Great Jewish Physicians
( Originally Published 1911 )
Any account of Old-Time Makers of Medicine without a chapter on the Jewish Physicians would indeed be incomplete. They are among the most important factors in medieval medicine, representing one of the most significant elements of medical progress. In spite of the disadvantages under which their race labored because of the popular feeling against them on the part of the Christians in the earlier centuries and of the Mohammedans later, men of genius from the race succeeded in making their influence felt not only on their own times, but accomplished so much in making and writing medicine as to influence many subsequent generations. Living the segregated life that as a rule they had to, from the earliest times.
My attention was called to the interesting story of the Jewish physicians of the Middle Ages and their scientific accomplishment while writing the article on Joseph Hyrtl for the Catholic En.cyclopedia. His " Das Arabisehe and Hebraische in der Anatomic " (Wien, 1879) has some interestingly suggestive material on these important chapters of the history of medicine. (I owe my opportunity to consult it to the courtesy of the Surgeon.General's library.) Biographic material has been obtained from Carmoly's " History of the Jewish Physicians," translated by Dr. Dunbar for the Maryiand Medical and Surgical Journal, some extra copies of which were printed by John Murphy and Co.., Baltimore, about- the middle of the nineteenth century. Baas and Haeser's Histories of Medicine and Pusehmann and Pagel's " Handbook " provided additional material, and I have found Landau's "Gesehiehte der Judischen Aerzte " (Berlin, 1895) of great service.
It is not unlikely that the difficult personal circumstances in which the Jews were placed bad a good deal to do at all times with stimulating their ambitions and making them accomplish all that was in them. Certain it is that at all times we find a wonderful power in the people to rise above their conditions. With them, however, as with other peoples, luxury, riches, comfort, bring a surfeit to initiative and the race does not accomplish so much. At various times in the early Middle Ages, particularly, we find Jewish physicians doing great work and obtaining precious acknowledgment for it in spite of the most discouraging conditions. Later it is not unusual to find that there has been a degeneration into mere money-making as the result of opportunity and consequent ease and luxury. At a number of times, however, both in Christian and in Mohamanedan countries, great Jewish physicians arose whose names have come to us and with whom every student of medicine who wants to know something about the details of the course of medical history must be familiar. There are men among them who must be considered among the great lights of medicine, significant makers always of the art and also in nearly all cases of the science of medicine.
A little consideration of the history of the Jewish people and their great documents eliminates any surprise there may be with regard to their interest in medicine and successful pursuit of it during the Middle Ages. The two great. collections of Hebrew documents, the Old Testament and the Talmud, contain an immense amount of material with reference to medical problems of many kinds. Both of these works are especially interesting because of what they have to say of preventive medicine and with regard to the recognition of disease. Our prophylaxis and diagnosis are important scientific departments of medicine dependent on observation rather than on theory. While therapeutics has wandered into all sorts of absurdities, the advances made in prophylaxis and in diagnosis have always remained valuable, and though at times they have been forgotten, re-discovery only emphasizes the value of preceding work. It is because of what they contain with regard to these two important medical subjects that the Old Testament and the Talmud are landma•ks in the history of medicine as well as of religion.
Baas, in his " Outlines of the History of Medicine," says: " It corresponds to the reality in both the actual and chronological point of view to consider the books of Moses as the foundation of sanitary science. The more we have learned about sanitation in the prophylaxis of disease and in the prevention of contagion in the modern time, the more have we come to appreciate highly the teachings of these old times on such subjects. Moses made a masterly exposition of the knowledge necessary to prevent contagious disease when he laid down the rules with regard to leprosy, first as to careful differentiation, then as to isolation, and finally as to disinfection after it had come to be sure that cure had taken place. The great lawgiver could insist emphatically that. the keeping of the laws of God not only was good for a man's soul but also for his body."
With this tradition familiarly known and deeply studied by the mass of the Hebrew people, it. is no surprise to find that when the next great Hebrew development of religious writing came in the Talmud during the earlier Middle Ages, that. also contains much with regard to medicine, not a little of which is so close to absolute truth as never to be out of date. Friedenwald, in his " Jewish Physicians and the Contributions of the Jews to the science of Medicine," a lecture delivered before the Gratz College of Philadelphia fifteen years ago, summed up from Baas' " History of Medicine " the instructions in the Talmud with regard to health and disease. The summary represents so much more of genuine knowledge of medicine and surgery than might be expected at the early period at which it was written, during the first and second century of our era, that it seems well to quote it at some length.
