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by Michael Nevins

When I first began to study my Jewish medical roots, I presumed naively that I could start in Eastern Europe where my grandparents had come from and then work backwards. To my surprise, I soon learned that Jewish doctors were scarce in pre-Revolutionary Russia and that such medical care as existed most likely was delivered by a melange of healers, empirics, magicians, bath-house attendants and the like. If a 19th century Jewish mother proudly spoke of "my son the doctor", more likely she was bragging about a partially trained paramedic (feldsher), than a physician in the modern sense.

Except for purveyors of folk medicine, prior to the middle of the last century Jewish medicine substantially was a Sephardic enterprise, its practitioners either personally or spiritually descended from the erudite rabbi-philosopher-physicians who practiced in Medieval Spain and Portugal. Luminaries such as Judah Halevi, Maimonides and Nachmanides were among the first outflow of Jewish physicians from Spain during the 12th through 14th centuries and after the Expulsion of 1492, the trickle became a deluge. The emigres first went to Portugal and from there fanned out to Amsterdam, Hamburg, Italy, Poland, Greece, the Ottoman Empire, Goa and the Americas. Although their lives were not uniformly comfortable, many Conversos resumed practicing their former religion in these less hostile lands. They were an intellectual elite, and adept at integrating into the new societies in which they found themselves. Many were professionally successful, but with very few exceptions they were not in the forefront of emerging new medical ideas being exponents of the prevailing Galenic old-school.

In this brief essay, I offer four points that I suspect are not widely known. The first is that the University of Padua in northern Italy was a particularly receptive locale where Sephardim joined with exiles from France and Germany to participate in the intellectual ferment of the Renaissance. In this melting pot, hundreds of students not only learned medicine, but partook of the new humanistic ideas of the day. As Professor David Ruderman has described, when they returned to their countries of origin, they served as a vanguard for the Jewish Enlightenment that would emerge in the 18th century. Some of these Paduan graduates were exponents of Maimonides' rationalistic approach to medicine, others were enamored with astrology or the magic of Kabbalah, while still others attempted to reconcile traditional Jewish teaching with secular ideas which were heady and seductive. Indeed, one famous Jewish physician, Toviah Cohen, warned that before tasting the new science, a Jew first should fill his belly with Torah.

A second point worth noting is how frequently Sephardic expatriate physicians were sought after by the politically powerful. Kings and Popes, nobles and commoners, all favored Jewish doctors. Even in the 16th and 17th centuries when Jewish fortunes were in eclipse, the Queens of France, Russia, England and Sweden were attended respectively by Drs. Elijah Montalto, Antonio Ribera Sanches, Rodrigo Lopes and Benedict de Castro. How can we explain the remarkable acceptance by Christian society of this generally despised remnant? It's unlikely that their appeal can be attributed merely to medical acumen or to superior ethical principles. More likely it was that the Jews were perceived by Christian Europe as having skills greater than those of their gentile competitors.

With this in mind, an intriguing hypothesis is suggested by historian Raphael Patai in his book "The Jewish Alchemists". Standard history sources usually ignore or deny that Jews played a significant role as originators of the ancient art of alchemy in which base metals allegedly could be transmuted into gold. Yet, Patai gathered an impressive collection of evidence demonstrating that, in fact, Jews were important participants, perhaps not so much in sheer numbers, but more importantly, since they were perceived by Christians to have been originators of "The Great Art". There was a prevailing belief that the Biblical patriarchs were alchemists and one of the most respected early alchemists "Maria the Jewess", who lived during the late second or early third century CE, maintained that alchemy was the heritage of the "seed of Abraham". Although many scholars were skeptical, for fifteen centuries many of the finest minds, e.g.Paracelsus, Newton and Goethe, considered alchemy to be legitimate.

During the 14th century there was a shortage of silver and gold coinage in Central and Western Europe and many kings and church leaders employed alchemists literally to make money. According to Patai, of those alchemists who were Jewish, most also were Sephardic physicians. Many of the most famous doctors, if not themselves practitioners, were at least sympathetic. For example Yaacov Rosales, born in Lisbon in 1588 into a Marrano family of physicians emigrated to Hamburg where he was a prolific author on a wide range of subjects. He accepted the possibility of transmutation and wrote that the Philosopher's Stone, the alchemists' name for the universal panacea, "is a great medicine which can cure the severest diseases....better than Avicenna and Galen."

