ASAPH HA-ROFE

ASAPH HA-ROFE (i.e., Asaph the physician; also known as Asaph ha-Yehudi, Rabbenu Asaph, Asaph ben Berechiah, Asaph ha-Yarhoni ; sixth century), physician who gave his name to a Hebrew book on medicine, Sefer Asaf ha-Rofe, written somewhere in the Middle East. As yet unpublished, it is extant in 16 manuscripts, some complete; it constitutes a source of information on ancient customs and Jewish medical ethics as well as of ancient Jewish remedies and Hebrew, Aramaic, Persian, Latin, and Greek medical terminology. Excerpts from Greek medical books, some of which have been lost and are not known from any other sources, appear in Hebrew in this book. The most complete manuscripts are in Munich, Oxford, Brit. Museum London, Florence, and Paris. The book was not written by Asaph himself, but by his disciples. They mention, as teachers, R. Johanan b. Zavda and R. Judah ha-Yarḥoni, as well as Asaph. Some sections of the book are very old, though others were written or translated from other languages as late as the seventh until the tenth century. The antiquity of the work is apparent from its style, similar to that of the older Midrashim, from its use of Persian (rather than Arabic) synonyms, and from the mention of weights current in Palestine during the talmudic period. The many sentences in the book which begin "And I shall teach you" indicate that its contents had, at one time, constituted oral medical teaching. Asaph's close connection with Babylonia, the cradle of astrology, is indicated by the surname Yarḥoni (i.e., one versed in the lunar calendar, or an astronomer) attributed to him, as well as by the nature of some of his medicaments and names of the scholars referred to as authorities. These facts denote that he lived somewhere between Upper Galilee and Babylonia. Since the book contains no indication of the influence of Arabic medicine and mentions pagan witch doctors, it can be assumed that Asaph lived before the Arab conquest of the Middle East.

Several early writers make direct or indirect reference to Asaph. The tenth-century grammarian, R. Judah *Ibn Quraysh, apparently refers to Sefer Asaf when he mentions a book of remedies bearing Aramaic names. In the commentary on Tohorot, attributed to *Hai Gaon, Asaph is mentioned by name. Al-Razi also mentions him, and in the Latin translation (1279) of his ninth- or tenth-century book, Asaph the Jew – "Judaeus" – is included among the famous medical authors. Ibn al-Gezzar (tenth century), a disciple of Isaac *Israeli, mentions Asaph b. Berechiah in his book Ẓeidah li-Derakhim and in its Greek translation, Asaph is referred to as "Ασιψ ὑιὸς Ιρακιου" *Naḥmanides refers to Asaph by name in Sha'ar ha-Gemul. Sefer ha-Refu'ot shel Shem b. No'aḥ quoted by R. *Solomon b. Jeroham (920) is apparently Sefer Asaf ha-Rofe which mentions Shem in its introduction. The same applies to Sefer ha-Refu'ot ("Book of Remedies") mentioned by Rashi (on Judges 15:5) and by *Nathan b. Jehiel of Rome, author of the Arukh (s.v.vatan which is a sinew mentioned in Sefer ha-Refu'ot).

In the introduction to the book, the editor refers to the pillars of medical science Hippocrates, Dioscorides, and Galen, and apparently considers their contemporary Asaph as their equal, referring to him as "the Jew." Asaph translated these Greek sources into idiomatic Hebrew and added commentaries. The book includes a Hebrew translation of the Aphorisms of Hippocrates with a short commentary on the first chapter entitled "Ha-Midrash." It notes the basic rules of medical science during the classical and medieval period. This is the first known Hebrew translation and commentary of any Greek medical work. There is also information derived from the lost Pharmaceutics of Hippocrates. Foremost among Hippocrates' writings which served Asaph as a model was the famous oath, in which he made basic changes. Although Asaph's medical teachings are fundamentally Hippocratic, they are also influenced by Rufus of Ephesus, Dioscorides, and to a lesser extent, Galen. The Greek influence is especially manifest in Asaph's theories on the nature of water and the Mediterranean climate and in his instructions on healing the poor. In anatomy, Asaph retains early Hebrew medical tradition and terminology. Blood vessels are called gidim ("sinews"), mesillot meforadot ("separate paths"), te'alot ("channels"); limbs are called maḥlekot ha-guf ("body parts"); and ḥadrei ha-mo'aḥ ("chambers of the brain") are discussed.