" Fever was regarded as nature's effort to expel morbific matter and restore health; which is a much safer interpretation of fever, from a practical point of view, than most of the theories. bearing on this point that have been taught up to a very recent period. They attributed the halting in the hind legs of a lamb to a callosity formed around the spinal cord. This was a great advance in the knowledge of the physiology of the nervous system. An emetic was recommended as the best remedy for nausea. In many eases no better remedy is known to-day. They taught that a sudden change in diet was injurious, even if the quality brought by the change was better. That milk fresh from the udder was the best. The Talmud describes jaundice and correctly ascribes it to the retention of bile, and speaks of dropsy as due to the retention of urine. It teaches that atrophy or rupture of the kidneys is fatal. Induration of the lungs (tuberculosis) was regarded as incurable. Suppuration of the spinal cord had an early, grave meaning. Rabies was known. The following is a description given of the dog's condition : His mouth is open, the saliva issues from his mouth; his ears drop; his tail hangs between his legs; he runs sideways, and the dogs bark at him; others say that he barks himself, and that his voice is very weak. No man has appeared who could say that he has seen a man live who was bitten by a mad dog.' The description is good, and this prognosis as to hydrophobia in man has remained unaltered till in our day when Pasteur published his startling revelation. The anatomical knowledge of the Talmudists was derived chiefly from dissection of the animals. As a very remarkable piece of practical anatomy for its very early date is the procuring of the skeleton from the body of a prostitute by the process of boiling, by Rabbi Ishmael, a physician, at the close of the first century. He gives the number of bones as 252 instead of 232. The Talmudists knew the origin of the spinal cord at the foramen magnum and its form of termination ; they described the esophagus as being composed of two coats; they speak of the pleura as the double covering of the lungs; and mention the special coat of fat about the kidneys. They had made progress in obstetrics; described monstrosities and congenital deformities; practised version, evisceration, and Caesarian section upon the dead and upon the living mother. A. II. Israels has clearly shown in his Dissertatio torico-Medica Inanguralis that Caesarian section, according to the Talmud, was performed among the Jews with safety to mother and child. The surgery of the Talmud includes a knowledge of dislocation of the thigh bone, contusions of the skull, perforation of the lungs, esophagus, stomach, small intestines, and gall bladder; wounds of the spinal cord, windpipe, of fractures of the ribs, etc. They described imperforate anus and how it was to be relieved by operation. Chanina Ben Chania inserted natural and wooden teeth as early as the second century, C. E."
There is a famous summing up of the possibilities of life and happiness in the Talmud that has been often quoted—its possible wanting in gallantry being set down to the times in which it was written. " Life is compatible with any disease, provided the bowels remain open; any kind of pain, provided the heart remain unaffected; any kind of uneasiness, provided the head is not attacked; all manner of evils, except it be a bad woman."
There are many other interesting suggestions in the Talmud. Sometimes they have come to he generally accepted in the modern time, sometimes they are only curious notions that have not, however, lost all their interest. The crucial incision for carbuncle is a typical example of the first class and the suggestion of the removal of superfluous fat from within the abdomen or in the abdominal wall itself by operation is another. That they had some idea of the danger of sepsis may be gathered from the fact that they suspected iron surgical instruments and advised the use of others of less enduring character.
The Talmud itself was indeed a sort of encyclopedia in which was gathered knowledge of all kinds from many sources. It was not particularly a book of medicine, though it contains so many medical ideas. In many parts of it the authors' regard for science is emphatically expressed. Landau, in his " History of Jewish Physicians," closes his account of the Talmud with this paragraph:
" I conclude this brief review of Talmudic medicine with some reference to bow high the worth of science was valued in this much misunderstood work. In one place we have the expression occupation with science means more than sacrifice. In another science is more than priesthood and kingly dignity."
