The legendary figure of the Jewish doctor goes back many centuries. The late L. Wallerstein has here outlined the long history of a type that still retains some trappings of myth, and suggested the elements in Jewish life and tradition that may have contributed to the eminence of Jews in the science of healing.
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A 16th-century anecdote relates that Francis I of France, suffering from a lingering illness, asked the Holy Roman Emperor, Charles V, to send him his Jewish physician. When the doctor arrived, the king directed a few barbs at his religious faith. The doctor hastened to point out that he was no longer a Jew, having been converted to the only true faith. Whereupon the indignant king of France immediately dismissed him and asked for a real Jewish physician.
The currency given this story in non-Jewish sources of medical history is testimony to the persistence of the popular image of “the Jewish doctor.” The traditional image has several elements: the Jewish doctor’s prevalence, his unusually large numbers in almost every country, and his excellence, particularly as a specialist. Nor in fact is this image far removed from the reality. It has been estimated that in pre-Nazi Germany Jewish doctors constituted about 30 per cent of their profession, while the Jews as a whole were only one per cent of the population. As for the United States, an informed statistical survey turns up the information that of approximately one hundred thousand physicians, about 12 to 15 per cent are Jews, though Jews constitute something less than 4 per cent of the population. And more than 50 per cent of American psychiatrists and psychoanalysts are Jews. The whole point has only recently been dramatized by the conferring of the 1953 Prize for Medicine on two German-born Jews, Dr. Hans Adolf Kregs, now at Sheffield in England, and Dr. Alfred Lippman, now at Harvard Medical School. And this was by no means the first such occasion in Nobel Prize history.
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As our anecdote might lead us to suspect, the contemporary situation is but the latest exemplification of that traditional association of Jews and medicine.
Here, for instance, is the text of a letter written by a Roman senator in the 14th century granting Roman citizenship to a Jewish physician:
In the name of God, Amen. We, Franciscus de Panciaticus, Knight of Pistoia, Doctor of Laws, Honorable Senator of the City of Rome; and We, the Reformers of the City and Administrators of the Roman People in peace and war; to the learned Master Elijah di Sabbato, the Jew, Physician and Doctor of Medicine, Our Greeting and Favor:
The faithlessness of the Jews whom the Lord of the world has created must be rejected, and the stubbornness of their disbelief must be crushed. Nevertheless, their preservation is useful and necessary to Christians in certain respects, especially those [Jews] who are well trained in medical art and who show themselves helpful in restoring Christians to their former health. Since you, as we know from experience, have in the past and at this time used your well-known skill in medical art to cure not only our citizens but many strangers who, suffering from various diseases, have called upon you for help; therefore, considering how necessary and beneficent your life is as restorer of the health of the Romans and of others, we appoint you a Roman citizen.
Going back to the Roman Empire of the 3rd century, we find Celsus, in the fifth volume of his medical compendium, citing Jewish doctors as originators of some of his prescriptions. Marcellus Empiricus, physician to Emperor Theodosius, praises a remedy for disease of the spleen which he learned from the Patriarch Gamaliel III. The “Antidotus Esdrae,” a remedy supposedly taken from Ezra the Scribe (4th century B.C.E.), is recorded by Aetius in the 3rd century C.E., by Alexander of Tralles in the 8th century, and by Nicolai, the author of the standard manual Antidotarium, used in the Salerno medical school. There is no evidence that these remedies are genuinely of Jewish origin, but their attribution testifies to the antiquity of the popular image of the Jewish doctor.
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The Jews’ own appreciation of the practice of medicine has even more ancient origins. In the Prophetic era, Isaiah cured a serious illness of King Hezekiah. In the Rabbinic period, a Midrashic source, commenting on another matter, attributes to Moses a knowledge of “the art of healing.” Finally, at the height of Judaism’s medieval glory, Maimonides, who is today certainly far more renowned as a profound philosopher and as the greatest of Rabbinic scholars, was also a busy and distinguished physician, the court attendant to the ruler of Egypt. And Maimonides’ career was no isolated instance. Its pattern was repeated among Jews for many centuries throughout the Dispersion, from Constantinople to Castile, from the Mediterranean to the Baltic. Particularly in the five hundred years between the 10th and the 16th centuries, Jewish physicians attained universally recognized eminence in three characteristic pursuits: the translation of medical works from Greek to Arabic, and later from Arabic to Hebrew, the composition of original medical treatises, and the practice of medicine at noble courts or, by special license, in cities otherwise forbidden to Jews.