According to Asaph, the heart is the seat of the soul. The movement of the blood is explained as follows: "The pulsations of the blood vessels (the pulse) derive from the animating spirit; they originate from the heart, travel to the farthest extremities of the body, from which they return to the heart like water propelled by the wind…." Specific locations are assigned to the sekhel ("intellect"), binah ("understanding"), da'at ("knowledge"), and the yeẓer ("will"). "The spirit (ru'aḥ) resides in the head; understanding, in the heart; and fear, in the hidden recesses of the body." Asaph asserts that "melancholy is spiritual, not corporeal." He gives the number of bones (evarim) from the Talmud (Oho. 1:8; Mak. 23b) as 248, but adds 365 as the number of sinews corresponding to the days of the lunar year. The bones are fed by their marrow. From the Talmud, Asaph accepts the legend of the existence of an imperishable bone – the luz ("the nut of the spinal column"; os resurrectionis). He adopts the talmudic view that the embryo is completely shaped in its mother's womb 40 days after conception. The section "On the Influence of Diet" is based on Hippocrates, but Asaph devotes greater length to the various foods, drawing on the sayings of Jewish sages as well as on popular wisdom. He mentions only the meat of animals allowed under Jewish law. Asaph generally bases his treatment of illnesses on that of Hippocrates, though his is more comprehensive and is sometimes based on different points of view. He was the first medical writer to recognize the possibility of a hereditary factor in certain diseases.

Asaph's approach to pathology follows the theory of the four humors. Disease, according to this theory, involves a disturbance of the correct blending of the four elements (earth, air, fire, water), and of the four primary qualities (dryness, moisture, cold, heat) in the body. He also deals with prognosis, diagnosis, hygiene, and pharmacology. His rules for hygiene and diet in many cases parallel those of the Talmud. Asaph seeks primarily to prevent disease through a detailed and exact regimen which calls for physical exercise, baths, ointments, massage, sunshine, fresh air, clean water, various beverages, proper choice of foods, rules for sexual intercourse, cupping, blood-letting, and correct breathing. Most of his prescriptions are borrowed from the Greeks, but he also lists formulae from Babylonia, Persia, India, and Egypt; popular remedies from Ethiopia and Sudan; and ancient Hebrew medicaments which Asaph claims were used by *Samuel Yarḥinai and date back to "the days of the Judges, before a king ruled in Israel." Medicines took the forms of liquids, tablets, pills, gargles, eye-, ear-, and nose-drops, incense, ointment, suppositories, enemas, unguents, and oil-perfumes.

Asaph was deeply religious and tried to harmonize his faith and science. He believed that many diseases come as divine retribution for sins and that sincere prayer, together with repentance and charity, are important factors in healing. He saw the objective of the Bible's prohibitions of certain foods and in the distinction between clean and unclean animals, as the prevention of disease. He often emphasized that God is the only true healer and that physicians' first duties are to fear God and to practice virtue. Asaph's teachings reflect his scrupulous medical ethics. He vigorously attacked venality in physicians, bound his students to treat the poor without charge, and listed medicines easily procured or prepared at minimum cost. He addressed himself only to the well-trained professional physician and sharply censured quacks and amateurs who discredit true medicine. Asaph and his colleague, R. Johanan b. Zavda, required of the students whom they qualified as physicians a one-thousand word oath which evidenced the high ethical standards demanded: "… Take heed that ye kill not any man with the sap of a root; and ye shall not dispense a potion to a woman with a child by adultery to cause her to miscarry; and ye shall not lust after beautiful women to commit adultery with them; and ye shall not disclose secrets confided unto you.… Be strong and let not your hands slacken, for there is a reward for your labors. God is with you when ye are with Him. If ye will keep His covenant and walk in His statutes to cleave unto them, ye shall be as saints in the sight of all men and they shall say: 'Happy is the people that is in such a case; happy is that people whose God is the Lord.' … Ye shall not cause the shedding of blood by any manner of medical treatment. Take heed that ye do not cause malady to any man; and ye shall not cause any man injury by hastening to cut through flesh and blood with an iron instrument, or by branding, but shall first observe twice and thrice and only then shall ye give your counsel…."

An Israeli government hospital in Sarafand is named after Asaph ha-Rofe.

bibliography:

H. Friedenwald, Jews and Medicine, 1 (1944), 147–8; S. Muntner, Mavo le-Sefer Asaf ha-Rofe (1957); idem, in: Ha-Rofe ha-Ivri, 20 (1947), 107–14; idem, in: S.R. Kagan (ed.), Abraham Levinson Anniversary Volume (1949), 247 ff.; idem, in: Bulletin of the History of Medicine, 25 (1951), 101–31; S. Muntner and F. Rosner, in: Journal of the American Medical Association, 205 (1968), 912–13; L. Venetianer, Asaf Judaeus, 3 vols. (Ger., 1915–17).

[Suessmann Muntner]