Indian Journal of Medical Ethics

EXCERPTS


The aphorisms of Isaac Judaeus (1)

Aphorism 2: As the science of medicine is so extensive and the life of man too short to attain the whole, physicians of experience should be separated from the foolish. They must purify and refine themselves by their constant study of literature and ceaseless investigation.

Aphorism 3: The rapidity or slowness or hesitation in the work of an artisan depends upon the importance of the object upon which he is working. He who is busy drilling pearls must be very careful not to destroy the beauty of his work through haste. But it is different for he who is collecting filth off the street.

It is fitting that he who is engaged in the cure of human bodies (which are the most precious of all the creations of this world) consider and examine carefully the diseases that may occur and give his directions after mature deliberation and consideration so that he make no irreparable error. Therefore the sage (Mesue) says: ‘If you find a physician who is ready as soon as asked to give information about every disease and particularly to praise his own methods, regard him as a knave.‘ The prince of physicians (Ibn Zoar) says: ‘I have never given a person a purge without having been anxious in my mind and having spent sleepless nights before and after. ‘

Aphorism 4: Just as the physician, according to what has just been said, should not be over hasty in acting, so he dare not be negligent or dilatory, for in the case of most diseases there is no time to be lost. He should hold to the mean between these two extremes and be neither too hasty and precipitate nor too tardy and negligent. In acute diseases he must think and act quickly because they are pressing.

Aphorism 11: The physician does not bring about the cure, but he prepares and smoothens the way for nature; nature is the actual healer.

Aphorism 15: The need of the physician is two-fold, preserving health and curin gd .isease. The demand for the former is greater for it is better for man to avoid falling ill than that h e become ill and be cured.

Aphorism 17: The physician who promises to cure disease with certainty takes a serious responsibility upon himself.

Aphorism 21: If it is possible to bring about a cure by means of foods or healthful nourishment, do not administer drugs as these – especially those that purge – are contrary to nature and are her enemies.

Aphorism 23: Endeavour in thy treatment always to use the simple drugs because it is easier for thee to acquire the knowledge of their action than that of those that are complicated.

Aphorism 25: Never rely, in treatment, upon wonder-working drugs for these depend mostly upon ignorance and superstition.

Aphorism 27: It is fitting to the profession of a physician that he should be moderate in eating – that he should not become a debaucher nor a glutton. It is a shame and a reproach if he should suffer from a tedious illness for then people will say: ‘How should he who cannot cure himself, cure others?’

Aphorism 28: Seal thy mouth to prophetic and self-evident expressions. What thou sayest should generally be stated as conditional.

Aphorism 29: Suffer not thy mouth to condemn when something has his evil day. Let thy deeds praise thee and seek not thine honour in another’s shame

Aphorism 30: Make it thy special concern to visit and treat poor and needy patients, for in no way canst thou find more meritorious service

Aphorism 31: Try to ease the mind of the patient. Encourage him to look art not thyself convinced of it, for this will greatly strengthen his nature.

Aphorism 38: When the patient does not follow thine instructions or his servants and people do not promptly obey thine instructions or show thee the proper respect, it is better to give up the treatment.

Aphorism 42: Do not visit thy patient too often and do not remain with him too long, unless the treatment of the disease demands it, for it is seeing the docto r anew that gives joy to the patient.

Aphorism 43: Too large a practice confuses the judgement of the physician and causes him to give mistaken directions.

Aphorism 50: Excessive activity and effort diminishes the power of the physician and weakens his spirit for he must constantly think and be concerned about each patient, hopeful of his recovery and pray for him as though he were one of his kin.

References

  1. Friedenwald Harry: The ethics of the practice of medicine from the Jewish point of view. Johns Hopkins Hospital Bulletin 1917; 318: 256-266.

(Abu Jacob Ishak ben Soleiman El-Israeli, also known as Isaac Judaeus, was born in Egypt around 830, lived in Mauritania and Cyrenaica in north Africa and died around 932.

We have abbreviated and modified slightly the version provided by Dr. Friedenwald, Editor)