:
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1. sal ammoniac (i.e., a mineral made up of ammonium chloride), which is water soluble and still in use today as an expectorant; 2. galbanum, a plant, with resin derived from its stems, which is also an expectorant; 3. white honey; and 4. Mah. ozan brine. In a frequently cited description of the medicinal properties of sal ammoniac, the Encyclopedia Britannica (1911) explains that “it has a specific effect on mucous membranes as the elimination of the drug takes place largely through the lungs, where it aids in loosening bronchial secretions . . . it has been used with success in gastric and intestinal catarrhs.”24 This usage appears to be an example of late antique medical alchemy, for which sal ammoniac was likely a key ingredient, as it was in early Arabic medicine.25 In the Sasanian era, sal ammoniac was imported from China, and its medical-alchemical use may have been known in the medical schools of the time.26 Pointing to this outside influence, the Talmudic recipe above contains at least three Iranian loanwords: pleurisy, sal ammoniac, and pistachio. Other therapies use natural ingredients in other ways. In b. ‘Abod. Zar. 28b, the Talmud lists remedies for an earache, some of which involve heating animal parts into liquids—for instance, the juice from a buck’s kidney and the fat of a large beetle—that one pours into the ear. Other remedies for an earache entail filling the ear with wads of wool soaked in pomegranate juice: “Let him bring a flock of unbeaten wool [dyed] with pomegranate [juice] and place it in [his ear].”27 There existed a similar practice in Mesopotamian medicine for different types of earaches: “you sprinkle 1 shekel of nurmû-pomegranate juice (and) 2 shekels of infusion of kanaktu-aromatic on a tuft of wool (and) insert (it) into his ears.”28 Despite the tendency for scholars to attribute empirical influences on Talmudic medicine to the influence of Greek thought, this example illustrates how Akkadian also plays a role in the development. For hemorrhoids and anal fissures, the Talmud prescribes putting medicine into a patient’s linens, or more precisely in “worn-out linen rags in the summer and cotton [rags] in the winter.”29 For other afflictions the Talmud recommends baths or compresses.30 The therapies also employ everyday objects, such as coins to slaughter an animal in a medical ritual and to alleviate or cover wounds.31 Again, all of these highlight the empirical background of Talmudic medical thought.
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The therapy for a lower anal fissure in b. ‘Abod. Zar. 28b gives four options for relief, all of which avail themselves of natural ingredients. Bring the fat of a virgin she-goat, melt it, and smear it on [the fissure]. If not, bring three gourd leaves that were dried in the shade, burn them, pound them in a mortar, and spread [the ashes] on [the fissure]. If not, bring snail shells and burn them and stick them [on it]. If not, bring an ointment of bitumen and attach it to worn-out linen rags in the summer and cotton [rags] in the winter.32
The four materia medica listed here are goat-fat, gourd leaves, snail shells, and bitumen. While the instructions seem straightforward—one smears, spreads, and sticks the substances—other natural remedies contain more detailed directions. For example, the Talmud specifies how to mix and consume elixirs, like this one to treat “inflammation of the bones.” This passage begins with Abaye translating into Aramaic Rabbi Eleazar’s Hebrew identification of an affliction called ah. ilu. After this, Abaye quotes his mother’s rules and remedy. What is ah. ilu? Rabbi Eleazar said: “Fever of the bones.” What is fever of the bones? Abaye said: “Inflammation of the bones.” What is its remedy? Abaye said: “Mother said to me, ‘All [medicinal] drinks [are taken for] three, seven, or twelve [days], except [this one] until [the sick person is] cured. All drinks [are taken] on an empty stomach. But [this one is taken as follows]: After eating, drinking, entering and exiting the privy, and washing one’s hands, they should bring him a measure of lentil porridge and a measure of old wine, mix them together, and eat it. Let him wrap himself 33 in his cloth and sleep, and no one should make him get up until he gets up on his own. When he gets up, he should remove the cloth. If not, it will return to him.’ ”34
This text begins with Rabbi Eleazar identifying ah. ilu as “fever of the bones,” which Abaye then translates into Aramaic as “inflammation of the bones” (or “bone fever”). After this, Abaye’s mother states that people should normally take medicinal drinks for a duration of three, seven, or twelve days on an empty stomach—except in the case of ah. ilu, when one should consume lentil porridge and wine on a full stomach for as long as necessary. Lentils, which appear in other remedies, were likely part of a regular diet.35 After eating porridge, one should wrap oneself up and sleep as long as possible, and then remove the cloth, lest the inflammation of the bones returns. This warning of a relapse (“if not, it will return”) is found in at least two other therapies, where more specific conditions are given: for day-blindness one has to break the bloodletter’s sherd which is part of the healing ritual; and for ra’atan one has to burn the insect
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after its surgical removal from the brain.36 These warnings reinforce that those performing the therapies must follow the given instructions carefully (see below). Bavli Git.t.in 69a instructs someone suffering from pustules or pimples in the larynx (or tonsillitis) to take several steps to resolve the problem. The remedy, attributed to Rabbi Yoh. anan, reads as follows: For [pustules in] the larynx. Rabbi Yoh. anan said: Pyrethrum is like [or: “as effective as”] the mamru-plant, and the root of pyrethrum is better than a mamru-plant. One should hold them in the mouth.37 These impede it. To suppurate,38 bring bran from the top of the sieve, lentils in their dirt, fenugreek, and a bud39 of dodder, and [the afflicted should] hold an amount the size of a nut [of these ingredients mixed together] in the mouth. To lance [the abscess?],40 let another person blow white cress [into the throat] with a wheat straw. To close [the wound?],41 bring dust from the shade of a privy, mix it with honey and eat it, for it is beneficial for him.42
This therapy records four steps related to the removal of the pimples: 1. to impede the growth (by holding plants in the mouth); 2. to suppurate (by holding plants in the mouth); 3. to open the abscess (by having someone else blow white cress into the throat); and 4. to close the wound (by eating privy-dust and honey). At least one of these procedures required the assistance of “another person.” Two of the ingredients in the remedy, pyrethrum and mamru, are unique to this recipe, while others are used in different therapies (e.g., dodder is an antidote for snake venom in b. ‘Abod. Zar. 31b). The four steps listed are presented in a logical order: stop the growth, let it suppurate, lance the abscess, and then close the wound. Although it is hard to prove, given the technical nature of the therapy and the fact that it does not explicitly mention the involvement of a professional physician, this may point to the Talmud’s preference to turn such therapies into so-called everyday home remedies. It is notable that this therapy is not followed by an alternative one (“if not”). Another remedy with multiple steps also references “closing [a wound].” This is found in b. ‘Abod. Zar. 28a’s treatment for an open wound (or a wound from a sword), which Shmuel declares to be a mortal danger and thus treatable on the Sabbath:
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Shmuel said: “This open wound is a danger to life, and we may desecrate the Sabbath for it.” What is the remedy? To stop the blood, [apply/drink?] cress in vinegar.43 To close [the wound], [apply?] scrapings of cynodon and44 scrapings of a dilmun date, or a compress from a garbage dump.45
After Shmuel’s classification of an open wound as a danger to life and the anonymous question, the Bavli describes two steps for treatment: first, to stop the flow of blood by either applying or drinking cress in vinegar; and second, to close the wound by applying scrapings of a dilmun date or garbage dump compresses. This remedy is incomplete, as many are, as it does not have verbs of application: is one supposed to eat or rather apply the cress? Despite this ambiguity, this text illustrates how some therapies contain step-by-step instructions.
warning labels At least a dozen remedies contain warnings against potential hazards (“be careful,” “lest,” or “if [one does] not [follow these instructions] . . .”). One therapy forewarns about the risks of blindness from accidentally pouring animal blood in the eyes, while others discourage the use of iron tools for surgical cutting lest they cause inflammation.46 These warnings document observations of the potential negative consequences of certain treatments. The accurate execution of the remedies was therefore essential on avoiding such problems. Here is one example of these warnings from the Git.t.in Book of Remedies: For cataracts, bring a scorpion with seven joints, dry it in the shade, pound it in a mortar [into] two portions of kohl and one portion of [scorpion], and paint the eye with three paint-sticks on this eye and three paint-sticks on that eye, [but] do not paint with more, because if [one does] not [follow these instructions], the eye may burst.47
Here, the Talmud cautions against putting too much ground-up scorpion on a cataract patient’s eye, which can cause it damage (i.e., “to burst”). The therapies frequently use parts of animals and insects, including hazardous ones, as medical substances, thereby warranting caution. Interestingly, the therapy uses the phrase “if not”—which we have seen often introduces alternative therapies—to express the warning.
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Later in the Git.t.in Book of Remedies, the Talmud reports on the potential danger of drinking a potion with seeds that can puncture the intestines. The therapy for a fierce sting (or white worms) reads: For a fierce sting/white worms, bring a seed of rocket, tie it in a towel, soak it in water overnight, and drink it, but be careful of the seed lest it puncture his intestines.48
For this ailment, the Book of Remedies proposes soaking the seed of garden rocket in a towel and then drinking it. But the seeds must be avoided since swallowing them can cause internal injury. The fact that this remedy alerts its audience to the grave risk of injury from the rocket seed suggests that the handbook is recording failures of past attempts of the therapy. The Talmud also includes advice against doing the opposite of a given remedy. For example, b. ‘Abod. Zar. 28b–29a puts forward simple measures to treat a fever/sickness, gas, scorpion and hornet stings, among other afflictions: A long radish for a fever/sickness, and mangel-wurzel for chills [or: “flatus”]. The opposite is dangerous. Hot [water/compresses?] for a scorpion [sting], and cold [water/compresses?] for a hornet [sting]. The opposite is dangerous. Hot for a thorn, and cold for a skin disease/scabs. The opposite is dangerous. Vinegar for bloodletting [or: “blood/hemorrhage”] and brine for [breaking] a fast. The opposite is dangerous.49
Four times in a row this text warns against doing the opposite of the recommended therapy. The Talmud may be using these pairs of words—long radish50 and fever/sickness; mangel-wurzel and chills/flatus—which sound alike in the original language, as mnemonics to avoid any such mix-ups. Moreover, as Rashi explains, since radishes cool down the body and beets warm it up, the Talmud advises that each not be eaten by someone with chills or fevers, respectively, as that will only exacerbate the illness.
surgery and medical tools In ancient Mesopotamia, the practice of surgery was limited, and although anesthetics such as wine and myrrh were probably used, there are few references to them.51 For its part, the Talmud describes some surgical procedures and instruments, including a bloodletter’s scalpel, and tongs for removing a
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snake from a vagina or an insect from the brain of someone infected with a skin affliction called ra’atan.52 In b. Ketub. 77b, translated below, Abaye delineates a brain surgery for this latter disease. This procedure appears in the middle of a legal discussion regarding how ra’atan affects a marriage—for instance, by preventing a husband from having sex with his wife.53 The identification of ra’atan is contested. Most classify it as a type of leprosy, while others believe it is trachoma, syphilis, lupus, lung disease, a tumor, meningitis, or chronic sinusitis.54 These identifications are based mostly on the list of symptoms given in the Talmud. What are its symptoms? His eyes tear up, his nostrils discharge mucus, saliva comes out of his mouth, and flies swarm him. What is its cure? Abaye said: “Pela-plant, ladanum, scrapings of a nut tree(?), scrapings of a dressed hide(?), melilot, spathe of a red date palm, and boil them together from morning until evening, and [then] bring [the afflicted] into a marble room—and if there is no marble room, bring [the afflicted] into a room seven-and-a-half bricks [thick]—and pour three hundred cups [of this mixture] on his head until the bottom of his skull softens, and [then] tear open his skull, and bring four myrtle leaves, lift up each leg [of the insect] and put one [leaf underneath], take it out with tongs, and burn it in fire, because if [this is] not [done] it will return.”55
This text is organized around anonymous questions about the etiology, symptoms, and cure for the disease. The Talmud—or, more specifically, Rav Pappa, according to a principal manuscript—catalogs the symptoms: dripping eyes, a runny nose, saliva, and flies swarming on the body. According to Boris S. Ostrer, this passage’s “description of the symptoms and etiology demonstrates a strong parallel to Greek medicine.”56 Another article has also pointed to its similarities with the seventh-century Byzantine surgeon Paul of Aegina, author of Epitome of Medicine.57 This Hellenistic context is corroborated by the fact that ra’atan is attested in Palestinian rabbinic texts. If this is correct, then the Bavli here is reworking a Jewish-Hellenistic medical idea to suit its Babylonian context by adding Abaye’s instructions for surgery, which contain motifs specific to Bavli medicine. For Abaye, after boiling together six ingredients, one pours three hundred cups of the mixture onto the skull to soften it. The afflicted is taken into a sterile marble room, or a room with walls that are seven-and-a-half bricks thick—two choices that appear in other Talmudic surgical sources.58 From here, someone—presumably a physician or surgeon
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(who is never mentioned by title)—uses tongs and a myrtle leaf to remove the insect infecting the brain.
biomedical perspectives As medical anthropologists have shown, biomedical perspectives of efficacy are biased against traditional forms of therapy to the extent that they favor the curing of diseases—that is, ridding the body of a pathology or fixing a physiological abnormality—over the healing of illnesses in their psychosocial or cultural dimensions.59 According to this model, Talmudic medicine healed illnesses; it did not cure diseases. This bias notwithstanding, research on Talmudic therapies can benefit from contemporary scientific studies to shed light on the efficacy of ancient therapies. An evaluation of the materia medica in the Bavli using current encyclopedias of herbal medicines can sometimes yield useful information, or at least provide context, about how they may have worked.60 It is not inconceivable that some of the Talmudic materia medica were effective, even if we cannot identify them or prove their effectiveness. Ethnobotanists’ quests for new plant and animal medicines, such as in the Amazon rain forests and elsewhere, show how today’s pharmacopoeia is incomplete and unaware of species of plants with medicinal properties.61 New plant-based medicines are being developed all the time—including for malaria, impotence, and glaucoma, among other afflictions.62 Even common cancer drugs are made of tree bark, such as paclitaxel, “the most widely used breast cancer drug,” which is “isolated from the bark of Taxus brevifolia (Pacific Yew).” 63 In addition to new discoveries, many pharmaceuticals used today are derived from natural ingredients that have been known for millennia. Aspirin, for instance, is made of willow bark, which contains the active agent salicin. Its analgesic property is mentioned as far back as the Ebers Papyrus, an Egyptian work from the sixteenth century b.c.e.64 Recently, scientists have made successful discoveries—one to treat Staphylococcus aureus, and the other a drug with antitumor activity—based on experiments that followed medieval AngloSaxon and ancient Chinese recipe books.65 While none of this proves that Talmudic plants would have been efficacious, at the very least it demonstrates that the rabbis participated in mankind’s eternal quest for healing by nature and may have known things that we do not. Rabbinic medicine avails itself of many different plants and other natural ingredients.66 Some we know were effective—take, for example, garlic, which
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Rabbah bar Rav Huna advocates for treating tooth pain: the pungent bulb has well-known anti-inflammatory and antibiotic properties.67 Honey, too, which the rabbis recommend for the eyes and skin, has been proven to be an effective treatment for specific types of these ailments.68 Other examples are less obvious—like caraway,69 which in b. ‘Abod. Zar. 29a is one of six ingredients that Abaye recommends to treat an unknown condition, borrowed from Greek, which literally means “hook” and which Marcus Jastrow translates as “nausea/bent heart cartilage” (unqele), presumably in part because another rabbi identifies it as an opening of the stomach/heart.70 Does the fact that contemporary science, which confirms that caraway—if this is indeed the exact same plant to which Abaye refers—alleviates digestive issues help scholars, via reverse engineering, more accurately identify unqele?71 In other words, in light of this information, is unqele a digestive issue? Perhaps it is impossible to know, but there is no reason to avoid these types of data as pieces of the puzzle. That said, I have been able to find only a limited number of instances— including cumin, safflower, and cypress—where the medical uses of plants and trees in the Talmud match the same plants’ entries in modern herbal handbooks. Even if ineffective from the perspective of current scientific knowledge, some of the Talmudic therapies, including wholly magical ones, must have provided the sick with a modicum of psychological relief.72 A patient’s mental perspective matters, even in cases when physiological symptoms persist. Some therapies summoned the mental processes of expectancy, persuasion, and suggestibility.73 If a sick individual believes that he or she will get better by performing a ritual that their ancestors did or neighbors do—a sort of conditioning by communal authority—then they might feel better after doing it. Moreover, as Howard Brody, an expert on the topic of the placebo response, explains, neuroimaging proves that so-called placebo benefits—which are related to “symbolic aspects of a therapeutic intervention” that lead to “a change in a person’s health status”—do in fact work: “When a placebo response can be detected by neuroimaging, it appears to involve the same anatomic centers as would be active in a pharmacologic response to the medication that the placebo mimics.”74 The hope and the empowerment stimulated by the Talmudic therapies helped sick people cope with symptoms and provide pain relief. In this way, the therapies may not have worked in the specific way that the rabbis intended them to, but they nevertheless alleviated anxiety and provided a sense of control over one’s illness.
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efficacy of amulets Did the Babylonian rabbis believe in the efficacy of the therapies recorded in the Talmud? And did they actually practice them? If we suspend our contemporary judgments, the answer to both these questions is presumably yes.75 Efficacy is subjective and a cultural construct, meaning that the rabbis did not necessarily have the same criteria that we do for determining whether a given therapy is successful.76 When our science debunks the efficacy of Talmudic medical practices, this does not mean that ancient Jews did not practice them or believe that they worked.77 Rabbinic knowledge of science and medicine was historically determined and rational. The fact that the Amoraim and redactors viewed the therapies as valuable information worthy of transmission supports the assumption that they believed they worked, as do the descriptions of rabbis debating and doing therapies. Relatedly, it is hard for me to discern what the religious or didactic value of the therapies would be if they were not intended to be practiced. Moreover, the existence of the incantation bowls, as archaeological relics, proves that Sasanian Mesopotamians believed in the healing power of amulets and incantations. In late antique Judaism, wearing amulets was thought to eradicate demons and other evil spirits from the body for prophylactic and healing purposes.78 In a series of illuminating texts, the rabbis explain how they test the reliability of amulets. They recorded the number of times that a given amulet worked as a way to prove which amulets were “effective” (mumh. e) and which amulet-makers were “experts” (mumh. e). In doing this, they rationalized their engagement with the supernatural invisible world using what we today would characterize as scientific methods of trial and error and observation; the rabbis lay out testing guidelines for a magical object that, to us, cannot in reality protect a person from sickness. This cognitive dissonance is paradigmatic of the emic-etic tension that scholars face when analyzing the concept of healing efficacy in the ancient world.79 One wonders: How could the rabbis believe in the efficacy of amulets if, after using them, they could not have worked in the way that they expected them to?80 Or perhaps it is possible that we are wrong, and the amulets did in fact work? It is important to remember that the rabbis considered amulets to be a possible, plausible, and inferred explanation as to why someone who wore them recovered from an illness, even if that recovery would have occurred without the amulet. In other words, if someone wearing an amulet recovered, one could attribute the improvement to the magical object. Given that the amulets’
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antagonists were supernatural demons or disease-spirits, a person’s experiences could not deny their existence, since it is difficult to falsify the existence of imaginary things that people believe exist. Helping to entrench such beliefs were certain social forces, such as professional sorcerers and amulet-makers who likely had a financial stake in convincing their clients that their products were effective. Let us now examine the rabbinic sources that discuss testing amulets. Mishnah Šabbat 6:2 embeds the concept of the effective amulet in a list of Sabbath prohibitions, stating that a person is not permitted to go out on the Sabbath with an amulet that has not been prepared by an expert (mumh. e). The Mishnah focuses on the amulet-maker, not the amulet itself. By contrast, t. Šabb. 4:9 is more interested in the efficacy of the amulet. It explains: “Any that heals twice or three times, both a written amulet or an amulet of roots that is made not only for the epileptic, [but] even when it is to prevent epilepsy.”81 The Tosefta here defines an effective amulet, in the context of epilepsy,82 as one amulet that has been proven to heal three times. The term mumh. e denotes both the expertise of the amulet-maker and the effectiveness of the amulet. Rabbinic literature also uses this term in reference to gentile physicians and to experts more broadly. For example, b. ‘Abod. Zar. 26b–27a and 28a discuss under what circumstances one may trust expert non-Jewish doctors (rope mumh. e) to give reliable medical advice or to perform procedures. The rabbis express less suspicion of these experts based on the assumption that they would not want to damage their professional reputation by intentionally harming a Jewish patient.83 Building on the Tannaitic traditions, both Talmuds evaluate the criteria for determining an expert amulet-maker and an effective amulet. But who is responsible for tracking these criteria? In a tradition ascribed to Rabbi Abbahu in the name of Rabbi Yoh. anan, the Yerushalmi Talmud states that it is a physician who is responsible for recording which amulets have proven to be effective three times. Amulets were an area of overlap between rabbis, physicians, and amulet-makers.84 Rabbi Abbahu said in the name of Rabbi Yoh. anan: “The physician may be trusted to say, ‘This amulet is effective [since] I healed with it [once], twice, and three times.’ ” Rabbi Shmuel said in the name of Rabbi Zeira: “[If] the amulet healed one man, it is reliable for one man; [if it healed] two men, it is reliable for two; [if it healed] three men, it is reliable for everybody.”85
The rabbis trust a physician (rope) to declare that an amulet has been proven to be effective three times, matching the Tosefta’s standards. The rabbis thus
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endorse, rather than co-opt, the expertise of a physician. In general, this text supports the idea that rabbis, physicians, and amulet-makers operated within the same spheres of influence when it came to amulets used for healing purposes. In b. Šabb. 61a–b, Rav Pappa, a fourth-century Babylonian who is active in medical thought, is the protagonist in a complex deliberation over the criteria of determining effective amulets and expert amulet-makers. I will now translate this text in three sections, divided into lines A–F. Here is the first section: A. “And one may not [go out on the Sabbath] with an amulet that has not been prepared by an expert” (m. Šabb. 6:2). Rav Pappa86 said: Do not say [that one is not allowed] until the person [who made the amulet] is an expert and the amulet is effective. Rather, [one may wear it] when the person [who made it] is an expert, even if the amulet is not effective. This is also precise, for the Mishnah teaches, “And one may not [go out on the Sabbath] with an amulet that has not been prepared by an expert,” and it does not teach, “as long as it is not effective.” Conclude from this [that any amulet from an expert is permitted to be worn on the Sabbath].87
In line A, Rav Pappa’s interpretation of the Mishnah is straightforward. The criteria for determining whether wearing an amulet is permitted on the Sabbath is whether or not an expert amulet-maker produced it. After this, b. Šabb. 61a–b pits two Tannaitic traditions against each other before resolving the contradiction. B. Our rabbis taught in a baraita: Which amulet is effective? Any that has healed twice and three times; both a written amulet or an amulet of roots; either by a sick person in danger of dying or a sick person who is not in danger of dying; not [limited to] to someone with epilepsy; rather, so that he does not get epilepsy. . . . C. But it was taught in a [different] baraita: Which amulet is effective? Any that has healed three men as one. D. There is no difficulty: this [latter baraita] is to prove the expertise of the person [who made the amulet], [whereas] this [former baraita] is to prove the efficacy of the amulet.88
This text probes the criteria that one should use to determine that an amulet is effective and that an amulet-maker is an expert. Line B argues that an amulet should heal three times. Although somewhat ambiguous (especially the phrase “as one”), line C appears to say that an effective amulet is one that
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heals three different people. Line D resolves this contradiction by stressing that line C is the criterion that one should use to determine whether an amulet-maker is an expert, not whether an amulet is effective. The implication of this conclusion, based on the commentaries, seems to be that an expert amulet-maker heals three different people, each with a different illness, using three unique amulets. The text then continues, with Rav Pappa clarifying the issue at hand: E. Rav Pappa said: It is obvious to me—[when there are] three [different] amulets for three people, each [healing] three times, [then] the person [who made the amulet] is proven to be an expert and the amulet is proven to be effective. [When there are] three [different] amulets for three people, each [healing] one time, [then] the person [who made it] is proven to be an expert, [but] the amulet is not proven to be effective. [When there is] one amulet for three people, the amulet is proven effective [but] the person [who made it] is not proven to be an expert. F. Rav Pappa asked: What [about when there are] three [different] amulets for one person? The amulet is definitely not proven to be effective. Is the person proven to be an expert, or not proven to be an expert? Shall we say that this [person] cured him [three times],89 or perhaps it is that person’s guardian angel who accepts the amulet [lit.: “writings”]? Let it stand.90
The minimum standard for determining the expertise of an amulet-maker or the potency of an amulet is for each to demonstrate three cases of proven effectiveness. In line E, Rav Pappa articulates the criteria that are needed to declare both that an amulet is effective and that an amulet-maker is an expert—namely, when three amulets are effective three times for three different people (presumably with three different diseases). But in cases when three amulets are effective one time for three people, then the amulet-maker is an expert but the amulet is not proven to be effective. And in cases when there is one amulet that is effective for three people, then the amulet is deemed to be effective but the amulet-maker is not considered to be an expert. In all, this text lays out the basic criteria for categorizing amulets as effective and amuletmakers as experts—namely, the number of different people and diseases that an amulet heals, and the number of effective amulets that an amulet-maker has made. The point that I want to emphasize is that the Talmud is here elucidating a set of standards, met via trial-and-error testing, for determining efficacy. Although the Talmud never mentions similar tests for the medical therapies, this passage reveals that the rabbis were invested in thinking about the healing efficacy of amulets in an empirical way.
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therapies with empirical and magical elements Some therapies in the Talmud juxtapose what we today would identify as magical and empirical ways of thinking. Magical healing rituals often rely on the logic of inversion, reversal, transference, substitution, similarity, or sympathy as the basis of their perceived efficacy.91 One sees examples of this in Talmudic medicine. For example, in b. Šabb. 66b someone with a fever can transfer the illness onto an ant in a bronze tube by reciting the words, “my load upon you, your load upon me.” In b. Šabb. 129a, sympathetic logic gets expressed when Rav and Shmuel choose meat and wine as part of a meal after bloodletting because the former is “life for life,” and the latter is “red for red” (i.e., wine for blood). Such thinking is found in etiological speculation as well: in b. Ned. 54b, Shmuel says that eating a bird after bloodletting causes one’s heart to palpitate like the fluttering of a bird. And finally, there are numerous instances where the substances in the cure match the affliction in some way, as in the case of the use of a goat spleen to heal a diseased spleen in b. Git.. 69b. These forms of rationality were engrained in everyday life and seeped into some of the more empirical remedies, or vice versa. In some cases, it may have been so-called magical thinking that convinced an herbalist to try a particular plant for a medical condition in the first place—and then the observation of its effects that convinced experts of its utility; in other cases, the potency of a plant to treat an illness may have been explained by dint of its sympathetic qualities. One Talmudic therapy that exemplifies the combination of magic and empirical approaches is the one for a nosebleed in the Git.t.in Book of Remedies. For a nosebleed, bring a Kohen whose name is Levi, and write for him [the name] Levi backwards. If not, write for him backwards, “I, Papi Shila bar Sumqi.” If not, write: “The taste of a bucket in silver water, the taste of a bucket in contaminated water.” If not, bring a root of old alfalfa, rushes of an old bed, safflower seed, safflower, and red covering on the pith of the date palm, and burn them in a fire, and [then] bring tufts of wool and twist a tampon, soak it in vinegar, roll it in that ash, and put it in the nostrils. If not, look for a canal that flows east to west, step [over it], and stand with one leg on this side and one leg on that side, and take mud [from the canal] with his right hand under his left leg and with his left hand under his right leg, and twist a tampon, soak it in the mud, and put it in the nostrils. If not, let him sit/stand under the rain spout, and they should bring a pitcher of water and pour it on him and say: “Just as this water stops flowing so too should the blood of so-and-so the son of so-and-so [woman] stop flowing.”92
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The goal of these magical and empirical therapies is to reverse or stop the flow of blood from the nose. It begins by appealing to the principle of inversion: one should find a Kohen named Levi and write the name Levi backwards, or, alternatively, write the name Papi Shila bar Sumqi backwards. As Joseph Naveh explains, writing words backwards was considered to be more powerful, and “the belief was that reversing the order of letters or words led to reversing the natural order of things.”93 This is followed by the practical strategy of placing tampons with medicine on them into the nostrils. The third option then combines inversion and a practical approach: while the main ingredient to place in the nose is canal mud, the procurement of it involves taking mud with the left hand from under the right leg, and vice versa. The inversion was probably thought to activate the healing properties of the mud in the nose. Many of the Talmudic remedies are thus a mixture of empirical and magical elements side by side. Such distinctions are of course largely ours. In this book, I have stressed the empirical aspects of the therapies because they are often overlooked in favor of the magical spells and amulets. In doing so, I have highlighted the detailed instructions on how to employ natural substances and warning labels that suggest a background of testing and trial and error.
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chapter 5
Talmudic Medicine in Its Sasanian Context
The Jews of late antique Babylonia resided in one of the cultural heartlands of the Persian-Sasanian Empire alongside other religious communities. Researchers have increasingly begun to explore the Babylonian rabbis’ interactions with these other groups, especially Christians and Zoroastrians. For example, Talmudists have traced Zoroastrian influences on the rabbis’ agricultural policies, purity laws, notions of sexuality, storytelling, and political and judicial institutions.1 The topic of Talmudic medicine represents another case study for contextual research, since the therapies integrated outside medical ideas and terms. The transmission of medical knowledge between communities was in part facilitated by the therapies’ roots in the empirical observation of nature. The inhabitants of the Sasanian Empire also had a set of shared historical experiences and afflictions, such as exposure to parasitic worms that cause schistosomiasis as a result of living near canals, and the outbreaks of various epidemics.2 When it came to health and illness, no community or culture in Sasanian Persia was fully isolated. As this chapter will show, there were at least two streams of medical thought flowing through Sasanian and early Islamic Iran. One was a nexus between Syriac, Middle Persian, New Persian, and Arabic literature, largely based on the Greek medical tradition. There is limited evidence that the Babylonian rabbis were privy to this medical tradition.3 The second stream was a constellation of Akkadian, Talmudic, Mandaic, and bowl texts. While there were points of overlap between these two streams of medical knowledge, especially in Mesopotamia, the question of how and when they converged, 89
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and whether it was a tense or harmonious encounter, remains unresolved. The Talmudic therapies represent one piece of this larger puzzle in the history of medicine in Sasanian Iran. In this chapter, I outline an exploratory map for the relationship between Talmudic medicine and these other traditions.
akkadian medicine in the talmud In a series of groundbreaking publications, Markham J. Geller shows that the Bavli’s therapies borrowed heavily from the rich tradition of indigenous Babylonian medicine.4 From the perspective of Talmudic studies, Geller’s emphasis on the Akkadian background points to an unexploited context of the Bavli that, as Robert Brody claims, may prove to be an even more productive comparative lens than the Iranian one.5 Ancient Babylonian remedies and incantations are numerous and diverse, with many dating back in Mesopotamian history to around a thousand years or more before the rise of the rabbis. Despite the cessation of the production of cuneiform tablets before the first generation of Amoraim, the authority and knowledge of Babylonian therapy persisted well into the Sasanian period via Aramaic, with the Bavli being one of its main residual legacies.6 Comparisons of Akkadian and Talmudic medical sources are based on this premise. It is also important to remember that there were Jewish communities in this region since the sixth century b.c.e., making it likely that some Jews had been exposed to cuneiform medicine, even if this exposure is unattested in the historical record. Did the first-generation Amoraim, especially Rav and Shmuel, learn therapies from these earlier generations of Jews and non-Jews? In b. ‘Abod. Zar. 11b, Rav—who headed the academy of Sura near Babylon—reports that there were pagan temples still in use in his lifetime.7 Indeed, the origins of Talmudic medicine blossom with the first generation of Amoraim, that is, with Rav and Shmuel in the third century c.e. This (or perhaps the fourth or early fifth century) is also the approximate date of the Git.t.in Book of Remedies. As Geller’s scholarship demonstrates, the early Amoraim thus filled in the vacuum of medical knowledge that was left by the decline of the indigenous Babylonian tradition. Moreover, centuries later, the innovation of incantation bowls—some of which contain stock pagan themes—may also have been an effort to succeed the lost cuneiform heritage.8 The Talmud’s access to and appropriation of cuneiform medicine was selective. The Talmud appears to depaganize such borrowings by eliminating objects, rituals, or ideas that were prohibited in Judaism. It was, in other words,
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a process of literal and cultural translation. The Talmud repurposed and Aramaicized the original Akkadian therapies to serve the Jewish community. By any measure, the Akkadian therapies are way more detailed and comprehensive than the Bavli’s, and the Talmud’s borrowings were fragmentary and incomplete. Geller’s research often stresses this point. For example, in a comparison of Talmudic and Babylonian renal disease, he explains: The Babylonian recipes illustrate the fact that the Talmud only supplies the bare minimum of information about medical recipes, perhaps only one or two of the most unusual ingredients. This is because the Talmud only partially preserved the vestiges of a 2000-year-old tradition of medicine. It is the last record we possess of a much fuller treatment of renal disease in Babylonia, which we now can reconstruct more fully from cuneiform tablets.9
The fragmentary nature of the Talmudic therapies notwithstanding, Geller’s pioneering research proves that the ancient Babylonian heritage greatly influenced Bavli medicine in both its magical and empirical manifestations.
greek medicine in the talmud A perennial debate in the study of Talmudic medicine is the extent of Hellenistic influence. In my opinion, there is less Greek medical thought in the Babylonian strata of the Bavli than what some scholars have maintained.10 This is not to deny that some evidence exists for such an impact. The Bavli alludes to humoral theory, for instance in its discussions of blood, the gall, and jaundice.11 But many of the traditions with ostensible Greek influence are in Hebrew, attributed to Palestinian rabbis, or otherwise traceable to the land of Israel where Greco-Roman medicine flourished.12 Linguistic evidence is also a clue. According to a recent count by Theodore Kwasman, there are a limited number of Greek loanwords for afflictions and materia medica in Jewish Babylonian Aramaic: ravenous hunger, acacia, rue, salve, and malabathrum.13 In addition, the Greek anatomical terms for “a tight opening” and “finger bone” appear in texts about bent heart cartilage and a crack in the skin, and the word for “face” is used in reference to what might be some sort of demonic seizure in b. B. Mes.i‘a 86a.14 All in all, these loanwords do not display a deep penetration of Greek medical terminology into Babylonian Talmudic medicine. That said, it is important to remember that loanwords are not foolproof data for gauging the depth or channels of exchanges between communities.
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The Bavli contains long texts about bloodletting, a common practice in Galenic medicine.15 In the Greek system, phlebotomy rebalances the humors to treat a variety of ailments, including “gout and arthritis, dizziness and blackouts, epilepsy, melancholy, peripneumonia, pleurisy, liver disease,” among others.16 Although bloodletting’s origins in the Near East date as far back as the Egyptian Ebers Papyrus, the practice is not mentioned frequently in ancient Babylonian medicine.17 As Geller has rightly inquired, how, then, did the Babylonian Talmud end up with such an intricate understanding of venesection? Is this evidence of Greek influence?18 While it may be the case that the Babylonian rabbis learned about this practice from their Palestinian coreligionists, in part from traveling between the two centers of rabbinic activity,19 Palestinian rabbinic texts do not contain specific information about phlebotomy. A baraita in b. Qidd. 82a also gives a damning list of the ten negative qualities of a bloodletter (gara‘) who is described as arrogant, parsimonious, and negligent,20 a negative attitude that stands in contrast to the Bavli’s favorable view of Abba the Bloodletter in b. Ta‘an. 21b–22a. It is possible, but in my view unlikely, that the Babylonian rabbis learned about Greek medical practices and bloodletting via the Syriac translation movement that disseminated Galenic medicine beginning circa the sixth century c.e.21 This phase of Syriac medicine is exemplified by the career of the Christian priest and physician Sergius of Ras al-‘Ayn (d. 536 c.e.), whose medical activities were based on Alexandrian models.22 It was also around this time that the first hospitals were constructed, perhaps with the support of the Sasanian king Khusrow I (531–79 c.e.).23 They appear to have organized centers of medical learning in Jundishapur and Nisibis, although scholars debate whether the presence of a medical school at Jundishapur is a later fictitious creation.24 Writers translated and wrote commentaries on the likes of Aristotle and Galen, contributing a new chapter in the centuries-long history of the dissemination of the Greek sciences in Persia and paving the way for Islamic and Pahlavi medical thought.25 Were these Syriac translations of Galen a possible route through which Greek medical ideas, words, and practices entered into the Bavli?
the syriac book of medicines and the talmud The Babylonian rabbis did not have direct access to the Greek writings of Galen.26 Nor is there much proof, at least as of yet, that the rabbis were directly
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privy to the Greco-Syriac medical tradition.27 In what follows, I will compare the Talmudic therapies with the Syriac Book of Medicines, a vast collection of remedies and other materials. The dating of this latter work is debated, with opinions ranging from the sixth to twelfth century c.e. In all likelihood, it is layered compilation of earlier sources with a complex redaction history.28 Grigory Kessel argues that E. A. Wallis Budge’s famous manuscript is actually three independent sources: (1) Galenic, (2) zodiacal, and (3) magical and natural recipes.29 The Syriac Book of Medicines is clearly indebted to Galenic thought but also exhibits Mesopotamian, Iranian, and Indian content, terms, and influences.30 Its first source has “anatomical and pathological discussions,” many of which, according to Siam Bhayro and Stefanie Rudolf, “are best described as ‘thematic abridgements’ of the works of Galen, combined with medical recipes.”31 Important for our purposes, Bhayro has shown that there are nevertheless some Mesopotamian recipes redacted into the work, and that this “shows how Mesopotamian herbals persisted in the face of the arrival of Greco-Roman science” and “how this new science was received and amended to suit its new cultural, material and religious context.”32 I have found some similarities between the first section of the Syriac Book of Medicines (based on Budge’s translation) and Talmudic therapies: for instance, both treat nostrils by inserting medicine into them using a cloth dipped in vinegar or wine.33 To repeat, pending further research (especially of Syriac medicine) it is probable that experts in Syriac and Talmudic literature will discover other points of similarity or contact, which may provide evidence for rabbinic knowledge of Greek medicine via the intermediary of Syriac. Overall there are more differences between the Bavli therapies and the Syriac Book of Medicines. For starters, the latter work in its entirety includes around 650 recipes and is more eclectic, theoretical, and intricate than the Talmudic medical canon.34 Unlike the Talmud, where, save for the Git.t.in Book of Remedies and parts of ‘Abodah Zarah 27a–29a, therapies are often the byproducts of, or least linked to, halakha and aggada, the Syriac Book of Medicines is focused on medical thought with a detailed taxonomy of afflictions and a rich catalog of pharmacology, with some other materials, such as astrology, mixed in. These differences notwithstanding, there are a number of noteworthy similarities between the Bavli and the third section of the Syriac Book of Medicines, which Budge calls “The Book of Medicines of the Country (i.e., Native Medicines).”35 Bhayro and Rudolf find cause to name it the “Book of Local Medicines,”36 while Adam H. Becker has argued that its
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actual title may be “Book of Topical Medicines.”37 In any case, the third section of this work appears to contain recipes that were indigenous to Mesopotamia.38 Its exact date of origin is unknown, but some have suggested, albeit without providing proof, that it is a product of the sixth century.39 If these opinions are correct, then the third section of the Syriac Book of Medicines comes from the same general historical context as the Babylonian Talmud. To the best of my knowledge, the similarities between the Bavli and the third section of the Syriac Book of Medicines are formal, thematic, and methodological, rather than in the form of parallel remedies (i.e., the exact same procedure using the exact same materia medica to treat the exact same illness). Many of their empirical methods of treatment are identical—applying salves, eating herbs, drinking potions, and the like. Like the Talmud, some Syriac therapies list alternative options and offer warnings against potentially hazardous side effects. For example, here is a remedy for sores and scabs on the head in the third section of the Syriac Book of Medicines. For an ulcer and for scabs on the head: Frankincense, dust, bread crusts, crush them up together, mix with olive oil, and smear it on the ulcer and the scabs. . . . Or smear the blood of a person on the scabs. Or crush camphor leaves in vinegar . . . Be careful lest this mixture harm the patient. Or pound the root of pyrethrum . . .40
The literary structure of this remedy resembles the anonymous Talmudic therapies. It begins by identifying the ailment with “for,” followed by the list of ingredients and the instructions for their preparation and application, before then ending with a series of alternative options. The method of treatments in the excerpt above—smearing a mixture of natural ingredients or human blood on the scabs—as well as its warning against potential side-effects (“be careful lest . . .”) are all likewise attested in the Talmud. The Syriac remedy also uses terms that have cognates in the Talmudic medical lexicon, illustrating the shared medical discourse among Aramaic-speaking communities. However, such linguistic matches are superficial—that is to say, as best as I can discern these two corpora do not recommend the exact same treatments or the exact same drugs for the exact same ailments, even in cases when such cognate terms are attested. Moreover, at times cognates and loanwords do not have identical denotations across languages or dialects. In sum, the Talmud and the third section of the Syriac Book of Medicines are probably not directly borrowing from one another, but are rather part of the same common
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stock of medical information and discourse that circulated among Aramaicspeaking communities in Sasanian Iran. The stylistic features of the Talmudic therapies and the Syriac Book of Medicines were part of a broader medical culture that extended well beyond Mesopotamia, both east and west.41 The rabbis were participants in this global network of medical thought, which they localized to suit their own cultural specificities. Some of the Talmudic therapies hint at this broader milieu and to the possible overlap between the two streams of medical knowledge flowing through Sasanian Persia. For example, the following remedy for an illness, which has sometimes (but probably erroneously) been identified as hemorrhoids, refers to both Greek and Iranian plants and metals. Many of the terms here have Syriac cognates. For an illness (“hemorrhoids,” “anal worms,” or “gall-bladder disease”?), bring acacia [aqaqya < Gk.],42 aloe, white lead [ispedaka < MIr.],43 silver dross [marteka < MIr.],44 a bead of malabathrum [pilon < Gk.],45 and salves of glaucium, and hold them in worn-out linen rags in the summer or in cotton (rags) in the winter. If not, let him drink pure beer.46
This anonymous remedy in the Git.t.in Book of Remedies is a mixture of Greek and Middle Iranian loanwords. Some of these terms, like acacia and salve, are attested in the Syriac Book of Medicines.47 Whether these loanwords constitute evidence of a shared language between the Talmud and the Greco-SyriacIranian stream of medicine—and, if so, if this proves direct influences and exchanges of knowledge between these different systems and communities— are questions on which experts in the Greco-Syriac materials can hopefully shed more light. Moreover, as the text above intimates, it is likely too simplistic to assume that the political divisions between the Roman and Persian empires stymied the exchange of scientific knowledge between Roman and Sasanian populations. Indeed, one can find scientific sources from the Greek and Roman world—such as, to name but a few, Greco-Egyptian recipe books of alchemical texts from the third century or earlier, or parts of Pliny’s Natural History and the Medicina Plinii—that have comparable formal characteristics with the Talmudic therapies, even if they are only indirectly related to
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one another.48 Broadly conceived, the Bavli was part of the global transfer of scientific and medical knowledge and discourse from the Mediterranean through Persia to India and China, and vice versa, in late antiquity.
mandaic medicine and the talmud The Mandaeans are another Sasanian community with whom the Jews had interactions.49 Although from a theological perspective, Mandaic polemics against Judaism point to a hostile encounter, excavations of incantation bowls show that some Jewish and Mandaic families resided next to one another in Nippur and other locales.50 Given the closeness of Aramaic dialects, Jews and Mandaeans were probably able to communicate with one another.51 But does this mean that the two communities also shared medical knowledge? Talmudic and Mandaic magico-medical sources share in common cognate words and foreign loanwords, motifs, and methods of treatments. The Mandaic astrological work the Book of the Zodiac—a mix of astrology, omens, magic, and medicine—is a particularly rich source of comparison with the Talmudic therapies.52 It delineates how one’s date of birth forecasts illness. Francesca Rochberg dates the original astrological parts of the text to the Sasanian period and highlights its Mesopotamian features.53 Similar to the Git.t.in Book of Remedies and the Syriac Book of Medicines, this work’s Mandaic religious affiliation is muted. As Ethel S. Drower notes, this is indicative of the fact that it is a translation of an earlier work.54 In the following passage, the Book of the Zodiac refers to some afflictions with Talmudic cognates: With death, Pisces. So that, as he grows older, he will find favor (or “will decline”?). And, towards old age his forearm and side will trouble him, a red rash will come out on him, an (evil) spirit will seize on his heart, and in the cavity of the navel he will have strangury [or: “inflammation”]. Or else, he will be attacked by pleurisy, and will die a seemly death.55
This text predicts the problems that a man will have in his old age, including a rash, strangury, or pleurisy. Outside of the shared terms for afflictions, this excerpt, which does not include a remedy, does not have much in common with the Bavli therapies, save for perhaps its juxtaposition of diseases and an evil spirit. Elsewhere, the Book of the Zodiac discusses magic and medicine together:
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Pisces is at the culmination. He will cause a disturbance in the family; or else, (he will have) a malady for two years or for four, from which, after the four years, he will recover. A woman will utter magic spells upon him and he will be made ill (thereby), but will be cured by exorcisms and medicinal herbs. He will fall from a height.56
This text predicts that a man will get sick for a few years and then recover. After this, he will be cursed by a woman who utters magic spells and then be cured with exorcisms and herbs. Like the rabbis, the Mandaeans thought that spells could cause illness and that magic and natural ingredients could facilitate recovery. The Book of Zodiac also contains some detailed remedies. Here is a therapy that drives out a demon that causes an unidentified nose affliction. The demon which cometh on a Thursday. Bring him the juice of herbs and sal ammoniac and the leaves of the mouse-ear, the urine of a red and white bull, saffron, and the kidney-fat of a lion. Put these medicaments together and pour into his nostrils or put into sesame oil and then pour into his nostrils. (It is) a great (powerful) medicine and he (the demon) will leave him. This demon is of Jupiter.57
The remedy—intended to eradicate a demon—recommends pouring into the nostrils a concoction of herb juice, sal ammoniac, bull urine, saffron, and the kidney-fat of a lion. Other remedies do not explicitly contain references to supernatural threats. For example, here is one therapy that recommends rubbing drugs on the body for an unspecified illness. If he survives his forty-sixth year he will live to be ninety-eight and will (then) die, and they should keep him away from water. And when he falls ill, take him some goat’s horn, and some catgut (bow-string) and sesame-oil; boil, and rub (the result) into all his body and he will obtain relief.58
This palliative remedy involves taking animal parts mixed with sesame oil and rubbing it on the body. Its verbs are instructional (take, boil, rub), just like those in the Talmudic therapies. The verb boil (BŠL) is cognate with the same verb used in the Git.t.in Book of Remedies.59 This shared language is not surprising given the closeness of the two languages and the use of everyday language in medicinal remedies. These are just some of the therapies in the Mandaic Book of the Zodiac that one can compare to Talmudic medicine. Although the Book of the Zodiac does not follow the same literary formula as the Talmudic (and some Syriac) therapies, and exhibits other differences with them, their
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similar language and worldview support the idea that there was a shared medical culture among Sasanian communities.
incantation bowls and talmudic medicine The corpus of Jewish incantation bowls from the late Sasanian era are among the best comparanda with Talmudic medicine.60 As Dan Levene has explained in an article comparing the Git.t.in Book of Remedies and the Jewish incantation bowls, these two corpora are not only “products of the same cultural environment,” but “they also share the same language, motifs and concepts of magic /medicine.” 61 The bowls and Talmud reference many of the same afflictions. Scholars of the bowls are increasingly finding points of overlap between the bowls and rabbinic culture. In an article titled “Rabbis in Incantation Bowls,” Shaul Shaked has translated a bowl made for a client named Rav Ashi son of Mah. lafta—who could be the same Rav Ashi in the Talmud—which aims to protect him from an evil spirit that has been causing him pain and illness.62 In both the Talmud and the incantation bowls, demons and evil spirits are a root cause of illness, and in many cases all are conflated into a single phenomenon.63 Sicknesses become personified as evil spirits through the use of the phrase “the spirit of [disease/demon].” 64 In the Babylonian Jewish imagination, disease-causing demons were hiding around every corner, skulking in dark or dirty places like shadows or drainpipes. Given the extensive number of evil spirits and diseases in the Bavli and the bowls, it is clear that the Jews of the Sasanian world innovated in this aspect of human experience.65 The Talmud and the bowls often do not distinguish between evil spirits and diseases. Such demon-diseases appear in some bowls’ lists of dangers. For example, here is an excerpt about a lengthy countercharm, made for a client named Abba son of Barkhita, which is intended to thwart the black magic commissioned against him by Imi daughter of Rebecca and her children Mar and Lili.66 In the middle of its list, it refers to different types of fevers, alongside other perils such as curses, oaths, bans, and wicked amulet spirits. This is a charm to make void the sorcery and a curse and a vow and an aversion of Imi daughter of Rebecca and Mar and Lili the sons of Imi who have cursed him and vowed [concerning] him. And from the mouths of three old men who were sitting in a furnace and two that were sitting on the Sea of Salt may they release Abba son of Barkhita the curses, and oaths, and afflictions, and mishaps, and neck charms, and afflictions and afflictions, and rites, and bans, and hypocracies, and
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demons, and sorcery of the cemetery, and sorceries of the house of idols, and sorceries of the synagogue, and oaths of the cemetery, and oaths of the house of idols, and the oath of the synagogue, and fever, and chills, and tertian fever, inflammation of the bone, and periodic fever, and spirits that come by sorceries, and spirits that come of their own accord, and [those] that are sent from heaven, and wicked amulet spirits . . .
