The Exodus of a Medical School

TO THE EDITOR:

Edzard Ernst's praiseworthy article [1] about the fate of Viennese Jewish physicians in 1938 contains a statement that deserves comment. Dr. Ernst notes that, “Historically, medicine had been the only academic subject that Jews were allowed to take up (during the great plagues of the Middle Ages, doctoring was a risky business).” The implication is that during the plagues, Jewish physicians were considered to be expendable, the medical equivalent of cannon fodder, an attitude that explained their entry into the medical field in disproportionate numbers. I suggest that such a reading of history is unsubstantiated.

The 1346 to 1347 calamity known as the Black Death wiped out nearly one third of the European population and was followed by waves of varying severity that caused further devastation. Physicians could not combat the contagion, and many took their own advice and fled to safer climes. Others recognized a responsibility to provide comfort and remained, but the prestige of the profession was badly damaged. A 1348 report observed that “there were no doctors to be had, because they died like everyone else. Those available wanted an exorbitant sum in hand before entering the patient's house, and once inside they felt his pulse with their faces turned away and inspected his urine from afar, holding strong smelling substances to their noses” [2].

As a result of the plagues, the medical profession was reconstituted, but no evidence suggests that this accounted for an unusual influx of Jewish physicians. In Florence, for example, the sons of established families chose other careers after the Black Death, and their places were filled by immigrant physicians from the countryside or small towns. Boccaccio and others complained about these “incompetent foreign doctors.” Perhaps a few members of this generation of “new men” were Jewish, but it is noteworthy that between 1320 and 1444, only 10 Jews were members of Florence's doctors' guild [3].

During the fifteenth century, Padua became a haven for hundreds of Jewish medical students from all over Europe, but the first did not graduate until 1409 [4]. As the Renaissance progressed, the social climate became more hospitable and, particularly in Italy, Jewish physicians found it easier to integrate into the general community. These physicians were still excluded from most other occupations and from public office, and their success in medicine was an example of taking advantage of opportunity despite societal intolerance.

A few Jewish physicians are known to have treated patients during times of plague, some died of it, and, no doubt, some were self-sacrificing—even heroic. No evidence suggests, however, that they were uniquely so or that the epidemics of the Middle Ages can be used as an explanation for later Jewish predilection for the medical profession.

• Copyright ©2004 by the American College of Physicians