Posted on November 13th, 2014 by Rachel
“Oh God of faithfulness, place in the heart of the sick trust in me and my work, and an ear to listen to my advice. Remove from their bedside every quack [and all] heralds and saviors who come forth regularly… [and] dare to rise up and criticize the work of a doctor.” –Physician’s Prayer, written by Marcus Herz, 1789
I am indebted for the substance of this post to John M. Efron’s Medicine and the German Jews: A History (2001)
Title page, Uber die fruhe Beerdigung der Juden (On the Premature Burial of the Jews), by Marcus Herz, 1787. Courtesy of The National Library of Israel, Jerusalem.
Among Dr. Harry Friedenwald’s magnificent collection of books and manuscripts documenting the activities of Jewish physicians through the ages (selections of which will be displayed in our upcoming exhibition on Jews and medicine in America, scheduled to open in fall 2015) is a sixty-page pamphlet titled Uber die fruhe Beerdigung der Juden, On the Premature Burial of the Jews. Its riveting cover illustration cries out for explanation from the world of the author, Dr. Marcus Herz (1747-1803).
Marcus Herz, c. 1790s at the height of his reputation. Painted by Friedrich Georg Weitsch.
Herz was a sought-after physician, philosopher and friend of Immanuel Kant, and wealthy socialite who, together with his brilliant and beautiful wife Henriette, opened his home to the literati of his time, Jewish and Christian. Son of a poor sofer (Torah scribe), the precocious Herz first studied for the rabbinate, then became a clerk in a commercial concern, and at age 19 began to attend lectures at the University of Koenigsberg. He could not then afford to continue his studies, but made such an impression while there that Kant asked Herz to act as his “advocate” in the defense of his dissertation. Several years later, having acquired a patron among the Jewish reformers of the city to support him, he completed degrees in medicine and philosophy. While his education and social contacts led him to abandon ritual observance (and his persuasively rationalist lectures caused, in the words of a contemporary, “many an orthodox Jew…to doubt the teachings on miracles”), Herz remained proudly Jewish, a pioneer in a model of Jewish communal leadership and philanthropy we would recognize today. A proponent of the Haskalah (Jewish Enlightenment), his sincere concern was to lead his Jewish brethren out of the ghettoes and into European citizenship.
With all the authority of his position in the community and status as a physician, Herz stepped into a raging controversy of the day: the medical uncertainty in determining the death of an individual and the resulting fear of premature burial that scholars have described as “pathological” and “a vast anxiety [which took] hold of the collective consciousness” (Ingrid Stoessel and Philippe Aries, quoted in Efron). Having learned how to resuscitate a drowning victim, scientists of the day began to question formerly agreed upon signs of death: lack of respiration and pulse, skin pallor, rigor mortis. Many insisted one could be sure death had occurred only with the onset of decay. As scientists argued and public feeling ran high, the state began to weigh in with legislation requiring burial be delayed until that point.
Henriette De Lemos Herz, 1778 around the time of her marriage to Marcus at age 15. Painted by Anna Dorothea Lisiewska. For more information about this interesting and independent woman, see the entry on her in the Jewish Women’s Archive’s online encyclopedia http://jwa.org/encyclopedia/article/herz-henriette
Among Christians burial several days after death was normal custom, but Jews are enjoined by Torah (Deuteronomy 21:22-3) to bury the dead within twenty-four hours. The first official action affecting Jewish burial customs came in 1772 when the Duke of Mecklenburg-Schwerin decreed that Jews be required to wait three days before burying their dead. Moses Mendelssohn, the great interpreter of secular and Jewish culture, interceded for the community by suggesting that a physician be required to certify death before burial, a solution uneasily accepted by both sides of the controversy. The issue created lasting rifts within the Jewish community because physicians of the haskalah such as Herz, for reasons articulated in his 1787 pamphlet, tended to side with the state, while traditional authorities maintained that burial society members were quite expert in recognizing death.
Detail, Uber die fruhe Beerdigung der Juden. You may need to enlarge this image to see how the man’s entire upper body seems to be emerging from the mound of dirt on his grave in the background. Courtesy of The National Library of Israel, Jerusalem.