The list then ends: . . . and the sorcery and knots, and graves, and charms, and unpleasant water, that have acted against him and that are acting against Abba son of Barkhita. May they overturn and go against their practitioners and the ones who send them.67
This bowl lists demons, afflictions, and other dangers side by side in an attempt to be comprehensive in its protection of the client. Toward the end of the excerpt, the bowl also alludes to three potential sources of spirits: (1) by sorceries of other sorcerers, (2) by their own agency, and (3) from heaven. Moreover, there are a number of bowls that begin with the phrase “may there be healing from heaven” for the specified clients, and others that conclude with declarations about the healing power of God, such as “I have written (the incantation) and God, the Lord of All, will heal.” 68 These bowls’ appeals to the role of heaven, angels, and God in effectuating healing are less frequently found in the genre of Talmudic therapies, especially ones with empirical procedures. The bowls describe demons and spirits reclining in, seizing, or controlling specific body parts of their victims.69 The rabbis and the bowls both refer to the 248 or 252 limbs of the body of a woman and a man, respectively.70 Some bowls offer other enumerations, such as 300 members of a male client’s body.71 Here is an example of a bowl, made for an Iranian-named woman, Mahdukh daughter of Newandukh, that protects the client from a harmful spirit that has affixed itself on her temples, ear, and belly, shuts her mouth, and controls her 252 limbs: I adjure and invoke against you, that you should not have power over Mahdukh daughter of Newandukh, that you should depart and go out of Mahdukh daughter of Newandukh, from the 252 limbs that are in her. . . . Make her live, Mahdukh daughter of Newandukh, in whose temples and ear a spirit has fixed itself and officiates in the seven openings of her head. (That spirit) shuts up her mouth, destroys her face, and confuses the tongue in her mouth, and is fixed in the thread of her navel and in her belly, and controls the 252 limbs that are in her.72
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As Shaked has observed, there are at least thirty bowls for Mahdukh daughter of Newandukh, illustrating the seriousness with which she took her health.73 The sorcerer-scribes whom this woman commissioned drew from multiple traditions to try to protect her and her family from illnesses caused by harmful spirits: bowls for this woman contain elements from Greek, Mesopotamia, rabbinic culture, and elsewhere. For example, one bowl for Mahdukh invokes the Greek term for headache in a “reduced writing” technique (“Kephalargia, phalargia, [largia,] rgia, gia, ia”).74 Others reference Rabbi H . anina ben Dosa in their historiola.75 Unlike the Talmud, which tends to obfuscate its borrowings, the bowls are seemingly less concerned with maintaining the perception of identity boundaries. Both the Talmud and the bowls assume that curses can precipitate illness. For instance, in b. Nid. 20a–b Rabbi Ishmael the son of Rabbi Jose hexes with diphtheria anyone who follows Rabbi H . anina’s method of testing clay water. In a similar vein, one aggressive bowl aims to make an unnamed client’s personal enemy suffer from bodily injuries and to be imprisoned: And her name is Baruqta [“cataract”]. I call you evil spirit that sits in the cemetery and dwells in ditches and crouches between alfalfa/clover and crushes vines. And you will attack Mar son of Ahot and sit upon his head and upon his temples and upon his eyes and dissolve the great sinew/nerve of his neck. And he will say woe woe woe woe woe woe woe woe about the injury. The injury that afflicted his body and it injured him (away) from me. From me I call to you evil spirit and I adjure you by the name of Michael and Ramiel, that you may bring upon him, Mar son of Ahot, misfortune louse eggs and vermin and (then) he will be imprisoned in a jail, amen amen quickly. (T. T. ) G Š (T) ” Q (G) H S. S. M N B W Y T. ‘ L76
In this spell, a sorcerer conjures up an evil spirit that dwells in a cemetery and hides in the bushes to attack the head, eyes, and neck of Mar son of Ahot. It also wishes to send him to a real or metaphorical prison. The goal is, through cursing, to make the personal foe cry out in pain, “woe woe woe woe woe woe woe woe.” In another bowl, a man named Mar Zutra son of Ukmay is the target of a lengthy death curse by a client who yearns for a series of bodily afflictions on him, in addition to making him a pariah among his loved ones and neighbors. Here is the first part of the bowl spell: This charm is to send a spirit against Mar Zutra son of Ukmay. In the name of Qas.piel the angel of death. I have adjured you, Infarat, the evil spirit: Go against Mar Zutra son of Ukmay and dwell with him, in his body and his frame, of Mar Zutra son of Ukmay, and inflate his bowels like a bow and mix within him blood
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and pus and sit like a bolt on his heart and like a load on his brain, and kill him after thirty days. . . . Go against Mar Zutra son of Ukmay and cast him in exhaustion upon his bed, and do not give him bread to eat and water to drink until he shouts and neighs noise and howls; until his children despise him and his neighbors distance themselves from him. And cast down his strength as fails that of a toiling ox and remove his spirit from the two hundred and forty eight organs of his body and kill him with anger and wrath and great fury.77
Illness here gets expressed as the violent desires of members of a community against one another, or as a form of social conflict. Human beings, with the help of bowl-scribes, could call on the demons to strike the bodies of other people. This ubiquitous belief in death curses must have induced widespread anxiety of becoming a victim of black magic.78
rabbis and “others” in talmudic medicine The Talmud alludes to the fact that the rabbis were part of a shared medical culture when it portrays Arabs, pagans, and women transmitting and performing effective therapies alongside the Jewish sages. The rabbis express a level of comfort with learning healing practices from these individuals outside rabbinic circles. Let us look at one of these texts that describes “a certain Arab” curing Rav Pappa with water and honey. Rav Ah. a the son of Rava pounded [the ingredients] together in a mortar, took five fingers full of it, and drank it. Rav Ashi pounded them in a mortar one by one, took a pinch, and drank. Rav Pappa said: “I did all these, but I was not cured until a certain Arab said to me, ‘Bring a new pitcher, fill it up with water, put it under the stars until morning, put in it a spoonful of honey, [and drink it].’ I did so and was cured.”79
After Rav Ah. a the son of Rava and Rav Ashi perform slight variations of the same remedy, Rav Pappa gives a first-person account of how these remedies failed to heal him. Instead, he learns the effective remedy from an Arab, who advises him to put water (qua medicine) under the stars, a known Mesopotamian medical practice.80 As seen here, rabbinic texts often portray Arabs as stock figures representing outsiders with esoteric knowledge of the natural world and the body.81 Rav Pappa’s story clearly privileges the therapies of a non-Jew over two rabbis’ own practices, demonstrating the openness of rabbinic medicine to outside knowledge.
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In b. Šabb. 82a, however, the roles are rearranged, such that an Arab heals himself in a way that accords with a rabbi’s advice: Rav Yirmiyah from Difti witnesses an Arab following Rav H . isda’s advice on how to relieve oneself of constipation by continuously standing and sitting. The exchange of knowledge thus worked both ways; the rabbis had knowledge of effective remedies to teach others as well. In a variation of this motif, b. Šabb. 110b describes an Arab acting on, but also modifying, an anonymous therapy that the Bavli gives for jaundice. The text reads: If not, eat leeks from garden beds(?). There was a certain Arab who was sick [with jaundice]. He said to a vegetable gardener: “Take my garment [as payment], and give me leeks from a garden bed.” He gave it to him, and he ate it. [The Arab] said [to the gardener]: “Lend me your garment so that I can sleep in it for a little bit.” He wrapped himself [with it] and slept in it. When he got up and was warm, [the garment] fell off of him little by little.82
The Talmud proposes eating leeks for jaundice, which the sick Arab does by selling his garment to a gardener as payment. After eating the leeks, however, the Arab, somewhat humorously, borrows the garment back from the gardener in order to take a nap and warm up his body. The Arab, in other words, goes one step further than the Talmud’s recommendation of eating leeks. Again, part of the message here is that the Arab’s medical practices were effective. Rabbinic law debates what were prohibited versus permitted interactions between Jews and non-Jews when it came to medical treatment. In general, the rabbis did not look favorably on Jews healing non-Jews and were suspicious of being treated by gentiles. Abraham Ofir Shemesh has summarized well the rabbinic perspective: The rabbis basically imposed a double restriction: First of all, they prohibited the provision of medical services to non-Jews: treating them, circumcising them, or delivering their babies, officially based on the injunction against assisting and supporting pagan societies that contradict the foundations of monotheistic Jewish faith. At the same time, receiving services from non-Jewish physicians and healers was limited for fear of harassment or murder disguised as a medical failure. It was forbidden to receive medical treatment from non-Jews or to buy medicine that might be lethal, such as opium . . . and Theriac, of which inexact doses may be lethal. Another concern was the use of idolatrous elements contradicting the patient’s Jewish faith as part of the medical treatment, or negative religious influence of the non-Jewish physician on the Jewish patient.83
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The rabbis did, however, allow Jews to turn to gentile physicians in certain situations. Shemesh adds: Rabbis permitted Jews to receive medical treatment from non-Jews with a number of restrictions: If the patient is an important and prominent person, or if the physician is an expert with a well-known reputation, such that he would be prevented from any harmful intentions toward Jews, or if the patient is at death’s door, as in such case the treatment could only be beneficial.84
It is interesting to note that the rabbis’ suspicious attitude toward non-Jewish physicians was not based on their potential incompetence or lack of access to effective therapies, but rather on their personal animosity toward Jews. Moreover, medical interactions have the potential to help other religions thrive or to convert Jews to other faiths. One can see, then, why the rabbis appropriated—but depaganized and rabbinized—medical knowledge from these non-Jewish communities, since, though their knowledge was practically useful in healing Jewish bodies, allowing Jews to interact with non-Jewish physicians could lead to idolatrous beliefs.
jewish women in talmudic medicine Women play a central role in the rabbinic therapies, as they did in ancient medicine more broadly.85 Although rabbinic texts sometimes link women with witchcraft, there is counterevidence that portrays them conducting beneficial ritual acts, including healing practices.86 Indeed, rabbis appeal to women’s medical knowledge. For example, Tal Ilan describes a tradition in y. Sot.ah 1:4 (16d) where “Rabbi Meir pretends to have a sore eye and asks those present in the synagogue, ‘is there a woman here who knows how to whisper on an eye?,’ ” which is then followed by a story that says that spitting in the eye is an effective therapy.87 The Bavli also depicts the mothers and wives of rabbis preparing potions. For instance, in b. Ber. 40a Rabbi Yirmiyah’s mother sticks on, but then scrapes off, from baked bread the dangerous substance black cumin, which Rabbi H . ama the son of Rabbi H . anina said prevents heart pain. And in b. Šabb. 109b, the mother of a lesser-known sage named Rav Ah. adboy Bar Ammi participates in a series of possible cures for someone who drank from uncovered water contaminated with snake poison. Here is the latter source: “And drink eupatorium” (m. Šabb. 14:3). What is eupatorium? Polygonum. What is polygonum? A plant of the polygonum family. What is it used for? For an
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uncovered drink that may have been poisoned by a snake. Bring five melilot and five cups of beer, boil them together until there is the amount of an anpak, and [then] drink. The mother of Rav Ah. adboy bar Ammi made [a potion of] one melilot and one cup of beer for a certain man. She boiled them and gave it to him to drink, and [then] she heated up the oven and raked it and put a brick inside of it [for him to sit on], and [the poison] came out [of him] like a green palm leaf.88
This text begins with an identification of the mishnaic term eupatorium as “polygonum,” which it says is useful for protecting someone from snake poison. After this, the remedy offers an alternative to consumption of polygonum: instead, one can bring five melilot boiled in five cups of beer, which the mother of Rav Ah. adboy Bar Ammi successfully made once “for a certain man.” The mother’s recipe had a different potency—she used only one melilot and one cup of beer instead of the recommended five of each—and she also helped the man warm up his body in the oven. The result? The poison discharged from his body like a green palm-leaf. The most famous woman in Talmudic medicine is Abaye’s foster-mother, whom Abaye quotes many times with an introductory formula: “Abaye said: Mother said to me . . .”89 In a study of these attributions, Charlotte Fonrobert concludes that this attribution might be an “attempt to circumscribe the authority of Abaye’s mother to a more personalized ‘family’ tradition,” which in effect sidelines her perspective.90 Despite this, it is clear that Abaye’s mother is one of the Talmud’s foremost medical authorities. Ilan has argued that the figure Em (“mother”) was a famous female physician: Furthermore, one other rabbi, aside from Abbaye, his late contemporary Ravina (the editor of the Talmud) is also mentioned as quoting Em authoritatively in the same way (BT Berakhot 39b; BT Menahot 68b). This suggests that Em was perhaps a famous, authoritative woman known to the rabbis of Babylonia. It is therefore interesting to note what is the source of her authority . . . Nevertheless, gossip, amulets, folk medicine and the raising of children are traditional women’s occupations, and it is exactly in these areas that we find Em’s advice undisputed. It therefore seems that Em must have been an impressive Jewish woman in Babylonia, a physician with a great reputation, who gained the rabbis’ confidence and trust to a very high degree.91
This woman’s expertise is not limited to issues relating to the female body, as it also consists of advice about fevers, bandages, and potions. Still, as Ilan
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notes, it is not unexpected that many of her traditions relate to women’s issues. In antiquity, women were midwives and medical experts who dealt with problems of infertility, childbirth, and rearing newborns.92 These were common problems for women in the Sasanian world, as illustrated in an Aramaic incantation bowl that was intended to aid in a full-term pregnancy for a client, Mihranahid daughter of Ah. at (“she will have living and abiding children”).93 Abaye’s mother was also an expert in pediatrics. In b. Šabb. 134a, she gives eight consecutive therapies for pediatric disorders, including using barley grain to cut a slit in an infant’s closed anus, or heating up an infant’s cold lips to help suckling. Here are these two remedies, as translated by Fonrobert: Abaye also said: Mother told me: A baby whose anus is not visible should be rubbed with oil and sit for one day; then, where it appears transparent it should be torn crosswise with a barley grain, but not with a metal instrument, because that causes inflammation. Abaye also said: Mother told me: A baby who cannot suck, his lips are cold. What is the remedy? A vessel with glowing coals should be brought and held near his mouth, for this will warm his mouth and he will suck.94
These practical therapies contain motifs found in other medical sources, such as the use of barley grain as a tool to prevent inflammation, and the anonymous question (“what is the remedy?”). Abaye’s mother’s remedies are part and parcel of the Talmudic medical tradition. In b. Šabb. 66b, Abaye’s mother describes three options to treat a one-day fever: an amulet or two transference rituals involving verbal expressions of wish. From a redactional point of view, without the attribution to Abaye’s mother (and the rabbinic interlude in section II), the therapy conforms to the standard therapy formula (see chapter 1). It appears that the attribution to Abaye’s mother was added to the anonymous therapy. Here is the text, broken up into three sections: I. Amulet and Transference Ritual Abaye said: Mother said to me, For a one-day fever, take a silver zuz coin and go to a salt pit and weigh its weight in salt, and [then] tie [the salt] at the empty space of the neck with a yellow string. If not, one should sit at a crossroads and when one sees a large ant carrying something, one should take [the ant] and insert it into a bronze tube, and close it up with lead and seal it with sixty sealings, and shake it and scatter it, and say to [the ant]: “My load upon you, your load upon me.”
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II. Rabbinic Interlude Rav Ah. a son of Rava95 said to Rav Ashi: But perhaps someone else had found [this ant] and [his fever] was terminated by it. Rather, one should say to [the ant]: “My load and your load upon you.” III. River Ritual If not, let one take a new pitcher and go to the river and say to it: “River, river! Lend me a pitcher of water for the guest who happened to come to me.” Let one twirl [the pitcher] around [the head] seven times, and throw [the water] behind the back, and say to the river: “River, river! Take back the water that you gave me for the guest that happened to come to me has come and gone on the same day.” 96
In the first section of this text, which exhibits Akkadian influences,97 Abaye’s mother proposes tying an amulet made of salt around the neck. But if this amulet does not work or is not feasible, one can go in search of an ant at a crossroads, insert it into a bronze tube, and recite words that transfer the fever onto the ant. In the third section, the text describes a river ritual where the person with a fever recites words that, again, symbolically transfer the fever back to the river. In the second section of this text, Rav Ah. a the son of Rava suggests to Rav Ashi that they should revise the original recitation because of the possibility that the ant had already been cursed and was carrying someone else’s sickness—in which case saying “your load upon me” would cause even more harm. Just to be safe, Rav Ah. a the son of Rava recommends that the recitation should be sure to transfer both the sick person’s load and the ant’s load back onto the ant. The structure of this source is telling for two reasons. First, as I mentioned above, it is possible that Abaye’s mother was added to what was initially an anonymous therapy. Second, the middle section is a rabbinic interlude between the anonymous therapies that object to the anonymous therapy, an example of the process of rabbinization that I would like to discuss now.
rabbinization of therapies As this chapter has shown up to now, the Talmudic therapies were part of an Aramaic koine of medicine in Sasanian Mesopotamia. The Babylonian rabbis adopted and adapted magical and empirical therapies that they either learned from or shared in common with non-Jews.98 In terms of knowledgetransmission, the Aramaic-speaking communities were operating on a
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horizontal axis of influence, borrowing and learning from one another.99 At the same time, the Talmudic therapies were indebted to the extensive Babylonian medical heritage that was native to the region for centuries before the rise of the rabbis, an inheritance that represents Talmudic medicine’s vertical axis of influence. The rabbis took steps to legitimate and integrate this outside knowledge, valuing its potential to heal more than its potential for idolatry. As Giuseppe Veltri puts it, “the ancient empirical sciences constituted the main area where they tacitly or consciously accepted gentile customs and findings.”100 But in doing so, the rabbis transformed—or “rabbinized”101—this new information in ways that suited their goals and worldview by harmonizing foreign knowledge with their own legal culture. The rabbis, in other words, did not receive medical knowledge passively, and they edited some of what they inherited.102 As an emergent elite group seeking social authority over their Jewish peers, the rabbis appropriated medical learning, not only in order to display their mastery of a secondary branch of knowledge that would enrich their legal agenda, but also to be able to regulate the behavior of their Jewish peers via the creation of laws surrounding healing practices. The rabbis thus strove to control and co-opt scientific discourse, expertise, and authority.103 In addition to adopting outside knowledge across these two axes of influence, the Talmudic therapies also invented new configurations of terms, plants, and techniques derived from the common stock of such phenomena circulating within the medical koine. This helps to explain some of their unique content. Still, there are a few difficulties with this thesis. First, as we have seen, the Talmud rarely offers insight into the invention of (or logic behind) its therapies; instead, it merely presents them as finished products with presumed efficacy. If the rabbis did invent them, one would hope to find more traces of that process. Second, the rabbis—despite their “rhetoric of insularity”104 and general reticence to acknowledge external influences—indicate that they learned therapies from Arabs, gentiles, and nonrabbis. Indeed, Abaye and Rava declare that Jews are permitted to perform any act that heals, even if it has foreign origins. Abaye and Rava both say: “Whatever is done for healing is not subject to the prohibition of the Ways of the Amorites. Whatever is not done for healing is subject to the prohibition of the Ways of the Amorites.” 105
The rabbis are here alluding to the Amorites, who appear in the Bible as native inhabitants in the land of Canaan. As Beth Berkowitz and others have shown,
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the phrase the “Ways of the Amorites” is a rabbinic legal category for idolatrous and forbidden foreign practices from the Mediterranean and Near East, including ones that both Jews and non-Jews in late antiquity were performing.106 In rabbinic literature, the “Ways of the Amorites” is, in other words, an emic category for foreign superstitious practices that the rabbis prohibit—such as dancing and clapping one’s hands to put out a fire, or plugging up with thorns a hole in a window in a room where a woman is giving birth. Although there are a few instances where the rabbis accept these acts because they are able to find biblical justifications for them, they typically express a hostile attitude toward them, with the goal of delegitimizing the ritual power of outsiders on Jewish life based on the principles expressed in the Torah (Lev. 18 and Deut. 18) which state that the Israelites should not imitate the practices of surrounding cultures. The “Ways of the Amorites” is usually the phrase that the rabbis use to differentiate themselves from forbidden non-Jewish practices. Given this, it is extraordinary that Abaye and Rava express leniency toward any acts that heal, even if they are foreign and would normally be prohibited, as a way to reassure their followers that they will not be labeled idolaters for doing such practices. Healing was an exception to the rule. The rabbis thus prioritized health over the threat of idolatry, one of the gravest sins for a Jew.107 As we have seen, the Babylonian rabbis openly state that they learned effective remedies from non-Jews. In b. ‘Abod. Zar. 28a, Abaye says that after he tried two of his colleagues’ remedies for the tooth ailment scurvy, neither of which worked, he learned an effective therapy from an Arab. The text, which I already discussed in chapter 3, reads: What did [the noblewoman] make for him? Rav Ah. a the son of Rava said: “Yeast water, olive oil, and salt.” Rav Ashi said: “Yeast, olive oil, and salt.” Rav Yemar said: “Fat of the goose in the goose-wing [or: ‘applied with a goose feather’?].” Abaye said: “I did all these [recipes], but I was not cured until a certain Arab said to me, ‘Bring olive pits that have not ripened [more than] a third [of the way] and roast them on a new spade and stick [the ashes on the affected area].’ I did this, and I was cured.”108
Richard Kalmin has brought attention to the uniqueness of this text’s pattern of attribution to Abaye: Abaye’s statement is achronological, since he predates Rav Ah. a b. de-Rava, Rav Yemar, and Rav Ashi and cannot have commented on their statements. This case is particularly important because it depicts observation and trial and error trumping tradition, whereas we never find in standard halakic discussions that a rabbi
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will be credited with saying that he performed the previously listed opinions and they did not work, but that he knows of another that does. This case is particularly striking since the cure that does work for Abaye derives from a non-Jew.109
Abaye’s rejection of competing therapies based on empirical grounds is ubiquitous in ancient medical writings. Moreover, as Lennart Lehmhaus points out, the fact that Abaye himself is sick and that he experiments on himself legitimates his claim to this medical authority.110 In this way, this text conforms more to scientific discourse than to halakhic discourse, while at the same time admitting that Abaye heals himself using a therapy taught to him by an Arab. But the rabbis’ leniency toward outside medical knowledge was not without its problems. The rabbis openly grapple with how to harmonize foreign therapies with their own legal traditions. One sees this in a therapy in the Git.t.in Book of Remedies for the symptom “blood coming from the mouth.” In it two sages cite a tradition from the Mishnah regarding the signs of t.repa (i.e., an animal with an illness or defect that makes it unfit for consumption) among cattle in order to contradict an unattributed diagnostic technique that uses a wheat straw for determining whether blood pouring out of the mouth is originating from the lungs or the liver. There is a cure only if the blood comes from the lungs.111 Similar to the therapy for a one-day fever in b. Šabb. 66b, translated above, sections I and III of this text, which probably made up the original therapy, are anonymous, while section II is a rabbinic dialogue that cites the Mishnah. I. Diagnosis For blood coming from the mouth, [the afflicted] should be tested with a wheat straw. If [the blood] sticks [to it], it is coming from the lungs, and there is a remedy for it. But if [it does] not [stick], it is coming from the liver, and there is no remedy for it. II. Mishnah Rav Ati112 said to Rav Ashi: “But surely we have learned the opposite, ‘[These are accounted t.repa among cattle:] . . . or if the liver is gone and naught soever of it remains; or if the lung is pierced or defective’ (m. H . ul. 3:1).” [Rav Ashi] said to [him]: “When it comes from the mouth, say that [the liver] is completely disintegrated.” The master said: “[If] it comes from the lungs, there is a remedy.” III. Therapy What is its remedy? Bring seven measures of chopped mangel-wurzel, seven measures of chopped leeks, five measures of pomegranate seeds, three measures of lentils, a measure of cumin, a measure of spices, and a corresponding amount of unleavened bread, and cook and eat [it], and drink strong beer of T. evet [or: “of
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good quality”].113
This text has three sections: (1) an anonymous diagnostic test, (2) the rabbis’ objection based on the list of t.repa signs in Mishnah H . ullin, and (3) an anonymous recipe with specific amounts of seven ingredients. For our purposes, what matters most here is the second section. This is, in fact, the first appearance of a rabbi in the Git.t.in Book of Remedies. The two rabbis debate the validity of the anonymous diagnostic test in section I vis-à-vis their own legal traditions. More specifically, the rabbis pit the conclusion of the diagnostic test against a tradition from the Mishnah which lists the physical defects in cattle that make them unfit for consumption. That the rabbis mention animals in this way is not unusual, since one of their main sources of knowledge about human anatomy was through animal inspection. In having this dialogue, the rabbis attempt to harmonize the anonymous diagnostic test with their knowledge of animal defects. Rav Ati argues that the Mishnah contradicts the diagnostic information because it suggests that blood coming from the lungs is a more severe condition than if it comes from the liver. Rav Ashi responds by saying that since the liver is below the lungs, it must be dissolved and its blood has been backed up into the lungs—that is, there are cases when the blood from the lungs comes from the liver. Tellingly, at the end of section II, the rabbis succeed in synchronizing these traditions, to the extent that they conclude that if the blood comes from the lungs, then there is a remedy for it, which, lo and behold, the Book of Remedies appends to the end of the text. In other instances, the rabbis express a distrustful attitude toward anonymous therapies. For example, in b. Git.. 69b Ravin of Naresh goes against the guidance for dysentery, which is to “bring three hundred long peppers and every day drink one hundred of them in wine.” Instead, he gives Rav Ashi’s daughter, who is suffering from the infection, one hundred and fifty of “our” peppers, which cures her. As this tradition illustrates, the rabbis’ modifications of the anonymous instructions are often minor adjustments rather than wholesale revisions. Similarly, in a remedy for heart palpitations, two fifthcentury rabbis—including Ravina, who, along with Rav Ashi, is, according to tradition, considered to be an editor of the Bavli—contradict and then revise an anonymous recipe. The text reads: For a heart palpitation, bring three barley-cakes and smear them with a milk-dish that is less than forty days old, and eat them and afterward drink diluted wine. Rav Ah. a of Difti said to Ravina: “[If one does this] then all the more will the
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heart palpitate.” [Ravina] said to [Rav Ah. a of Difti]: “I said [that this is] for heaviness of heart; for a heart palpitation, bring three wheat-cakes, smear them with honey, eat them, and drink unmixed wine with them.”114
Rav Ah. a of Difti tells Ravina that the opening anonymous recipe will exacerbate the heart palpitations that it is intended to cure. In response to this, Ravina says that it should actually be used for a different heart condition, and then offers a slightly modified recipe for heart palpitations. Redactionally, the appearances of the rabbis in this text are probably later interpolations into what was originally two anonymous therapies. The classic anonymous formula gets reworked. These maneuvers turn the rabbis into the experts by effectively rabbinizing the anonymous therapy genre. Here is the most obvious example of this process, in the remedy for molar pain: For a [painful] molar. Rabbah bar Rav Huna said: Bring a clove of garlic, crush it with oil and salt, put it on the thumbnail on the side that hurts, and surround it with a rim of dough, but be careful of the flesh because it can cause leprosy.115
Without the attribution to the rabbi, it is clear that the therapy follows the anonymous genre: For a [painful] molar: bring a clove of garlic . . .
One finds other examples of this phenomenon among the medical therapies in the Talmud, raising the prospect that such rabbinic attributions are later interpolations to the anonymous therapy genre.116 Since throughout Near Eastern history, garlic, a natural anti-inflammatory, was used for toothaches, the Talmud—by absorbing this widespread knowledge into the rabbinic system of attributions—enhances the rabbis’ reputations as medical specialists. The rabbis also sought to regulate how their coreligionists performed medical practices according to the basic parameters of Jewish law. If it is true that the therapies in the Git.t.in Book of Remedies represent local customs that Babylonian Jews practiced prior to the emergence of the rabbinic movement in the third century c.e., then one of the tensions that the rabbis had to resolve was between, on the one hand, inherited customs that their peers shared in common with non-Jews and, on the other hand, rabbinic law. For the rabbis, these medical customs were “correlative data” to laws, and their production of canonical laws was obligated to accommodate such unofficial but “potent customs.”117 In other words, the rabbis could not transmit these therapies, placing themselves as the
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authorities behind them, without establishing some ground rules of behavior so that the people who practiced them did not violate rabbinic laws. As we have seen throughout this book, one question that arises time and again is whether a Jew is permitted to prepare or consume drugs on the Sabbath. To answer this question, the rabbis utilized their medical expertise to establish appropriate conduct. For instance, the rabbis considered ailments that they knew were “a danger to life.” Following the principle of piquah. nefeš, the rabbis permitted treatment on the Sabbath in such dire circumstances. We saw this in the case of an open wound: Shmuel said: “This open wound is a danger to life, and we may desecrate the Sabbath for it.” What is the remedy? To stop the blood, [apply/drink?] cress in vinegar. To close [the wound], [apply?] scrapings of cynodon and scrapings of a dilmun date, or a compress from a garbage dump.118
This tradition juxtaposes a legal ruling with an anonymous therapy. In the first line, Shmuel’s medical knowledge facilitates his legal acumen: that is, he knows enough about an open wound to determine that it is in fact a danger to life, thereby necessitating treatment on the Sabbath. The layout of this text turns the remedy into supplemental advice that is offered in light of Shmuel’s decision that one may treat an open wound on the Sabbath. This text is just one example where the rabbis regulate how and when a Jew can perform the remedies. In conclusion, the rabbis adopted and adapted therapies that they inherited from the Akkadian tradition or shared in common with other Sasanian communities. Rather than filter out or outcast such foreign practices as illicit magic—as they did with other Amoritic acts—the rabbis instead absolved their peers who did them of idolatry and integrated the remedies into their legal system. Beginning in the early rabbinic period, the Amoraim began to appropriate some of the healing traditions to which their Jewish peers had long been accustomed, while at the same time transforming and regulating such behaviors to conform to their desired worldview and rabbinic law. This rabbinization of foreign knowledge in exilic Babylonia was in fact the main creative impetus that made the Talmud the richest repository of medicine in ancient Judaism.
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Conclusion
The focus of this book has been the genre of healing therapies in the Babylonian Talmud. This rabbinic corpus, which is mostly known for its laws and stories, also contains the richest collection of medical information in ancient Judaism. As we have seen, many authoritative rabbis in Sasanian Babylonia were deeply invested in the healing arts. They transmitted dozens of complex therapies and practiced them on themselves and one another as a way to help their community stay healthy. The Bavli refers to over seventy physical afflictions in Jewish Babylonian Aramaic, ranging from everyday problems like headaches and toothaches to life-threatening conditions that a Jew should desecrate the Sabbath in order to treat. Saving lives and maintaining good health were core rabbinic values, even trumping in importance violations of Jewish law or acts of idolatry. In terms of healing therapies, the Talmud recommends a panoply of techniques, including diet, recipes, salves, bloodletting, baths, sympathetic rituals, spells, and amulets. Some of these therapies were rooted in the observation of nature and trial-and-error testing. Overall, this medical eclecticism—indicative of the lack of a systematic approach— illustrates the diversity of Babylonian Jewish healing practices. Medicine in the Talmud consists of both natural and supernatural therapies that operated between magic and science. Like many societies in world history, the rabbis of late antiquity conceptualized and rationalized “potentially contradictory belief systems about biological phenomena” through their “access to multiple explanatory frameworks.”1 For the rabbis, magical and empirical medicine, or natural and supernatural etiologies and therapies, were not mutually exclusive 113
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or even dichotomous so much as they were fused together in the real world. Even today, in our scientific era, one cannot deny the role that so-called magical or irrational thinking plays in helping human beings cope with illness and death.2 Despite the rabbis’ medical acumen, the Talmudic therapies have been marginalized in the Jewish tradition since the Geonic era. As a result of this, among other reasons, the academic field of Talmudic studies today has largely ignored the importance of the therapies for understanding rabbinic culture and the formation of the Talmud. This disregard of Talmudic medicine is partially a result of the therapies’ perceived inefficacy and irrationality, which has undermined their status and value in spite of their codification within the sacred canon. Not long after the editing of the Bavli, the dissemination of Galenic medicine rendered the Talmudic therapies passé. Today, biomedicine has a similar effect. Medieval and early modern Jews who subscribed to the medical sciences of their time, while at the same time upholding the authority of their rabbinic predecessors, were forced to explain away the dilemma of why the Oral Torah contained ineffective remedies: some argued that, because “nature had changed,” the ancient remedies were scientifically anachronistic; others said that it was impossible to properly identify or procure the plants mentioned in the Talmud; and still others viewed the remedies as old customs that the rabbis promoted only because they did not have access to the Greek sciences. Regardless of their explanation, most Jewish authorities since the Talmudic era have not endorsed or practiced the Talmudic therapies in an extensive manner. To scholars today, the therapies tend to be either conflated with superstitious magic or viewed apologetically as prescient science. The fact that the vast majority of scholarship on Talmudic medicine since the middle of the eighteenth century has been published by physicians, scientists, historians of medicine, ethicists, classicists, and Assyriologists—essentially by everyone except Talmudists—has left the study of the Talmudic therapies without a center of gravity in the field of late antique Judaism. This book is an attempt to fill in this gap by researching the therapies from the perspective of Talmudic studies and Sasanian culture more broadly.
whence comes talmudic medicine? Where did the medical therapies in the Talmud come from? In this book, I have argued that there were at least five sources of the Babylonian rabbis’
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medical knowledge: exegesis, law, outside (non-Jewish) influences, physicians, and innovation. The Babylonian rabbis had to be creative when it came to “medical exegesis” since the Bible, Mishnah, and Yerushalmi Talmud only occasionally delineate detailed treatments or lists of drugs for named afflictions. The Bavli’s healing therapies generally do not have deep roots in exegesis or biblical thought. For instance, the Talmud’s materia medica are based much more on local botany than on biblical plants. Bavli medicine was, in other words, by and large a Sasanian historical phenomenon. That said, although the Bible was not an authoritative source of medical therapies per se, the rabbis do cite biblical verses as prooftexts that support their claims to medical expertise and authority. For example, the rabbis interpret Exodus 21:18–19—which states that an assailant must pay for a victim’s medical bills—to uphold their belief in the value of human physicians. For the rabbis, the Torah thus demonstrates that God authorized human beings to heal their own illnesses. This clever interpretation allows the rabbis to alleviate any anxiety stemming from their drift away from the biblical belief that God is the only true healer and toward their own preference for nature-based medicine. With respect to the Mishnah, the rabbis’ stance is more direct and commentarial. The Mishnah often generically alludes to diseases and cures in the context of broader legal discussions. For example, Mishnah Šabbat 14, which is the textual stimulus for Bavli Šabbat 108b–111b, discusses whether one is allowed on the Sabbath to eat foods that are consumed as both medicine and food. But because the Mishnah here does not describe what particular ailments hyssop and pennyroyal can be used to treat, the Gemara explains that they can cure worms, as well as how to consume them with seven dates. Time and again, the Gemara probes and builds on the Mishnah’s medical allusions by identifying its plants or diseases with Jewish Babylonian Aramaic terms or by adding therapies. Indeed, when it comes to health and illness, the main difference between the Bavli and other rabbinic sources is its emphasis on recording therapies for specific bodily ailments. By comparison, the Yerushalmi Talmud contains only a limited number of complex remedies on par with the Bavli’s. Nevertheless, there are some parallel traditions between the two Talmuds, and the Bavli was at times influenced by Palestinian rabbinic medical traditions, as seen in the case of s.apdina. With respect to the relationship between medicine and law, it is clear that the rabbis acquired medical knowledge as a way to enhance their legal
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prowess. In this way, halakha was not necessarily a source of information about health and disease, but rather a motivation for learning about them. (There are of course some important exceptions to this—that is, where halakhic expertise contributed to medical knowledge—such as the ritual inspection of animals in tractate H . ullin, which the rabbis used to better understand human anatomy and disease.) In general, medical knowledge helped the rabbis become better lawyers. For example, the Sabbath prohibitions against grinding and other forms of labor created a need for the rabbis to become proficient in differentiating between which ailments were life-threatening and thus treatable on the Sabbath versus which were not. The Talmud also contains medical laws on an array of other subjects, ranging from circumcision and menstruation, to patients’ rights, to visiting a pagan physician. It is, however, important to note that the rabbis neither discuss the therapies in and of themselves as permitted or forbidden acts, nor mandate them as obligatory acts that satisfy a commandment from God. In the end, the therapies were presumably thought of more like customs. In addition to legal considerations, the rabbis learned about medicine from the other communities around them in Sasanian Babylonia. The Talmud was part of a wider medical koine in late antiquity. As Markham J. Geller has demonstrated, the early Babylonian Amoraim inherited, adapted, and transmitted Akkadian magico-medical treatments and terms as a way to fill in the void left by the cessation of the production of cuneiform tablets. In subsequent generations, the rabbis shared in common medical knowledge with other Aramaic groups in Mesopotamia. This exchange of knowledge is seen in the linguistic and formal similarities that exist between the Talmudic therapies, the Syriac Book of Medicines, Mandaic sources like the Book of the Zodiac, and the incantation bowls. The fact that the Talmudic therapies, especially anonymous ones, are largely devoid of references to God, the Torah, biblical figures, and Jewish motifs is likely a byproduct of their ties to this common culture. In fact, the Talmud itself portrays the rabbis learning effective therapies from non-Jews. Perhaps most tellingly, this ideological posture is explicit in the rabbis’ belief that anything that heals is not considered the Ways of the Amorites. With this brief statement, the rabbis recognize but dismiss the threat of idolatry that comes with performing medical practices that the Jews either borrowed from or shared in common with outside communities. The rabbis did not necessarily view healing as an expression of Jewish identity. The rabbis’ leniency toward outside medical knowledge also prompted them
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to create specific laws that would dictate how their coreligionists practiced medicine. By rabbinizing the therapies that they learned from the outside world, the rabbis were able to maintain control over an essential aspect of everyday life. The rabbis also learned about medicine from physicians and other medical experts. Jewish Babylonia’s medical system consisted of physicians, bloodletters, midwives, rabbis, amulet-makers, and bowl-scribes, among others. The lines between these professionals are sometimes unclear. Unfortunately, the Talmud does not offer many details about professional Jewish physicians, mentioning only a few by name, such as Benjamin the Physician and Abba the Bloodletter. Abaye’s mother is also one of the most important voices in Talmudic medicine, illustrating that women played a central role in the health of the community and the transmission of medical knowledge. The rabbis express both positive and negative attitudes toward these professionals. At times they were dependent on physicians’ expertise to help them properly adjudicate the law, while in other instances they describe them as competitors who are hostile to rabbinic norms. Moreover, the Talmud portrays the rabbis divulging the secrets of physicians to the public, causing angst among the physicians. This suggests that part of the rabbis’ aim was to disseminate therapies as so-called home remedies, thus cutting out the need for professional intervention while at the same time raising their own status when it came to healing. Finally, the rabbis were innovators of medical thought, sometimes deriving their opinions based on their own life experiences. Thus, Rav believes that the evil eye was the main threat to community health because he lived in Babylonia and practiced magic in graveyards, whereas Rabbi H . anina, who lived in Sepphoris where it was cold, says that ninety-nine out of a hundred people died from cold weather. In the case of amulets, the Bavli offers specific criteria for standardized tests to determine which new amulets are effective and which are not. These tests were, in essence, verifications of technological innovations, or Talmudic versions of clinical trials.
medicine and magic One of the goals of this book has been to interrogate the dichotomy between medicine and magic, and to use the former category to dismantle the latter, which continues to be a central paradigm in the study of late antique Judaism.