"Of course there are many absurd things recommended in the Tal mud. We cannot remind ourselves too often, however, that there have been absurd things at all times in medicine, and especially in therapeutics. It is curious how often some of these absurdities hare repeated themselves. We are liable to think it very queer that men should have presumed, or somehow jumped to the conclusion, that portions of animals might possess wonderful virtue for the healing of diseases of the corresponding special parts of man. We ourselves, however, within a After all this of national tradition in medicine before and after Christ, it is only what we might quite naturally expect to find, that there is scarcely a century of the Middle Ages which does not contain at least one great Jewish physician and sometimes there are more. Many of these men made distinct contributions to medical science and their names have been held in high estimation ever since. Perhaps I should say that they were held in high estimation until that neglect of historical studies which characterized the eighteenth century developed, and that there has been a reawakening of interest in our time. We forget this curious decadence of the later seventeenth and eighteenth eenturies which did so much to obscure history and especially the history of the sciences. Fortunately the scholars of the sixteenth and early seventeenth centuries accomplished successfully the task of printing many of the books of these old-time physicians and secured their publication in magnificent editions. These were bought. eagerly by scholars and libraries all over Europe little more than a decade, had a phase of opotherapy—how much less absurd it seems under that high-sounding Greek term—that was apparently very learned in its scientific aspects yet quite as absurd as many phases of old-time therapy, as we look at it. We administered cardin for heart disease and nephrin for kidney trouble, cerebrin for insanity (save the mark '), and even prostate tissue for prostatism—and with reported good results How many of us realize now that in this we were only repeating the absurdities, so often made fun of in old medicine, with regard to animal tissue and excrement therapeutics? The Talmud has many conclusions with regard to the symptoms of patients drawn from dreams ; as, for instance, it is said to be a certain sign of sanguineous plethora when one dreams of the comb of a cock. One phase of our psycho-analysis in the modern time, however, has taken us back to an interpretation of dreams different of course from this, yet analogous enough to be quite striking in spite of the high price they commanded in that era of slow, laborious printing. The Renaissance exhibits some of its most admirable qualities in its reverence for these old workers in science and above all for the careful preparation by its scholars of the text of these first editions of old-time physicians. The works have often been thus literally preserved for us, for some of them at least would have disappeared among the vicissitudes of the intervening time, most of which was anything but favorable to the preservation of old-time works, no matter what their content or value.
During the second and third centuries of our era, while the Talmudic writings were taking shape, three great Jewish physicians came into prominence. The first of them, Chanina, was a contemporary of Galen. According to tradition, as we have said, he inserted both natural and artificial teeth before the close of the second century. The two others were Rab or Raw and Samuel. Rab has the distinction of having studied his anatomy from the human body. According to tradition he did not hesitate to spend large sums of money in order to procure subjects for dissection. At this time it is very doubtful whether Galen, though only of the preceding generation, ever had the opportunity to study more than animals or, at most, a few human bodies. Samuel, the third of the group, was an intimate friend of Bab's, perhaps a disciple, and his fame depends rather on his practice of medicine than of research in medical science. He was noted for his practical development of two specialties that cannot but seem to us rather distant from each other. His reputation as a skilful obstetrician was only surpassed by the estimation in which he was held as an oculist. He seems to have turned to astronomy as a hobby, and was highly honored for his knowledge of this science. Probably there is nothing commoner in the story of great Jewish physicians than their successful pursuit of some scientific subject as a hobby and reaching distinction in it. Their surplus intellectual energy needed an outlet besides their vocation, and they got a rest by turning to some other interest, often accomplishing excellent results in it. Like most great students with a hobby, the majority of them were long-lived. Their lives are a lesson to a generation that fears intellectual overwork.
During the fourth century we have a number of very interesting traditions with regard to a great Jewish physician, Abba Oumna, to whom patients flocked from all over the world. He seems particularly to have been anxious to make his services available to the scholars of his time. fie looked upon them as brothers in spirit, fellow-laborers whose investigations were as important as his own and whose labors for mankind he Loped to extend by the helpfulness of his profession. In order that it might be easy for them to come to him without feeling abashed by their poverty, and yet so that they might pay him anything that they thought they were able to, he hung up a box in his anteroom in which each patient might deposit whatever he felt able to give. Ills kindliness towards men became the foundation for many legends. Needless to say he was often imposed upon, but that seems to have made no difference to him, and he went on straightforwardly doing what he thought he ought to do, regardless of the devious ways of men, even those whom he was generously assisting. While we do not know much of his scientific medicine, we do know that he was a fine example of a practitioner of medicine on the highest professional lines.
With the foundation of the school at I)jondisabour in Arabistan or Khusistan by the Persian monarch Chosroes, some Jewish physicians come into prominence as teachers, and this is one of the first important occasions in history when they teach side by side with Christian colleagues. Djondisabour seems distant from us now, lying as it does in the province just above the head of the Persian Gulf, and it is a little hard to understand its becoming a centre of culture and education, yet according to well-grounded historical traditions students flocked here from all parts of the world, and its medical instruction particularly became famous. According to the documents and traditions that we possess, clinical teaching was the most significant feature of the school work and made it famous. As a consequence graduates from here were deemed fully qualified to become professors in other institutions and were eagerly sought by various medical schools in the East.
