Israel and Medicine
By Sir William Osler
SIR WILLIAM OSLER (born in Ontario, Canada, in 1849) Regius Professor of Medicine at Oxford and one of the world's leading medical authorities; distinguished not merely as investigator, teacher, and practitioner, but also as essayist and ethical teacher of singular grace and humanity, as shown in the volumes entitled "Aequanimitas" and "Counsels and Ideals." The present address, delivered in London at the twenty-fifth anniversary of the Jewish Historical Society of England, is here given its first publication in this country, with Sir William's special authorization.
IN estimating the position of Israel in the human values we must remember that the quest for righteousness is Oriental, the quest for knowledge Occidental. With the great prophets of the East—Moses, Isaiah, Mahomet—the word was, "Thus saith the Lord"; with the great seers of the West, from Thales and Aristotle to Archimedes and Lucretius, it was "What says Nature?" They illustrate two opposite views of man and his destiny—in the one he is an "angelus sepultus" in a muddy vesture of decay; in the other, he is the "young light-hearted master" of the world, in it to know it, and by knowing to conquer. Modern civilization is the outcome of these two great movements of the mind of man, who to-day is ruled in heart and head by Israel and by Greece. From the one he has learned responsibility to a Supreme Being, and the love of his neighbor, in which are embraced both the Law and the Prophets; from the other he has gathered the promise of Eden to have dominion over the earth on which he lives. Not that Israel is all heart, nor Greece all head, for in estimating the human value of the two races, intellect and science are found in Jerusalem and beauty and truth at Athens, but in different proportions.
Medicine in the Talmud
IT is a striking fact that there is no great Oriental name in science—not one to be put in the same class with Aristotle, with Hippocrates, or with a score of Grecians. We do not go to the Bible for science, though we may go to Moses for instruction in some of the best methods in hygiene. Nor is the Talmud a fountain-head in which men seek inspiration to-day as in the works of Aristotle. I do not forget the saying:
| "In uns'rem Talmud kann man Jedes lesen, |
| Und Alles ist schon einmal dagewesen." |
With much of intense interest for the physician, and in spite of some brave sayings about the value of science, there is not in it the spirit of Aristotle or of Galen. It is true we find there one of the earliest instances in literature of an accurate diagnosis confirmed post mortem. A sheep of the Rabbi Chabiba had paralysis of the hind legs. Rabbi Jemar diagnosed ischias, or arthritis, but Rabbina, who was called in, said that the disease was in the spinal marrow. To settle the dispute the sheep was killed, and Rabbina's diagnosis was confirmed.
The Role of Jewish Physicians in the Middle Ages
IN the early Middle Ages the Jewish physicians played a role of the first importance as preservers and transmitters of ancient knowledge. With the fall of Rome the broad stream of Greek science in western Europe entered the sud of mediævalism. It filtered through in three streams—one in South Italy, the other in Byzantium, and a third through Islam. At the great school of Salernum in the tenth, eleventh and twelfth centuries, we find important Jewish teachers; Copho II wrote the Anatomia Porci, and Rebecca wrote on fevers and the fœtus. Jews were valued councillors at the court of the great Emperor Frederick. With the Byzantine stream the Jews seem to have had little to do, but the broad, clear stream which ran through Islam is dotted thickly with Hebrew names. In the eastern and western Caliphates and in North Africa were men who to-day are the glory of Israel, and bright stars in the medical firmament. Three of these stand out preëminent. The writings of Isaac Judæus, known in the Middle Ages as Monarcha Medicorum, were prized for more than four centuries. He had a Hippocratic belief in the powers of nature and in the superiority of prevention to cure. He was an optimist and held strongly to the Talmudic precept that the physician who takes nothing is worth nothing. Rabbi ben Ezra was a universal genius and wanderer, whose travels brought him as far as England. His philosophy of life Browning has depicted in the well-known poem, whose beauty of diction and clarity of thought atone for countless muddy folios.
