For at least a thousand years, on all the continents of their wanderings, Jews have been recognized by friend and foe as medical superstars. Even in intolerant surroundings they have filled the ranks of physicians, wildly out of proportion to their numbers in the population. Historically speaking, one might almost say that medicine has been the Jewish profession — not just in our modern scientific age, but also in the long era when medicine was largely groping in the dark. The reasons for this intimate link between Jews and medicine have varied considerably across centuries and continents. Book learning, religious attitudes towards the body, superstitious awe among gentiles, the portability of medical knowledge across borders, historical tradition, and (in more modern times) independent and creative thinking of the "outsider," have all played a role. The book tells the history of Jews in medicine as a flowing epic, from the (pre-) Biblical era to the mid-twentieth century, from the Middle East, through the countries of Southern, Eastern and Northern Europe, to the Orient, and to America - always against the backdrop of the cultural, religious, political, and scientific developments of the times. In so doing the book also narrates the most important scientific accomplishments of the likes of Maimonides (classical medicine), Cohn (germ thoery), Freud (psychoanalysis), Ehrlich (immunology and chemotherapy), Chain (penicillin), and Waksman (antibiotics), as well as many other luminaries and Nobel prize winners.
For at least a thousand years, on all the continents of their wanderings, Jews have been recognized by friend and foe as medical superstars. Even in intolerant surroundings they have filled the ranks of physicians, wildly out of proportion to their numbers in the population. Historically speaking, one might almost say that medicine has been the Jewish profession — not just in our modern scientific age, but also in the long era when medicine was largely groping in the dark. The reasons for this intimate link between Jews and medicine have varied considerably across centuries and continents. Book learning, religious attitudes towards the body, superstitious awe among gentiles, the portability of medical knowledge across borders, historical tradition, and (in more modern times) independent and creative thinking of the "outsider," have all played a role. The book tells the history of Jews in medicine as a flowing epic, from the (pre-) Biblical era to the mid-twentieth century, from the Middle East, through the countries of Southern, Eastern and Northern Europe, to the Orient, and to America - always against the backdrop of the cultural, religious, political, and scientific developments of the times. In so doing the book also narrates the most important scientific accomplishments of the likes of Maimonides (classical medicine), Cohn (germ thoery), Freud (psychoanalysis), Ehrlich (immunology and chemotherapy), Chain (penicillin), and Waksman (antibiotics), as well as many other luminaries and Nobel prize winners.
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Overview
For at least a thousand years, on all the continents of their wanderings, Jews have been recognized by friend and foe as medical superstars. Even in intolerant surroundings they have filled the ranks of physicians, wildly out of proportion to their numbers in the population. Historically speaking, one might almost say that medicine has been the Jewish profession — not just in our modern scientific age, but also in the long era when medicine was largely groping in the dark. The reasons for this intimate link between Jews and medicine have varied considerably across centuries and continents. Book learning, religious attitudes towards the body, superstitious awe among gentiles, the portability of medical knowledge across borders, historical tradition, and (in more modern times) independent and creative thinking of the "outsider," have all played a role. The book tells the history of Jews in medicine as a flowing epic, from the (pre-) Biblical era to the mid-twentieth century, from the Middle East, through the countries of Southern, Eastern and Northern Europe, to the Orient, and to America - always against the backdrop of the cultural, religious, political, and scientific developments of the times. In so doing the book also narrates the most important scientific accomplishments of the likes of Maimonides (classical medicine), Cohn (germ thoery), Freud (psychoanalysis), Ehrlich (immunology and chemotherapy), Chain (penicillin), and Waksman (antibiotics), as well as many other luminaries and Nobel prize winners.
Product Details
| ISBN-13: | 9780881257731 |
|---|---|
| Publisher: | KTAV Publishing House, Inc. |
| Publication date: | 01/01/2002 |
| Pages: | 604 |
| Product dimensions: | 5.91(w) x 9.06(h) x (d) |
Read an Excerpt
Chapter One
A Serpent upon a Pole
Every thing that may abide the fire, ye shall make it go through the fire, and it shall be clean: nevertheless it shall be purified with the water of separation: and all that abideth not the fire ye shall make go through the water. And ye shall wash your clothes on the seventh day and ye shall be clean, and afterwards ye shall come into the camp.
(Numbers 31:19-24)
And the Lord said unto Moses, Make thee a fiery serpent, and set it upon a pole: and it shall come to pass, that everyone that is bitten, when he looketh upon it, shall live. And Moses made a serpent of brass, and put it upon a pole, and it came to pass, that if a serpent had bitten any man, when he beheld the serpent of brass, he lived.