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Such reevaluations of the category of “magic” are of course nothing new, and yet its persistent use in historical research in part flows from the fact that scholars’ endorsements of alternative concepts can themselves often fall short; indeed, every etic category carries with it negative implications. In this book, I have tried anew to define rabbinic healing in a way that includes but also transcends the limitations of the category of magic. I do this by focusing on those healing therapies that scholars of magic tend to ignore—namely, the more empirical, nature-based ones. In other words, this book casts a wider net by analyzing rabbinic traditions and practices that seek to rid or prevent illness from the body, regardless of whether they contain magical elements. Using the category of medicine has several advantages. First off, the Talmud contains an identifiable genre of medical therapies—meaning that there is an emic basis for the category. As I discussed throughout this book, this genre of therapies represents an idiosyncratic strain of Talmudic thought with unique literary features that differentiate them from halakhic and aggadic discourse. Second, as an academic rubric “medicine” is more stably definable across cultures and history than other categories such as magic. Whereas scholars of ancient magic tend to lump together a very broad range of different ideas, goals, and practices under the flag of “magic,” the definition of medicine (or healing) is relatively straightforward, as a system of practices that treat physical illness using a variety of methods. Finally, medicine is in some ways a more neutral concept with less baggage than magic or religion. To the extent that ancient medical practices were based on the observation of nature, the senses, and trial-and-error experimentation, they can perhaps be thought of as “secular science.” Indeed, this is the reason why ancient medical knowledge was often transmitted across religious, imperial, and linguistic boundaries. The desire for good health makes it less likely that people will reject ideas and practices that may in fact work simply because they emanate from outsiders.
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NOTES
chapter 1. medicine on the margins 1. See Barry Scott Wimpfheimer, Narrating the Law: A Poetics of Talmudic Legal Stories (Philadelphia: University of Pennsylvania Press, 2011), 1–7, on the genre of legal stories and the division between law and narrative. On the anthological model and court archives, see Eliezer Segal, “Anthological Dimensions of the Babylonian Talmud,” in The Anthology in Jewish Literature, ed. David Stern (New York: Oxford University Press, 2004), 81–107. On the category of folklore in rabbinics, see Dina Stein, “Let the ‘People’ Go? The ‘Folk’ and Their ‘Lore’ as Tropes in the Reconstruction of Rabbinic Culture,” Prooftexts 29 (2009): 206–41. On magic, see Gideon Bohak, Ancient Jewish Magic: A History (New York: Cambridge University Press, 2008). 2. This is the approximate number of ailments referenced in this book, which is not comprehensive. For a helpful list, see Benjamin Lee Gordon, Medicine throughout Antiquity (Philadelphia: F. A. Davis, 1949), 763–75. There are many relevant topics— including gynecology, embryology, reproduction, circumcision, and others—that I do not discuss, in large part because they are not the main subject matter of the therapy genre upon which this book is based. Some of these topics have been previously researched, often from the angle of gender studies; for examples, see Charlotte Elisheva Fonrobert, Menstrual Purity: Rabbinic and Christian Reconstructions of Biblical Gender (Stanford: Stanford University Press, 2000); Gwynn Kessler, Conceiving Israel: The Fetus in Rabbinic Narratives (Philadelphia: University of Pennsylvania Press, 2009); Rachel Neis, “The Reproduction of Species: Humans, Animals and Species Nonconformity in Early Rabbinic Science,” Jewish Studies Quarterly 24 (2017): 289–317; and Lawrence A. Hoffman, Covenant of Blood: Circumcision and Gender in Rabbinic Judaism (Chicago: University of Chicago Press, 1996). 3. For examples from the bowls, see James Nathan Ford, “A New Parallel to the Jewish Babylonian Aramaic Magic Bowl IM 76106 (Nippur II N 78),” Aramaic Studies 119
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120 Notes to page 2
9 (2011): 249–77. For one example of an affliction mentioned in the Sword of Moses but not in the Bavli, see “type of sore” (h. azorta) in DJBA 444, and Yuval Harari, “The Sword of Moses (H . arba de-Moshe): A New Translation and Introduction,” Magic, Ritual, and Witchcraft 7 (2012): 58–98, esp. 84, line 24. 4. On toothaches, see b. Šabb. 111a, b. Bes.ah 18b, and b. Git.. 69a. On migraines, see b. Šabb. 90a, b. Git.. 68b, and Shaul Shaked, James Nathan Ford, and Siam Bhayro, eds., with contributions from Matthew Morgenstern and Naama Vilozny, Aramaic Bowl Spells: Jewish Babylonian Aramaic Bowls, vol. 1, Manuscripts in the Schøyen Collection (Boston: Brill, 2013), 59–67, 71–82, and 94–96 (JBA 2–4, 6–9, and 12), usually as “spirit of” or “daughter of” migraine. On pleurisy, see b. Git.. 69a and b. H . ul. 105b. On liver or lung problems, see b. Git.. 69a and the references in M. Westreich, “Liver Disease in the Talmud,” Journal of Clinical Gastroenterology 12 (1990): 57–62. 5. On autopsies in ancient Judaism, see Fred Rosner, Encyclopedia of Medicine in the Bible and the Talmud (Northvale, NJ: Jason Aronson, 2000), 34–36, and Jason Misher, “Autopsies in Jewish Law: A Dissection of the Sources,” Verapo Yerape: The Journal of Torah and Medicine of the Albert Einstein College of Medicine Synagogue 3 (2011): 111–29. Like the Talmud, ancient Babylonian medicine had a minimal understanding of internal anatomy due to prohibitions against autopsies, on which see Markham J. Geller, “The Babylonian Background to Talmudic Science,” European Association for Jewish Studies Newsletter 6 (1999): 27–31, esp. 27–28. On kidney diseases in the Talmud, see Shaul G. Massry, Miroslaw Smogorzewski, Elizur Hazani, and Shaul M. Shasha, “Influence of Judaism and Jewish Physicians on Greek and Byzantine Medicine and Their Contribution to Nephrology,” American Journal of Nephrology 17 (1997): 233–40, esp. 237; Markham J. Geller, “Hippocrates, Galen and the Jews: Renal Medicine in the Talmud,” American Journal of Nephrology 22 (2002): 101–6; and Estée Dvorjetski, “The History of Nephrology in the Talmudic Corpus,” American Journal of Nephrology 22 (2002): 119–29. On the spleen, see Fred Rosner, “The Spleen in the Talmud and Other Early Jewish Writings,” Bulletin of the History of Medicine 46 (1972): 82–85. On heart problems, see b. Ber. 40a, b. Šabb. 140a, b. ‘Erub. 29b, b. Git.. 69b, among others, and the two articles by Isidore Simon, “Les notions de cardiologie bibliques et talmudiques,” Revue d’histoire de la médecine hébraïque 148 (1984): 3–6, and “Les notions de cardiologie bibliques et talmudiques (suite et fin),” Revue d’histoire de la médecine hébraïque 149 (1984): 26–30. On the intestines, see Mira Balberg, “In and Out of the Body: The Significance of Intestinal Disease in Rabbinic Literature,” Journal of Late Antiquity 8 (2015): 273–87. 6. See, e.g., Solomon R. Kagan, “Talmudic Medicine,” Medical Leaves 3 (1940): 164–73, esp. 168, and Mohammadali M. Shoja and R. Shane Tubbs, “The History of Anatomy in Persia,” Journal of Anatomy 210 (2007): 359–78, esp. 360, who argue that the Bavli is “the earliest use of animal models for the study of human disease,” citing John H. Rust, “Animal Models for Human Diseases,” Perspectives in Biology and Medicine 25 (1982): 662–72. The rabbis also learned about eye anatomy by inspecting animals, according to Elan Rosenblat, “Eye of the Beholder: Ophthalmic Illness in Talmudic Literature,” in And You Shall Surely Heal: The Albert Einstein College of
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Medicine Synagogue Compendium of Torah and Medicine, ed. Jonathan Wiesen (Jersey City: Yeshiva University Press, distr. by KTAV, 2009), 231–37, esp. 232. On rabbinic zoology more broadly, see Abraham Ofir Shemesh, “Biology in Rabbinic Literature: Fact and Folklore,” in The Literature of the Sages, pt. 2, Midrash and Targum, Liturgy, Poetry, Mysticism, Contracts, Inscriptions, Ancient Science, and the Languages of Rabbinic Literature, ed. Shmuel Safrai, Zeev Safrai, Joshua Schwartz, and Peter J. Tomson (Assen: Royal Van Gorcum and Fortress Press, 2006), 509–19. As seen in tractate H . ullin, in some cases the rabbis had a meticulous understanding of animal pathology and anatomy. In particular, Bavli H . ullin chapter 3 contains extraordinary details of animal ailments, including cysts, pus, and defects in bronchial tubes and the intestines. Bavli H . ullin 18b and 48b refer to cartilage and tubercles on the lungs of animals—terms that do not appear in reference to human beings. 7. See Stephen T. Newmyer, “Climate and Health: Classical and Talmudic Perspectives,” Judaism 33 (1984): 426–38. 8. Scholars have long emphasized this point; by way of example, see the statements in Jacob Snowman, A Short History of Talmudic Medicine (London: J. Bale, Sons, and Danielsson, 1935), esp. 7, and Norman Solomon, “From Folk Medicine to Bioethics in Judaism,” in Religion, Health and Suffering, ed. John R. Hinnells and Roy Porter (New York: Routledge, 2011), 166–86, esp. 168. On how the rabbis used scientific ideas current in their time in their homiletic and legal exegeses, see Edward Reichman, “The Incorporation of Pre-Modern Scientific Theories into Rabbinic Literature: The Case of Innate Heat,” Torah U-Madda Journal 8 (1998–99): 181–99. 9. See Fred Rosner, “Who Heals the Sick—God or Man?,” Tradition: A Journal of Orthodox Jewish Thought 12 (1971): 55–68. See also chapter 3. 10. For one helpful overview of the Bavli medical texts, see the chapter on this topic in Plinio Prioreschi, A History of Medicine, vol. 3, Roman Medicine, 3rd ed. (Omaha: Horatius Press, 2001), 663–95. 11. See Gary B. Ferngren, “Early Christianity as a Religion of Healing,” Bulletin of the History of Medicine 66 (1992): 1–15. 12. Samuel S. Kottek, “Medical Interest in Ancient Rabbinic Literature,” in The Literature of the Sages, pt. 2, Midrash and Targum, Liturgy, Poetry, Mysticism, Contracts, Inscriptions, Ancient Science, and the Languages of Rabbinic Literature, ed. Shmuel Safrai, Zeev Safrai, Joshua Schwartz, and Peter J. Tomson (Assen: Royal Van Gorcum and Fortress Press, 2006), 485–96, esp. 486. 13. Technically the handbook ends at the top of b. Git.. 70a, but it is followed by therapies in other literary forms up to 70b. Moreover, debates over medical laws extend as far as 71b if one wants to include discussions about the deranged, deaf-mutes, and involuntary nodding of the head. For more on this, see below. 14. For translations and studies on this medical handbook, see Giuseppe Veltri, Magie und Halakha: Ansätze zu einem empirischen Wissenschaftsbegriff im spätantiken und frühmittelalterlichen Judentum (Tübingen: Mohr Siebeck, 1997), 239–49; David L. Freeman, “The Gittin ‘Book of Remedies,’ ” Korot 13 (1998–99): 151–64; and Markham J. Geller, “An Akkadian Vademecum in the Babylonian Talmud,” in From Athens to
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Jerusalem: Medicine in Hellenized Jewish Lore and in Early Christian Literature, ed. Samuel S. Kottek, Manfred Horstmanshoff, Gerhard Baader, and Gary Ferngren (Rotterdam: Erasmus, 2000), 13–32. 15. Markham J. Geller, Akkadian Healing Therapies in the Babylonian Talmud (Berlin: Max Planck Institute for the History of Science, 2004), 20. 16. Geller, “Akkadian Vademecum,” 15. On plants, see also Geller, “Akkadian Medicine in the Babylonian Talmud,” in A Traditional Quest: Essays in Honour of Louis Jacobs, ed. Dan Cohn-Sherbok (Sheffield: Journal for the Study of the Old Testament Press, 1991), 102–12, esp. 109. 17. According to Amots Dafni and Barbara Böck, “Medicinal Plants of the Bible— Revisited,” Journal of Ethnobiology and Ethnomedicine 15, no. 57 (2019): 1–14, esp. 5 (table 1), the two plants that the Bible and Talmud both use medicinally are hyssop and figs. On hyssop, see below. On the use of figs, cf. 2 Kings 20:7 and b. Menah. . 64a, where Rabbah and Rava discuss figs given to the sick. 18. See Freeman, “Gittin,” 153–56. Lists from head to toe appear in Greek and Babylonian medical works, including Celsus’s De Medicina and the Diagnostic Handbook (see Freeman, “Gittin,” 156–57, and Geller, “Akkadian Vademecum,” 15). The magic bowls and Mandaic sources also order the disease-causing spirits from head to legs. On this, see Siam Bhayro, “The Reception of Mesopotamian and Early Jewish Traditions in the Aramaic Incantation Bowls,” Aramaic Studies 11 (2013): 187–96, esp. 195, citing bowl JBA 11:7–8 in Shaked et al., Aramaic Bowl Spells, 91, and Ethel S. Drower, “A Phylactery for Rue (An Invocation of the Personified Herb),” Orientalia 15 (1946): 324–46, esp. 337–41. The healing recipes in the Sword of Moses follow this pattern too (see Harari, “Sword of Moses,” 62). 19. This list stops at the top of b. Git.. 70a. For the Aramaic words, see the glossary. In general, the basic manuscript for tractate Git.t.in and the Book of Remedies is MS Vatican 130, as chosen by the Historical Dictionary Project, on which see Menachem Katz, Asael Shmeltzer, Hillel Gershuni, and Sarah Prais, “The Complete Manuscripts of the Babylonian Talmud,” Introduction: The Friedberg Project for Talmud Bavli Variants (Version 2, 2019), 27. My translations usually follow the entries in Sokoloff’s DJBA. Some of these terms’ meanings are debatable, and some are based on later commentaries. I fully expect that linguists will continue to refine our understanding of many of them. In some cases, depending on a given scholar’s goals and approach, such updates may yield new readings; yet, on the other hand, as I discuss in chapter 2, there are fallacies in continued attempts to identify ancient diseases and drugs, which, in some ways, make the quest for more accurate translations a futile enterprise. Compare my list here with that of Geller, “Akkadian Vademecum,” who adds a number of ailments that I do not include due to differences in interpretation. Geller’s reliance on Akkadian etymologies and loanwords are often useful in helping to identify the afflictions. At times, however, this approach can backfire in its assumption that Akkadian etymologies equal JBA meanings. 20. This is a loanword from Akkadian. Cf. the translation in Geller, “Akkadian Vademecum,” 19: “blurriness (of eyes), both of night and day.” For more, see Marten
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Stol, “Blindness and Night-Blindness in Akkadian,” Journal of Near Eastern Studies 45 (1986): 295–99, and Markham J. Geller and Strahil V. Panayotov, Mesopotamian Eye Disease Texts: The Nineveh Treatise (Boston: Walter de Gruyter, 2020), esp. 17, 24, 260, and 289–90. Cf. also b. Pesah. . 112a and b. ‘Abod. Zar. 12b. 21. Cf. the translation in Geller, Akkadian Healing Therapies, 21: “tonsillitis(?).” 22. For barsam, see DJBA 247, MS Arras 889, and Cambridge T-S F6.6. Cf. this same term in b. H . ul. 105b (MS Vatican 122). 23. Cf. Geller, “Akkadian Vademecum,” 24, who writes that the variant “ ‘sinew’ is the more likely reading, since it is a euphemism for the penis.” 24. Cf. MS Vatican 130 and others that instead read “sickness of the heart,” an affliction that is likewise attested in b. Ber. 40a, where it is said that eating mustard every day for a month causes it (except see MS Paris 671, which reads “intestinal inflammation”), and in b. ‘Erub. 29b, where Abaye’s mother recommends a therapy for it involving meat from the thigh of a ram and excrement of the pasture. 25. The word is difficult. For the meaning “sting,” see DJBA 578. See kirs.a in Genizah Cambridge T-S F6.6 and Oxford MS heb. e.77/45. Cf. the translations in Marcus Jastrow, Dictionary of the Targumim, Talmud Bavli, Talmud Yerushalmi, and Midrashic Literature (New York: Judaica Treasury, 1971), 673, “intestinal worms,” and Geller, “Akkadian Vademecum,” 26, “some abdominal condition.” 26. See the previous note. Cf. the translation in Marcus Jastrow, Dictionary, 673: “white worms.” Veltri, Magie und Halakha, 246, and Geller, “Akkadian Vademecum,” 26, agree that the adjective here is “white.” 27. See the notes in DJBA 1129, s.v. “an illness.” See šh. t’ in Oxford heb. e.77/45. In this book, for the sake of ease, I will translate this term as “hemorrhoids.” Cf. Geller, “Akkadian Vademecum,” 27, “gall-bladder disease.” 28. See DJBA 1132 and 1180, s.v. “a malady.” Cf. the translation in Veltri, Magie und Halakha, 248: “sciatica.” 29. See DJBA 960–61. Cf. the translation in Veltri, Magie und Halakha, 248: “Outer/inner fever.” 30. See Richard Kalmin, “Observation in Rabbinic Literature of Late Antiquity,” in The Faces of Torah: Studies in the Texts and Contexts of Ancient Judaism in Honor of Steven Fraade, ed. Michal Bar-Asher Siegal, Tzvi Novick, and Christine Hayes (Göttingen: Vandenhoeck and Ruprecht, 2017), 359–83, esp. 380. 31. Giuseppe Veltri, “Magic and Healing,” in The Oxford Handbook of Jewish Daily Life in Roman Palestine, ed. Catherine Hezser (New York: Oxford University Press, 2010), 587–602, esp. 598. 32. Freeman, “Gittin,” 153. 33. On how the medical handbook fits into the wider literary context of Git.t.in chapter 7, see Lennart Lehmhaus, “Listenwissenschaft and the Encyclopedic Hermeneutics of Knowledge in Talmud and Midrash,” in In the Wake of the Compendia: Infrastructural Contexts and the Licensing of Empiricism in Ancient and Medieval Mesopotamia, ed. J. Cale Johnson (Boston: Walter de Gruyter, 2015), 59–100, esp. 84–93.
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34. See Dan Levene, “ ‘A Happy Thought of the Magicians,’ The Magical Get.,” in Shlomo: Studies in Epigraphy, Iconography, History and Archaeology in Honor of Shlomo Moussaieff, ed. Robert Deutsch (Tel Aviv: Archaeological Center Publication, 2003), 175–84, esp. 178 and n. 18. 35. On this phenomenon, see Abraham Weiss, Studies in the Literature of the Amoraim (New York: Horeb Yeshiva University Press, 1962; Hebrew), 251–94. On the Chapter of the Pious in b. Ta‘an. 18b–26a, see Jason Mokhtarian, “Clusters of Iranian Loanwords in Talmudic Folklore: The Chapter of the Pious (b. Ta‘anit 18b–26a) in Its Sasanian Context,” in The Aggada of the Bavli and Its Cultural World, ed. Geoffrey Herman and Jeffrey L. Rubenstein (Providence: Brown Judaic Studies, 2018), 125–48. On the dreambook in b. Ber. 55a–57b, see Philip S. Alexander, “Bavli Berakhot 55a–57b: The Talmudic Dreambook in Context,” Journal of Jewish Studies 46 (1995): 230–48. These studies point to the impact of outside contexts on these independent sources. 36. See Levene, “Magical Get..” On p. 184, the author proposes that it is possible that the rabbis codified the handbook in tractate Git.t.in because they viewed it as a magical git. à la the same motif in the magic bowls. 37. Moshe Halbertal, People of the Book: Canon, Meaning, and Authority (Cambridge, MA: Harvard University Press, 1997), 3 (author’s italics). Although Halbertal’s use of this concept is slightly different from how I use it here in reference to the rabbis’ perspective, it still resonates. 38. Halbertal, People of the Book, 5. Debates over the value (or lack thereof) of the medical passages in the Talmud continue until today. With no obvious legal or didactic purpose to the remedies, some Orthodox students of the Talmud merely skip over them. For example, it is interesting to cite a 2010 blog post titled “Talmudic Medicine and Halakhah” which explains, in reference to the Talmudic therapy for an infected pustule, that “passages like this are seldom taken seriously, insofar as even many stringently Orthodox pay them no heed. I recall that during my time studying at an Orthodox yeshiva in Israel, I heard two of the brightest students engaged in heated debate over whether or not to ‘just skip the medical parts.’ One argued in favor of skipping because the passages were didactically useless. One argued studying them anyway, despite their being didactically useless.” See yschwartz, “Talmudic Medicine and Halakhah,” New Voices, September 14, 2010, www.newvoices.org/2010/09/14/halakhah-and-talmudic-medicine. 39. Regardless, the therapies share in common formal features and vocabulary with ritual texts. To give one example, in b. Menah. . 42b–43a the rabbis deliberate over how to make and test the fitness of blue wool dye in fringes. This source refers to some of the same natural ingredients found in the medical remedies: “Is there no way to test the tekelet wool? But Rav Yitzh. ak the son of Rav Yehudah tested it. Mnemonic: GŠM. Let one bring alum, an infusion of fenugreek, and the urine of a child forty days old, and soak it in it overnight. [If the dye’s] color faded, then it is unfit; [if] the color did not fade, then it is fit.” Elsewhere in the Bavli, two of the materials used here to test the wool—the chemical compound alum and the plant fenugreek—function as substances in therapeutic recipes (see b. Šabb. 110a–b and b. Git.. 69a). Unlike the medical therapies, however, this test of the wool is done for the sake of determining its ritual
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fitness. That said, a number of traditions juxtapose medical therapies with discourses of permissibility. See, e.g., a therapy for a snake bite in b. Šabb. 109b, which says that the donkey whose womb gets placed on the bite will be effective if the donkey was not deemed to be t.repa (cf. m. H . ul. 3:5). 40. See Yehudah Levi, The Science in Torah: The Scientific Knowledge of the Talmudic Sages (New York: Feldheim Publishers, 2004), 94. 41. See Philip van der Eijk, Markham J. Geller, Lennart Lehmhaus, Matteo Martelli, and Christine Salazar, “Canons, Authorities and Medical Practice in the Greek Medical Encyclopaedias of Late Antiquity and in the Talmud,” in Wissen in Bewegung: Institution—Iteration—Transfer, ed. Eva Cancik-Kirschbaum and Anita Traninger (Wiesbaden: Harrassowitz, 2015), 195–221, esp. 208–13 and 217. 42. See Mansour Shaki, “The Dēnkard Account of the History of the Zoroastrian Scriptures,” Archiv Orientální 49 (1981): 114–25, esp. 119. 43. On this point in the case of Jewish magic, see Gideon Bohak, “Prolegomena to the Study of the Jewish Magical Tradition,” Currents in Biblical Research 8 (2009): 107–50, esp. 122. See also the argument—which my book corroborates—in Giuseppe Veltri, A Mirror of Rabbinic Hermeneutics: Studies in Religion, Magic, and Language Theory in Ancient Judaism (Boston: Walter de Gruyter, 2015), 110, on how the empirical nature of rabbinic medicine was intended to fulfill everyday needs. 44. See Daniel Boyarin, Carnal Israel: Reading Sex in Talmudic Culture (Berkeley: University of California Press, 1993). 45. See Levi, Science in Torah, 120–21, and Netanel Berko, “Jewish Bioethical Perspectives on the Therapeutic Use of Stem Cells and Cloning,” in And You Shall Surely Heal: The Albert Einstein College of Medicine Synagogue Compendium of Torah and Medicine, ed. Jonathan Wiesen (Jersey City: Yeshiva University Press, distr. by KTAV, 2009), 153–69, esp. 158 and n. 26, on b. Yoma 85b’s interpretation of Leviticus 18:5. 46. For one take on questions of redaction, see David Weiss Halivni, The Formation of the Babylonian Talmud, transl. Jeffrey L. Rubenstein (New York: Oxford University Press, 2013). 47. Geller, Akkadian Healing Therapies, 20. 48. See H. L. Strack and Günter Stemberger, Introduction to the Talmud and Midrash, transl. and ed. Markus Bockmuehl (Minneapolis: Fortress Press, 1996), 92 and 86, for these dates. See below on the variant attribution of the remedy for a toothache (i.e., to Rava, who died 352 c.e., according to Strack and Stemberger, Introduction, 95). See chapter 5 on how these attributions are, in fact, probably later interpolations to what were originally anonymous therapies. 49. On that introductory formula, see below. On this switch, see Lehmhaus, “Listenwissenschaft,” 89–91, who calls it an epilogue. 50. Kalmin, “Observation,” 379. 51. Gianna Pomata, “The Medical Case Narrative: Distant Reading of an Epistemic Genre,” Literature and Medicine 32 (2014): 1–23, esp. 2. 52. B. Git.. 69a. MS Vatican 130 attributes the therapy to Rava and reads de- in lieu of ve- (“but”).
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53. This word is difficult. Some witnesses read ’lry’ here (though not subsequently). Cf. Marcus Jastrow, Dictionary, 73: Greek, ileus, meaning “spasm of the abdominal muscles connected with vomiting.” 54. B. Git.. 70a. 55. See Marcus Jastrow, Dictionary, 311 and 325. 56. B. Git.. 70a. On this text, see Markham J. Geller, “Diet and Regimen in the Babylonian Talmud,” in Food and Identity in the Ancient World, ed. Cristiano Grottanelli and Lucio Milano (Padua: S.A.R.G.O.N., 2004), 217–42, esp. 238–39, who translates the affliction as “disability.” 57. See below for more on these points, and Geller, “Akkadian Medicine,” 102–6, on the Akkadian context. 58. See Markham J. Geller, “Namburbi and Talmud Rituals,” in The Melammu Project: The Heritage of Mesopotamia and the Ancient Near East, www.melammuproject.eu. 59. See b. Šabb. 109b and 110b, b. Git.. 67b, and b. ‘Abod. Zar. 28b. 60. See b. Šabb. 110b, b. Git.. 69b, and b. ‘Abod. Zar. 28a–b. 61. On cumin, see b. Šabb. 67a and 110b, b. Git.. 69b, and b. ‘Abod. Zar. 29a. On worm-colored alkali, see b. Šabb. 110b, b. Git.. 69b, and b. ‘Abod. Zar. 28b. On pounding drugs in a mortar, see b. Šabb. 110a, b. Git.. 69a, and b. ‘Abod. Zar. 28b. 62. On the medicinal properties of dates, see Rosner, Encyclopedia of Medicine, 91–92. See esp. b. Ketub. 10b, where Rav H . ana Bagdata, Rav, and Abaye’s mother offer their opinions. 63. See, e.g., Jerry Stannard, “Herbal Medicine and Herbal Magic in Pliny’s Time,” Helmantica 37 (1986): 95–106. 64. B. Šabb. 110b. See DJBA 759–60 for additional information. Cf. the use of an ostrich egg for a woman who menstruates at the improper time in Harari, “Sword of Moses,” 84–85, line 76. Many such terms, especially plants, are hapax legomena. 65. See MS Vatican 130. 66. B. Git.. 86a. 67. See Geller, “Akkadian Vademecum,” 16; Geller, Akkadian Healing Therapies, 20–21; and Lehmhaus, “Listenwissenschaft,” 84. Examples are found in the Git.t.in Book of Remedies, b. Šabb. 110a–b, and, often in a modified style, in b. ‘Abod. Zar. 27a–29a. Variations of the formula appear elsewhere; see, e.g., Abaye’s mother’s solutions for a child’s scorpion and bee sting in b. Ketub. 50a. On parallels with non-Jewish sources, see chapter 5. As I discuss later in this book, there are other common forms of medical passages in the Bavli. 68. See Donald S. Whitcomb, Before the Roses and Nightingales: Excavations at Qasr-i Abu Nasr, Old Shiraz (New York: Metropolitan Museum of Art, 1985), 158–59, fig. 59a, with the image available online: www.metmuseum.org/art/collection /search/323040. 69. On this, see Marten Stol, “Beer in Neo-Babylonian Times,” in Drinking in Ancient Societies: History and Culture of Drinks in the Ancient Near East—Papers of a Symposium Held in Rome, May 17–19, 1990, ed. Lucio Milano (Padua: Sargon, 1994),
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155–83, esp. 158–61; Geller, “Diet,” 237–40; and Ana María Rosso, “Beer and Wine in Antiquity: Beneficial Remedy or Punishment Imposed by the Gods?,” Acta MedicoHistorica Adriatica 10 (2012): 237–62, referencing the Talmud on 252–55. Other sources could be cited; see, e.g., b. Ber. 51a on the effects of asparagus and wine on the heart, eyes, and intestines. 70. See the translations of Geller, “Akkadian Medicine,” 103, “Let him (the healer) take . . .”; and Geller, “Diet,” 239, “Let (the physician) bray . . .” 71. See the example in b. Git.. 69a on pimples in the larynx (or tonsillitis), discussed in chapter 4. 72. B. Git.. 68b (see MS Vatican 130, with glosses between lines). The reference to water (or “infusion”?) is unique to MS Vatican 130. Compare the translation in Geller, “Akkadian Vademecum,” 17. 73. See the analysis in Geller, “Akkadian Vademecum,” 16–17. 74. See Harari, “Sword of Moses”; Michael A. Morgan, Sepher Ha-Razim: The Book of the Mysteries (Chico, CA: Scholars Press, 1983); and, among the publications of magic in the Cairo Genizah, see Joseph Naveh and Shaul Shaked, Magic Spells and Formulae: Aramaic Incantations of Late Antiquity (Jerusalem: Magnes Press, 1993), and Amulets and Magic Bowls: Aramaic Incantations of Late Antiquity, 3rd ed. (Jerusalem: Magnes Press, 1998), among other resources. A detailed study of the relationship between Talmudic medicine and relevant sources in the Cairo Genizah is a desideratum. Looking back in time, it is possible, though in my view unlikely, that the style of the Bavli’s medical therapy formula has some antecedents in the Hebrew Bible’s priestly consecration and anointing rituals (see Exod. 29–30 and Lev. 8). In Exodus 30:22–38, for instance, God instructs Moses on how to apply the sacred anointing oil made of myrrh, cinnamon, cane, and cassia on sanctuary utensils and priests. These texts, however, explicitly forbid its use for other, profane purposes, including rubbing it on the body. The instructional language and the specific quantities of ingredients listed here are, as Maurice Bear Gordon once put it, “explicit directions to the compounder!” that resonate with the Talmudic therapies (M. Gordon, “Medicine among the Ancient Hebrews,” Isis 33 [1941]: 454–85, esp. 477). Despite some similarities, I have not discovered many direct correlations between the Talmudic therapies and these biblical sources. That said, it is interesting to note that Jews, since, I believe, the Middle Ages, read biblical passages about incense as a way to heal the community, a practice inspired by Numbers 17, where Aaron ends a plague using incense. During epidemics Ashkenazi Jews of the eighteenth and nineteenth century recited forwards and backwards Exodus 30:34, which describes the use of holy incense, according to Marek Tuszewicki, A Frog under the Tongue: Jewish Folk Medicine in Eastern Europe, transl. Jessica Taylor-Kucia (London: Littman Library of Jewish Civilization, in association with Liverpool University Press, 2021), 48. 75. See, e.g., Peter Schäfer, “Jewish Magic Literature in Late Antiquity and Early Middle Ages,” Journal of Jewish Studies 41 (1990): 75–91, esp. 88–89. 76. For an example of this approach, see Michael D. Swartz, “Scribal Magic and Its Rhetoric: Formal Patterns in Medieval Hebrew and Aramaic Incantation Texts from
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128 Notes to pages 15–16
the Cairo Genizah,” Harvard Theological Review 83 (1990): 163–80. See chapter 2 on how the empirical therapies in the Talmud often do not match the phenomenological definitions of magic. 77. See Schäfer, “Jewish Magic Literature,” 85–88. 78. See the Git.t.in Book of Remedies, b. Šabb. 66b, 109b–110b, and 129a, and b. ‘Abod. Zar. 12b and 28b. 79. See Geller, Akkadian Healing Therapies, 21. 80. Kalmin, “Observation,” 380 n. 42. 81. Veltri, “Magic and Healing,” 598. 82. See Kalmin, “Observation,” 380, who argues that this is implied in cases when “the alternative cure requires the same technical expertise as the first suggested cure.” 83. Veltri, “Magic and Healing,” 598 (author’s italics). 84. This is a “large carp,” according to Daniel T. Potts, “Fish and Fishing,” in A Companion to the Archaeology of the Ancient Near East, vol. 1, ed. Daniel T. Potts (Malden, MA: Wiley-Blackwell, 2012), 220–35, esp. 223. 85. B. Šabb. 110b (MS Oxford Opp. Add. fol. 23). For other examples of this, see b. ‘Erub. 29b (“if there is no excrement of the pasture”) and b. Ketub. 77b (“if there is no marble room”). These examples are narrower than the traditional “if not” to the extent that they provide alternative options for specific ingredients or procedures, as opposed to a different therapy altogether. 86. On the consumption of locusts in antiquity, see Susan Weingarten, “Wild Foods in the Talmud: The Influence of Religious Restrictions on Consumption,” in Wild Food: Proceedings of the Oxford Symposium on Food and Cookery 2004, ed. Richard Hosking (Totnes: Prospect Books, 2006), 321–32, esp. 328–30. 87. This is not always the case and is often hard to determine. See, e.g., above on the remedies for “blood of the head” which—to the extent that they differ in ingredients (seven plants versus one white rose with leaves standing in a row) and dosages (three hundred cups versus sixty cups), rather than in preparation or application (both are boiled and then poured on the head)—support the idea that it was the procurement of the materia medica that was the distinguishing factor between these two options. In this case, it is hard to know how to interpret which remedy’s ingredients would have been more difficult to obtain, since although the first remedy requires more ingredients (many of which are not mentioned in other therapies, perhaps suggesting that they were less ubiquitously used and available), the second remedy has a very specific type of rose that on the surface sounds obscure to find. 88. See DJBA 830. 89. B. Git.. 67b, and see DJBA 138–39, s.v. “submerge oneself,” and 830, s.v. “to become putrid.” This therapy recalls a baraita in b. Yoma 83b, which in the context of a wider legal discussion alludes to the remedies for a snake bite: “We call a doctor for him . . . we cut open a hen [and place it on the bite?], and we cut leeks and feed [them] to him.” 90. On leeks in remedies, see the other examples in this book, as well as in b. Git.. 69b and b. Pesah. . 116a.