A key factor in understanding this remarkable phenomenon is that these men were not only distinguished physicians, but Rabbinic scholars and leaders of the Jewish community. This cultural element, possibly indeed the key to the whole story, has not been understood by non-Jewish medical historians. The tendency, rather, has been to attribute the historical Jewish role in medicine to a congenital national aptitude.
Thus, the German historian Rudolf Virchow, speaking at an international medical congress in 1895 about the Jew’s great contribution to the development of medicine and about the many Hebrew manuscripts that testify to the role played by Jewish physicians in medical teaching and research from the early Middle Ages to modern times, attributed this to “the hereditary aptitude of the Jew for medical science.” The distinguished Spanish medical historian Professor José Gavanes y Capdevilla told his colleagues at the Tenth International Congress of the History of Medicine in 1935 that “no other people is capable of bringing so brilliant a group of distinguished men into the field of medicine.” And in our own country Karl Menninger speaks of the genius of the Jew in psychiatry. All this testimony smacks a little of the awestruck wonder of primitives confronted with the magical tricks of the tribal medicine-man.
Actually, there is no need for such near-mystical explanations of a phenomenon which, though admittedly difficult and complex, is explicable in cultural-historical terms. Virtually every particular in the life of the Jews was from the very beginning conditioned by their self-awareness as the Chosen People, the elected carriers of God’s Word, and the teachers and exemplars of His Law—and the Law was not merely religious and ethical injunctions, but eminently practical wisdom for the better ordering of the physical regimen, and the hour-by-hour, day-to-day routine of personal life.
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Biblical Judaism was not an other-worldly religion; its emphasis was clearly on life in this world, and it is significant that nowhere in the Old Testament is there to be found a reference to a life beyond. If it was stern, it was not the sternness of cruel fate but of a determined insistence on the necessity to make difficult choices. Rewards and punishments were received here on earth, and the whole teaching of the Torah was directed toward a good and long life on earth as exemplified by the Patriarchs—the length of a life was one of the measures of its success. Even the Garden of Eden was not located in Heaven or suspended somewhere in mid-air; it was in Mesopotamia. The Bible is full of promises of a good life and good health, peace, and plenty, if God’s commandments are obeyed; but unrighteousness will be punished by war, exile, drought, and disaster. In his final summation to the Children of Israel as their long sojourn in the desert neared its end, Moses exhorted them with these words: “Behold, I have set before you this day life and good, death and evil. Therefore choose life . . . .” The keynote of Scripture is: life is good and worth preserving. A people that believed in only one life, and that always emphasized the wholeness of man as a physical, social, and religious being, was certain to take this to heart.
But even with the introduction of the belief in personal immortality during the Hellenistic period and the general acceptance in Rabbinic Judaism of the notion of a life beyond death, with life in this world viewed as an antechamber to life in the world to come, the Biblical emphasis on the good, long life on earth was in no wise diminished, in contrast to Christianity, which systematically denigrated the physical, and the life on earth, as against the spiritual and the afterlife. In Rabbinic Judaism the value of a healthy, vigorous life in this world was if anything enhanced—God’s Law was, after all, intended for man here and now, and nowhere else. The Biblical injunction to “take good heed of thy life” was interpreted by the Rabbis to mean: don’t take any chances with your health. The whole Law, according to them, was intended to enable man to serve the Lord joyously; and just as they devised a multiplicity of means to express gratitude to God for the goods of life, so also did they prescribe a blessing to be said upon recovery from dangerous illness. Thus, whatever the disparities between Biblical and Talmudic Judaism, there was a continuous development of this fundamental common strain: the value and goodness of life on earth. It was an emphasis that could not but lead directly and logically to a serious concern with health.
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A potent element of the Judaic “ideology,” stressed especially by the Rabbis for whom it served to justify their grandiose legislative expansion of the Bible, was the view that once having presented something to man, God then left him free to use it. “The Heavens are the Lord’s,” the Psalmist exclaimed, “but the earth He gave to the children of man.”
The bearing on medicine of this view is illustrated by two anecdotes from the Midrash and the Mishnah. According to the Bible, Miriam, the sister of Moses, was stricken with a skin disease when she criticized him for taking an Ethiopian wife. Moses, however, pleaded with God for her recovery. The Midrash relates that Moses went before God and said, “You taught me the art of medicine and now I am a competent physician; I would prefer that you heal my sister, but if you refuse I will do it on my own account.”