The cover of Herz’s pamphlet is macabre. An engraving by Wilhelm Chodwiecki shows a mourner contemplating Moses Mendelssohn’s headstone while behind him in the moonlight, hands reach out, begging for liberation from a newly covered grave. Herz, at least partially motivated by a near-death illness of his own, gives passionate voice to the scene depicted on the cover: “My brothers, you simply can never have imagined the true horror of what it must be like for someone to awake in the grave!…He opens his eyes, around him everything is dark and desolate….He groans, cries, pleads with all the powers that he has struggled so hard to regain: to no avail, he languishes unheard.”
Herz proposed that Jews wait two to three days before burying their dead, with the alleged deceased resting in a mortuary and visited by a physician trained to recognize the signs of returning life or of decay. In the interim, the body was not to be considered a corpse or prepared for burial. In this he was opposed, as one might expect, by traditional Jewish authorities. But Herz was also challenged by conservative members of his own movement, who saw things differently. These opponents, also medically trained, argued—with some justification—that premature burial was not only a Jewish problem, that to single out Jewish practice for legislation was an act of discrimination by the state, and that, in fact, early burial was more hygienic than delayed burial, a claim backed by a Berlin College of Medicine study of victims of smallpox and other contagious diseases.
Is this story an example of official discrimination against the Jews, or of the struggle between Jewish traditionalists and reformers? In either case, it is a powerful demonstration of the ways in which medical arguments were mustered by those on both sides of the debate, suggesting the complexity of the relationships between medicine and the Jews.
A blog post by Curator Karen Falk. To read more posts from Karen click HERE.
Posted on July 24th, 2014 by Rachel
18th-century portrait of Maimonides, from the Thesaurus antiquitatum sacrarum by Blaisio Ugolino.
Born: 1136, Cordoba, Spain
Died: December 12, 1204, Fustat, Egypt
Education: University of Al Karaouine
Children: Abraham ben Moses ben Maimon
Siblings: David ben Maimon (and several unnamed female relatives)
-Sherwin B. Nuland, Maimonides. Nextbook, Schocken, New York, 2005.
Maimonides sculpture, Cordoba, Spain
“Why is it, in fact, so many Jews have become doctors”?
During the Middle Ages and Renaissance the legend of the Jewish doctor’s special skill is still current today . . . along-side the legend of the profession’s attractiveness to young Jews as a career. Intertwined with myth, the legendary relationship between the Jew and the Art of Healing continues to evoke response . . .
SPAIN, MOROCCO, EGYPT
As a young child, Moses was an indifferent and uncaring student despite his father’s determined efforts. Unresponsive to Maimon’s encouragement, cajoling and finally his ire and punishment Moses refused to learn until his father called him a person of the lowest order, like his very common place mother. He became angry and ran away. Moses would hide in, as the legend goes, in the Women’s Section of the Synagogue where no one would think to look for him. He would lament to God praying for some relief from the failure that some must have attributed to his having been the offspring of an unlearned butcher’s daughter.
When Moses began studying, his father, the elder Maimon, had a vast library in Cordoba which Moses enjoyed looking at. Being a precocious boy, Moses learned Jewish Law, philosophy, rhetoric, astronomy, science, and mathematics. He poured over his father’s medical books. He was taught by his father and tutors as well after choosing to study.
On fleeing Cordoba, teachers were found among the fleeing Jews to educate Moses as best they could while on the journey.
Moses was able to absorb large quantities of information and remember it without notes. Once read, the contents of entire books seem to have remained in his memory. As for so many intellectually gifted students of the medieval period, the goal was set for him to master all knowledge. Other details of Moses’ early life is not certain and has fallen into myth.
The Almohad Caliphate map
Because of a change of leadership in Spain and Fez, Morocco, in 1148 by the Almohads, a violent fundamentalist fanatical Muslim group of Berbers, the Maimon family moved to Fez hoping for some relief from the persecution and mayhem. Moses began writing during this period which became a regular part of his life until his death. At about age 20, he began writing a form of the Mishnah, called the Gemara, produced as a work the common man could understand. He wrote under restless and dangerous travel.