With the rise of the strong political power of the Mohammedans enough of peace came to the East at least to permit the cultivation of arts and sciences to some extent again, and then at once the eminence of Jewish physicians, both as teachers and practitioners of medicine, once more becomes manifest. The first of the race who comes into prominence is Maser Djawah Ebn Djeldjal, of Basra. To him we owe probably more than to anyone else the preservation of old scientific writings and the cultivation of arts and sciences by the Mohammedans. He prevailed on Caliph Moawia I, whose physician he had become, to cause many foreign works, and especially those written in Greek, to be translated into Arabic. He seems to have taken a large share of the labor of the translation on himself and prevailed upon his pupil, the son of Moawia, to translate some works on chemistry. The translation for which Maser I)jawah is best known is that of the Pandects of Haroun, a physician of Alexandria. The translation of this work was made toward the end of the seventh century. Unfortunately the " Pandects " has not come down to us, either in original or translation, but we have fragments of the translation preserved by Ehazes, the distinguished Arabian medical writer and physician of the ninth century, arid there seems no doubt that it contained the first good description of smallpox, a chapter in medicine that is often—though incorrectly attributed to Rhazes himself. Rhazes quoted Maser Djawah freely and evidently trusted his declarations implicitly.
The succeeding Caliphs of the first Arabian dynasty did not exhibit the same interest in education, and above all in science, that characterized Moawia. Political ambition and the desire for military glory seem to have filled up their thoughts and perhaps they had not the good fortune to fall under the influence of physicians so wise and learned as Maser Djawah. More probably, however, they themselves lacked interest. Toward the end of the seventh century they were succeeded by the Abbassides. Almansor, the second Caliph of this dynasty, was attacked by a dangerous disease and sent for a physician of the Nestorian school. After his restoration to health he became a liberal patron of science and especially medical science. The new city of Bagdad, which had become the capital of the realm of the Abbassides, was enriched by him with a large number of works on medicine, which he caused to be translated from the Greek. lie did not confine himself to medicine, however, but also brought about translations of works with regard to other sciences. One of these, astronomy, was a favorite. He made it a particular point to search out and encourage the translation of such books as had not previously been translated from Greek into Arabic. While he provided a translation of Ptolemy he also had translations made of Aristotle and Galen.
It is not surprising, then, that the school of Bagdad became celebrated. Jewish physicians seem to have been most prominent in its foundation, and the most distinguished product of it is Isaac Ben Emran, almost as celebrated as a philosopher as he is as a physician. One of his expressions with regard to the danger of a patient having two physicians whose opinions disagree with regard to his illness has been deservedly preserved for us. Zeid, an Emir of one of the chief cities of the Arabs in Barbary, fell ill of a tertian fever and called Isaac and another physician in consultation. Their opinions were so widely in disaccord that Isaac refused to prescribe anything, and when the Emir, who had great confidence in him, demanded the reason, he replied, " disagreement of two physicians is more deadly than a tertian fever." This Isaac, who is said to have died in 799, is the great Jewish physician, one of the most important members of the profession in the eighth century. His principal work was with regard to poisons and the symptoms caused by them. This is often quoted by medical writers in the after time.
The prominent Jewish physician of the ninth century was Joshua Ben Nun. Haroun al-Raschid, whose attempts to secure justice for his people are the subject of so much legendary lore, and whose place in history may be best recalled by the fact that he is a contemporary of Charlemagne, was particularly interested in medicine. He founded the city of Tauris as a memorial of the cure of his wife. He was a generous patron of the school of Djondisabour and established a medical school also at Bagdad. He provided good salaries for the professors, insisted on careful examinations, and raised the standard of medical education for a time to a noteworthy degree. The greatest teacher of this school at Bagdad was Joshua Ben Nun, sometimes known as the Rabbi of Seleucia. His teaching attracted many students to Bagdad and his fame as one of the great practitioners of medicine of this time brought many patients. Among his disciples was John Masuee, whose Arabian name is so different, Yahia Ben Masoviah, that in order to avoid confusion in reaching it is important to know both. Almost better known, perhaps, at this time was Abu Joseph Jacob Ben Isaac Kendi. Fortunately for the after time, these men devoted themselves not only to their own observations and writings but made a series of valuable translations. Joshua Ben Nun seems to have been particularly zealous in this matter, following the example of Maser Djawah of Basra.
