After the disruptions of the many expulsions of Jews from most West European kingdoms from the thirteenth through the fifteenth centuries¸ it is no wonder that Jews as medical practitioners tended almost everywhere to fade away The two places where they remained in evidence however were those lands where major disasters had not yet taken place such as most of the Italian citystates and kingdoms including Sicily and the Iberian kingdoms before the crises in the 1490s Particularly after the mass conversion in 1496 of all Jews in Portugal including Castilian refugees from the expulsion of 1492 most of the Jewish physicians became crypto Jews and they remained such for the most part Many of these highlyeducated sophisticated and cosmopolitan individuals had converted or were born into families that had several generations earlier accepted or been forced to accept baptism (in which case they were anusim); if their conversion was voluntary they would be called marranos rather than crypto Jews unless they chose to maintain a secret practice and belief in Judaism

One of the key loopholes governing the regulations imposed on forced converts in Portugal was that medical books in Hebrew were neither confiscated nor destroyed clearly a concession to the supposed superiority of Jewish physicians who were expected to continue their roles as teachers and practitioners and hence needed access to their primary textbooks Since other rabbinical literature was removed the Church and Crown presumed that there would be and in many ways there was a radical disjuncture; that is Jewish communities were cut off from their intellectual roots and pursuits

However those Hebrew texts concerned with medicine were not strictly scientific treatises in the modern sense They contained within them rabbinical commentaries and anecdotes and the commentaries on Greek and Arabic authorities also expressed attitudes shaped by Jewish understandings of nature the body and the mind Doctors would whether in a personal clinical text or a supposed translation or commentary on an ancient author integrate their own experiences This means that whatever else they were these Hebrew books served as both reservoirs of traditional rabbinical learning and Jewish history and as vehicles for the transmission of the cryptoJewish doctor’s own perceptions and experiences of the world

Another important point is that the condition of being a New Christian leads to a perception of the world that is quite different from that of Old Christians This is so whether the trauma of conversion remains as a vague memory or still plays a vital and painful role in shaping the personality of the physician Two or three or more generations down the line from the baptism which changed an ancestor nominally from Jew to Catholic these persons were still stigmatized by opprobrious name of converso New Christian or marrano This differed from theological principle and prior experience of conversions in other times and places To be so called was to be always held under suspicion by the Inquisition as well as in popular social intercourse of being an insincere Christian a judaizer a heretic and an agent of the devil

On the one hand the Holy Office pursued New Christians with more or less rigor for five hundred years sending in its own familiars to spy out indications of Jewish practice or ideology or rewarding malsines or informers usually from inside the previously Jewish community whose motives were more often than not meanspirited vindictive and crazy On the other hand civic bodies guilds military orders and religious houses often instituted legal restrictions to membership based on limpieza de sangre purity of blood (as though the poison or pollution of Jewishness could not be eradicated by baptism) by sincerity of devotion to Catholic saints and sacraments or by the passage of time and sustained assimilation to Christian community life

Before the mass conversions in Iberia most Jewish physicians trained by apprenticeship rather than by attendance at university Fathers or other male relatives took in young men to study with them and so medical knowledge was passed on in a strictly Jewish context As New Christians these individuals could also train at universities in an ecclesiastical scholastic context thus having two ways to see themselves and their roles in science and society Despite this when they went into other nations to work they tended to be recognized primarily as working within Jewish tradition

For these three reasons then the cryptoJewish physician would tend to look at the relationship of the person his body and disease in a new set of ways: the healthy integrity of the person was a matter of an apparent normality in regard to the external environment and an unseen inner strength of character that resisted disease imposed from the outside

These medical theorists and practitioners would also think of blood in terms of some sort of genetic carrier of inherited traits even if they rejected out of hand the spiritual and social debilities that Iberian bigots claimed as inherent in Jews Though raciallymotivated the concept of pure and impure blood nevertheless brought into play several important factors: (a) a constitutional proclivity towards and susceptibility to certain kinds of diseases (b) what we might call genetic predilections towards forms of mental illness read in terms of moral or physical traits (c) new relationships between persons of different “blood” through intermarriage wetnursing (since mother’s milk was understood as a type of blood) and bleeding as a prophylactic and treatment of particular conditions Other physicians might also be alert to these new factors concerning blood but crypto Jews would find a greater necessity to investigate the implications of the Spanish and Portuguese legal and social implications of the concept of racial purity and impurity

Ancient medicine and its medieval and Renaissance developments would either tend towards a Christian notion of illness as a punishment or concomitant of sinfulness a phenomenon sent by God to afflict and test individuals and groups so that medical interventions were at best either temporary alleviations of pain or opportunities for the show of Christian endurance charity and faith; or towards a Gallenic scientific understanding of disease as an imbalance of humors which could be treated and sometimes cured by restoration of a healthy balance Treatments in this case would be by adjusting the patient’s diet mode of behavior or location occasionally through the intervention of herbal medicines or surgical relief of pressures Jewish and cryptoJewish medicine tended strongly towards the new Renaissance sense of physiological disease with the cryptoJewish physicians alert to the role of foreign bodies intruding into the organic system of the body the traitorous failure or hostility of parts of the soma against the health of the whole organism or the consequence of mental or emotional strains brought on by persecution and worry and manifest in weakening of the body’s natural defenses

Although the cryptoJewish or marrano physician might see his relationship to patients as a form of inquisition whereby he sought out the heretical pollution or the residue of prior debilities sometimes through intensive questioning and searching of the body and soul of the patient and sometimes through the inflicting of controlled pain in order to expose points of origin or sites of development of disease at the same time the crypto Jew would understand the need to respect and enhance the powers of the secret center of the patient’s being

The New Christian medical practitioner whatever his private beliefs would be aware of his own family background and the dangers thus always threatening his safety and security; and hence he would also be aware that what may appear superficially or symptomatically as disease and breakdown of bodily strength could also be indicative of the attempt by those secret parts of the patient’s real self to deflect attention from actual sources of pain and humiliation and to mask one pain in the form of another

Selected Background Sources

Harry Friedenwald The Jews and Medicine: Essays 2 vols Baltimore: The Johns Hopkins Press 1944

Immanuel Jakobovits Jewish Medical Ethics: A Comparative and Historical Study of the Jewish Religious Attitude to Medicine and its Practice 2nd expanded ed New York: Bloch 1975 (orig 1959)

Jan Ehrenwald ed From Medicine Man to Freud: An Anthology New York: Dell 1956

Aron Gurevich Medieval Popular Culture: Problems of Belief and Perception trans János M Bak and Paul A Hollingsworth Cambridge: Cambridge University Press and Paris: Editions de la Maison des Sciences de l’Homme 1997 {1988}

Gábor Klaniczay The Uses of Supernatural Power: The Transformation of Popular Religion in Medieval and EarlyModern Europe trans Susan Singerman ed Karen Margolis Oxford: Polity Press 1990

Emmanuel Le Roy Ladurie Jasmin’s Witch trans Brian Pearce New York: George Braziller 1987; orig 1983