Writing in Arabic using Hebrew letters, he wrote a book called the Siraj, “Luminous Light.” The book was meant to elucidate concepts that might be abstruse to the common man.
TRAGEDY AND DEPRESSION
Moses’ brother, David Maimon, went into commerce selling gems. David was Moses’ younger brother who, because he was so successful, encouraged Moses to continue studying and subsidized his study. David was also responsible for several aunts and cousins. The gem business became so successful, David began travelling farther and farther away from to sell his wares.
When Moses’ brother died in a shipwreck in the Indian Ocean, the family fortune went down with him. David left Moses his widow and a little daughter plus the other relatives to care for. At age 30, Moses went into a severe depression due to the loss of David and the heavy responsibility that fell onto his shoulders. Upon coming out of the depression, he looked around to see what he could do to earn money to overcome his financial problems. He tried to lecture and teach on the subject of depression and wrote a treatise on the subject. Because he couldn’t make enough money to solve his problems from his lecturing and teaching, he had turn to other means.
He didn’t want to teach Torah for money because this was a sacred trust for him. He looked around for something to do. He, therefore, turned to thoughts of practicing medicine. He remembered “studying his father, Maimon’s, medical texts, he was fascinated by disease and the ways in which the body yielded to illness and then attempts to rally against it.”
Moses read the Greek masters Hippocrates and Galen and was familiar with the works of those who came after them: Aretaeus, Paul of Aegina, and Oribasius. He studied herbs from the great herbalist and medical botanist, Dioscorides from the first century C.E. He also knew the biological theories of Aristotle as though he had performed the experiments and observations himself. Being the scholar he was, he studied more recent treatises of the leading physicians who wrote in Arabic including Rabbi Isaac Judaeus and three Muslim physicians and the man who had been his friend, Averroes from Cordoba, Spain. Moses studied the great Persian physicians who were two generations before him. Moses learned medicine from books not bedside practice and from years of discussions with his or his father’s friends.
He was aware of the high fees physicians could be paid and he became a doctor. He brought to medicine the advantages of long years of study, virtually photographic memory, wide knowledge of philosophy and science and the rational approach to evidence they had taught him; the wisdom and compassion for God’s creatures that were so much a part of his Jewish heritage and his personal faith.
His years of being a healer elevated him to professional prominence and he was invited to treat patients at court.
- Maimonides for Kids, Islamic Medicine
Maimonides wrote a book about how to stay healthy and not get sick in the first place. He realized that people in cities got sick from drinking water contaminated by sewage. Dysentery and cholera germs seeped into the water supply. His advice was to try to live in a city surrounded by forests and outside water. He encouraged people to keep clean, eat good food, get plenty of fresh air and exercise. According to Maimonides, depressed people were more likely to get sick. His antidote was to tell his patients to listen to music, look at paintings, and take pleasant walks. If you got sick, eat chicken soup. For snake bites use tourniquets, burning out the poison, and rest. He like Aristotle and other physicians of the day, didn’t completely understand the properties of herbal medicines. He also didn’t know that some physical problems caused depression.
He,like Aristotle, believed scientific experiment and logical thought were the way to learn what caused disease.
- Rabbi Abraham Joshua Heschel
A typical day for Maimonides was to go to the Sultan of Cairo’s palace to care for anyone in the household who became sick. Then upon returning home in the afternoon, his anti-chamber was filled with patients of all social class and strata of the surrounding area. His first activity upon reaching home was to wash his hands and eat a light meal, the only meal he ate in a 24 hour period.
Maimonides became a physician only after his brother David died in a capsized ship. Caring for the family fell upon him alone. After casting around for ideas on a way to make a living, he remembered his father’s medical books and how much he enjoyed reading them as a child. He began to read everything he could on available Islamic medicine, Aristotle and Galen of Pergamon and he studied herbal medicines by the great men of the day. Because he retained whole pages and books, he was able to recall what he needed to treat a patient. Because there weren’t very many cures in the 12th century, he concentrated on preventive medicine which he was very successful at spreading his name and skills far and wide.