Bagdad then became a centre for Arabian culture. Malimoud, one of Haroun's successors, provided in Bagdad a refuge for the learned men of the East who were disturbed by the wars and troubles of the time. He became a liberal patron of literature and education. When the Emperor Michael III of Constantinople was conquered in battle, one of the obligations imposed upon him was to send many camel loads of books to Bagdad, and Aristotle and Plato were studied devotedly and translated into Arabic. The era of culture affected not only the capital but all the cities, and every-where throughout the Arabian empire schools and academies sprang up. We have records of them at Basra, Samareand, Ispalian. From here the thirst for education spread to the other cities ruled by the Mohammedans, and each town became affected by it. Alexandria, the cities of the Barbary States, those of Sieily and Provence, where Moorish influences were prominent, and of distant Spain, Cordova, Seville, Toledo, Granada, Saragossa, all took up the rivalry for culture which made this a glorious period in the history of the intellectual life.
Already, in the chapter on " Great Physicians in Early Christian Times," I have pointed out that many of the teachers of the Arabs were Christian physicians. Here it is proper to emphasize the other important factor in Arabian medicine, the Jewish physicians, who influenced the great Arabian rulers, and were the teachers of the Arabs in medicine and scienee generally. These Christian and Jewish physicians particularly encouraged the translation of the works of the great Greek physicians and thus kept the Greek medical tradition from dying out. It is not until the end of the ninth, or even the beginning of the tenth, century that we begin to have important contributors to medieine from among the Arabs themselves. Even at this time they have distinguished rivals among Jewish physicians. Indeed these acquired such a reputation that they became the physicians to monarchs and even high ecclesiastics, and we find them nearly everywhere throughout Europe. Their success was so great that it is not surprising that after a time the vogue of the Jewish physicians should have led to jealousy of them and to the passage of laws and decrees limiting their sphere of activity.
The great Jewish physician of the ninth century was Isaac Ben Soliman, better known as Isaac el Israili, and who is sometimes spoken of as d'Israeli. He was a pupil of Isaac Ben Amram the younger, probably a grandson of another Isaac Ben Amram, who, after having become famous in Bagdad, went to Cairo and became the physician of the Emir Zijadeth TH. The younger Tsaac established a school, and it was with him that Israeli obtained his introduetion to medicine. He practised first as an oculist and then became body-physician to the Sultan of Morocco. Because of the sympathy of his character and his unselfishness he acquired great popularity. Hyrtl refers to him respectfully as " that scholarly son of Israel." Curiously enough, considering racial feeling in the matter, he never married, and when asked why he had not, and whether he did not think that he might regret it, he replied, " I have written four hooks through which my memory will be better preserved than it would be by descendants." The four books are his " Treatise on Fevers," his " Treatise on Simple Medicines and Ailments," a treatise on the " Elements," and a treatise " On the Urine." Besides these, we have from him shorter works, " On the Pulse," " On Melancholy," and " On Dropsy." His hope with regard to his fame from these works was fulfilled, for they were printed as late as 1515 at Leyden, and Sprengel declared them the best compendium of simple remedies and diet that we have from the Arabian times. One of his translators into Latin has called him the monarch of physicians.
Some of his maxims are extremely interesting in the Tight of modern notions on the same subjects. Tie declared emphatically that " the most. important duty of the physician is to prevent illness." "Most patients get better without much help from the physician by the power of nature." lie emphasized his distrust of using many medicines at the same time in the hope that some of them would do good. lie laid it down as a rule : " Employ only one medicine at a time in all your cases and note its effects carefully." He was as wise with regard to medical ethics as therapeutics. He advised a young physician, " Never speak unfavorably of other physicians. Every one of us has his lucky and unlucky hours." It is pleasant to learn that the old gentleman lived to fill out a full hundred years of life, and that in his declining years lie was surrounded by the good will and the affection of many who had learned to know his precious qualities of heart and mind. More than of any other class of physicians do we find the large human sympathies of the Jewish physicians of the Middle Ages praised by their contemporaries and succeeding generations.