Many others believed that alchemy was not only a reasonable method of healing but perhaps the best way and, like scientific medicine, was understood as a way of restoring nature's perfect state. There was a notion of an essential unity underlying all of nature and the power of humans to intervene, with G-d's help, in effecting nature's course. Many alchemists saw themselves as healers and in addition to making gold, made potions and salves which they claimed had curative powers and. Some also combined their healing efforts with astrology, magic or with kabalistic practices believing that all of the occult arts had a legitimate role both scientifically and Jewishly. Considering the medieval fascination with alchemy, it seems plausible that some of the appeal of Jewish physicians can be attributable to the widely-held perception that their medical armamentarium included unconventional methods of healing.

After the 17th century Sephardic influence began to wane and with the Scientific Revolution magic and mysticism also began to recede. But then a surprising phenomenon occurred during the late 18th century in pre-Enlightenment Germany and this is my third general point. As historian Ismar Schorsch has written, German-speaking Jewry became "unhinged" from its East European origins where most Jews lived and instead became intellectually grounded in Iberia. A virtual 'Spanish' mystique emerged which served to justify the plight of those West European Jews who rejected the closed-mindedness of the Ashkenazim in favor of the cultural openness and appreciation of philosophy, science and aesthetics that had characterized earlier Sephardic Jewry. Some called this phenomenon "the Andalusian legacy." The religious component of Jewish identity receded and learning took on value for its own sake; as Michael Meyer put it, "For many Jews the serious study of any worthy subject became a way of being Jewish."

Such a liberal approach to life and learning was just what the newly emancipated German Jews needed to redefine and validate themselves. Thus legitimized, they felt ready to enter Christian society although too soon many learned that the key to professional success was to jettison their religious heritage altogether. Regardless, the Sephardim served as role models who inspired 19th century Jews to enter gentile society where they would play leadership roles in the emerging glory of German medicine.

A final point worthy of mention is that nowhere was Sephardic Jewish influence on medicine more evident than in the United States. Jacob Lumbrozzo was the first on the scene arriving in Maryland in 1656. He was followed in 1733 by Samuel Nunez Ribiero in Georgia and others like John de Sequeyra (Virginia, 1745), David D'Isaac Nassy (Philadelphia, 1792) and Jacob de la Motta (South Carolina, 1812). David Camden de Leon, twice wounded in the Mexican War which earned him the sobriquet "The fighting doctor", was the first surgeon general of the Confederate army.

Philadelpha was an important Sephardic center and among its distinguished 19th century Jewish physicians were the brothers Solis-Cohen -- Jacob, one of the founding fathers of otolaryngology and Solomon, pioneer in medical therapeutics who wrote proudly of his Sephardic roots. The ophthalmologist Isaac Hayes was an outstanding medical editor and was the individual most responsible for the A.M.A.'s first code of medical ethics while the internist Jacob Mendes DaCosta was considered by many to be the equal of Sir William Osler.

In conclusion, I have described how from the Middle Ages on, Sephardic Jews often were ubiquitous court physicians throughout Europe. Some of their appeal may have reflected the fact that they were perceived by Christians to have unique healing skills which perhaps was associated with their knowledge of the pseudo-science of alchemy. After their expulsion from Iberia, many Jewish physicians learned their trade, and much more, at the University of Padua. Graduates from this enclave spread ideas of the Renaissance to the towns and cities of Europe. Then at the onset of the Enlightenment, medieval Spain served as a historic role-model and legitimation for those German-speaking Jews who were eager to participate in the dominant culture. The Sephardic influence on medicine also was dominant in our own country, at least until the great waves of immigration from Central and Eastern Europe which began in the second half of the 19th century. Whatever our personal origins, most contemporary Jewish physicians are intellectually indebted to our Sephardic predecessors; in a sense, we are all Sephardim.

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