Why did Jews go into medicine in the Middle Ages and the Renaissance? Medicine was available to them and their Talmudic and Torah education gave them special skills for learning medicine and then practicing it. Medicine was lucrative as a way to support their families and their Talmudic studies. There is still a mystique about the Jewish doctor among the populations of many countries. The hey-day for Jewish physicians seems to be passing but others will take their place.
A blog post by Exhibitions Intern Barbara Israelson. To read more posts from interns, click HERE. To read more about Maimonides, check out his wikipedia article HERE.
Posted on July 18th, 2014 by Rachel
This week I have invited curator Karen Falk to share her recent research for the exhibit Jews, Health and Healing. The exhibit is scheduled to open at JMM in the fall of 2015. I think you will agree that Karen has uncovered some compelling insights.
Our upcoming exhibition about Jews and medicine has required a revolution in my consciousness, one that has brought me new awareness of the medical professions, the history of medicine, and the impact of medicine on Jewish identity. So a request to share some insights gained while working on this exciting project was a welcome assignment.
Perhaps the most enduring lesson I learned—to my surprise, I admit— was just how absorbing it is to study the history of medicine! Other surprises, from each section of the exhibition, include:
Caliphs, princesses, popes and saints.
Many people have noted with a sense of irony that even while Jews were persecuted in medieval and renaissance Europe, rulers seeking medical advice often turned to Jewish physicians. Turns out there’s a lot of fact underpinning this conventional wisdom. Baltimore ophthalmologist Harry Friedenwald thoroughly documented this history in his collection of books and manuscripts produced by Jewish physicians from the fourteenth through the nineteenth centuries. Among them: a 14th century manuscript of works by Isaac Israeli (c. 850-950; yes, he is said to have lived 100 years!), who was court physician to the Fatimite Caliph Obaid Allah; several works by Maimonides, philosopher and physician to Saladin, first sultan of Egypt; a full set of the 700 case histories written up by the 16th century physician Amatus Lusitanus, who treated Pope Julius III but spent his life outrunning the Inquisition; a letter from the physician Felipe Rodriguez (Elijah) de Luna Montalto to his patient, Queen Marie (de Medicis) of France (wife of King Louis XIII); even a 1487 woodcut depicting a 4th century scene in which the Jewish physician Ephraim attends the ailing St. Basil. Friedenwald’s collection became the first-ever exhibition about Jews and medicine, shown at Johns Hopkins University in 1943.
The Jewish physician is shown in 15th century German clothing, including distinctive headwear.
“Never admit more than five Jews…”
The number of Jewish doctors in Europe in the early twentieth century was astounding. Almost half the physicians in Berlin were Jewish; in Vienna, it was about 60%, and in Warsaw it was 70%. As the children of immigrants from Central and Eastern Europe began to enter colleges in the first decades of the twentieth century, similarly high percentages were aiming for medical school. All across the country, university and medical school deans were alarmed, and began to put into place measures that limited Jewish enrollment. The University of Michigan, for example, used interviews to determine a candidate’s “personal acceptability and magnetism” (many Jews failed this test). Many schools determined Jewish heritage based on last names, and when that failed because of the growing practice of Americanizing one’s name, they asked for the applicant’s mother’s maiden name. What is perhaps most surprising about this situation is the response of some Jews. Milton Charles Winternitz, the Jewish dean of Yale Medical School, was complicit. “Never admit more than five Jews, take only two Italian Catholics, and take no blacks at all,” Winternitz told his admissions officers. Baltimore Hebrew Congregation’s Rabbi Morris Lazaron did a national study of medical school admissions practices in 1934, and concluded that Jews were admitted at a rate of about 20% of the student bodies. He felt he had documented discrimination, but advised accommodating the quotas. He never published his report, afraid it would make things worse. Leon Sachs, longtime head of the Baltimore Jewish Council, negotiated with both Johns Hopkins University and the University of Maryland medical schools in the 1940s and 50s over the numbers of Jewish students admitted each year. Documents in the JMM collection show that Hopkins claimed that 75% of its applications came from Jewish students. The university began with a 10% quota on Jewish admissions, and thanks to Sachs, raised it first to 14% and then to 17% in subsequent years. [Credit goes to Antero Pietila for making these documents public in his book Not in My Neighborhood: How Bigotry Shaped a Great American City (2010, Ivan Dee, Inc.)]