Maimonides: Prince Among Physicians
BUT the prince among Jewish physicians, whose fame as such has been overshadowed by his reputation as a Talmudist and philosopher, is the Doctor Perplexorum—dux, director, demonstrator, neutrorum dubitantium et errantium!—Moses Maimonides. Cordova boasts of three of the greatest names in the history of Arabian medicine: Avenzoar, Albucasis, and Averroes (Avenzoar is indeed claimed to be a Jew). Great as is the fame of Averroes as the commentator and transmitter of Aristotle to scholastic Europe, his fame is enhanced as the teacher and inspirer of Moses ben Maimon. Exiled from Spain, this great teacher became in Egypt the Thomas Aquinas of Jewry, the conciliator of the Bible and the Talmud with the philosophy of Aristotle. He remains one of Israel's great prophets, and while devoted to theology and philosophy, he was a distinguished and successful practitioner of medicine and the author of many works highly prized for nearly five centuries, some of which are still reprinted. He says pathetically, "Although from my youth Torah was betrothed to me and continues to live by me as the wife of my youth, in whose love I find a constant delight, strange women, whom I took at first into my house as her handmaids, have become her rivals and absorbed part of my time." The spirit of the man is manifest in his famous prayer, one of the precious documents of our profession, worthy to be placed beside the Hippocratic oath. It ends with: "In suffering let me always see only my fellow creature."[A]
Jewish Physicians and Medieval Popes
IN the revival of learning in the thirteenth century, which led to the foundation of so many of the universities, Hebrew physicians took a prominent part, particularly in the great schools of Montpelier and of Paris; and for the next two or three centuries in Italy, in France, and in Germany, Hebrew physicians were greatly prized. But too often the tribulations of Israel were their lot. As one reads of the grievous persecutions they suffered, there comes to mind the truth of Zunz' words: "Wenn es eine Stufenleiter von Leiden giebt, so hat Israel die hochste Staffel erstiegen." Their checkered career is well illustrated by the relations with the Popes, some of whom uttered official bulls and fulminations against them, others seem to have had a special fondness for them as body physicians. Paul III was for years in charge of Jacob Montino, a distinguished Jewish physician, who translated extensively from the Arabic and Hebrew into Latin, and his edition of Averroes is dedicated to Pope Leo X. In my library there is a copy of the letter of Pope Gregory XIII, dated March 30th, 1581, and printed in 1584, confirming the decrees of Paul IV and Pius V, which he regrets were by no means held in observance, "but that there are still many among Christian persons who desiring the infirmities of their bodies be cured by illicit means, and especially by the service of Jews and other infidels. . . ." It was at Mantua that a Jewish physician, Abraham Conath, established a printing press, from which the first Hebrew works were issued.
Names of Distinction in Later Centuries
THROUGHOUT the sixteenth, seventeenth, and eighteenth centuries in France, Germany, and Italy we meet many distinguished names in the profession, and in his Geschichte der Jüdischen Aertz Landau pays a very just tribute to their work. Only a few are met with in England. Isaac Abendana, a Spaniard, practised in Oxford and lectured on Hebrew at Magdalen College. We have at the Bodleian Jewish almanacs which lie issued at the end of the seventeenth century, and a great Latin translation of Mishnah. He afterwards migrated to Cambridge. A more important author was Jacob de Castro Sarmento, a Portuguese Jew, who became licentiate of the Royal College of Physicians in 1725, and Fellow of the Royal Society in 1730. There is in the Bodleian an interesting broadsheet from the Register of the London Synagogues respecting charges made when his name was proposed at the Royal Society. He contributed many papers to the Philosophical Transactions, and was the author of several works. In the eighteenth century Jean Baptiste de Silva, of a Portuguese Jewish family, became one of the leading physicians of Paris, consulting physician to Louis XV, and the friend of Voltaire, who remarks, "C'était un de ces médecins que Moliere n'eut ni pu ni osé rendre ridicules." One of the special treasures of my library is a volume of the Henriade superbly bound by Padeloup, and a presentation copy from Voltaire to de Silva, given me when I left Baltimore by my messmates in "The Ship of Fools" (a dining club). Voltaire's inscription reads as follows:
"A Monsieur Silva, Esculape François. Recevez cet hommage de votre frère en Apollon. Ce Dieu vous a laissé son plus bel héritage, tous les Dons de l'esprit, tous ceux de la raison, et je n'eus que des Vers, hélas, pour mon partage."
The Achievement of Recent Years
IN the nineteenth century, with the removal of the vexatious restrictions, the Jew had a chance of reaching his full development, and he has taken a position in the medical profession comparable to that occupied in the palmy Arabian days of Cordova and Bagdad. In Germany particularly, the last half of the century witnessed a remarkable outburst of scientific activity. Traube, who may well be called the father of experimental pathology; Henle, the distinguished anatomist and pathologist; Valentin, the physiologist; Lebert, Remak, Romberg, Ebstein, Henoch, have been among the clinical physicians of the very first rank. Cohnheim was the most brilliant pathologist of his day; to Weigert pathological histology owes an enormous debt, and, to crown all, the man whose ideas have revolutionized modern pathology, Paul Ehrlich, is a Jew. In America Hebrew members of our profession for many years occupied a very prominent position. The father of the profession to-day, a man universally beloved, is Abraham Jacobi, full of years and honors; and the two most brilliant representatives in physiology and pathology, Simon Flexner and Jacques Loeb, carry out the splendid traditions of Traube and Henle.
I have always had a warm affection for my Jewish students, and the friendships I have made with them have been among the special pleasures of my life. Their success has always been a great gratification, as it has been the just reward of earnestness and tenacity of purpose and devotion to high ideals in science; and, I may add, a dedication of themselves as practitioners to everything that could promote the welfare of their patients. In the medical profession the Jews had a long and honorable record, and among no people is all that is best in our science and art more warmly appreciated; none in the community take more to heart the admonition of the son of Sirach, "Give place to the physician, let him not go from thee, for thou hast need of him."
FOOTNOTE:
[A] I am told by authorities that the attribution of this prayer to Maimonides is doubtful. Where is the original?