(Numbers 21:5-9)
From the northern reaches of the land of Israel, the Great Rift Valley makes its way along the River Jordan, across the Dead Sea basin, down into the Gulf of Aqaba, and over the Red Sea. From there it continues for over 1,000 miles through Ethiopia, Kenya, and Tanzania. This East African stretch of the Rift Valley is generally considered today to have been the evolutionary counterpart of the biblical creation myth and the Garden of Eden—the place where the species Homo sapiens arose in the course of a few million years ofgenetic mutations under the pressure of natural selection. An earthly paradise sub-Saharan Africa certainly was, with regard to the vast variety of life forms its tropical ecology could sustain. Man's quickly evolving intelligence, planning ability, and tool- and weapon-making skills brought about his transition from vegetarian to omnivore and placed him in a dominant position in the food chain. (In the biblical parable: "And the fear of you and the dread of you shall be upon every beast of the earth, and upon every fowl of the air, upon all that moveth upon the earth, and upon all the fishes of the sea; into your hands they are delivered"—Genesis 9:2).
But not all was paradise for Homo sapiens in this African homeland. Man's acquiring of an intellect, a mere moment in the biblical account of Adam at the tree of knowledge, went hand in hand with an increase in brain size that in terms of the evolutionary clock was hardly less dramatic in its speed—by some estimates, just a million years. So rapid was this development that adaptations in the woman's pelvis could only imperfectly keep pace with the size of the baby's brain at term. "In sorrow thou shalt bring forth children" (Genesis 3:16) has ever since been part of the human condition. So also is the particularly vulnerable infant, needing far longer nurturing than its simian relatives. And so, too, are the slipped disc, inguinal hernias, hemorrhoids, digestive system blockages, and a host of other ailments that, even several thousand generations later, Homo sapiens continues to pay as the price of early man's perhaps too rapid evolution from horizontal four-footer to upright biped.
And although club- and spear-wielding man may have had relatively little to fear from hungry predators, he was less secure from insults from other creatures. The serpent in the biblical parable was deceitful, but in the Rift Valley he was also likely to be poisonous. So, too, were various spiders, scorpions, and plants. The bush also teemed with parasitic insects and worms. But most important for our story was the fact that for every single plant or animal that man could see, there were countless trillions more that he could not. Among the members of this invisible 200 were entities so simple that they were virtually unchanged from the very first forms of life on earth that had emerged some four billion years earlier. For the next million years or so, no member of the species Homo sapiens would ever set eyes on any of them, and only a handful of humans would even conceive of their existence. Yet the influence of these infinitesimal creatures on the lives of men and the course of human history would be enormous.
So warm and lush were the rain forests of Africa that a broad spectrum of microorganisms could flourish without needing any animal host. The microbes were not quite so independent on the savanna of the Rift Valley and the tropical grasslands and shrubs. One such strain, however, which would one day be visualized and given the names Trypanosoma gambiense and Trypanosoma rhodesiense, was particularly hostile to man. Transmitted by the tsetse fly, these germs had long lived in a fairly benign and stable relationship to the herds of antelope they infested. But when they entered the human bloodstream, their effect was usually devastating.
With the number of humans increasing due to their skills in tool- and weapon-making, but their expansion into much of the rest of Africa inhibited by the trypanosomes and other hostile microorganisms, the time was ripe—around 100,000 years ago—for an exodus of some Homo sapiens out of Africa. Their gateway to the other continents was along the Rift Valley, across the Sinai Peninsula, and into the land that countless millennia later would be known as Israel. Skeletal remains at Mount Carmal, near Haifa, attest to this Israeli route out of Africa. In taking this path, Homo sapiens followed in the already million-year-old footsteps of the nearly human primate Homo erectus. (The account in Genesis in fact speaks of a first creation of humans, who were not capable of agriculture ["there was not a man to till the ground" (2:5)], followed by a second creation of humans, who later were ["Therefore the Lord God sent him forth from the Garden of Eden, to till the ground from whence he was taken" (3:23)].) Homo sapiens was also traveling the route that some of his distant descendants, called Hebrews, would again trace in their Exodus from Egypt.