During the next centuries a number of Jewish physicians became prominent, though none of them until Maimonides impressed themselves deeply upon the medical life of their own and succeeding centuries. Very frequently they were the physicians to royal personages. Zedkias, for instance, was the physician to Louis the Pious and later to his son Charles the Bald. His reputation as a physician was great enough to give him the popular estimation of a magician, but it did not save him from the accusation of having poisoned Charles when that monarch died suddenly. There seem to be no good grounds, however, for the accusation. There were a number of schools of medicine, in Sicily and the southern part of Italy, in which Jewish, Arabian, and Christian physicians taught side by side. One of these teachers was Jude Sabatai Ben Abraham, usually kown by the name of Donalo who was famous both as a writer on medicine and on astronomy. Donolo studied and probably taught at Tarentum, and there were similar schools at Palermo, at Bari, and then later on the mainland at Salerno. The foundation of Salerno, in which Jewish physicians also took part, we shall discuss later in the special chapter devoted to that subject.
One of the great translators whose work meant very much for the medical science of his own and succeeding generations was the distinguished Jewish physician, Faradj Ben Salim, sometimes spoken of as Farachi Faragut or Ferrarius, who was born at Girgenti in Sicily. He made his medical studies in Salerno and did his work under the patronage of Charles of Anjou towards the end of the thirteenth century. His greatest work is the translation of the whole of the " Continens " of Blazes. The translation is praised as probably the best of its time made in the Middle Ages. Faradj came at the end of a great century, when the intellectual life of Europe had reached a high power of expression, and it is not surprising that he should have proved equal to his environment. This translation has also some additions made by Faradj himself, notably a glossary of Arabian names.
In Spain also Jewish physicians rose to distinction. The most distinguished in the tenth century was Chasdai Ben Schaprut. Like many other of the great physicians of this time, he had studied astronomy as well as the medical sciences. He became the physician of the Caliph Abd-er-Rahman III of Cordova. He seems also to have exercised some of the functions of Prime Minister to the Caliph, and took advantage of diplomatic relations between his sovereign and the Byzantine Emperor to obtain some works of Dioscorides. These he translated into Arabian with the help of a Greek monk, whom lhe seems also to have secured through the diplomatic relations. Undoubtedly he did much to usher in that enthusiasm for education and study which characterized the next centuries, the eleventh and twelfth, at Cordova in Spain, when such men as Avenzoar, Avicenna, and Averroes attracted the attention of the educational world of the time. Jewish writers have sometimes claimed one of the most distinguished of these, Avenzoar himself, as a Jew, but Hyrtl and other good authorities consider him of Arabic extraction and point to the fact that his ancestors bore the name of Mohammed. This is not absolutely conclusive evidence, but because of it I have preferred to class Avenzoar among the Arabian physicians.
The one historical fact of importance for us is that everywhere in Europe at that time Jews were being accorded opportunities for the study and practice of medicine. There are local incidents of persecution, but we are not so far away from the feelings that brought these about as to misunderstand them or to think that they were anything more than local, popular manifestations. The more we know about the details of the medical history of these times the deeper is the impression of academic freedom and of opportunities for liberal education.
Much bas been said about the intolerance of ecclesiastical authorities toward the Jews, and of Church decrees that either absolutely forbade their practice of the medical profession and their devotion to scientific study, or at least made these pursuits much more difficult for them than for others. Of course it has to be conceded, even by those who most insistently urge the existence of formal legislation in the matter, that in spite of these decrees and intolerance and opposition, Jews continued to practise medicine and to be the chosen physicians of kings and even of high ecclesiastical dignitaries, as well indeed of the Popes themselves. This, it is usually declared, must be attributed to the surpassing skill of the Jewish physicians, causing men to overcome their prejudices and override even their own legal regulations. There is no doubt at all about the skill of Jewish physicians at many times during the Middle Ages. There is no doubt also of the sentiment of opposition that often developed between the Christian peoples and the .Taws. Any excuse is good enough to justify men, to themselves at least, in putting obstacles in the paths of those who are more successful than they are themselves. Religion often became a cloak for ill-will and persecution.
The state of affairs that has been presumed however, according to which laws and decrees were being constantly issued forbidding the practice of medicine to .Jews by the ecclesiastical authorities, while at the same time they themselves and those who were nearest to them were employing Jewish physicians, is an absurdity that on the face of it calls for investigation of the conditions and from its very appearance would indicate that the ordinary historical assumption in the matter must be wrong.
