Maimonides' Diet, A Journey through Ancient and Modern Concepts of Health and Disease
Elena Salmoirago-Blotcher, MD, PhD, University of
Massachusetts Medical School
During times of raising health care costs and research budgets cuts, defining what “being healthy” means becomes exceedingly important, because resources are invested based on our expectations of what health should be. The purpose of this work is to compare current views about health with Maimonides’ perspective.
Modern Western societies give great emphasis to health, as shown by an almost obsessive preoccupation with physical wellbeing and by an almost idolatrous worship of one’s body. Another example is the media’s obsession with certain lifestyle habits (diet) and conditions (overweight) that affect our body image while similarly unhealthy habits (i.e. drinking) are given less attention because they are “aesthetically” more acceptable.
Our concept of health mostly stems from epidemiological and medical definitions. These, however, can be quite different from “real” health. Epidemiological health is typically based on the presence or absence of a certain pathological condition, defined in accordance with rather arbitrary (and constantly changing) definitions. As a result, and thanks to the availability of more invasive (and expensive) testing, an increasing number of individuals are now technically defined “unhealthy”, even when asymptomatic and even when the disease, if left alone, would not lead to any serious consequence. Once diagnosed, diseases tend to be treated aggressively based on the (incorrect) assumption that “more is better” and that a more intense therapy will necessarily produce better health outcomes and longer survival. Several examples based on important epidemiological studies will be presented to substantiate these considerations.
The second part of this presentation will focus on the great medieval philosopher and physician Maimonides’ views on health. These are presented in the “Book of Knowledge” of the “Mishne Torah”, Maimonides’ commentary to Biblical and Talmudic texts. A first important observation is that health recommendations are not expounded in a separate chapter; rather, they are presented in the larger context of the laws of individual spiritual growth. For Maimonides, care for the body and care for the soul cannot be separated; we cannot care about physical health without caring at the same time for our spiritual health. Second, in contrast to our “narcissistic” idea of health, for Maimonides physical health is only a means to an end, not an end in itself. Since the ultimate purpose of human existence is to serve G-d, a healthy body is just a (necessary) tool to perform G-d’s commandments. Abandoning theistic and religious language, the purpose of health in this context is ultimately to transcend our self and individual bodies to serve a larger universal purpose.
Finally, Maimonides’ views on physical and spiritual health are similarly informed by the principle of the “middle path”. Excesses in either direction, (including excesses in behaviors that are ethically acceptable or even desirable) are inherently wrong and should be avoided at all cost. The contrast with the aggressive diagnostic and therapeutic attitudes of modern medicine is impressive.
We will conclude with a reflection on how Maimonides’ insights can lead us – as physicians, researchers and policy makers - to more human and realistic perspectives on health.
During times of raising health care costs and research budgets cuts, defining what “being healthy” means becomes exceedingly important, because resources are invested based on our expectations of what health should be. The purpose of this work is to compare current views about health with Maimonides’ perspective.
Modern Western societies give great emphasis to health, as shown by an almost obsessive preoccupation with physical wellbeing and by an almost idolatrous worship of one’s body. Another example is the media’s obsession with certain lifestyle habits (diet) and conditions (overweight) that affect our body image while similarly unhealthy habits (i.e. drinking) are given less attention because they are “aesthetically” more acceptable.
Our concept of health mostly stems from epidemiological and medical definitions. These, however, can be quite different from “real” health. Epidemiological health is typically based on the presence or absence of a certain pathological condition, defined in accordance with rather arbitrary (and constantly changing) definitions. As a result, and thanks to the availability of more invasive (and expensive) testing, an increasing number of individuals are now technically defined “unhealthy”, even when asymptomatic and even when the disease, if left alone, would not lead to any serious consequence. Once diagnosed, diseases tend to be treated aggressively based on the (incorrect) assumption that “more is better” and that a more intense therapy will necessarily produce better health outcomes and longer survival. Several examples based on important epidemiological studies will be presented to substantiate these considerations.
The second part of this presentation will focus on the great medieval philosopher and physician Maimonides’ views on health. These are presented in the “Book of Knowledge” of the “Mishne Torah”, Maimonides’ commentary to Biblical and Talmudic texts. A first important observation is that health recommendations are not expounded in a separate chapter; rather, they are presented in the larger context of the laws of individual spiritual growth. For Maimonides, care for the body and care for the soul cannot be separated; we cannot care about physical health without caring at the same time for our spiritual health. Second, in contrast to our “narcissistic” idea of health, for Maimonides physical health is only a means to an end, not an end in itself. Since the ultimate purpose of human existence is to serve G-d, a healthy body is just a (necessary) tool to perform G-d’s commandments. Abandoning theistic and religious language, the purpose of health in this context is ultimately to transcend our self and individual bodies to serve a larger universal purpose.
Finally, Maimonides’ views on physical and spiritual health are similarly informed by the principle of the “middle path”. Excesses in either direction, (including excesses in behaviors that are ethically acceptable or even desirable) are inherently wrong and should be avoided at all cost. The contrast with the aggressive diagnostic and therapeutic attitudes of modern medicine is impressive.
We will conclude with a reflection on how Maimonides’ insights can lead us – as physicians, researchers and policy makers - to more human and realistic perspectives on health.