In the Mishnaic story, Rabbi Akiba, Rabbi Ishmael, and a friend of theirs, a farmer, were walking in the streets of Jerusalem. A sick man approached and asked them for medical advice. They diagnosed his illness, prescribed for it, and assured him he would be cured. When the sick man left, the farmer asked the Rabbis, “Who afflicted this man with his disease?” “God,” they answered. “And how dare you,” the farmer retorted, “interfere with the will of God? He smote that man and you undertake to cure him!” “Don’t you,” the Rabbis replied, “interfere with the divine order by tilling the soil, pruning trees, and fertilizing fields? Why don’t you leave things as God created them?” “Yes, I do all that work because without my efforts there would be no food.” “And that,” the Rabbis responded, “is precisely what we were doing when we prescribed for the sick man. Just imagine that man as the tree in your orchard, the doctor as the tiller of the soil, the medicine we prescribed as the fertilizer you use, and the cure of the man as the fruit you reap.”
This fundamental Rabbinic attitude had important effects on the study and practice of medicine. In later centuries, an exclusive reliance on divine providence in case of illness was severely condemned. According to Maimonides, the avoidance of medical help when it is needed is like refusal to reach for food when one is hungry: it is against the will of God. Even the school of ultra-Orthodox, obscurantist rabbis of 13th-century Spain and France, who forbade the study of philosophy and the sciences before the mature age of thirty, expressly excepted the science of medicine from their ban, and agreed that it is a sin to rely on prayer alone in sickness without employing the aid of a physician. Man has been commanded by God to bring relief to the suffering, and he must not shirk this duty.
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No sharper contrast can be found than that between Jewish and Christian views in the Middle Ages on the practice of medicine. At bottom the cleavage was theological, but it was mirrored in the advanced state of Jewish practice as against the primitivism of the Christian world in this respect. Medieval Christian theologians were preoccupied with other-worldly matters and negated the importance of life and happiness on earth precisely because they stressed the evil nature of the body; this was a cardinal tenet of Christianity, fundamental to its doctrines of sin and salvation. The Jewish attitude toward the body was a more “common-sensical” one: the body was the divinely created vessel through which the human soul could operate to perform God’s will on earth. The Christian dualism of soul and body was opposed by a pragmatic Judaic monism. This contrast is especially reflected in the differing views on sex. To the Christian mind, the sex act was perhaps the very crux of sin; in Judaism, it was the beginning of the performance of the first Mitzvah: “Be fruitful and multiply.” The many Old Testament passages about sex indicate an unquestioning acceptance of it as a value, and in later centuries the Jewish custom of having sexual intercourse on the Sabbath is a revealing testimonial to the connection between the holiness of religion and the sanctity of bodily delights. The Christian position, closely associated with a general hostility to the then emerging science, was not one conducive to progress in medicine.
Allied with this major strain of Jewish thinking were two other crucial elements in Judaism: the unceasing insistence on the maintenance of monotheistic purity and the later emergence of the doctrine of free will. The first concept involved the utter rejection of all other deities, semi-deities, or supernatural forces, and of any attention to and reliance on them. The second doctrine led traditional Judaism formally to eschew the notion of predestination. In both cases, the result was the repudiation, in a continuous line from the Prophets to the Rabbis, of all forms of magic, astrology, amulets, incantations, exorcism: in effect, any beliefs and activities that would thrust responsibility from man and his partner, the One God. “Thus saith the Lord, learn not the way of the nations and fear not the signs of heaven, for the heathen is dismayed at them. . . . They indulge in such abominations, but you shall be wholehearted with the Lord, thy God.” “Israel,” the Talmud asserts, “is under no influence of any star.” And Maimonides called those who would resort to these spurious means “evil fools.” Once again, traditional Judaism establishes a clear directive to man to care for his health and ills through his own efforts, aided only by faith in God.
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Finally, and perhaps more important than all other factors, Judaism was a religious system which took care to legislate all of its basic ideological beliefs, outlooks, and directives into an intricate network of operational prescriptions. It left as little as possible to chance; the whole of human life and activity was its domain, and the Torah was meant to encompass all knowledge and wisdom. In an atmosphere, extending uninterruptedly century upon century, where everything was subjected to protracted legislative argument, analysis, and decision, medicine too, a legitimate area for intelligent consideration, took its place alongside civil and criminal law, ethical discussions, labor and commercial relations.