I have been at some pains, then, to try to find out just what were the conditions in Europe with regard to the practice of medicine by the Jews. There is no doubt that at Salerno, where the influence of the Benedictines was very strong and where the influence of the Popes and the ecclesiastical authorities was always dominant, full liberty of studying and teaching was from the earliest days allowed to the Jews. Down at Montpellier it seems clear that Jewish physicians had a large part in the foundation of the medical school, and continued for several centuries to be most important factors in the maintenance of its reputation and the uphuilding of that fame which draw students from even distant parts of Europe to this medical school of the south of France. During the ninth, tenth, eleventh, and twelfth centuries Jewish physicians were frequently in attendance on kings and the higher nobility, on bishops and archbishops, cardinals, and even Popes. Every now and then the spirit of intolerance among the populace was aroused, and occasionally the death of some distinguished patient while in a Jewish physician's hands was made the occasion for persecution. We must not forget, after all, that even as late as Elizabeth's time, when Shakespeare wrote " The Merchant of Venice," he was taking advantage of the popular sentiment aroused by the execution of Lopez, the Queen's physician, for a real or supposed participation in a plot against her Majesty's life. Shylock was presented the next season for the sake of adventitious popularity that would thus accrue to the piece. The character was played so as to depict all the worst traits of the Jew, and was scornfully laughed at at every representation. This is an index of the popular feeling of the time. Bitter intolerance of the Jew has continued. Down almost to our own time the Ghettos have existed in Europe, and popular tumults against them continue to occur. Quite needless to say, these do not depend on Christianity, hut on defective human nature.
During the Middle Ages the best possible criterion of the attitude of the Church authorities towards the Jews is to be found in the legislation of Pope Innocent III. He is the greatest of the Popes of the Middle Ages; he shaped the policy of the Church more than any other ; his influence was felt for many generations after his own time. His famous edict with regard to them was well known : " Let no Christian by violence compel them to come dissenting or unwilling to Baptism. Further, let no Christian venture maliciously to harm their persons without a judgment of the civil power or to carry off their property or change their good customs which they have hitherto in that district which they inhabit." Innocent himself and several of his predecessors and successors are known to have had Jewish physicians. Example speaks even louder than precept, and the example of such men must have been a wonderful advertisement for the Jewish physicians of the time.
Besides Innocent III, many of the Popes of the twelfth and thirteenth centuries issued similar decrees as to the Jews. It may be recalled that this was the time when the Papacy was most powerful in Europe and when its decrees had most weight in all countries. Alexander II, Gregory IX, and Innocent IV all issued formal documents demanding the protection of the Jews, and especially insisting that they must not be forced to receive Baptism nor disturbed in the celebration of their festivals. Clement VI did the same thing in the next century, and even offered them a. refuge from persecution throughout the rest of France at Avignon. Distinguished Jewish scholars, who know the whole story from careful study, have given due credit to the Popes for all that they did for their people. They have even declared that if the Jews were not exterminated in many of the European countries it was because of the protection afforded by the Church. We have come to realize in recent years that persecution of the Jews is not at all a religious matter, but is due to racial prejudice and jealousy of their success by the peoples among whom they settle. All sorts of pretexts are given for this persecution at all times. Formal Church documents and the personal activities of the responsible Church officials show that during the Middle Ages the Church was a protector and not a persecutor of the Jews.
There is abundant historical authority for the statement that the Popes were uniformly beneficent in their treatment of the Jews. In order to demonstrate this there is no need to quote Catholic historians, for non-Catholics have been rather emphatic in bringing it out. Neander, the German Protestant historian, for instance, said:
" It was a ruling principle with the Popes after the example of their great predecessor, Gregory the Great, to protect the Jews in the rights which had been conceded to them. When the banished Popes of the twelfth century returned to Rome, the Jews went forth in their holiday garments to meet them, bearing before them the thora,' and Innocent II, on an occasion of this sort, blessed them."
English non-Catholic, historians can be quoted to the same effect_ The Anglican Dean Milman, for instance, said: " Of all European sovereigns, the Popes, with some exceptions, have pursued the most humane policy towards the Jews. In Italy, and even in Rome, they have been more rarely molested than in the other countries."
Hallam has expressed himself to the same effect, especially as regards the protection afforded to the Jew by the laws of the Church from the injustice of those around him. Laws sometimes fail of their purpose and the persecuting spirit of the populace is often hard to control, but everything that the central authority could do to afford protection was done and essential justice was enshrined in the Church laws.
Prominent ecclesiastics would naturally follow the lines laid down by their Papal superiors. The attitude of those whose lives mark epochs in the history of Christianity and who had more to do almost with the shaping of the policy of the Church at many times than the Popes themselves, can be quoted readily to this same effect. Neander has called particular attention to St. Bernard's declarations with regard to the evils that would follow any tolerance of such an abuse as the persecution of the Jews.
