Portrait of Moses Maimonides

In the New Testament, Jesus refers to a Jewish proverb that was apparently popular in his day, "Physician, heal thyself" (Luke 4:23). Rabbinic and medieval Jewish literature might have coined a correlative proverb, "Patient, heal thyself." The latter proverb would articulate the view that the patient (and not the physician) is primarily responsible for his or her own health and that the initiation of medical care is primarily the responsibility of the patient (see e.g. Rabbi Joel Sirkes' commentary on the legal code Arba'ah Turim—Yoreh De'ah 336:1). Furthermore, a person who refuses to seek medical care when needed is compared to an individual who deliberately walks through fire with the foolish expectation that God would provide protection from injury (see e.g. Rabbi Judah Ayash's commentary to the code Shulhan Arukh—Yoreh De'ah 336:1).

Medieval Jewish ethical treatises taught that a person's physical and moral vices can engender physical ailments. For example, moral vices such as greed, unbridled lust and gluttony, could stimulate the onset of a variety of diseases and physical maladies. Consequently, responsibility for preventing illness and for inducing health when absent should rest primarily with the patient and only secondarily with the physician. A midrashic rabbinic text puts it this way: "Rabbi Aha said: It depends upon a person himself that diseases should not come upon him. What is the proof? For, said Rabbi Aha, Scripture states, 'The Lord will keep away from you all sickness' (Deut. 7:15); this means it is from you [i.e., dependent upon you] that disease should not come upon you" (Leviticus Rabbah 16:8).

In his Treatise on Asthma, Moses Maimonides listed six "obligatory regulations" that one should observe in order to preserve one's own health. These obligations are: (1) clean air to breathe, (2) proper diet, (3) regulation of emotion, (4) moderate bodily exercise, (5) proper sleep, and (6) proper and regular excretion.

Regarding clean air, Maimonides already observed in the twelfth century, "the concern for clean air is the foremost rule in preserving the health of one's body and soul."

For Maimonides, proper diet is a religious obligation that includes but also goes beyond the prescriptions of the Jewish dietary laws. Maimonides considered "improper diet as a fatal poison, the basis for all illness." He particularly cautioned against the hazards to health that derive from overeating. In one of his medical treatises, Maimonides advised that it is a general rule of the preservation of health, and a specific rule with regard to proper diet that "if a person took as good care of himself as he does of his animals, he would be saved from many illnesses."

For regulating the emotions, many of the Jewish medievals advocated the "golden mean." Of special concern were the physical and moral dangers posed by worry and depression. In this regard, Rabbi Joseph ibn Aknin quoted an earlier proverb in his treatise on "the hygiene of the soul." He wrote: "Sickness is the prison of the body and worry is the prison of the mind."

In his discussion of the beneficial effects of exercise, Maimonides states that it should relate to the "exercise of the soul," that physical exercise should lead one to the development of an emotional and psychological state of happiness, joy and contentment. In his legal code, Maimonides observes further, "If a person leads a sedentary life and does not take exercise, neglects the calls of nature, or is constipated—even if he eats wholesome food and takes care of himself with medical rules—he will, throughout his life, be subject to aches and pains, and strength will fail him."

Already in talmudic literature, the normal functioning of the urinary tract and of the bowels was considered an expresssion of divine grace and a condition that one should seek to maintain. In his legal code, Maimonides related proper and regular excretory functioning to a happy and healthy life, and warns that "if there is constipation or if the bowels move with difficulty, grave disorders can result." According to Maimonides, if a person follows his health regimen, many diseases would be prevented and health would be maintained.

The patient's primary responsibility for the preservation of his or her own health is related by Jewish law to two legal prohibitions, which are exegetically derived from the verse in Deuteronomy (4:9), "But take utmost care and watch yourselves scrupulously." These two prohibitions are (1) not to take any action that might endanger one's own life (see e.g. in the codes, Shulhan Arukh—Yoreh De'ah 116:5), and (2) to remove any obstacle considered dangerous to one's life or health. Both of these laws rest upon a theological assumption that presumes that life is a gift of God, a trust that each of us maintains as a steward and trustee of God. Thus, the concern with health is, in the final analysis, a preoccupation with how one cares for the life God entrusts to him or to her. According to Shem Tov ben Joseph ibn Falaquera in his treatise "A Regimen for a Healthy Body," the preservation of health is an act of worship, an expression of divine service. He writes, "a person must care for his or her body like an artisan for his or her tools. For body is the instrument through which one serves one's Creator."