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91. B. Šabb. 110b. 92. See András Bácskay, “Asakkû: Demons and Illness in Ancient Mesopotamia,” in Studies on Magic and Divination in the Biblical World, ed. Helen R. Jacobus, Anne Katrine de Hemmer Gudme, and Philippe Guillaume (Piscataway, NJ: Gorgias Press, 2013), 1–8, esp. 6. See Geller, “Akkadian Medicine,” 108, on this parallel. 93. JoAnn Scurlock, “Animals in Ancient Mesopotamian Religion,” in A History of the Animal World in the Ancient Near East, ed. Billie Jean Collins (Boston: Brill, 2002), 361–87, esp. 386. See also Koot van Wyk, “Pig Taboos in the Ancient Near East,” International Journal of Humanities and Social Science 4 (2014): 111–34, esp. 126. 94. B. ‘Abod. Zar. 28a. MS Munich 95 ascribes this therapy to Rav Ashi. MS Paris 1337 reverses the two ingredients in the first section. See another example of the phrase “in the meantime” for an anal fissure in b. ‘Abod. Zar. 28a–b. 95. On the history of the study of peripheral traditions within Jewish canons, see Ra‘anan Boustan, Oren Kosansky, and Marina Rustow, “Introduction: Anthropology, History, and the Remaking of Jewish Studies,” in Jewish Studies at the Crossroads of Anthropology and History: Authority, Diaspora, Tradition, ed. Ra‘anan Boustan, Oren Kosansky, and Marina Rustow (Philadelphia: University of Pennsylvania Press, 2011), 1–28, esp. 15. 96. See, e.g., Jonathan Ben-Dov, “The Jewish Calendar and Jewish Sciences,” in A Guide to Early Jewish Texts and Traditions in Christian Transmission, ed. Alexander Kulik, Gabriele Boccaccini, Lorenzo DiTommaso, David Hamidović, and Michael E. Stone (New York: Oxford University Press, 2019), 417–27, esp. 418 and n. 3. 97. On these issues, see Annette Yoshiko Reed, “Was There Science in Ancient Judaism? Historical and Cross-Cultural Reflections on ‘Religion’ and ‘Science,’ ” Studies in Religion/Sciences Religieuses 36 (2007): 461–95, esp. 467–68. 98. See Fred Rosner, transl. and ed., Julius Preuss’ Biblical and Talmudic Medicine (Northvale, NJ: Jason Aronson, 1993; orig. pub. 1978), 4 (author’s italics excluded). Cf. Jeff Levin and Michele F. Prince, “Judaism and Health: Reflections on an Emerging Scholarly Field,” Journal of Religion and Health 50 (2011): 765–77, esp. 768, who, writing about Torah, Talmud, and Midrash, believe that “it has been suggested that this collected wisdom constitutes a uniquely ‘Hebraic medicine’ (Epstein 1987), akin to traditional Chinese medicine, the Islamic Unani system, and the Hindu Āyurveda.” Problematically, the authors cite Gerald Epstein, “Hebraic Medicine,” Advances 4 (1987): 56–66, which is an autobiographical “personal essay” about what Epstein, a psychiatrist, discovered during a quest to find “the lost Hebraic form” of the medical arts (p. 57). 99. There are, however, a few exceptions to this rule, such as the possible influence of Exodus 12’s apotropaic background on the therapy for a headache. In b. Git.. 68b, the Talmud gives the following therapy for a migraine: “For a migraine, bring a hoopoe, slaughter it with a silvered zuz, [and put the blood] on the side that hurts, but be careful that the blood does not blind the eyes. Then hang [the hoopoe] on the doorpost of the gate so that one rubs against it when entering and rubs against it when exiting.” This therapy has some similarities with Exodus 12, when God orders the Israelites to
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slaughter a lamb and put some of the blood from it on their doorposts to serve as a signal for Him to pass over their houses. This prevents the angel of death from entering as God metes out the plague to the Egyptians. Although there are numerous differences between the texts, it is possible that the Talmudic therapy owes some of its symbolic import to Exodus 12, since the rabbis were aware of the apotropaic background of the Passover blood ritual. On this latter point, see Bernard M. Levinson, Deuteronomy and the Hermeneutics of Legal Innovation (New York: Oxford University Press, 1997), 58–59, and Mira Balberg, Blood for Thought: The Reinvention of Sacrifice in Early Rabbinic Literature (Oakland: University of California Press, 2017), 171–72. 100. On these intermediaries, see Annette Yoshiko Reed, “ ‘Ancient Jewish Sciences’ and the Historiography of Judaism,” in Ancient Jewish Sciences and the History of Knowledge in Second Temple Literature, ed. Jonathan Ben-Dov and Seth L. Sanders (New York: New York University Press and Institute for the Study of the Ancient World, 2014), 195–253, esp. 207–8. 101. On Talmudic medicine as “secular,” see Freeman, “Gittin,” 153; Noah J. Efron, Judaism and Science: A Historical Introduction (Westport, CT: Greenwood Press, 2007), 57; and Yechiel Michael Barilan, Jewish Bioethics: Rabbinic Law and Theology in Their Social and Historical Contexts (New York: Cambridge University Press, 2014), 30. Relatedly, scholars debate whether health and medicine in the Bavli are “religious” in nature; see the positive viewpoint in Stephen T. Newmyer, “Talmudic Medicine and Greco-Roman Science: Crosscurrents and Resistance,” in Aufstieg und Niedergang der römischen Welt, vol. 37/3, pt. 2, ed. Wolfgang Haase and Hildegard Temporini (Berlin: Walter de Gruyter, 1996), 2895–2911, esp. 2898, versus the contrary opinion in Samuel S. Kottek, “Selected Elements of Talmudic Medical Terminology, with Special Consideration to Graeco-Latin Influences and Sources,” in Aufstieg und Niedergang der römischen Welt, vol. 37/3, pt. 2, ed. Wolfgang Haase and Hildegard Temporini (Berlin: Walter de Gruyter, 1996), 2912–32, esp. 2932. 102. See Elinor Lieber, “Asaf’s Book of Medicines: A Hebrew Encyclopedia of Greek and Jewish Medicine, Possibly Compiled in Byzantium on an Indian Model,” Dumbarton Oaks Papers 38 (1984): 233–49, esp. 234. 103. For an overview of medieval Jewish medicine, see Carmen Caballero-Navas, “Medicine among Medieval Jews: The Science, the Art, and the Practice,” in Science in Medieval Jewish Cultures, ed. Gad Freudenthal (New York: Cambridge University Press, 2011), 320–42. On the Cairo Genizah, which contains different types of relevant sources, as a resource, see Shelomo Dov Goitein, “The Medical Profession in the Light of the Cairo Geniza Documents,” Hebrew Union College Annual 34 (1963): 177–94, and Paul Fenton, “The Importance of the Cairo Genizah for the History of Medicine,” Medical History 24 (1980): 347–48. See also the search engine of the approximately two thousand leaves on medicine called “Medicine in Medieval Egypt” that is available on the Cambridge University Library website. Genizah medical recipes tend to be Galenic (and not Talmudic), as seen in the selections in Efraim Lev and Leigh Chipman, Medical Prescriptions in the Cambridge Genizah Collections: Practical Medicine and Pharmacology in Medieval Egypt (Boston: Brill, 2012). On medical notebooks in the
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Genizah, see Efraim Lev, “Mediators between Theoretical and Practical Medieval Knowledge: Medical Notebooks from the Cairo Genizah and Their Significance,” Medical History 57 (2013): 487–515. On the lack of Talmudic sources in Genizah medicine, see the preliminary observation by Haskell D. Isaacs, “Medieval JudaeoArabic Medicine as Described in the Cairo Geniza,” Journal of the Royal Society of Medicine 83 (1990): 734–37. For a list of Cambridge Genizah medical manuscripts, see Haskell D. Isaacs, with the assistance of Colin F. Baker, Medical and Para-Medical Manuscripts in the Cambridge Genizah Collections (New York: Cambridge University Press, 1994). 104. For an overview of the role of the Greco-Arabic translation movement in the development of medieval Islamic medicine, see Peter E. Pormann and Emilie SavageSmith, Medieval Islamic Medicine (Washington, DC: Georgetown University Press, 2007), 23–35. See also the case of Isaac Israeli (d. ca. 950 c.e.), a Neoplatonist, physician, and author of the famous Book on Fevers, whose medical writings follow Galen. See, e.g., Ariel Bar-Sela and Hebbel E. Hoff, “Isaac Israeli’s Fifty Admonitions to the Physicians,” Journal of the History of Medicine and Allied Sciences 17 (1962): 245–57, esp. 251–52. 105. On the idea of incommensurability in the history of science, see Thomas S. Kuhn, The Structure of Scientific Revolutions, 4th ed. (Chicago: University of Chicago Press, 2012; orig. pub. 1962), esp. 147–49. On how the disappearance of the bowls was likely caused by the introduction of Greco-Syriac medicine in Mesopotamia, see Markham J. Geller, “Magic Bowls Belong in Babylonia,” in Zauber und Magie im antiken Palästina und in seiner Umwelt: Kolloquium des Deutschen Vereins zur Erforschung Palästinas vom 14. bis 16. November 2014 in Mainz, ed. Jens Kamlah, Rolf Schäfer, and Markus Witte (Wiesbaden: Harrassowitz, 2017), 95–106, esp. 97. 106. See Avraham Steinberg, Encyclopedia of Jewish Medical Ethics, transl. Fred Rosner (New York: Feldheim Publishers, 2003), 144. 107. Yaakov Neuberger, “Halakhah and Scientific Method,” Torah U-Madda Journal 3 (1991–92): 82–89, esp. 87. See also Eli Turkel, “The Nature and Limitations of Rabbinic Authority,” Tradition: A Journal of Orthodox Jewish Thought 27 (1993): 80–99, esp. 88. 108. See Aryeh Leibowitz, “Doctors and Medical Knowledge in Tosafist Circles,” Tradition: A Journal of Orthodox Jewish Thought 42 (2009): 19–34, esp. 29 n. 30. With respect to the Karaites’ stance on medicine, there is some disagreement. See Daniel J. Lasker, “Medieval Karaism and Science,” in Science in Medieval Jewish Cultures, ed. Gad Freudenthal (New York: Cambridge University Press, 2011), 427–37, esp. 428–29 and n. 7, who argues against the thesis that the Karaites did not permit the use of medicine, on which see also Lenn E. Goodman, “Bah. yā and Maimonides on the Worth of Medicine,” in Maimonides and His Heritage, ed. Idit Dobbs-Weinstein, Lenn E. Goodman, and James Allen Grady (Albany: State University of New York Press, 2009), 61–93, esp. 66. For other studies on Karaites and medicine, see Barry Dov Walfish with Mikhail Kizilov, Bibliographia Karaitica: An Annotated Bibliography of Karaites and Karaism (Boston: Brill, 2011), 703–5. Regarding the limited use of
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Talmudic medicine by other medieval Talmudic scholars, philosophers, and physicians, see the following examples: the lack of entries on Talmudic plants in an important pharmacological dictionary written in Cordova in the eleventh century by the lexicographer and physician Jonah Ibn Ğanāh. , as explained by Paul Fenton, “Jonah Ibn Ğanāh. ’s Medical Dictionary, the Kitāb al-Talḫ īs.: Lost and Found,” Aleph: Historical Studies in Science and Judaism 16 (2016): 107–43, esp. 117; a comparable situation in a thirteenth-century medical work titled Balm for the Body, the author of which protests that the Hebrew language and rabbinic literature do not have sufficient technical terms available for a full rendering of medical phenomena, as described by Gerrit Bos and Resianne Fontaine, “Medico-Philosophical Controversies in Nathan b. Yo’el Falaquera’s Sefer S. ori ha-Guf,” Jewish Quarterly Review 90 (1999): 27–60, esp. 28–29; and the few references to rabbinic literature by the fourteenth-century philosopher, doctor, and author R. Moses ben Joshua of Narbonne, who composed a fascinating medical work full of treatments for all sorts of ailments, as recorded by Gerrit Bos, “R. Moshe Narboni: Philosopher and Physician, A Critical Analysis of Sefer Orah. H . ayyim,” Medieval Encounters 1 (1995): 219–51, esp. 226–27. The topic of the use of charms and natural remedies among medieval and early modern Kabbalists is too complex to treat here. But based on the research that I have done on this topic, the Talmud does not appear to have been their primary source of information, though it did sometimes play a role. For one example of potential rabbinic influence, see, e.g., Hymen Saye, “Medical Excerpts from Sefer Mif’alot Elokim [The Book of God’s Deeds], Joel Ba’al Shem and Naphtali Katz,” Bulletin of the Institute of the History of Medicine 4 (1936): 299–331, esp. 301, on not eating milk or cheese during bloodletting (cf. b. Ned. 54b). But these remedies, published in the early eighteenth century, are not rabbinic in origin, but rather appear to be based on the medical knowledge of that time, according to Immanuel Etkes, The Besht: Magician, Mystic, and Leader, transl. Saadya Sternberg (Waltham, MA: Brandeis University Press, 2005), 39. For another interesting case study, see the description of the sixteenth-century Italian mystic and physician Abraham Yagel by David B. Ruderman, Kabbalah, Magic, and Science: The Cultural Universe of a Sixteenth-Century Jewish Physician (Cambridge, MA: Harvard University Press, 1988), esp. 25–42, including how he drew from the Zohar, alongside Galen and astral knowledge, for his medical ideas. Finally, for a fascinating article on the healing practices of practical Kabbalists in eighteenth-century Poland and Lithuania, which similarly seem more influenced by contemporary trends than rabbinic traditions, see Yohanan Petrovsky-Shtern, “ ‘You Will Find It in the Pharmacy’: Practical Kabbalah and Natural Medicine in the Polish-Lithuanian Commonwealth, 1690–1750,” in Holy Dissent: Jewish and Christian Mystics in Eastern Europe, ed. Glenn Dynner (Detroit: Wayne State University Press, 2011), 13–54. 109. See Y. Tzvi Langermann, “Science in the Jewish Communities,” in The Cambridge History of Science, vol. 2, Medieval Science, ed. David C. Lindberg and Michael H. Shank (New York: Cambridge University Press, 2013), 168–89, esp. 180. 110. See David B. Ruderman, “Contemporary Science and Jewish Law in the Eyes of Isaac Lampronti of Ferrara and Some of His Contemporaries,” Jewish History 6
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(1992): 211–24, esp. 218–20, who emphasizes the author’s inconsistent views. See also Debra Glasberg Gail, “Scientific Authority and Halakah in Isaac Lampronti’s Pah. ad Yis.h. aq,” in Nuovi studi su Isacco Lampronti: Storia, poesia, scienza e halakah, ed. Mauro Perani (Florence: Giuntina, 2017), 277–85, on how Lampronti successfully amalgamated rabbinic ideas with contemporary medicine. One sees similar tensions in earlier centuries as well. See, e.g., a letter by Rabbi Isaac bar Sheshet, from fourteenth-century Barcelona, which states a preference for Talmudic learning over scientific medicine and natural philosophy and delimits the duty of a doctor to the treatment of afflictions, cited in Luis García-Ballester, Lola Ferre, and Eduard Feliu, “Jewish Appreciation of Fourteenth-Century Scholastic Medicine,” Osiris 6 (1990): 85–117, esp. 100. 111. See Ruderman, “Contemporary Science,” 218. On this interpretation of kidneys in rabbinic thought, see Dvorjetski, “History of Nephrology,” 121–22. 112. See Tuszewicki, Jewish Folk Medicine, 40–42. The situation was, however, complex, as not all folk medicine relied on the Talmud; for example, on 40 the author explains that, à la Maimonides and Joseph Karo, some of the “later authors who compiled collections of traditional remedies (segulot urefuot) were also fairly sparing in their citation of the Gemara.” See also Deatra Cohen and Adam Siegel, Ashkenazi Herbalism: Rediscovering the Herbal Traditions of Eastern European Jews (Berkeley, CA: North Atlantic Books, 2021), 18. Today, exceptions to Judaism’s tendency to marginalize the Talmudic medical therapies, albeit rare, do exist among some authorities; on this, see Neuberger, “Halakhah and Scientific Method,” 85–86 and n. 13, citing a 1982 article titled “Homeopathic Medicine on Pesach” by the Sephardic Chief Rabbi of Tel Aviv Hayyim David Halevi. Finally, it is worth mentioning that, although not based on the Talmud, there are still segulot that are commonly used among Jews in Israel today, such as the use of pigeons to treat jaundice in a transference remedy; see Fred Rosner, “Pigeons as a Remedy (segulah) for Jaundice,” New York State Journal of Medicine 92 (1992): 189–92. 113. See Langermann, “Science in the Jewish Communities,” 178–79. According to John M. Efron, “A Perfect Healing to All Our Wounds: Religion and Medicine in Judaism,” in Quo Vadis Medical Healing: Past Concepts and New Approaches, ed. Susanna Elm and Stefan N. Willich (Dordrecht: Springer, 2009), 55–67, esp. 56, by the thirteenth century Jews “constituted about 1% of European society” but “as much as 50% of the physicians in a given locale,” a figure that lasted until the twentieth century. 114. See Fred Rosner and Samuel S. Kottek, eds., Moses Maimonides: Physician, Scientist, and Philosopher (Northvale, NJ: Jason Aronson, 1993). For a list of Rambam’s medical writings, see L. Goodman, “Bah. yā and Maimonides,” 62–63, and the translations in a book series edited by Gerrit Bos (see, e.g., Moses Maimonides, On Asthma, vol. 1, transl. and ed. Gerrit Bos [Provo: Brigham Young University Press, 2002]). On the extent to which Maimonides followed Galenic medicine, see Elinor Lieber, “Galen: Physician as Philosopher, Maimonides: Philosopher as Physician,” Bulletin of the History of Medicine 53 (1979): 268–85, esp. 268. 115. See Daniel Sinclair, “The Obligation to Heal and Patient Autonomy in Jewish Law,” Journal of Law and Religion 13 (1998–99): 351–77, esp. 359–60, and Benjamin
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Gesundheit, “Maimonides’ Appreciation for Medicine,” Rambam Maimonides Medical Journal 2 (2011): 1–8, esp. 2–3. On the duty to heal and to visit the sick, see Elliot N. Dorff, “The Jewish Tradition: Religious Beliefs and Healthcare Decisions,” in Caring and Curing: Health and Medicine in the Western Religious Traditions, ed. Ronald L. Numbers and Darrel W. Amundsen (Baltimore: Johns Hopkins University Press, 1998), 5–39, esp. 5 and 25–26. Other medieval authorities support the practice of medicine using different prooftexts, such as Nah. manides’s interpretation of Leviticus 19:18 (“love your fellow as yourself”); on this, see J. David Bleich, “The Obligation to Heal in the Judaic Tradition: A Comparative Analysis,” in Jewish Bioethics, ed. Fred Rosner and J. David Bleich (Hoboken, NJ: KTAV, 1979), 3–46, esp. 26. 116. Maimonides, Guide of the Perplexed, Book 3, ch. 14 (see Moses Maimonides, The Guide of the Perplexed, vol. 2, transl. Shlomo Pines, with intro. by Leo Strauss [Chicago: University of Chicago Press, 1963], 459). On this, see David B. Ruderman, Jewish Thought and Scientific Discovery in Early Modern Europe (New Haven: Yale University Press, 1995), 30–31. 117. See Solomon, “Folk Medicine to Bioethics,” 169–70, on how Maimonides favors Galenic to Talmudic medicine. According to Steinberg, Encyclopedia of Jewish Medical Ethics, 141, Maimonides ignores and contradicts some of the dietary advice in the Talmud. Going against this, see Fred Rosner, “Moses Maimonides and Preventive Medicine,” Journal of the History of Medicine and Allied Sciences 51 (1996): 313–24, esp. 316, on how Maimonides’s approach toward baths, bloodletting, and sex comes from the Talmud. For a key source, see Mishneh Torah, Laws of Character Traits, ch. 4. Cf. also the assertion by Rambam’s son Abraham: “The superiority of the talmudic sages and the completeness of their qualifications in the exposition of the Torah . . . all this does not imply that we must defend and uphold their statements in matters of medicine, natural science, and astronomy, and to believe them as we believe them concerning the exposition of the Torah, where they have the ultimate wisdom.” On this, see Menachem Kellner, Maimonides on the “Decline of the Generations” and the Nature of Rabbinic Authority (Albany: State University of New York Press, 1996), 57, citing the translation from Yehudah Levi, “The Sciences as ‘Maidservants of the Torah’ in Maimonides’ Writings,” in Moses Maimonides: Physician, Scientist, and Philosopher, ed. Fred Rosner and Samuel S. Kottek (Northvale, NJ: Jason Aronson, 1993), 97–104, esp. 103. 118. See Ariel Bar-Sela, Hebbel E. Hoff, and Elias Faris, “Moses Maimonides’ Two Treatises on the Regimen of Health: Fī Tadbīr al-S. ih. h. ah and Maqālah fī Bayān Ba‘d. al A‘rad. wa-al-Jawāb ‘anhā,” Transactions of the American Philosophical Society 54 (1964): 3–50, esp. 6. To the best of my knowledge, Maimonides does not discuss the Git.t.in Book of Remedies in any substantive way. 119. Isadore Twersky, “Aspects of Maimonides’ Epistemology: Halakah and Science,” in From Ancient Israel to Modern Judaism: Intellect in Quest of Understanding— Essays in Honor of Marvin Fox, vol. 3, ed. Jacob Neusner, Ernest S. Frerichs, and Nahum M. Sarna (Providence: Brown Judaic Studies, 1989), 3–23, esp. 12. 120. See Sarah Stroumsa, “ ‘Ravings’: Maimonides’ Concept of Pseudo-Science,” Aleph: Historical Studies in Science and Judaism 1 (2001): 141–63, esp. 162.
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121. See note 117 above, as well as H. S. Lewis, “Maimonides on Superstition,” Jewish Quarterly Review 17 (1905): 475–88, esp. 485–87, and Steinberg, Encyclopedia of Jewish Medical Ethics, 144–45. 122. On expert amulets, see chapter 4. On Maimonides and amulets, see Bohak, Ancient Jewish Magic, 37 and 41–42. Elsewhere, however, Maimonides disapproves of amulets, according to David Horwitz, “Rashba’s Attitude towards Science and Its Limits,” Torah U-Madda Journal 3 (1991–92): 52–81, esp. 56–57. 123. Maimonides, Mishneh Torah, On Idolatry, ch. 11.10. 124. Maimonides, Mishneh Torah, On Idolatry, ch. 11.11. 125. Maimonides, Guide of the Perplexed, Book 3, ch. 37 (Pines, transl., Guide, 543–44). On this text, see Yuval Harari, Jewish Magic before the Rise of Kabbalah, transl. Batya Stein (Detroit: Wayne State University Press, 2017), 347–50, and Horwitz, “Rashba’s Attitude towards Science,” 56. 126. See Nachum L. Rabinovitch, “Rambam, Science, and Ta’amei ha-Mitzvot,” in H . azon Nah. um: Studies in Jewish Law, Thought, and History Presented to Dr. Norman Lamm on the Occasion of His Seventieth Birthday, ed. Yaakov Elman and Jeffrey S. Gurock (New York: Yeshiva University Press, 1997), 187–205, esp. 200. 127. Langermann, “Science in the Jewish Communities,” 180. 128. See the argument of Moshe Beer summarized in Jacob Neusner, A History of the Jews in Babylonia, vol. 3, From Shapur I to Shapur II (Leiden: Brill, 1968), 115. By contrast, professional physicians appear to have earned income (see b. B. Qam. 85a below). 129. For a story about a rabbi and his daughter, see b. Pesah. . 25b, where Ravina rubs his daughter suffering from a “hot fever” with unripe fruits of orlah. For another occurrence of this type of fever, see also b. ‘Abod. Zar. 28a, where it is considered to be like an internal affliction. 130. For more, see Nathan Shapiro, “Rav Huna’s Views on Medicine and Public Health,” Korot 9 (1988): 262–69. 131. See, e.g., Estée Dvorjetski, Leisure, Pleasure and Healing: Spa Culture and Medicine in Ancient Eastern Mediterranean (Boston: Brill, 2007), 240–41 and 269–70. 132. Fred Rosner, Medicine in the Bible and the Talmud: Selections from Classical Jewish Sources (Hoboken, NJ: KTAV, 1977), 216. See also David Margalit, “Shmuel the Physician,” Hebrew Physician 29 (1956): 114–27 (Hebrew). 133. For this reading, see DJBA 186–87, s.v. “to examine” (mng. 3: “to defecate”), and 834–35, s.v. “to unravel.” 134. B. B. Mes.i‘a 85b. On this text, see Catherine Hezser, “Representations of the Physician in Jewish Literature from Hellenistic and Roman Times,” in Popular Medicine in Graeco-Roman Antiquity: Explorations, ed. William V. Harris (Boston: Brill, 2016), 173–97, esp. 195 and n. 69, and Dvorjetski, Leisure, 266–67. 135. B. Šabb. 110a–b. 136. See Hezser, “Representations,” 189–90. 137. See Estée Dvorjetski, “The Medical History of Rabbi Judah the Patriarch: A Linguistic Analysis,” Hebrew Studies 43 (2002): 39–55.
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136 Notes to pages 24–28
138. See b. Ber. 5b, b. Šabb. 127a, b. Ned. 39a–41b, b. Sot.ah 14a, and b. Sanh. 101a. 139. See Dov Noy, “The Talmudic-Midrashic ‘Healing Stories’ as a Narrative Genre,” Korot 9 (1988): 124–46. 140. See Balberg, “Significance of Intestinal Disease.” 141. See Paul Turner, “Jewish Responses to Suffering,” in Perspectives on Human Suffering, ed. Jeff Malpas and Norelle Lickiss (New York: Springer, 2012), 121–30, esp. 127–28, and Jeffrey L. Rubenstein, The Land of Truth: Talmud Tales, Timeless Teachings (Lincoln: University of Nebraska Press, 2018), 77–83. 142. On this latter point, see Dov Karoll, “Laws of Medical Treatment on Shabbat,” in And You Shall Surely Heal: The Albert Einstein College of Medicine Synagogue Compendium of Torah and Medicine, ed. Jonathan Wiesen (Jersey City: Yeshiva University Press, distr. by KTAV, 2009), 211–30, esp. 222. 143. Similarly, in b. Šabb. 90a, the Gemara states that peppers and resin, mentioned in the Mishnah, are used as treatments for bad breath and migraines, respectively. 144. B. Šabb. 140a. Cf. y. Šabb. 20:3 (17c), translated by Lennart Lehmhaus, “Beyond Dreckapotheke, Between Facts and Feces: Talmudic Recipes and Therapies in Context,” in Collecting Recipes: Byzantine and Jewish Pharmacology in Dialogue, ed. Lennart Lehmhaus and Matteo Martelli (Boston: Walter de Gruyter, 2017), 221–54, esp. 231, which references the Babylonians Rav Huna and Shmuel. The former warns that eating h. iltit can make someone’s “skin peel off.” 145. On these rules, see Karoll, “Laws of Medical Treatment on Shabbat.” 146. See b. ‘Abod. Zar. 27b–28a and y. Šabb. 14:4 (14d). 147. See Immanuel Jakobovits, Jewish Medical Ethics: A Comparative and Historical Study of the Jewish Religious Attitude to Medicine and Its Practice (New York: Bloch Publishing, 1959), 60–61. 148. See the translation by Michael Weingarten, Inyan haSakanah (On Danger) by Nahmanides—RAMBAN (lulu.com, 2017). On the medical knowledge of Nah. manides, see Samuel S. Kottek, “Medical Practice and Jewish Law: Nah. manides’ Sefer Torat Haadam,” in Medicine and Medical Ethics in Medieval and Early Modern Spain: An Intercultural Approach, ed. Samuel S. Kottek and Luis García-Ballester (Jerusalem: Magnes Press, 1996), 163–72. 149. B. ‘Abod. Zar. 28b (MS Paris 1337). 150. Cf. MS Munich 95 and printed eds.: “maidservant.” 151. The printed eds. do not refer to her death. 152. Cf. MS Munich 95 and printed eds.: “The next day, Mar Shmuel went . . .” 153. Printed eds.: “suspended from the projections of the heart” (see DJBA 84). 154. B. ‘Abod. Zar. 28b (MS Paris 1337). 155. Cf. the translation of the eye diseases in Geller, “Akkadian Medicine,” 105, and Akkadian Healing Therapies, 13. See the parallel text in b. Bes.ah 22a in a discussion between Rav Ashi and Ameimar. 156. See Samuel S. Kottek, “The Hospital in Jewish History,” Reviews of Infectious Diseases 3 (1981): 636–39.
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Notes to pages 28–30 137
157. See Samuel S. Kottek, “Le médecin à l’époque du Talmud: Entre techne et halakhah,” Medicina nei secoli 9 (1997): 313–30, and Rosner, Encyclopedia of Medicine, 241–45, for a list of references. On “doctor” (rope) in the Bible and its linguistic background, see Larry P. Hogan, Healing in the Second Temple Period (Göttingen: Vandenhoeck and Ruprecht, 1992), 8–10 and 19–20, and the list of references in Paul Humbert, “Maladie et médecine dans l’Ancien Testament,” Revue d’histoire et de philosophie religieuses 44 (1964): 1–29, esp. 28–29. On “physician” (asya), see below and DJBA 148, from Akkadian asû. On the roles of this professional title in ancient Babylonia, who is often depicted using plant-based medicines, along with the āšipu, who is usually thought to be more of an exorcist or magician, much can be cited; see, e.g., Robert D. Biggs, “Medicine, Surgery, and Public Health in Ancient Mesopotamia,” in Civilizations of the Ancient Near East, vol. 3, ed. Jack M. Sasson (New York: Scribner’s Sons, 1995), 1911–24, esp. 1918–21. For an analysis of these titles in Aramaic sources, see Paul E. Dion, “Medical Personnel in the Ancient Near East: asû and āšipu in Aramaic Garb,” ARAM 1 (1989): 206–16. For an overview of Jewish physicians in the Roman world, see Fridolf Kudlien, “Jüdische Ärzte im Römischen Reich,” Medizinhistorisches Journal 20 (1985): 36–57. 158. See Marcus Jastrow, Dictionary, 663, 667, and 867, and DJBA 598 and 725. 159. B. B. Qam. 85a. 160. See Margaret Jacobi, “Mai Gargutani? An Obscure Medical Term in Bava Kamma 85a,” Korot 13 (1998–99): 165–70, esp. 166. 161. That is, with the title rope or asya. See Rosner, Encyclopedia of Medicine, 244. See Reed, “ ‘Ancient Jewish Sciences,’ ” 236–37 and n. 132, for references to Theodos. On Benjamin (or Minyomi) the Physician, see b. Šabb. 133b, b. Sanh. 99b–100a, and b. ‘Abod. Zar. 28b, and on a physician or a son of one named Nathan, who is perhaps a rabbi, see b. Pesah. . 52a. The Mishnah includes some names in passing. See m. Roš Haš. 1:7, where Tobiah the Doctor observes the new moon in Jerusalem. For named physicians in the Yerushalmi, see Hezser, “Representations,” 187, on Rabbi Ammi the Physician in y. Ber. 2:2 (4c). In addition to these figures, there are other medical experts mentioned by name (but without the title of physician), such as Abaye’s mother, the daughter of Domitianus, and a man named Ben-Ah. iya who is appointed as a Temple officer who oversees diseases of the bowels (m. Šeqal. 5:1–2). On the latter figure, see Leonard J. Hoenig, “Ben Achiya: The First Gastroenterologist in Ancient Israel?,” Journal of Clinical Gastroenterology 11 (1989): 61–63. 162. See Prioreschi, History of Medicine, vol. 3, 666–68. 163. See Rosner, Medicine in the Bible and the Talmud, 212 and 230–31; Sinclair, “Obligation to Heal,” 352–53; and Benjamin Gesundheit, “The Best among the Physicians to Gehinom (to Hell)?,” Harefuah 143 (2004): 598–604, 621 (Hebrew). 164. On this text, see, e.g., David Margalit, “The Ideal Doctor as Depicted in Ancient Hebrew Writings,” Journal of the History of Medicine and Allied Sciences 12 (1957): 37–41. 165. B. Sanh. 99b–100a. On this text, see Jacob Neusner, A History of the Jews in Babylonia, vol. 4, The Age of Shapur II (Leiden: Brill, 1969), 363–64, and Yaakov Elman,
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“The Socioeconomics of Babylonian Heresy,” Jewish Law Association Studies 17 (2007): 80–127, esp. 87–88. 166. B. Šabb. 133b–134a (MS Oxford Opp. Add. fol. 23). 167. See Tzvi Novick, “ ‘Like an Expert Sharecropper’: Agricultural Halakhah and Agricultural Science in Rabbinic Palestine,” Association for Jewish Studies Review 38 (2014): 303–20, and “ ‘I Am Not a Butcher’: Authority and Expertise in Rabbinic Laws of Meat Production in Classical Rabbinic Literature,” Journal of Ancient Judaism 8 (2017): 112–44.
chapter 2. trends and methods in the study of talmudic medicine 1. For earlier surveys, see Harry Friedenwald, “The Bibliography of Ancient Hebrew Medicine,” Bulletin of the Medical Library Association 23 (1935): 124–57, and Solomon R. Kagan, “The Bibliography of Ancient Jewish Medicine,” Bulletin of the History of Medicine 22 (1948): 480–85. More recently, see Edward Reichman, “Biblical and Talmudic Medicine: A Bibliographical Essay,” in Encyclopedia of Medicine in the Bible and the Talmud, by Fred Rosner (Northvale, NJ: Jason Aronson, 2000), 1–9. Producing a comprehensive bibliography on Talmudic medicine would be a monumental task. This book’s bibliography—which focuses on scholarship in English—is nowhere near complete in this regard. 2. See, e.g., John M. Efron, Medicine and the German Jews: A History (New Haven: Yale University Press, 2001), 189. Today one sees a similar tension between ancient rituals and modern science in the case of circumcision, on which see David L. Gollaher, Circumcision: A History of the World’s Most Controversial Surgery (New York: Basic Books, 2000). 3. For an example of an early study of biblical medicine that assumes the Bible’s sacred character, see the 1672 publication by Thomas Bartholin, On Diseases in the Bible: A Medical Miscellany, 1672, transl. James Willis and ed. Johan Schioldann-Nielsen and Kurt Sørensen (Copenhagen: Danish National Library of Science and Medicine, 1994). Written by a Danish Lutheran doctor and theologian, this book was popular in its time, according to Ole Peter Grell, “Book Review: Thomas Bartholin, On Diseases in the Bible: A Medical Miscellany, 1672,” Medical History 41 (1997): 406–7. 4. One could cite many cases. For examples, see Solomon R. Kagan, “Talmudic Medicine,” Medical Leaves 3 (1940): 164–73, esp. 167–68, who adds that the reason that Talmudic medicine never impacted the practice of medicine throughout the centuries was because non-Jews could not comprehend the Bavli. See also the exaggeration that, when it comes to matters of health, “the Talmud was written a thousand years ahead of its time,” in an 1884 article in JAMA by the Ohioan doctor Carl H. von Klein, “Jewish Hygiene and Diet, the Talmud and Various Other Jewish Writings Heretofore Untranslated,” Journal of the American Medical Association 3 (1884): 345–52, esp. 351. A few years later, in a Cincinnati medical journal, this same author asked colleagues to commission him to write a book on Talmudic medicine; see von Klein, “A Proposition
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to Translate and Publish the Medicine and Hygiene of the Talmud,” The Cincinnati Lancet and Clinic, March 26, 1887. 5. See Raphael Patai, The Jewish Mind (New York: Jason Aronson, 1977), 315–42. But see the negative reviews of this book by Jerome Greenfield, “Reviewed Work: The Jewish Mind by Raphael Patai,” American Jewish History 68 (1978): 231–34, and others. Orthodox perspectives often promote the idea that Jewish success in the sciences is a result of the idiosyncrasies of Jewish texts, history, and genetic makeup. On this, see the article by physicist Cyril Domb, “Jewish Distinction in Science,” in Fusion: Absolute Standards in a World of Relativity—Science, the Arts, and Contemporary Life in the Light of Torah, ed. Arnie Gotfryd, Herman Branover, and Shalom Lipskar (New York: Feldheim Publishers, 1990), 29–44. On correspondences between halakhic antitraditionalism and modern scientific rationality (as expressed in the writings of Karl Popper), see the book by the philosopher of science Menachem Fisch, Rational Rabbis: Science and Talmudic Culture (Bloomington: Indiana University Press, 1997). For the view that Talmudic thinking is incompatible with contemporary science, see Jacob Neusner, “Why No Science in Judaism?,” Shofar 6 (1988): 45–71. 6. See Steven Gimbel, Einstein’s Jewish Science: Physics at the Intersection of Politics and Religion (Baltimore: Johns Hopkins University Press, 2012). See also Cyril Domb, “The Orthodox Jewish Scientist,” in Challenge: Torah Views on Science and Its Problems, 2nd ed., ed. Aryeh Carmell and Cyril Domb (New York: Feldheim Publishers, 1978), 16–29, on how contemporary scientists’ formal or informal rabbinical studies play a role in their professional success. 7. See Francis Schiller, “The Earliest Western Account of Talmudic Medicine,” Korot 9 (1988): 255–61, and “Benjamin Wolff Gintzburger’s Dissertation on Talmudic Medicine,” Korot 9 (1988): 579–600. For other early dissertations on ancient Jewish medicine, see Edward Reichman, “The History of the Jewish Medical Student Dissertation: An Evolving Jewish Tradition,” in Sacred Training: A Halakhic Guidebook for Medical Students and Residents, ed. Jerry Karp and Matthew Schaikewitz (New York: Ammud Press, 2018), xvii–xxxviii. As Reichman notes on xix, there was a dissertation published one year earlier than Gintzburger’s dissertation, in 1742, at the University of Halle in Germany, on the specific topic of gynecology and fertility in rabbinic literature, by Salomon Bernard Wolffsheimer. 8. On being the first Jewish student, see Schiller, “Earliest Western Account,” 255. On Galen, see Schiller, “Dissertation,” 586, and, for an older example, Abraham Bernstein, “The Talmud: A Medical Laboratory,” California and Western Medicine 49 (1938): 308–10. 9. On this tendency, see Reichman, “Bibliographical Essay,” 6, and, for one example of it, see the statement by Stephen T. Newmyer, “Climate and Health: Classical and Talmudic Perspectives,” Judaism 33 (1984): 426–38, esp. 435–36 (on “airborne bacterial contagion”). 10. On the two phases of nineteenth-century Wissenschaft des Judentums scholarship on Jewish medicine, from 1822–54 and 1855–96, see Robert Jütte, “Die jüdische Medizingeschichtsschreibung im 19. Jahrhundert und die ‘Wissenschaft des
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Judentums,’ ” Aschkenas: Zeitschrift für Geschichte und Kultur der Juden 9 (1999): 431–45. Other European authors of works on Talmudic medicine from the nineteenth to the early twentieth century include: the German physician and philosopher Markus Herz (d. 1803; see Brigitte Ibing, “Markus Herz: A Biographical Study,” Korot 9 [1985]: 113–21, and J. Efron, Medicine and the German Jews, 92–103); Sigismund Cohn, author of “De medicina talmudica” (PhD diss., University of Viadrina, 1846); the Moravian physician Joseph Bergel, author of Die Medizin der Talmudisten. Nebst einem Anhange: Die Anthropologie der alten Hebräer (Leipzig: Wilhelm Friedrich, 1885); the bibliographer and scholar Moritz Steinschneider, author of “Schriften über Medicin in Bibel und Talmud und über jüdische Aerzte,” Wiener Klinische Rundschau 10 (1896): 433–35 and 452–53; the medical professor and historian Wilhelm Ebstein, author of Die Medizin im Alten Testament and Die Medizin im Neuen Testament und im Talmud (Stuttgart: Ferdinand Enke, 1901–03), on whom see Ruth J. Mann and J. T. Lie, “The Life Story of Wilhelm Ebstein (1836–1912) and His Almost Overlooked Description of a Congenital Heart Disease,” Mayo Clinic Proceedings 54 (1979): 197–204; the physician A. Stern, who published Die Medizin im Talmud (Frankfurt: Sänger and Friedberg, 1909); and the German rabbi Max Grunwald, publisher of Die Hygiene der Juden: Im Anschluβ an die Internationale Hygiene-Ausstellung Dresden 1911 (Dresden: Historischen Abteilung der Internationalen Hygiene-Ausstellung, 1912). 11. J. Efron, Medicine and the German Jews, 191. 12. Quotation from Mitchell Hart, “Moses the Microbiologist: Judaism and Social Hygiene in the Work of Alfred Nossig,” Jewish Social Studies 2 (1995): 72–97, esp. 83 (and on Nossig’s anachronistic politicization of the Talmud, see p. 78). See also Alfred Nossig, Die Sozialhygiene der Juden und des altorientalischen Völkerkreises (Stuttgart: Deutsche Verlags-Anstalt, 1894), esp. 70–96. 13. See Ludwig Lewysohn, Die Zoologie des Talmuds (Frankfurt: Baer, 1858); Moritz Duschak, Zur Botanik des Talmud (Pest: Druck von I. Neuer, 1870); and Benedict Zuckermann, Das Mathematische im Talmud: Beleuchtung und Erläuterung der Talmudstellen mathematischen Inhalts (Breslau: A. Hepner, 1878). On these works and others, see Noah J. Efron, Judaism and Science: A Historical Introduction (Westport, CT: Greenwood Press, 2007), 43. 14. See Eliakim Carmoly, Histoire des médicins juifs anciens et modernes (Brussels: Société Encyclographique des Sciences Médicales, 1844), and Israel-Michel Rabbinowicz, La médecine du Thalmud, ou tous les passages concernant la médecine, extraits des 21 traités du Thalmud de Babylone (Paris, 1880). The book by Carmoly, a rabbi in Brussels, was translated into English: see Carmoly, History of the Jewish Physicians, transl. John R. W. Dunbar (Baltimore: John Murphy, 1845). Similar approaches appear in more recent publications, such as Nathan Koren, Jewish Physicians: A Biographical Index (Jerusalem: Israel Universities Press, 1973). 15. Reuben Joseph Wunderbar, Biblisch-talmudische Medicin (Riga, 1865). See J. Efron, Medicine and the German Jews, 192. 16. See, e.g., Isidore Simon, Asaph Ha-Iehoudi: Médicin et astrologue du moyen age (Paris: Librairie Lipschutz, 1933), and Sussman Muntner, “The Antiquity of Asaph
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the Physician and His Editorship of the Earliest Hebrew Book of Medicine,” Bulletin of the History of Medicine 25 (1951): 101–31. One can add to this list David Margalit, author of Jewish Sages as Physicians (Jerusalem: Mossad HaRav Kook, 1962) (Hebrew), and Joshua O. Leibowitz, an MD and historian of medicine at the Hebrew University and author of Some Aspects of Biblical and Talmudic Medicine: Meeting Held in the Library of the Wellcome Institute of the History of Medicine, 17th September 1968 (Jerusalem: Hadassah Medical School, 1969). 17. See Harefuah (1920–pres.), Hebrew Physician (1927–65), Medical Leaves (1937– 43), Revue d’histoire de la Medicine Hebraïque (1948–85), and Korot: The Israel Journal of the History of Medicine and Science (1952–pres.). 18. For example, posthumously published in 1928 was the four-hundred-page book by Dr. Judah Loeb Katzenelson, The Talmud and the Wisdom of Medicine (Berlin: Jalkut, 1928) (Hebrew). For a biography of this Russian doctor with rabbinical training, see Harry A. Savitz, Profiles of Erudite Jewish Physicians and Scholars: Biographical Essays (Chicago: Spertus College of Judaica Press, 1973), 56–61. In 1926, Moshe Perlman delved into the topic with a three-volume work titled Midrash of Medicine (Tel Aviv: Dvir, 1926–34) (Hebrew), on which see Reichman, “Bibliographical Essay,” 4. See also Meir Bar-Ilan, “Medicine in the Land of Israel in the First Centuries C.E.,” Cathedra 91 (1999): 31–78 (Hebrew). For a survey of medical writings in Hebrew from Asaph to the twentieth century, see Harry Friedenwald, “The Use of the Hebrew Language in Medical Literature,” Bulletin of the Institute of the History of Medicine 2 (1934): 77–111. Finally, see the collection of essays in Natalia Berger, ed., Jews and Medicine: Religion, Culture, Science (Philadelphia: Jewish Publication Society, 1995), based on an exhibition at The Museum of the Jewish Diaspora in Tel Aviv. 19. Jacob Snowman, A Short History of Talmudic Medicine (London: J. Bale, Sons, and Danielsson, 1935). 20. See Solomon R. Kagan, “Medicine According to the Talmud,” Jewish Advocate, May 26, 1927, A2; “The Causes of Diseases According to the Talmud,” Jewish Advocate, September 12, 1929, B7; and “Talmudic Medicine.” 21. See N. E. Aronstam, “Medicine of the Ancient Hebrews in the Bible and Talmud,” Detroit Jewish Chronicle, July 14, 1933, and Abraham Bernstein and Henry C. Bernstein, “Medicine in the Talmud,” California Medicine 74 (1951): 267–68. 22. See Arturo Castiglioni, “The Contribution of the Jews to Medicine,” in The Jews: Their Role in Civilization, ed. Louis Finkelstein (New York: Schocken Books, 1974), 184–210; Benjamin Lee Gordon, Medicine throughout Antiquity (Philadelphia: F. A. Davis, 1949), 725–93; Plinio Prioreschi, A History of Medicine, vol. 3, Roman Medicine, 3rd ed. (Omaha: Horatius Press, 2001), 663–95; and finally Laura M. Zucconi, Ancient Medicine: From Mesopotamia to Rome (Grand Rapids, MI: Eerdmans, 2019), 323–55. 23. See, e.g., the lack of references to the Talmud in Lawrence I. Conrad, Michael Neve, Vivian Nutton, Roy Porter, and Andrew Wear, The Western Medical Tradition: 800 BC to AD 1800 (New York: Cambridge University Press, 1995). To be fair, it can be debated whether the Talmud is in fact a part of the Western medical tradition (see
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chapter 5). Still, many other books that go beyond this paradigm and still do not engage the Talmudic medical tradition could be cited; see, e.g., Ruth Clifford Engs, ed., Health and Medicine through History: From Ancient Practices to 21st-Century Innovations, vol. 1, Antiquity through the 18th Century (Santa Barbara: Greenwood, 2019). 24. Julius Preuss, Biblisch-talmudische Medizin: Beiträge zur Geschichte der Heilkunde und der Kultur überhaupt (Berlin: S. Karger, 1911). 25. See Fred Rosner, transl. and ed., Julius Preuss’ Biblical and Talmudic Medicine (Northvale, NJ: Jason Aronson, 1993; orig. pub. 1978), and Uri Wurzburger, transl. and ed., Biblical and Talmudic Medicine (Jerusalem: Magnes Press, 2012) (Hebrew). The book was well received in its own time too (see Fred Rosner, “Neurology in the Bible and Talmud,” Israel Journal of Medical Sciences 11 [1975]: 385–97, esp. 385, on Karl Sudhoff’s praise). According to Rosner, transl. and ed., Preuss’ Biblical and Talmudic Medicine, xxii (intro.), Preuss’s book was reprinted many times, as late as 1971, before its translation in 1978. On the prominent place of this book today, see Reichman, “Bibliographical Essay,” 3. 26. For similar criticisms, see Markham J. Geller, Akkadian Healing Therapies in the Babylonian Talmud (Berlin: Max Planck Institute for the History of Science, 2004), 2–3. 27. For medical doctors, see the works by Charles J. Brim, “The Biliary System: Liver, Gallbladder, and Jaundice, Biblical and Talmudic Data,” Review of Gastroenterology 8 (1941): 255–59; Elinor Lieber, “A Mediaeval Hebrew Presage of the Circulation of the Blood, Based on Biblical and Talmudic Concepts,” Korot 9 (1985): 157–63; the pediatrician S. Levin, “Isaac’s Blindness: A Medical Diagnosis,” Judaism 37 (1988): 81–83; the dermatologist Michael A. Goldenhersh, “Rapid Whitening of the Hair First Reported in the Talmud: Possible Mechanisms of This Intriguing Phenomenon,” American Journal of Dermatopathology 14 (1992): 367–68; among others. For psychiatrists, see Anton Bumm, Spuren der Griechischen Psychiatrie im Talmud (Munich: Wolff and Sohn, 1902); Leon D. Hankoff, “Ancient Descriptions of Organic Brain Syndrome: The ‘Kordiakos’ of the Talmud,” American Journal of Psychiatry 129 (1972): 233–36; and Allan S. Kaplan and Paul E. Garfinkel, “Bulimia in the Talmud,” American Journal of Psychiatry 141 (1984): 721. Benjamin Lee Gordon was an ophthalmologist, as was Harry Friedenwald, author of The Jews and Medicine: Essays, 2 vols. (Baltimore: Johns Hopkins University Press, 1944). For more recent scholarship by ophthalmologists, see Ahmad M. Mansour, Daniel Gold, Haytham I. Salti, and Zaher M. Sbeity, “The Eye in the Old Testament and Talmud,” Survey of Ophthalmology 49 (2004): 446–53. For articles by dentists, see Samuel Greif, “Dental Materia Medica in the Talmud,” Dental Digest 21 (1915): 223–27; Milton B. Asbell, “A Review of Hebraic Dentistry from Earliest Times through the Middle Ages,” Medical Leaves 5 (1943): 31–42; and Arie Shifman, Shmuel Orenbuch, and Mel Rosenberg, “Bad Breath—A Major Disability According to the Talmud,” Israel Medical Association Journal 4 (2002): 843–45. For a coauthored article by a doctor and a rabbi, see R. M. Goodman and Ch. Plato, “A Talmudic Reference to a Family with Probable Testicular Feminization Syndrome,” Korot 8 (1982): 40–47. For works by individuals with rabbinical training and doctorates, see H. Jacob Zimmels, Magicians, Theologians, and Doctors: Studies in Folk-
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Medicine and Folk-Lore as Reflected in the Rabbinical Responsa, 12th–19th Centuries (London: E. Goldston, 1952); Immanuel Jakobovits, Jewish Medical Ethics: A Comparative and Historical Study of the Jewish Religious Attitude to Medicine and Its Practice (New York: Bloch, 1959); and David Bleich, “The Obligation to Heal in the Judaic Tradition: A Comparative Analysis,” in Jewish Bioethics, ed. Fred Rosner and J. David Bleich (Hoboken, NJ: KTAV, 1979), 3–46. 28. For examples, see Baruch A. Brody, “The Use of Halakhic Material in Discussions of Medical Ethics,” Journal of Medicine and Philosophy 8 (1983): 317–28; Gary Goldsand, Zahava R. S. Rosenberg, and Michael Gordon, “Bioethics for Clinicians: 22. Jewish Bioethics,” Canadian Medical Association Journal 164 (2001): 219–22; Avraham Steinberg, “Risky Treatments: A Jewish Medical Ethics Perspective,” Rambam Maimonides Medical Journal 6 (2015): 1–6; Jeff Levin and Michele F. Prince, “Judaism and Health: Reflections on an Emerging Scholarly Field,” Journal of Religion and Health 50 (2011): 765–77; Charles Sheer, “Bikkur Holim: The Origins of Jewish Pastoral Care,” Journal of Health Care Chaplaincy 15 (2008): 99–113, on the commandment to visit the sick; and John H. Davidson, “Empathy and Integrative Thinking: Talmudic Paradigms for the Essentials of a Medical Interview,” Medical Humanities 40 (2014): 80–83. 29. On how researchers who are not trained in history—including scientists—are more prone to the fallacy of presentism than professional historians, see David Hackett Fischer, Historians’ Fallacies: Toward a Logic of Historical Thought (New York: Harper Perennial, 1970), 135–37, and Stephen G. Brush, “Scientists as Historians,” Osiris 10 (1995): 214–31, esp. 217–23. 30. See K. Codell Carter, “Causes of Disease and Death in the Babylonian Talmud,” Medizinhistorisches Journal 26 (1991): 94–104; Stephen T. Newmyer, “Talmudic Medicine: A Classicist’s Perspective,” Judaism 29 (1980): 360–67; and Geller, Akkadian Healing Therapies. 31. For example, see the self-reflective comment by Samuel S. Kottek, “Selected Elements of Talmudic Medical Terminology, with Special Consideration to GraecoLatin Influences and Sources,” in Aufstieg und Niedergang der römischen Welt, vol. 37/3, pt. 2, ed. Wolfgang Haase and Hildegard Temporini (Berlin: Walter de Gruyter, 1996), 2912–32, esp. 2915, on not being a philologist of Hebrew and Aramaic. 32. This is not to deny the need to engage the history of medicine and science, broadly defined. That said, scholars have long debated to what extent it is necessary that historians of medicine be formally trained physicians and scientists; for a few interesting snapshots of this debate in the past, see, e.g., Owsei Temkin, “Henry E. Sigerist and Aspects of Medical Historiography,” Bulletin of the History of Medicine 32 (1958): 485–99, esp. 492–93, and Leonard G. Wilson, “Medical History without Medicine,” Journal of the History of Medicine and Allied Sciences 35 (1980): 5–7. This debate also exists among historians of science, on which see Thomas S. Kuhn, “The Relations between History and History of Science,” Daedalus 100 (1971): 271–304, and Brush, “Scientists as Historians.” 33. For example, see the working group “Religion, Medicine, Disability, and Health in Late Antiquity” (ReMeDHe) at www.remedhe.com.