" The most influential men of the Church protested against such un-Christian fanaticism. When the Abbot Bernard of Clairvaux was rousing up the spirit of the nations to embark in the second crusade, and issued for this purpose, in the year 1146, his letters to the Germans (East Franks), he at the same time warned them against the influence of those enthusiasts who strove to inflame the fanaticism of the people. He declaimed against, the false zeal, without knowledge, which impelled them to murder the Jews, a people who ought to be allowed to live in peace in the country."
But it has been said that there are decrees against Jewish physicians, issued especially in the south of France, by various councils and synods of the Church. Attention needs to lie called at once to the fact that these are entirely local regulations and have nothing to do with the attitude of the Church as a whole, but represent what the ecclesiastical authorities of a particular part of the country deem necessary for some special reason in order to meet local conditions. Indeed at the end of the thirteenth and the early fourteenth century, when these decrees were being issued in France, full liberty was allowed in Italy, and there were no restrictions either as to medical practice or education founded on adhesion to Judaism.
What need to be realized in order to understand the issuance of certain local ecclesiastical regulations forbidding Jews to practise medicine are the special conditions which developed in France at this time. Many Jews had emigrated from Spain to France, and the reputation acquired by .Jewish physicians at Montpellier led to a number of the race taking up the practice of medicine without any further qualification than the fact that they were Jews. That gave them a reputation for curative powers of itself because of the fame of some Jewish doctors and their employment by the nobility and the highest ecclesiastics. It was Lard to regulate these wandering physicians. As a consequence of this, the faculty at Paris, always jealous of its own rights and those of its students, at the beginning of the fourteenth century absolutely forbade Jews from. practising on Christian patients within its jurisdiction. Of course the faculty of the University of Paris was dominated by ecclesiastical authorities. The medical school was, however, almost entirely independent of ecclesiastical influence, and was besides largely responsible for this decree. It was felt that something had to be done to stop the evil that had arisen and the charlatanry and quackery which was being practised. This was, however, rather an attempt to regulate the practice of medicine and keep it in the bands of medical school graduates than an example of intolerance towards the Jews. Practically no Jews had graduated at its university, Montpellier being their favorite school, and Paris was not a little jealous of its rights to provide for physicians from the northern part of France. We have not got away from manifestations of that spirit even yet, as our non-reciprocating state medical laws show.
During the next quarter of a century decrees not unlike those of the University of Paris were issued in the south of France, especially in Provence and Avignon. Anyone who knows the conditions which existed in the south of France at this time with regard to medical practice will be aware that a number of attempts were made by the ecclesiastical authorities just at this time to regulate the practice of medicine. Great abuses had crept in. Almost anyone who wished could set up as a physician, and those who were least fitted were often best able to secure a large number of patients by their cleverness, their knowledge of men, and their smooth tongues. The bishops of various dioceses met, and issued decrees forbidding anyone from practising medicine unless he was a graduate of the medical school of the neighboring University of Montpellier. After a time it was found that the greatest number of violators of these decrees were Jews. Accordingly special regulations were made against them. They happen to be ecclesiastical regulations, because no other authority at that time claimed the right to regulate medical education and the practice of medicine.
What is sure is that many Jewish physicians reached distinction under Christian as well as Arabian rulers at all times during the Middle Ages. It would be quite impossible in the limited space at command here to give any adequate mention of what was accomplished by these Jewish physicians, whose names we have scarcely been able to more than cata- logue, nor of the place they hold in their times. As the physicians of rulers, their influence for culture and the cultivation of science was extensive, and as a rule they stood for what was best and highest in education. The story of one of them, who is generally known in the Christian world at least, Maimonides, given in some detail, may serve as a type of these Jewish physicians of the Middle Ages. He lived just before the flourishing period of university life in the thirteenth century brought about that wonderful development of medicine and surgery in the west of Europe that meant so much for the final centuries of the Middle Ages. His works influenced not a little the great thinkers and teachers whose own writings were to be the foundations of education for several centuries after their time. Maimonides was well known in the Western universities. Though his life had been mainly spent in the East, and he died there, there was scarcely a distinguished scholar of Europe who was not acquainted directly or indirectly with his works, and the greater the reputation of the scholar, as a rule, the more he knew of Maimonides, Moses AEgyptus, as he was called, and the more frequently he referred to his writings.