It was also a peculiarity of this system that knowledge was not restricted to one class or group and that all realms of knowledge were equally the domain of all who studied. The Torah was there for all to come and learn. The rabbis were not a special caste; as often as not, they had some trade or profession by which they earned their livelihood. They were merely the men who were especially proficient in their study and knowledge of the Torah; they were the judges, but this only meant that they decided issues of the application of the Torah, the all-encompassing religious Law. They were also expert, since every part of the Torah is of equal weight, in every matter the law dealt with, and this included medicine. It was for this reason that they were the leaders, the spokesmen, the determining force in the Jewish community. And it was no doubt this peculiarity that gave rise to an institution which flourished throughout the post-Rabbinic centuries of Jewish dispersion among the peoples of the Western world: the rabbi-scholar-physician-community leader. Thus, a standard text, Pushman’s History of Medical Education, points out that “whoever [among the Jews] aspired to be considered a learned man was obliged to be possessed of medical knowledge.” The learned men were, naturally, the rabbinic scholars, who were by the same token the leaders of the community.
Maimonides is only the most famous example of this type. Two hundred years earlier, in the 10th century, the Maecenaslike Hasdai ibn Shaprut lived and flourished in the Moslem court of Andalusia. Hasdai was the Foreign Minister and Minister of Finance and Commerce at Cordova. He was also a patron of the arts and the chief sponsor of the rising Jewish learning in Arab Spain. His accomplishments, in addition to statesmanship, scholarship, and communal leadership, naturally included medicine, although it is doubtful if his other activities permitted him time for practice. However, Hasdai did make an important contribution to the study of medicine through his translation of the highly valued Pharmacopoeia of the Greek Dioscorides. This book, greatly desired by the Caliph and the medical college at Cordova, was sent to Spain by Constantine VIII, the Byzantine Emperor. But it was a sealed book to the Arab physicians, who knew no Greek. The Caliph requested the Emperor to send him a scholar who understood both Greek and Latin. Constantine sent a monk, Nicholas, as interpreter. Since Hasdai was the only physician in Cordova who knew Latin, he was ordered by his ruler to take a leave from affairs of state to help in the translation. Nicholas translated the book from Greek to Latin, and Hasdai then translated it into Arabic.
A century later, also in Spain, the Hebrew poet and philosopher Judah Halevi practiced medicine in Christian Toledo and then in Moslem Cordova. Another famous name in the history of Jewish scholarship and philosophy, Nachmanides, practiced medicine in 13th-century Christian Aragon. And so the roster reads down through the centuries and in every country of the Western world until the dark period which endured more or less from the end of the Renaissance until the Enlightenment.
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To be sure, despite the marked and ancient association of Jews and medicine, despite the honorable position medicine occupied throughout Jewish history, it was never a distinct sub-division of knowledge per se. Thus, there was virtually no systematic treatment of the subject that could be called “Jewish medicine.” Although Rabbinic law was subsumed under a series of general rubrics or “orders” and sub-categories, neither the law nor the tradition lent itself to really rigorous systematization. And since medicine was in any case considered subordinate to other categories, medical discussions appear in Rabbinic literature in a highly informal and rather disorganized manner. So, for example, one might find a physiological discussion entered into by the Rabbis in the course of argument on the larger question of laws governing family relations; similarly, a debate on the laws concerning kosher and non-kosher animals could lead away into a discussion of anatomy and internal diseases.
Nevertheless, a perusal of this literature reveals extensive medical knowledge. Furthermore, it is possible to reconstruct from the many references to medical problems in Biblical and Talmudic literature the trend of thought and practice concerning medicine in classical Judaism.
Three points of emphasis emerge from this analysis: (1) the medical, as well as socio-economic-religious, significance of the weekly day of rest; (2) the vital necessity of prophylaxis: cleanliness of the body, clothing, and dwellings; cleanliness of city and camp during war; isolation of patients with communicable diseases; and finally (3) the importance of organic changes in body tissues as a result of disease. The principles embodied in these three points have only been confirmed by modern medicine.
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But the unique contribution of the Jews to medicine was less in discovery than in transmission. It was clear to their contemporaries, as it is clear to us now through historical hindsight, that during one particularly critical era in the history of knowledge, the so-called Dark Ages, transmission was as vital as discovery.