In leaving the tropical Eden for more temperate climes, the hunter bands distanced themselves from the extraordinary spectrum of parasitic microorganisms that flourish so well in warm and moist conditions. Of course, diseases such as rabies and tetanus could still be transferred to humans from wild animals and from the soil. But such infections were now scarcer than in mankind's tropical African cradle. Other afflictions such as yaws and herpes, which are spread by transmission of the Treponema pertenue spirochete and Herpesvirus hominis by direct human-to-human body contact, might have more or less permanently accompanied the wandering hunting communities. But even then, the human migrants had an advantage. Only those strains of microorganism that were fairly benign and chronic (or, at least, capable of remaining long dormant in the body) would have stood much chance of surviving for longer than a human generation or so. A quick-acting, virulent strain would result in the death or abandonment of the victim or else the annihilation of the whole migratory group before they could infect other bands. In either scenario, the virulent strain itself comes to a dead end. A mild, long-lasting strain, by contrast, allows a continual chain of infection between individuals and between groups. At the same time, it often provides the carriers or recovered people with a degree of immunity to the more virulent strains, thus beating them out in the competition for survival.
Yet even so, there were enough afflictions to plague primitive man. New mutant strains of pathogenic microbes could have devastatingly rapid effects. Deviant gene expression in the cells of man's own body triggered malignant cancers. The finely tuned human immune system, whose function is to guard against all such foreign and home-grown enemies, could go awry and turn against the very body it was supposed to defend, resulting in arthritis and other autoimmune disorders. Wandering man's search for new foods in new environments often entailed various degrees of tradeoff between nutritional benefits, on the one hand, and toxicity and digestive disorders, on the other. Slight deviations in the amounts of hormones secreted by one of the body's glands could have major effects on the entire system.
The primitive hunter-gatherers who fanned out from the African Rift Valley had a cerebral capacity similar to our own. As such, they had the concomitant mental abilities to learn to engage in formal reasoning using major and minor premises and syllogisms; manipulate random variables in controlled experiments; compute chi-square tests or establish statistical reliability; and balance organic chemistry equations involving double displacement reactions. But such things are, of course, very recent cultural developments in human history and would remain beyond the ken, though not beyond the intelligence, of Homo sapiens for tens of thousands of generations to come.
The way in which our Paleolithic ancestors sought to understand the world in general—and illness and cure in particular—is shrouded in the mists of prehistory. Yet there are even today Stone Age hunter-gatherers whose lifestyle has apparently evolved the least since the time of the exodus out of Africa. If we may extrapolate from the studies by the famed anthropologist James Frazer of Stone Age people early in the twentieth century, much of the primeval hunter-gatherers' understanding of cause and effect was dominated by two types of "sympathetic" relations between events: imitation and contagion. In the case of imitation, what happens to one object can supposedly influence a distant object merely by virtue of some physical similarity between the two. With contagion, on the other hand, the presumed influence between the distant objects is based on their once having been in physical contact (contagion and contact being derived from the Latin for "touching"). These prescientific concepts—overgeneralizations of the principle of association—formed the basis of many beliefs and practices that the modern mind calls magical. Added to this was the notion that one's thoughts and wishes, be they benevolent or malevolent, are able to cause or influence events—a vestigial unconscious memory (if one may trust psychoanalytic theory) of the infantile stage of cognitive development when the baby needed only feel hunger and desire food for it to appear.
Magical belief shaded into religious belief with the concept, still common to primitive peoples on all continents, of a world of transcendental spirits. The increasing mental capacities of Homo sapiens made him all the more aware of himself as a being with feelings and motivations and consciousness—a soul. Apparently inspired by his nightly experience of dreaming, in which he often encountered the dead in various settings far removed from the bed in which he was sleeping, primitive man further conceived of the soul or spirit as not indissolubly connected with a physical body and as capable of persisting after death. An extension of this was the concept of animism—primitive man's belief that combinations of substance and conscious spirit resided not only in himself and other humans and animals, but also in objects that the modern mind views as inanimate (e.g., trees) and even nonliving (rivers, rain) and nonmotile (rocks). Such spirits and ghosts were often called upon as intermediary agents in the carrying out of magical procedures.
The primitive attribution of animate and anthropomorphic characteristics to the spirits of even inanimate objects may be reflected in the gender markers that are still very present in many languages throughout the world, including those of the Semitic and Indo-European families (though only vestigially in the English branch). The earth, whose fertility brings forth the bounties of nourishment, was typically identified with a great female or mother spirit. Yet, in line with an extremely powerful predisposition toward religious belief among virtually all peoples stretching from the present back to the Stone Age, there also commonly emerged among the hunter-gatherers some dominant god of the masculine gender to be worshiped. This deity may at some time have been identified with the sky but was more commonly given plastic representation closer to home in the form of a carved statue of a sacred totem animal. Endowed with anthropomorphic properties, the totem typically evolved into an authoritative father-like god, derived (if we may again draw from psychoanalytic theory) from the universality of a father-figure in the infant stage of cognitive development and the ambiguous feelings of love and fear felt toward him.