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34. See Heidi Marx-Wolf and Kristi Upson-Saia, “The State of the Question: Religion, Medicine, Disability, and Health in Late Antiquity,” Journal of Late Antiquity 8 (2015): 257–72, esp. 257–63. Disability studies is also a productive lens that has received greater attention, on which see esp. the work of Julia Watts Belser, such as “Judaism and Disability,” in Disability and World Religions: An Introduction, ed. Darla Y. Schumm and Michael Stoltzfus (Waco: Baylor University Press, 2016), 93–113. 35. See, e.g., the 1916 article by D. Fraser Harris, “The Influence of Greece on Science and Medicine,” Scientific Monthly 3 (1916): 51–65. But such claims are overly simplistic, according to Peter Harrison, The Territories of Science and Religion (Chicago: University of Chicago Press, 2015), 22–34. 36. See Markham J. Geller, “Akkadian Medicine in the Babylonian Talmud,” in A Traditional Quest: Essays in Honour of Louis Jacobs, ed. Dan Cohn-Sherbok (Sheffield: Journal for the Study of the Old Testament Press, 1991), 102–12; “An Akkadian Vademecum in the Babylonian Talmud,” in From Athens to Jerusalem: Medicine in Hellenized Jewish Lore and in Early Christian Literature, ed. Samuel S. Kottek, Manfred Horstmanshoff, Gerhard Baader, and Gary Ferngren (Rotterdam: Erasmus, 2000), 13–32; and Akkadian Healing Therapies, among other relevant publications listed in the bibliography. 37. See Lennart Lehmhaus, ed., Defining Jewish Medicine. Transfer of Medical Knowledge in Premodern Jewish Cultures and Traditions (Wiesbaden: Harrassowitz, 2021), and the forthcoming Sourcebook of Medical Passages in Talmudic Texts. For dissertations, see Monika Amsler, “Effective Combinations of Words and Things: The Babylonian Talmud Gittin 67b–70b and the Literary Standards of Late Antiquity” (PhD diss., University of Zurich, 2018), and Shulamit Shinnar, “ ‘The Best of Doctors Go to Hell’: Rabbinic Medical Culture in Late Antiquity (200–600 C.E.)” (PhD diss., Columbia University, 2019). 38. The emic-etic distinction, made famous in the middle of the twentieth century by linguist Kenneth L. Pike (see Pike, Language in Relation to a Unified Theory of the Structure of Human Behavior [Glendale, CA: Summer Institute of Linguistics, 1954]), has by now penetrated nearly every corner of academia. Much scholarship could be cited here. For one example from late antique studies, see Pieter F. Craffert, “Taking Stock of the Emic-Etic Distinction in Social-Scientific Interpretations of the New Testament,” Neotestamentica 28 (1994): 1–21. From a historian’s perspective, see Carlo Ginzburg, “Our Words, and Theirs: A Reflection on the Historian’s Craft, Today,” in Historical Knowledge: In Quest of Theory, Method and Evidence, ed. Susanna Fellman and Marjatta Rahikainen (Newcastle: Cambridge Scholars Publishing, 2012), 97–119, esp. 107–11, who argues, correctly in my opinion, that historians today need to meditate more on emic-etic distinctions in their work. 39. In using the term “medicine” in this book, I do not wish to connote modern biomedical science that tries to cure a disease, as opposed to traditional medicine that tries to heal an illness (see chapter 4 for more on this distinction). While in principle I do not object to referring to all of Talmudic medicine as “healing,” there are a few reasons why I prefer “medicine.” First, this book is an intervention into the subfield that for centuries has been called Talmudic medicine, which compels me to continue this
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usage even if it is flawed. But the more important reason for this choice is because I want to make a distinction between so-called magical healing therapies versus empirical ones; that is, this book focuses on a genre of therapies that often (but not always) uses materia medica or other empirical techniques in a way that is rooted in the observation of nature—which is part of what distinguishes medicine from healing (see Paul U. Unschuld, What Is Medicine? Western and Eastern Approaches to Healing, transl. Karen Reimers [Berkeley: University of California Press, 2009], 6–7)—and that does not get included in studies of healing in the context of Jewish magic. When compared to medicine, healing is probably the larger category, of which medicine is but one aspect. Healing connotes a wider array of therapeutic tactics, including prayer, miracles, spells, exorcisms, and the like—all of which also appear in the Bavli’s arsenal, but which are not the focus of this book and which tend to get studied under other rubrics, such as magic and religion. Thus, perhaps “medical healing” would be an apt description of the Bavli’s empirical therapies. In this book, I sometimes use the terms “medicine” and “healing” interchangeably, usually for stylistic reasons, which I hope will not cause confusion. Finally, for what it is worth, etymologically the Latin word medicina means “the art of healing, or the means of healing, from medicinus, relating to healing, from medeor or medicor, to heal or cure” (Thelma Charen, “The Etymology of Medicine,” Bulletin of the Medical Library Association 39 [1951]: 216–21, esp. 216, citing Henry Alan Skinner, The Origin of Medical Terms [Baltimore: Williams and Wilkins, 1949], 228). 40. On trial and error, see Richard Kalmin, “Observation in Rabbinic Literature of Late Antiquity,” in The Faces of Torah: Studies in the Texts and Contexts of Ancient Judaism in Honor of Steven Fraade, ed. Michal Bar-Asher Siegal, Tzvi Novick, and Christine Hayes (Göttingen: Vandenhoeck and Ruprecht, 2017), 359–83, esp. 380. Kalmin clarifies that it is beside the point whether the rabbis’ observations were accurate from our perspective today; instead “all that matters is that they thought they were observing reality” (378, author’s italics). On the role of observation and tests in Mesopotamian medicine, see Ulrike Steinert, “ ‘Tested’ Remedies in Mesopotamian Medical Texts: A Label for Efficacy Based on Empirical Observation?,” in In the Wake of the Compendia: Infrastructural Contexts and the Licensing of Empiricism in Ancient and Medieval Mesopotamia, ed. J. Cale Johnson (Boston: Walter de Gruyter, 2015), 103–45. 41. There is a lengthy bibliography and range of perspectives on these complex issues in the history and philosophy of science, anthropology, religious studies, and other fields. Some publications that I have found useful include: Thomas S. Kuhn, “Commensurability, Comparability, Communicability,” Proceedings of the Biennial Meeting of the Philosophy of Science Association 2 (1982): 669–88; Paul Feyerabend, “Putnam on Incommensurability,” British Journal for the Philosophy of Science 38 (1987): 75–81; Josep Martí i Pérez, “Encountering the Irrational: Some Reflections on Folk Healers,” Folklore 99 (1988): 178–85; and Paul Stoller, “Rationality,” in Critical Terms for Religious Studies, ed. Mark C. Taylor (Chicago: University of Chicago Press, 1998), 239–55. 42. For one helpful article on this idea, see I. C. Jarvie and Joseph Agassi, “The Problem of the Rationality of Magic,” British Journal of Sociology 18 (1967): 55–74. 43. For an overview of materia medica, see B. Gordon, Medicine, 775–77.
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44. On the spirit of this problem, see Quentin Skinner, “Meaning and Understanding in the History of Ideas,” History and Theory 8 (1969): 3–53, esp. 27–30. 45. I borrow this language from Andrew Cunningham, “Getting the Game Right: Some Plain Words on the Identity and Invention of Science,” Studies in History and Philosophy of Science 19 (1988): 365–89, esp. 366, who says this about science. 46. For one example from world cultures, see Mary MacDonald, “Magic, Medicine and Sorcery,” in An Introduction to Melanesian Religions, ed. Ennio Mantovani (Goroka: The Melanesian Institute for Pastoral and Socio-Economic Service, 1984), 195–211, on Melanesian beliefs, which can stimulate questions on Talmudic medicine such as: do the rabbis, like Melanesians, select herbal drugs based on “the importance of a plant in a healing ritual” which “is related to its symbolism” (e.g., its shape or color, which might be the same shape or color of the injured body part) “rather than to its chemical properties” (202)? On this topic in Bavli medicine, see chapters 1, 3, and 4. 47. Nick Jardine, “Etics and Emics (Not to Mention Anemics and Emetics) in the History of the Sciences,” History of Science 42 (2004): 261–78, esp. 275. 48. For more on these methodological issues in the history of science, see G. E. R. Lloyd, “Methods and Problems in the History of Ancient Science: The Greek Case,” Isis 83 (1992): 564–77, esp. 564–67. 49. These are common topics discussed in medical anthropology. Although not dealing with antiquity, see, e.g., the articles by Arthur J. Rubel and Carmella C. Moore, “The Contribution of Medical Anthropology to a Comparative Study of Culture: Susto and Tuberculosis,” Medical Anthropology Quarterly 15 (2001): 440–54, quotations from 441, and a review of approaches in Linda C. Garro, “Cultural Meaning, Explanations of Illness, and the Development of Comparative Frameworks,” Ethnology 39 (2000): 305–34. 50. See the similar idea expressed in John M. Efron, “A Perfect Healing to All Our Wounds: Religion and Medicine in Judaism,” in Quo Vadis Medical Healing: Past Concepts and New Approaches, ed. Susanna Elm and Stefan N. Willich (Dordrecht: Springer, 2009), 55–67, esp. 55, citing Earl W. Count, “The Biological Basis of Human Sociality,” in Culture: Man’s Adaptive Dimension, ed. M. F. Ashley Montagu (New York: Oxford University Press, 1968), 114–58. My argument builds on a longstanding debate in various disciplines regarding the universal aspects of humanity, and in particular how scholars can (or cannot) use such human universals as the basis for crosscultural analysis. On universal aspects of health and illness, see Donald E. Brown, Human Universals (Boston: McGraw-Hill, 1991), as well as Steven Pinker, The Blank Slate: The Modern Denial of Human Nature (New York: Penguin Books, 2002), esp. the appendix on 435–39, which lists as human universals “beliefs about disease,” “healing the sick (or attempting to),” and “medicine,” as well as “magic.” 51. Nick Jardine, “Uses and Abuses of Anachronism in the History of the Sciences,” History of Science 38 (2000): 251–70, esp. 263. 52. See Elizabeth Shanks Alexander, “Introduction,” in Religious Studies and Rabbinics: A Conversation, ed. Elizabeth Shanks Alexander and Beth A. Berkowitz (New York: Routledge, 2018), 1–21, esp. 5.
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53. On this topic, see Shaul Shaked, “Rabbis in Incantation Bowls,” in The Archaeology and Material Culture of the Babylonian Talmud, ed. Markham J. Geller (Boston: Brill, 2015), 97–120. 54. See the index in Gideon Bohak, Ancient Jewish Magic: A History (New York: Cambridge University Press, 2008), s.v. “magic” with subentry “medical,” and pp. 41–42, 57, 76–77, 82, 152, 187, 236–37, 246–47, 260–61, 314–18, 364–65, 371–72, 379–80, and 407–20. See also Giuseppe Veltri, “Magic and Healing,” in The Oxford Handbook of Jewish Daily Life in Roman Palestine, ed. Catherine Hezser (New York: Oxford University Press, 2010), 587–602. Although nuanced, this conflation appears in classical anthropological and sociological research. See, e.g., Marcel Mauss and Henri Hubert, “A General Theory of Magic,” transl. Robert Brain, in Defining Magic: A Reader, ed. Bernd-Christian Otto and Michael Stausberg (Bristol: Equinox Publishing, 2013; orig. pub. 1902), 97–110, esp. 99–102 and 108–9, and Edward E. Evans-Pritchard, Witchcraft, Oracles, and Magic among the Azande (New York: Clarendon Press, 1976; orig. pub. 1937), 90–97, 176–204, and 227 (on the term Ngua). 55. See Joseph Naveh and Shaul Shaked, Magic Spells and Formulae: Aramaic Incantations of Late Antiquity (Jerusalem: Magnes Press, 1993), 31–39, and Peter Schäfer, “Magic and Religion in Ancient Judaism,” in Envisioning Magic: A Princeton Seminar and Symposium, ed. Peter Schäfer and Hans G. Kippenberg (New York: Brill, 1997), 19–43, esp. 34–35. By contrast, Palestinian rabbinic texts seldom connect physicians with magic, according to Catherine Hezser, “Representations of the Physician in Jewish Literature from Hellenistic and Roman Times,” in Popular Medicine in Graeco-Roman Antiquity: Explorations, ed. William V. Harris (Boston: Brill, 2016), 173–97, esp. 192. 56. Yuval Harari, Jewish Magic before the Rise of Kabbalah, transl. Batya Stein (Detroit: Wayne State University Press, 2017), 357 n. 9. 57. Bohak, Ancient Jewish Magic, 409. 58. It is possible that there was overlap between professionals. On physicians who produce amulets, see chapter 4. See also the interesting albeit conjectural conclusion from the 1888–90 University of Pennsylvania expedition to Nippur in John Punnett Peters, Nippur, or Explorations and Adventures on the Euphrates: The Narrative of the University of Pennsylvania Expedition to Babylonia in the Years 1888–1890, vol. 2, Second Campaign (New York: G. P. Putnam’s Sons, 1897), 183, based on the discovery in a single home, perhaps of a Jewish physician or pharmacist, of both magic bowls and bottles containing what might be medicine. 59. Naveh and Shaked, Magic Spells, 32. 60. Much can be cited here. For one defense of the category, see, e.g., Henk S. Versnel, “Some Reflections on the Relationship Magic–Religion,” Numen 38 (1991): 177–97. For a critique of its continued use, see Bernd-Christian Otto, “Towards Historicizing ‘Magic’ in Antiquity,” Numen 60 (2013): 308–47. For more on this ongoing debate, see also Andrew Durdin, “Redescribing ‘Magic’: Discourse, Alterity, and Religion in the Roman World” (PhD diss., University of Chicago, 2017). It is important to note that the majority of scholarship regarding the category of magic in antiquity is focused on the Greco-Roman world and not the Persian-Sasanian one. On the rabbinic
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definition of magic, see Philip S. Alexander, “The Talmudic Concept of Conjuring (’Ah. izat ‘Einayim) and the Problem of the Definition of Magic (Kishuf),” in Creation and Re-Creation in Jewish Thought: Festschrift in Honor of Joseph Dan on the Occasion of His Seventieth Birthday, ed. Rachel Elior and Peter Schäfer (Tübingen: Mohr Siebeck, 2005), 7–26. 61. Randall Styers, Making Magic: Religion, Magic, and Science in the Modern World (New York: Oxford University Press, 2004), 8. 62. See Meir Bar-Ilan, “Between Magic and Religion: Sympathetic Magic in the World of the Sages of the Mishnah and Talmud,” Review of Rabbinic Judaism 5 (2002): 383–99, esp. 384, on how “there are various categories of magic that should not be lumped together.” See Bernd-Christian Otto and Michael Stausberg, eds., Defining Magic: A Reader (Bristol: Equinox Publishing, 2013), 2–3, for a list of subcategories, including ones that fall under the scope of this book: amulets, formulae, fumigations, healing, herbs, incantations, potions, spells, among others. 63. Jonathan Z. Smith, “Trading Places,” in Ancient Magic and Ritual Power, ed. Marvin Meyer and Paul Mirecki (New York: Brill, 1995), 13–27, esp. 16–17. 64. On this last point, see the assessment by Giuseppe Veltri, “The Rabbis and Pliny the Elder: Jewish and Greco-Roman Attitudes toward Magic and Empirical Knowledge,” Poetics Today 19 (1998): 63–89, esp. 63–64 n. 2. Although some progress has been made since, the assessment is still relevant. 65. Y. Šabb. 6:10 (8c), based on Yaacov Sussmann, ed., Talmud Yerushalmi According to Ms. Or. 4720 (Scal. 3) of the Leiden University Library with Restorations and Corrections (Jerusalem: Academy of the Hebrew Language, 2001), 399. 66. B. H . ul. 77b. Cf. b. Šabb. 67a. 67. On this issue in Assyriology, see Eleanor Robson, “Mesopotamian Medicine and Religion: Current Debates, New Perspectives,” Religion Compass 2 (2008): 455–83, esp. 460–61. 68. Adrian Wilson, “On the History of Disease-Concepts: The Case of Pleurisy,” History of Science 38 (2000): 271–319, esp. 275. 69. See E. V. Hulse, “The Nature of Biblical ‘Leprosy’ and the Use of Alternative Medical Terms in Modern Translations of the Bible,” Palestine Exploration Quarterly 107 (1975): 87–105, esp. 91. 70. For but one example, in b. Šabb. 134a: just after Abaye quotes his mother regarding when it is safe to circumcise a newborn who is pale or red, Rabbi Nathan says that circumcision should wait until the baby regains color. This advice has sparked debates regarding the correct identification of the illness, ranging from anemia to neonatal thrombocytopenic purpura to jaundice; see Fred Rosner, “Hemophilia in Classic Rabbinic Texts,” Journal of the History of Medicine and Allied Sciences 49 (1994): 240–50, esp. 243. 71. See Neil H. Metcalfe, “A Description of the Methods Used to Obtain Information on Ancient Disease and Medicine and of How the Evidence Has Survived,” Postgraduate Medical Journal 83 (2007): 655–58. For an article that uses interdisciplinary approaches toward ancient Israel, see Joseph Zias, “Death and Disease in Ancient Israel,” Biblical Archaeologist 54 (1991): 147–59. As a model for what can be done, the
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Justinianic Plague has been studied from multiple angles, including using epidemiological models; see, e.g., Merle Eisenberg and Lee Mordechai, “The Justinianic Plague: An Interdisciplinary Review,” Byzantine and Modern Greek Studies 43 (2019): 156–80, and Lauren A. White and Lee Mordechai, “Modeling the Justinianic Plague: Comparing Hypothesized Transmission Routes,” PLOS ONE 15 (2020), www.doi.org/10.1371 /journal.pone.0231256. 72. For relevant studies on diseases in the Sasanian era, see St John Simpson and Theya Molleson, “Old Bones Overturned: New Evidence for Funerary Practices from the Sasanian Empire,” in Regarding the Dead: Human Remains in the British Museum, ed. Alexandra Fletcher, Daniel Antoine, and J. D. Hill (London: British Museum Press, 2014), 77–90, esp. 83, where hand bones from a stone ossuary from Liyan “display a systemic wasting condition, possibly rheumatoid arthritis” and thick cranial bones are “possibly due to anaemia or other nutritional deficiencies.” See also Arkadiusz Sołtysiak, “Paleopathology in Mesopotamia. A Short Overview,” Światowit 51 (2012): 91–108, esp. 94–95. Osteoarchaeology can provide background information for diseases mentioned in the Talmud, such as scurvy (see Paul Mogle and Joseph Zias, “Trephination as a Possible Treatment for Scurvy in a Middle Bronze Age [ca. 2200 BC] Skeleton,” International Journal of Osteoarchaeology 5 [1995]: 77–81, esp. 79–80), as well as for ailments in existence in Israel like arthritis (see Joseph Zias and Piers Mitchell, “Psoriatic Arthritis in a Fifth-Century Judean Desert Monastery,” American Journal of Physical Anthropology 101 [1996]: 491–502) and leprosy (see A. Rafi, M. Spigelman, J. Stanford, E. Lemma, H. Donoghue, and J. Zias, “DNA of Mycobacterium leprae Detected by PCR in Ancient Bone,” International Journal of Osteoarchaeology 4 [1994]: 287–90). Objects like combs with lice can also shed light on ancient diseases (see Kosta Y. Mumcuoglu, Joseph Zias, Mark Tarshis, M. Lavi, and Guy D. Stiebel, “Body Louse Remains Found in Textiles Excavated at Masada, Israel,” Journal of Medical Entomology 40 [2003]: 585–87, esp. 586 on Talmudic references). 73. On this, see Max Sussman, “Diseases in the Bible and the Talmud,” in Diseases in Antiquity: A Survey of the Diseases, Injuries and Surgery of Early Populations, ed. Don Brothwell and A. T. Sandison (Springfield, IL: Charles C. Thomas, 1967), 209–21, esp. 210–11. The author rightly mentions b. Git.. 56b’s description of the death of Titus caused by a gnat in his brain as a cautionary example of misreading legends as a basis of medical facts. 74. Nils P. Heeβel, “Reading and Interpreting Medical Cuneiform Texts— Methods and Problems,” Journal des médicines cunéiformes 3 (2004): 2–9, esp. 6. This problem has been known for a long time; see, e.g., Hans Zinsser, Rats, Lice, and History: Being a Study in Biography, Which, after Twelve Preliminary Chapters Indispensable for the Preparation of the Lay Reader, Deals with the Life History of Typhus Fever (London: Routledge, 1935), 106. More recently, see Jon Arrizabalaga, “Problematizing Retrospective Diagnosis in the History of Disease,” Asclepio 54 (2002): 51–70. 75. On some of these topics, see Cheryl Lyn Dybas, “Evolutionary Biology and Human Health,” BioScience 57 (2007): 729–34; David P. Clark, Germs, Genes, and Civilization: How Epidemics Shaped Who We Are Today (Upper Saddle River, NJ:
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Pearson Education, 2010); and Dietmar Steverding, “The Spreading of Parasites by Human Migratory Activities,” Virulence 11 (2020): 1177–91. 76. See T. Aidan Cockburn, “Infectious Diseases in Ancient Populations,” Current Anthropology 12 (1971): 45–62. 77. See Amots Dafni and Barbara Böck, “Medicinal Plants of the Bible—Revisited,” Journal of Ethnobiology and Ethnomedicine 15, no. 57 (2019): 1–14, esp. 3–4, for a list of problems in identifying biblical plants. Most of these issues are equally relevant for Talmudic plants. 78. See Efraim Lev and Zohar Amar, Practical Materia Medica of the Medieval Eastern Mediterranean According to the Cairo Genizah (Boston: Brill, 2008), 411–12. For another study of materia medica in the Cairo Genizah, see Lev and Amar, “Reconstruction of the Inventory of Materia Medica Used by Members of the Jewish Community of Medieval Cairo According to Prescriptions Found in the Taylor-Schechter Genizah Collection, Cambridge,” Journal of Ethnopharmacology 108 (2006): 428–44. 79. On the recognized medicinal properties of eruca sativa today, see Noor S. Jaafar and Iman S. Jaafar, “Eruca Sativa Linn.: Pharmacognostical and Pharmacological Properties and Pharmaceutical Preparations,” Asian Journal of Pharmaceutical and Clinical Research 12 (2019): 39–45. John M. Riddle calculates that around 90 percent of the 257 drugs in the Hippocrates Corpus are still in use; see Riddle, “Folk Tradition and Folk Medicine: Recognition of Drugs in Classical Antiquity,” in Folklore and Folk Medicines, ed. John Scarborough (Madison, WI: American Institute of the History of Pharmacy, 1987), 33–61, esp. 37. 80. See Avraham Steinberg, Encyclopedia of Jewish Medical Ethics, transl. Fred Rosner (New York: Feldheim Publishers, 2003), 141–50, and, for a list of other publications on this topic, see Edward Reichman, “Is There Life after Life? Superfetation in Medical, Historical, and Rabbinic Literature,” in And You Shall Surely Heal: The Albert Einstein College of Medicine Synagogue Compendium of Torah and Medicine, ed. Jonathan Wiesen, 39–55 (Jersey City: Yeshiva University Press, distr. by KTAV, 2009), 54 n. 29. 81. Translated in Yehudah Levi, The Science in Torah: The Scientific Knowledge of the Talmudic Sages (New York: Feldheim Publishers, 2004), 120. 82. Translated in Simhah Friedman, “EMUNAT HAKHAMIM: Faith in the Sages,” Tradition: A Journal of Orthodox Jewish Thought 27 (1993): 10–34, esp. 27. 83. See Raphael Isaacs, “Hematology in the Bible and Talmud 1430 B.C. to 500 A.D.,” Medical Leaves 1 (1937): 76–80, esp. 77–78; Rosner, “Hemophilia,” 249; and Samuel S. Kottek, “Medical Interest in Ancient Rabbinic Literature,” in The Literature of the Sages, pt. 2, Midrash and Targum, Liturgy, Poetry, Mysticism, Contracts, Inscriptions, Ancient Science, and the Languages of Rabbinic Literature, ed. Shmuel Safrai, Zeev Safrai, Joshua Schwartz, and Peter J. Tomson (Assen: Royal Van Gorcum and Fortress Press, 2006), 485–96, esp. 490–92. 84. See G. I. C. Ingram, “The History of Haemophilia,” Journal of Clinical Pathology 29 (1976): 469–79, esp. 469, and Daniel Eisenberg, “Hemophilia and Circumcision— From Observation to Classification: Connecting a Talmudic Presumption to a Modern Diagnosis,” Assia: Jewish Medical Ethics and Halacha 8 (2016): 30–39, esp. 32 and n. 14.
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85. See Ohr Margalit and Chariklia Tziraki-Segal, “Circumcision: Man’s Obligation and Woman’s Praxis,” Nashim: A Journal of Jewish Women’s Studies and Gender Issues 12 (2006): 10–38. 86. The root “to be loose, soft, weak” (DJBA 1091–92) is attested in other medical texts: one relates to the procedure by which one’s skull is made “soft” in preparation for ra’atan surgery, while another says that vinegar “loosens” teeth (see b. Ketub. 77b and b. Šabb. 111a, respectively). This shows how the same terms or roots can take on slightly different meanings in different medical contexts. Bavli Yebamot 64b’s terms (“to be weak” and “to constrict, contract” [DJBA 1023–24]) are also diametrically opposed in a remedy for constipation in b. Šabb. 110a: “[if] he is constricted [i.e., constipated], [the three ingredients will] loosen his [bowels; if] he has loose bowels, [they will] constrict him.” This helps to demonstrate the unity of medical discourse across passages. 87. B. Yebam. 64b. 88. See D. Eisenberg, “Hemophilia and Circumcision,” 32. Circumcising newborns with bleeding disorders is still a problem in medicine today. See Vilmarie Rodriguez, Ruetima Titapiwatanakun, Christopher Moir, K. A. Schmidt, and Rajiv K. Pruthi, “To Circumcise or Not to Circumcise? Circumcision in Patients with Bleeding Disorders,” Haemophilia 16 (2010): 272–76. 89. Kottek, “Medical Interest,” 492. 90. See the publications of Ford and Bhayro cited in the bibliography. 91. Already in 1933, Benjamin Lee Gordon, “Ophthalmology in the Bible and in the Talmud,” Archives of Ophthalmology 9 (1933): 751–88, esp. 757, explained the value of comparative linguistics. On eye diseases, see James Nathan Ford, “Two Syriac Terms Relating to Ophthalmology and Their Cognates,” Journal of Semitic Studies 47 (2002): 23–38. 92. On eye ailments, of which there are at least a dozen, see B. Gordon, “Ophthalmology,” and, on the medicines and therapies used to treat them, see Rivka Ulmer, The Evil Eye in the Bible and in Rabbinic Literature (Hoboken, NJ: KTAV, 1994), 183–90. On fevers and skin diseases, see below. 93. See Marten Stol, “Fevers in Babylonia,” in Disease in Babylonia, ed. Irving L. Finkel and Markham J. Geller (Boston: Brill, 2007), 1–39; JoAnn Scurlock, Sourcebook for Ancient Mesopotamian Medicine (Atlanta: Society of Biblical Literature Press, 2014), 407–28; and András Bácskay, “The Natural and Supernatural Aspects of Fever in Mesopotamian Medical Texts,” in Demons and Illness from Antiquity to the EarlyModern Period, ed. Siam Bhayro and Catherine Rider (Boston: Brill, 2017), 39–52. 94. See DJBA 126 and 1136, and the glossary at the end of this book. Terms for fevers also exist outside of rabbinic literature. See David Lincicum, “Greek Deuteronomy’s ‘Fever and Chills’ and Their Magical Afterlife,” Vetus Testamentum 58 (2008): 544–49. For references to fevers in the bowls, see James Nathan Ford, “A New Parallel to the Jewish Babylonian Aramaic Magic Bowl IM 76106 (Nippur II N 78),” Aramaic Studies 9 (2011): 249–77, esp. 272–75, with notes on some Syriac and Talmudic correspondences.
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95. Irina Wandrey, “Fever and Malaria ‘For Real’ or as a Magical-Literary Topos?,” in Jewish Studies between the Disciplines / Judaistik zwischen den Disziplinen: Papers in Honor of Peter Schäfer on the Occasion of His Sixtieth Birthday, ed. Klaus Herrmann, Margarete Schlüter, and Giuseppe Veltri (Boston: Brill, 2003), 257–66, esp. 260. 96. Ernest G. Clarke, Targum Pseudo-Jonathan: Deuteronomy (Collegeville, MN: Liturgical Press, 1998), 76. It is possible that the second term means “anguish/pain of the heart” or even something else. 97. On this debate, see Moshe J. Bernstein, “The Aramaic Versions of Deuteronomy 32: A Study in Comparative Targumic Theology,” in Targum and Scripture: Studies in Aramaic Translation and Interpretation in Memory of Ernest G. Clarke, ed. Paul V. M. Flesher (Boston: Brill, 2002), 29–52, esp. 48 n. 46. The Targum is often thought to have anti-Islamic polemics, suggesting a late date. 98. See MS Vatican 130 and DJBA 806, s.v. “fennel.” On fennel as a curative plant, see Andrew Dalby, Food in the Ancient World from A to Z (New York: Routledge, 2003), 142. 99. B. Git.. 67b. 100. See Julia Benedetti, “Description of Skin Lesions,” in Merck Manual: Professional Version (Kenilworth, NJ: Merck Sharp and Dohme Corp., 2018). On dermatology in ancient Judaism, see Samuel S. Kottek, “Medicine in Ancient Hebrew and Jewish Cultures,” in Medicine across Cultures: History and Practice of Medicine in NonWestern Cultures, ed. Helaine Selin (New York: Kluwer, 2003), 305–24, esp. 317–18. 101. Cf. Samuel S. Kottek, “Remarks on Talmudic Medical Terminology,” Korot 9 (1989): 650–63, esp. 652: “this is a case of furuncle, a forerunner of a spreading furunculosis, and a risk of septicemia (i.e. ishta).” 102. MS Paris 1337: “Rav.” 103. B. ‘Abod. Zar. 28a. 104. See Joshua O. Leibowitz, “Traumatic(?) Paraplegia as Reported in the Talmud,” Medical History 4 (1960): 350–51; DJBA 1132, s.v. “a malady”; and DJBA 191. 105. See Fred Rosner, “Bloodletting in Talmudic Times,” Bulletin of the New York Academy of Medicine 62 (1986): 935–46, esp. 945. 106. For one example, see b. B. Qam. 35a, on a clever ox with a bite on its back, which, as Beth A. Berkowitz, Animals and Animality in the Babylonian Talmud (New York: Cambridge University Press, 2018), 58 n. 72, notes, shares language (regarding “rolling in ash”) with b. Git.. 69a’s remedy for a nosebleed.
chapter 3. precursors of talmudic medicine 1. The bibliography on medicine in the Bible and related literatures is even more extensive than the one on Talmudic medicine. For samples, see Paul Humbert, “Maladie et médecine dans l’Ancien Testament,” Revue d’histoire et de philosophie religieuses 44 (1964): 1–29; J. V. Kinnier Wilson, “Medicine in the Land and Times of the Old Testament,” in Studies in the Period of David and Solomon and Other Essays: Papers Read at the International Symposium for Biblical Studies, Tokyo, 5–7 December, 1979, ed.
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Tomoo Ishida (Winona Lake, IN: Eisenbrauns, 1982), 337–65; Larry P. Hogan, Healing in the Second Temple Period (Göttingen: Vandenhoeck and Ruprecht, 1992); and others cited below. Although lacking remedies for afflictions akin to the Talmudic therapies, the Bible contains many texts about sickness and health, as well as technical knowledge about the body, diseases, skin afflictions, and anatomy. Some Psalms also discuss suffering and redemption in light of illness, such as Psalm 91, which b. Šebu. 15b calls a song of affliction that removed harmful spirits or ailments (see Hogan, Healing, 162–63, and Joseph Naveh, “Fragments of an Aramaic Magic Book from Qumran,” Israel Exploration Journal 48 [1998]: 252–61, esp. 253). With respect to pharmaceuticals, the Bible refers to only around five species of medicinal plants, according to Amots Dafni and Barbara Böck, “Medicinal Plants of the Bible—Revisited,” Journal of Ethnobiology and Ethnomedicine 15, no. 57 (2019): 1–14, esp. 4–5 and table 1. For a few examples, see Jeremiah 8:22 and 46:11, which mention a “balm of Gilead” for wounds, and 2 Kings 20:7, where a “cake of figs” is used as a poultice for King Hezekiah’s rash. Illness is often mentioned in narratives about kings, as studied in Isabel Cranz, Royal Illness and Kingship Ideology in the Hebrew Bible (New York: Cambridge University Press, 2021). There are other relevant texts as well; e.g., some commentators interpret Deuteronomy 14:3–21 on dietary laws as health regulations, and texts from the liturgy can also be included. 2. Hogan, Healing, 24. 3. See Jonathan Klawans, “Concepts of Purity in the Bible,” in The Jewish Study Bible, ed. Adele Berlin and Marc Zvi Brettler (New York: Oxford University Press, 2004), 2041–47, esp. 2043, who notes that only some, not all, diseases were thought to defile. See also Mira Balberg, Purity, Body, and Self in Early Rabbinic Literature (Berkeley: University of California Press, 2014), esp. 20–27. 4. See Mira Balberg, “Rabbinic Authority, Medical Rhetoric, and Body Hermeneutics in Mishnah Nega‘im,” Association for Jewish Studies Review 35 (2011): 323–46, including the review of other scholarship on 324–25 nn. 12–14. 5. The same is true of the Talmudic dreambook in b. Ber. 55a–57b, according to Philip S. Alexander, “Enoch and the Beginnings of Jewish Interest in Natural Science,” in The Wisdom Texts from Qumran and the Development of Sapiential Thought, ed. Charlotte Hempel, Armin Lange, and Hermann Lichtenberger (Leuven: Leuven University Press, 2002), 223–44, esp. 227. 6. See Maurice Bear Gordon, “Medicine among the Ancient Hebrews,” Isis 33 (1941): 454–85, esp. 456–58; Hogan, Healing, 15–16, 25, and 301; Nigel Allan, “The Physician in Ancient Israel: His Status and Function,” Medical History 45 (2001): 377–94, esp. 377–78; and Loren T. Stuckenbruck, “The Book of Tobit and the Problem of ‘Magic,’ ” in Jüdische Schriften in ihrem antik-jüdischen und urchristlichen Kontext, ed. Hermann Lichtenberger and Gerbern S. Oegema (Gütersloh: Gütersloher, 2002), 258–69, esp. 259 n. 4, with a list of texts, such as the curse for disobedience in Deuteronomy 28:15–68 and Miriam’s leprosy in Numbers 12. For a more skeptical outlook regarding the assumption that God damns sinners with sickness, see Samuel S. Kottek, “Concepts of Disease in the Talmud,” Korot 9 (1985): 7–33, esp. 8–11.
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7. B. Ned. 41a. 8. See y. Ber. 2:2 (4c). 9. Such divisions are old ones. See, e.g., W. H. R. Rivers, Medicine, Magic and Religion: The Fitzpatrick Lectures Delivered before the Royal College of Physicians of London in 1915 and 1916 (New York: Kegan Paul, Trench and Trübner, 1924), 7–12, and Joshua Trachtenberg, Jewish Magic and Superstition: A Study in Folk Religion (New York: Behrman’s Jewish Book House, 1939), 154–55. On etiologies in the Talmud, see Solomon R. Kagan, “The Causes of Diseases According to the Talmud,” Jewish Advocate, September 12, 1929, B7, and “Talmudic Medicine,” Medical Leaves 3 (1940): 164–73, esp. 166–70, as well as K. Codell Carter, “Causes of Disease and Death in the Babylonian Talmud,” Medizinhistorisches Journal 26 (1991): 94–104. On natural, environmental, and pathological explanations of disease in Rabbinic Judaism, see Shaul G. Massry, Miroslaw Smogorzewski, Elizur Hazani, and Shaul M. Shasha, “Influence of Judaism and Jewish Physicians on Greek and Byzantine Medicine and Their Contribution to Nephrology,” American Journal of Nephrology 17 (1997): 233–40, esp. 236–37. 10. See Yaakov Elman, “The World of the ‘Sabboraim’: Cultural Aspects of PostRedactional Additions to the Bavli,” in Creation and Composition: The Contribution of the Bavli Redactors (Stammaim) to the Aggada, ed. Jeffrey L. Rubenstein (Tübingen: Mohr Siebeck, 2005), 383–415, esp. 409–11. 11. See Daniel Sinclair, “The Obligation to Heal and Patient Autonomy in Jewish Law,” Journal of Law and Religion 13 (1998–99): 351–77, esp. 353–54. 12. See Plinio Prioreschi, A History of Medicine, vol. 3, Roman Medicine, 3rd ed. (Omaha: Horatius Press, 2001), 664–65 and 694–95, who explains the shift as the influence of Hellenism and a religious crisis caused by the destruction of the Second Temple. 13. B. Šabb. 77b. Some witnesses reverse the order of the colors in the last line. 14. Y. Ber. 9:2 (13c). See Yaacov Sussmann, ed., Talmud Yerushalmi According to Ms. Or. 4720 (Scal. 3) of the Leiden University Library with Restorations and Corrections (Jerusalem: Academy of the Hebrew Language, 2001), 70, and transl. in Lennart Lehmhaus, “Beyond Dreckapotheke, between Facts and Feces: Talmudic Recipes and Therapies in Context,” in Collecting Recipes: Byzantine and Jewish Pharmacology in Dialogue, ed. Lennart Lehmhaus and Matteo Martelli (Boston: Walter de Gruyter, 2017), 221–54, esp. 223, with minor changes. 15. Lehmhaus, “Talmudic Recipes,” 224. 16. Wisdom of Ben Sira 38. The translation is taken from Harold W. Attridge, The HarperCollins Study Bible: New Revised Standard Version with the Apocryphal/Deuterocanonical Books (New York: HarperCollins Publishers, 2006), 1428–29. For more on this famous passage, see Allan, “Physician in Ancient Israel,” 387–92. 17. See Pieter W. van der Horst, “Early Jewish Knowledge of Greek Medicine,” in Strength to Strength: Essays in Honor of Shaye J. D. Cohen, ed. Michael L. Satlow (Providence: Brown Judaic Studies, 2018), 103–13. 18. See Jenny R. Labendz, “The Book of Ben Sira in Rabbinic Literature,” Association for Jewish Studies Review 30 (2006): 347–92.
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19. Catherine Hezser, “Representations of the Physician in Jewish Literature from Hellenistic and Roman Times,” in Popular Medicine in Graeco-Roman Antiquity: Explorations, ed. William V. Harris (Boston: Brill, 2016), 173–97, esp. 180. 20. See, e.g., Howard Clark Kee, “Medicine and Healing,” in The Anchor Bible Dictionary, vol. 4: K–N, ed. David Noel Freedman (New York: Doubleday, 1992), 659–64, esp. 661, and Stuckenbruck, “Book of Tobit,” 260–61. 21. See Allan, “Physician in Ancient Israel,” 381–85, and Stuckenbruck, “Book of Tobit.” 22. See Joan E. Taylor, “ ‘Roots, Remedies and Properties of Stones’: The Essenes, Qumran and Dead Sea Pharmacology,” Journal of Jewish Studies 60 (2009): 226–44, and cf. the opinion of Philip S. Alexander, “The Demonology of the Dead Sea Scrolls,” in The Dead Sea Scrolls after Fifty Years: A Comprehensive Assessment, vol. 2, ed. Peter W. Flint and James C. VanderKam (Boston: Brill, 1999), 331–53, esp. 347–48. 23. See Samuel S. Kottek, “The Essenes and Medicine: A Comparative Study of Medical and Para-Medical Items with Reference to Ancient Jewish Lore,” Clio Medica 18 (1983): 81–99, esp. 82. 24. See Joseph Naveh, “A Medical Document or a Writing Exercise? The So-Called 4Q Therapeia,” Israel Exploration Journal 36 (1986): 52–55, and Joseph M. Baumgarten, “The 4Q Zadokite Fragments on Skin Disease,” Journal of Jewish Studies 41 (1990): 153–65. 25. The descriptions of illness in Josephus may be more historically reliable than these other sources. See, e.g., his description of Herod’s health and illness, which one scholar believes “is entirely compatible with degenerative cardiorenal disease” (A. T. Sandison, “Degenerative Vascular Disease,” in Diseases in Antiquity: A Survey of the Diseases, Injuries and Surgery of Early Populations, ed. Don Brothwell and A. T. Sandison [Springfield, IL: Charles C. Thomas, 1967], 474–88, esp. 479). On parallels between Josephus and the Talmud, see Tal Ilan and Vered Noam, “Remnants of a Pharisaic Apologetic Source in Josephus and in the Babylonian Talmud,” in Tradition, Transmission, and Transformation from Second Temple Literature through Judaism and Christianity in Late Antiquity, ed. Menahem Kister, Hillel I. Newman, Michael Segal, and Ruth A. Clements (Boston: Brill, 2015), 112–33. As far as I can tell there are few parallels between these corpora on the topic of medicine, save for stories about someone pretending to be ill. Cf. Antiquities II and b. Sot.ah 36b, as described in Samuel S. Kottek, Medicine and Hygiene in the Works of Flavius Josephus (New York: Brill, 1994), 36. Josephus and the Talmud mention some of the same medicinal substances, but there is little reason to think that the rabbis learned of these from the writings of Josephus; see, e.g., the case of biblical mandrakes (see Gen. 30:14–16, where it is an aphrodisiac), the medicinal properties of which Josephus knew well, but the identification of which the rabbis debate in b. Sanh. 99b. On this case, see Samuel S. Kottek, “Medicinal Drugs in the Works of Flavius Josephus,” in The Healing Past: Pharmaceuticals in the Biblical and Rabbinic World, ed. Irene Jacob and Walter Jacob (New York: Brill, 1993), 95–105, esp. 102–3. 26. See the baraita in b. Ber. 10b and b. Pesah. . 56a, as well as David J. Halperin, “The Book of Remedies, the Canonization of the Solomonic Writings, and the Riddle of
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Pseudo-Eusebius,” Jewish Quarterly Review 72 (1982): 269–92, and Fred Rosner, “The Illness of King Hezekiah and ‘The Book of Remedies’ Which He Hid,” Korot 9 (1985): 190–97. According to Kottek, “Essenes and Medicine,” 84, some scholars believe that the Essenes had access to this book. 27. R. H. Charles, The Apocrypha and Pseudepigrapha of the Old Testament, vol. 2, Pseudepigrapha (Oxford: Clarendon Press, 1913, repr. Berkeley, CA: Apocryphile Press, 2004), 28. On this text, see Kee, “Medicine and Healing,” 661; Allan, “Physician in Ancient Israel,” 385–86; Stuckenbruck, “Book of Tobit,” 261–62; Hezser, “Representations,” 175–76; and Chontel Syfox, “Israel’s First Physician and Apothecary: Noah and the Origins of Medicine in the Book of Jubilees,” Journal for the Study of the Pseudepigrapha 28 (2018): 3–23. This attribution of the therapies being passed down from angels to Noah, which he records in a book, is also attested in Asaph’s Book of Remedies (see chapter 4). 28. See van der Horst, “Early Jewish Knowledge of Greek Medicine,” 103–4, on the understanding of this text in the Septuagint and Josephus, which emphasize the role of doctors. 29. B. Ber. 60a. Cf. b. B. Qam. 85a. On these texts, see Fred Rosner, “Who Heals the Sick—God or Man?,” Tradition: A Journal of Orthodox Jewish Thought 12 (1971): 55–68, esp. 58–59; Sinclair, “Obligation to Heal,” 351–52; and Allan, “Physician in Ancient Israel,” 379–80. 30. See Samuel S. Kottek, “Medical Practice and Jewish Law: Nah. manides’ Sefer Torat Haadam,” in Medicine and Medical Ethics in Medieval and Early Modern Spain: An Intercultural Approach, ed. Samuel S. Kottek and Luis García-Ballester (Jerusalem: Magnes Press, 1996), 163–72, esp. 166–68 and n. 17. But cf. the contrary view of Nah. manides on Leviticus 26:11 (described on 167–68). 31. See Aryeh Leibowitz, “Doctors and Medical Knowledge in Tosafist Circles,” Tradition: A Journal of Orthodox Jewish Thought 42 (2009): 19–34, esp. 23–25, with transl. on 23–24. 32. On debates over these ideas among medieval and modern authorities, see Benjamin Gesundheit, “ ‘Permission Given to a Doctor to Heal’—Across the Generations and in the Thought of Rav Avraham Yitzchak Ha-Kohen Kook,” Verapo Yerape: The Journal of Torah and Medicine of the Albert Einstein College of Medicine Synagogue 2 (2010): 55–96. 33. See DJBA 821, which defines it as a “red-colored heart of Dracaena cinnabari used as a medication.” 34. B. B. Mes.i‘a 107b (MS Hamburg 165). See Kottek, “Concepts of Disease”; Rivka Ulmer, The Evil Eye in the Bible and in Rabbinic Literature (Hoboken, NJ: KTAV, 1994), 24–27; and Richard Kalmin, “The Evil Eye in Rabbinic Literature of Late Antiquity,” in Judaea-Palaestina, Babylon and Rome: Jews in Antiquity, ed. Benjamin Isaac and Yuval Shahar (Tübingen: Mohr Siebeck, 2012), 111–38, esp. 117–18. 35. On this manuscript, see Menachem Katz, Asael Shmeltzer, Hillel Gershuni, and Sarah Prais, “The Complete Manuscripts of the Babylonian Talmud,” Introduction: The Friedberg Project for Talmud Bavli Variants (Version 2, 2019), 35.
