HEALTH CARE IN THE BIBLE AND THE TALMUD

Daar is ’n rykdom van kosbare materiaal ten opsigte van mediese kennis in die Bybel en die Talmud te vind. Melding van ’n groot aantal siektes word gemaak, asook die diagnosering, behandeling en voorkoms daarvan. Dikwels word melding ook gemaak van onderwerpe soos etiek vir die geneesheer, anatomie enfisiologie, forensiese geneeskunde, geestelike ongesteldhede en veral higiëniese maatreëls. Dit is nie verniet dat Moses die “ Vader van Voorkomende Geneeskunde” genoem word nie. Daar bestaan 613 Bybelse voorskrifte en beperkinge waarvan 213 gesondheidsreëls is. Die Antieke Hebreeus het die beginsels van voorkomende geneeskunde via ’n godsdienstige roete na die Weste oorgedra.

There are 613 Biblical com m andm ents and prohibi tions o f which no less than 213 are health rules which were enforced by strictly observed cerem onial rites.
" The whole concept o f the isolation o f disease becam e the p roperty o f the West by the religious ro u te" . (R osner, p .3). M edicine and religion, am ong the ancient H ebrews, were inextricably intertw ined, as they were am ong all ancient peoples. Hygienic laws were enforced as religious laws, and the breaking o f one of these laws with the possible illness which resulted, was interpreted as Divine punishm ent. Nevertheless How ever in the m onotheistic concept o f ancient Israel there were no " healers" . Only G od could " h eal" sickness. Those physicians who called them selves " healers" (rofé in H ebrew) were generally foreigners and are spoken o f in a derogatory fashion (Jer. 8:22, H osea 5:13, Job 13:4). There was also a distinction m ade between physicians, surgeons and blood-lettersthe latter being considered o f a lower social order.
The geographic setting o f the Talm udic era covered not only Israel but also the adjacent countries. Neither the Bible nor the T alm ud were intended to be medical reference texts yet they contain a specialised Hebrew nom enclature for certain diseases and parts of the hum an anatom y. (See Preuss, Rosner et al).
A noted Biblical scholar, Jesus Ben Sira (Ca. 150 B C E) w rote at some length on the im portance o f medicine and the role o f the physician. It was prim arily due to Ben S ira's influence th at the physician through the ages, was held in such high esteem am ong the Jews, right up to the present time. A noted Talm udist who was also an outstanding physician was M ar Sam uel. He had considerable knowledge o f pharm acology and anatom y.
The Jewish sect, the Essenes, were active not only in religious and m oral questions, but also in medical p ro blems. They lived in small m onastic groups devoting themselves to handcrafts and the healing o f the sick.
The nam e Essene is derived from the A ram aic 'assia' m eaning 'helpers', i e physicians and therapists. Their therapeutic objectives were to bring the p atien t's soul " nearer to perfection and thus to G o d " . M any o f their teachings were adopted by the early C hristians.
" There were m any other Talm udic scholars who com m ented on health problem s, and that they possessed a hygienic conscience is evident from the Public H ealth regulations scattered through the Talm ud. The chief contribution o f Talm udic m edicine, like that o f Biblical medicine, was not so m uch in therapeutic m easures as in preventive medicine expressed in health rules based on religious and ethical principles." (R osner, p. 19).
It is surprising therefore th at Biblical and Talm udic medicine had no influence on m ediaeval medicine -not even on the great Jewish physicians, such as M aim onides, who were thoroughly conversant with Talm udic literature. M ediaeval medicine was totally under the influence o f G alen ( ± 150 A D) who was ac cepted as infallible on all things m edical, and the h talth rules in the Bible and the T alm ud were dismissed as be ing purely religious laws. " The historians o f medicine are unanim ous in their view that the science o f the healing art m ade no progress for m any centuries after the time o f G alen" . (R osner, p .20).

PREVENTIVE HEALTH IN THE BIBLE AND THE TALM UD
The main em phasis is not on therapy but on preven tive medicine and physical and m ental hygiene, as ap plied to the individual, the fam ily, the people, and socie ty in general. It is not possible here to enum erate all the public health laws appearing in the Bible and  Some examples o f these laws can be given. W hen a w atercourse was constructed for the washing o f clothes, it was illegal for it to be constructed near a party wall, and an em bankm ent had to be constructed to prevent contam inated water percolating into neighbouring p ro perty; threshing-barns, tanneries and carcasses were not allowed w ithin the city walls; shoes were to be worn as the soil was recognized to be a focus

SPE C IFIC DISEASES
A great m any diseases are m entioned in the Bible and the Talm ud, as well as their diagnosis, cure and preven tion. Some example o f these diseases are epilepsy, tu b er culosis, leprosy, dysenteric disorders, gout, rabies, scur vy, haem ophilia, helm inthic diseases, puerperal fever, and various unidentifiable fevers.
Space prohibits a m ore detailed description of all the diseases to be found in these works. The few diseases m entioned below will give an indication o f the scope of this subject.

Leprosy (Hebrew za ra'at)
A ccording to Preuss and other Semitic philologists the term " z a ra 'a t" could m ean not only leprosy, but also psoriasis and other skin diseases. The 13th book o f Leviticus deals with " zara'a t" and in  Venesection, the sewing-up o f w ounds, trep hina tions, am putations, splenectom ies, catheterizations o f the throat and even plastic surgery are described in the Talm ud. T here were also " operating room s" (batei shayish) with m arble-panelled walls. The various ways in which wounds heal was noted and it was generally recognised that deep wounds should heal from the bottom up. It was advised not to touch wounds because ''hands cause inflam m a tio n " . Cress steeped in vinegar was a favoured haem ostatic. Abscesses were opened and scraped, but this was preceded by charm s or superstitious gestures. Gangrenous or leprous limbs which had been am putated were buried in a separate section o f the cem etry, and there was a specific ritual o f washing and the burning o f clothes to be followed by both the patient and the surgeon after such an opera tion. T here is also frequent m ention m ade o f the use o f anaesthetics, or sleeping draughts, and disinfec tants which were generally vegetable concoctions.
The various selections m entioned here are only a small portion o f the wealth o f health-care to be gleaned from Biblical and Talm udic literature. In studying this subject one can use the chronological approach or look for specific topics, subjects or disease entities.
The religious laws o f the Jews em phasised the rules which a healthy person should follow not to become ill. Preventive health care rather than therapeutic care is the m ajor them e in Biblical and Talm udic health teaching. U nfortunately these teachings were ignored in the M id dle Ages because both Jewish and C hristian scholars regarded these health care principles as purely religious codes. In fact some com m entators (Tosafot) criticized the ancient health theories as being outdated and even dangerous, because in their opinion conditions and ways o f living had changed.
This ancient health-care lore is o f particular interest to m odern healthcare professionals today where the em phasis in com m unity health is on preventive health care.
The study o f ancient health-care brings us to the realisation that there is nothing new under the sun.

CONCLUSION
In 1911 Julius Preuss, who was both a physician and expert Semitic philologist, published his " Biblisch-Talmudische M edizin" which is the authorative work on the subject.