Inhabiting a universe of anthropomorphic spirits and parent-like gods, primitive man understandably sought to placate these entities and turn their force to his advantage. Inherent in this quest was the drawing up of positive rules and rituals (commandments) for worship and offerings and negative rules (prohibitions or taboos) on such things as the killing of the totem animal. Taboos on the consumption of certain foods may have had an instinctual basis or have derived in part from a process of trial and error as migrating bands entered new environments and tested new food sources. Other dietary taboos may have derived merely from cultural tastes that, like genetic drift, just happened to evolve differently in various groups but may then have been incorporated into the religious system and taken on the force of law. Similarly, laws of social interaction evolved partly on the basis of instinctual forces and revulsion that were more or less consciously recognized, partly due to forces that (if, again, we trust psychoanalytic theory) were sublimated and suppressed from collective awareness, and partly on the basis of each given culture's attempt to reconcile these pressures with the need for a suitable modus vivendi among the hunter-gatherers. The social rules as they evolved were likewise incorporated into the broader supernatural system and attained the power of religious commandments, prohibitions, and taboos.
It was largely within this prescientific, magico-religious framework that primitive man, and particularly the Ur-physician, the "medicine man," first sought to explain and cure disease. The term—derived from American Indian languages—belies the greater spiritual and political role he played, in accordance with the structure of primitive society and the nature of the transcendental world. The prehistoric medicine man was probably often chief of the band. He (or, in the case of a medicine woman, she) might also have been the bard, entrusted with preserving and recounting the history of his people and the myths surrounding the creation of the world. As priest and sorcercer, he used his transcendental powers to ensure victory in war and a sufficient food supply, as well as to cure the sick. For these purposes the medicine man knew special songs, prayers, rites, and fetishes. Medicine men were seers, who derived much of their knowledge and abilities from a guardian spirit that spoke to them. Or they were shamans, voluntarily possessed by a spirit that worked through them.
When a tribe member fell ill, the medicine man's first task was to determine the etiology by taking a kind of case history. His attention was likely directed toward finding out what taboos might have been broken; what spirits, ghosts, or deities offended; or what totem animal killed or eaten, by either the patient or his family. Confession itself was the first step toward healing, to be followed by purification, prayers of atonement, and sacrifices. Inquiries into the patient's dreams were highly appropriate, for his nocturnal interaction with the world of spirits, ghosts, and even his fellow man was considered part of reality. The medicine man might himself enter a trance state in order to commune with the spirits and obtain from them a diagnosis and prognosis. Or he might search for omens in waking life. If no broken taboo or offended spirit could be discovered, then the medicine man inquired about human enemies who might have fashioned an effigy of the patient in order to mutilate it (imitative magic) or who may have gained control of his nail clippings, hair, or other body products carelessly left around in order to harm them and thereby the patient (contagious magic). Furthermore, any unusual object the patient may have noticed, say, at the entrance to his hut, would be suspect as a fetish invested with malevolent powers.
Whatever the etiology, it was commonly assumed in hunter-gatherer societies that a person was sick because either something vital was removed from the body or something bad was introduced—general concepts quite reasonable even by modern standards. The removal or loss of the soul was typically suspected in the case of chronic or degenerative diseases that cause the patient to wither away or afflictions that cause him to lose consciousness. The soul may, for instance, have been trapped by a malevolent sorcerer who hung a noose above the path of the unsuspecting victim. Or someone may have gained control of his shadow, the spiritual counterpart of his body. Alternatively, in its nocturnal wanderings the soul may have failed to return to the sleeping body, either because it lost its way, met with an accident, or was bewitched and lured away by the laughter of ghosts of virgins. Or the soul may have been expelled from the body by a sudden fright or sneeze. The medicine man, initiated in the appropriate chants, spells, and prayers, was adept at navigating his way in the world of the spirits, had a variety of soul-capturing devices, and knew how to lure or trick a lost soul into re-entering the patient's body either directly or through an intermediary object or creature.