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36. Y. Šabb. 14:3 (14c) (Sussmann, Talmud Yerushalmi, 433). Cf. Leviticus Rabbah 16:8. 37. B. Sanh. 48b (MS Jerusalem–Yad Harav Herzog 1). 38. See Fred Rosner, “Gout in the Bible and the Talmud,” Annals of Internal Medicine 86 (1977): 833; Samuel S. Kottek, “A Renewed Study of Several Medical Terms in the Talmud,” Proceedings of the World Congress of Jewish Studies 10, div. D, vol. 1, The Hebrew Language, Jewish Languages (Jerusalem: World Union of Jewish Studies, 1989), 45–52, esp. 48–49 (Hebrew), and “Sur l’origine gréco-latine de certains termes médicaux utilisés dans le Talmud et le Midrash,” in Le latin médical: La constitution d’un langage scientifique, ed. Guy Sabbah (Saint-Étienne: Publications de l’Université de Saint-Étienne, 1991), 41–52, esp. 49–52; and Markham J. Geller, Akkadian Healing Therapies in the Babylonian Talmud (Berlin: Max Planck Institute for the History of Science, 2004), 11. 39. Giuseppe Veltri, “The ‘Other’ Physicians: The Amorites of the Rabbis and the Magi of Pliny,” Korot 13 (1998–99): 37–54, esp. 52. 40. Some MSS add the conjunction de- here (see MS Vatican 130). 41. B. Git.. 69b. 42. W. H. S. Jones, “Ancient Roman Folk Medicine,” Journal of the History of Medicine and Allied Sciences 12 (1957): 459–72, esp. 465. See also Pieter W. van der Horst, Japheth in the Tents of Shem: Studies on Jewish Hellenism in Antiquity (Leuven: Peeters, 2002), 27, who quotes an early-fifth-century tradition, reported by a Christian doctor in Gaul named Marcellus Empiricus, regarding a rabbinic remedy for the spleen: “For the spleen there is a special remedy which was recently demonstrated by the patriarch Gamaliel on the basis of approved experiments.” This rare piece of external evidence corroborates that the rabbis were known as medical specialists by nonJews. 43. For example, see t. Šabb. 12:12 and 15:4 and the discussion in b. Šabb. 134b. For the use of honey to treat a scab, see m. Šabb. 8:1 and b. Šabb. 77b. 44. See Noori S. Al-Waili, Khelod Salom, and Ahmad A. Al-Ghamdi, “Honey for Wound Healing, Ulcers, and Burns; Data Supporting Its Use in Clinical Practice,” Scientific World Journal 11 (2011): 766–87. 45. B. Yoma 83a. 46. See David Novak, The Election of Israel: The Idea of the Chosen People (New York: Cambridge University Press, 1995), 140–42. This passage is frequently discussed by medical ethicists; see, e.g., Zackary Berger and Joshua Cahan, “Patient Autonomy in Talmudic Context: The Patient’s ‘I Must Eat’ on Yom Kippur in the Light of Contemporary Bioethics,” Journal of Religion and Health 55 (2016): 1778–85. See also Lieve Teugels, “ ‘Whoever Saves a Soul Saves an Entire World’: Pikuah Nefesh in Rabbinic Literature,” in Religion and Illness, ed. Annette Weissenrieder and Gregor Etzelmüller (Eugene, OR: Cascade Books, 2016), 235–60, esp. 243–44. On the question of patient autonomy from a legal perspective, see Ayelet Hoffmann Libson, “ ‘The Heart Knows Its Own Bitterness’: Authority, Self, and the Origins of Patient Autonomy in Early Jewish Law,” Americal Journal of Legal History 56 (2016): 303–26.
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47. Y. Yoma 8:5 (45a–b) (see Sussmann, Talmud Yerushalmi, 598), transl. in Hezser, “Representations,” 185, with minor changes. 48. B. B. Mes.i‘a 78b. See Geller, Akkadian Healing Therapies, 13 nn. 41–42. 49. See, e.g., b. Tem. 15b, where doctors have a pious man with a heart problem drink goat’s milk from its udder. Bavli Ketubbot 74b discusses a case of a vow when a man betroths a woman with a physical defect, and the latter is healed by a doctor. 50. See Markham J. Geller, “Diet and Regimen in the Babylonian Talmud,” in Food and Identity in the Ancient World, ed. Cristiano Grottanelli and Lucio Milano (Padua: S.A.R.G.O.N., 2004), 217–42, esp. 224–31. For other examples analyzed by Geller, see also b. ‘Erub. 55b–56a and b. Pesah. . 42a. On Jewish physicians in the Roman context, see van der Horst, Japheth in the Tents of Shem, 32. 51. B. B. Qam. 82a. 52. See Efraim Lev and Zohar Amar, Practical Materia Medica of the Medieval Eastern Mediterranean According to the Cairo Genizah (Boston: Brill, 2008), 412. 53. B. ‘Abod. Zar. 29a. 54. B. ‘Erub. 28b–29a (MS Oxford Opp. Add. fol. 23). 55. B. Ber. 44b. 56. See, e.g., m. Parah 11:6–9 and 12:1–6. On the identifications of this plant, see Alfred C. Andrews, “Hyssop in the Classical Era,” Classical Philology 56 (1961): 230–48, and Lehmhaus, “Talmudic Recipes,” 232–38, for a philological analysis of hyssop and related terms. 57. Alexander Fleisher and Zhenia Fleisher, “Identification of Biblical Hyssop and Origin of the Traditional Use of Oregano-Group Herbs in the Mediterranean Region,” Economic Botany 42 (1988): 232–41, esp. 239. 58. See K. Husnu Can Baser, “Biological and Pharmacological Activities of Carvacrol and Carvacrol Bearing Essential Oils,” Current Pharmaceutical Design 14 (2008): 3106–19. 59. See Zohar Amar, “Medicinal Substances in Eretz-Israel in the Times of the Bible, the Mishnah and the Talmud in Light of Written Sources,” in Illness and Healing in Ancient Times, ed. Ofra Rimon (Haifa: Hecht Museum, University of Haifa Press, 1996), 52–61, esp. 54. 60. B. Šabb. 109b. 61. See DJBA 705 and Davoud Monchi-Zadeh, “Xusrōv i Kavātān ut Rētak: Pahlavi Text, Transcription and Translation,” in Monumentum Georg Morgenstierne, vol. 2 (Leiden: Brill, 1982), 47–91, esp. 80, line 81. 62. Some witnesses do not mention water here. 63. B. Šabb. 109b. The text goes on to present three additional therapies for curing fluke worms—swallowing white cress, sucking on a meat bone while fasting, and drinking a potion made from the scrapings of a dilmun date. 64. See DJBA 889. The sister text in y. Šabb. 14:3 (14c) identifies it as polytrichon, which is probably a Greek plant (see Lehmhaus, “Talmudic Recipes,” 233–35). 65. For more on worms in the Talmud, see Benjamin Lee Gordon, Medicine throughout Antiquity (Philadelphia: F. A. Davis, 1949), 753–54.
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66. B. Šabb. 90a. MS Munich 95 attributes the first tradition to Rav Yosef. 67. See, e.g., Christine Hayes, Between the Babylonian and Palestinian Talmuds: Accounting for Halakhic Difference in Selected Sugyot from Tractate Avodah Zarah (New York: Oxford University Press, 1997). 68. Geller, Akkadian Healing Therapies, 4. 69. On the lack of magic, see Hezser, “Representations,” 174. 70. Y. Šabb. 14:4 (14d) (Sussmann, Talmud Yerushalmi, 434). 71. See y. Šeb. 3:4 (34c) (Sussmann, Talmud Yerushalmi, 187). 72. See DJPA 546. 73. Y. Šabb. 14:4 (14d) (Sussmann, Talmud Yerushalmi, 434). On cress, see Fred Rosner, Encyclopedia of Medicine in the Bible and the Talmud (Northvale, NJ: Jason Aronson, 2000), 87, and Lehmhaus, “Talmudic Recipes,” 229–30. 74. Y. Ber. 5:2 (9b) (Sussmann, Talmud Yerushalmi, 45). 75. See Kottek, “Renewed Study,” 49, and Lehmhaus, “Talmudic Recipes,” 241. 76. Lehmhaus, “Talmudic Recipes,” 242. 77. On this point, see Tal Ilan, “Review: Giuseppe Veltri, Magie und Halakha: Ansätze zu einem empirischen Wissenschaftsbegriff im spätantiken und frühmittelalterlichen Judentum. Tübingen: Mohr Siebeck, 1997,” Scripta Classica Israelica 17 (1998): 257–62, esp. 260, and Silencing the Queen, 169. 78. Y. Šabb. 14:4 (14d) (see Sussmann, Talmud Yerushalmi, 434), transl. based on Tal Ilan, Silencing the Queen: The Literary Histories of Shelamzion and Other Jewish Women (Tübingen: Mohr Siebeck, 2006), 168. 79. This is the reading of MS Paris 1337. 80. There are variants of these three rabbis’ names in the manuscripts of b. ‘Abod. Zar. 28a and b. Yoma 84a, but most of them read as rendered here. 81. B. ‘Abod. Zar. 28a ( = b. Yoma 84a), with a few changes based on the manuscripts.
chapter 4. empiricism and efficacy 1. Fred Rosner, transl. and ed., Julius Preuss’ Biblical and Talmudic Medicine (Northvale, NJ: Jason Aronson, 1993; orig. pub. 1978), 7. The author refers to folk medicine instead of magic, but these are essentially synonymous. For another older example of the division between folk medicine (or magic) versus scientific medicine, compare the two entries in The Jewish Encyclopedia: A Descriptive Record of the History, Religion, Literature, and Customs of the Jewish People from the Earliest Times to the Present Day, ed. Isidore Singer (New York: Funk and Wagnalls, 1901–06; online edition: www. jewishencyclopedia.com): Joseph Jacobs, “Folk-Medicine,” focuses on the magical rituals and amulets in b. Šabb. 61a and 66b–67a, whereas Solomon Schechter, C. D. Spivak, Joseph Jacobs, and Frederick T. Haneman, “Medicine,” covers pharmacology, anatomy, and surgery, from the Bible up to modern times. Folklorists have noted that folk medicine can include the use of herbal drugs and dietary rules alongside its focus on the supernatural (see David J. Hufford, “Medicine, Folk,” in Folklore: An Encyclopedia of Beliefs, Customs, Tales, Music, and Art, ed. Thomas A. Green [Santa
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Barbara: ABC-CLIO, 1997], 544–53, esp. 547). On this aspect of Talmudic medicine, see below. 2. Rosner, transl. and ed., Preuss’ Biblical and Talmudic Medicine, 7. 3. Philip S. Alexander, “Enoch and the Beginnings of Jewish Interest in Natural Science,” in The Wisdom Texts from Qumran and the Development of Sapiential Thought, ed. Charlotte Hempel, Armin Lange, and Hermann Lichtenberger (Leuven: Leuven University Press, 2002), 223–44, esp. 224. On 226–29, the author goes on to claim, as I do, that the rabbis were interested in understanding the principles of nature, via the study of medicine, as well as dreams, alchemy, cosmology, and other sciences. 4. On this, see, e.g., Saul Lieberman, Hellenism in Jewish Palestine: Studies in the Literary Transmission, Beliefs and Manners of Palestine in the I Century B.C.E.–IV Century C.E., 2nd ed. (New York: Jewish Theological Seminary of America, 1962), 180–83. 5. See Giuseppe Veltri, “On the Influence of ‘Greek Wisdom’: Theoretical and Empirical Sciences in Rabbinic Judaism,” Jewish Studies Quarterly 5 (1998): 300–317, esp. 302 n. 7 and 308–13, and A Mirror of Rabbinic Hermeneutics: Studies in Religion, Magic, and Language Theory in Ancient Judaism (Boston: Walter de Gruyter, 2015), 106–10. Others have characterized Talmudic medicine in this way too; see, e.g., David M. Feldman, Health and Medicine in the Jewish Tradition: L’Hayyim—To Life (New York: Crossroad Publishing Company, 1986), 36, and the discussion in Mădălina Vârtejanu-Joubert, “The Right Type of Knowledge: Theory and Experience in Two Passages of the Babylonian Talmud,” Korot 19 (2007–8): 161–80. 6. For a skeptical view, see Jacob Neusner, “Why No Science in Judaism?,” Shofar 6 (1988): 45–71. More recently, see Menachem Fisch, Rational Rabbis: Science and Talmudic Culture (Bloomington: Indiana University Press, 1997); Mladen Popović, Reading the Human Body: Physiognomics and Astrology in the Dead Sea Scrolls and Hellenistic–Early Roman Period Judaism (Boston: Brill, 2007); Annette Yoshiko Reed, “Was There Science in Ancient Judaism? Historical and Cross-Cultural Reflections on ‘Religion’ and ‘Science,’ ” Studies in Religion/Sciences Religieuses 36 (2007): 461–95; Jonathan Ben-Dov, Head of All Years: Astronomy and Calendars at Qumran in Their Ancient Context (Boston: Brill, 2008); and Jonathan Ben-Dov and Seth L. Sanders, eds., Ancient Jewish Sciences and the History of Knowledge in Second Temple Literature (New York: New York University Press and Institute for the Study of the Ancient World, 2014). 7. See Veltri, “Theoretical and Empirical Sciences,” 300–302, and P. Alexander, “Enoch,” 225–30. 8. On these works, see Y. Tzvi Langermann, “On the Beginnings of Hebrew Scientific Literature and on Studying History through ‘Maqbilot’ (Parallels),” Aleph: Historical Studies in Science and Judaism 2 (2002): 169–89, and “Science in the Jewish Communities,” in The Cambridge History of Science, vol. 2, Medieval Science, ed. David C. Lindberg and Michael H. Shank (New York: Cambridge University Press, 2013), 168–89, esp. 169–71. The dates of some of these texts are not firm, and some may contain materials dating back to the early centuries of the common era.
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Notes to page 73 161
9. On this date, see Annette Yoshiko Reed, “ ‘Ancient Jewish Sciences’ and the Historiography of Judaism,” in Ancient Jewish Sciences and the History of Knowledge in Second Temple Literature, ed. Jonathan Ben-Dov and Seth L. Sanders (New York: New York University Press and Institute for the Study of the Ancient World, 2014), 195–253, esp. 207. 10. For part of the text in the original language, see Aviv Melzer, “Asaph the Physician—the Man and His Book: A Historical-Philological Study of the Medical Treatise, The Book of Drugs” (PhD diss., University of Wisconsin, 1972). For Asaph’s adherence to religious commandments and the idea that God wounds and heals, see the famous “Oath of Asaph,” which is related to the Hippocratic oath, translated in Elinor Lieber, “The Covenant Which Asaf Son of Berakhyahu and Yoh. anan Son of Zebda Made with Their Pupils: Text and Translation,” in Memorial Volume in Honor of Prof. S. Muntner, ed. Joshua O. Leibowitz (Jerusalem: Israel Institute of the History of Medicine, 1983), 83–94. See also the study of the oath by Shlomo Pines, “The Oath of Asaph the Physician and Yoh. anan ben Zabda: Its Relation to the Hippocratic Oath and the Doctrina Duarum Viarum of the Didachē,” Proceedings of the Israel Academy of Sciences and Humanities 5 (1971–76): 223–64. On Hippocratic influences, mixed with biblical allusions and ideas, see Elinor Lieber, “Asaf’s Book of Medicines: A Hebrew Encyclopedia of Greek and Jewish Medicine, Possibly Compiled in Byzantium on an Indian Model,” Dumbarton Oaks Papers 38 (1984): 233–49, esp. 238, where the author adds that the work contains no magic, and 243–44. 11. Lieber, “Hebrew Encyclopedia,” 233, also makes note of this. See also chapter 1. 12. Cf. Sussman Muntner, “The Antiquity of Asaph the Physician and His Editorship of the Earliest Hebrew Book of Medicine,” Bulletin of the History of Medicine 25 (1951): 101–31, esp. 104–5, who dates Asaph himself to sixth-century Tiberias and calls the work “a Jewish anthology of medical science with parts composed from the second up to the twelfth century” (105); and Elinor Lieber, “A Mediaeval Hebrew Presage of the Circulation of the Blood, Based on Biblical and Talmudic Concepts,” Korot 9 (1985): 157–63, esp. 158, who calls it “a pseudepigraphic work, probably compiled in Italy in the ninth or tenth century, although based on much earlier material.” See also Lieber, “Hebrew Encyclopedia,” 236–37, esp. on the tenth-century Jewish-Italian physician Donnolo’s borrowings from Asaph’s work, and an overview of past datings at 246 nn. 93–94. For other medieval authors’ references to Asaph’s book, see Rebecca Scharbach, “The Rebirth of a Book: Noachic Writing in Medieval and Renaissance Europe,” in Noah and His Book(s), ed. Michael E. Stone, Aryeh Amihay, and Vered Hillel (Boston: Brill, 2010), 113–33, esp. 114 n. 1. 13. See Samuel S. Kottek, “Medical Interest in Ancient Rabbinic Literature,” in The Literature of the Sages, pt. 2, Midrash and Targum, Liturgy, Poetry, Mysticism, Contracts, Inscriptions, Ancient Science, and the Languages of Rabbinic Literature, ed. Shmuel Safrai, Zeev Safrai, Joshua Schwartz, and Peter J. Tomson (Assen: Royal Van Gorcum and Fortress Press, 2006), 485–96, esp. 486, who calls Asaph a “Babylonian physician . . . who lived in the sixth or seventh century.” Supporting a Sasanian context, Ronit Yoeli-Tlalim, “Exploring Persian Lore in the Hebrew Book of Asaf,” Aleph: Historical
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Studies in Science and Judaism 18 (2018): 123–45, makes connections with Syriac and Persian. Despite all this, I have not seen much evidence that connects Asaph’s Book of Remedies and the Talmud. Norman Solomon, “From Folk Medicine to Bioethics in Judaism,” in Religion, Health and Suffering, ed. John R. Hinnells and Roy Porter (New York: Routledge, 2011), 166–86, esp. 169, agrees with this assessment; but Stephen T. Newmyer, “Asaph’s ‘Book of Remedies’: Greek Science and Jewish Apologetics,” Sudhoffs Archiv 76 (1992): 28–36, esp. 30–31, disagrees, and Efraim Lev and Zohar Amar, Practical Materia Medica of the Medieval Eastern Mediterranean According to the Cairo Genizah (Boston: Brill, 2008), 37, allude to some symmetry in language between the Bavli and Asaph’s work. The fact that the book is in Biblical Hebrew, not in Aramaic, according to Newmyer, “Asaph’s ‘Book of Remedies,’ ” 35–36, distances its ties to Sasanian Babylonia, at least linguistically. It is nevertheless likely that this is a pseudo-language from later times (see Lieber, “Hebrew Encyclopedia,” 246). 14. See Melzer, “Asaph the Physician,” 68–72. On 63–66 and 77–78, the author argues that Asaph may have worked in Jundishapur, home to centers of medical learning (see chapter 5 of the present volume). Compare the analysis by Marla Segol, Kabbalah and Sex Magic: A Mythical-Ritual Genealogy (University Park: Pennsylvania State University Press, 2021), 59. 15. Some have argued—unconvincingly in my view—that this figure is Asaph son of Berekiah, in 1 Chronicles 15:17’s description of King David’s installing of the Ark of the Covenant. As Lieber, Yoeli-Tlalim, and others have noted, the ascription to Asaph is probably pseudonymous, as proven by the existence of “an extensive Persian tradition that links a legendary figure by the name of Ās.af b. Barakhyā to knowledge” (YoeliTlalim, “Persian Lore,” 129–30 and nn. 19–20). 16. See Scharbach, “Noachic Writing,” 114–17. 17. Yoeli-Tlalim, “Persian Lore,” 128–29. See also Ariel Bar-Sela and Hebbel E. Hoff, “Asaf on Anatomy and Physiology,” Journal of the History of Medicine and Allied Sciences 20 (1965): 358–89. 18. As I mention in chapter 2, the study of rabbinic sciences flourished in the past before the lull mentioned above; see, e.g., William M. Feldman, Rabbinical Mathematics and Astronomy (London: M. L. Cailingold, 1931), and Solomon Gandz, “Studies in Hebrew Mathematics and Astronomy,” Proceedings of the American Academy for Jewish Research 9 (1938–39): 5–50. For more recent studies, see Markham J. Geller, “The Influence of Ancient Mesopotamia on Hellenistic Judaism,” in Civilizations of the Ancient Near East, vol. 4, ed. Jack M. Sasson (New York: Scribner’s Sons, 1995), 43–54, esp. 46–49; Boaz Tsaban and David Garber, “On the Rabbinical Approximation of π,” Historia Mathematica 25 (1998): 75–84; Abraham Ofir Shemesh, “Biology in Rabbinic Literature: Fact and Folklore,” in The Literature of the Sages, pt. 2, Midrash and Targum, Liturgy, Poetry, Mysticism, Contracts, Inscriptions, Ancient Science, and the Languages of Rabbinic Literature, ed. Shmuel Safrai, Zeev Safrai, Joshua Schwartz, and Peter J. Tomson (Assen: Royal Van Gorcum and Fortress Press, 2006), 509–19; and Andrea D. Lobel, “Under a Censored Sky: Astronomy and Rabbinic Authority in the Talmud Bavli and Related Literature” (PhD diss., Concordia University, 2015).
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19. Cf. Veltri, “Theoretical and Empirical Sciences,” 301: “Rabbinic Judaism contains the cultural premises which enabled the so-called Middle Ages to absorb ‘foreign’ knowledge and not to ignore or reject it outright just because of religious misgivings or even bans.” That said, when it came to integrating foreign medical knowledge into Jewish thought, medieval Jews were faced with a set of different considerations than the rabbis of late antiquity were; see Lola Ferre, “The Incorporation of Foreign Medical Literature into the Medieval Jewish Corpus,” in Late Medieval Jewish Identities: Iberia and Beyond, ed. Carmen Caballero-Navas and Esperanza Alfonso (New York: Palgrave Macmillan, 2010), 171–83. 20. On these three pillars, see Paul Tillich, “The Relation of Religion and Health: Historical Considerations and Theoretical Questions,” Review of Religion 10 (1946): 348–84, esp. 356–69. 21. On the use of animal products, see Efraim Lev, “Traditional Healing with Animals (Zootherapy): Medieval to Present-Day Levantine Practice,” Journal of Ethnopharmacology 85 (2003): 107–18, esp. 108 for rabbinic sources. 22. See MS Vatican 130 and DJBA 213–14. 23. B. Git.. 69a–b. The translation relies on relevant entries in DJBA. 24. The Encyclopædia Britannica: A Dictionary of Arts, Sciences, Literature and General Information, Eleventh Edition, Volume XXIV, Sainte-Claire Deville to Shuttle (New York: Cambridge University Press, 1911), 59. 25. Although dated, see the still useful article by H. E. Stapleton, “Sal-Ammoniac: A Study in Primitive Chemistry,” Memoirs of the Asiatic Society of Bengal 1 (1905): 25–42. In general, scholars have argued against the idea that the rabbis engaged in alchemy, on which see, e.g., the conclusions of Raphael Patai, The Jewish Alchemists: A History and Source Book (Princeton: Princeton University Press, 1994), 41–46. See b. Yoma 44b–45a as a case study into this question. 26. See Richard N. Frye, “Sasanian-Central Asian Trade Relations,” Bulletin of the Asia Institute 7 (1993): 73–77, esp. 75. See also the synopsis of past publications on this substance in Mircea Eliade, The Forge and the Crucible: The Origins and Structures of Alchemy, transl. Stephen Corrin, 2nd ed. (Chicago: University of Chicago Press, 1978), 216–17. 27. B. ‘Abod. Zar. 28b. See DJBA 85, s.v. “flock or wad (of wool, etc.).” 28. JoAnn Scurlock, Sourcebook for Ancient Mesopotamian Medicine (Atlanta: Society of Biblical Literature Press, 2014), 382. See also Robert D. Biggs, “Medicine, Surgery, and Public Health in Ancient Mesopotamia,” in Civilizations of the Ancient Near East, vol. 3, ed. Jack M. Sasson (New York: Scribner’s Sons, 1995), 1911–24, esp. 1915–16. 29. See b. Git.. 69b and b. ‘Abod. Zar. 28b. 30. On therapeutic baths, see Fred Rosner, Encyclopedia of Medicine in the Bible and the Talmud (Northvale, NJ: Jason Aronson, 2000), 42–43, and Estée Dvorjetski, Leisure, Pleasure and Healing: Spa Culture and Medicine in Ancient Eastern Mediterranean (Boston: Brill, 2007). On compresses, see below. 31. See b. Git.. 68b and b. Šabb. 65a.
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32. B. ‘Abod. Zar. 28b, based on MS Paris 1337. 33. The wrapping in cloth was presumably to heat up the body. For this reading, see DJBA 601–2 (mng. 4) and compare the remedy for jaundice in b. Šabb. 110b, where an Arab, after eating leeks, “wrapped himself up [in the garment] and slept in it” and became hot. 34. B. Git.. 70a. MS Vatican 130 does not include the first attribution to Abaye, and MS Munich 95 does not refer to Abaye’s mother, just Abaye. Some witnesses do not refer to hand-washing. For more on this text, see Markham J. Geller, “Diet and Regimen in the Babylonian Talmud,” in Food and Identity in the Ancient World, ed. Cristiano Grottanelli and Lucio Milano (Padua: S.A.R.G.O.N., 2004), 217–42, esp. 232–35. Cf. the parallel text in b. Ber. 32a, which alludes to Moses having been seized by ah. ilu. On the variants of the affliction “inflammation of the bones” in the Bavli and the bowls, see James Nathan Ford, “A New Parallel to the Jewish Babylonian Aramaic Magic Bowl IM 76106 (Nippur II N 78),” Aramaic Studies 9 (2011): 249–77, esp. 272–74. 35. See Rosner, Encyclopedia of Medicine, 190. 36. See b. Git.. 69a and b. Ketub. 77b. 37. Some manuscripts, including MS Vatican 130, do not refer to holding them in the mouth. 38. See DJBA 250. See Giuseppe Veltri, Magie und Halakha: Ansätze zu einem empirischen Wissenschaftsbegriff im spätantiken und frühmittelalterlichen Judentum (Tübingen: Mohr Siebeck, 1997), 243 n. 193. 39. See DJBA 806. 40. See DJBA 946, “to open, lance.” Cf. the similar usage in b. Sanh. 84b. 41. See DJBA 816 (mng. 13), with attestations in other medical texts. Cf. Veltri, Magie und Halakha, 244: “to remove.” 42. B. Git.. 69a. Cf. Markham J. Geller, “An Akkadian Vademecum in the Babylonian Talmud,” in From Athens to Jerusalem: Medicine in Hellenized Jewish Lore and in Early Christian Literature, ed. Samuel S. Kottek, Manfred Horstmanshoff, Gerhard Baader, and Gary Ferngren (Rotterdam: Erasmus, 2000), 13–32, esp. 22–23, who reads these as separate illnesses. 43. MS Paris 1337: “cress and vinegar.” 44. MS Paris 1337: “scrapings of a plant(?) [ = rora] or . . .” 45. B. ‘Abod. Zar. 28a. 46. See b. Git.. 68b and b. Yebam. 76a. 47. B. Git.. 69a. For more on cataracts, see b. Šabb. 78a, where one paints the eye with hoopoe blood, and b. Pesah. . 111b, which attributes the cause to drinking water from a plate. 48. B. Git.. 69b (MS Vatican 130). Some of the words are difficult. See DJBA 1121–22, s.v. “towel,” as well as DJBA 203, s.v. “seed,” for the reading “*lest” (in lieu of “because if not”). Regarding rocket seeds, MS Oxford Heb. e.77/45–48 specifies “seven measures of” and MS Arras 889 “three hundred.” The latter posology appears in other remedies and implies a large quantity.
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49. B. ‘Abod. Zar. 28b–29a. As indicated in the translation, MS Paris 1337 reads “flatus” instead of “chills,” and MS Munich 95 and MS New York–JTS Rab. 15 read “blood/hemorrhage” instead of “bloodletting.” 50. For radishes, of which there are different types, in rabbinic medicine, see Rosner, Encyclopedia of Medicine, 268, b. ‘Erub. 55b–56a, and b. Pesah. . 116a. Asaph also prescribes radish leaves as medicine, on which see Daniel Fuks, Oriya Amichay, and Ehud Weiss, “Innovation or Preservation? Abbasid Aubergines, Archaeobotany, and the Islamic Green Revolution,” Archaeological and Anthropological Sciences 12 (2020): 1–16, esp. 8. Pliny and Dioscorides likewise used radishes for certain cures, on which see Moshe Negbi, Eliezer E. Goldschmidt, and Nikolaj Serikoff, “Classical and Hebrew Sages on Cultivated Biennial Plants, Part I,” Scripta Classica Israelica 22 (2003): 103–34, esp. 118. 51. See P. B. Adamson, “Surgery in Ancient Mesopotamia,” Medical History 35 (1991): 428–35, esp. 433, and Fred Rosner, “Anesthesia in the Bible and Talmud,” Anesthesia and Analgesia 50 (1971): 298–99. 52. See Benjamin Lee Gordon, Medicine throughout Antiquity (Philadelphia: F. A. Davis, 1949), 779–82; Samuel S. Kottek, “The Surgeon as Depicted in Talmudic Literature,” in Proceedings of the 37th International Congress on the History of Medicine, September 10–15, 2000, ed. Chester R. Burns, Ynez Violé O’Neill, Philippe Albou, and José Gabriel Rigau-Pérez (Galveston: Institute for the Medical Humanities, 2002), 275–79; and Estée Dvorjetski, “Biblical and Talmudic Surgery and Surgical Practice,” Journal of Surgery and Surgical Research 6 (2020): 178–81. On bloodletting, see below. In addition to ra’atan surgery, see the description of hypospadias in b. Yebam. 76a, where a burrowing ant repairs a damaged urethra, a procedure that was influenced by Indian tradition according to Kottek, “Medicine in Ancient Hebrew and Jewish Cultures,” in Medicine across Cultures: History and Practice of Medicine in Non-Western Cultures, ed. Helaine Selin (New York: Kluwer, 2003), 305–24, esp. 315. See also the incident of stomach surgery in b. B. Mes.i‘a 83b. Many of these sources may be fictitious. On medical tools, see Kottek, “Medical Interest,” 489. On a bloodletter’s scalpel and shard, see, e.g., b. Šabb. 129a, b. Ketub. 39b, and b. Git.. 69a. For the use of a tong, see b. Šabb. 110a and below. 53. On the legal context, see Adam Weinberg, “A Case of Cranial Surgery in the Talmud,” Journal of the History of the Neurosciences 15 (2006): 102–10, esp. 103–5. Just before the text below, the Talmud asks “whence does it come?” and answers with a baraita which says that when a man and woman let blood and have sex, they will have children infected with the disease. For other texts on this disease, see t. Ketub. 7:11, Leviticus Rabbah 16:1, b. Git.. 70a, and b. Nid. 17a. 54. See Max Sussman, “Diseases in the Bible and the Talmud,” in Diseases in Antiquity: A Survey of the Diseases, Injuries and Surgery of Early Populations, ed. Don Brothwell and A. T. Sandison (Springfield, IL: Charles C. Thomas, 1967), 209–21, esp. 215; Fred Rosner, “The Illness ‘Ra’atan’ (Insect in the Brain?),” Korot 10 (1993–94): 157–61, esp. 159; Boris S. Ostrer, “Ra’atan Disease in the Context of Greek Medicine,” Review of Rabbinic Judaism 4 (2001): 234–48, esp. 247; Weinberg, “Cranial Surgery,” 109; and Moshe Feinsod, “Neurology in the Bible and the Talmud,” in Handbook of Clinical
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Neurology, vol. 95, History of Neurology, ed. Stanley Finger, François Boller, and Kenneth L. Tyler (Amsterdam: Elsevier, 2010), 37–47, esp. 46. 55. B. Ketub. 77b. MS St. Petersburg 187 attributes the list of symptoms to Rav Pappa. Manuscripts add the references to “from morning until evening” and “in fire,” which I have added here. On this text, see Markham J. Geller, Akkadian Healing Therapies in the Babylonian Talmud (Berlin: Max Planck Institute for the History of Science, 2004), 24–25, with a note on its possible corruptions (e.g., “house of marble” means “at twilight”). 56. Ostrer, “Ra’atan Disease,” 247. 57. See Weinberg, “Cranial Surgery,” 105, and Raffi Gurunluoglu and Aslin Gurunluoglu, “Paul of Aegina: Landmark in Surgical Progress,” World Journal of Surgery 27 (2003): 18–25. 58. The reference to a marble room is also attested in the surgical text in b. B. Mes.i‘a 83b, and in a discussion of the cutting of organs in b. Yebam. 121a. On walls that are seven-and-a-half bricks thick, see the text on bloodletting in b. Šabb. 129a. 59. See James B. Waldram, “The Efficacy of Traditional Medicine: Current Theoretical and Methodological Issues,” Medical Anthropology Quarterly 14 (2000): 603–25, and William S. Sax, “Ritual and the Problem of Efficacy,” in The Problem of Ritual Efficacy, ed. William S. Sax, Johannes Quack, and Jan Weinhold (New York: Oxford University Press, 2010), 3–16, esp. 9. On the well-established distinction between healing and curing—as well as between disease, illness, and sickness—in medical anthropology, much can be cited; some famous articles that are cited often include Leon Eisenberg, “Disease and Illness: Distinctions between Professional and Popular Ideas of Sickness,” Culture, Medicine and Psychiatry 1 (1977): 9–23; Arthur Kleinman and Lilias H. Sung, “Why Do Indigenous Practitioners Successfully Heal?,” Social Science and Medicine 13 (1979): 7–26; and Allan Young, “The Anthropologies of Illness and Sickness,” Annual Review of Anthropology 11 (1982): 257–85. 60. See, e.g., Linda Skidmore-Roth, Mosby’s Handbook of Herbs and Natural Supplements, 4th ed. (St. Louis: Elsevier, 2010), and Andrew Chevallier, Encyclopedia of Herbal Medicine: 550 Herbs and Remedies for Common Ailments (New York: Penguin Random House, 1996), and Herbal Remedies Handbook: More than 140 Plant Profiles; Remedies for Over 50 Common Conditions (New York: Penguin Random House, 2007). 61. For example, see Mark J. Plotkin, Medicine Quest: In Search of Nature’s Healing Secrets (New York: Viking, 2000). See also Gideon Bohak, Ancient Jewish Magic: A History (New York: Cambridge University Press, 2008), 42. 62. See, e.g., Jennie Gwynn and Peter J. Hylands, “Plants as a Source of New Medicines,” Drug Discovery World, August 17, 2000. 63. Daniel A. Dias, Sylvia Urban, and Ute Roessner, “A Historical Overview of Natural Products in Drug Discovery,” Metabolites 2 (2012): 303–36, esp. 310. 64. See Michael J. R. Desborough and David M. Keeling, “The Aspirin Story— From Willow to Wonder Drug,” British Journal of Haematology 177 (2017): 674–83. 65. See Freya Harrison et al., “A 1,000-Year-Old Antimicrobial Remedy with Antistaphylococcal Activity,” American Society for Microbiology 6 (2015): 1–7, and Wing
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Lam et al., “YIV-906 (PHY906) enhanced the anti-tumor activity of immune checkpoint blockade therapy (Anti-PD1) against liver cancer by changing the tumor microenvironment associated with M1 macrophages infiltration,” Proceedings of the American Association for Cancer Research Annual Meeting 2019 79 (2019): 2252. 66. For plants, the count of forty-three is given in Amots Dafni and Barbara Böck, “Medicinal Plants of the Bible—Revisited,” Journal of Ethnobiology and Ethnomedicine 15, no. 57 (2019): 1–14, esp. 2, in reference to both the Mishnah and the Talmud. The total is seventy according to Löw’s Flora der Juden (see Lev and Amar, Practical Materia Medica, 60). 67. See b. Git.. 69a. See Samuel Greif, “Dental Materia Medica in the Talmud,” Dental Digest 21 (1915): 223–27, esp. 224. According to Lev and Amar, Practical Materia Medica, 413, medieval Arab doctors likewise used it for toothaches. On garlic’s medical properties, see Skidmore-Roth, Mosby’s Handbook, 281–85, and Chevallier, Herbal Remedies Handbook, 60–61. Rabbinic texts also refer to the use of vinegar and salt for tooth pain, treatments that are still used as home remedies (see m. Šabb. 14:4, b. Šabb. 111a, and b. ‘Abod. Zar. 28a). 68. On skin, see above. On eyes, see Ahmad M. Mansour, “Epithelial Corneal Oedema Treated with Honey,” Clinical and Experimental Ophthalmology 30 (2002): 149–50. As far as I know, the rabbis however do not recommend putting honey on the eyes. 69. On this word, see Marcus Jastrow, Dictionary of the Targumim, Talmud Bavli, Talmud Yerushalmi, and Midrashic Literature (New York: Judaica Treasury, 1971), 665, and DJBA 599–600. 70. Marcus Jastrow, Dictionary, 30. 71. See Mohaddese Mahboubi, “Caraway as Important Medicinal Plants in Management of Diseases,” Natural Products and Bioprospecting 9 (2019): 1–11. 72. On psychological benefits of Mesopotamian medicine and the magic bowls, see Markham J. Geller, “Freud, Magic and Mesopotamia: How the Magic Works,” Folklore 108 (1997): 1–7, and Harriet Walker, “Possible Psychological Roles of the Aramaic Incantation Bowls: Therapeutic Functions of Belief in Demons and the Practice of Incantations,” Aramaic Studies 13 (2015): 95–109. On the similarities between ancient healing practices and modern psychotherapy, see Kenneth M. Calestro, “Psychotherapy, Faith Healing, and Suggestion,” International Journal of Psychiatry 10 (1972): 83–113. 73. See Howard Brody, “Ritual, Medicine, and the Placebo Response,” in The Problem of Ritual Efficacy, ed. William S. Sax, Johannes Quack, and Jan Weinhold (New York: Oxford University Press, 2010), 151–67, esp. 155–57, and Menachem M. Brayer, “Psychosomatics, Hermetic Medicine, and Dream Interpretation in the Qumran Literature (Psychological and Exegetical Consideration),” Jewish Quarterly Review 60 (1970): 213–30, esp. 214 and n. 46. 74. H. Brody, “Ritual, Medicine, and the Placebo Response,” esp. 151 and 157–59. On how biomedicine disregards the placebo effect, see Waldram, “Efficacy of Traditional Medicine,” 617. 75. See Gideon Bohak, “Conceptualizing Demons in Late Antique Judaism,” in Demons and Illness from Antiquity to the Early-Modern Period, ed. Siam Bhayro and Catherine Rider (Boston: Brill, 2017), 111–33, esp. 133, on this assumption.
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76. See Nina L. Etkin, “Cultural Constructions of Efficacy,” in The Context of Medicines in Developing Countries: Studies in Pharmaceutical Anthropology, ed. Sjaak van der Geest and Susan Reynolds Whyte (Boston: Kluwer Academic Publishers, 1988), 299–326. 77. Literature on these issues is long. For one classic formulation that I have found useful, see J. D. Y. Peel, “Understanding Alien Belief-Systems,” British Journal of Sociology 20 (1969): 69–84, esp. 72–73. More recently, see Lorraine Daston, “Science Studies and the History of Science,” Critical Inquiry 35 (2009): 798–813. 78. For more on ancient Jewish amulets, see Bohak, Ancient Jewish Magic, 114–23, 149–53, 231–35, and 370–76, and Yuval Harari, Jewish Magic before the Rise of Kabbalah, transl. Batya Stein (Detroit: Wayne State University Press, 2017), 216–30, 345–49, 357–58, and 401–2. 79. For a related issue, see the claims that beliefs in demonic diseases were the ancient precursors of modern understandings of germs and contagion. On this idea, see Morris Jastrow, “The Liver in Antiquity and the Beginnings of Anatomy,” Transactions of the College of Physicians of Philadelphia 29 (1907): 117–38, esp. 117, and Benjamin Lee Gordon, “Ophthalmology in the Bible and in the Talmud,” Archives of Ophthalmology 9 (1933): 751–88, esp. 787–88. Compare these older views with the fascinating discussion of these types of analogies in Bohak, “Conceptualizing Demons.” 80. On why people may not perceive the failure of their magic, see the classic explanations in Edward E. Evans-Pritchard, Witchcraft, Oracles, and Magic among the Azande (New York: Clarendon Press, 1976; orig. pub. 1937), 201–4. 81. T. Šabb. 4:9 (Venice print). 82. For more on this disease, see Samuel S. Kottek, “From the History of Medicine: Epilepsy in Ancient Jewish Sources,” Israel Journal of Psychiatry and Related Sciences 25 (1988): 3–11. 83. Cf. the use of the term rope uman in b. Sanh. 91a and y. ‘Abod. Zar. 2:2 (40d). 84. See, e.g., Bohak, Ancient Jewish Magic, 375. See also Leviticus Rabbah 26:5’s reference to a “physician who was an expert in amulets [or: who made use of amulets made by experts],” in the context of a story about an Israelite and a priest who were afflicted with epilepsy (transl. in Catherine Hezser, “Representations of the Physician in Jewish Literature from Hellenistic and Roman Times,” in Popular Medicine in Graeco-Roman Antiquity: Explorations, ed. William V. Harris [Boston: Brill, 2016], 173–97, esp. 192). 85. Y. Šabb. 6:2 (8b), based on Yaacov Sussmann, ed., Talmud Yerushalmi According to Ms. Or. 4720 (Scal. 3) of the Leiden University Library with Restorations and Corrections (Jerusalem: Academy of the Hebrew Language, 2001), 397. 86. MS Munich 95: “Rav Safra.” Later, however, it cites Rav Pappa. 87. B. Šabb. 61a. Some of the specifics of this passage are ambiguous and alternative readings are therefore possible. 88. B. Šabb. 61a–b. 89. MS Oxford Opp. Add. fol. 23 adds “three times.” 90. B. Šabb. 61a–b.