2006.013.1224 Leon Sachs was executive director of the Baltimore Jewish Council from 1941-1975.
“Promoting Christianity amongst the Jews.”
Jewish hospitals surprise people today, possibly because the maintenance of a hospital seems like a daunting project for a tiny minority community. They were founded by necessity. As places of danger and death throughout most of the nineteenth century, hospitals were the stamping grounds of missionaries hoping to save the souls of the sick and dying and Jewish patients were their prime targets. Baltimore’s Hebrew Hospital and Asylum (now Sinai Hospital and part of Lifebridge Health, a sponsor of our exhibition) was built in 1868, one of many founded in cities across the country to alleviate this pervasive problem. The practice of proselytizing in hospitals was global and persistent. Henrietta Szold and the women of Hadassah founded Hadassah Hospital in Jerusalem in 1902 as a specific response to this issue.
1991.203.003. An early view of the Hebrew Hospital and Asylum.
“They wanted to make ladies of us.”
The alumni of Sinai Hospital’s training program for nurses, which closed in 1975, have been valued supporters of the JMM, sharing memories and donating uniforms, caps, tools, photos, and documents from their years as students and on the job. We were completely agog, however, when they brought in an elaborate silver tea set, with matching candelabra. How was this unexpected set of objects part of a nursing curriculum? “Tea” was held every Friday afternoon. “They wanted to make ladies of us,” Bobbie Horwitz told us. It appears that Jews—along with most Americans—had very different ideas about the ways in which men and women could be involved in medicine. Parents were sometimes hesitant to allow their daughters to go to nursing school. “My older sister broke them down. She was the first to become a nurse,” Myra Framm told us. Young women might face harassment in the workplace. Toby Mower recalled, “The doctors used to kid around with the new nurses that were rotating through the operating room: ‘Oh would you run to central supply and get me a fallopian tube?’ and we would run off to the central supply to get these fallopian tubes. They would have a laugh and we would wind up being embarrassed.”
2010.020.027 Nurses enjoy Friday afternoon tea at Sinai hospital.
Garcia da Orta: Converso, physician, plant hunter.
Born in Portugal just a few years after the Jews were expelled from Spain, Garcia da Orta was a Converso physician in Lisbon and professor of medicine at the Lisbon University. As the Inquisition in Portugal became more repressive, he signed on as a ship’s doctor with the Portuguese navy and soon found himself in India, where he began a thriving medical practice, and learned about the curative properties of the sub-continent’s botanicals. His book, Conversations on the simples, drugs and medicinal substances of India (1563) introduced many new remedies to the European material medica. The Inquisition finally caught up with him and his family. Da Orta died in 1568, but his sister was burned as a heretic in 1569, and da Orta’s remains were exhumed and burned in 1580. Still, he is remembered as “the most illustrious representative of the Portuguese spirit in the natural sciences.”
Doctor, scientist, entrepreneur.
Dr. Morris Abramovitz came to Baltimore from Lithuania in 1901, had completed his medical studies at University of Maryland by 1906, and was a special student taking classes at Johns Hopkins Medical School in 1907. He opened a practice in East Baltimore, tending to a diverse immigrant neighborhood as well as sailors on leave in Baltimore’s harbor. Although a practitioner with a humble neighborhood practice, Abramovitz represented the scientific sprit of his time. Observing that many sailors among his patients suffered from syphilis, he was intrigued with the opportunities and problems of a new chemical treatment from Germany, known as Salvarsan. Unstable and difficult to prepare as a solution for injection, a more stable compound called Neo-salvarsan came out in 1912. Neo-salvarsan was less effective against the disease, however. Abramovitz developed and marketed an apparatus to administer both drugs at once, minimizing the problems of preparing Salvarsan while boosting the effectiveness of its replacement with some of the original. Side effects were unpleasant, and the treatment was replaced by penicillin in the 1940s.
2001.026.062.006 Marketing postcard from Dr. Morris Abramovitz, showing the “Combined Method Apparatus,” c. 1915.
To catch up on previous JMM Insights, click HERE.