As for more acute or localized diseases, these were sooner attributed to the patient's acquiring something malevolent, be it spiritual or tangible, rather than his losing something vital (his soul). The Paleolithic medicine man's treatment was correspondingly based on expelling the pathogenic agent. Trepanation—the grooving or boring out of a section of the skull—may have had some origin in practical measures: the removal of arrowheads or the relief of pressure of intracranial bleeding from other trauma. But in the transcendental universe, the procedure was widely used to release the evil spirits assumed to be causing headaches, epilepsy, psychoses, and probably a variety of non-neurological afflictions as well. Similarly, the very widespread Paleolithic therapeutic practice of drawing blood from a sick person by means of venesection or scarification may have owed some of its origin to practical observations—namely, the relief felt by some febrile patients when a spontaneous hemorrhage, nosebleed, or menstruation decongested their systems. Bloodletting also accompanied the medicine man's sucking out of the body of tangible objects such as arrowheads, splinters, and worms. But no doubt most important within the magico-religious framework of the prehistoric hunter-gatherers was the assumption that pathogenic spirits left the body along with the patient's blood. Less pleasant were the prehistoric procedures involving the whipping and fumigating of the patient—to the accompaniment of jarring noises and frightening masks—in order to made the bodily abode so inhospitable to the malevolent spirit that he abandoned it. Patient-friendlier procedures involved enticing the spirit out of the body with food or the use of magical chants and commands to exorcise the demon and call upon more powerful and benevolent spirits and deities to intervene.
It was within the magico-religious conceptual framework that Paleolithic pharmacology had its origins, as bands of Homo sapiens migrating to the four corners of the earth continually encountered new flora, fauna, and minerals. The simple principle of association gave rise to the doctrine of signatures, whereby some external characteristic of a plant or mineral supposedly made it appropriate for strengthening a certain body part or treating a certain affliction (red flowers or coral for the blood, the weasel plant to ease childbirth, the mandrake root as an aphrodisiac, and so on). In some remedies an incipient homeopathic (like-cures-like) principle was also at work (yellow plants and emeralds to treat jaundice, toads to eliminate boils, spotted white snake skins to cure leprosy, red-speckled blood-stone to staunch bleeding). Other drugs arose from trial and error rather than outward signs. Vomitives and evacuants supposedly purged a patient of malevolent spirits along with the contents of his digestive system. Various stimulants, intoxicants, and hallucinogens found in leaves, seeds, barks, and roots were used in communal religious ceremonies and helped the medicine man in particular to enter the trance state and consult the spirits.
Some of the diverse drugs chosen for their influence in the transcendental scheme of things in fact had pharmacologically useful properties. Certain psychotropic drugs relieved pain, stimulated the appetite, had aphrodisiac effects, and countered indigestion. Evacuants purged the body of worms. Some fumigants eased the distress of asthma or other respiratory afflictions.
Even in the transcendental universe of the Paleolithic hunter-gatherers, magic and religion gave way to empirical and pragmatic concepts, particularly with regard to afflictions that were endemic—that "everybody" seemed to get. The counter-irritation provided by the massaging of aching muscles or the swelling reduction afforded by the application of a poultice of warm cow clung to a sprained ankle were practical measures hardly needing rationalization in terms of the driving or drawing out a spirit. Where malaria, yaws, certain venereal diseases, and tuberculosis were commonplace, sufferers were likely to seek the services of a herbalist woman rather than the medicine man, as were patients with colds, dyspepsia, common rashes, diarrhea, and the like. Visible parasites such as ringworm and hookworm were likewise sooner viewed in a mundane rather than transcendental light. Instead of being ceremoniously anointed, the tribesmen's feet were smeared with common oil to protect against infestation. Broken bones were splinted or put in casts of clay, dislocations were reduced by manipulation, and hemorrhaging was staunched by direct pressure of sand, down, or animal hides on the wound.
In the transcendental world, no less than in the age of modern rational medicine, an ounce of prevention was worth a pound of cure. On all continents, the wearing of tiger teeth, eagle claws, sharp flints, and the like served to fend off evil spirits. Malodorous substances repelled them. Phallic and vaginal symbols afforded protection through, respectively, their masculine potency and their live-giving forces. The glittering of diamonds and other precious jewels neutralized the evil eye. Collective dancing and hostile displays with weapons and frightening masks provided a prophylactic effect against evil spirits that was greater than the sum of individual efforts. For the potentially benign spirits and protective gods, placation in the form of offerings of food and drink were called for.
(Continues...)
Excerpted from Jews and Medicine by Frank Heynick. Copyright © 2002 by Frank Heynick. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.