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91. Again, it is important to recognize that these categories are by and large modern constructs. See, e.g., Charles Coury, “The Basic Principles of Medicine in the Primitive Mind,” Medical History 11 (1967): 111–27, esp. 117. 92. B. Git.. 69a. 93. Joseph Naveh, “Lamp Inscriptions and Inverted Writing,” Israel Exploration Journal 38 (1988): 36–43, esp. 41.
chapter 5. talmudic medicine in its sasanian context 1. For examples, see Yaakov Elman, “ ‘Up to the Ears’ in Horses’ Necks (B. M. 108a): On Sasanian Agricultural Policy and Private ‘Eminent Domain,’ ” Jewish Studies, an Internet Journal 3 (2004): 95–149; Shai Secunda, The Talmud’s Red Fence: Menstrual Impurity and Difference in Babylonian Judaism and Its Sasanian Context (New York: Oxford University Press, 2020); Yishai Kiel, Sexuality in the Babylonian Talmud: Christian and Sasanian Contexts in Late Antiquity (New York: Cambridge University Press, 2016); Geoffrey Herman and Jeffrey L. Rubenstein, eds., The Aggada of the Bavli and Its Cultural World (Providence: Brown Judaic Studies, 2018); Geoffrey Herman, A Prince without a Kingdom: The Exilarch in the Sasanian Era (Tübingen: Mohr Siebeck, 2012); and Jason Mokhtarian, Rabbis, Sorcerers, Kings, and Priests: The Culture of the Talmud in Ancient Iran (Oakland: University of California Press, 2015). 2. On schistosomiasis, see Jacob Neusner, A History of the Jews in Babylonia, vol. 4, The Age of Shapur II (Leiden: Brill, 1969), 369–70. For epidemics in the Sasanian period, including Sheroe’s Plague, see Michael W. Dols, “Plague in Early Islamic History,” Journal of the American Oriental Society 94 (1974): 371–83, esp. 375–76, and Peter Christensen, The Decline of Iranshahr: Irrigation and Environments in the History of the Middle East, 500 B.C. to A.D. 1500 (Odense: Museum Tusculanum Press, 1993), 73–83. 3. On Greek and Greco-Syriac influences, see below. The medical texts in Pahlavi are typically a mixture of Zoroastrian, Greek, Greco-Syriac, Indian, and Egyptian ideas. Based on what I have seen, it appears that they have had little direct impact on Talmudic medicine, despite some loanwords and commonalities such as a belief in demonic etiologies, words of healing, and herbal remedies. For more on these aspects of Zoroastrian medicine, see John R. Hinnells, “Health and Suffering in Zoroastrianism,” in Religion, Health and Suffering, ed. John R. Hinnells and Roy Porter (New York: Routledge, 2011), 1–22, esp. 1–9; Philippe Gignoux, “Health in Persia, i. Pre-Islamic Period,” Encyclopædia Iranica, online ed., 2003 (upd. 2012), www.iranicaonline.org/articles /health-in-persia-i; Fariba Sharifian, “Medicine during the Sassanid Era,” Journal of Medical Ethics and History of Medicine 6 (2013): 11–22 (Persian); and Arman Zargaran, “Ancient Persian Medical Views on the Heart and Blood in the Sassanid Era (224–637 AD),” International Journal of Cardiology 172 (2014): 307–12. Among the relevant Pahlavi sources, see esp. Dēnkard Book III ch. 157 in Jean de Menasce, Le troisième livre du Dēnkart, traduit du pehlevi (Paris: Librairie C. Klincksieck, 1973), 158–68, along with the helpful synopsis in Samra Azarnouche, “Religions de l’Iran ancien: Études zoroastriennes,” Annuaire de l’École pratique des hautes études, Section des sciences religieuses
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127 (2020): 59–69, esp. 61–63. On the Sasanian positions of the ērān-drustbed and drustbed (“chief physician”), the latter of which could be held by non-Zoroastrians, including a Christian under Khusrow II, see Ahmad Tafazzoli, “Drustbed,” Encyclopædia Iranica, online ed., 1996 (upd. 2011), www.iranicaonline.org/articles/drustbed. See also Wizīdagīhā ī Zādspram chs. 29–31 in Philippe Gignoux and Ahmad Tafazzoli, Anthologie de Zādspram: Édition critique du texte pehlevi, traduit et commenté (Paris: Association pour l’Avancement des Études Iraniennes, 1993), 94–113, and the book by Peter Sohn, Die Medizin des Zādsparam: Anatomie, Physiologie und Psychologie in den Wizīdagīhā ī Zādsparam, einer zoroastrisch-mittelpersischen Anthologie aus dem frühislamischen Iran des neunten Jahrhunderts (Wiesbaden: Harrassowitz, 1996); and Pahlavi Widēwdād chs. 20–22 in Mahnaz Moazami, Wrestling with the Demons of the Pahlavi Widēwdād: Transcription, Translation, and Commentary (Boston: Brill, 2014), 452–69. 4. See the extensive list of Geller’s publications in the bibliography. 5. See Robert Brody, “Irano-Talmudica: The New Parallelomania?,” Jewish Quarterly Review 106 (2016): 209–32, esp. 232 n. 67, citing Markham J. Geller, “An Akkadian Vademecum in the Babylonian Talmud,” in From Athens to Jerusalem: Medicine in Hellenized Jewish Lore and in Early Christian Literature, ed. Samuel S. Kottek, Manfred Horstmanshoff, Gerhard Baader, and Gary Ferngren (Rotterdam: Erasmus, 2000), 13–32. 6. Again, see Geller’s oeuvre. See also David B. Weisberg, “Some Observations on Late Babylonian Texts and Rabbinic Literature,” Hebrew Union College Annual 39 (1968): 71–80; Markham J. Geller, “The Last Wedge,” Zeitschrift für Assyriologie und Vorderasiatische Archäologie 87 (1997): 43–95; and Alison Salvesen, “The Legacy of Babylon and Nineveh in Aramaic Sources,” in The Legacy of Mesopotamia, ed. Stephanie Dalley (New York: Oxford University Press, 1998), 139–61. 7. On this text, see Stephanie Dalley, “Bel at Palmyra and Elsewhere in the Parthian Period,” ARAM 7 (1995): 137–51, esp. 143. 8. The exact relationship between the magic bowls and earlier Babylonian ideas and practices is debated. See Erica C. D. Hunter, “Incantation Bowls: A Mesopotamian Phenomenon?,” Orientalia 65 (1996): 220–33, esp. 226–27, as well as Rebecca Lesses, “Exe(o)rcising Power: Women as Sorceresses, Exorcists, and Demonesses in Babylonian Jewish Society of Late Antiquity,” Journal of the American Academy of Religion 69 (2001): 343–75, esp. 345 n. 2, citing McGuire Gibson, James A. Armstrong, and Augusta McMahon, “The City Walls of Nippur and an Islamic Site Beyond: Oriental Institute Excavations, 17th Season, 1987,” Iraq 60 (1998): 11–44, esp. 24–25, who have found bowls “often buried below the floors, in private houses of every period we have excavated from Early Dynastic through Achaemenid,” which they believe were in part intended “to ward off illness or other misfortunes,” implying that the “Aramaic incantation bowls of Sasanian and Early Islamic times were merely an elaborated version of the practice” that predates late antiquity. Cf. Markham J. Geller, “Tablets and Magic Bowls,” in Officina Magica: Essays on the Practice of Magic in Antiquity, ed. Shaul Shaked (Boston: Brill, 2005), 53–72. Recently, see also Ortal-Paz Saar, “Mesopotamian Double-Jar Burials and Incantation Bowls,” Journal of the American Oriental Society 138 (2018): 863–73.
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9. Markham J. Geller, “Hippocrates, Galen and the Jews: Renal Medicine in the Talmud,” American Journal of Nephrology 22 (2002): 101–6, esp. 105. 10. For pro-Greek conclusions, see the work of Stephen T. Newmyer, such as “Talmudic Medicine and Greek Sources,” Korot 9 (1985): 34–57. My opinion agrees with Geller, who downplays the Greek impact (see, e.g., Geller, “Renal Medicine,” 103), and David L. Freeman, “The Gittin ‘Book of Remedies,’ ” Korot 13 (1998–99): 151–64, esp. 159, who points out that there are no Greek influences in the Git.t.in Book of Remedies. 11. See, e.g., Stephen T. Newmyer, “Talmudic Medicine and Greco-Roman Science: Crosscurrents and Resistance,” in Aufstieg und Niedergang der römischen Welt, vol. 37/3, pt. 2, ed. Wolfgang Haase and Hildegard Temporini (Berlin: Walter de Gruyter, 1996), 2895–2911, esp. 2901. 12. Many examples could be cited. For anonymous Palestinian Hebrew traditions about diet in the Bavli, see Philip van der Eijk, Markham J. Geller, Lennart Lehmhaus, Matteo Martelli, and Christine Salazar, “Canons, Authorities and Medical Practice in the Greek Medical Encyclopaedias of Late Antiquity and in the Talmud,” in Wissen in Bewegung: Institution—Iteration—Transfer, ed. Eva Cancik-Kirschbaum and Anita Traninger (Wiesbaden: Harrassowitz, 2015), 195–221, esp. 217. See also the case of a “mad dog bite” in m. Yoma 8:6 and b. Yoma 83b–84a: in the Bavli, a quote from m. Yoma 8:6 (“Someone who was bitten by a mad dog may not be given the lobe of the liver to eat, but Rabbi Mattiah ben H . eresh permits it”) is followed by a baraita which lists the five signs that a dog is mad. These five signs sound similar to those given by the Greek physicians Philumenos, Oribasios, and others (cf. Jean Théodoridès, “Rabies in Byzantine Medicine,” Dumbarton Oaks Papers 38 [1984]: 149–58, esp. 149, 151, and 154). Given that Rabbi Mattiah ben H . eresh was a Tanna who led an academy in Rome, it is perhaps not surprising that his cure for rabies follows in the footsteps of Dioscorides and Galen (see Fred Rosner, “Rabies in the Talmud,” Medical History 18 [1974]: 198–200, esp. 198). 13. See Theodore Kwasman, “Loanwords in Jewish Babylonian Aramaic: Some Preliminary Observations,” in The Archaeology and Material Culture of the Babylonian Talmud, ed. Markham J. Geller (Boston: Brill, 2015), 333–86, esp. 354 and 363. For more on Greek and Latin medical words in rabbinic literature, see Samuel S. Kottek, “Sur l’origine gréco-latine de certains termes médicaux utilisés dans le Talmud et le Midrash,” in Le latin médical: La constitution d’un langage scientifique, ed. Guy Sabbah (Saint-Étienne: Publications de l’Université de Saint-Étienne, 1991), 41–52. 14. See Kwasman, “Loanwords,” 355. 15. See esp. b. Šabb. 129a–b. For a list of other sources, see Fred Rosner, “Bloodletting in Talmudic Times,” Bulletin of the New York Academy of Medicine 62 (1986): 935–46, and Encyclopedia of Medicine in the Bible and the Talmud (Northvale, NJ: Jason Aronson, 2000), 55–57. On the Greek context, see Peter Brain, Galen on Bloodletting: A Study of the Origins, Development and Validity of His Opinions, with a Translation of the Three Works (New York: Cambridge University Press, 1986). 16. Shigehisa Kuriyama, “Interpreting the History of Bloodletting,” Journal of the History of Medicine and Allied Sciences 50 (1995): 11–46, esp. 11.
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17. See Liakat Ali Parapia, “History of Bloodletting by Phlebotomy,” British Journal of Haematology 143 (2008): 490–95. The practice continues today as a way to control certain ailments, such as those caused by an excess of iron, on which see Ralph G. DePalma, Virginia W. Hayes, and Leo R. Zacharski, “Bloodletting: Past and Present,” Journal of the American College of Surgeons 205 (2007): 132–44. On the lack of bloodletting in Babylonian medicine, see Robert D. Biggs, “Medicine, Surgery, and Public Health in Ancient Mesopotamia,” in Civilizations of the Ancient Near East, vol. 3, ed. Jack M. Sasson (New York: Scribner’s Sons, 1995), 1911–24, esp. 1921, and Markham J. Geller, “Bloodletting in Babylonia,” in Magic and Rationality in Ancient Near Eastern and Graeco-Roman Medicine, ed. Manfred Horstmanshoff and Marten Stol (Boston: Brill, 2004), 305–24. Cf. the less skeptical opinion of Nathan Wasserman, “On Leeches, Dogs, and Gods in Old Babylonian Medical Incantations,” Revue d’Assyriologie et d’archéologie orientale 102 (2008): 71–88, esp. 79. 18. For a detailed discussion of this question, see Geller, “Bloodletting in Babylonia.” 19. On travel between Rome and Persia, see Catherine Hezser, Jewish Travel in Antiquity (Tübingen: Mohr Siebeck, 2011), 311–64. Other channels may have been the result of eastern Roman cultural influences or the presence of Hellenism in Mesopotamia itself, on which, see Richard Kalmin, Migrating Tales: The Talmud’s Narratives and Their Historical Context (Oakland: University of California Press, 2014); Daniel Boyarin, “Hellenism in Jewish Babylonia,” in The Cambridge Companion to the Talmud and Rabbinic Literature, ed. Charlotte Elisheva Fonrobert and Martin S. Jaffee (New York: Cambridge University Press, 2007), 336–63; and, regarding medicine specifically, Gül Russell, “Greece, x. Greek Medicine in Persia,” Encyclopædia Iranica, online ed., 2002 (upd. 2012), www.iranicaonline.org/articles/greece-x. 20. For more on this tradition, see Samuel S. Kottek, “The Surgeon as Depicted in Talmudic Literature,” in Proceedings of the 37th International Congress on the History of Medicine, September 10–15, 2000, ed. Chester R. Burns, Ynez Violé O’Neill, Philippe Albou, and José Gabriel Rigau-Pérez (Galveston: Institute for the Medical Humanities, 2002), 275–79, esp. 276. 21. For a periodization of Syriac translations from the third to thirteenth century, see Siam Bhayro, “The Reception of Galen’s Art of Medicine in the Syriac Book of Medicines,” in Medical Books in the Byzantine World, ed. Barbara Zipser (Bologna: Eikasmós Online, 2013), 123–44, esp. 124–25. For overviews of Syriac medicine, see Alexey Muraviev, “La médecine thérapeutique en Syriaque (IVe–VIIe siècle),” in Les sciences en syriaque, ed. Émilie Villey (Paris: Geuthner, 2014), 253–84, and Grigory Kessel, “Syriac Medicine,” in The Syriac World, ed. Daniel King (New York: Routledge, 2019), 438–59. Some previously understudied Syriac medical works are now being researched; see, e.g., the preliminary study of such a work that was produced in the ninth century by Kessel, “A Syriac Medical Kunnāšā of Īšō‘ bar ‘Alī (9th c.): First Soundings,” Intellectual History of the Islamicate World 5 (2017): 228–51. 22. See Henri Hugonnard-Roche, “Note sur Sergius de Reš‘ainā, traducteur du Grec en Syriaque et commentateur d’Aristote,” in The Ancient Tradition in Christian and Islamic Hellenism: Studies on the Transmission of Greek Philosophy and Sciences
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Dedicated to H. J. Drossaart Lulofs on His Ninetieth Birthday, ed. Remke Kruk and Gerhard Endress (Leiden: Research School of the Centre of Non-Western Studies, 1997), 121–43, and Siam Bhayro, “Syriac Medical Terminology: Sergius and Galen’s Pharmacopia,” Aramaic Studies 3 (2005): 147–65. 23. See Kessel, “Syriac Medicine,” 441. 24. See the map in Jean-François Duneau, “Quelques aspects de la pénétration de l’hellénisme dans l’Empire perse sassanide (IVe–VIIe siècles),” in Mélanges offerts à René Crozet à l’occasion de son soixante-dixième anniversaire, vol. 1, ed. Pierre Gallais and Yves-Jean Riou (Poitiers: Société d’Études Médiévales, 1966), 13–22, esp. 14, which shows these two cities on the Silk Road. For more information, see Michael W. Dols, “The Origins of the Islamic Hospital: Myth and Reality,” Bulletin of the History of Medicine 61 (1987): 367–90; Nigel Allan, “Christian Mesopotamia and Greek Medicine,” Hermathena 145 (1988): 39–58; Gerrit J. Reinink, “Theology and Medicine in Jundishapur: Cultural Change in the Nestorian School Tradition,” in Learned Antiquity: Scholarship and Society in the Near-East, the Greco-Roman World, and the Early Medieval West, ed. Alaisdair A. MacDonald, Michael W. Twomey, and Gerrit J. Reinink (Dudley: Peeters, 2003), 163–74; and Adam H. Becker, Fear of God and the Beginning of Wisdom: The School of Nisibis and the Development of Scholastic Culture in Late Antique Mesopotamia (Philadelphia: University of Pennsylvania Press, 2006), 94–95. On Greek medicine in Edessa, a city near Nisibis, see Cyril Elgood, A Medical History of Persia and the Eastern Caliphate from the Earliest Times until the Year A.D. 1932 (Cambridge: Cambridge University Press, 1951), 45–46; Allan, “Christian Mesopotamia”; and Russell, “Greek Medicine in Persia.” 25. On these topics, see Philippe Gignoux, Man and Cosmos in Ancient Iran (Rome: Istituto italiano per l’Africa e l’Oriente, 2001), 41–45; Russell, “Greek Medicine in Persia”; Anya King, “The New materia medica of the Islamicate Tradition: The PreIslamic Context,” Journal of the American Oriental Society 135 (2015): 499–528; and John C. Lamoreaux, ed. and transl., with an appendix by Grigory Kessel, H . unayn ibn Ish. āq on His Galen Translations: A Parallel English-Arabic Text (Provo: Brigham Young University Press, 2016). For a New Persian medical text written in Syriac script in the Turfan collection, see Nicholas Sims-Williams, “Early New Persian in Syriac Script: Two Texts from Turfan,” Bulletin of the School of Oriental and African Studies 74 (2011): 353–74, esp. 361–67, including p. 363 on its similarities with the first section of the Syriac Book of Medicines. On Babylonian parallels to some Turfan texts, see SimsWilliams, “Medical Texts from Turfan in Syriac and New Persian,” in The History behind the Languages: Essays of Turfan Forum on Old Languages of the Silk Road, ed. Academia Turfanica (Shanghai: Shanghai Guji Chubanshe, 2012), 13–19. 26. See Geller, “Renal Medicine,” 103. 27. On this I concur with Geller, “Bloodletting in Babylonia,” 309. But because Syriac medicine is understudied (see Kessel, “Syriac Medicine”), it is possible that future studies focused on this comparison could unearth new data that demonstrate rabbinic and Syriac parallels. See my discussion below of the third section of the work, as well as Jonas C. Greenfield and Michael Sokoloff, “Astrological and Related Omen
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Texts in Jewish Palestinian Aramaic,” Journal of Near Eastern Studies 48 (1989): 201–14, esp. 211, on a text on zodiacal influences on human beings in the Bavli (b. Šabb. 156a, in Palestinian Aramaic) that has an analog in the Syriac Book of Medicines. Intersections between Syriac medicine and Jewish script emerge in later sources, such as those from the Cairo Genizah. See, e.g., Siam Bhayro, “A Judaeo-Syriac Medical Fragment from the Cairo Genizah,” Aramaic Studies 10 (2012): 153–72, on a Genizah medical fragment, probably of Syrian provenance, where “a Jewish scribe has transcribed a Syriac medical text into Jewish Aramaic characters” (157). 28. See Bhayro, “Reception of Galen’s Art of Medicine,” 126. 29. See Kessel, “Syriac Medicine,” 444–46. 30. On Galen in the Book of Medicines, see Bhayro, “Reception of Galen’s Art of Medicine.” For Iranian medical loanwords in the Syriac Book of Medicines, consult Claudia A. Ciancaglini, Iranian Loanwords in Syriac (Wiesbaden: Ludwig Reichert, 2008); examples include Belleric myrobalan, bitumen, and oil of sesame (see pp. 129, 203, and 263). Philippe Gignoux has been at the forefront of researching Iranian terms in Syriac pharmacology; see Gignoux, “On the Syriac Pharmacopoeia,” The Harp 11–12 (1998–99): 193–201, and Lexique des termes de la pharmacopée syriaque (Paris: Association pour l’Avancement des Études Iraniennes, 2011). On similarities with Arabic pharmacology, see King, “New materia medica,” esp. 501–2. On Indian drugs, see E. A. Wallis Budge, Syrian Anatomy, Pathology and Therapeutics, or “The Book of Medicines,” vol. 2, English Translation and Index (New York: Oxford University Press, 1913), 150, 152, and 265. 31. Siam Bhayro and Stefanie M. Rudolf, “Budge’s Syriac Book of Medicines after One Hundred Years: Problems and Prospects,” in Mesopotamian Medicine and Magic: Studies in Honor of Markham J. Geller, ed. Strahil V. Panayotov and Luděk Vacín (Boston: Brill, 2018), 116–30, esp. 116. See also Bhayro, “Reception of Galen’s Art of Medicine,” 134. 32. Bhayro, “Reception of Galen’s Art of Medicine,” 141. 33. Cf. b. Git.. 69a with Budge, “Book of Medicines,” 68. More similarities will likely be found. 34. The count is according to Gignoux, “Syriac Pharmacopoeia,” 194. 35. Budge, “Book of Medicines,” 656–714. 36. Bhayro and Rudolf, “Budge’s Syriac Book of Medicines,” 117. 37. See Adam H. Becker, “Doctoring the Past in the Present: E. A. Wallis Budge, the Discourse on Magic, and the Colonization of Iraq,” History of Religions 44 (2005): 175–215, esp. 183–88. 38. For examples in reference to eye diseases, see Markham J. Geller and Strahil V. Panayotov, Mesopotamian Eye Disease Texts: The Nineveh Treatise (Boston: Walter de Gruyter, 2020), 24–25, 28–31, 275–78. For other potential similarities, alluded to in the previously cited work, see R. Campbell Thompson, “Assyrian Medical Texts,” Journal of the Royal Society of Medicine 17 (1924): 1–34, and “Assyrian Medical Texts,” Journal of the Royal Society of Medicine 19 (1926): 29–78. 39. See David Stophlet Flattery and Martin Schwartz, Haoma and Harmaline: The Botanical Identity of the Indo-Iranian Sacred Hallucinogen “Soma” and Its Legacy in
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Notes to pages 94–96 175
Religion, Language, and Middle Eastern Folklore (Berkeley: University of California Press, 1989), 87 n. 21, who hint at the possibility that the recipes were “apparently copied from some non-Greek (Iranian?) source.” 40. My translation based on Budge, “Book of Medicines,” 658 (see the Syriac text in Budge, vol. 1, 554–55). Cf. the remedies for diseases of the head in Thompson, “Assyrian Medical Texts” (1924). 41. For more on this, especially in light of Greco-Roman medical culture, see the forthcoming work by Monika Amsler, Making the Talmud. 42. See DJBA 161; Kwasman, “Loanwords,” 363; and Michael Sokoloff, A Syriac Lexicon: A Translation from the Latin, Correction, Expansion, and Update of C. Brockelmann’s Lexicon Syriacum (Winona Lake, IN: Eisenbrauns; Piscataway, NJ: Gorgias Press, 2009), 93. 43. See DJBA 149, and Kwasman, “Loanwords,” 368. 44. See DJBA 711, and Kwasman, “Loanwords,” 368. 45. See DJBA 900, and Kwasman, “Loanwords,” 354. 46. B. Git.. 69b (MS Vatican 130). 47. Acacia appears in the Syriac Book of Medicines for a variety of ailments. On salve, see Sokoloff, Syriac Lexicon, 1553, s.v. “eye salve, paste, pill.” 48. See, e.g., Robert Halleux, Les alchimistes grecs, tome I, Papyrus de Leyde, Papyrus de Stockholm, Fragments de recettes (Paris: Les Belles Lettres, 1981); Pliny the Elder, Natural History: A Selection, transl. John F. Healy (New York: Penguin Books, 1991); and Yvette Hunt, The Medicina Plinii: Latin Text, Translation, and Commentary (New York: Routledge, 2020). 49. See Nathaniel Deutsch, Guardians of the Gate: Angelic Vice Regency in Late Antiquity (Boston: Brill, 1999), 2–4. 50. On polemics, see Ethel S. Drower, “Mandaean Polemic,” Bulletin of the School of Oriental and African Studies 25 (1962): 438–48, and Dan Shapira, “Ein Mazal Le-Yisrael: Celestial Race, the Jews,” Kabbalah: Journal for the Study of Jewish Mystical Texts 5 (2000): 111–27. On residences, see Erica C. D. Hunter, “Aramaic-Speaking Communities of Sasanid Mesopotamia,” ARAM 7 (1995): 319–35, esp. 333. 51. See Deutsch, Guardians of the Gate, 3. 52. The astrological and zodiacal dimensions of health and illness do not appear often in the Talmud except for bloodletting and a few other instances. See b. Šabb. 129a–b and cf. Ethel S. Drower, The Book of the Zodiac (Sfar Malwašia) (London: Royal Asiatic Society, 1949), 71 and 100–101. 53. See Francesca Rochberg, “The Babylonian Origins of the Mandaean Book of the Zodiac,” ARAM 11–12 (1999–2000): 237–47. 54. See Drower, Book of the Zodiac, 3. See also the translator’s note on p. 110. Drower, “A Mandæan Bibliography,” Journal of the Royal Asiatic Society 85 (1953): 34–39, esp. 38, describes it as “derived from Arab, Greek, Jewish, and Sassanian sources.” 55. Drower, Book of the Zodiac, 18. For “strangury/inflammation,” see Ethel S. Drower and Rudolf Macuch, A Mandaic Dictionary (Oxford: Clarendon Press, 1963), 200, s.v. kapta 1, and 395–96, s.v. s.mirta. On pleurisy, see Drower and Macuch, Diction-
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ary, 51, s.v. barsam, an Iranian loanword found in JBA (see DJBA 247, b. Git.. 69a, and b. H . ul. 105b). Other afflictions attested in both languages include “hip-disease” and “stupor” (see DJBA 1132 and 1198, and Drower and Macuch, Dictionary, 462 and 483, respectively). 56. Drower, Book of the Zodiac, 12. 57. Drower, Book of the Zodiac, 86–87. 58. Drower, Book of the Zodiac, 58. 59. Cf. Drower and Macuch, Dictionary, 71, and DJBA 250. 60. For an older article that views the bowls as part of the history of medicine, see Maurice Bear Gordon, “Popular Medicine in Sasanian Babylonia,” Annals of Medical History 4 (1942): 241–45. 61. Dan Levene, “ ‘A Happy Thought of the Magicians,’ The Magical Get.,” in Shlomo: Studies in Epigraphy, Iconography, History and Archaeology in Honor of Shlomo Moussaieff, ed. Robert Deutsch (Tel Aviv: Archaeological Center Publication, 2003), 175–84, esp. 179–83 and nn. 23 and 45 (quotation on 181). Levene gives many examples of shared terms, figures, and motifs that appear in both, though he focuses more on the SolomonAshmedai tale than on the therapies in the Book of Remedies. For an example of magical words that appear in both the bowls and b. Šabb. 67a, see the preliminary note (and reference to a forthcoming article) in James Nathan Ford and Matthew Morgenstern, Aramaic Incantation Bowls in Museum Collections, vol. 1, The Frau Professor Hilprecht Collection of Babylonian Antiquities, Jena (Boston: Brill, 2020), 144 n. 517. 62. See Shaul Shaked, “Rabbis in Incantation Bowls,” in The Archaeology and Material Culture of the Babylonian Talmud, ed. Markham J. Geller (Boston: Brill, 2015), 97–120, esp. 106 and 109–13. 63. Not all demons in the Bavli are related to illness. On the ties between demons, disease, and healing, see Samuel S. Kottek, “Demons and Diseases in Bible and Talmud,” in Illness and Healing in Ancient Times, ed. Ofra Rimon (Haifa: Hecht Museum, University of Haifa Press, 1996), 32–38, and Sara A. Ronis, “ ‘Do Not Go Out Alone at Night’: Law and Demonic Discourse in the Babylonian Talmud” (PhD diss., Yale University, 2015), 146–49. 64. At times the Bavli uses ruah. before a disease that the bowls do not, and vice versa. See, e.g., b. Pesah. . 111b: “If one defecates on the stump of a palm tree, ruah. palga [apoplexy] seizes him, and if one leans his head on the stump of a palm tree, ruah. s.edara [vertigo] seizes him” (transl. based on Theodore Kwasman, “The Demon of the Roof,” in Disease in Babylonia, ed. Irving L. Finkel and Markham J. Geller [Boston: Brill, 2007], 160–86, esp. 163, and analysis on 161–65 and 174–79). The use of ruah. in relation to mental diseases may already appear in the Bible; see King Saul’s “evil spirit” (1 Sam. 16:13–23), discussed in Ephraim Nissan and Abraham Ofir Shemesh, “King Saul’s ‘Evil Spirit’ (ruach ra‘ah): Between Psychology, Medicine and Culture,” La Ricerca Folklorica 62 (2010): 149–56, esp. 150–51, who identify it as possibly melancholia. 65. There are some precedents of demonic illness in earlier Jewish texts on which the Bavli and Midrashim build, such as “bitter destruction/deadly pestilence” (qet.eb meriri) (see Deut. 32:24 and Ps. 91:6). But the Bible likely does not understand qet.eb
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Notes to pages 98–99 177
as a demon as the rabbis do (see Kottek, “Demons and Diseases,” 34). After describing this demon in terms of some sort of vessel of a milk-dish(?), b. Pesah. . 111b tells a short story about how Abaye once placed Rav Pappa as a shield against the demon while encountering it on a walk. As Kottek, “Demons and Diseases,” 34, explains based on the Talmud, which says that it is a danger in the summer months and lurks in the privy, “some scholars have argued that it could be a personification of intestinal (epidemic) diseases particularly dreaded in the summer.” Numbers Rabbah 12:3 and Lamentations Rabbah 1:29 also contain accounts of this demon. 66. The bowls’ preference for naming clients matrilineally is likewise attested in some of the Bavli’s spells, such as b. Yoma 83b–84a’s remedy for rabies, which includes writing a spell on a hyena hide according to the mother’s name. It is possible that this was a more precise way of identifying a client, or that it reflects the central role of women in the production of the amulets, according to Tal Ilan, “Review: Giuseppe Veltri, Magie und Halakha: Ansätze zu einem empirischen Wissenschaftsbegriff im spätantiken und frühmittelalterlichen Judentum. Tübingen: Mohr Siebeck, 1997,” Scripta Classica Israelica 17 (1998): 257–62, esp. 259, and “Women in Jewish Life and Law,” in The Cambridge History of Judaism, vol. 4, The Late Roman–Rabbinic Period, ed. Steven T. Katz (New York: Cambridge University Press, 2006), 627–46, esp. 642. 67. Dan Levene, Jewish Aramaic Curse Texts from Late-Antique Mesopotamia: “May These Curses Go Out and Flee” (Boston: Brill, 2013), 37 (VA.2423). 68. Ford and Morgenstern, Aramaic Incantation Bowls in Museum Collections, 73 (HS 3023), with other examples on 78–80. 69. On “to seize” in reference to demons and illnesses, see DJBA 103 (mng. 2) and 773–75 (mng. 5). See also Levene, “Magical Get.,” 179 n. 20, on examples of the verb in medical and demonic contexts. For spirits that “recline in” different body parts—as well as other verbs that are sometimes used for specific body parts, such as “to buzz in the ears”—see JBA 1–12 in Shaul Shaked, James Nathan Ford, and Siam Bhayro, eds., with contributions from Matthew Morgenstern and Naama Vilozny, Aramaic Bowl Spells: Jewish Babylonian Aramaic Bowls, vol. 1, Manuscripts in the Schøyen Collection (Boston: Brill, 2013), 56–96 (as well as the explanation of “to buzz” on 55). See also “the evil spirit who controls the belly of” a client in Dan Levene, A Corpus of Magic Bowls: Incantation Texts in Jewish Aramaic from Late Antiquity (New York: Kegan Paul, 2003), 111 (M155, line 7). 70. See, e.g., m. ’Ohal. 1:8 and b. Bek. 45a. For bowls, see below. Rabbinic literature interprets the count of 248 via the numerical value of Abraham’s name or in relation to the 248 positive commandments (see b. Ned. 32b and b. Mak. 23b). Tradition adds that there are also 365 tendons or blood vessels, which, when added to the number of limbs, equals 613, the total number of commandments, on which see Sussman Muntner, “Medicine in the Talmud,” Medica Judaica 2 (1972): 4–8, esp. 6. For an overview of rabbinic anatomy, see Benjamin Lee Gordon, Medicine throughout Antiquity (Philadelphia: F. A. Davis, 1949), 729–44. This anatomical information extends beyond Jewish Mesopotamia and is found even in the writings of Avicenna, who may have learned it from Jewish doctors, according to Robert Jütte, The Jewish Body: A History, transl.
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178 Notes to pages 99–103
Elizabeth Bredeck (Philadelphia: University of Pennsylvania Press, 2021), 7. Asaph the Physician likewise counts 248 bones. See Stephen T. Newmyer, “Asaph’s ‘Book of Remedies’: Greek Science and Jewish Apologetics,” Sudhoffs Archiv 76 (1992): 28–36, esp. 30. See also Ronit Yoeli-Tlalim, “Exploring Persian Lore in the Hebrew Book of Asaf,” Aleph: Historical Studies in Science and Judaism 18 (2018): 123–45, esp. 142–44, on the similarities between Asaph’s work and a Syriac medical text in reference to the 248 bones. 71. See, e.g., Tapani Harviainen, “An Aramaic Incantation Bowl from Borsippa: Another Specimen of Eastern Aramaic ‘Koiné,’ ” Studia Orientalia 51 (1981): 3–28, esp. 6 (line 11) (see DJBA 362–63). 72. These are selected excerpts from Shaul Shaked, “ ‘Peace Be upon You, Exalted Angels’: On Hekhalot, Liturgy and Incantation Bowls,” Jewish Studies Quarterly 2 (1995): 197–219, esp. 207–10 (Moussaieff Collection, Bowl 1). 73. Shaul Shaked, “Transmission and Transformation of Spells: The Case of the Jewish Babylonian Aramaic Bowls,” in Continuity and Innovation in the Magical Tradition, ed. Gideon Bohak, Yuval Harari, and Shaul Shaked (Boston: Brill, 2011), 187–217, esp. 191–92 and n. 13, and 202. Shaked notes that there are also additional bowls produced for other individuals in Mahdukh’s family. 74. Shaked, “Transmission,” 198 (MS 2053/13) and 204. 75. See, e.g., Shaked et al., Aramaic Bowl Spells, 56 (JBA 1). 76. Levene, Jewish Aramaic Curse Texts, 88 (VA.2418). For more on cataracts, see Levene, Corpus, 118. 77. Levene, Jewish Aramaic Curse Texts, 119 (O40A [BM 91767]). 78. On this topic, see, e.g., Gilbert Lewis, “Fear of Sorcery and the Problem of Death by Suggestion,” Social Science and Medicine 24 (1987): 997–1010. See also an earlier study that explains how voodoo death curses can perhaps result in organ failure and death, by Walter B. Cannon, “ ‘Voodoo’ Death,” American Anthropologist 44 (1942): 169–81. 79. B. ‘Abod. Zar. 29a (MS Paris 1337). Cf. b. ‘Abod. Zar. 28a’s tale about an Arab helping cure Abaye of a tooth ailment. 80. See András Bácskay, “Magical Elements of Mesopotamian Medical Texts,” Acta Antiqua Academiae Scientiarum Hungaricae 49 (2009): 269–80, esp. 274. 81. See Carol Bakhos, Ishmael on the Border: Rabbinic Portrayals of the First Arab (Albany: State University of New York Press, 2006), 72. 82. B. Šabb. 110b, with a few changes based on the MSS. 83. Abraham Ofir Shemesh, “Medical Relationships between Jews and Non-Jews in the Ottoman Empire in Pre-Modern Times According to Rabbinic Literature: Halakhah and Reality,” in Jews and Muslims in the Islamic World, ed. Bernard Dov Cooperman and Zvi Zohar (Bethesda: University Press of Maryland, 2013), 303–20, esp. 304–5, along with key primary texts cited in the footnotes. 84. Shemesh, “Medical Relationships,” 305. 85. On women in Greek medicine, see, e.g., Rebecca Flemming, “Women, Writing and Medicine in the Classical World,” Classical Quarterly 57 (2007): 257–79, and Holt
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Notes to pages 103–106 179
N. Parker, “Galen and the Girls: Sources for Women Medical Writers Revisited,” Classical Quarterly 62 (2012): 359–86, and, in Talmudic medicine, see Ilan, “Review,” 260–61. 86. See Rebecca Lesses, “ ‘The Most Worthy of Women Is a Mistress of Magic’: Women as Witches and Ritual Practitioners in 1 Enoch and Rabbinic Sources,” in Daughters of Hecate: Women and Magic in the Ancient World, ed. Kimberly B. Stratton and Dayna S. Kalleres (New York: Oxford University Press, 2014), 71–107, esp. 89–92. 87. Ilan, “Review,” 261. 88. B. Šabb. 109b, with a few changes based on the MSS. This excerpt is followed by several other remedies for uncovered water attributed to rabbis. 89. On Abaye’s mother, see Charlotte Elisheva Fonrobert, Menstrual Purity: Rabbinic and Christian Reconstructions of Biblical Gender (Stanford: Stanford University Press, 2000), 151–59; Lesses, “Exe(o)rcising Power,” 362–64; and Samuel S. Kottek, “Amra li em: La transmission de la médicine populaire par les femmes dans le Talmud,” Revue des études juives 169 (2010): 419–37. For the medical sources, see b. Šabb. 66b and 133b–134a, b. ‘Erub. 29b, b. Yoma 78b, b. Ketub. 10b, 39b, and 50a, b. Git.. 67b and 70a, and b. ‘Abod. Zar. 28b. 90. Fonrobert, Menstrual Purity, 152. 91. Tal Ilan, “Female Personalities in the Babylonian Talmud,” Jewish Women: A Comprehensive Historical Encyclopedia, 2009, www.jwa.org/encyclopedia/article /female-personalities-in-babylonian-talmud. 92. See Louise Cilliers and François P. Retief, “The Healing Hand: The Role of Women in Graeco-Roman Medicine,” Acta Theologica Supplementum 7 (2005): 165–88, and John M. Riddle, “Women’s Medicines in Ancient Jewish Sources: Fertility Enhancers and Inhibiters,” in Disease in Babylonia, ed. Irving L. Finkel and Markham J. Geller (Boston: Brill, 2007), 200–214. 93. See Siam Bhayro, “An Aramaic Magic Bowl for Fertility and Success in Childbirth: Lisboa, Museu da Farmácia (Lisbon, Pharmacy Museum), Inv. No. 10895,” Aramaic Studies 15 (2017): 106–11, with quotation from line 4. 94. B. Šabb. 134a (transl. Fonrobert, Menstrual Purity, 154). 95. Printed eds.: “Rav Ah. a son of Rav Huna.” MS Munich 95: “Rav Ah. a son of Ravina.” 96. B. Šabb. 66b (MS Oxford Opp. Add. fol. 23, with minor edits). 97. The use of salt as an antiwitchcraft substance is attested in the Maqlû salt incantation, on which see Jeffrey Stackert, “The Variety of Ritual Applications for Salt and the Maqlû Salt Incantation,” in Gazing on the Deep: Ancient Near Eastern and Other Studies in Honor of Tzvi Abusch, ed. Jeffrey Stackert, Barbara Nevling Porter, and David P. Wright (Bethesda, MD: CDL Press, 2010), 235–52. Salt also has medical properties used in other Talmudic therapies (see Rosner, Encyclopedia of Medicine, 274–75). On the Akkadian background to the river ritual, see Markham J. Geller, Akkadian Healing Therapies in the Babylonian Talmud (Berlin: Max Planck Institute for the History of Science, 2004), 49. 98. This was already alluded to by Saul Lieberman, Hellenism in Jewish Palestine: Studies in the Literary Transmission, Beliefs and Manners of Palestine in the I Century
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180 Notes to pages 107–108
B.C.E.–IV Century C.E., 2nd ed. (New York: Jewish Theological Seminary of America, 1962), 190, who wrote: “Many of the popular remedies mentioned in rabbinic literature (and especially in the Babylonian Talmud) probably have their origin in the Orient where they were acquired by the Rabbis through direct contact with the eastern peoples.” 99. On horizontal versus vertical knowledge-transmission, see Jochen Althoff, Dominik Berrens, and Tanja Pommerening, “The Construction and Transfer of Knowledge in the Pre-Modern Era,” in Finding, Inheriting or Borrowing? The Construction and Transfer of Knowledge in Antiquity and the Middle Ages, ed. Jochen Althoff, Dominik Berrens, and Tanja Pommerening (Bielefeld: Transcript, 2019), 13–38. 100. Giuseppe Veltri, “On the Influence of ‘Greek Wisdom’: Theoretical and Empirical Sciences in Rabbinic Judaism,” Jewish Studies Quarterly 5 (1998): 300–317, esp. 302. 101. On this concept’s history, see Ra‘anan Boustan, “Afterword: Rabbinization and the Persistence of Diversity in Jewish Culture in Late Antiquity,” in Diversity and Rabbinization: Jewish Texts and Societies between 400 and 1000 CE, ed. Gavin McDowell, Ron Naiweld, and Daniel Stökl Ben Ezra (Cambridge: Open Book Publishers, 2021), 429–49. 102. See Christoph Ulf, “Rethinking Cultural Contacts,” in Kulturkontakte in antiken Welten: Vom Denkmodell zum Fallbeispiel—Proceedings des internationalen Kolloquiums aus Anlass des 60. Geburtstages von Christoph Ulf, Innsbruck, 26. bis 30. Januar 2009, ed. Robert Rollinger and Kordula Schnegg (Walpole, MA: Peeters, 2014), 507–64. 103. See the comparable thesis about rabbinic control over the astronomical sciences in Andrea D. Lobel, “Under a Censored Sky: Astronomy and Rabbinic Authority in the Talmud Bavli and Related Literature” (PhD diss., Concordia University, 2015). 104. See the use of this phrase in Albert de Jong, “Zoroastrian Religious Polemics and Their Contexts: Interconfessional Relations in the Sasanian Empire,” in Religious Polemics in Context: Papers Presented to the Second International Conference of the Leiden Institute for the Study of Religions (LISOR) Held at Leiden, 27–28 April 2000, ed. Theo L. Hettema and Arie van der Kooij (Assen: Royal Van Gorcum, 2004), 48–63, esp. 58. 105. B. H . ul. 77b (cf. b. Šabb. 67a–b). See m. H . ul. 4:7, m. Šabb. 6:10, and t. Šabb. 6–7. On the Amorites and healing, see Judah Goldin, “The Magic of Magic and Superstition,” in Aspects of Religious Propaganda in Judaism and Early Christianity, ed. Elisabeth Schüssler Fiorenza (Notre Dame: University of Notre Dame Press, 1976), 115–47, esp. 117–21; Giuseppe Veltri, “The Rabbis and Pliny the Elder: Jewish and Greco-Roman Attitudes toward Magic and Empirical Knowledge,” Poetics Today 19 (1998): 63–89, and “The ‘Other’ Physicians: The Amorites of the Rabbis and the Magi of Pliny,” Korot 13 (1998–99): 37–54; and Gideon Bohak, Ancient Jewish Magic: A History (New York: Cambridge University Press, 2008), 382–87. 106. See Beth A. Berkowitz, Defining Jewish Difference: From Antiquity to the Present (New York: Cambridge University Press, 2012), 96–100 and 146–52, with citations to other scholarship. 107. This is admittedly a more complicated issue than what I describe above, since it includes questions about, for instance, the proper use of Torah and whether or not one is permitted to invoke the name of Jesus for the sake of healing. On the latter
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Notes to pages 108–111 181
question, see, e.g., Bohak, Ancient Jewish Magic, 399. Cf. also b. Pesah. . 25a–b on the restrictions against idolatry, incest, and murder in cures. 108. B. ‘Abod. Zar. 28a ( = b. Yoma 84a). See notes in chapter 3. 109. Richard Kalmin, “Observation in Rabbinic Literature of Late Antiquity,” in The Faces of Torah: Studies in the Texts and Contexts of Ancient Judaism in Honor of Steven Fraade, ed. Michal Bar-Asher Siegal, Tzvi Novick, and Christine Hayes (Göttingen: Vandenhoeck and Ruprecht, 2017), 359–83, esp. 379 (on b. Yoma 84a). 110. See Lennart Lehmhaus, “Bodies of Texts, Bodies of Tradition: Medical Expertise and Knowledge of the Body among Rabbinic Jews in Late Antiquity,” in Finding, Inheriting or Borrowing? The Construction and Transfer of Knowledge in Antiquity and the Middle Ages, ed. Jochen Althoff, Dominik Berrens, and Tanja Pommerening (Bielefeld: Transcript, 2019), 123–66, esp. 150–52. 111. On the difference between hemoptysis (blood from the lungs) versus hematemesis (blood from the liver), see M. Westreich, “Liver Disease in the Talmud,” Journal of Clinical Gastroenterology 12 (1990): 57–62, esp. 61. 112. Cf. Vilna, “Rav Ammi,” and MS Arras 889, “Rav Assi.” These names are often interchanged; see David Brodsky, A Bride without a Blessing: A Study in the Redaction and Content of Massekhet Kallah and Its Gemara (Tübingen: Mohr Siebeck, 2006), 403 n. 95 and 497–98 n. 3. 113. B. Git.. 69a (MS Vatican 130). See Geller, “Akkadian Vademecum,” 21–22 and nn. 50–61, on the Akkadian background, and 21–22 also for the reading, “strong beer which is of good quality.” 114. B. Git.. 69b (MS Vatican 130). At the end, other witnesses read “afterward” instead of “with them.” 115. B. Git.. 69a. There are numerous studies in the field that assess the reliability and unreliability of rabbinic attributions, although as far as I can tell none of them have taken into consideration the medical remedies as a case study. Indeed, it would seem that these medical traditions, which appear to have had different streams of transmission than the typical legal and narrative ones, would be unique information for understanding the status of attributions and related redactional issues. For two examples of studies on attributions, see David Kraemer, “On the Reliability of Attributions in the Babylonian Talmud,” Hebrew Union College Annual 60 (1989): 175–90, and Marc Bregman, “Pseudepigraphy in Rabbinic Literature,” in Pseudepigraphic Perspectives: The Apocrypha and Pseudepigrapha in Light of the Dead Sea Scrolls—Proceedings of the International Symposium of the Orion Center for the Study of the Dead Sea Scrolls and Associated Literature, 12–14 January, 1997, ed. Esther G. Chazon and Michael Stone, with the collaboration of Avital Pinnick (Boston: Brill, 1999), 27–41. 116. See the forthcoming work by Monika Amsler, Making the Talmud, for a detailed analysis of the redactional background to different forms of the therapies. 117. On similar issues in a contemporary context, see Haym Soloveitchik, “Rupture and Reconstruction: The Transformation of Contemporary Orthodoxy,” Tradition: A Journal of Orthodox Jewish Thought 28 (1994): 64–130. Above, I have paraphrased and borrowed some language from Soloveitchik, pp. 67 and 71 (“Custom was a correlative
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182 Notes to pages 112–114
datum of the halakhic system” and “Custom is potent, but its true power is informal” [author’s italics]). 118. B. ‘Abod. Zar. 28a. See chapter 4 for more on this text.
conclusion 1. Cristine H. Legare and Susan A. Gelman, “Bewitchment, Biology, or Both: The Co-Existence of Natural and Supernatural Explanatory Frameworks across Development,” Cognitive Science 32 (2008): 607–42, esp. 608. 2. See, e.g., Eugene Subbotsky, “The Belief in Magic in the Age of Science,” SAGE Open 4 (2014): 1–17.