The role of the Jews in the transmission of classical philosophy and science to the Western world has by now received general recognition. What may not be so widely appreciated is that they performed the same function in medicine too, as translators of classical works and as writers of compendiums of current medical knowledge. The nature of medical knowledge and practice at the time made it virtually inevitable for the Jews to perform this particular kind of creative service. For medicine was chiefly a book-science in the medieval period, depending essentially on the recorded experience and accumulated knowledge of generations of practitioners.
For nearly five centuries most Jews lived under the friendly domination of the Arabs and Islam, first in the Near East and later, with the dwindling of the importance of that community, in North Africa and Spain. And the bulk of the translation of the Greek classics into Arabic was accomplished by Jews. By the 13th century, virtually every significant work of classical antiquity had been translated into Hebrew as well, and during the next two centuries the Jews performed the very same function for the Christian world, translating from the Arabic and Hebrew into Latin. Legend has it that the two great medieval medical colleges at Salerno and Montpelier were founded with Jewish collaboration. However that might have been, it is certain that for some time after their establishment, Hebrew and Arabic were languages of instruction, alongside Latin, and Jewish teachers and students were a significant and respected element there.
The mediating role of the Jews has been described in this way by Charles Singer, in his Legacy of Israel: “It is in the earlier ‘Revival of Learning,’ that of the thirteenth century, that this influence may be most clearly discerned. Without Jewish aid this earlier Renaissance would have been long delayed and would have assumed a different form. Without the earlier Renaissance the more familiar classical and humanist revival of the fifteenth and sixteenth centuries would have been retarded. The one movement was historically, intellectually, and spiritually the preparation for the other. . . . Philosophy and science, medicine and law, lay there [in the realm of Islam] beyond the confines of Christendom. The Western mind was awakening from its secular slumber. There was a longing for the intellectual treasures held by the East [Islam]. And yet Europe was haunted by a fear and repugnance for Eastern religion and Eastern thought similar to that which the East now often feels for the West . . Such was the stage whereon, during the Middle Ages, the Jewish role was played. These are the conditions under which the Jews acted as intermediaries between Orient and Occident. . . . The Jewish carriers represent perhaps the most continuously civilized element in Europe.”
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The true “dark ages” for Jewish medicine, indeed for all Jewish participation in secular learning, paradoxically began when the intellectual clouds lifted over the rest of the Western world. For the excesses of the Reformation and Counter Reformation, when the aroused religious and political passions of the Christian world too often expended themselves in attacks on the scattered and helpless communities of the Jews, drove the Jews farther eastward in Europe, away from the great centers of learning, farther downward into poverty and degradation, and farther inward into an unprecedented intellectual and spiritual isolation. But despite the slaughters, the expulsions, the depradations, the bans, and the forced baptisms to which the Jews were everywhere periodically subjected in medieval Europe, they were still able to play their critical role in the transmission of learning and as physicians in many courts and attending universities.
The leitmotif of the post-Renaissance attitude seemed to be: the Jew has done his work; get rid of him. Before the Renaissance, men learned medicine by sitting at the feet of a master who practiced and taught. Now the universities were becoming the focal point for scientific and medical studies—medicine increasingly became a laboratory science, and the laboratories were associated with the universities—and just at this point the doors of the universities were closed to the Jews. And so the Jews were crowded off and away into an isolation from which they did not emerge until the Emancipation.
The very nature of this emergence points up, in its own way, the crisis of contemporary Jewish life. For it reveals a grave dichotomy that was never before present in the Jewish community and system of values. Jews began to populate the universities of France, Italy, and Germany, despite the potent vestiges of traditional disabilities and obstacles, and laboratories and research departments began to be staffed by Jews. But it was a revolutionary and radically different world from the one they had known during the previous centuries of their medical preeminence. It was no longer a world where science and faith, as Maimonides believed, were the dual elements of divine wisdom available to man. The very act of bursting forth into the modern secular world constituted a rejection of the Jewish world. And while the return to medicine especially was a form of return to a traditional Jewish role and to a Judaistic concept, it was only partial; it was not a return to the whole traditional image of the rabbi-scholar-physician-community leader. And so the secular doctor—and the scientist generally—supplanted the rabbi-scholar of the older Jewish tradition in the scale of modern Jewish prestige-values. In a special and revealing way, this development reflects one of the central paradoxical dilemmas, as far as Judaism is concerned, of modern Jewish living. But as for the role of the Jew in medicine—now that he was no longer “religious” but “secular”—he still remained, and has remained to this day, in the forefront of medical research and practice, contributing far beyond his numbers to the alleviation of pain and disease, and to bettering and extending of man’s span on earth.
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