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GLOSSARY OF AILMENTS
This list only includes ailments in Jewish Babylonian Aramaic. For the sake of consistency, I usually follow the translations and Aramaic renderings in Michael Sokoloff’s Dictionary of Jewish Babylonian Aramaic. For further details, see my discussion of each term in the book. english–aramaic abscess abscess/boil anal fissure apoplexy, a demon arrow (injury by) blood coming from the mouth blood of the head boil cataracts crack in the skin day-blindness dimness of the eyes diphtheria (drinking) uncovered water dysentery eye disease eye pain fever fever/sickness
בועתא מורסא פיקעא פלגא גירא דמא דאתי מפומא דמא דרישא שיחנא ברוקתי סימטא שברירי דיממא אוכלא אסכרא גילוייא כאב מעיא נהורתא דיצא אישתא חמא 183
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184 Glossary
fierce sting/white worms flatus fluke worm heart palpitation heatstroke/fever heaviness of heart hemorrhoids/illness hip-disease/malady hot fever infected pustule inflammation of the bones inflammation (of the eye) internal hemorrhage (eye) intestinal inflammation involuntary nodding of the head jaundice larynx (pustules of) leprosy migraine molar (pain) night-blindness nosebleed ongoing heatstroke open wound parasitic worm pleurisy ravenous hunger scurvy secretion sickness of the heart skin disease skin disease/scabs skin lesion sore (skin) spleen (diseased) sting/worms strain the rectum strangury strangury (inner) strangury (outer) stupor tearing (eye) vertigo
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כירצא חיורא זיקא ארקתא פירחא דליבא שימשא יוקרא דליבא שחתא שיגדונא אישתא צמירתא עינבתא אישא דגרמי קידחא דמא צירחא דליבא שהייא ירקונא חינכי חיורא צילחתא ככא שברירי דליליא דמא דאתי מנחירא שימשא עתיקתא פדעתא קוקנא ברסם בולמוס צפדינא רירא חולשא דליבא חזזיתא חוספניתא חרפופיתא כיבא טחלא כירצא טחר צימרתא צימרא גויא צימרא ברא תונבא דמעתא צדרא
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Glossary 185
aramaic–english אוכלא אישא דגרמי אישתא אישתא צמירתא אסכרא ארקתא בולמוס בועתא ברוקתי ברסם גילוייא גירא דיצא דמא דמא דאתי מנחירא דמא דאתי מפומא דמא דרישא דמעתא זיקא חולשא דליבא חוספניתא חזזיתא חיורא חינכי חמא חרפופיתא טחלא טחר יוקרא דליבא ירקונא כאב מעיא כיבא כירצא כירצא חיורא ככא מורסא נהורתא סימטא עינבתא פדעתא פיקעא
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dimness of the eyes inflammation of the bones fever hot fever diphtheria fluke worm ravenous hunger abscess cataracts pleurisy (drinking) uncovered water arrow (injury by) eye pain internal hemorrhage (eye) nosebleed blood coming from the mouth blood of the head tearing (eye) flatus sickness of the heart skin disease/scabs skin disease leprosy larynx (pustules of) fever/sickness skin lesion spleen (diseased) strain the rectum heaviness of heart jaundice dysentery sore (skin) sting/worms fierce sting/white worms molar (pain) abscess/boil eye disease crack in the skin infected pustule open wound anal fissure
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186 Glossary
פירחא דליבא פלגא צדרא צילחתא צימרא ברא צימרא גויא צימרתא צירחא דליבא צפדינא קוקנא קידחא רירא שברירי דיממא שברירי דליליא שהייא שחתא שיגדונא שיחנא שימשא שימשא עתיקתא תונבא
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heart palpitation apoplexy, a demon vertigo migraine strangury (outer) strangury (inner) strangury intestinal inflammation scurvy parasitic worm inflammation (of the eye) secretion day-blindness night-blindness involuntary nodding of the head hemorrhoids/illness hip-disease/malady boil heatstroke/fever ongoing heatstroke stupor
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Mokhtarian-Medicine in the Talmud.indd 222
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Source Index
Hebrew Bible Genesis 30:14–16
155n25
Exodus 12 15:26 21:18–19 29–30 30:22–38 30:34
129–30n99 52 28–29, 56–57, 70, 115 127n74 127n74 127n74
Leviticus 8 13–14 14:1–12 18 18:5 19:18 26:11 26:16 Numbers 12 17 19
127n74 51 63 108 125n45 133–34n115 156n30 48
153n6 127n74 63
Deuteronomy 7:15 57–59, 70
14:3–21 18 22:2 28:15–68 28:22 32:34
152–53n1 108 21 153n6 48 176–77n65
1 Samuel 16:13–23
176n64
2 Samuel 3:29
59
1 Kings 15:23
59
2 Kings 20:7
122n17, 152–53n1
Jeremiah 8:22 46:11 Psalms 25:14 51 91 91:6 103:3 Proverbs 4:22
152–53n1 152–53n1
59 63 152–53n1 176–77n65 52
52
223
Mokhtarian-Medicine in the Talmud.indd 223
12/03/22 2:24 PM
.
224 Source Index 14:10 22:5
61 58
Job 33:25
70
1 Chronicles 15:17
162n15
Second Temple Sources Jubilees 10:10–14
55
Wisdom of Ben Sira 38
54
Mishnah
Yoma 8:5 8:6
180n105
’Ohalot 1:8
177–78n70
Parah 11:6–9 11:9 12:1–6
158n56 64 158n56
52
Ecclesiastes 7:12
Šabbat 6:2 6:10 8:1 14 14:2–4 14:3 14:4
4:7
Tosefta Šabbat 4:9 6–7 12:12 15:4
84 180n105 157n43 157n43
Ketubbot 7:11
165n53
Yerushalmi Talmud 84, 85 180n105 157n43 10, 115 10 63, 65, 103–4 69, 167n67
Berakot 2:2 (4c) 5:2 (9b) 9:2 (13c) Šebi‘it 3:4 (34c)
137n161, 154n8 67 54
159n71
Roš Haššanah 1:7
137n161
Šabbat 6:2 (8b) 6:10 (8c) 14:3 (14c) 14:4 (14d) 20:3 (17c)
Šeqalim 5:1–2
137n161
Yoma 8:4 (45a–b)
61
29
Bes.ah 1:5 (60c)
28
9
Yebamot 8:1 (9a)
23
Sot.ah 1:4 (16d)
103
Qiddušin 4:14 ‘Abodah Zarah 2:2 H . ullin 3:1 3:5
Mokhtarian-Medicine in the Talmud.indd 224
61 171n12
109 124–25n39
84 44 58–59, 69, 158n64 67, 68, 69, 136n146 136n144
12/03/22 2:24 PM
.
Source Index 225 ‘Abodah Zarah 2:2 (40d)
168n83
Midrash Leviticus Rabbah 16:1 16:8 26:5
165n53 157n36 168n84
Numbers Rabbah 12:3
176–77n65
Lamentations Rabbah 1:29
176–77n65
Babylonian Talmud Berakot 5a 5b 10b 32a 39b 40a 44b 51a 55a–57b 60a 61a
25 136n138 155–56n26 164n34 104 103, 120n5, 123n24 63 126–27n69 124n35, 153n5 56 20
Šabbat 61a 61a–b 65a 66b 66b–67a 67a 67a–b 77b 78a 82a 90a 108b–109a 108b–111b 109a 109b
85, 159–60n1 21, 85, 86 163n31 49, 87, 105–6, 109, 128n78, 179n89 159–60n1 22, 50, 126n61, 148n66, 176n61 180n105 53, 157n43 164n47 23, 102 65, 120n4, 136n143 10 2, 3, 10, 71, 115 46 63, 64, 65, 103–4, 124–25n39, 126n59
Mokhtarian-Medicine in the Talmud.indd 225
109b–110b 110a 110a–b 110b 164n33 111a 127a 129a 129a–b 133b 133b–134a 134a 134b 137a 140a 156a
128n78 126n61, 151n86, 165n52 10, 124–25n39, 126n67 15, 16, 24, 102, 126n59, 126n60, 126n61, 126n64, 120n4, 151n86, 167n67 136n138 87, 128n78, 165n52, 166n58 171n15, 175n52 137n161 30, 179n89 105, 148n70 157n43 23 25–26, 120n5 173–74n27
‘Erubin 28b–29a 29b 54a 55b–56a
63 120n5, 123n24, 128n85, 179n89 52 158n50, 165n50
Pesah. im 25a–b 25b 42a 52a 56a 110a 111b 112a 113a 116a
180–81n107 135n129 158n50 137n161 155–56n26 53 164n47, 176n64, 176–77n65 122–23n20 23, 29 128n90, 165n50
Yoma 44b–45a 78b 83a 83b 83b–84a 84a 85b Bes.ah 18b 22a
163n25 179n89 60, 61 128n89 171n12, 177n66 70, 159n80, 159n81, 181n108, 181n109 125n45
120n4 136n155
12/03/22 2:24 PM
.
226 Source Index Ta‘anit 18b–26a 20b 21b–22a
124n35 23 29, 92
Yebamot 64b 71a–b 76a 121a
47, 151n86 23 164n46, 165n52 166n58
Ketubbot 10b 39b 50a 74b 77b
126n62, 179n89 165n52, 179n89 126n67, 179n89 158n49 9, 80, 128n85, 151n86, 164n36
Nedarim 32b 39a–41b 41a 50b 54b 81a
177–78n70 136n138 52 24 87, 131–32n108 49
Sot.ah 14a 36b Git.t.in 56b 67b 68b 68b–69b 68b–70b 69a 69a–b 69a–70a 69b
Mokhtarian-Medicine in the Talmud.indd 226
136n138 155n25
149n73 16, 49, 126n59, 179n89 14, 120n4, 129–30n99, 163n31, 164n46 41 2, 3, 126n67, 128n78 7, 8, 77, 78, 87, 109–10, 111, 120n4, 124–25n39, 126n61, 127n71, 152n106, 164n36, 165n52, 167n67, 174n33, 175–76n55 74 12 11, 49, 50, 60, 79, 87, 95, 110–11, 120n5, 126n60, 126n61, 128n90, 163n29
70a 70b 71b 86a Qiddušin 82a
7, 8–9, 63, 76, 121n13, 122n19, 165n53, 179n89 121n13 121n13 11–12, 14
92
Baba Qamma 35a 46b 82a 85a
152n106 28 62 28–29, 135n128, 156n29
Baba Mes.i‘a 78b 83b 85b 86a 107b 113b
62 165n52, 166n58 24 91 57–58 24
Baba Batra 58b
12
Sanhedrin 48b 75a 84b 91a 99b 99b–100a 101a
59 30 49, 50, 164n40 168n83 155n25 29–30, 137n161 136n138
‘Abodah Zarah 11b 12b 26b–27a 27a–29a 27b–28a 28a 28a–b 28b
90 122–23n20, 128n78 84 2, 3, 9, 10, 71, 93, 126n67 136n146 10, 18, 50, 68, 69–70, 78, 84, 108, 112, 135n129, 159n80, 167n67, 178n79 126n60, 129n94 18, 26, 27, 30, 75, 76, 126n59, 126n61, 128n78, 137n161, 163n29, 179n89
12/03/22 2:24 PM
.
Source Index 227 28b–29a 29a 31b
79 62, 64, 82, 101, 126n61 77
Šebu‘ot 15b
152–53n1
Makkot 23b
177–78n70
Menah. ot 42b–43a 64a 68b
124–25n39 122n17 104
H . ullin 18b 47a 48b 51a 77b 105b Bekorot 45a
120–21n6 50 120–21n6 50 44, 107 13, 53, 120n4, 123n22, 175–76n55
177–78n70
Aramaic Bowls Ford and Morgenstern, Bowls in Museum Collections HS 3023 177n68 Levene, Corpus of Magic Bowls M155 Levene, Jewish Aramaic Curse Texts 040A (BM 91767) VA.2418 VA.2423 Shaked, “On Hekhalot, Liturgy and Incantation Bowls” Moussaieff Bowl 1 Shaked, “Transmission” MS 2053/13 Shaked et al., Aramaic Bowl Spells JBA 1 JBA 1–12 JBA 2–4, 6–9, 12 JBA 11:7–8
177n69
100–101 100 98–99
99
100
178n75 177n69 120n4 122n18
Maimonides
Temurah 15b
158n49
Niddah 17a 20a–b
Guide of the Perplexed Book 3, ch. 14 Book 3, ch. 37
21 22
165n53 100
Mishneh Torah, On Idolatry 11.10–11
21
Targum PseudoJonathan Deuteronomy 28:22
Middle Persian Sources Dēnkard Book III, ch. 157 Khusrow son of Kawād and the Page line 81
Jewish Magical Sources Sword of Moses (Harari ed.) 62 84 84–85
Mokhtarian-Medicine in the Talmud.indd 227
169–70n3
48
122n18 119–20n3 126n64
64
Pahlavi Widēwdād chs. 20–22
169–70n3
Wizīdagīhā ī Zādspram chs. 29–31
169–70n3
12/03/22 2:24 PM
.
228 Source Index
Syriac Sources Book of Medicines (Budge ed., vol. 2) 68 150 152 265 656–714 658
Mokhtarian-Medicine in the Talmud.indd 228
Mandaic Sources 174n33 174n30 174n30 174n30 174n35 94
Book of the Zodiac (Drower ed.) 12 18 58 71 86–87 100–101
97 96 97 175n52 97 175n52
12/03/22 2:24 PM
General Index
Abaye, 8–9, 11–12, 14, 23, 29, 44, 53, 56, 69–70, 76, 80, 107–9, 176–77n65 Abaye’s mother, 30, 49, 76, 104–6, 123n24, 126n62, 126n67, 137n161, 148n70. See also women, role of, in Talmudic medicine Abba the Bloodletter, 29, 92 abscess, 49, 50 abscess/boil, 49 ailments, types of, in the Talmud, 2–5, 10. See also bowls, diseases referenced in; Git.t.in Book of Remedies, list of ailments in; medicine, in the Talmud, ailments in, number of; methodological issues, in the study of Talmudic medicine, identification of diseases and drugs, problem of; rabbis, suffer from afflictions Akkadian medicine: compared to Greek medicine, 66, 75; influences of, on the Babylonian Talmud, 3, 5, 10, 15, 17, 75, 90–91, 106, 112, 137n157. See also Geller, Markham J.; Git.t.in Book of Remedies, Akkadian context of; loanwords or cognates, in Talmudic Aramaic medical texts, from Akkadian; physicians, in Akkadian, with parallels in the Talmud alchemy, 75, 95 Alexander, Elizabeth Shanks, 40 Alexander, Philip S., 72 Amar, Zohar, 63 Amsler, Monika, 36 amulets: Maimonides on, 21–22; role of physicians in, 84–85, 168n84; testing and effi-
cacy of, 83–86; used for healing purposes, 41. See also magic, ancient Jewish anachronism, problems of, in the study of ancient medicine. See study of, Talmudic medicine, apologetic and anachronistic tendencies anal fissure, 75–76 anatomy: knowledge of, based on observation, 72; knowledge of, from animals, 2, 110, 120–21n6; number of limbs, of a human body, 99, 177–78n70 animals: diseases of, compared to human ones, 50, 120–21n6, 152n106; use of, in therapies, 15, 16–17, 30, 53–54, 60, 74, 75, 76, 78, 97, 105–6, 124–25n39, 129–30n99, 158n49, 165n52. See also anatomy, knowledge of, from animals; t.repa anonymity, of Talmudic therapies. See Git.t.in Book of Remedies, anonymity of; redaction, of Talmudic medical passages; therapies, genre of, in the Babylonian Talmud, anonymity of apoplexy, 176n64 Arab, figure of, in the therapies, 69–70, 101–2, 107–9 Arabic medicine: influenced by Greek, and impact on medieval Jewish medicine, 19–20, 21, 51, 74 Asaph the Physician, 19, 73 astrology: Maimonides on, 21–22; in the Mandaic Book of the Zodiac, 96; in Second Temple writings, 73; in the Syriac Book of
229
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230 General Index astrology (continued) Medicines, 93; in the Talmud, 74; in Talmudic medicine, 173–74n27, 175n52 authority, to heal, given to humans, 56–57 autopsy, restrictions against, 2 Babylonian medicine. See Akkadian medicine Babylonian Talmud. See medicine, in the Babylonian Talmud; therapies, genre of, in the Babylonian Talmud Bacharach, Yair Chaim, 46 Balberg, Mira, 25, 51 baraitot, medical ideas in, 60, 62–63 bath/bathhouse, 15–16, 75 Becker, Adam H., 93–94 bee sting, 126n67 beer, used with medicine, 12, 104 Benjamin the Physician, 29–30 bent heart cartilage, 64, 82, 91 Berkowitz, Beth, 107–8 Bhayro, Siam, 48, 93 Bible, medical texts in: concept of God as healer in, 52; hyssop in, 63–64; key texts in, about health and illness, 152–53n1; lack of direct relationship to Talmudic medicine, 4, 8, 48, 51–53, 127n74; lack of therapies in, 51; rabbinic exegesis of, 57–59, 70; ritual impurity and disease in, 51, 63; role in Asaph’s work, 73; study of, 31, 152–53n1 blood coming from the mouth, 109–10 blood of the head, 14, 128n87 bloodletting: for animals and humans, 50; in Greek and Babylonian medicine, 66, 92; Maimonides on, 21–22; meal after, sympathetic logic of, 87; negative qualities of, 92; prayer for, 56; rabbis as experts in, 23, 64; role of astrology in, 175n52; for a two-day heatstroke, 49; use of scalpel and shard in, 76, 79; vinegar taken for, 79. See also Abba the Bloodletter Bohak, Gideon, 41–42 boils, 11–12, 49, 53 Book of Mysteries (Sefer ha-Razim), 14 Book of Remedies, hidden by King Hezekiah, 55 Book of Tobit, 55 bowls, Aramaic incantation: diseases referenced in, 2, 48; end of production of, 19–20; influenced by Akkadian heritage, 90, 170n8; on the margins of the rabbinic tradition, 40–41; for protecting a pregnancy, 105; in
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relation to Talmudic medicine, 6, 42, 98–101, 176n61, 176n64, 177n66, 177–78n70; used for healing purposes, 41, 83. See also demons, and diseases; magic, ancient Jewish Boyarin, Daniel, 6–7 Brody, Howard, 82 Brody, Robert, 90 Budge, E. A. Wallis, 93 Cairo Genizah, medical sources in, 14, 19, 45–46, 60, 173–74n27 Carmoly, Eliakim, 32 Castiglioni, Arturo, 33 cataract, 14, 78, 100, 164n47 catarrh, 74–75 Celsus, 60 changes in nature, concept of, 20, 46 compress, 75, 78 constipation, 67, 102, 151n86 crack in the skin, 49–50, 91 dates, 11, 63–65, 68 day-blindness, 76 Dead Sea Scrolls, 55, 73 delareya. See diarrhea demons, and diseases, 17, 53, 55, 66, 74, 83–84, 91, 97–101, 176–77n65, 177n69. See also bowls, Aramaic incantation; etiology, concepts of, in the Talmud; magic, ancient Jewish diarrhea, 8–9 diet, role of, in medicine: in the Greek tradition, 66; in Hebrew traditions, influenced by Greek, 62, 71; Maimonides on, 21–22; Rav on, 23. See also food, role of, in health or illness dimness of the eyes, 27–28 Dioscorides, 62, 73, 171n12 diphtheria, 100 disease. See ailments, types of, in the Talmud doctors. See physicians drinking uncovered water, 103–4 Drower, Ethel S., 96 drugs. See materia medica, in the Babylonian Talmud Dvorjetski, Estée, 23 dysentery, 100 earache, 18, 30, 75 efficacy, or inefficacy, of Talmudic medicine, 5, 37, 64, 107; biomedical perspectives on,
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General Index 231 81–82; and magical thinking, 87; as perceived from the Middle Ages until today, 19–22, 35, 46; as perceived by the rabbis, 83. See also amulets Efron, John M., 32 empiricism, role of, in Talmudic medicine, 5, 8, 17–18, 37, 42, 43, 49, 62, 72, 74, 75, 87–88, 94, 144–45n39. See also observation, role of, in Talmudic medicine; trial and error, role of, in Talmudic medicine ethics, medical, 26, 34. See also physicians, and patients’ rights etiology: concepts of, in the Talmud, 52–53; of frailty, 9; of ra’atan, 80, 165n53; of scurvy, 69–70; sympathetic logic of, 87. See also demons, and diseases; inflammation, causes of; wine, cause of disease evil eye, 23, 57–59 expert doctor, 68, 84, 103. See also physicians external afflictions, 26. See also internal afflictions eye disease, 24, 27–28, 46, 48, 62, 103. See also cataract; day-blindness; dimness of the eyes; eye pain; inflammation (of the eye); internal hemorrhage; secretion; tearing eye pain, 27 fever, 23, 48–50, 87, 98–99. See also fever/ sickness; heatstroke; hot fever; one-day fever fever/sickness, 79 fierce sting/white worms, 79 flatus, 79 fluke worm, 65, 158n63 Fonrobert, Charlotte, 104–5 food, role of, in health or illness, 11, 62–63, 65, 74. See also diet, role of, in medicine Ford, James Nathan, 48 frailty, 9, 13 Freeman, David L., 5 Galen/Galenic medicine: in Arabic, 21; bloodletting in, 92; in Genizah recipes, 130– 31n103; in Greco-Syriac tradition, 92–93; influences of, on Isaac Israeli, 131n104; influences of, on Maimonides, 21; influences of, on the Mishnah, 51; study of, in relation to the Talmud, 32; unknown to the rabbis, 92. See also Greek medicine gall, 57–59, 91 garguteni: 28–29
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garlic, 8, 62, 81–82, 111 Geller, Markham J., 3, 5, 7, 10, 15, 35, 66, 90–91, 92, 116, 122n19. See also Akkadian medicine Geonim, 20. See also Sherira Gaon Gintzburger, Benjamin Wolff, 32 Git.t.in Book of Remedies, 3–9: Akkadian context of, 3–4; anonymity of, 7; date of, 7, 90; differences with magical sources, 41–42; as an independent source, reasons for inclusion of, in the Talmud, 5–7; lack of Jewish elements in, 8, 19, 96; list of ailments in, 4–5; rabbis in, 8–9, 110–12; therapies in, not viewed as commandments, 6–8; written template of, 60. See also ailments, types of, in the Talmud; Akkadian medicine, influences of, on the Babylonian Talmud; empiricism, role of, in Talmudic medicine; materia medica, in the Babylonian Talmud; medicine, in the Babylonian Talmud; observation, role of, in Talmudic medicine; rabbinization, of therapies; redaction, of Talmudic medical passages; therapies, genre of, in the Babylonian Talmud Gordon, Benjamin Lee, 33 Greek medicine: compared to Babylonian medicine, 66, 75; influences of, on Asaph, 73; influences of, on the bowls, 100; influences of, on Hebrew medical traditions, 62, 66, 171n12; influences of, on the rabbis and the Talmud, 23, 80, 91–92; lack of influences of, on the Git.t.in Book of Remedies, 171n10; as pillar of western medicine, 35; status of, in the Middle Ages, 19–20, 51. See also diet, role of, in medicine, in the Greek tradition; Galenic/Galenic medicine; diet, role of, in medicine, in Hebrew traditions, influenced by Greek; loanwords or cognates, in Talmudic Aramaic medical texts, from Greek Halbertal, Moshe, 6 Harari, Yuval, 41 headache. See migraine healing. See amulets, used for healing purposes; bowls, Aramaic incantation, used for healing purposes; magic, ancient Jewish, medicine or healing, as subcategory of; medicine, in the Babylonian Talmud; therapies, genre of, in the Babylonian Talmud
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232 General Index heart palpitation, 110–11 heatstroke, 48; one-day, two-day, three-day, 49; ongoing, 16 heaviness of heart, 25–26, 111 Heeßel, Nils P., 45 hemophilia, 47–48 hemorrhoids, 11, 75, 95 Hezser, Catherine, 55 hip-disease/malady, 50 honey, medical uses of, 18, 60, 74–75, 77, 82, 101, 111 hospitals. See institutions, medical hot fever, 135n129 hypospadias, 165n52 hyssop, 63–65 identification, problems of, of diseases and drugs. See methodological issues, in the study of Talmudic medicine, identification of diseases and drugs, problem of “if not . . . ” (phrase in therapies), 12, 14, 15–18 Ilan, Tal, 68, 103, 104–5 infected pustule, 17–18 inflammation (of the eye), 27 inflammation of the bones, 48, 76, 99 inflammation, causes of, 27, 78, 105 institutions, medical, 28, 92 internal afflictions, 26–27, 57, 69, 135n129. See also external afflictions; life-threatening illnesses internal hemorrhage (eye), 27 intestinal disease, 25, 176–77n65 intestinal inflammation, 48, 123n24 Jardine, Nick, 38, 39–40 Jastrow, Marcus, 8, 82 jaundice, 15, 16, 17, 24, 91, 102, 133n112 Josephus, 55, 155n25 Jubilees, 19, 55–56, 73 Jundishapur, 92, 162n14 Kagan, Solomon, 33 Kalmin, Richard, 5, 7, 15, 108–9 Karaites, attitude of, toward medicine, 20, 131–32n108 Kessel, Grigory, 93 kidneys: advise person, to do good or evil, 20; of an animal, used as medicine, 30, 75, 97 Kottek, Samuel S., 2–3, 34, 47 Kwasman, Theodore, 91
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Lampronti, Isaac, 20 Langermann, Tzvi, 22 larynx (pustules of), 7, 77 law (halakha): medical, rabbis’ regulation of, 74, 107, 111–12; therapies, referenced in the context of, 2, 9–10, 60; scientific knowledge in a canon of, 6. See also Bible, medical texts in; Mishnah, medicine in; nonJews, permission to be healed by; Sabbath, laws of, and medicine; therapies, genre of, in the Babylonian Talmud, not viewed as commandments leeks, 16–17, 102 Lehmhaus, Lennart, 35–36, 53–54, 68, 109 lentils, 76 leprosy, 8, 44, 80, 111 Levene, Dan, 5, 98 lexicon, of medical terms, 11–12. See also loanwords or cognates, in Talmudic Aramaic medical texts life-threatening illnesses: internal afflictions, defined as, 26–27; treated by non-Jews, 9–10; treated on the Sabbath, 67–69, 77–78, 112. See also internal afflictions; Sabbath, laws of, and medicine; saving a life linen rags, 10–11, 75–76 liver, blood coming from, 109–10 loanwords or cognates, in Talmudic Aramaic medical texts: from Akkadian, 3–4, 28, 122n19, 122–23n20, 137n157; comparative linguistics, value of, for identifying diseases and drugs, 48; with different meanings across languages, 94, 122n19; as evidence for shared medical discourse, 94–95; from Greek, 11, 67–68, 82, 91, 95, 158n64; from Mandaic, 96, 97, 175–76n55; from Middle Persian or Middle Iranian, 11, 64, 75, 95, 175–76n55; from Syriac, 94–95; as technical terms, 11 lovesickness, 30 lungs, blood coming from, 109–10 mad dog bite, 70, 171n12, 177n66 magic, ancient Jewish: differences with therapies, Jews aware of, 42; and empirical therapies, 17–18, 49–50, 87–88; as healing, lack of, in the Yerushalmi Talmud, 66; in “if not” alternatives, 17; literary forms of, similarities and differences with therapies, 14–15; medicine or healing, as sub-
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General Index 233 category of, 34, 41; problems with category of, vis-à-vis medicine and science, 36, 39, 41–44, 72, 144–45n39; Rav on, the use of, to heal, 23, 57–58. See also amulets; bowls, Aramaic incantation; demons, and diseases; Git.t.in Book of Remedies, differences with magical sources; study of, Talmudic medicine, as subcategory, of magic; Sword of Moses; therapies, genre of, in the Babylonian Talmud, compared to books of magic; Ways of the Amorites Maharsha. See Shmuel Eliezer Edels Maimonides, Moses, 19–22, 134n117 Mandaic sources, medicine in, 96–98 marble room, for surgery, 80 marginalization, of the Talmudic therapies. See medicine, in the Talmud, reception and marginalization of, from the Middle Ages until today Mar Ukva, 9, 25–26 Marx-Wolf, Heidi, 35 materia medica, in the Babylonian Talmud: composed of, natural substances, 37, 74; connections with the Bible and the Mishnah, 64–65; efficacy of, based on modern science, 81–82; external influences on, 3–4, 95; given by God, 53–55; identification of, 8–9, 44–48; influenced by local botany, 4; lack of Jewish symbolism of, 17, 19; lack of references to, in the Middle Ages, 131–32n108; number of, 37; procurement of, in “if not” therapies, 128n87; related to magical thinking, 87; in the Yerushalmi Talmud, 66–67. See also alchemy; dates; diet, role of, in medicine; efficacy, or inefficacy, of Talmudic medicine; food, role of, in health or illness; honey, medical uses of; hyssop; kidneys, of an animal, used as medicine; leeks; lentils; loanwords or cognates, comparative linguistics, value of, for identifying diseases and drugs; methodological issues, in the study of Talmudic medicine, identification of diseases and drugs, problem of; posology; wine, used in remedies Melzer, Aviv, 73 medicine, in the Babylonian Talmud: ailments in, number of, 2; definition and category of, 1, 36–41, 144–45n39; reception and marginalization of, from the Middle Ages until today, 19–22, 34–35, 47,
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57, 124n38, 131–32n108, 133n112. See also ailments, types of, in the Talmud; Akkadian medicine, influences of, on the Babylonian Talmud; Bible, medical texts in, lack of direct relationship to Talmudic medicine; bowls, Aramaic incantation, in relation to Talmudic medicine; diet, role of, in medicine; efficacy, or inefficacy, of Talmudic medicine; etiology; Git.t.in Book of Remedies; Greek medicine, influences of, on the rabbis and the Talmud; law (halakha); magic, ancient Jewish; materia medica, in the Babylonian Talmud; methodological issues, in the study of Talmudic medicine; physicians; rabbis; redaction, of Talmudic medical passages; therapies, genre of, in the Babylonian Talmud; women, role of, in Talmudic medicine methodological issues, in the study of Talmudic medicine: identification of diseases and drugs, problem of, 20, 44–50, 80, 81–82, 148n70; use of archaeological sources, value of, 45; use of marginal sources, value of, in this book, 40–41; using modern categories for ancient terms, problem of, 36–40. See also magic, ancient Jewish, problems with category of, vis-à-vis medicine and science; study of, Talmudic medicine migraine, 14, 129–30n99, 136n143 Mishnah, medicine in, 60–65, 71, 109–10 molar (pain). See toothache mortal danger. See life-threatening illnesses Muntner, Sussman, 33 Nah. manides, 26, 53, 57 Naveh, Joseph, 42, 88 Nisibis, 23, 92 Noah, and the origins of medicine, 19, 55–56, 73 non-Jews: gentile doctors, access to, in Palestine, 66–67; healing by, rabbis discourage, 13, 17, 102; medical customs, Jews shared in common with, 19, 106–7, 111–12; permission to be healed by, 9, 84, 102–3; rabbis learn therapies from, or vice versa, 13, 90, 101–2, 108–9. See also Arab, figure of, in the therapies; Ways of the Amorites nosebleed, 87–88
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234 General Index Nossig, Alfred, 32 Novick, Tzvi, 30 observation, role of, in Talmudic medicine, 5, 37, 65, 72, 74, 83, 89, 108–9, 144–45n39. See also empiricism, role of, in Talmudic medicine; trial and error, role of, in Talmudic medicine one-day fever, 49, 105–6 one-day heatstroke. See heatstroke ongoing heatstroke. See heatstroke open wound, 77–78, 112 Ostrer, Boris S., 80 parasitic worms, 63–65, 89 Paul of Aegina, 80 physicians: in Akkadian, with parallels in the Talmud, 137n157; Hebrew traditions about, 62, 158n49; names of, in rabbinic literature, 29, 137n161; not mentioned in therapies, 13, 77; official position of, in the Sasanian Empire, 169–70n3; overlap with other professionals, 85, 147n58; and patients’ rights, 60–61; praised by Ben Sira, 54–55; relationship with rabbis, 28–30; role of, in amulets, 84–85, 168n84; role of, in ra’atan surgery, 80–81; stories about, in the Yerushalmi Talmud, 67; title of, rabbis called, 24, 137n161. See also Abaye’s mother; Abba the Bloodletter; Asaph the Physician; authority, to heal, given to humans; Benjamin the Physician; bloodletting; expert doctor; Maimonides; non-Jews; Rabbi Ammi the Physician; Shmuel; study of, Talmudic medicine, majority of, by physicians and scientists; Yerushalmi Talmud, medicine and physicians in pleurisy, 13, 74–75, 96 Pliny, 95 posology, 14, 74, 110 Preuss, Julius, 18–19, 33, 72 Prioreschi, Plinio, 33 qet.eb meriri, 176–77n65 ra’atan, 9, 76–77, 79–81 Rabbi Ammi the Physician, 137n161 rabbinization, of therapies, 3, 7–8, 10, 103, 106–12
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Rabbinowicz, Israel-Michel, 32 rabbis: discuss medicine, in the academies, 25–26; innovations of, in medicine, 107; invested in the study of nature, 72; learn medicine, from non-Jews, 10, 101–2, 106– 8; leniency toward foreign medical knowledge, 43–44, 106–8; own reasoning, leads to medical thought, 58–59; participate in, global transfer of medical knowledge, 95–96; regulate medical practices, 7, 13, 74, 107, 111–12; role of, in therapies, 8–9, 22–25; suffer from afflictions, 10, 24–25. See also Bible, medical texts in, rabbinic exegesis of; bloodletting, rabbis as experts in; Git.t.in Book of Remedies, rabbis in; physicians, relationship with rabbis; physicians, title of, rabbis called; rabbinization, of therapies Rabbi Yehudah the Patriarch, 24 Rabbi Yoh. anan, 7, 8, 16, 24, 47, 61–62, 65, 68–70, 77, 84 rabies. See mad dog bite Rashba. See Shlomo ben Adret Rav, 8, 23, 26, 27, 29, 53, 57–59, 87, 90 Rava, 8, 23, 25, 29–30, 44, 106, 107–8 Rav Ashi, 28, 98, 101, 106, 109–10 ravenous hunger, 91 Rav H . isda, 9, 23, 63, 102 Rav Huna, 23, 70 Ravina, 110–11, 135n129 Rav Pappa, 80, 85–86, 101, 176–77n65 redaction, of Talmudic medical passages, 2, 4–8, 17, 83, 105–6, 110–11, 181n115. See also Git.t.in Book of Remedies, as an independent source, reasons for inclusion of, in the Talmud; rabbinization, of therapies Rochberg, Francesca, 96 Rosner, Fred, 24, 34 Rudolf, Stefanie, 93 Sabbath, laws of, and medicine, 10, 25–28, 63, 67, 68–69, 77–78, 112. See also law (halakha); life-threatening illnesses; saving a life salves, 11–12, 24, 27, 30, 68, 91, 94, 95 s.apdina. See scurvy Sasanian Empire, medicine in: shared experience and discourse of, between communities, 89, 94–95; study of, 35; two streams of thought in, 89–90, 95. See also physi-
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General Index 235 cians, official position of, in the Sasanian Empire saving a life, 7, 112. See also Sabbath, laws of, and medicine; life-threatening illnesses science, definition and study of, in ancient Judaism, 72–74 scorpion sting, 79, 126n67 Scurlock, JoAnn, 17 scurvy (s.apdina), 68–70, 108 secretion (eye), 27 Shaked, Shaul, 42, 98, 100 Shemesh, Abraham Ofir, 102–3 Sherira Gaon, 6, 20 Shinnar, Shulamit, 36 Shlomo ben Adret (Rashba), 20 Shmuel, 8, 23–24, 30, 57–58, 67, 77–78, 87, 90, 112 Shmuel Eliezer Edels (Maharsha), 46 sickness of the heart, 123n24 Simon, Isidore, 33 skin diseases: in the Bible and the Mishnah, 51, 63; in the Dead Sea Scrolls, 55; taxonomy of, in the Talmud, 48–49. See also abscess; abscess/boil; boils; crack in the skin; infected pustule; leprosy; ra’atan; skin lesion; skin disease/scabs; sore (skin) skin disease/scabs, 30, 79 skin lesion, 49 Smith, Jonathan Z., 43 snake, bite and venom, 53, 77, 103–4, 124–25n39, 128n89; removal of, from vagina, 79–80 Snowman, Jacob, 33 sore (skin), 49, 94 spleen (diseased), 11, 14, 60, 87, 157n42 Steinberg, Avraham, 34 strain the rectum, 23 study of, Talmudic medicine: apologetic and anachronistic tendencies, 31–33, 35; majority of, by physicians and scientists, rather than by Talmudists, 33–35; popularity of, in the twentieth century, 33; recent trends in, 35–36; as subcategory, of magic, 34, 41. See also methodological issues, in the study of Talmudic medicine stupor, 60–61 Styers, Randall, 43 surgery, 79–81 Sword of Moses, 2, 14–15, 41, 60 Syriac sources, medicine in, in relation to Talmudic medicine, 92–96
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tearing (eye), 27 Testament of Solomon, 55 therapies, genre of, in the Babylonian Talmud: anonymity of, 7–8, 13–14; commonalities between key sources of, 10–11; compared to books of magic, 14–15, 41–42; as home remedies, 13, 77; “if not . . . ” phrase in, 15–18; influenced by foreign medical systems, 3, 5, 10, 15, 17, 18, 53, 75, 89–98, 106– 9, 112; lack of didactic message in, 6, 83, 124n38; lack of Jewish elements in, 8, 18–19; lack of moralizing and theological language in, 52–53; literary forms of, 12–15; main sources of, 2, 3, 9; not viewed as commandments, 6–8, 19; parallels with other rituals, 124–25n39. See also ailments, types of, in the Talmud; Bible, medical texts in, lack of therapies in; Bible, medical texts in, lack of direct relationship to Talmudic medicine; empiricism, role of, in Talmudic medicine; Git.t.in Book of Remedies; “if not . . . ” (phrase in therapies); law (halakha), therapies, referenced in the context of; magic, ancient Jewish; materia medica, in the Babylonian Talmud; medicine, in the Babylonian Talmud; non-Jews; observation, role of, in Talmudic medicine; physicians, not mentioned in therapies; rabbinization, of therapies; rabbis, role of, in therapies; redaction, of Talmudic medical passages; trial and error, role of, in Talmudic medicine tools, used for medical purposes, 12, 74, 78, 79–81 toothache, 7, 8, 10, 69, 81–82, 111 Tosafists, on Talmudic medicine, 20, 46, 57 t.repa, 29, 109–10, 124–25n39 trial and error, role of, in Talmudic medicine, 5, 37, 74, 83, 86, 108. See also empiricism, role of, in Talmudic medicine; observation, role of, in Talmudic medicine Tuszewicki, Marek, 20–21 Twersky, Isadore, 21 two-day heatstroke. See heatstroke Upson-Saia, Kristi, 35 Veltri, Giuseppe, 5, 15, 59–60, 72, 107 vertigo, 176n64 visiting the sick, 24
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236 General Index Wandrey, Irina, 48 warnings: against incorrect use of therapies, 78–79; of potential relapse, 76–77; of side effects, 8, 52, 94 Ways of the Amorites, 22, 43–44, 107–8 wine: cause of disease, 9, 12–13; used in remedies, 12, 49, 67, 76, 79, 87, 93, 110–11, 126– 27n69 Wilson, Adrian, 44 Wisdom of Ben Sira, 54–55 women, role of, in Talmudic medicine, 47, 68–70, 103–6. See also Abaye’s mother
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word-play, as basis of medical thought, 62–63, 79 Wunderbar, Reuben Josef, 32–33 Yerushalmi Talmud, medicine and physicians in, 23, 28, 53–54, 55, 58–59, 61–62, 65–69, 84 zaba, 10, 11 Zoroastrianism: influences on Talmud, in non-medical contexts, 89; medicine in, 169–70n3 Zucconi, Laura M., 33
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